Disorders of the skin; Burns & infectious agents

The parents of an 8-year-old boy diagnosed with frostbite are distraught and state to the nurse, "We can't believe we didn't make our child come inside when he complained about his fingers being numb and hurting." How should the nurse respond? A. "I can't imagine how you are feeling right now, but I'm sure you had no idea frostbite could happen. We will take good care of your son." b. Lets just hope he doesnt have second or third degree burns c. Local damage occurs when the tissue temperature drops to 32

"I can't imagine how you are feeling right now, but I'm sure you had no idea frostbite could happen. We will take good care of your son."

The school nurse has completed an educational program on first aid practices in the home. Which statement about burn care by a participant would indicate a need for further education? a. "If my child has a superficial burn, I will run cool water over it." b."For a superficial burn, I can cover it with a clean nonadherent dressing." c."Mild soap can be used to clean a superficial burn." d."I guess my mom was right, she always put ice on our burns when we were kids."

"I guess my mom was right, she always put ice on our burns when we were kids."

The nurse has completed client teaching with a 16-year-old female who has been prescribed isotretinoin for cystic acne. Which statements indicate learning has occurred? Select all that apply. a."If I am sexually active I need to let my doctor know." b."I am young so I won't need to have the liver tests the pamphlet suggests." c."It's important I get my CBC blood test when my doctor orders it." d."This is not a drug to be used for all forms of acne. My sister has minor acne so I told her this wasn't for her." e. "As long as I use two forms of birth control I don't need to have monthly pregnancy testing.

"If I am sexually active I need to let my doctor know." "This is not a drug to be used for all forms of acne. My sister has minor acne so I told her this wasn't for her." "It's important I get my CBC blood test when my doctor orders it."

A pediatric client was brought to the emergency department by the parents after experiencing extensive urticaria following consumption of a seafood dinner. Upon discharge from the facility the nurse provided client teaching. Which statement by the parents indicate learning occurred? A. the hives should not last over a couple of days if they last longer ;contact physician B. We will hive our child an antihistamiie and corticosteroid next time we eat C. Since our child only had hives we ciuld allow her to have seafood again D. "We need to get our child a medical alert bracelet as soon as possible in case this happens again."

"We need to get our child a medical alert bracelet as soon as possible in case this happens again."

An adolescent is diagnosed with psoriasis. After speaking with the nurse about treatment options suggested by the primary health care provider, the adolescent states, "Since ultraviolet rays help, I am going to buy a tanning package so I can tan year round." How will the nurse respond? A. Go for it! B. Be sure to not get burned while tanning C. I dont think your provider meant for you to tan year round D. "Year round tanning is not what your health care provider intended. Tanning puts you at high risk for skin cancer and other problems."

"Year round tanning is not what your health care provider intended. Tanning puts you at high risk for skin cancer and other problems."

The parent of a 1-week-old infant is concerned with white scales that have begun to flake off the infant's scalp. The parent asks the nurse what to do to treat this. How should the nurse best respond? A. how often do you bathe your child? B. Your child most likely has dandruff . You can treat it daily with antiseborric shampoo like head and shoudlers C. "Your child most likely has cradle cap (seborrhea). You can care for it by cleansing the hair and scalp daily with baby shampoo and applying baby oil."

"Your child most likely has cradle cap (seborrhea). You can care for it by cleansing the hair and scalp daily with baby shampoo and applying baby oil."

A 4-month-old infant is experiencing dermatitis in the diaper area. What treatments will be beneficial to this condition? Select all that apply. A.Apply ointment with Vitamin A to the diaper area B. Apply petroleum jelly to the diaper area C. Apply powder to the diaper area D. Allow the diaper area to the air dry E. Use ointment containing zinc on the diaper area

Allow the diaper area to air dry. Apply petroleum jelly to the diaper area. Apply ointment with vitamin A to the diaper area. Use ointments containing zinc on the diaper area.

The nurse is educating a parent about the treatment for a child's tinea cruris. What medication class would the nurse include in the teaching plan?

Antifungal

The camp nurse is caring for a child who was bitten on the leg by a dangerous spider. The child is being taken to a health care provider. What is the most appropriate action for the nurse to do with this child? A. Apply ice to the affected area B. Briskly rub the site C. Administer pain medication D. Splint the leg

Apply ice to the affected area R: spider bites can cause serious illness if untreated. Bites of black widow spiders, brown recluse spiders, and scorpions demand medical attention. Applying ice to the affected area until medical care is obtained can slow absorption of the poison.

An adolescent girl is going to be treated for a severe case of acne vulgaris. A pregnancy test should be done prior to the adolescent starting treatment with: A. Benzoyl peroxide B. Tretinoin C. Isotretinoin D. Erythromycin

C. Isotretinoin

A nurse is assessing a 6-month-old girl with an integumentary disorder. The nurse notes three virtually identically sized, round red circles with scaling that are symmetrically spaced on both of the girl's inner thighs. What should the nurse ask the mother? A. Dose she wear sleepers with metal snaps? B. has she been exposed to poison ivy? C. Do you change her diapers regulary D. Tell me about your family history of allergies

Does she wear sleepers with metal snaps? r: Small round red circles with scaling, symmetrically located on the girl's inner thighs, point to nickel dermatitis that may occur from contact with jewelry, eyeglasses, belts, or clothing snaps. The nurse should inquire about any sleepers or clothing with metal snaps

A nurse is teaching a group of parents about burn safety. Which statement made by the parent requires intervention? A. I always make sure the little ones stay out the kitchen when I am cooking B. We made a song about " stop, drop and roll " to each of the children for fire safety C. I had our plumber lower the water heater temperature to 130 F D. We installed smoke detectors on every floor of our home

I had our plumber lower the water heater temperature to 130 F R; Water heater temperature should be 120°F (49°C) or lower to prevent significant burns. Installing smoke detectors on every floor of a home is recommended. Keeping young children out of the kitchen during food preparation is important. Teaching children to stop, drop, and roll is important for fire safety.

The nurse is providing education to a teen who has tinea pedis. What information should be included in the discussion? Select all that apply. A. Wear cotton socks B. Rinse feet daily with a solution of equal parts water and hydrogen peroxide C. Apply petroleum jelly to affected areas of the feet D. Use Talcum powder twice dailuy E. Keep feet clean and dry

Keep feet clean and dry Wear cotton socks

An infant is seen in the emergency department with several raised red welts over the abdomen and lower extremities. The parent states that the symptoms developed suddenly over the past few hours. The infant is fussy and has a low grade temperature. What assessment is most important for the nurse to perform? A. Observe the infants respiratory effort B. Question the parent about methods of punishment C. Examine the lips and oral mucous for cyanosis D. Determine whether the child is bottle fed or formula fed

Observe the infant's respiratory effort

The nurse is discussing dietary intake with the parents of a 4-year-old child who has been diagnosed with atopic dermatitis. Later, the nurse notes the menu selection made by the parents for the child. Which selection indicates the need for further instruction? A. Peanut butter and jelly sandwitch B. Carrots and celery sticks C. Chicken nuggets D. Tomato soup

Peanutbutter and jelly sandwich r: Atopic dermatitis is commonly associated with allergies to food. Common culprits may include peanuts, eggs, orange juice, and wheat-containing products.

Which intervention is the most beneficial for a burn client undergoing a skin graft? A. Provide Diversional Activities B. Provide pain medication on a PRN schedule as soon as pain is reported C. Provide around the clock pain medication as soon as pain is reported D. Provide an egg crate mattress or gel mattress for the client to lay on

Provide around-the-clock pain medication as soon as pain is reported.

A nurse completes an assessment on an 8-month-old infant seen in the pediatrician's office for a well-child visit. The nurse notes that the infant's buttocks, perineum and inner thighs are covered in a thick coating of white ointment. When questioned, the parent says the infant has a diaper rash and the ointment is to protect the infant's skin. What is the best action for the nurse to take? a. Tell the parent that he or she has used too much ointment. b. Commend the parent on addressing the infant's diaper rash. c. Explain that frequent diaper changes will prevent diaper rash. d. Provide instruction on how to care for a diaper rash.

Provide instruction on how to care for a diaper rash.

The nurse caring for a child with a skin allergy recognizes that the highest priority in the treatment for skin allergies is aimed at: A. Managing pain and comfort B. Reducing swelling and relieving itching

Reducing swelling and relieving itching R: Treatment for skin allergies is aimed at reducing the swelling and relieving the itching. With swelling in various parts of the body, the child may have pain, nausea and vomiting, but reducing the swelling would prevent those symptoms from occurring.

A young child has just been admitted to the emergency department with a burn that encompasses the epidermis and the underlying dermis. From which type of burn does this child suffer? A. Second degree or partial thickness burn B. First degree or superficial burn C.Third degree or full thickness burn D. Second degree or partial thickness burn

Second degree or partial thickness burn

A 3-year-old child is admitted after being severely burned. The nurse collects the following data. What finding would be most important for the nurse to report immediately? a. The child's hourly urinary output is 150 ml. b. The child's temperature is 101.2°F (38.4°C). c. The child's respiratory rate is 42 breaths/min. d The child's pain level is a 7 on a 10-point pain scale.

The child's respiratory rate is 42 breaths/min. r: An increase in the respiratory rate after a severe burn may be an indication of possible serious respiratory complications and should be reported immediately in case an endotracheal tube needs to be inserted. A temperature of 101.2°F (38.4°C) would be expected with a burn. A child who has just been severely burned would be expected to have a lower urine output not higher. An hourly urine output of 150 ml exceeds the expected output of a 3-year-old child. That child should be producing 1 to 2 ml/kg/hr.

The nurse is providing teaching on ways to maintain skin integrity and prevent infection for the parents of a boy with atopic dermatitis. Which response indicates a need for further teaching? A. We need to develop ways to prevent him from scratching B. We should avoid tight clothing and heat C. We should keep his fingernails short and clean D. We should avoid using petroleum jelly

We should avoid using petroleum jelly R: It is important to apply moisture multiple times throughout the day. Petroleum jelly is a recommended moisturizer that is inexpensive and readily available. The other statements are correct.

In working with infants diagnosed with atopic dermatitis, the nurse anticipates that when these children are older they will likely have a tendency to have which disorder? a.hemophilia b.asthma c.otitis media d. rheumatoid arthritis

asthma Infants who have atopic dermatitis (infantile eczema) tend to have allergic rhinitis or asthma later in life.

The school nurse is leading a discussion with a group of adolescents on the various sexually transmitted infections (STIs). The nurse determines the session is successful when the students correctly choose which STIs as considered curable with proper treatment? Select all that apply. a. trichomoniasis b. gonorrhea c. condylomata acuminata d. chlamydia e. herpes type II virus

chlamydia gonorrhea trichomoniasis

The nurse is assessing a child who has had an open wound for the last 2 weeks with no signs of healing. The parents report they have been using over-the-counter antibiotic ointment with no signs of improvement. The child is active in football in the fall and the swim team in the winter. What disorder does the nurse suspect? A. Impetigo B. Maleria C. community Ascquired MRSA

community acquired MRSA

The nurse is caring for a child with a severe burn. The treatment for this child during the first 48 hours will be most likely be related to: A. Curling ulcer B. Graft placement C. Hypovolemic shock D. Wound care

hypovolemic shock. R; In severe burns the increased capillary permeability results in vasodilation. This increases hydrostatic pressure in the capillaries, causing water and electrolytes to leak out of the vasculature and resulting in edema. Around 48 to 72 hours, the capillary permeability returns to normal causing severe diuresis. Hypovolemic shock is the major manifestation in the first 48 hours in massive burns

The nurse is presenting an in-service to a group of nurses who will be working in a dermatology clinic. One participant asks the nurse about a bacterial skin infection that she has seen in children. The nurse most likely is referring to: A. Seborric dermatitis B. Candidiasis C. Impetigo D. Malaria rubra

Impetigo

A newborn has a generalized rash on the skin, which the nurse identifies as erythema toxicum neonatorum. Which information would the nurse include when explaining the condition to the newborn's parent? a. "What you see on your newborn's skin is erythema toxicum neonatorum. It is a common newborn skin condition. You will need to apply a topical cream twice a day until it disappears." b "This is a normal newborn rash; do not be so worried." "c. What you see on your newborn's skin is erythema toxicum neonatorum. It is a common newborn skin condition that typically resolves on its own in about 1 week. There is nothing special you will need to do for this." d. "What you see on your newborn's skin is erythema toxicum neonatorum. It is an extensive skin condition that is rare in newborns. You will need to treat the infant as soon as possible to prevent its spread."

"What you see on your newborn's skin is erythema toxicum neonatorum. It is a common newborn skin condition that typically resolves on its own in about 1 week. There is nothing special you will need to do for this."

The nurse is caring for a child with a second-degree (partial-thickness) burn. What assessment findings would the nurse expect to observe? a. Edema with dry or waxy skin B. Edema with wet blistering skin C. Peeling skin with eschar D. Reddened area with leathery skin

Edema with wet blistering

The nurse is caring for a mom and her baby on a postpartum unit. The mom states she has received advice not to use baby powder on newborns. She asks the nurse if this is true, and if so, why. Which nurse response is correct? a. "Baby powder should not be used on newborns due to the risk of aspiration upon application." b. "Baby powder can be used anytime with no concerns." c. " Baby powder should not be used since so many people are allergic to the ingredients in it." d "Baby powder may be used if sprinkled on your hand away from the baby to prevent aspiration."

"Baby powder should not be used on newborns due to the risk of aspiration upon application."

A topical corticosteroid is prescribed for a child with contact dermatitis. Which statement by the mother would indicate the teaching was successful? a. "I should use the highest-potency steroid cream I can find." b. "I need to shake the preparation before using it." c. "I should apply the medicine at bedtime and rinse it off in the morning." d. "I should not cover the area with plastic wrap after applying the cream."

"I should not cover the area with plastic wrap after applying the cream." r:An occlusive dressing such as plastic wrap over the area should not be used with topical corticosteroids. High-potency preparations should not be used. There is no need to shake topical corticosteroids. Benzoyl peroxide requires shaking before use. Applying the medication at night and rinsing off in the morning is used for coal tar preparations.

An adolescent experiencing contact dermatitis reports experiencing pruritis. What intervention will the nurse to recommend to relieve the itching? a. Use a fragrance-free moisturizer. b. Apply calamine lotion if lesion is weeping. c. Keep the area covered with clothing. d. Bathe with a product that is oatmeal-based.

Bathe with a product that is oatmeal-based. r: Pruritis is a common problem associated with contact dermatitis. By healing the lesions, the itching will subside. Bathing with oatmeal-based products will accomplish this healing

The nurse is caring for a client brought to a pediatric clinic for swelling in the lower extremities with reddened skin that has undefined borders and pits slightly when pressed. What is the most likely diagnosis of the client's skin alteration? a. Cellulitis B. Stapphylococcal scalded skinsyndrome C. cat scratch disease D. Impetigo

Cellulitis R; Cellulitis is characterized by reddened or lilac-colored swollen skin that pits when pressed by the fingertips. ullou

The nurse is caring for a child with a second-degree (partial-thickness) burn. What assessment findings would the nurse expect to observe? A. Edema with dry or waxy looking skin B. Peeling skin with eschar C. Edema with wet blistering skin D. Reddened and leathery skin

Edema with blistering skin

The nurse is examining a child for indications of frostbite and notes blistering with erythema and edema. The nurse notes which degree of frostbite? A. First degree B. Second degree C. Third Degree

Second degree R; Second-degree frostbite demonstrates blistering with erythema and edema. First-degree frostbite results in superficial white plaques with surrounding erythema. In third-degree frostbite, the nurse would note hemorrhagic blisters that would progress to tissue necrosis and sloughing when the fourth degree is reached.

A nurse is caring for a child with second- and third-degree (partial- and full-thickness) burns over 15% of the body. The child reports severe itching in and around the burn sites. Which action would be most appropriate for the nurse to perform? a.Provide diversional activities. b.Turn the child every 2 hours. c.Administer diphenhydramine. d.Soak the child in a colloidal bath.

Administer diphenhydramine. r: As nerve endings heal they cause intense itching that can be relieved with the use of medications (e.g., diphenhydramine hydrochloride, loratadine) and by applying soothing lotions such as Nivea or Eucerin. Turning the child every two hours will not relieve the itching. Soaking in a colloidal bath is contraindicated with burn clients. Although diversional activities can help somewhat, they will not relieve the child's itching.

The nurse is conducting a physical examination of a boy with erythema multiforme. Which assessment finding should the nurse expect? A. Thick flakey greasy yellow scales B. Superficial tan or hyper-pigmented oval shaped lesions on the upper back and chest and proximal arms C. Lesions over the hands and feet and extensor surfaces of the extremities with spread to the trunk

C. Lesions over the hands and feet and extensor surfaces of the extremities with spread to the trunk R: Erythema multiforme typically manifests in lesions over the hands and feet, and extensor surfaces of the extremities with spread to the trunk. Thick or flaky/greasy yellow scales are signs of seborrhea. Silvery or yellow-white scale plaques and sharply demarcated borders define psoriasis. Superficial tan or hypopigmented oval-shaped scaly lesions, especially on the upper back and chest and proximal arms, are indicative of tinea versicolor.

The nurse is caring for an infant with diaper dermatitis. Which statement by the child's parent would indicate a need for further education? a. "I can leave her diaper off when she naps each afternoon." b. "I will use rubber pants over the cloth diapers in the future." c. "I can still use fragrance fee diaper wipes." d. "I will use a warm blow dryer on the rash area for a few minutes every time I change her diaper."

"I will use rubber pants over the cloth diapers in the future." r: Prevention and management of diaper dermatitis includes avoiding rubber pants, avoiding diaper wipes with fragrance or preservatives. Treatment of a rash includes allowing the child to go diaperless for a period of time each day and using a warm blow dryer on the area for 3 to 5 minutes.

The nurse is teaching parents about the care of diaper rash. The nurse would be concerned about the parents' level of understanding if they made which statement? A. I should only use ointments and creams as instructed by the HCP B. I need to wash and rinse clothes thoroughly to be sure all of the detergent is washed out C. I should be certain to use fabric softener in the care of the infants clothes D. I should not overdress the infant

I should be certain to use fabric softener in the care of the infants clothes R; Fabric softeners should be avoided because their use can result in skin irritation in the infant