Integumentary - 29

A new parent brings the 3-month-old infant to the clinic for a well-baby check up. During the visit, the parent asks the nurse, "I know the rays from the sun can be harmful, so what should I do to protect my infant?" Which suggestion by the nurse would be most appropriate? a. "The best thing to do is keep any infant under the age of 6 months out of the sun." b. "A wide-brimmed hat and an umbrella for shade should be enough for your infant." c. "As long as you use a sunscreen, your infant will be protected from the sun." d. "Invest in clothing that has sun protective factor (SPF) already in the material."

a

A nurse is preparing a presentation for a group of parents of toddlers at the local community center. The topic of the presentation is burn prevention. When describing burns in toddlers, which situation would the nurse likely identify as the most common cause of thermal burns? a. Scalding from pulling a hot pan off the stove b. Playing unsupervised with matches c. Touching an open, hot oven door d. Playing with a household cleaning agent container

a

A school-aged child is recovering from varicella. The parent calls the school nurse and states, "my child is feeling much better" and asks when the child can return to school. What information does the nurse provide the parent? a. "Your child may return to school when all of the lesions have crusted over." b. "Your child may return to school when a health care provider has given written permission." c. "Your child may return to school when there has been no fever for 48 hours." d. "Your child may return to school when free of any lesions."

a

The nurse is assessing the skin of a 6-year-old child with urticaria. When interviewing the child and parents, which question would be most important for the nurse to ask? a. "Is the child having any trouble breathing?" b. "When did you first notice the rash?" c. "Is there any itching with the rash?" d. "Did you do anything at home to treat the rash?"

a

The nurse is caring for a child brought to the emergency department after an animal bite. Which action will the nurse perform first? a. Ask if the animal was provoked prior to the bite. b. Administer rabies vaccine and rabies immune globulin. c. Question the child about malaise, pain, and hydrophobia. d. Assess the child's height, weight, and temperature.

a

The nurse is teaching the parents of a 13-year-old child with folliculitis about potential causes of the condition. What will the nurse include in the teaching? Select all that apply. a. hygiene b. exposure to contaminated water c. shaving d. repetitive contact with an irritant e. airborne allergens

a, b, c

The nurse is caring for a 4-year-old child with a full-thickness (third-degree) burn injury who was trapped in a bedroom during a house fire. What diagnostic testing will the nurse anticipate in the child's plan of care? Select all that apply. a. arterial blood gases b. carboxyhemoglobin level c. electrolyte panel d. complete blood count with differential e. electrocardiogram

a, b, c, d

The nurse is caring for a 2-month-old infant. What action(s) will the nurse take to help prevent skin breakdown? Select all that apply. a. Perform frequent diaper changes as appropriate. b. Ensure linens are not overly dry. c. Assess the skin at regular intervals. d. Avoid repositioning. e. Note areas of redness on the skin.

a, c, e

The nurse is preparing to perform a dressing change for a 9-year-old child with a severe burn injury. What nonpharmacologic intervention(s) will the nurse perform to decrease pain and discomfort for the child? Select all that apply. a. Allow the child to choose means of distraction. b. Avoid speaking during the dressing change. c. Allow the child to choose where on the body to start procedure. d. Encourage the child to ignore the procedure. e. Provide positive feedback.

a, c, e

A 30-month-old child has been discharged from the hospital after receiving treatment for second-degree (partial-thickness) burns over 6% of the body. One week later, the parent calls the nurse to say that the child has been drinking from a cup for one year, but is now constantly pulling at the mother's breast trying to nurse and refuses to drink from a cup. What is the best way for the nurse respond? a. Tell the parent to allow the child to nurse as much as the child wants. b. Explain that children who have had a serious injury sometimes exhibit regressive behavior. c. Make an appointment for the parent to bring the child to the clinic for evaluation. d. Encourage the parent to explain to the child that he or she must drink from the cup.

b

A nursing instructor is teaching about infectious diseases in childhood. The teacher identifies a need for clarification when a student makes which of the following statements? a. "Lesions in smallpox progress at the same time." b. "Lesions in chickenpox progress at the same rate." c. "Lesions of smallpox arise as one crop of lesions." d. "Lesions of smallpox resemble those of chickenpox."

b

A nursing student learning about childhood infectious diseases correctly identifies which of the following as the disease related to chickenpox, which tends to occur in older children or young adults? a. smallpox b. herpes zoster c. measles d. mumps

b

A young girl arrives at the emergency room after being bitten by a neighbor's dog. The mother is concerned her daughter will get rabies. The nurse carefully examines and treats the bite and questions the mother and daughter about the details surrounding the dog biting her. What information would most strongly indicate a risk for rabies infection in this client? a. There have been no other reported instances in the area b. The dog was unprovoked when he bit the girl c. The dog belonged to a neighbor d. The dog was properly immunized for rabies

b

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. Determine whether the child is breastfed or formula fed. b. Observe the infant's respiratory effort. c. Examine the lips and oral mucosa for cyanosis. d. Question the parent about methods of punishment.

b

The nurse is inspecting the skin of a child with a rash on the lower legs and documents the above findings. Based on the findings, which question would the nurse most likely ask next? Linear lesions on both legs, below the knees Reddened macules and pustules in linear fashion intense prutitis a. "Is there any metal in your child's clothing that is near the lower legs?" b. "Was your child outside near some plants that could be poison ivy?" c. "Did you recently change your detergent for washing your clothes?" d. "What type of soap does your child use to wash the skin?"

b

When providing care for a child with herpes zoster (shingles), the parents ask the nurse how the child contracted this infectious disorder. Which response by the nurse is most appropriate? a. "Your child must have been exposed to someone with herpes zoster." b. "Herpes zoster is a reactivation of a previous varicella zoster infection." c. "Handwashing is an effective way to prevent the spread of infectious disorders." d. "Children who are immunocompromised are more likely to contract shingles."

b

Two siblings, a 5-year-old child and a 3-year-old child are brought to the clinic by their parents. The parents are concerned because each child has developed a rash. The nurse documents the assessment findings. Which information would the nurse include when teaching the parents about caring for their children? Select all that apply. a. "Check your children's bedroom first thing in the morning for bedbugs." b. "Schedule a professional exterminator to come in to get rid of the bugs." c. "Wash all of your sheets and clothes in hot water." d. "Put items that cannot be washed into a closed trash bag for at least 3 days." e. "Wipe down all the surfaces in your home with a disinfectant."

b, c, d

A school nurse has discovered that one of the children has acquired a case of head lice. The school principal asks the nurse to write a letter that will be sent to parents explaining about head lice and measures to prevent infestation. What information is important for the nurse to include in the letter? Select all that apply. a. Head lice infestation is the result of poor personal hygiene. b. Children should avoid sharing personal items such as combs and hats. c. Any medicated shampoo may be used to treat head lice. d. Parents should inspect their child's head for nits with a fine tooth comb. e. A second treatment one week after the first is recommended.

b, d, e

A 10-year-old child is brought to the health care provider's office by the child's parent. The parent voices concern over the appearance of the child's arms. The nurse documents the assessment above. The nurse suspects folliculitis. Which question would the nurse ask to help confirm the suspicion? a. "Did the child have any recent cuts or trauma to the skin?" b. "Has your child ever been vaccinated against rubeola?" c. "Has the child been swimming in a lake or hot tub recently." d. "Has the child been in the woods near any poison ivy or oak?"

c

A child has been hospitalized with a diagnosis of severe impetigo. The nurse is interviewing the family. Which question will have the greatest impact on the child's care? a. "Do you have any concerns about filling the prescriptions?" b. "Is there anything else you think we should know about your family?" c. "Does your child have any allergies to medications?" d. "How long has the child had the infection?"

c

A child is seen in the clinic because of a rash over the face and trunk area for the past 4 days. The nurse completes an assessment and suspects the child has rubeola. Which assessment finding best supports the nurse's suspicion? a. pruritus b. fever c. Koplik spots d. malaise

c

An adolescent is brought to the urgent care clinic for evaluation of the hands. The adolescent had been out snowboarding for the past several hours in 20oF (-6.7oC) temperatures. The adolescent was wearing gloves but took them off because they were wet and causing problems with holding onto the snowboard. The nurse completes an assessment and documents the findings. Based on the assessment findings above, which action would be appropriate as part of the plan of care? a. Massaging both hands vigorously for 5 minutes b. Contacting a plastic surgeon to debride the skin c. Placing the hands in warm water for 30 minutes d. Notifying the health care provider if the hands become red

c

What information should be included in the teaching plan for a child with varicella? a. Utilize salt solutions to assist in healing oral lesions. b. Administer aspirin for fever. c. Remind the child not to scratch the lesions. d. Place the child in a warm bath for skin discomfort.

c

A nurse is providing care to an infant who is admitted with burns over the face, neck and chest. The nurse identifies which goal as priority for planning the infant's care? a. Pain is at a tolerable level. b. Wounds remain infection-free. c. Fluid balance is maintained. d. Airway remains patent.

d

A parent is observing a nurse provide care for the parent's 2-year-old toddler who was burned in a house fire. When the nurse is finished, the parent tells the nurse "I cannot believe this has happened. I should have been able to prevent this from happening." What is the best action for the nurse to take? a. Tell the parent he or she could not have prevented the fire b. Give the parent a hug. c. Tell the parent to be thankful that the child is alive. d. Encourage the parent to talk more about feelings.

d

The nurse is administering a chickenpox vaccination to a 12-month-old girl. Which concern is unique to varicella? a. Children with this disease need to avoid pregnant women. b. Dehydration is caused by mouth lesions. c. Vitamin A is indicated for children younger than 2 years. d. This disease can reactivate years later and cause shingles.

d

The nurse is teaching the parents of a 5-year-old child diagnosed with head lice about using permethrin. The nurse determines that the teaching was successful based on which statement by the parents? a. "We should apply the medication to our child's hair and scalp when it is dry." b. "If we use the medicine, we will not have to use the special comb for the nits." c. "One application of the medication should be enough to get rid of the lice." d. "We need to leave the medication on for about 10 minutes before rinsing it off."

d

The nurse is teaching the parents of a 7-year-old child who was exposed to an adolescent infected with measles about 2 weeks ago. The child has not been immunized. Which statement by the parents requires further follow up by the nurse? a. "My child is contagious for 4 days prior to the appearance of a rash." b. "It is not recommended for my child to receive Ig or the MMR vaccine at this time." c. "The best treatment for measles is prevention with the MMR vaccine." d. "It has been 14 days since the exposure, so my child is not infected."

d

The nurse is teaching the parents of a child diagnosed with erythema multiforme about the condition. The nurse determines that the teaching was successful based on which statement by the parents? a. "After this one episode, our child will not have it again." b. "We need to have our child avoid exposure to nickel." c. "The sulfa drug our child was taking caused this rash." d. "The rash should go away in about 2 weeks."

d

The parents of a child diagnosed with varicella are concerned about their other children getting it. The nurse instructs the parents that their child is contagious for how much longer now that the rash has appeared? a. For up to 8 days more after the rash initially appears b. For 4 days more now that the rash is present c. Until the rash disappears, which is about 3 days d. Until there are no more new lesions and lesions have crusted over

d

A nurse is conducting a parenting class on infant skin care. What information should the nurse include when preparing materials on the characteristics of the skin of infants? Select all that apply. a. Skin is less susceptible to the sun. b. Sweat glands are fully functioning at birth. c. The epidermis is thicker than in adults. d. Substances are easily absorbed. e. It is thinner and more fragile than an adult's

d, e

What is a true statement regarding varicella zoster virus infection? a. Secondary bacterial infections of the skin can occur. b. It is transmitted by fecal-oral route. c. The incubation period is 7 days. d. It tends to be more severe in children.

a

When describing measles to a local parent group, the nurse explains that which of the following is the hallmark clinical manifestation? a. Conjunctivitis b. Fever c. Cough d. Koplik spots

d

A 7-year-old child with an earache comes to the clinic. The child's parent reports that 1 day ago the child had a fever and headache and did not want to play. When the nurse asks where it hurts, the child points to the jawline in front of the earlobe. What does the nurse expect the diagnosis will be for this child? a. Mumps b. Fifth disease c. Measles d. Mononucleosis

a

A child is hospitalized with a diagnosis of severe cellulitis. The nurse is preparing the family for discharge. Which instruction is most important for the nurse to convey to the family? a. Complete the prescribed antibiotics. b. Perform proper hand hygiene. c. Keep follow-up appointments. d. Monitor for signs of worsening condition.

a

The appearance of which hallmark clinical manifestation occurs in measles? a. Koplik spots b. Cough c. Fever d. Conjunctivitis

a

The nurse is caring for an 11-year-old child with a primary open skin lesion. What action(s) will the nurse include in the plan of care to prevent infection in the child? Select all that apply. a. Advise the child not to scratch the affected area. b. Assess for hypopigmentation. c. Teach hand hygiene to the child and parents. d. Teach the child and parents to keep the lesion uncovered. e. Assess for increased warmth around the wound.

a, c, e