Ch. 41
The dermatologist treating a 16-year-old girl with a history of severe acne has ordered a pregnancy test so she can be started on a course of isotretinoin. The teen's caregiver has said that her daughter is a virgin and she refuses to allow her to have the required pregnancy testing. What would be the best action for the nurse to take? C. Arrange for the daughter to have the pregnancy testing without the caregiver's knowledge. B. Speak with the teen alone to ask her if she is sexually active. If she says she is not sexually active, let the provider know that it is okay to write the prescription. A. Acknowledge the caregiver's discomfort about the pregnancy testing but encourage her to allow the daughter to have the testing so that she can use the medication. D. Have the caregiver sign a permission form acknowledging that the girl has been given the drug without pregnancy testing.
a
A pediatric client who has been seriously burned is being given IV fluid replacements. It has been determined that the client will initially need 24 ounces of replacement fluids. In following a normal burn replacement treatment for this child, if the treatment is started at 10:00 AM, which of the following would be correct? The child would have received: B. 12 ounces of IV fluid replacement by 6:00 PM. A. 12 ounces of IV fluid replacement by 4:00 PM. C. 18 ounces of IV fluid replacement by 4:00 PM. D. 18 ounces of IV fluid replacement by 6:00 PM.
b
The caregiver of a fifth-grade boy calls the pediatrician's office and reports that her son has been scratching at his groin for a week or so. Despite his need for privacy, he's finally allowed the caregiver to look at the groin area. The caregiver describes the area to the nurse saying, "It looks like black pin dots that seem to have dark tails." The nurse suspects that the child may have which of the following? C. ringworm A. lice B. scabies D. prickly heat
b
The nurse is presenting an in-service to a group of nurses who will be working in a dermatology clinic. They are discussing various disorders related to the integumentary system. One of the nurses describes a disorder by telling the group that it is common in children during the summer when it is hot or when the child is overdressed. Which disorder is the nurse most likely referring to? A. seborrheic dermatitis C. candidiasis B. miliaria rubra D. impetigo
b
Which of the following infections is often contracted by having contact with an infected dog or cat? D. tinea cruris A. tinea capitis B. tinea corporis C. tinea pedis
b
The nurse is caring for an infant who has impetigo and is hospitalized. Which nursing action is priority? D. The nurse applies elbow restraints to the infant. A. The nurse soaks the skin with warm water. C. The nurse follows contact precautions. B. The nurse applies topical antibiotics to the lesions.
c
The nurse is reinforcing teaching regarding the treatment for head lice with the caregiver of a child who has the disorder. Which of the following is most accurate related to the treatment for the child with an infection of head lice? A. The treatment will be done every day for about 2 weeks. D. The treatment is done one time and won't need to be repeated. C. The treatment will need to be repeated in about 7 to 9 days. B. The treatment will need to be repeated about once per month for a year.
c
The caregiver of a 4-year-old girl who lives in a heavily wooded area calls the clinic nurse to report that the child has a swollen tick on her arm. What would be the best action for the caregiver to follow in removing the tick? D. The caregiver should use tweezers to carefully remove the tick without crushing it. C. The caregiver should hold a gauze pad beneath the tick to catch the blood and carefully crush the tick. B. The caregiver should have another adult hold the child still, light a match and let it burn for 1 second, then blow out the match and quickly hold it on the tick. A. The caregiver should take the child to a health care facility where the tick can be removed aseptically.
d
The nurse admits a 10-year-old who has just eaten lobster and has hives over much of the body. In collecting data regarding this child, which question should the nurse ask the caregiver first? A. "Has the child ever eaten shellfish before now?" B. "Is your child allergic to peanuts or other foods?" D. "Have you ever given your child antihistamines?" C. "Does anyone in your family have any food allergies?"
a
The public health nurse is discussing immunizations with a group of caregivers of infants. One of the mothers asks the nurse why the child will need immunizations. Which statement would be the most appropriate for the nurse to make to this mother? B. "The antibodies the fetus gets from the mother are in the placenta, so after birth they are no longer available to the infant." A. "The infant is born with immunity to some diseases, but those immunities decrease over the first year of life." D. "Infants are unable to develop antibodies to protect them from diseases so they must be immunized." C. "The immunities that the infant is born with are not for the same diseases they will be immunized against."
a
An adolescent girl and her caregiver present at the pediatrician's office. The adolescent reports severe abdominal pain. A diagnosis of pelvic inflammatory disease (PID) is made. The nurse notes in the child's chart that this is the third time she has been treated for PID. Which action by the nurse would be most appropriate? A. Contact the necessary authorities to report a suspected case of sexual abuse. D. Talk to the child and caregiver together and explain that the condition is often a result of a sexually transmitted infection and discuss the importance of safe sex practices. C. Take the caregiver to a private room and tell her that the child's diagnosis can only come from sexual activity. B. Take the child to a private room and interview her regarding her sexual history and partners.
b
The nurse instructor is reviewing the integumentary system during a presentation to a group of student nurses. Which statement made by the instructor is the most accurate regarding the integumentary system? D. "One role of the integumentary system is to distribute oxygen to the body cells." A. "The sebaceous and sweat glands are fully functional in the infant." C. "The integumentary system is not in place until after the child is born and then takes many years to mature." B. "The largest organ of the body helps regulate body temperature."
b
The nurse is collecting data on a 4-month-old child brought to the clinic by the caregiver. The nurse observes the child's mouth and notes a white coating that looks like milk curds. Which of the following questions would be most important for the nurse to ask the caregiver? C. "Are you breastfeeding or bottle feeding your baby?" B. "Has your child been treated for any type of infection recently?" A. "Did you have a vaginal delivery with this baby?" D. "Does everyone in your house wash their hands often?"
b
The nurse is discussing acne vulgaris with a group of adolescents. The teenagers make the following statements regarding the topic. Which statement is the most accurate regarding acne vulgaris? C. "My next door neighbor told me that acne was caused by a fungus." D. "There is a new immunization that you can get to keep from having acne." A. "My mom says I have acne because I eat too much chocolate." B. "Sometimes I get acne when I use my sister's makeup."
b
The nurse is discussing skin disorders with a group of caregivers. Which caregiver statement indicates an understanding of tinea capitis? C. "My son got that infection when he was at the swimming pool." A. "That is an infection that you get under your fingernails." D. "My husband had that once and his groin itched so much." B. "I always tell my daughter to use her own hairbrush."
b
When teaching a group of caregivers of infants, the nurse is discussing the topic of diaper rash. The caregivers in the group make the following statements. Which statement is the most accurate related to the child with diaper rash. B. "My child gets diaper rash if I wash her clothes in the same detergent we use for the family." C. "Sometimes if I leave the diaper off and let him be in the sunshine he gets diaper rash." A. "The formula she drinks sometimes causes her to have a diaper rash." D. "They told me to use baby powder every time I change her so she won't get diaper rash."
b
An 8-month-old has been diagnosed with infantile eczema. At a follow-up appointment, the child's caregiver seems exhausted and angry. He explains that he has done all of the child's care because his wife is repulsed by the child's raw and uncomfortable appearance. What responses would be appropriate for the nurse to say to this caregiver? B. "I understand her feelings. It is hard to see a child in pain sometimes." A. "He will be better soon and your family can get back to normal." D. "That's not an uncommon reaction, although it's hard on you and on your child." C. "That's not fair to you; she should get some counseling to learn how to cope with illness better."
d
The nurse caring for children with fungal infections most often administers which medication? A. benadryl D. griseofulvin B. acetaminophen C. prednisone
d
The nurse is discussing medications to be given to a child who has been diagnosed with oral candidiasis (thrush). Which medication would most likely be prescribed for the child? B. ampicillin C. aspirin D. nystatin A. acetaminophen
d
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 that involves honey-colored crusted lesions. The nurse most likely is referring to: A. seborrheic dermatitis. D. impetigo. B. miliaria rubra (heat rash). C. candidiasis.
d