Ch. 42, 43
The parent of a child with mumps on one side of the face is concerned that the disease can develop on the other side in the future. What should the nurse respond to the mother about this concern? A) The child is immune to further attacks of the disease. B) It does not matter because mumps in adulthood is not serious. C) The child should receive active immunization against mumps. D) There is nothing that can be done to prevent another attack of mumps in the future.
A
What nursing instruction would best identify foods to which a child is allergic? A) Thoughtful elimination of diet choices B) Hyposensitivity testing in the arm C) Complete dietary protein restriction D) Corticosteroid challenge testing
A
The nurse is teaching a child with stinging-insect allergies how to avoid insects. Which instruction is best? A) Wear perfume but not cologne. B) Do not take out the garbage. C) Wear a hairnet to contain hair. D) Do not go outside in the heat of the day.
B
A 5-year-old has allergic rhinitis. It would be most appropriate to collect information regarding the child's exposure to which substances? A) Pollens B) Foods C) Drugs D) Metals
A
A chief danger of scarlet fever is that children may develop: A) acute glomerulonephritis. B) liver destruction. C) local areas of skin necrosis. D) respiratory obstruction.
A
A child is experiencing anaphylactic shock. Which nursing action takes priority? A) Facilitate breathing. B) Counteract hypertension. C) Enhance the action of histamine. D)Reverse sympathetic nervous system responses.
A
The nurse is planning a program for community members that focus on the 2020 National Health Goals for allergies and immunologic functioning. What content should the nurse include in this program? Select all that apply. A) Promote following safe sexual practices. B) Discourage the use of intravenous substances. C) Discuss the role of sexual relations in HIV transmission. D) Explain how certain foods promote food borne illnesses. E) Encourage parents to discuss the air quality in the schools with the school district.
A, B, C, E
The nurse is caring for a child diagnosed with category B HIV. What should the nurse expect to review in this patient's medical history? (Select all that apply.) A) Pneumonia B) Herpes zoster C) Kaposi sarcoma D) Cardiomyopathy E) Positive tuberculosis test
A, B, D
The health care provider instructs the parents of a toddler with allergies to avoid secondary smoke. What teaching should the nurse provide to assist these parents? (Select all that apply.) A) Frequent smoke-free establishments. B) Declare the home and car smoke-free zones. C) Spray air freshener in the room after smoking. D) Ask individuals who smoke to smoke out of doors. E) Encourage family and friends to begin quit-smoking programs.
A, B, D, E
The nurse is preparing educational materials for a group of new parents about allergic reactions. Which specific immunoglobulin should the nurse emphasize as being responsible for these types of reactions? A) IgA B) IgE C) IgG D) IgM
B
. A school-aged child has a bee-sting allergy. When the child is stung by a bee during a school recess, assuming that all of the following interventions are covered by school protocol, which initial intervention by the school nurse would be most appropriate? A) Immediately transport the child to the local hospital. B) Administer epinephrine immediately. C) Notify the child's mother. D) Apply a warm compress to the site of the bee sting.
B
A 6-month-old baby diagnosed with atopic dermatitis has been receiving treatment by the parents. Which approach that the parents are using indicates that additional health teaching is necessary? A) After a bath, the mother applies Eucerin cream. B) To dry lesions, the father applies alcohol to lesions daily. C) The mother gives the baby a daily bath without using soap. D) To aid healing, the father applies hydrocortisone cream to the lesions.
B
An 88-pound boy has a severe allergic reaction to a test allergen that has been administered. Which dosage of subcutaneous epinephrine would be appropriate for him? A) 0.01 mL B) 0.4 mL C) 2.2 mL D) 88.8 mL
B
The rash in roseola is pruritic. Which measure would you teach the father to provide comfort? A) Dress the child warmly to bring out the rash so that it fades quickly. B) Apply cool compresses to the skin to stop local itching. C) Discuss with the child the importance of not scratching lesions. D) Administer infant aspirin every 4 hours as necessary for comfort.
B
When caring for a child experiencing anaphylactic shock, the most important nursing action would be to: A) counteract hypertension. B) facilitate breathing. C) reverse sympathetic nervous system responses. D) enhance the action of histamine.
B
Which action is most important to include in the plan of care for a child with infectious mononucleosis? A) Limiting fluid intake B) Moving the child carefully C) Administering a corticosteroid D)Counseling the child to stop kissing
B
During a health promotion seminar with community members, the nurse provides information to support the 2020 National Health Goal to prevent and reduce the incidence of infectious disease in children. What information did the nurse most likely provide? A) Participating in age-appropriate exercise B) Getting adequate rest and sleep each day C) Importance of maintaining appropriate immunizations D)Ingesting the recommended amount of fresh fruit and vegetables
C
The nurse is caring for a 6-month-old child with a rash. Which information from the parent strongly suggests that roseola is the diagnosis? A) The rash is a mixture of papules and pustules. B) The infant is lethargic and not interested in playing. C) The infant's temperature fell when the rash appeared. D) The infant's temperature rose at the same time as the rash appeared.
C
Which immunoglobulin is associated with allergic reactions? A) IgM B) IgG C) IgE D) IgA
C
A 6-month-old girl is diagnosed as having atopic dermatitis. When interviewing her parents, they describe the following care measures. Which one would lead you to think more health teaching is needed? A) The mother gives her a daily bath without using soap. B) After a bath, the mother applies Eucerin cream. C) To aid healing, the father applies hydrocortisone cream to the lesions. D) To dry lesions, the father applies alcohol to lesions daily.
D
A child with a known allergy to bees, is stung while on the playground at school. The school nurse is the first to arrive and notes the child is wheezing and begins vomiting. What will the nurse do first? A) Call an ambulance. B) Apply ice to the sting. C) Give an antihistamine. D) Administer epinephrine.
D
The nurse is caring for a school-age child with varicella. What should the nurse observe about the rash that is associated with this infection? A) Dark red color B) Noticeable crusts but no pruritus C) Dark red, macular, very pruritic lesions D) Various stages of lesions present at the same time
D
The nurse is teaching the parents of a child with multiple environmental allergies on ways to control allergens in the home. What should the nurse include in these instructions? (Select all that apply.) A) Remove all carpeting. B) Install a dehumidifier in the home. C) Consider having fish as pets instead of a dog or cat. D) Remove stuffed toys unless filled with synthetic material. E) Replace furniture with upholstered chairs and sofas for sitting.
A, B, D
The nurse is reviewing the immunization schedule with the parent of a child who is HIV positive. What information should the nurse provide? Select all that apply. A) Pneumococcal vaccination can be given. B) The child should receive live vaccines only. C) The human papillomavirus vaccine should not be given. D) The varicella vaccine should not be given if the child is symptomatic. E) If the CD4 count is low, the measles, mumps, and rubella vaccine should not be given.
A, D, E
A group of grade-school children is going camping. As a school nurse, you would offer them which advice to prevent Lyme disease? A) "Don't drink water from mountain streams while hiking." B) "Don't approach strange animals outside the campsite." C) "Wear jeans tucked inside your socks when in the woods." D) "Don't touch any bush without knowing what kind it is."
C
A parent whose son has mumps on the left side of the face is concerned that mumps may develop on the right side in the future. Which instruction is most helpful? A) "To prevent this, your son should receive active immunization against mumps as soon as he is well." B) "Your son is immune to further attacks of the disease." C) "There is nothing that can be done to prevent another attack of mumps." D) "It is immaterial; mumps in adulthood are not serious."
B
An infant is seen in an ambulatory clinic for streptococcal-based impetigo. An important point of care you would teach the mother would be A) avoidance of thumb sucking. B) proper administration of penicillin. C) proper administration of a topical steroid. D) good dressing-change technique.
B
A school-age child has been placed in airborne precautions until the microorganism causing the child's symptoms can be identified. Which diagnosis should the nurse identify as being the most appropriate for the child at this time? A) Altered body temperature (fever) related to systemic infection B) Knowledge deficit related to disease prognosis, prevention, and treatment C) Social isolation related to precautions required to prevent infection transmission D) Deficient diversional activity related to activity restriction and precautions to prevent disease transmission
C
A school-age child is placed in contact precautions for a communicable disease. Which observation indicates that teaching about these precautions has been effective? A) Family members sitting on the patient's bed B) Father applies a face mask before entering the child's room C) Mother applies a gown and gloves before entering the child's room D) Younger brother applies a face mask, gown, gloves, and face shield before entering the room
C
A school-age child with a rash over the abdomen now has a bright red tongue. The health care provider is going to begin treatment for scarlet fever. On which medication should the nurse instruct the mother for the child's care? A) Aspirin B) Steroids C) Antibiotics D) Antifungal medication
C
The nurse is teaching the mother of a 10-month-old baby on the method to administer nystatin liquid as treatment for thrush. Which technique should the nurse instruct the mother to use? A) Administer it immediately after meals. B) Give it just prior to meals for best absorption. C) Give it mixed with orange juice to disguise the taste. D) Administer it mixed with milk to decrease stomach irritation.
A
To avoid anaphylactic reactions in children, which question would be most important to ask a parent before administering penicillin to her infant? A) "Has she ever had penicillin before?" B) "Is there any family history of allergy to penicillin?" C) "What do you give her to alleviate itching?" D) "Do you have a telephone to call us immediately if she develops trouble breathing?"
A
When the physician looks in a child's mouth during a sick-visit exam, the mother exclaims: "Her tongue is bright red! It was not like that yesterday." The physician would most likely order which medication based on the probable diagnosis of scarlet fever? A) Steroids to decrease the inflammation B) Acetaminophen to decrease the throat pain C) Penicillin to prevent acute glomerulonephritis D) Erythromycin to prevent the spread to siblings
C
Which drug should be available for emergency treatment of a child who goes into anaphylactic shock? A) Morphine sulfate B) Meperidine C) Epinephrine D) Vistaril
C
You anticipate that a 16-year-old girl with infectious mononucleosis will be placed on bed rest to A) protect her from joint involvement. B) prevent irritation of her stiff neck. C) prevent splenic rupture. D) prevent liver involvement.
C
The home care nurse is observing a mother prepare mupirocin to treat a preschool-aged child's skin rash. At which point should the nurse stop the mother during the preparation of the medication? A) Mother washes the lesions before using the medication. B) Mother washes own hands after touching the child's rash. C) Mother is still using the medication on day 9 of the infection. D) Mother measures out a teaspoon of the medication for the child to take orally.
D
During a routine assessment, the nurse determines that a school-age child has head lice. What did the nurse assess in this child? A) Macular rash on the arms B) White flecks on hair shafts C) Red raised rash on the neck D) Pustule formation on the trunk
B
Nebulized albuterol should be available to counteract anaphylactic shock. This drug: A) counteracts hypotension. B) facilitates breathing. C) depresses the central nervous system. D) increases the pulse rate.
B
The nurse has received morning report on a group of pediatric clients. Which pediatric client will the nurse see first? A) a child with IgA deficiency reporting rhinitis B) a child reporting coughing, itching, and anxiety C) a child with HIV who reports feeling lethargic D) a child reporting a vesicular rash with yellow crusts
B
The nurse is assessing an 8 year old with mumps (infectious parotitis). The client states a 7 on the 0-10 pain scale. Before administering a pain medication, at which location will the nurse assess for parotid gland swelling? A) Immediately behind the ear B) In front of the ear, above the jawline C) In front of the ear, below the jawline D) Above and in front of the ear
B
The nurse is caring for a preschool-age child who has been seen in the emergency department for an allergic reaction to stinging insects twice in the last month. What should the nurse instruct the parents to help reduce the child's exposure to insects? A) Keep the child's hair short. B) Keep the child away from the trash. C) Use lightly scented powders and lotions. D) Avoid going outdoors during the heat of the day.
B
The nurse is caring for a school-age child recently diagnosed with an allergy to peanuts. Which nursing action is a priority? A) Advise parents the child may benefit from skin testing. B) Include the child when discussing foods that contain peanuts. C) Offer the parents information about a community support group. D) Remind parents to report the allergy to the child's school teacher.
B
The nurse is evaluating outcomes for teaching provided to the mother of a school-age child with an itchy rash. Which outcome indicates that teaching has been effective? A) Mother applies hot compresses to itchy skin areas every few hours B) Child drinks a glass of water every 1 to 2 hours throughout the day C) Child showers in hot water and uses soap on the rash every morning D) Child wearing long denim pants and a long-sleeve shirt while playing outside
B
Which intervention would be the most important for the nurse to include in the plan of care for a child with infectious mononucleosis? A) Limiting fluid intake B) Moving the child carefully C) Administering a corticosteroid D) Counseling the child to stop kissing
B
Which nursing diagnosis should the nurse use to guide care for a child with allergic rhinitis? A) Risk for fluid volume deficit B) Pain related to sinus edema and headache C) Ineffective tissue perfusion related to frequent nosebleeds D) Disturbed self-esteem related to inherited tendency for illness
B
Which personal protective equipment will the nurse wear while inserting a urinary catheter on a child positive for HIV and tuberculosis? Select all that apply. A) simple mask B) sterile gloves C) N-95 respirator D) disposable gown E) protective eye shield
B, C, D, E
A 6-month-old boy develops roseola. When obtaining information from his father, what would you expect him to report? A) The infant's temperature rose at the same time as the rash appeared. B) The rash is a mixture of papules and pustules. C) The infant's temperature fell when the rash appeared. D) The infant is lethargic and not interested in playing.
C
A child with allergic rhinitis is prescribed a nasal antihistamine spray. When advising parents about the use of such sprays, you would tell them about a rebound phenomenon. This phenomenon results in A) a permanent increase in nasal secretions. B) a decrease in histamine release after an initial increase. C) an increase in nasal secretions after an initial decrease. D) reflux of gastric contents into the esophagus.
C
A child with allergic rhinitis is prescribed a nasal antihistamine spray. When advising the parents about the use of the sprays, what should the nurse explain about the rebound phenomenon? A) It causes a permanent increase in nasal secretions. B) It causes reflux of gastric contents into the esophagus. C) It causes an increase in nasal secretions after an initial decrease. D) It causes a decrease in histamine release after an initial increase.
C
A preschool-age child is being seen for a rash that occurred after the mother applied a sunscreen prior to permitting the child to swim at the beach. For which type of allergic reaction should the nurse prepare teaching materials for the mother? A) Autoimmunity B) Atopic dermatitis C) Contact dermatitis D) Delayed hypersensitivity
C
A toddler is treated for pinworms. To prevent reinfection, what advice would you give the mother? A) Don't allow the child to play on the floor. B) Don't allow the child to play with the family dog. C) Help the child wash hands before eating. D) Urge the child to void as frequently as possible.
C
An infant is diagnosed with streptococcal-based impetigo. What should the nurse teach the mother about the infant's care? A) Help avoid thumb-sucking. B) Change the dressings every day. C) Provide penicillin as prescribed. D) Administer the steroid as prescribed.
C
What advice would be most appropriate for the child with a stinging-insect allergy? A) Join a peer support group to help relieve anxiety about this problem. B) Consult a genetic counselor to reveal other susceptible family members. C) Obtain a medical alert ID bracelet so the presence of the allergy can be identified easily. D) Arrange for allergy testing for foods with ingredients similar to those in insect venom.
C
When administering nystatin liquid for treatment of thrush, which of the following administration techniques would be best? A) Give it just prior to meals for best absorption. B) Give it mixed with orange juice to disguise the taste. C) Administer it immediately after meals. D) Administer it mixed with milk to decrease stomach irritation.
C
A toddler is being treated for pinworms. What advice should the nurse give to the mother to prevent reinfection? A) Help the child wash hands before eating. B) Don't allow the child to play on the floor. C) Urge the child to void as frequently as possible. D) Don't allow the child to play with the family dog.
A
Infants or children receiving antibiotics may develop thrush (oral candidiasis). Which of the following findings suggests that an infant has thrush? A) Presence of a white membrane on tongue B) Diffuse buccal erythema without discharge C) Mucopurulent sputum D) Oral pruritus
A
The nurse is helping the parents of a toddler identify foods that are causing allergic symptoms in the child. Which strategy should the nurse encourage the parents to use? A) Elimination diet B) Hyposensitivity testing C) Corticosteroid challenge testing D) Complete dietary protein restriction
A
A parent calls the nurse to discuss a rash which the mother suspects as Varicella. The nurse states that the rash possibly could be Varicella when the parent describes rash characteristics as which? A) Dark red color (red hen marks) B) Various stages of lesions present at the same time C) Noticeable crusts papules but no pruritus D) Dark red, macular, very pruritic lesions
B
A group of grade-school children is going camping. Which information should the school nurse provide to prevent Lyme disease? A) "Don't approach strange animals outside the campsite." B) "Don't touch any bush without knowing what kind it is." C) "Don't drink water from mountain streams while hiking." D) "Wear jeans tucked inside your socks when in the woods."
D
Parents usually ask when their child can return to school after having chickenpox. The correct answer would be: A) not until all lesions have completely faded. B) as soon as the temperature is normal. C) 10 days after the initial lesions appear. D) as soon as all lesions are crusted.
D