Chapter 29 Integumentary Disorders adaptive quizzing
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? Give the parent a hug. Encourage the parent to talk more about feelings. .Tell the parent to be thankful that the child is alive. Tell the parent he or she could not have prevented the fire
Encourage the parent to talk more about feelings.
The nurse is providing care to a 6-year-old child who was stung by a honey bee. Inspection reveals that the stinger is still present. Which action by the nurse would be appropriate? Use a paste of baking soda to soften the stinger. Apply a cold compress over the stinger to loosen it. Pinch the skin to cause the stinger to fall out. Remove the stinger by scraping the skin.
Remove the stinger by scraping the skin. Explanation: If the stinger is still present, the nurse should remove it by scraping the skin
The nurse is assessing a child with a varicella infection. The nurse would be alert for which possible complication(s)? Select all that apply. Scarring Encephalitis Secondary bacterial infection Scarlet fever Pneumonia
Secondary bacterial infection Pneumonia Scarring Encephalitis
The nurse is caring for a 6-year-old boy with mumps. Which of the following statements by the child would cause the nurse to suspect the boy is experiencing a complication of mumps? "I feel wobbly when I walk." "Please talk a little louder." "I keep coughing up mucus." "My knees are sore and stiff."
"Please talk a little louder." Explanation: Complications of mumps include meningoencephalitis with seizures and auditory neuritis, which can result in deafness.
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. The epidermis is thicker than in adults. Sweat glands are fully functioning at birth. It is thinner and more fragile than an adult's Substances are easily absorbed. Skin is less susceptible to the sun.
It is thinner and more fragile than an adult's Substances are easily absorbed. Explanation:
A child hospitalized for surgery develops varicella. The health care provider prescribes isolation for the child. Which type of isolation precautions will the nurse take to provide care for this child? contact standard droplet airborne
airborne Explanation: Varicella is a respiratory infection spread by tiny droplets via an infected person coughing or sneezing. These droplets become airborne after coughing and can spray an area 30 feet (9 meters) or further
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? "Herpes zoster is a reactivation of a previous varicella zoster infection." "Children who are immunocompromised are more likely to contract shingles." "Handwashing is an effective way to prevent the spread of infectious disorders." "Your child must have been exposed to someone with herpes zoster."
"Herpes zoster is a reactivation of a previous varicella zoster infection."
A nurse is teaching a group of parents about burn safety. Which statement made by a parent requires intervention by the nurse? "We installed smoke detectors on every floor in our home." "We made a song out of 'stop, drop and roll' to teach our children fire safety." "I had our plumber lower our water heater temperature to 130°F (53°C). "I always make sure the little ones stay out of the kitchen when I am cooking."
"I had our plumber lower our water heater temperature to 130°F (53°C). Explanation: Water heater temperature should be 120°F (49°C) or lower to prevent significant burns.
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? "Is the child having any trouble breathing?" "When did you first notice the rash?" "Is there any itching with the rash?" "Did you do anything at home to treat the rash?"
"Is the child having any trouble breathing?"
The nurse is teaching the parents of an 8-year-old child diagnosed with folliculitis on both arms about caring for their child. The nurse determines that additional teaching is needed based on which statement by the parents? "We can apply a steroid cream to the area to help with the itching." "We need to wash the area with warm soap and water to keep it clean." "We should call our health care provider if the lesions get bigger in size." "We should apply warm compresses to the area several times a day."
"We can apply a steroid cream to the area to help with the itching." Folliculitis is self-limiting but is often treated with topical antibiotics. However, the lesions generally do not cause pain or pruritus. Therefore, there is no need to apply steroid creams
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? Make an appointment for the parent to bring the child to the clinic for evaluation. Encourage the parent to explain to the child that he or she must drink from the cup. Tell the parent to allow the child to nurse as much as the child wants. Explain that children who have had a serious injury sometimes exhibit regressive behavior.
Explain that children who have had a serious injury sometimes exhibit regressive behavior.
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? fever Koplik spots malaise pruritus
Koplik spots Explanation: Koplik spots (bright red spots with white centers on the buccal mucosa) are specific to rubeola.
A nursing instructor is describing the progression of signs and symptoms associated with varicella from earliest to latest. Place the signs and symptoms below in the sequence that the instructor would describe them. Low-grade fever Vesicle formation Papular rash Macular rash Crusting
Low-grade fever Macular rash Papular rash Vesicle formation Crusting
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? Measles Fifth disease Mumps Mononucleosis
Mumps Explanation: Mumps begins with a fever, headache, anorexia, and malaise. Within 24 hours an earache occurs. When pointing to the site of pain, however, the child points to the jawline just in front of the earlobe
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? The dog belonged to a neighbor There have been no other reported instances in the area The dog was properly immunized for rabies The dog was unprovoked when he bit the girl
The dog was unprovoked when he bit the girl
What is a true statement regarding measles? Peak outbreaks are in the summer. The incubation period is 10 to 12 days. It is not contagious. It is transmitted by the fecal-oral route.
The incubation period is 10 to 12 days.
The nurse is administering a chickenpox vaccination to a 12-month-old girl. Which concern is unique to varicella? Dehydration is caused by mouth lesions. Children with this disease need to avoid pregnant women. Vitamin A is indicated for children younger than 2 years. This disease can reactivate years later and cause shingles.
This disease can reactivate years later and cause shingles.
After teaching the parents of a 7-year-old how to apply the prescribed topical medication, the nurse determines that the teaching was successful when the parents state they will do which of the following? Wash the area with warm water and dry completely before application Not wear gloves but wash their hands after applying the medication Wash the area with soapy water, rinse and leave the area moist before application Apply a generous amount of medication to the skin
Wash the area with warm water and dry completely before application
The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which skin condition best describes pustule? redness of the skin produced by congestion of the capillaries small elevation of epidermis filled with a viscous fluid small, circumscribed, solid elevation of the skin discolored skin spot not elevated at the surface
small elevation of epidermis filled with a viscous fluid
Question 5 of 10 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? Keep follow-up appointments. Monitor for signs of worsening condition. Perform proper hand hygiene. Complete the prescribed antibiotics.
Complete the prescribed antibiotics.
Question 9 of 10 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? Playing with a household cleaning agent container Touching an open, hot oven door Playing unsupervised with matches Scalding from pulling a hot pan off the stove
Scalding from pulling a hot pan off the stove
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? For up to 8 days more after the rash initially appears Until the rash disappears, which is about 3 days Until there are no more new lesions and lesions have crusted over For 4 days more now that the rash is present
Until there are no more new lesions and lesions have crusted over Explanation: With varicella, children are contagious 1 to 2 days before the rash appears and continue to be contagious until there are no more new lesions and all lesions are crusted over
An infant is diagnosed with streptococcal-based impetigo. What should the nurse teach the mother about the infant's care? Change the dressings every day. Provide penicillin as prescribed. Help avoid thumb-sucking. Administer the steroid as prescribed.
Provide penicillin as prescribed.
A nurse is providing care to a 3-year-old child hospitalized with second-degree (partial-thickness) and deep partial-thickness burns to the dorsal portion of both legs. The nurse is preparing to change the child's dressings. Which action(s) should the nurse take to elicit the child's cooperation in the dressing change? Select all that apply. Allow the child to decide which leg's dressing to change first. Have the parent instruct the child to cooperate with the nurse. Permit the child to choose a method of distraction. Encourage the parent to hold the child's hand during the dressing change. Tell the child to watch television while the dressing is changed.
Allow the child to decide which leg's dressing to change first. Permit the child to choose a method of distraction. Encourage the parent to hold the child's hand during the dressing change.
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? Question the parent about methods of punishment. Examine the lips and oral mucosa for cyanosis. Determine whether the child is breastfed or formula fed. Observe the infant's respiratory effort.
Observe the infant's respiratory effort. Explanation: The raised red welts are likely urticaria or hives, an allergic response to a substance (food, drugs, plants, etc.). As such, it is most important to observe the infant's respiratory effort since that reaction can involve the lips, tongue, and airway
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? Notifying the health care provider if the hands become red Placing the hands in warm water for 30 minutes Massaging both hands vigorously for 5 minutes Contacting a plastic surgeon to debride the skin
Placing the hands in warm water for 30 minutes Explanation: The key to treating second-degree frostbite is to rewarm the affected area.
Question 4 of 10 The nurse is caring for a 10-year-old child with a skin rash. The nurse should include which intervention to manage the associated pruritis? Press the pruritic area. Encourage warm baths. Apply hot compresses. Rub powder on the pruritic area.
Press the pruritic area. Explanation: Pruritis may be managed by pressing on the area instead of scratching.
The nurse is caring for multiple clients on the pediatric unit. Which child will the nurse see first? a child diagnosed with measles experiencing photophobia and coryza a child with erythema infectiosum experiencing fatigue and confusion a child diagnosed with chicken pox reporting nausea and malaise a child with herpes simplex who is reporting mouth pain and pruritis
a child with erythema infectiosum experiencing fatigue and confusion Explanation: A child with erythema infectiosum experiencing fatigue and confusion is showing signs of decreased oxygenation, possibly related to aplasia of erythrocytes caused by the virus.
A child is diagnosed with early disseminated Lyme disease. The nurse informs the parents the child will most likely receive antibiotic therapy for which length of time? 14 to 28 days 10 to 14 days 14 to 18 days 7 to 10 days
14 to 28 days Explanation: For early disseminated or late Lyme disease, intravenous penicillin or ceftriaxone is used for 14 to 28 days.
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? "We need to leave the medication on for about 10 minutes before rinsing it off." "One application of the medication should be enough to get rid of the lice." "If we use the medicine, we will not have to use the special comb for the nits." "We should apply the medication to our child's hair and scalp when it is dry."
"We need to leave the medication on for about 10 minutes before rinsing it off."
The nursing is caring for a hospitalized child diagnosed with varicella-zoster virus. The child's parents ask how to prevent the child's siblings from contracting the virus. Which response by the nurse is best? "As long as your other children wash their hands, they should not contract the virus." "We will place your child on contact and airborne precautions. It is best for the other children not to visit." "Since this is a virus, there is nothing you can do to prevent your other children from getting it." "Vaccinating your other children is the only way to prevent them from contracting the virus."
"We will place your child on contact and airborne precautions. It is best for the other children not to visit." Explanation: The causative agent for chickenpox is the varicella-zoster virus, which is spread through contact and airborne methods. The client should be placed on precautions and limit visitors who are at risk.
Question 7 of 10 A parent brings an infant to the clinic for a well child visit. During the assessment, the parent asks the nurse why the infant never seems to sweat. What action should the nurse take? Explain that this is because an infant's temperature normally runs lower than an adult's. Tell the parent that the infant will need to see an endocrine specialist about the problem. Make a note to inform the health care provider of the parent's concern. Explain that this normal mechanism keeps the infant from losing too much water through the skin.
Explain that this normal mechanism keeps the infant from losing too much water through the skin.
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? "Does your child have any allergies to medications?" "Is there anything else you think we should know about your family?" "Do you have any concerns about filling the prescriptions?" "How long has the child had the infection?"
"Does your child have any allergies to medications?"
A nurse is providing care to a child with partial and full thickness burns over 26% of the body. In monitoring the child's output the nurse expects an output of 1 to 2 mL/kg/hr. The nurse has emptied 46 mL from the foley catheter for the past hour. The child weighs 62 lb (28 kg). What action should the nurse take? Check the catheter tubing for any kinks. Increase the intravenous fluid rate to compensate. Notify the health care provider that the output is too low. Document the output and continue to monitor.
Document the output and continue to monitor.
When describing measles to a local parent group, the nurse explains that which of the following is the hallmark clinical manifestation? Koplik spots Cough Conjunctivitis Fever
Koplik spots Explanation: The hallmark of measles is the appearance of Koplik spots. Other typical symptoms include fever, conjunctivitis, and a cough.