Chapter 45 Nursing Care of the Child With an Alteration in Tissue Integrity / Integumentary Disorder

The nurse is caring for a child with widespread itching and has recommended bathing as a relief measure. After teaching the mother about this, which statement from the mother indicates a need for further instruction? A) "After bathing, I need to rub his skin everywhere to make sure he is completely dry." B) "I must make sure I use lukewarm water instead of hot water." C) "Oatmeal baths are helpful; we can add Aveeno skin relief bath treatment." D) "We should leave his skin moist before applying medication or moisturizer."

A

The nurse is providing care to a child with folliculitis. Which of the following would the nurse expect to administer? A) Topical mupirocin B) Oral cephalosporin C) Intravenous oxacillin D) Topical Eucerin cream

A

A group of students are preparing for a class exam on skin disorders. As part of their preparation, they are reviewing information about acne vulgaris and its association with increased sebum production. The students demonstrate understanding of the information when they identify which areas as having the highest sebaceous gland activity? Select all answers that apply. A) Face B) Upper chest C) Neck D) Back E) Shoulders

ABD

A nurse is assessing the skin of a child with cellulitis. Which of the following would the nurse expect to find? A) Red raised hair follicles B) Warmth at skin disruption site C) Papules progressing to vesicles D) Honey-colored exudate

B

A nurse is inspecting the skin of a child with atopic dermatitis. Which of the following would the nurse expect to observe? A) Erythematous papulovesicular rash B) Dry, red, scaly rash with lichenification C) Pustular vesicles with honey-colored exudates D) Hypopigmented oval scaly lesions

B

A nurse is performing a primary survey on a child who has sustained partial thickness burns over his upper body areas. Which of the following would the nurse do first? A) Inspect the child's skin color B) Assess for a patent airway C) Observe for symmetric breathing D) Palpate the child's pulse

B

A nurse is preparing a presentation for a local parent group about burn prevention and care in children. Which of the following would the nurse be least likely to include in the presentation when describing how to care for a superficial burn? A) Using cool water over the burned area until the pain lessens B) Applying ice directly to the burned skin area C) Covering the burn with a clean, nonadhesive bandage D) Giving the child acetaminophen for pain relief

B

An instructor is developing a plan for a class of nursing students on the various skin disorders. When describing urticaria, which of the following would the instructor include? A) It is a type IV hypersensitivity reaction. B) Histamine release leads to vasodilation C) Wheals appear first followed by erythema. D) The nonpruritic rash blanches with pressure.

B

The nurse is caring for a 15-year-old boy who has sustained burn injuries. The nurse observes the burn developing a violaceous color with discharge and a foul odor. The nurse suspects which of the following infections? A) Burn wound cellulitis B) Invasive burn cellulitis C) Burn impetigo D) Staphylococcal scalded skin syndrome

B

The nurse is caring for an infant with candidal diaper rash. Which topical agent would the nurse expect the physician to order? A) Corticosteroids B) Antifungals C) Antibiotics D) Retinoids

B

The nurse is conducting a physical examination of a 9-month-old baby with a flat, discolored area on the skin. The nurse documents this as which of the following? A) Papule B) Macule C) Vesicle D) Scaling

B

The nurse is providing parental teaching about home care for an 8-year-old boy with widespread sunburn on his back and shoulders. Which of the following responses indicates a need for further teaching? A) "Cool compresses may help cool the burn." B) "He should manually peel off any flaking skin." C) "Nonsteroidal anti-inflammatory drugs like ibuprofen are helpful." D) "He should avoid hot showers or baths for a couple of days."

B

The nurse is teaching the mother of a toddler about burn prevention. Which response by the mother indicates a need for further teaching? A) "We will leave fireworks displays to the professionals." B) "I will set our water heater at 130 degrees." C) "All sleepwear should be flame retardant." D) "The handles of pots on the stove should face inward."

B

Which of the following would the nurse include when teaching an adolescent about tinea pedis? A) "Keep your feet moist and open to the air as much as possible." B) "Dry the area between your toes really well." C) "Wear nylon or synthetic socks every day." D) "Go barefoot when you are in the locker room at school."

B

A nurse is preparing a class for parents of infants about managing diaper dermatitis. Which of the following would the nurse include in the presentation? Select all answers that apply. A) Applying topical nystatin to the diaper area B) Using a blow dryer on warm to dry the diaper area C) Refraining from using rubber pants over diapers D) Using scented diaper wipes to clean the area E) Washing the diaper area with an antibacterial soap

BC

A 3-year-old child has sustained significant severe burns and is ordered to receive 100% oxygen. Which of the following would the nurse use to administer the oxygen? A) Nasal cannula B) Venturi mask C) Nonrebreather mask D) Oxygen hood

C

A 4-year-old is brought to the emergency department with a burn. Which of the following would alert the nurse to the possibility of child abuse? A) Burn assessment correlates with mother's report of contact with a portable heater. B) Parents state that the injury occurred approximately 15 to 20 minutes ago. C) Clear delineations are noted between burned and nonburned skin areas. D) The burn area appears asymmetric and nonuniform.

C

A nurse is caring for a 5-year-old in Buck traction. When conducting a skin examination for signs of pressure ulcers, the nurse pays particular attention to which area? A) Sacral area B) Hip area C) Occiput D) Upper arm

C

After teaching a class about the differences in the skin of infants and adults, the nurse determines that additional teaching is necessary when the class states which of the following? A) "An infant's skin is thinner than an adult's, so substances placed on the skin are absorbed more readily." B) "The infant's epidermis is loosely connected to the dermis, increasing the risk for breakdown." C) "The infant has a lower risk for damage from ultraviolet radiation because the skin is more pigmented." D) "An infant has less subcutaneous fat, which places the infant at a higher risk for heat loss."

C

The nurse is preparing a class for a group of adolescents about reducing the risk of skin cancer. Which of the following would the nurse include? A) Using a sunscreen with para-aminobenzoic acid (PABA) with an SPF of at least 10 B) Applying sunscreen at least 1 hour before going outside in the sun C) Avoiding sun exposure between the hours of 10 a.m. and 2 p.m. D) Using artificial UV tanning beds instead of sun exposure

C

The nurse is providing care for a 14-year-old girl with severe acne. The girl expresses sadness and distress about her appearance. Which response by the nurse would be most appropriate? A) "Are you using your medicine every day?" B) "Your condition will most likely improve in a year or two." C) "Many people feel this way; I know someone who can help." D) "If you have any scarring you can undergo dermabrasion."

C

When developing the plan of care for a child with burns requiring fluid replacement therapy, which of the following would the nurse expect to include? A) Administration of colloid initially followed by a crystalloid B) Determination of fluid replacement based on the type of burn C) Administration of most of the volume during the first 8 hours D) Monitoring of hourly urine output to achieve less than 1 mL/kg/hour

C

A 6-year-old boy has been admitted to the hospital with burns. The nurse notes carbonaceous sputum. Which of the following would be the priority? A) Determining the burn depth B) Eliciting a description of the burn C) Estimating burn extent D) Ensuring a patent airway

D

A child is diagnosed with atopic dermatitis. Which laboratory test would the nurse expect the child to undergo to provide additional evidence for this condition? A) Erythrocyte sedimentation rate B) Potassium hydroxide prep C) Wound culture D) Serum immunoglobulin E level

D

A nurse is caring for a 14-year-old girl who received an electrical burn. The nurse would anticipate preparing the girl for which diagnostic tests as ordered? A) Pulse oximetry B) Fiberoptic bronchoscopy C) Xenon ventilation-perfusion scanning D) Electrocardiographic monitoring

D

As part of a clinical conference with a group of nursing students, the instructor is describing the burn classification. The instructor determines that the teaching has been successful when the group identifies which of the following as characteristic of full thickness burns? A) Skin that is reddened, dry, and slightly swollen B) Skin appearing wet with significant pain C) Skin with blistering and swelling D) Skin that is leathery and dry with some numbness

D