NCLEX- Pediatrics Infectious & communicable diseases
Several children have contracted rubeola (measles) in a local school, and the school nurse conducts a teaching session for the parents of the school children. Which statement, if made by a parent, indicates a need for further teaching regarding this communicable disease? 1."Small blue-white spots with a red base may appear in the mouth." 2."The rash usually begins centrally and spreads downward to the limbs." 3."Respiratory symptoms such as a very runny nose, cough, and fever occur before the development of a rash." 4."The communicable period ranges from 10 days before the onset of symptoms to 15 days after the rash appears."
4."The communicable period ranges from 10 days before the onset of symptoms to 15 days after the rash appears." The communicable period for rubeola ranges from 4 days before to 5 days after the rash appears, mainly during the prodromal (catarrhal) stage. Options 1, 2, and 3 are accurate descriptions of rubeola. The small blue-white spots found in this communicable disease are called Koplik spots. Option 3 describes the incubation period for rubella, not rubeola.
A child seen in the clinic is found to have rubeola (measles) and the mother asks the nurse how to care for the child. Which instruction should the nurse provide to the mother? 1.Keep the child in a room with dim lights. 2.Give the child warm baths to help prevent itching. 3.Allow the child to play outdoors because sunlight will help the rash. 4.Take the child's temperature every 4 hours and administer 1 baby aspirin for fever.
1.Keep the child in a room with dim lights. A nursing consideration in rubeola is eye care. The child usually has photophobia, so the nurse should suggest that the parent keep the child out of brightly lit areas. Children with viral infections are not to be given aspirin because of the risk of Reye's syndrome. Warm baths and the sun will aggravate itching. In addition, the child needs to rest
A child is diagnosed with chicken pox. The nurse collects data regarding the child. Which finding is characteristic of chicken pox? 1.Macular rash on the trunk and scalp 2.Pseudomembrane formation in the throat 3.Maculopapular or petechial rash on the extremities 4.Small, red spots with a bluish-white center and red base
1.Macular rash on the trunk and scalp A macular rash that first appears on the trunk and scalp and then moves to the face and the extremities is a characteristic of chicken pox. Pseudomembrane formation in the throat is characteristic of diphtheria. A maculopapular or petechial rash primarily on the extremities is characteristic of Rocky Mountain spotted fever. Small red spots with a bluish-white center and red base are known as Koplik spots and are characteristic of measles
n planning care for a child with contact dermatitis, which concern is the highest priority for the child? 1.Pain 2.Infection 3.Skin breaks 4.Parental knowledge about care
1.Pain In any skin disorder, the goal with children is to offer comfort interventions so that the child can rest. Once pain has decreased, the skin can be assessed for integrity and infection. Although important, teaching is not the priority in this situation.
A child is diagnosed with scarlet fever. The nurse collects data regarding the child. Which is characteristic of scarlet fever? 1.Pastia's sign 2.Abdominal pain and flaccid paralysis 3.Dense pseudoformation membrane in the throat 4.Foul-smelling and mucopurulent nasal drainage
1.Pastia's sign Pastia's sign is a rash seen among children with scarlet fever that will blanch with pressure, except in areas of deep creases and in the folds of joints. The tongue is initially coated with a white furry covering with red projecting papillae (white strawberry tongue). By the fourth to fifth day, the white strawberry tongue sloughs off and leaves a red, swollen tongue (strawberry tongue). The pharynx is edematous and beefy red in color. Option 2 is associated with poliomyelitis. Options 3 and 4 are characteristics of diphtheria
The nurse is caring for a hospitalized child with a diagnosis of rubella (German measles). The nurse reviews the primary health care provider's progress notes and reads that the child has developed Forchheimer sign. Based on this documentation, which should the nurse expect to note in the child? 1.Swelling of the parotid gland 2.Petechiae spots located on the palate 3.A fiery red edematous rash on the cheeks 4.Small blue-white spots noted on the buccal mucosa
2.Petechiae spots located on the palate Forchheimer sign refers to petechiae spots, which are reddish and pinpoint and located on the soft palate. Small blue-white spots noted on the buccal mucosa are known as Koplik's spots seen in rubeola. A fiery red edematous rash on the cheeks, also called "slapped cheeks" is seen in erythema infectiosum. Swelling of the parotid gland is seen in mumps.
A child is hospitalized with Rocky Mountain spotted fever (RMSF). The health record reveals documentation that the child was bitten by a tick 2 weeks ago. The child presents with complaints of headache, fever, and anorexia, and the nurse notes a rash on the palms of the hands and soles of the feet. The nurse reviews the primary health care provider's prescriptions and anticipates that which medication should be prescribed? 1.Ganciclovir 2.Amantadine 3.Doxycycline 4.Amphotericin B
3.Doxycycline The care of a child with RMSF caused by the bacterium Rickettsia rickettsii will include the administration of the antibacterial, doxycycline. Amphotericin B is used for fungal infections. Ganciclovir is used to treat cytomegalovirus. Amantadine is used to treat influenza A virus.
A mother brings her 15-month-old child to the primary health care provider's office with complaints that the child has suddenly developed a bright red rash on her cheeks. She has no other symptoms and has been playing and eating as usual. Based on the appearance of the child, the nurse might suspect that the child has which communicable disease? 1.Rubella 2.Roseola 3.Fifth disease 4.Chickenpox
3.Fifth disease Fifth disease has the general appearance of "slapped cheeks." Many children do not have any symptoms before the appearance of the reddened cheeks. This characteristic is not associated with the communicable diseases identified in options 1, 2, or 4.
The nurse prepares to administer a measles, mumps, and rubella (MMR) vaccine to a 5-year-old child. How should the nurse plan to administer the vaccine? 1.Intramuscularly in the deltoid muscle 2.Subcutaneously in the gluteal muscle 3.Subcutaneously in the outer aspect of the upper arm 4.Intramuscularly in the anterolateral aspect of the thigh
3.Subcutaneously in the outer aspect of the upper arm MMR is administered subcutaneously in the outer aspect of the upper arm. Each child should receive two vaccinations, the first between 12 and 15 months of age and the second between 4 and 6 years or 11 and 12 years.
The nurse of a well-baby clinic prepares to administer an immunization to a child. The mother of the child tells the nurse that the child has had a fever and is taking antibiotics. The nurse takes the child's temperature and notes that it is 101.5° F rectally. The nurse plans to take which action? 1.Delay the immunization. 2.Administer the immunization. 3.Administer one of the three scheduled immunizations. 4.Administer one half of the prescribed dose of each scheduled immunization.
1.Delay the immunization. High fevers and severe illnesses are reasons to delay immunization, but only until the child has recovered from the acute stage of the illness. Minor illnesses such as a cold, otitis media, or mild diarrhea without fever are not contraindications to immunization.
A mother of a child brings the child to a clinic and reports that the child has a fever and has developed a rash on the neck and trunk. Roseola is diagnosed, and the mother is concerned that her other children will contract the disease. Which instruction should the nurse reinforce to the mother to prevent the transmission of the disease? 1."Disease transmission is unknown." 2."The disease is transmitted through the urine and feces, so the other children should use a separate bathroom." 3."The disease is transmitted through the respiratory tract, so the child should be isolated from the other children as much as possible." 4."The disease is transmitted by contact with body fluids, so any items contaminated with body fluids need to discarded in a separate receptacle."
1."Disease transmission is unknown." The method of transmission of roseola is unknown. Options 2, 3, and 4 are not correct transmission routes of roseola.
The nurse is reinforcing home-care instructions to the parents of a 3-year-old child with scabies. Which statement by a parent indicates the need for further teaching? 1."I understand that I need to leave the scabicide on for 4 hours before washing it off." 2."I will need to seal up all my child's nonwashable toys in a plastic bag for at least 4 days." 3."I realize that everyone who has come in contact with my child will need to be treated for scabies." 4."I know I need to wash all the clothing and bedding in hot water with detergent and dry in a hot dryer."
1."I understand that I need to leave the scabicide on for 4 hours before washing it off." The treatment for scabies involves applying a scabicide to cool, dry skin at least 30 minutes after bathing, which needs to be left on the skin for 8 to 14 hours, then washed off. The other statements are correct.
The school nurse prepares a list of home care instructions for the parents of school children who have been diagnosed with pediculosis capitis (head lice). Which should be included in the list? Select all that apply. 1.Siblings may also need treatment. 2.Use antilice sprays on all bedding and furniture. 3.Use a pediculicide shampoo and repeat treatment in 14 days. 4.Grooming items such as combs and brushes should not be shared. 5.Launder all the bedding and clothing in hot water and dry on high heat. 6.Vacuum floors, play areas, and furniture to remove any hairs that may carry live nits.
1.Siblings may also need treatment. 4.Grooming items such as combs and brushes should not be shared. 5.Launder all the bedding and clothing in hot water and dry on high heat. 6.Vacuum floors, play areas, and furniture to remove any hairs that may carry live nits. Bedding and linens should be washed with hot water and dried on a hot setting. Thorough home cleaning is necessary to remove any remaining lice or nits. Siblings may need to be treated and combs and brushes may need to be discarded or soaked in boiling water for 10 minutes. Antilice sprays are unnecessary. Additionally, they should never be used on bedding, furniture, or a child. The pediculicide product needs to be used as prescribed, and the parents are instructed to follow package instructions for timing the application and for contraindications for their use in children.
The nurse is caring for a 4-month-old infant with respiratory syncytial virus (RSV). Several clients are being admitted to the unit and assignments are being made. The nurse should question being assigned which newly admitted clients? Select all that apply. 1.The 6-month old with bronchopulmonary dysplasia 2.The 11-month-old client with diarrhea 3.The 16-year-old client taking antibiotics 4.The 1-year-old client taking corticosteroids 5.The 15-year-old with bone marrow suppression
1.The 6-month old with bronchopulmonary dysplasia 4.The 1-year-old client taking corticosteroids Clients with respiratory syncytial virus (RSV) should not be cared for by nurses who are also assigned to clients at high risk for RSV infection. RSV is most dangerous in children between 2 and 7 months of age. Older children and adults do not become as seriously ill. Therefore, the nurse should question being assigned the 6-month-old with bronchopulmonary dysplasia who is more susceptible to serious problems with respiratory infection because the client is between 2 and 7 months of age and already has serious respiratory issues. The 1-year-old taking corticosteroids may have a decreased immune system and be more at risk for serious problems associated with RSV infection; thus, the nurse should question this assignment also. Although the 15-year-old client with bone marrow suppression is at a greater risk for infection and ideally would not be assigned to the nurse taking care of a client with RSV, because of the anatomy of the client's lungs, an infection with RSV would not be as detrimental to this client as it would to an infant with immunosuppression. The 11-month-old with diarrhea and the 16-year-old taking antibiotics are not at as high of a risk of adverse effects to RSV infection.
The nurse is reinforcing instructions regarding the prevention of Lyme disease to a group of teenagers going on a hike in a wooded area. Which points should the nurse include in the session? Select all that apply. 1.Tuck pant legs into socks. 2.Wear closed shoes when hiking. 3.Apply insect repellent containing DEET. 4.Cover the ground with a blanket when sitting. 5.Remove attached ticks by grasping with thumb and forefinger. 6.Wear long sleeves and long pants in dark colors when in high-risk areas.
1.Tuck pant legs into socks. 2.Wear closed shoes when hiking. 3.Apply insect repellent containing DEET. 4.Cover the ground with a blanket when sitting. Measures to prevent tick bites focus on covering the body as completely as possible and spraying insect repellent containing DEET on the skin and clothing. Long sleeves and pants tucked into the socks along with closed shoes will offer some protection. Light-colored clothing should be worn so that ticks would be easily visible. Hikers should not sit directly on the ground and should cover the ground with an item such as a blanket. Ticks should be removed with tweezers.
The nurse reviews the home care instructions with a parent of a 3-year-old with pertussis. Which statement by the parent indicates a need for further teaching? 1."I know that my child will make a loud whooping sound." 2."I understand this whooping cough is viral and I have to let it run its course." 3."I understand that I need to watch for respiratory distress signs with pertussis." 4."I can reduce the environmental factors that can trigger coughing, like dust and smoke."
2."I understand this whooping cough is viral and I have to let it run its course." Pertussis is caused by the bacteria Bordetella pertussis and treatment requires antimicrobial therapy. Symptoms of pertussis consist of a respiratory infection followed by increased severity of cough with a loud whooping on inspiration. The child may experience respiratory distress, and the parents should be instructed on reducing environmental factors that cause coughing spasms, such as dust, smoke, and sudden changes in temperature.
The school nurse is visiting a kindergarten classroom to teach the students the importance of hand washing. During the teaching session the nurse notes that one girl is scratching her head. On inspection, the nurse determines that the child has pediculosis capitis. When reinforcing instructions to the mother about care of this condition, which statement by the mother indicates that she needs further teaching regarding this condition? 1."I will put all the stuffed animals in a sealed plastic bag for 14 days." 2."I will call a carpet cleaning service to clean all my carpets in the house." 3."My two daughters should not share their hairbrushes or hair ribbons." 4."I will machine wash all the washable clothing, towels, and bed linens in hot water."
2."I will call a carpet cleaning service to clean all my carpets in the house." Teaching about measures to prevent the spread of pediculosis capitis includes washing items in hot water, vacuuming carpets, discouraging sharing of personal items, and sealing items in plastic bags that cannot be vacuumed. Option 2 is too costly for many families and is unnecessary. Option 2 indicates the mother does not understand the measures that will prevent the spread of the parasite.
A mother brings her child to the health care clinic because the child has developed lesions located around the mouth and nose, and mild impetigo is diagnosed. The nurse reinforces instructions to the mother regarding care of the child. Which statement by the mother indicates the need for further teaching? 1."The impetigo is extremely contagious." 2."My child will need to be treated with oral antibiotics." 3."The crusts on the lesions need to be soaked and carefully removed." 4."The lesions should be washed gently three times a day with a warm, soapy washcloth."
2."My child will need to be treated with oral antibiotics." Impetigo is extremely contagious and may spread to other parts of the child's skin or to others who touch the child, use the same towel, or drink from the same glass. Lesions should be washed gently three times a day with a warm, soapy face cloth and crusts soaked and carefully removed. Mild cases are treated with topical antibiotic ointment. The topical antibiotic ointment is applied to the lesions after they are washed. Severe cases are treated with oral antibiotics.
The nurse reinforces instructions regarding the use of permethrin 1% to the parents of a child who has been diagnosed with pediculosis capitis. Which statements by the parents indicate they understand the instructions? Select all that apply. 1."We will need to apply another application in 48 hours." 2."The hair should not be shampooed for 24 hours after treatment." 3."The medication can be obtained over the counter in a local pharmacy." 4."The medication is applied to the hair after shampooing and left on for 24 hours." 5."The medication is applied to the hair after shampooing, left on for 5 to 10 minutes, and then rinsed out."
2."The hair should not be shampooed for 24 hours after treatment." 3."The medication can be obtained over the counter in a local pharmacy." 5."The medication is applied to the hair after shampooing, left on for 5 to 10 minutes, and then rinsed out." Permethrin 1% is an over-the-counter, antilice product that kills lice and eggs with one application and that has residual activity for 10 days. It is applied to dried hair after shampooing and left for 5 to 10 minutes before it is rinsed (not shampooed) out. The hair should not be shampooed for 24 hours after the treatment
The nurse obtains a health history from a mother of a 15-month-old child before administering a measles, mumps, and rubella (MMR) vaccine. Which is essential information to obtain before the administration of this vaccine? 1.A recent cold 2.Allergy to eggs 3.The presence of diarrhea 4.Any recent ear infections
2.Allergy to eggs Before the administration of a measles, mumps, and rubella vaccine, a thorough health history needs to be obtained. The MMR vaccine is used with caution in a child with a history of allergy to gelatin or eggs because the live measles vaccine is produced by chick embryo cell culture. The MMR vaccine also contains a small amount of the antibiotic neomycin. Options 1, 3, and 4 are not contraindications to administering this immunization.
A child with rubeola (measles) is being admitted to the hospital. When preparing for the admission of the child, which precautions should be implemented? Select all that apply. 1.Enteric 2.Contact 3.Airborne 4.Protective 5.Neutropenic
2.Contact 3.Airborne Rubeola is transmitted via airborne particles or direct contact with infectious droplets. Airborne precautions and contact precautions are required; a mask and gloves are worn by those who come in contact with the child. Gowns and gloves are not indicated. Articles that are contaminated should be bagged and labeled. Options 1, 4, and 5 are not indicated for rubeola
A nursing student is asked to discuss human immunodeficiency virus (HIV) during a clinical conference. The nursing student should include which correct item in the discussion? 1.HIV primarily attacks the hematological system. 2.HIV virus attacks the immune system by destroying T lymphocytes. 3.Most newborns of HIV-positive women test positive for HIV virus. 4.In HIV, the B cells are depleted and cannot signal T4 cells to form protective antibodies.
2.HIV virus attacks the immune system by destroying T lymphocytes. The virus attacks the immune system by destroying T lymphocytes. Children born to HIV-positive women test positive for HIV antibody, not HIV virus. This is actually a measure of maternal antibody and not indicative of true infection. T4 cells are depleted in number and cannot signal B cells to form protective antibodies to fight off the invading virus.
Which criterion should the nurse determine are characteristics of scabies? Select all that apply. 1.It is caused by a fungal infection. 2.It appears as burrows or fine, grayish-red lines. 3.It is transmitted by close personal contact with an infected person. 4.It is endemic among schoolchildren and institutionalized populations. 5.Meticulous skin care and the application of antifungal cream are components of treatment. 6.Household members and contacts of the infected child need to be treated at the same time that the child is being treated.
2.It appears as burrows or fine, grayish-red lines. 3.It is transmitted by close personal contact with an infected person. 4.It is endemic among schoolchildren and institutionalized populations. 6.Household members and contacts of the infected child need to be treated at the same time that the child is being treated. Scabies usually appears as burrows or fine, grayish-red lines. It is not caused by a fungal infection, and it is treated with the application of a topical scabicide. It is transmitted by close personal contact with an infected person, and it is endemic among schoolchildren and institutionalized populations. Household members and contacts of the infected child need to be treated at the same time that the child is being treated.
The nurse assigned to care for a child with mumps is monitoring the child for the signs and symptoms associated with the common complication of mumps. The nurse monitors for which sign/symptom that is indicative of this common complication? 1.Pain 2.Deafness 3.Nuchal rigidity 4.A red, swollen testicle
3. Nuchal rigidity The most common complication of mumps is aseptic meningitis, with the virus being identified in the cerebrospinal fluid. Common signs include nuchal rigidity, lethargy, and vomiting. A red, swollen testicle may be indicative of orchitis. Although this complication appears to cause most concern among parents, it is not the most common complication. Although mumps is one of the leading causes of unilateral nerve deafness, it does not occur frequently. Muscular pain, parotid pain, or testicular pain may occur, but pain does not indicate a sign of a common complication
A 6-month-old infant receives a diphtheria, tetanus, and pertussis (DTaP) immunization at the well-baby clinic. The mother returns home and calls the clinic to report that the infant has developed swelling and redness at the site of injection. Which is the appropriate response by the nurse? 1."Monitor the infant for a fever." 2."Bring the infant back to the clinic." 3."Apply an ice pack to the injection site." 4."Apply a warm pack to the injection site."
3."Apply an ice pack to the injection site." Occasionally, tenderness, redness, or swelling may occur at the site of the injection. This can be relieved with ice packs for the first 24 hours followed by warm compresses if the inflammation persists. It is not necessary to bring the infant back to the clinic. Option 1 may be an appropriate intervention but is not specific to the subject of the question
Griseofulvin is prescribed for a child with tinea capitis. The nurse reinforces instructions to the family regarding administration of the medication. Which statement by the mother indicates a need for further teaching? 1."I need to keep my child out of the sun." 2."I need to continue the therapy as long as it is prescribed." 3."I need to administer the medication 2 hours before meals." 4."I need to shake the oral suspension before preparing the dose.
3."I need to administer the medication 2 hours before meals." Griseofulvin is given with or after meals to avoid gastrointestinal (GI) irritation and to increase absorption. Oral suspensions should be shaken well. Parents are instructed to continue therapy as prescribed and not to miss a dose. Exposure to the sun is avoided during treatment
The nurse is preparing to administer a measles, mumps, rubella (MMR) vaccine to a 15-month-old child. Before administering the vaccine, which question should the nurse ask the mother of the child? 1."Has the child had any sore throats?" 2."Has the child been eating properly?" 3."Is the child allergic to any antibiotics?" 4."Has the child been exposed to any infections?"
3."Is the child allergic to any antibiotics?" Before administration of the MMR vaccine, a thorough health history must be obtained. MMR is used with caution in a child with a history of an allergy to gelatin, eggs, or neomycin because the live measles vaccine is produced by chick embryo cell culture, and MMR also contains a small amount of the antibiotic neomycin. Options 1, 2, and 4 are not contraindications to administering immunizations.
The nurse assists with providing an instructional session to parents regarding impetigo. Which statement by a parent indicates the need for further teaching? 1."It is extremely contagious." 2."It is most common during humid weather." 3."Lesions are most often located on the arms and chest." 4."It begins in an area of broken skin, such as an insect bite."
3."Lesions are most often located on the arms and chest." Impetigo is most common during the hot and humid summer months. It begins in an area of broken skin, such as an insect bite. It may be caused by Staphylococcus aureus, group A β-hemolytic streptococci, or a combination of these bacteria. It is extremely contagious. Lesions are most often located around the mouth and nose, but they may be present on the extremities
Several children have contracted measles (rubeola) in a local school, and the nurse provides information to the mothers of the children about this communicable disease. Which statement by a mother indicates a need for further teaching? 1."The disease is caused by a virus." 2."We will watch for the complication of otitis media." 3."The symptoms increase in severity after the rash appears." 4."Small, irregular red spots with a minute, bluish white center are seen on buccal mucosa before the rash appears."
3."The symptoms increase in severity after the rash appears." Symptoms gradually increase in severity until second day after rash appears, when they begin to subside. Options 1, 2, and 4 are accurate descriptions of rubeola. Option 3 is not true for the rubeola disease.
The nurse reinforces home care instructions to the parents of a child hospitalized with pertussis. The child is in the convalescent stage and is being prepared for discharge. Which statement by the parents indicates a need for further teaching? 1."We need to encourage adequate fluid intake." 2."Coughing spells may be triggered by dust or smoke." 3."We need to maintain respiratory precautions and a quiet environment for at least 2 weeks." 4."Good hand-washing techniques need to be instituted to prevent spreading the disease to others."
3."We need to maintain respiratory precautions and a quiet environment for at least 2 weeks." Pertussis is transmitted by direct contact or respiratory droplets from coughing. The communicable period occurs primarily during the catarrhal stage. Respiratory precautions are not required during the convalescent phase. Options 1, 2, and 4 are components of home care instructions
A 6-month-old infant receives a diphtheria, tetanus, and acellular pertussis (DTaP) immunization at the well-baby clinic. The parent returns home and calls the clinic to report that the infant has developed swelling and redness at the site of injection. Which instruction by the nurse is appropriate? 1.Monitor the infant for a fever. 2.Bring the infant back to the clinic. 3.Apply an ice pack to the injection site. 4.Leave the injection site alone, because this always occurs.
3.Apply an ice pack to the injection site. Occasionally tenderness, redness, or swelling may occur at the site of the injection. This can be relieved with cool packs for the first 24 hours and followed by warm or cool compresses if the inflammation persists. It is not necessary to bring the infant back to the clinic. Option 1 may be an appropriate intervention, but it is not specific to the question.
An infant is suspected to be human immunodeficiency virus (HIV) positive, and the nurse provides information to the parents about the care of their infant. Which indicates to the nurse that the parents need further teaching about the care of their HIV-positive infant? 1.The parents ask about a prescription for an antiretroviral medication. 2.The parents are able to verbalize signs and symptoms of failure to thrive. 3.The parents plan to use rice cereal to help with watery stools when they occur. 4.The parents state they will not allow anyone with a cold to hold and kiss the baby.
3.The parents plan to use rice cereal to help with watery stools when they occur. If an infant is having diarrhea, the parents need to seek medical attention because this could be the beginning of an opportunistic infection. Self-treatment is not encouraged. Asking for antiretroviral therapy, understanding signs and symptoms of failure to thrive, and being protective of an immunocompromised infant are evidence of understanding the needs of the infant.
A parent calls the clinic nurse to schedule an appointment for her child's diphtheria, tetanus, and pertussis vaccination. The parent tells the nurse that her child had a swelling at the injection site and low-grade fever after the last diphtheria, tetanus, and pertussis (DTaP) vaccination. Which instructions should the nurse give to the parent to lessen this type of reaction to the upcoming vaccination? 1.To give the child a sugary juice drink before coming to the clinic appointment 2.To request that the injection be given with a shorter needle than the one used before 3.To administer an appropriate dose of Tylenol 45 minutes before the appointment 4.To bring a dose of Tylenol to the appointment and administer it before leaving the clinic
3.To administer an appropriate dose of Tylenol 45 minutes before the appointment Nurses can involve the parent in minimizing the potential adverse effects of the vaccine by recommending administration of an appropriate dose of acetaminophen 45 minutes before the appointment time. A sugary drink will not be effective to lessen the pain of the injection. Needle length (appropriate to deliver into the muscle) is an important factor and fewer reactions to immunizations are observed when the vaccine is given deep into the muscle rather than into subcutaneous tissue. A shorter needle may place the vaccination into subcutaneous tissue. Giving the Tylenol after the injection can be advised, but the dose before the injection is more effective.
An adolescent is seen in the health care clinic with complaints of chronic fatigue. On physical examination, the nurse notes that the adolescent has swollen lymph nodes. A laboratory test is performed, and the results indicate the presence of Epstein-Barr virus (mononucleosis). The nurse calls the mother of the adolescent to inform the mother of the test results and reinforces instructions regarding the care of the adolescent. Which statement by the mother indicates an understanding of the care measures? 1."I need to keep my child on bed rest for 3 weeks." 2."I will call the primary health care provider if my child is still feeling tired in 1 week." 3."I need to isolate my child so that the respiratory infection is not spread to others." 4."I need to call the primary health care provider if my child complains of abdominal pain or left shoulder pain."
4."I need to call the primary health care provider if my child complains of abdominal pain or left shoulder pain." The mother needs to be instructed to notify the primary health care provider if abdominal pain, especially in the left upper quadrant, or left shoulder pain occurs because this may indicate splenic rupture. Children with enlarged spleens are also instructed to avoid contact sports until splenomegaly resolves. Bed rest is not necessary, and children usually self-limit their activity. No isolation precautions are required, although transmission can occur via saliva, close intimate contact, or contact with infected blood. The child may still feel tired in 1 week as a result of the virus.
The nurse reinforces instructions to the mother of a child diagnosed with pediculosis (head lice). Permethrin has been prescribed. Which statement by the mother regarding the use of the medication indicates a need for further teaching? 1."I need to purchase the medication from the pharmacy." 2."After rinsing out the medication, I need to avoid washing my child's hair for 24 hours." 3."I need to shampoo my child's hair, apply the medication, and leave the medication on for 24 hours." 4."I need to shampoo my child's hair, apply the medication, leave it on for 10 minutes, and then rinse it out."
4."I need to shampoo my child's hair, apply the medication, leave it on for 10 minutes, and then rinse it out." Permethrin is an over-the-counter antilice product that kills both lice and eggs with one application and has residual activity for 10 days. It is applied to the hair after shampooing and left for 10 minutes before rinsing out. The hair should not be shampooed for 24 hours after the rinsing treatment.
The nurse reviews measures to prevent tick bites with a parent of a child with Rocky Mountain spotted fever. Which statement by the parent indicates a need for further teaching? 1."I will have my child wear long sleeves and long pants to keep covered up." 2."I will have my child stay on well-worn paths and not stray into tall grass." 3."I will check my child for ticks after being exposed to a high-risk tick-infected area." 4."I will have my child wear dark colored clothing so the tick will not be attracted to the colors."
4."I will have my child wear dark colored clothing so the tick will not be attracted to the colors." Protection from tick bites includes wearing light colored clothing to make the ticks more visible if they get on the child. Prevention of Rocky Mountain spotted fever includes measures to take to protect getting tick bites and includes wearing long-sleeved shirts, long pants tucked into socks, and a hat. Checking for ticks on children after they have been exposed to a high-risk area and using insect repellents containing diethyltoluamide and permethrins are also measures to take.
The nurse is reviewing instructions to a parent of a 6-year-old on how to prevent influenza. Which statement by the parent indicates a need for further teaching? 1."I will get a flu shot and I will have my child get a flu shot too." 2."I will avoid having my child come into contact with sick children." 3."I will have my child wash her hands frequently during the flu season." 4."I will not let my child play with other children who have the flu unless they are taking acetaminophen.
4."I will not let my child play with other children who have the flu unless they are taking acetaminophen. Children who have influenza should be kept home and away from other children until they are fever-free without the use of antipyretics. Influenza may be prevented with the annual vaccine, by avoiding other children who are sick, and with frequent hand washing
A mother brings her child to the clinic because the child has developed a rash on the trunk and scalp. The child is diagnosed with varicella. What will the nurse tell the mother about the infectious period? 1."The infectious period is unknown." 2."The infectious period ranges from 2 weeks or less up to several months." 3."The infectious period is 10 days before the onset of symptoms to 15 days after the rash appears." 4."The infectious period is 1 to 2 days before the onset of the rash to 5 days after the onset of lesions and the crusting of lesions."
4."The infectious period is 1 to 2 days before the onset of the rash to 5 days after the onset of lesions and the crusting of lesions." Varicella is known as chickenpox. The infectious period for varicella is 1 to 2 days before the onset of the rash to 5 days after the onset of lesions and the crusting of lesions. In roseola, the infectious period is unknown. Option 2 describes diphtheria. Option 3 describes rubella.
The school nurse notes that the child has a rash and suspects that it is caused by erythema infectiosum (fifth disease). The nurse bases this determination on the observation that the rash results in which appearance? 1.Rose-pink maculopapules 2.Pruritic macule-to-papules 3.Pinkish red maculopapules 4.A "slapped-face" appearance
4.A "slapped-face" appearance The classic rash of erythema infectiosum, or fifth disease, is the erythema on the face. The discrete rose-pink maculopapular rash is the rash of exanthema subitum (roseola). The highly pruritic profuse macule-to-papule rash is the rash of varicella (chickenpox). The discrete pinkish red maculopapular rash is the rash of rubella (German measles)
A mother brings her 4-month-old infant to the well-baby clinic for immunizations. Which immunizations should be administered to this infant? 1.Diphtheria, tetanus, acellular pertussis (DTaP), Measles, mumps, rubella (MMR), inactivated poliovirus vaccine (IPV) 2.Varicella and hepatitis B vaccines 3.MMR, Hib, DTaP 4.DTaP, Hib, IPV, pneumococcal vaccine (PCV)
4.DTaP, Hib, IPV, pneumococcal vaccine (PCV) DTaP, Hib, IPV, and PCV are administered at 4 months of age. DTaP is administered at 2 months, 4 months, 6 months, between 12 and 18 months, and between 4 and 6 years of age. Hib is administered at 2 months, 4 months, 6 months, and between 12 and 15 months of age. IPV is administered at 2 months, 4 months, 6 months, and between 4 and 6 years of age. The first dose of MMR is administered between 12 and 15 months of age; the second dose is administered at 4 to 6 years of age (if the second dose was not given by 4 to 6 years of age, it should be given at the next visit). The first dose of hepatitis B vaccine is administered between birth and 2 months, the second dose is administered between 1 and 4 months, and the third dose is administered between 6 and 18 months of age. Varicella zoster vaccine is administered between 12 and 18 months of age. PCV is administered at 2, 4, and 6 months of age and between 12 and 15 months of age.
The nurse provides instructions to the mother of a child with impetigo regarding the application of antibiotic ointment. The mother asks the nurse when the child can return to school. Which response by the nurse is appropriate? 1.Ten days after using the antibiotic ointment 2.One week after using the antibiotic ointment 3.As soon as the antibiotic ointment is started 4.Forty-eight hours after using the antibiotic ointment
4.Forty-eight hours after using the antibiotic ointment The child should not attend school for 24 to 48 hours after the initiation of systemic antibiotics or for 48 hours after the use of the antibiotic ointment. The school should be notified of the diagnosis. Therefore, the remaining options are incorrect.
A child is diagnosed with infectious mononucleosis. The nurse reinforces homecare instructions to the parents about the care of the child. Which instruction should the nurse provide to the parents? 1.Maintain the child on bed rest for 2 weeks. 2.Maintain respiratory precautions for 1 week. 3.Notify the pediatrician if the child develops a fever. 4.Notify the pediatrician if the child develops abdominal or left shoulder pain.
4.Notify the pediatrician if the child develops abdominal or left shoulder pain. The parents need to be instructed to notify the pediatrician if abdominal pain (especially in the left upper quadrant) or left shoulder pain occurs, because this may indicate splenic rupture. Children with enlarged spleens are also instructed to avoid contact sports until the splenomegaly resolves. Bed rest is not necessary and children usually self-limit their activity. Respiratory precautions are not required, although transmission can occur via direct intimate contact or contact with infected blood. Fever is treated with acetaminophen
A preschool child who was admitted to the hospital for a minor surgery develops a rash on the second day after hospitalization and is diagnosed with chicken pox (varicella). The nurse should take which action to provide safety for all children on the unit? 1.Place only the infected child in isolation. 2.Keep siblings from visiting the infected child. 3.Place the child and any other children who were exposed in isolation. 4.Place the infected child and any immunocompromised children in isolation.
4.Place the infected child and any immunocompromised children in isolation. The period of communicability for chicken pox is 1 day before the eruption of vesicles to about 1 week when crusts are formed. The infected child should be isolated until vesicles have dried, and other high-risk children (immunocompromised) should be isolated from the infected client.
The mother of a toddler with mumps asks the nurse what she needs to watch for in her child with this disease. The nurse bases the response on the understanding that mumps is which type of communicable disease? 1.Skin rash caused by a virus 2.Skin rash caused by a bacteria 3.Respiratory disease caused by virus involving the lymph nodes 4.Respiratory disease caused by a virus involving the parotid gland
4.Respiratory disease caused by a virus involving the parotid gland Mumps is caused by a paramyxovirus that causes swelling from the parotid gland, causing jaw and ear pain. It is transmitted via direct contact or droplets spread from an infected person, salive from infected saliva, and possibly by contact with urine. Airborne and contact precautions are indicated during the period of communicability. Options 1, 2, and 3 are incorrect.
The nurse is reinforcing instructions to the mother of a preschool child who was recently diagnosed with pediculosis capitis (head lice). Which item should be included in discussions to prevent a reinfestation? 1.Spray the home's furniture and beds with insecticide. 2.Shave the child's hair if pediculicide and nit-removal combs prove ineffective. 3.Machine wash all of the child's clothing, towels, and bed linens, and place in a warm dryer for at least 20 minutes. 4.Seal nonwashable items in a plastic bag for 2 to 3 weeks in a warm place if they cannot be vacuumed or dry cleaned.
4.Seal nonwashable items in a plastic bag for 2 to 3 weeks in a warm place if they cannot be vacuumed or dry cleaned. The adult louse can survive up to 48 hours away from a host, although nits can hatch in 7 to 10 days if they are shed into the environment. Thus, 2 weeks represents a safe interval of time that prevents reinfestation from occurring. Hot water and hot air should be used in the washer and dryer. Shaving the hair is unnecessary with proper treatment and would have an adverse psychological effect on the child. Insecticides can endanger children and animals and should not be sprayed on furniture and beds.
A child is brought to a clinic after developing a rash on the trunk and on the scalp. The parents report that the child has had a low-grade fever, has not felt like eating, and has been generally tired. The child is diagnosed with chickenpox. Which statement by the nurse is accurate regarding chickenpox? 1.The communicable period is unknown. 2.The communicable period ranges from 2 weeks or less up to several months. 3.The communicable period is 10 days before the onset of symptoms to 15 days after the rash appears. 4.The communicable period is 1 to 2 days before the onset of the rash to 6 days after the onset and crusting of lesions.
4.The communicable period is 1 to 2 days before the onset of the rash to 6 days after the onset and crusting of lesions. The communicable period for chickenpox is 1 to 2 days before the onset of the rash to 6 days after the onset and crusting of lesions. In roseola the communicable period is unknown. Option 2 describes diphtheria. Option 3 describes rubella.