Pediatric Dermatological Diseases

57. Katie is caring for a pediatric patient with extensive burns due to a house fire. She anticipates that pain medication will be administered via which route? 1. Oral 2. Intravenous 3. Intramuscular 4. Subcutaneous

ANS: 2 Feedback 1. Decreased perfusion occurs to the GI tract to break down the medication due to the extensive burns. 2. Can be absorbed in the blood stream 3. Medication cannot be absorbed due to the injury. 4. Medication cannot be absorbed due to the injury.

59. A child has burns on the face and hands. These are classified as: 1. Partial burns. 2. Major burns. 3. Minor burns. 4. First degree burns.

ANS: 2 Feedback 1. The face and hands are considered major areas for burns because of the surface area. 2. The face and hands are considered major areas for burns because of the surface area. 3. The face and hands are considered major areas for burns because of the surface area. 4. The face and hands are considered major areas for burns because of the surface area.

10. The key to successful treatment of eczema is hydration of the skin. Examples of emollients are: 1. Eucerin. 2. Desitin. 3. Petroleum jelly. 4. Choices 1 and 3

ANS: 4 Feedback 1. Eucerin and petroleum jelly are emollients. 2. Desitin is a barrier cream. 3. Eucerin and petroleum jelly are emollients. 4. Eucerin and petroleum jelly are emollients. Desitin is a barrier cream.

The clinical nursing instructor gives a lecture regarding maintenance of skin integrity while caring for a hospitalized child. Later, one of the nursing students is caring for a hospitalized child. Which action by the nursing student demonstrates that the teaching was effective? 1. Changes the location of the pulse oximeter every 2 hours 2. Trims the infant's fingernails and toenails 3. Scrubs the infant vigorously with every diaper change 4. Holds the infant in a rocking chair for an hour

ANS 1 1 This is correct. Newborns and infants have skin issues because their skin is thinner and weaker; therefore, skin probes must be carefully monitored for skin breakdown, and changing the site is recommended every 2 to 6 hours. 2 This is incorrect. Trimming of infants' fingernails is not recommended. 3 This is incorrect. Scrubbing the infant's skin is not advised. It can contribute to irritation and skin breakdown. 4 This is incorrect. Although it is helpful to change an infant's position to prevent skin breakdown, holding an infant for 1 hour will not prevent pressure from the pulse oximeter, which can cause injury to the thin skin.

Parents of a toddler with eczema are concerned about alleviating discomfort from itching and preventing infection, since constant scratching has been an issue. They ask the nurse what measures they can take to care for their child. The nurse creates a teaching sheet to provide information regarding the care of a patient with eczema. Which concept should the nurse include on the teaching? 1. Maintain hydration of the skin. 2. Bathe frequently with warm to hot water using mild soaps. 3. Apply cool, wet compresses four times daily. 4. Avoid use of fabric softeners.

ANS 1 1 This is correct. The key to successful treatment is hydration of the skin. 2 This is incorrect. Someone with eczema should limit bathing to every other day. The water should be warm, not hot, and a mild soap should be used. 3 This is incorrect. Cool, wet compresses applied four times daily is the appropriate care for contact dermatitis, not eczema. 4 This is incorrect. Fabric softeners do not have to be eliminated completely. However, any fabric softeners used should be mild and fragrance free.

The nurse is preparing a home-care plan for a child whose leg wound cultured positive for MRSA. Which information should the nurse include? Select all that apply. 1. Do not share towels or any personal care items. 2. Wash hands with soap, rubbing for 30 seconds before rinsing. 3. Line dry clothes after washing. 4. Disinfect surfaces with bleach effective for MRSA. 5. Leave the wound open to air.

ANS 1,2,4 1. This is correct. Towel and personal care items can be contaminated and spread MRSA to other family members. 2. This is correct. Careful hand hygiene is essential to prevent infection. 3. This is incorrect. Use of a clothes dryer is recommended. The high temperature is more effective to eliminate MRSA contamination. 4. This is correct. Surfaces need to be disinfected with bleach. Labels should be checked for effectiveness against MRSA and should include an Environmental Protection Agency (EPA) registration number. 5. This is incorrect. Wounds, boils, and any draining sores should be covered.

19. A high school freshman visits the school nurse to ask how she can get rid of the warts on her hands. She is embarrassed what her friends will think if they notice them, and she fears spreading them to others. Which of the following should the nurse include in the plan of care? Select all that apply. 1. Plantar or palmar warts are caused by human papillomavirus (HPV). 2. Hand hygiene should be performed after touching warts. 3. Old warts can be picked or scraped off as they become dry. 4. Cryosurgery is an option once she reaches age 18. 5. A patch with salicylic acid (Duofilm) is helpful to dissolve warts.

ANS 1,2,5 1. This is correct. Plantar warts on the soles of the feet or the palms of the hands are due to HPV-1. 2. This is correct. Warts may be mildly contagious. Hand hygiene is critical. 3. This is incorrect. The patient should be advised to avoid scratching or picking at warts. This may lead to a secondary bacterial infection and scarring. 4. This is incorrect. Cryosurgery may be required for warts that are resistant to other therapy. This treatment is an option for adolescents. 5. This is correct. Salicylic acid in the form of liquid, gel, or a patch (Duofilm) may be effective in removing warts.

The nurse educator of a burn unit is developing a counseling module for an adolescent who was burned in a house fire. Which of the following should be included in the discharge counseling for the adolescent and the adolescent's parents? Select all that apply. 1. Feelings of anxiety, guilt, and depression may be experienced. 2. Post-traumatic stress declines over the first 2 to 3 months. 3. Post-traumatic stress is often at its worse immediately after the incident. 4. There may be a lack of support groups in which to participate. 5. Patients may have body image disturbance 2 years after the injury.

ANS 1,3,5 1. This is correct. Children and families who have suffered from burn injuries may experience anxiety, guilt, depression, and post-traumatic stress disorder (PTSD). 2. This is incorrect. Improved pain management and support of the family and child decreases symptoms and likelihood of long-term PTSD. However, patients often have psychological stress 2 years after a burn injury. 3. This is correct. Most patients will show symptoms of PTSD, especially early after the initial injury. 4. This is incorrect. It is important for nurses to offer emotional support to children and their families following burn injuries and to refer both children and families to therapy or to support groups as part of their discharge planning. 5. This is correct. Patients often have psychological stress and body image disturbances 2 years after a burn injury.

A 5-year-old child is brought to the urgent care center for treatment of a bite. The nurse asks what happened, and the parent explains that the child disturbed their pet cat while it was sleeping. The cat was started and bit the child. Which intervention should the nurse perform first? 1. Question the mother about the cat's rabies vaccination status. 2. Wash the wound with large amounts of sterile saline under pressure. 3. Apply a butterfly adhesive dressing. 4. Determine when the child last received a tetanus immunization.

ANS 2 1 This is incorrect. Although it is important to ask about rabies vaccinations, this is not the first action. 2 This is correct. The nurse should give immediate wound care. Wounds may be irrigated under pressure with large amounts of sterile saline. 3 This is incorrect. Tissue adhesive dressings are not used for closing bite wounds because of reduced drainage and increased chance of infection. 4 This is incorrect. The nurse should check the child's immunization record to determine whether tetanus immunizations are up to date, but this is not the first action.

An adolescent is brought to the health-care provider's office for evaluation of an arm lesion that is swollen, red, and warm. There is also a fluid weeping from the wound. The nurse should anticipate which test will most likely be ordered? 1. X-ray of the extremity 2. Culture and sensitivity of the fluid 3. Comprehensive metabolic panel (CMP) 4. Skin biopsy

ANS 2 1 This is incorrect. An x-ray would be appropriate if there was a need to noninvasively see below the skin's surface. For example, it allows visualization of bones, tumors, and foreign bodies. It would not be of diagnostic value in this scenario. 2 This is correct. Diagnostic testing of a skin lesion includes culture and sensitivity tests on any drainage present, which would identify the organism causing the symptoms of cellulitis. 3 This is incorrect. A CMP is used to assess a person's metabolism and chemical balance. It would not be useful in this scenario. 4 This is incorrect. A skin biopsy provides information about the cellular growth of skin cells. It is not typically the first step.

An 86-month-old child is brought to the well-baby clinic for her immunizations. The nurse observes that the child's extremities are bright red, with a few blisters. The nurse questions the mother about the extent of sun exposure and determines that the child has a second-degree sunburn. After administering the immunization, the nurse provides education about sunburn prevention to the infant's mother. Which statement by the mother indicates that she needs more teaching? 1. "I make sure to avoid the midday sun." 2. "I apply sunscreen right after we get to the pool." 3. "At the pool, we do not sit close to the water." 4. "I will try to buy clothes that have SPF protection."

ANS 2 1 This is incorrect. No further teaching is needed. Infants older than 6 months and older children should not be exposed to direct sunlight between 10 a.m. and 4 p.m. 2 This is correct. Sunscreen should be applied 30 minutes before going out in the sun. This statement demonstrates that the mother needs more teaching. 3 This is incorrect. No further teaching is needed. Sunlight reflecting off of water can damage the skin. 4 This is incorrect. No further teaching is needed. Buying clothing with SPF protection can help prevent overexposure to damaging rays.

A 7-year-old with a myelomeningocele is paralyzed from the waist to her feet. She is either in bed or in a chair day and night. A physical evaluation is performed regularly to check skin integrity. While conducting a skin assessment, the nurse finds a partial-thickness skin loss with exposed dermis on the sacrum. How does the nurse classify this pressure ulcer on the assessment form? 1. First-degree pressure ulcer 2. Second-degree pressure ulcer 3. Deep tissue pressure ulcer 4. Unstageable ulcer

ANS 2 1 This is incorrect. Stage 1 is seen as nonblanchable erythema of intact skin. 2 This is correct. Stage 2 is manifested by a partial-thickness skin loss with exposed dermis. 3 This is incorrect. Deep tissue injury is manifested as a persistent nonblanchable deep red, maroon, or purple discoloration. 4 This is incorrect. Unstageable is obscured by full-thickness skin and tissue loss.

A junior high school student is cooking in the home economics room when some oil splashes on her fingers and hand. She immediately rinses her hand with cool tap water. The skin is not broken, but soon, a blister begins to form. The teacher sends the student to the school nurse for evaluation and treatment. Which nursing intervention is most appropriate? 1. Apply ice to the burned area for 20 minutes. 2. Soak the burn in cool water and apply aloe vera cream. 3. Puncture the blister with a sterile needle. 4. Apply baby oil and wrap with a sterile dressing.

ANS 2 1 This is incorrect. The application of ice could cause additional injury. 2 This is correct. Soaking in cool water and applying aloe vera cream is the appropriate first aid for superficial burns. Do not use butter, oils, or ice on the burn. These may cause additional injury. 3 This is incorrect. Blisters should not be broken purposely. The intact blister forms a barrier against infection. With partial-thickness burns with blistering, the patient may soak the burn in cool water but should not break the blisters. 4 This is incorrect. Applying oil to a burn will cause additional injury by trapping in the heat.

The nurse is providing care for an 8-year-old child who was treated for a cat bite. Before discharging the child home, the nurse plans a play session, with the parents included, that focuses on safety around animals and pets in the home. What points would the nurse present during the session? Select all that apply. 1. Avoidance of animals while the wound is healing 2. Importance of not disturbing animals while they are sleeping or eating 3. Diseases that pets can transmit to humans, such as tetanus 4. Supervision of young children and pets 5. Stopping antibiotics when the redness and swelling go down

ANS 2,3,4 1. This is incorrect. The child can interact with animals while healing. The nurse should, however, teach caregivers to watch for signs of cellulitis or localized infection: erythema, warmth, red streaking, edema, purulent drainage, fever, increased pain. 2. This is correct. Children should be taught to treat pets with respect and kindness. 3. This is correct. The nurse should explain that some diseases can be transmitted from animals to humans. The nurse should also explain the importance of keeping tetanus immunizations up to date and keep rabies vaccinations up to date for pets. 4. This is correct. Young children should not be left alone with a pet. 5. This is incorrect. The entire course of oral antibiotics should be completed.

The school nurse is educating preschool parents about the management of lice infestation, which has currently become a problem among the students. Which recommendations should the nurse include in the caregiver education? Select all that apply. 1. Use a pediculicide shampoo every day and let the hair air dry. 2. Use a fine-toothed comb to remove nits from wet hair. 3. Apply mayonnaise to the hair and cover with a plastic cap. 4. Wash clothing and bedding in hot soapy water and dry on hot cycle. 5. Wash hair with a regular shampoo daily and blow dry with a cool setting.

ANS 2,3,4 1. This is incorrect. The nurse should assess for history of asthma or allergies before recommending pediculicide shampoos. Nix (permethrin or pyrethrin) is contraindicated for children with ragweed allergies. These products may cause an allergic reaction or an exacerbation of asthma. If use is safe for the individual, it is only used every 7 to 10 days. 2. This is correct. A fine-toothed comb can help remove nits from the hair. 3. This is correct. Application of mayonnaise, olive oil, or petroleum jelly has been recommended to suffocate the lice. Parents are instructed to cover the child's hair with the oil-based product, cover with a shower cap overnight, and shampoo the next morning. 4. This is correct. Washing clothing and bedding in hot soapy water and drying on a hot cycle is recommended. Hot air with the removal of existing nits additionally has shown some promise in studies. 5. This is incorrect. Regular shampoo will not kill the insects. A cool blow dryer will not affect them either. Lice are killed by a pesticide and heat.

During an outside gym class, a high school student was stung on the lip by a bee. After determining that the student was not allergic to bee stings, which treatment should the school nurse recommend to soothe the sting? Select all that apply. 1. Apply vinegar and oil drops to the site of the sting. 2. Create a paste of baking soda and water and apply to the lip. 3. Wash the lip with cool water and apply ice to the sting. 4. Take an over-the-counter antihistamine. 5. Apply a hot pack to the lip.

ANS 2,3,4 1. This is incorrect. Vinegar and oil will not draw out the sting. 2. This is correct. A baking soda paste made by mixing baking soda with cold water may be soothing to a sting site. This is considered a complementary and alternative therapy. 3. This is correct. The immediate care of a sting is to wash the site of the sting. To reduce pain and swelling, the patient can apply ice to the sting. 4. This is correct. The child can be given an over-the-counter oral antihistamine such as Benadryl. 5. This is incorrect. A hot pack is contraindicated. It will not relieve pain and swelling.

A 6-month-old infant presents to the clinic with a diaper rash. The nurse observes a well-demarcated rash and satellite lesions on buttocks and legs. Based on the assessment, which treatment will the nurse recommend? 1. An antiviral medication 2. Baby powder application at each diaper change 3. An ointment containing nystatin (Mycostatin) 4. A hydrocortisone ointment

ANS 3 1 This is incorrect. The rash is not viral. Viral infections are not well demarcated but rather present as a fine rash. 2 This is incorrect. Baby powder is not recommended due to possible respiratory inhalation. It would not be used to treat this rash. 3 This is correct. Mycostatin is the treatment of choice for a Candida infection. Infection with Candida albicans, a yeastlike fungus, results in candidiasis of the diaper area. Erythematous areas are well demarcated, and satellite lesions may be noted on the buttocks, legs, and abdomen. 4 This is incorrect. Hydrocortisone may be ordered for atopic rashes, but this rash is consistent with a Candida infections.

An eighth-grade student appears in the school infirmary with a skin manifestation that itches. He states that it began on the way to school after he took a shortcut through a field. The nurse performs a skin assessment and finds areas of erythema with streaks and patches on both legs. She determines that he is exhibiting signs of contact dermatitis. What is the first action that the nurse should take? 1. Alert the child's parents. 2. Apply cool, wet compresses. 3. Wash the area thoroughly with soap and water. 4. Contact medical help by notifying the child's health-care provider.

ANS 3 1 This is incorrect. This is not the priority action. 2 This is incorrect. Although this is a valid treatment, it is not the first action. 3 This is correct. Washing the exposed area with soap and water should be done immediately to remove the resin oils that are causing the irritation. 4 This is incorrect. Medical help is necessary only if the rash is extensive or involves the face.

A teenager suffered second-degree burns of the face and hands while at a campfire that burned out of control. Emergency treatment is provided, and the patient is then admitted to a burn treatment center. Which nursing action should the nurse perform first? 1. Place a nasogastric tube for feeding. 2. Monitor intake and output. 3. Check wound for infection. 4. Maintain adequate airway and oxygen supply.

ANS 4 1 This is incorrect. A feeding tube may be ordered if the child cannot be fed orally or cannot maintain increased caloric requirement due to change in metabolic state. However, there is nothing in this scenario to suggest that the patient is unable to eat. 2 This is incorrect. Although monitoring intake and output is an important part of care, it is not the first nursing action. 3 This is incorrect. This is an ongoing assessment but is not the first nursing action. 4 This is correct. The nurse should assess for signs of respiratory distress: dyspnea, wheezing, stridor, tachypnea, decreased breath sounds, retractions. A pulse oximeter is used to monitor oxygen saturation levels. The nurse should administer oxygen or assist with endotracheal intubation as needed and keep the head of bed elevated.

A teenager is being cared for in the emergency department after being trapped in a garage fire at her home. Partial-thickness burns are present on the side of the face, as well as on both arms. Which nursing action is the highest priority? 1. Apply cool compresses to the burns. 2. Remove all clothing from the patient. 3. Give pain medication as ordered. 4. Give 100% humidified oxygen.

ANS 4 1 This is incorrect. Applying cool, sterile, normal saline compresses to cool and protect the skin is done after airway, breathing (oxygen), and circulation is established. 2 This is incorrect. Although it is important to remove clothing that is burned, hot in temperature, or contaminated with chemicals, this is not the highest priority. 3 This is incorrect. Although pain medication should be administered as needed, this is not the priority action. 4 This is correct. The priority action is establishing airway, breathing (oxygen), and circulation. The nurse should give 100% oxygen if the individual has been burned severely or if the fire was in a confined space. A pulse oximeter is used to monitor oxygen saturation levels.

A 15-month-old toddler has a strange rash on his nose and mouth. It contains papules and vesicles and has a honeylike, glazed look. The toddler has a history of eczema, but the nurse differentiates the features of the presenting rash and explains that he has developed a secondary infection. What is the treatment of choice for this type of dermatological disease? 1. Bath the skin daily with hydrogen peroxide. 2. Apply Caladryl lotion to dry the lesions. 3. Use an antiviral lotion as ordered for 7 to 10 days. 4. Administer topical antibiotics as ordered until the skin is clear.

ANS 4 1 This is incorrect. Bathing with hydrogen peroxide is not recommended. 2 This is incorrect. Caladryl is used to relieve the pruritus of contact dermatitis such as poison ivy. 3 This is incorrect. The superimposed infection is not viral. 4 This is correct. A topical antibiotic is the treatment of choice for impetigo. In severe cases, an oral antibiotic will be given in addition to the ointment. Staphylococcus aureus or group A beta-hemolytic streptococcus are causative factors for impetigo.

A 15-year-old male is very distressed about the skin problems on his face, neck, and back. He has whiteheads on his face and some blackheads. The nurse educates him about acne and designs a plan of care to use to treat and prevent skin eruptions. Which statement should the nurse include when teaching about skin care? 1. Chocolate should be eliminated from the diet. 2. It is important to use oil-based lotions. 3. Squeezing whiteheads should be done only after a thorough cleansing. 4. Keep hair clean and off the face.

ANS 4 1 This is incorrect. Changes to the diet will not affect acne. 2 This is incorrect. Successful management of acne includes washing the skin with a gentle cleanser and avoiding oil-based lotions, creams, or makeup. 3 This is incorrect. Whiteheads (closed comedones) should never be squeezed. Squeezing them can cause inflammation, infection, and scarring. 4 This is correct. Hair should be kept clean and off the face.

A school nurse is examining a third-grade student complaining of a small lump on her head. After parting the hair, it is evident that a tick has embedded into the scalp. Which nursing intervention should the school nurse take? 1. Apply mineral oil to the site of attachment and wait for the tick to back out. 2. Squeeze the tick and pull it off with bare fingers. 3. Spray DEET directly on to the child's skin where the tick is embedded. 4. Use tweezers or forceps to remove the tick, pulling up with steady pressure.

ANS 4 1 This is incorrect. This procedure it not recommended. There is no evidence that this will prevent injury from the exposure to disease organisms. 2 This is incorrect. Squeezing is not recommended because the tick may not be removed intact. Also, tick feces can contain disease organisms. 3 This is incorrect. DEET should never be sprayed directly on the child's skin. 4 This is correct. The tick should be removed with tweezers. A steady pressure should be applied while pulling upward.

A nursing student is taking care of a 2-year-old girl and notices her oxygen saturation has decreased. The patient has stridor when breathing and her hairline appears singed. The nurse should anticipate: 1. Possible intubation because of the airway being compromised. 2. This is normal for a patient after 36 hours. 3. To reposition the patient for better airway clearance. 4. This is furthering infection and may require antibiotics.

ANS: 1 Feedback 1. A possible inhalation injury has occurred due to the oxygen saturations, stridor, and hairline being singed. This may not manifest until between the 24 to 48 hours after the initial injury. 2. This is not normal, and a doctor should be notified. 3. Repositioning may help with initially increasing oxygen saturations, but due to the stridor, the saturation level will not remain stable. 4. Infection could be developing, but this is not the priority at this point.

Chloe, a 13-year-old girl, has herpes simplex 1 on her lip. She asks the school nurse if the virus is contagious. The best answer from the school nurse is: 1. Yes, it is contagious for at least one week. 2. No, the virus is dormant in your body and is not contagious. 3. Yes, but it is past the incubation period once you see it on your skin, so it is no longer contagious. 4. No, the virus occurs because of poor hygiene.

ANS: 1 Feedback 1. Herpes simplex 1 is contagious for at least one week after the outbreak occurs. 2. The virus may be dormant, but it is contagious. 3. It remains contagious after eruption. 4. The virus is not linked to poor hygiene.

18. A 10-year-old child presents to the ER with a large circular rash on the leg, along with a fever, headache, and achiness. What is your assessment? 1. Lyme disease 2. Eczema 3. MRSA infection 4. Spider bite

ANS: 1 Feedback 1. Lyme disease has a characteristic rash that is circular, along with a fever, headache, and aching present. 2. Several dry areas would be present. 3. Oozing from the wound and fever would be present. 4. A streak of several small bites would be noted for a spider bite.

12. Home care education for children with eczema includes: 1. Applying moisturizers 2 to 3 times a day. 2. Wearing wool and cotton clothing. 3. Keeping the environment warm and humidified. 4. None of the above

ANS: 1 Feedback 1. Moisturizing 2 to 3 times a day is correct. 2. Wool may irritate the area. 3. This may cause the body may sweat more and cause more breakouts. 4. One answer is correct

Pain management is required for children throughout the healing process with burns. In the emergent phase, the child may require medication during the debridement and dressing changes. What type of pain management would be appropriate at this time? 1. Opiates 2. Narcotics 3. Acetaminophen 4. Ibuprofen

ANS: 1 Feedback 1. Opiates prior to the debridement process will aid in pain management. 2. Narcotics are not recommended for children because of the side effects. 3. Acetaminophen will not be enough for pain management during this process. 4. Ibuprofen will not be enough for pain management during this process

48. A child with who has __________ should not use pediculicide shampoos. 1. Asthma 2. Cystic fibrosis 3. Latex allergies 3. Neurological disorders

ANS: 1 Feedback 1. Pediculicide shampoos can cause an asthma exacerbation. 2. Pediculicide shampoos do not affect children with cystic fibrosis. 3. Pediculicide shampoos are not linked to latex allergies. 4. A child with neurological disorders can use pediculicide shampoos.

50. A camp nurse has been notified that one of the campers, who has an allergy to bee stings, has been stung. The nurse gets to the child and begins her assessment. The child is noted to have stridor and has broken out in hives over her entire body. The nurse knows that this is a medical emergency and has brought the childs medication with her to the site. What is the anticipated medication the nurse should administer at this time? 1. EpiPen 2. Benadryl 3. Tylenol 4. An antihistamine

ANS: 1 Feedback 1. The EpiPen will help decrease the respiratory tract swelling because this is an anaphylactic episode. 2. Benadryl can be used, but in this case, the child is in respiratory danger and needs a fast-acting medication. 3. Tylenol is not used in this anaphylactic event. 4. An antihistamine can be used, but it works too slowly for this situation due to the respiratory involvement.

The most common areas for infantile eczema to appear are the: 1. Face, hands, and scalp. 2. Face, feet, and abdomen. 3. Extremities only. 4. Abdomen only.

ANS: 1 Feedback 1. The face, hands, and scalp are the most common areas for infantile eczema.

49. A common area for scabies to occur on children under the age of 2 is/are the: 1. Head and neck. 2. Extremities. 3. Abdomen. 4. Buttocks.

ANS: 1 Feedback 1. This is the most common area for scabies in young children. 2. Scabies usually does not occur on the extremities. 3. Scabies usually does not occur on the abdomen in young children. 4. Scabies usually does not occur on the buttocks of young children.

When treating chemical burns, the initial treatment should include: 1. Washing the area with large amounts of water. 2. Soaking the body part in cool water. 3. Using ice on the burn. 4. Applying antibiotic cream.

ANS: 1 Feedback 1. You need to rinse as much of the chemical off as possible as soon as possible. 2. Soak for partial thickness burns with blistering, not for chemical burns. 3. Applying ice can cause additional injuries. 4. This can be done after the injury has been treated.

Keshia, a 10-year-old girl, was removed from a burning apartment complex and brought to the ER via the ambulance. The EMTs have reported that Keshia is struggling to breathe. The nurse knows that: (Select all that apply.) 1. There could be an inhalation injury due to the smoke. 2. She will need to be monitored on the pulse oximeter. 3. The child will need emotional support while in the ER. 4. The child should be placed on a cardiac monitor. 5. The parents should not be allowed in the room until the child is stable.

ANS: 1, 2, 3, 4 Feedback 1. Breathing struggles indicate inhalation injuries in this situation. 2. Monitoring the pulse oximeter will give aid in knowing if the patient needs oxygen support. 3. The child may need emotional assistance because of the situation. 4. The child should be placed on a cardiac monitor because of the respiratory compromise. 5. The parents should be allowed into the room to help calm the patient.

A 3 month old is in the pediatric clinic for her well-child checkup. The mother states that the childs diaper area is very red and tender with some raised bumps. The doctor diagnoses the child with candida albicans and prescribes hydrocortisone for the area. The nurse is supposed to teach the mother about the signs and symptoms of possible infection and care to the area. The teaching should include all except: 1. Reporting if the sores increase in size. 2. Reporting if the sores decrease in size. 3. Reporting if the sores have purulent drainage 4. The use of a mild soap to cleanse the area at each diaper change.

ANS: 2 Feedback 1. A spread for infection occurs if the area expands. 2. An area decreasing in size indicates healing. 3. Drainage from the site indicates possible infection. 4. This is the proper technique for cleansing the area.

45. The nurse is instructing a 13 year old and her mother on alternative therapies for cold sores. The alternative therapies consist of: 1. Warm compresses to the lips. 2. Mouthwash with 1 teaspoon of sodium bicarbonate in slightly warm water. 3. Using lip gloss to create a barrier so that the drainage decreases. 4. None of the above is an alternative therapy for cold sores.

ANS: 2 Feedback 1. A warm compress may irritate the cold sore. 2. The mixture provides comfort and can dry out the cold sore. 3. The gloss does not decrease the drainage. 4. One answer is correct.

55. The wound nurse has prescribed the use of a hydrocolloid dressing for an abdominal wound that is not healing. The childs primary nurse knows that this type of dressing is effective because: 1. The dressing allows the child to be mobile. 2. The dressing aids in the regeneration of skin and helps the wound heal. 3. The dressing is soothing and reduces pain for the child. 4. The dressing absorbs a large amount of fluid, so the wound will heal.

ANS: 2 Feedback 1. The mobility is not part of the healing for this situation. 2. The regeneration of skin is important for wound healing. 3. The dressing may not help reduce pain. 4. The dressing does not absorb fluid.

58. Myoglobinuria is occurring with a child with extensive partial thickness burns. The nurse knows that this is occurring because: 1. The childs stomach has a large amount of acid and is causing the stomach to bleed. 2. It is a byproduct of the muscle damage due to the extensive burns. 3. The kidneys are failing. 4. The child has consumed a large amount of red oral fluids.

ANS: 2 Feedback 1. The myoglobinuria is related to the muscle, not a stomach bleed. 2. The extensive damage causes the myoglobinuria. 3. The kidneys are working harder at this point, but it is not the cause for myoglobinuria. 4. The child taking in red oral fluids would not be noted at this time.

51. Karen is a camp nurse and is preparing information about Lymes disease to give to the campers. Karen knows that a child could be initially infected without her knowing because: 1. The bite is so small that it is hard to with the human eye. 2. Children do not usually react to a tick bite immediately after it occurs. 3. Signs and symptoms may appear up to 32 days after the initial bite. 4. Mosquito bites and tick bites look similar, so children do not notice.

ANS: 3 Feedback 1. A bite has a distinct target shape, but may take days to develop. 2. Children may not show signs for a long period of time. 3. Signs and symptoms can take 32 days to appear. 4. The bites are not similar.

2. The nurse asks a nursing student if any systemic signs and symptoms were present when assessing a 5-year-old client. Which answer would demonstrate that the nursing student understood? 1. Itchy, red rash 2. Vesicles present 3. Fever and headache 4. Blistering

ANS: 3 Feedback 1. A rash is not a systemic sign. 2. Vesicles are not a systemic sign. 3. Systemic signs and symptoms include fever, headache, decreased responsiveness, and pain. 4. Blistering is not a systemic reaction.

60. The rule of nines contains all of the following except: 1. Head 9 percent. 2. Anterior trunk 18 percent. 3. Posterior trunk 9 percent. 4. Each lower extremity 18 percent

ANS: 3 Feedback 1. Contained in the rule of nines 2. Contained in the rule of nines 3. The posterior and anterior trunk consists of 18% in the rule of nines. 4. Contained in the rule of nines

19. The nursing instructor asks the student nurse to teach the parents tick bite prevention strategies. In evaluating the session, the instructor asks the parents what they have learning about this topic. Which statement would demonstrate what they have learned? 1. I dont know. I am not an outdoor person. 2. Avoid going outside if possible. 3. Use DEET spray on the skin. 4. All of the above

ANS: 3 Feedback 1. Even if not an outdoor person, the parent should have learned the information for his/her child. 2. Preventing a child from going outside is not a feasible task. 3. DEET and Permethrin can be used to prevent tick bites. 4. DEET and Permethrin can be used to prevent tick bites.

30. Seborrheic dermatitis differs from contact dermatitis because: 1. Seborrheic dermatitis is caused by fungus. 2. Seborrheic dermatitis is caused by latex. 3. The general appearance of seborrheic dermatitis is greasy with scales. 4. The general appearance of seborrheic dermatitis is raised bumps with white centers.

ANS: 3 Feedback 1. Seborrheic dermatitis is not caused by fungus. 2. Seborrheic dermatitis is not a reaction to latex. 3. Seborrheic dermatitis usually has scales and is predominately seen on the head of a child. 4. Seborrheic dermatitis is not raised, nor does it have white centers.

26. While doing a skin assessment, the nurse assesses for the color of a child with dark skin. The nurse knows that the best place to assess for pallor is/are the: 1. Chest. 2. Extremities. 3. Inside of cheek. 4. Fingernails.

ANS: 3 Feedback 1. The chest is used to test capillary refill in children, not pallor. 2. Because of the differing temperatures of the extremities, pallor should not be assessed in this area. 3. Appropriate assessment of pallor is done inside the cheek. 4. The fingernail beds can be used to test capillary refill, but are not appropriate to test skin color.

3. The nurse in the PICU is checking for areas of skin breakdown on her 4-year-old patient. The most common areas for skin breakdown in the pediatric client include all of the following except the: 1. Ears. 2. Occiput. 3. Heels. 4. Scapula.

ANS: 3 Feedback 1. The most common areas for pressure ulcers in children are the ears, occiput, sacrum, and scapula because of the pressure points. 2. The most common areas for pressure ulcers in children are the ears, occiput, sacrum, and scapula because of the pressure points. 3. The heels do not have as much pressure placed upon them when the child is in bed. 4. The most common areas for pressure ulcers in children are the ears, occiput, sacrum, and scapula.

56. The clinic nurse has a patient arrive in the triage room with a dog bite that occurred three days ago. Which patient complaint would alert the nurse to the presence of a possible infection? 1. Puncture wounds 2. Blanching and swelling 3. Pain and purulent drainage 4. Bruising to the area

ANS: 3 Feedback 1. The puncture wound can be present, but not indicate infection. 2. Blanching and swelling can be present because of the tissue damage, but they are not a direct link to infection. 3. Pain and drainage indicate infection. 4. Bruising is common and does not indicate infection.

An outbreak of head lice has occurred on the high school softball team. The school nurse has given handouts about therapy to kill the nits. One mother asks what the best way of going through her childs hair would be. The best response from the nurse would be: 1. Wash her hair with pediculicide shampoo and towel dry. This is a one-time treatment. 2. Use a fine-toothed comb to remove the nits when the hair is dry. 3. Make sure to wash all bedding with hot, soapy water and dry on the hot cycle after each night. This reduces the nits in her bedding. 4. Wash her hair and towel dry, then apply the RID and rinse after 10 minutes. Repeat this several times throughout the day.

ANS: 3 Feedback 1. The treatment may need to occur more than one time. 2. Even after removal, the nits may be present on other objects that the teen possesses. 3. Washing everything in hot water will help kill the nits. 4. The RID will help kill the nits, but the parent needs to clean all of the bedding because nits can live on bedding and re-infest the teen.

A mother calls the pediatric triage nurse and states, I dont know what is on her hand. It is red with clear drainage coming out of small bumps. She got into the poison ivy patch yesterday. The nurse instructs the mother to: 1. Apply warm compresses to help reduce the pain. 2. Use a body wash, such as Dove, to help with the itching. 3. Use Calamine lotion to help with the itching. 4. Apply a thin coat of Cetaphil to help with itching.

ANS: 3 Feedback 1. The warm compresses my increase pain and itching. 2. Dove will moisturize the area and not decrease the itching sensation. 3. Calamine lotion will help dry the drainage and decrease the itching. 4. Cetaphil will not decrease the drainage and will not help with the itching.

40. A 9 year old is in the ER. His mother has brought him because of a leg injury. The child has been diagnosed with cellulitis. The nursing plan of care would include all of the following except: 1. Vital signs, including a heart rate, should be taken every 2 to 4 hours to monitor for furthering infection. 2. Assessing perfusion to the extremity. 3. Keeping the leg in a dependent position. 4. Encouraging oral fluids.

ANS: 3 Feedback 1. Vital sign changes can indicate furthering infection 2. Perfusion indicates if the tissue is receiving the adequate nutrition it needs to heal. 3. Keeping the leg in a dependent position allows for blood pooling and does not help the healing process. 4. Oral fluids help the patient stay hydrated during this time.

Identify the correct order for wound healing for a child. __ Saturation phase __ Inflammation phase __ Proliferation phase

ANS: 3, 1, 2

A pediatric intensive care nurse is caring for a boy with superficial partial thickness burns on his lower legs and chest. Which of the following would the nurse expect to note during the emergent phase of the burn injury? (Select all that apply.) 1. A decrease in the baseline heart rate 2. An increase in blood pressure 3. Decreased body temperature 4. An elevated hematocrit 5. Decreased hemoglobin

ANS: 3, 4 Feedback1.The baseline heart rate may be elevated at this time.2.The blood pressure will be decreased because of the fluid loss.3.The body temperature will be low because of the lack of subcutaneous tissue and capillary permeability.4.The hematocrit will be elevated due to the increased capillary permeability and water loss.5.The hemoglobin will be increased due to the increased capillary permeability and water loss.

25. A community health nurse is participating in a health fair. What prevention strategies can the nurse teach to prevent house fires? 1. Have a functional indoor smoke alarm. 2. Keep a fire extinguisher in the home. 3. Educate the children on fire safety. 4. All of the above

ANS: 4 Feedback 1. An adequate prevention strategy 2. An adequate prevention strategy 3. Education should be provided for prevention 4. All of the above are fire prevention strategies.

34. Identify the possible nursing diagnosis for a teenager with severe acne. 1. Knowledge deficit related to hygiene 2. Self-esteem issues related to personal appearance 3. Insufficient nutrition related to skin breakouts 4. All of the above would be appropriate nursing diagnoses for the teenager.

ANS: 4 Feedback 1. Appropriate for the situation, along with others 2. Appropriate for the situation, along with others 3. Appropriate for the situation, along with others 4. All of the diagnoses would be appropriate for the situation.

17. As the camp nurse, you have three campers who are allergic to bee stings. What is the appropriate treatment for these campers if they get stung? 1. Keep Benadryl on hand with counselors. 2. Use baking soda paste for application on the bee sting. 3. Scrape the stinger off if a bee sting occurs. 4. Keep an EpiPen on hand at all times and be able to give IM.

ANS: 4 Feedback 1. Benadryl can be a long-term treatment. 2. The concoction would be appropriate for pain relief, but not for the allergic reaction. 3. Removing the stinger is important, but will not stop an allergic reaction. 4. An EpiPen may be needed if child is known to be allergic to bee stings.

23. A nurse in the PICU is caring for a 7-year-old child with burns on more than 30 percent of the body. Which statement made by the parents indicates an understanding of the severity of the burns? 1. Im glad that he doesnt have any burns on his face. 2. I feel so bad that he got burned. 3. When do you think he will be out of the ICU? 4. Nurse, is he going to make it?

ANS: 4 Feedback 1. Burns to the face can increase the risk of complications, but burns on any part of the body increase the risk for infections. 2. The feeling of guilt is common, but does not demonstrate an understanding of the situation. 3. The parent needs to deal with the severity of the injury and concentrate on the present. 4. The parents are able to verbalize that death may occur because of the extent of the burns.

7. You are examining an infant under your care. While assessing the head, you note greasy and scaly areas on the scalp. What true statements can be said about this condition? 1. Called cradle cap 2. Caused by a yeast organism 3. Called kiddy crud 4. Choice 1 and 2

ANS: 4 Feedback 1. Cradle cap is caused by yeast and looks like greasy, scaly patches on the scalp. 2. Cradle cap is caused by yeast and looks like greasy, scaly patches on the scalp. 3. Kiddy cap does not exist. 4. Cradle cap is caused by yeast and looks like greasy, scaly patches on the scalp.

13. What principles of skin care can you teach your adolescent patient regarding acne? 1. Eliminate chocolate and soda from your diet. 2. Cleanse your face gently on a daily basis. 3. Avoid oil-based cosmetics, creams, and makeup. 4. Choices 2 and 3

ANS: 4 Feedback 1. Dietary changes do not affect acne. 2. Cleansing helps prevent the clogging of pores and promotes good circulation. 3. Oil-based products and makeup clogs pores, increasing the risk for acne. 4. 2 and 3 are correct. Dietary changes do not affect acne.

9. Which of the following is characteristic of eczema? 1. Triggered by food allergies and topical irritants 2. A family history of asthma 3. No family history of asthma 4. Choices 1 and 2

ANS: 4 Feedback 1. Eczema is triggered by food allergies, topical irritants, and is also linked to a family history of asthma. 2. Eczema is triggered by food allergies, topical irritants, and is also linked to a family history of asthma. 3. A family history is usually present with this disease process. 4. Eczema is triggered by food allergies, topical irritants, and is also linked to a family history of asthma.

20. As the nurse at the pediatric call center, you give advice to parents regarding follow-up care of a laceration. The most important signs and symptoms to teach caregivers to look for are: 1. Erythema. 2. Tenderness and swelling. 3. Drainage. 4. All of the above

ANS: 4 Feedback 1. Erythema is a sign of infection. 2. Tenderness and swelling are signs of infection. 3. Drainage is a sign of infection. 4. Erythema, tenderness, swelling, drainage, and fever are all signs of infection.

11. Which of the following statements regarding atopic dermatitis is true? 1. Complementary Foods must have a delayed introduction beyond 4 to 6 months. 2. Fish in the diet before nine months reduces the risk of eczema in infants. 3. Exclusive breastfeeding for four months may delay or prevent eczema. 4. Choices 2 and 3

ANS: 4 Feedback 1. Foods will not influence the atopic dermatitis. 2. Fish in the diet before nine months and exclusive breastfeeding for four months have been shown to be helpful. 3. Fish in the diet before nine months and exclusive breastfeeding for four months have been shown to be helpful. 4. Fish in the diet before nine months and exclusive breastfeeding for four months have been shown to be helpful.

39. A child on the pediatric floor has been diagnosed with MRSA. The nurses discharge teaching should include all of the following except: 1. Good hand hygiene. 2. Completing the entire course of antibiotics. 3. Disinfecting the shower/bathtub and other surfaces. 4. Leaving the wound open so that it airs out twice a day.

ANS: 4 Feedback 1. Hand hygiene helps prevent the spread of MRSA. 2. Antibiotic therapy can help reduce the chance of spreading the disease. 3. Disinfecting the area helps prevent the spread of the MRSA. 4. Leaving the wound open can increase the spread of the bacteria.

A mother and father have come to a baby education class at the local hospital. The nurse is teaching families about the prevention of burns. This teaching would include all the following except: 1. Not holding infants while cooking. 2. Not holding infants while heating bottles. 3. Not placing a bottle in the microwave to be heated. 4. All should be include in the teaching.

ANS: 4 Feedback 1. Holding the infant when cooking increases the chance of the child obtaining a burn. 2. Heating bottles can cause steam burns, so an infant should not be held while performing this task. 3. Heating bottles in the microwave can cause hot spots within the milk and burn the child. 4. All of the teachings should be taught to the parents for the safety of their infant.

6. A mother brings her child in for a 4-week visit to the pediatrician. You observe that the child has a diaper rash. What caregiver education would you, the nurse, provide for this mother? 1. Keep diaper areas dry and change diapers frequently. 2. Air dry the diaper area as much as possible. 3. Use baby wipes to cleanse the diaper area. 4. Choices 1 and 2

ANS: 4 Feedback 1. Home care of diaper rash includes frequent diaper changes and air drying. 2. Home care of diaper rash includes frequent diaper changes and air drying. 3. Warm water and mild soaps should be used, not wipes. 4. Home care of diaper rash includes frequent diaper changes and air drying. Warm water and mild soaps should be used, not wipes.

As the school nurse, you receive a call from a mother who says her daughter has head lice. What information should you tell her? 1. Distinguish nits from dandruff. Nits are firmly attached to the hair shaft. 2. Treat with pediculicide shampoo and repeat in seven days. 3. Toys and clothes can be tied up in a bag for two weeks. 4. All of the above

ANS: 4 Feedback 1. Identification of nits needs to be made. 2. The shampoo will help treat and kill the nits and eggs. 3. All things the child has been exposed too should be wrapped up to prevent the spread of lice. 4. All of the above statements are caregiver education that you would share.

15. The mother of a 4-year-old with impetigo wants to know if she can still take the child to day care. The nurses most appropriate response would be: 1. It is okay for her child to go to day care as long as there is no fever. 2. She can attend day care if you teach her hand washing. 3. She can attend day care as long as the lesions are covered. 4. She can attend day care as long as the lesions are crusted and removed, and she has been on antibiotics for 24 hours.

ANS: 4 Feedback 1. Impetigo is contagious. Lesions should be crusted, removed, and treated with antibiotics for 24 hours. 2. Impetigo is contagious when the lesions are open, so even hand washing will not prevent the spread of the germ. 3. Impetigo is contagious. Lesions should be crusted, removed, and treated with antibiotics for 24 hours. 4. Impetigo is contagious. Lesions should be crusted, removed, and treated with antibiotics for 24 hours.

A 14-year-old boy is asking the nurse about how to decrease his atopic dermatitis. Which of the following statements is an appropriate teaching? 1. Wear loose cotton clothing. 2. Apply moisturizers 2 to 3 times a day. 3. Use mild soap for cleansing. 4. Keep warm and be in a moist environment while asleep.

ANS: 4 Feedback 1. Loose clothing may increase the dermatitis. 2. Moisturizers may irritate the area and increase the dermatitis. 3. Soap may irritate the area and increase the dermatitis. 4. Keeping warm and moist overnight will increase the healing rate.

22. A lifeguard needs education regarding sunburn prevention in the future. What education needs to be provided by the nurse? 1. Apply sunscreen SPF 30 and reapply every hour. 2. A shirt should be worn while outdoors. 3. Ask the boss if you can avoid the sun from 10 to 2 p.m. 4. Choices 1 and 2

ANS: 4 Feedback 1. Prevention is the best way to avoid serious sunburns. Applying the sunscreen will help reduce burns. 2. A shirt will help prevent burning to sensitive areas of the body. 3. Not a realistic request for a lifeguard 4. Prevention is the best way to avoid serious sunburns.

14. The mother of a 4 year old brings her child into the clinic. Impetigo is present on the face around the mouth and nose. What information should the nurse share with the mother? 1. This is caused by staphylococcus aureus. 2. After caring for child, carefully wash your hands. 3. Administer topical antibiotics. 4. All of the above

ANS: 4 Feedback 1. Staphylococcus aureus is the bacteria responsible for impetigo. 2. Hand washing should occur to help prevent the spread of the disease. 3. Topical antibiotics will help reduce the spread of the disease. 4. All of the above statements regarding impetigo are true.

4. Which of the categories are parts of the Braden Q scale? 1. Mobility and activity 2. Sensory perception 3. Nutrition, tissue perfusion, and oxygenation 4. All of the above

ANS: 4 Feedback 1. The Braden Q scale includes assessment of mobility and activity. 2. The Braden Q scale includes assessment of sensory perception. 3. The Braden Q scale includes assessment of nutrition, tissue perfusion, and oxygenation. 4. The Braden Q scale includes assessment of mobility, activity, sensory perception, moisture, friction shear, nutrition, tissue perfusion, and oxygenation.

The mother of an 8 year old with steri-strips to the right temporal area has been receiving teaching about caring for the wound. The nurse knows that the mother understands the teaching when she states: 1. I will need to remove the stitches in two days, and then bring my child back for more steri-strips. 2. I will clean the area with peroxide and keep the steri-strips dry. 3. I will keep the sterile dressing over the wound for the next 12 hours. 4. I will leave the steri-strips alone, and they will fall off in 7 to 10 days.

ANS: 4 Feedback 1. The child does not have stitches. 2. Cleansing the area with peroxide will not keep the area dry. 3. A sterile dressing is not needed at this time because the steri strips are in place. 4. The steri strips should be left alone to fall off when the wound heals.

27. Amber, a 10 year old, has been in fixed traction for a femur fracture for the past two weeks. Her parents are currently getting breakfast in the cafeteria. The nursing plan of care indicates that she should be moved every two hours and assess for skin breakdown. Today, Amber is refusing to move and tells the nurse I am not going to do it. The best way for the nurse to handle this situation is: 1. I will speak with the doctor to see if we can change your orders so you do not need to be moved so often. 2. We will call your mother to come back and move you. 3. I will give you 10 minutes to think about how you want to be positioned. After that, you can ring your call light, and we will move you to the position of your choosing. 4. I understand that you do not want to move today, but we have to make sure you do not get any sores on your back or leg. I will let you be for 10 minutes, and then when you ring the call light, I will come in and move you to the position of your choosing.

ANS: 4 Feedback 1. The child needs to be moved to prevent pressure sores. 2. Waiting for the parent to return may not be acceptable at this time, and the parent needs a break. 3. The nurse is not addressing what the child needs and allows for the child to have the control of the situation. 4. The nurse acknowledges the childs needs and has control of when the repositioning will occur.

The mother brings a 10-month-old child into the clinic due to an unusual rash that she has noted. In completing the history, the nurse should ask about: 1. The general health of the child. 2. Allergies. 3. Recent immunizations or medications. 4. All of the above.

ANS: 4 Feedback 1. The general health history is needed at this time. 2. Allergies will help identify the cause of the rash. 3. Immunizations and medications can cause rashes, thus should be assessed. 4. All of the above should be included in assessing the child for dermatologic conditions.

5. Which of the following interventions will assist the acute care patient in the PICU with the prevention of skin breakdown? 1. Using water-based skin moisturizers for dry skin 2. Keeping the child well oxygenated and well nourished 3. Changing positions at least every two hours 4. All of the above

ANS: 4 Feedback 1. The intervention will help prevent skin breakdown. 2. Oxygenation and nutrition are important factors in prevention of skin breakdown. 3. Changing positions helps prevent the pressure points from developing breakdown. 4. The interventions listed all help to prevent skin breakdown of the hospitalized child.

24. When working in the ER, how does the nurse determine whether a burn was an intentional injury? 1. Consider that the incidence of unintentional burns is 5% to 25% as reported by the World Health Organization. 2. Consider if the history is compatible with the pattern of injury. 3. Consider the childs age and development. 4. All of the above

ANS: 4 Feedback 1. The percentage of burn should be reviewed. 2. A history should be taken to identify if the pattern of injury is consistent. 3. The age of the child determines the size of the burn in proportion to the body. 4. All of the above considerations should be reviewed.

21. A 17-year-old lifeguard presents to the health center with blistering of the skin on his back. What nursing interventions should you provide for him? 1. Cool baths and compresses 2. Additional fluids to prevent dehydration 3. Acetaminophen or Ibuprofen for pain 4. All of the above

ANS: 4 Feedback 1. This will provide comfort to the area. 2. The teen is at risk for dehydration because of the amount of fluid being released from the burned skin. 3. The medication will help reduce inflammation to the area. 4. All of the above are appropriate for second-degree sunburns.

33. Alternative therapies may be used to treat eczema in adolescents. Which of the following is considered an alternative therapy? 1. Vitamin A 2. Vitamin B 3. Zinc 4. Calcium

ANS: 4 Feedback 1. Vitamin A does not demonstrate effectiveness with eczema in adolescents. 2. Vitamin B does not demonstrate effectiveness with eczema in adolescents. 3. Zinc does not demonstrate effectiveness with eczema in adolescents. 4. Calcium is known to help reduce eczema in adolescents.

8. The mother of an infant tells you how she has been treating the infants scalp. Which answer demonstrates that she needs education regarding care? 1. Washing the babys hair once a week 2. Using an antiseborrheic shampoo 3. Applying baby oil, and then gently brushing the scalp 4. Choices 2 and 3

ANS: 4 Feedback 1. Washing of the hair needs to occur more often to reduce the dirt and oil. 2. Washing the babys scalp daily with seborrheic shampoo would be appropriate. 3. Washing the babys scalp daily would be appropriate. 4. Washing the babys scalp daily with seborrheic shampoo would be appropriate. Washing the babys scalp daily would be appropriate.

53. The school nurse has a 6 year old enter the office with a laceration to the left leg. The area is bleeding profusely. The nurses first reaction to the situation should be to: 1. Apply a sterile dressing and antibiotic ointment to the area. 2. Apply a band-aid. 3. Irrigate the wound with normal saline. 4. Use sterile gauze to apply pressure.

ANS: 4 Feedback 1. Will be an important step, but is not the initial response needed 2. Depending on the size of the wound, a band-aid may not be appropriate. Also, it is not the initial response needed. 3. Cleansing the wound is important, but it is not the immediate need in this situation. 4. Stopping the bleeding is the priority nursing intervention.

69. Dressing changes are no longer needed after epithelialization occurs. True or False

True Epithelization is the creation of skin, and thus does not need a dressing