Chapter 37: NCLEX style

The rash in roseola is pruritic. Which measure would you teach the father to provide comfort?

Apply cool compresses to the skin to stop local itching.

When providing care for a child with herpes zoster (shingles), the parents ask the nurse how the child contracted this infectious disorder. Which response by the nurse is most appropriate?

"Herpes zoster is a reactivation of a previous varicella zoster infection."

A nurse is preparing a presentation for parents about common childhood infectious diseases. What conditions would the nurse include as being caused by a tick bite? Select all that apply.

- Lyme disease

The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which best describes a macule?

Discolored skin spot not elevated at the surface

The home care nurse is observing a mother prepare mupirocin (Bactroban) to treat a preschool-aged child's skin rash. At which point should the nurse stop the mother during the preparation of the medication?

Mother measures out a teaspoon of the medication for the child to take orally.

The student nurse is discussing the plan of care for a child admitted to the hospital for treatment of an infection. Which action should be taken first?

Obtain blood cultures

The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which skin condition best describes erythema?

Redness of the skin produced by congestion of the capillaries

The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which skin condition best describes pustule?

Small elevation of epidermis filled with a viscous fluid

A school-age child has been placed in airborne precautions until the microorganism causing the child's symptoms can be identified. Which diagnosis should the nurse identify as being the most appropriate for the child at this time?

Social isolation related to precautions required to prevent infection transmission

The nurse at the pediatrician's office receives a call from the mother of a child who has just been bitten by the neighbor's dog. What action would be the priority?

Tell the mother to seek medical help immediately.

A nurse is promoting vaccine administration. When instructing on the physiological changes, which statement best explains what occurs in the child when vaccines are administered?

The child develops an active immunity.

The nurse is administering a chicken pox vaccination to a 12-month-old girl. Which concern is unique to varicella?

This disease can reactivate years later and cause shingles.

Which child will the nurse identify as being at greatest risk for developing a hospital-acquired infection (HAI)?

an 18-month-old child receiving chemotherapy over 5 days

The nurse is discussing fever with the parents of a child who is in the emergency department with a temperature of 101 degrees Fahrenheit. Which statement by a parent indicates an understanding about fevers and their management in the ill child?

"Fevers can be beneficial because they can slow down the growth of the bacteria or virus that may be causing the infection."

The nurse is providing teaching to the parents of a child with varicella. Which statement indicates that the parents have understood the instructions?

"We need to make sure that he washes his hands frequently."

The mother of a an 8-year-old boy with mumps tells the nurse that she does not understand how her son could have gotten mumps since he was immunized according to her physician's recommendations. What is the best response by the nurse?

"While immunizations are highly effective they aren't 100% effective at preventing infectious diseases."

The physician has ordered ibuprofen 150 mg every 6 hours as needed for a 3-year-old child for a fever greater than 38 Celsius. The label of the ibuprofen bottle reads "ibuprofen oral suspension 100 mg/5 mL." How much ibuprofen liquid will the nurse administer if the child's temperature goes above 38 C? Record your answer using one decimal place.

7.5

What is the leading cause of neonatal sepsis and death?

Group B streptococcus

A child is brought to the emergency department by his parents. The parents report that he stepped on a rusty nail about a week and a half ago. The child is complaining of cramping in his jaw and some difficulty swallowing. The nurse suspects tetanus. When assessing the child, the nurse would be alert to which muscle groups being affected next?

Neck

The parents of a 4-month-old diagnosed with sepsis tell the nurse that the physician explained sepsis to them but they don't really understand it. The parents state, "Could you please explain it to us?" What is the best response by the nurse?

"The infection your child has causes the release of toxins into the system, which can lead to impaired function in the lungs, liver, and kidneys."

An adolescent girl and her caregiver present at the pediatrician's office. The adolescent reports severe abdominal pain. A diagnosis of pelvic inflammatory disease (PID) is made. The nurse notes in the child's chart that this is the third time she has been treated for PID. Which action by the nurse would be most appropriate?

Take the child to a private room and interview her regarding her sexual history and partners

The parents of a 3-year-old child report he was exposed to pertussis 2 days ago. They are concerned and ask the nurse how long it will take until he becomes ill if he indeed contracted the infection. What response by the nurse is indicated?

"The signs of disease will be noted in 1 to 3 weeks."

A nurse is preparing a presentation for a local mothers' group about common viral infections associated with a rash during childhood. When describing rubella, what information would the nurse include? Select all that apply.

- Incubation period usually ranges from 16 to 18 days. - The infection is communicable for a week before to a week after the rash appears. - Any itching with the rash is usually mild.

Parents bring their 9-year-old child to the clinic for a well-child visit. They are concerned because several children in the neighborhood have developed Lyme disease and ask for suggestions on what to do to reduce their child's risk. What would be appropriate for the nurse to suggest? Select all that apply.

- Wearing protective clothing when playing in wooded areas. - Inspecting the skin closely for ticks after the child plays in wooded areas. - Contacting the health care provider if there is any area of inflammation that might be a bite.

A child is diagnosed with early disseminated Lyme disease. The nurse informs the parents the child will most likely receive antibiotic therapy for which length of time?

14 to 28 days

A nursing instructor is teaching the students about the standard and transmission-based precautions. What type of precautions require placing a client in an isolated room with limited access, wearing gloves during contact with the client and all body fluids or contaminated items, wearing two layers of protective clothing, and avoiding sharing equipment between clients?

Contact precautions

The mother of a 10-year-old child diagnosed with rubella asks what can be done to help her child feel better during her illness. What information can be provided?

Encourage rest and relaxation.

A young client arrives at the clinic with a rash on the trunk and flexor surfaces of the extremities. The mother informs the nurse that the rash started a day before on the exterior surfaces of the extremities; 2 days before, the child had a really bad rash on the face. The physician diagnoses the child with erythema infectiosum. The nurse tells the mother that this is also known as

fifth disease

A 3-year-old girl was in the hospital for a week following open heart surgery. By the end of the week, she had contracted an infection. The nurse recognizes this type of infection as a

health care-associated infection (HAI).

The nurse is caring for a child admitted to the hospital for sepsis. Which assessment finding is the most concerning?

urine output of 10 ml over 3 hours