Chapter 41(PEDS)
A child who developed parotid gland swelling on March 5 was diagnosed with mumps. The nurse determines that the child will no longer be contagious at which time? a) March 14 b) March 8 c) March 12 d) March 19
March 14
What is a characteristic sign of a full thickness burn ? a) Redness b) Minimal pain c) Blisters and warmth d) Severe pain
Minimal pain
Which of the following actions would be the most important to include in the plan of care for a child with infectious mononucleosis? a) Moving the child carefully b) Administering a corticosteroid c) Limiting fluid intake d) Counseling the child to stop kissing
Moving the child carefully
The nurse is discussing medications to be given to a child who has been diagnosed with Candidiasis. Which of the following medications would most likely be prescribed for the child? a) Acetaminophen b) Ampicillin c) Nystatin d) Aspirin
Nystatin
When developing the plan of care for a child with burns requiring fluid replacement therapy, which of the following would the nurse expect to include? a) Monitoring of hourly urine output to achieve less than 1 mL/kg/hour b) Determination of fluid replacement based on the type of burn c) Administration of colloid initially followed by a crystalloid d) Administration of most of the volume during the first 8 hours
Administration of most of the volume during the first 8 hours
The nurse is caring for a 6-year-old patient brought into the emergency department for burns from a house fire. The nurse notes burn areas surrounding the patient's nose and mouth upon initial assessment. Which of the following priority complications should the nurse be alerted to? a) One third area of fluid leakage resulting in hypovolemic shock b) Presence of an ileus c) Airway obstruction related to upper respiratory swelling d) Nutritional requirements increased
Airway obstruction related to upper respiratory swelling
The nursing diagnosis of risk for infection related to a disruption in the protective skin barrier is noted on a child's plan of care. Which action would be of greatest importance? a) Obtaining a culture of the impaired skin area b) Using appropriate hand hygiene c) Urging adequate nutritional intake d) Assessing temperature every 4 hours
Using appropriate hand hygiene
When you assess a boy with mumps (infectious parotitis) for parotid gland swelling, you would expect to find the main swelling present a) in front of the ear, above the jawline. b) above and in front of the ear. c) immediately behind the ear. d) in front of the ear, below the jawline.
in front of the ear, above the jawline
The nurse is caring for a 1-week-old child with a feeding intolerance. The mother expresses a concern with white scales that have began to flake off the infant's scalp and she asks the nurse what she can do to prevent this. Which of the following is the best nursing response? a) "Your child most likely has dandruff. You can treat it with daily with antiseborrheic shampoo." b) "How often do you bathe your infant? The infant should have a thorough shampooing every day to prevent things like this." c) "Your child most likely has infantile seborrheic dermatitis, or cradle cap. You can care for it by cleansing the hair and scalp daily with baby shampoo. You can also apply baby oil to the area for 10 to 15 minutes and then rinse away the flakes." d) "Your child most likely has infantile seborrheic dermatitis, or cradle cap. There is no intervention needed and it should resolve in one week."
"Your child most likely has infantile seborrheic dermatitis, or cradle cap. You can care for it by cleansing the hair and scalp daily with baby shampoo. You can also apply baby oil to the area for 10 to 15 minutes and then rinse away the flakes."
The nurse working in the burn unit is caring for a child with a severe burn. The treatment for this child during the first 48 hours will be most likely be related to which of the following? a) Curling's ulcer b) Graft placement c) Wound care d) Hypovolemic shock
Hypovolemic shock
The nurse is presenting an in-service to a group of nurses who will be working in a dermatology clinic. One participant asks the nurse about a bacterial skin infection that she has seen in children. Which of the following disorders is the nurse most likely referring to? a) Impetigo b) Candidiasis c) Miliaria rubra d) Seborrheic dermatitis
Impetigo
The nurse is caring for a mom and her baby on a postpartum unit. The mom states she has received advice not to use baby powder on newborns. She asks the nurse if this is true, and if so, why. Which of the following nurse responses is correct? a) "Baby powder may be used if sprinkled on your hand away from the baby to prevent aspiration." b) "Baby powder should not be used since so many people are allergic to the ingredients in it." c) "Baby powder can be used anytime with no concerns." d) "Baby powder should not be used on newborns due to the risk of aspiration upon application."
"Baby powder should not be used on newborns due to the risk of aspiration upon application."
When doing teaching with a group of caregivers of infants the nurse is discussing the topic of diaper rash. The caregivers in the group make the following statements. Which statement is the most accurate related to the child with diaper rash. a) "Sometimes if I leave the diaper off and let him be in the sunshine he gets diaper rash." b) "My child gets diaper rash if I wash her clothes in the same detergent we use for the family." c) "The formula she drinks sometimes causes her to have a diaper rash." d) "They told me to use baby powder every time I change her so she won't get diapter rash."
"My child gets diaper rash if I wash her clothes in the same detergent we use for the family."
After teaching a class about the differences in the skin of infants and adults, the nurse determines that additional teaching is necessary when the class states which of the following? a) "The infant's epidermis is loosely connected to the dermis, increasing the risk for breakdown." b) "An infant's skin is thinner than an adult's, so substances placed on the skin are absorbed more readily." c) "An infant has less subcutaneous fat, which places the infant at a higher risk for heat loss." d) "The infant has a lower risk for damage from ultraviolet radiation because the skin is more pigmented."
"The infant has a lower risk for damage from ultraviolet radiation because the skin is more pigmented."
The nurse is reviewing the integumentary system during a presentation to a group of nurses. Which of the following statements made by the nurses is the most accurate regarding the integumentary system? a) "The integumentary system is not in place until after the child is born and then takes many years to mature." b) "The largest organ of the integumentary system helps regulate body temperature." c) "The accessory structures of the integumentary system include the sebaceous or sweat glands." d) "One role of the integumentary system is to distribute oxygen to the body cells."
"The largest organ of the integumentary system helps regulate body temperature."
A pediatric nursing instructor is discussing diaper rash with a group of students. The instructor would be concerned about understanding of the care of diaper rash if a student stated which of the following? a) "Mothers should be instructed not to overdress their infants." b) "The mother should be instructed to be certain she uses fabric softener in the care of the infant's clothes." c) "Clothes should be washed and rinsed thoroughly to be sure all of the detergent is washed out." d) "Ointments and creams should only be used as instructed by the health care provider."
"The mother should be instructed to be certain she uses fabric softener in the care of the infant's clothes."
The nurse is providing home care instructions for the parents of an infant with cradle cap. Which response by the parents indicates a need for further teaching? a) "We can safely use a selenium sulfide shampoo on his hair." b) "We can massage his head with mineral oil first and then shampoo it." c) "We can scrape off the crusts on his scalp with a cotton swab." d) "We should wash or shampoo the scalp areas with mild soap."
"We can scrape off the crusts on his scalp with a cotton swab."
The nurse is providing teaching on ways to maintain skin integrity and prevent infection for the parents of a boy with atopic dermatitis. Which response indicates a need for further teaching? a) "We should avoid using petroleum jelly." b) "We should keep his fingernails short and clean." c) "We should avoid tight clothing and heat." d) "We need to develop ways to prevent him from scratching."
"We should avoid using petroleum jelly."
The nurse is monitoring the urinary output of 3-year-old child admitted with a severe burn. The child weighs 44 pounds. Which of the following would be a desirable and adequate urinary output for this child? a) 10 to 12 mL/kg/hr b) 1 to 2 mL/kg/hr c) 15 to 25 mL/kg/hr d) 15 to 25 mL/kg/hr
1 to 2 mL/kg/hr
A pediatric patient who has been seriously burned is being given IV fluid replacements. It has been determined that the patient will initially need 24 ounces of replacement fluids. In following a normal burn replacement treatment for this child, if the treatment is started at 10:00 AM, which of the following would be correct? The child would have received a) 12 ounces of IV fluid replacement by 6:00 PM b) 18 ounces of IV fluid replacement by 4:00 PM c) 18 ounces of IV fluid replacement by 6:00 PM d) 12 ounces of IV fluid replacement by 4:00 PM
12 ounces of IV fluid replacement by 6:00 PM
The nurse is caring for a burn patient in a pediatric hospital. Which of the following would be an appropriate nursing diagnosis for this patient? a) Acute pain related to thermal injuries and procedures b) Knowledge deficit related to daily care procedures in the acute care setting c) Risk for aspiration related to effects of medication d) Risk for fluid volume overload related to thermal injuries
Acute pain related to thermal injuries and procedures
After teaching the parents of a child with varicella zoster, the nurse determines that the parents have understood the teaching when they state that their child can return to school at which time? a) After the lesions have crusted b) When the rash is completely healed c) Once the rash appears d) After day 5 of the rash
After the lesions have crusted
The nurse is caring for an infant with candidal diaper rash. Which topical agent would the nurse expect the physician to order? a) Antifungals b) Retinoids c) Antibiotics d) Corticosteroids
Antifungals
A nurse is preparing a presentation for a local parent group about burn prevention and care in children. Which of the following would the nurse be least likely to include in the presentation when describing how to care for a superficial burn? a) Applying ice directly to the burned skin area b) Covering the burn with a clean, nonadhesive bandage c) Giving the child acetaminophen for pain relief d) Using cool water over the burned area until the pain lessens
Applying ice directly to the burned skin area
A nurse is performing a primary survey on a child who has sustained partial thickness burns over his upper body areas. Which of the following would the nurse do first? a) Palpate the child's pulse b) Inspect the child's skin color c) Assess for a patent airway d) Observe for symmetric breathing
Assess for a patent airway
In working with infants diagnosed with atopic dermatitis, the nurse anticipates that when these children are older they will likely have a tendency to have which of the following disorders? a) Hemophilia b) Asthma c) Rheumatoid arthritis d) Otitis media
Asthma
Infectious mononucleosis ("mono") is caused which of the following? a) Epstein-Barr virus b) Treponema pallidum c) Streptococcal bacterium d) Microsporum canis
Epstein-Barr virus
A nurse is implementing interventions to prevent a negative nitrogen balance from occurring in a child with a burn injury? Which of the following would be most effective? a) Providing emotional support b) Providing IV fluids c) Providing adequate pain relief d) Establishing an adequate nutritional intake balance
Establishing an adequate nutritional intake balance
The nurse is caring for a 1-year-old patient in a pediatric clinic. The patient was brought to the clinic with symptoms of dry, itchy red patches of skin on the arms and legs. A diagnosis of atopic dermatitis (eczema) is made. Which of the following is a key element in the treatment regimen for this diagnosis? a) Frequently rehydrating the skin b) Daily oral cortisone c) Teaching the child not to scratch the "itchy" skin d) Applying topical antibiotics routinely
Frequently rehydrating the skin
The nurse is working in a community setting and receives a call from a local day care center. One of the children in the center has been diagnosed with impetigo, and the director of the day care center wants to know whether she should be concerned. The nurse's response should reflect which of the following related to impetigo? a) Impetigo is usually caused because of sensitivity to pollens and molds. b) Impetigo is highly contagious and can spread quickly. c) Impetigo is a sexually transmitted infection and should be reported. d) Impetigo cannot be treated with medication and has to run its course.
Impetigo is highly contagious and can spread quickly.
The caregiver of a 17-year-old boy reports that her normally active son has a temperature of 101 degrees Fahrenheit, a sore throat, a headache, and seems completely exhausted. He has just had a nosebleed. The care provider sees the child and makes a diagnosis of infectious mononucleosis. The treatment most likely to be recommended for this child would include a) Increased fluids, bed rest, analgesics b) Admission to the hospital for about 7 days c) A high-protein, high-fiber, low-fat diet d) A 10-day course of antibiotics
Increased fluids, bed rest, analgesics
A child is brought to the clinic with fever, cough, and coryza. The nurse inspects the child's mouth and observes what look like tiny grains of white sand with red rings. The nurse documents this as which of the following? a) Nits b) Lymphadenopathy c) Koplik spots d) Slapped cheek appearance
Koplik spots
When describing measles to a local parent group, the nurse explains that which of the following is the hallmark clinical manifestation? a) Cough b) Conjunctivitis c) Koplik's spots d) Fever
Koplik's spots
The nurse is preparing a plan of care for a 5-year-old boy with chickenpox. Which of the following nursing interventions should be questioned? a) Keep the child's fingernails short. b) Monitor fluid intake and output. c) Provide alcohol baths as needed. d) Administer antipyretics as ordered.
Provide alcohol baths as needed.
Which of the following interventions is the most beneficial for a burn patient undergoing a skin graft? a) Provide diversional activities for the patient. b) Provide an egg-crate mattress or gel mattress for the patient to lie upon. c) Provide pain medication on a PRN schedule as soon as pain is reported. d) Provide around-the-clock pain medication as soon as pain is reported.
Provide around-the-clock pain medication as soon as pain is reported.
The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which of the following best describes erythema? a) Discolored skin spot not elevated at the surface b) Small, circumscribed, solid elevation of the skin c) Redness of the skin produced by congestion of the capillaries d) Small elevation of epidermis filled with a viscous fluid
Redness of the skin produced by congestion of the capillaries
An infant has presented at the clinic with impetigo. The mother is asking what antibiotic should be used. The nurse bases her response on knowledge that impetigo in infants is usually caused by which of the following? a) Group A beta hemolytic strep b) S. aureus c) Methicillin-resistant S. aureus d) E. coli
S. aureus
As part of a clinical conference with a group of nursing students, the instructor is describing the burn classification. The instructor determines that the teaching has been successful when the group identifies which of the following as characteristic of full thickness burns? a) Skin that is reddened, dry, and slightly swollen b) Skin with blistering and swelling c) Skin that is leathery and dry with some numbness d) Skin appearing wet with significant pain
Skin that is leathery and dry with some numbness
The nurse is conducting a primary survey of a child with burns. Which assessment finding points to airway injury from burn or smoke inhalation? a) Cervical spine injury b) Internal injuries c) Stridor d) Burns on hands
Stridor
The nurse admits a child who has sustained a severe burn. The child's immunizations are up to date. Which of the following immunizations would the child most likely be given at this time? a) Hepatitis B vaccine b) Tetanus toxoid vaccine c) Hepatitis A vaccine d) Haemophilus influenzae type B vaccine
Tetanus toxoid vaccine
The nurse is collecting data on a child admitted to the burn unit with a partial-thickness burn. Which of the following is most accurate regarding this type of burn? a) There is no destruction of tissue. b) The child will likely have blisters. c) The child will have minimal pain. d) The nerve ending are destroyed.
The child will likely have blisters.
The nurse is collecting data on a 4-year-old child admitted to the burn unit. The nurse is concerned about the possibility of the child going into hypovolemic shock. Which of the following data would the nurse recognize as an indication that this may be occurring? a) The child's blood pressure is 128/86. b) The child is complaining of intense pain. c) The child's apical pulse is 140 bpm. d) The child's face is bright red in color.
The child's apical pulse is 140 bpm.
The nurse is caring for an infant who has impetigo and is hospitalized. Which of the following nursing interventions is the highest priority for this child? a) The nurse soaks the skin with warm water. b) The nurse applies topical antibiotics to the lesions. c) The nurse follows contact precautions. d) The nurse applies elbow restraints to the infant.
The nurse follows contact precautions.
The nurse is caring for a newborn who was delivered vaginally. The infant has a white coating in the mouth that looks like milk curds. The nurse suspects that the infant has which of the following? a) Atopic dermatitis b) Pediculosis c) Tinea capitis caused by Microsporum audouinii d) Thrush caused by Candida albicans
Thrush caused by Candida albicans
You anticipate that a 16-year-old girl with infectious mononucleosis will be placed on bed rest to a) protect her from joint involvement. b) prevent splenic rupture. c) prevent liver involvement. d) prevent irritation of her stiff neck.
prevent splenic rupture.
