Pediatric PrepU Chapter 45.

The nurse is discussing skin disorders with a group of caregivers. Which caregiver statement indicates an understanding of tinea capitis? a. "I always tell my daughter to use her own hairbrush." b. "My son got that infection when he was at the swimming pool." c. "My husband had that once and his groin itched so much." d. "That is an infection that you get under your fingernails."

a. "I always tell my daughter to use her own hairbrush."

The school nurse has completed an educational program on first aid practices in the home. Which statement about burn care by a participant would indicate a need for further education? a. "I guess my mom was right; she always put ice on our burns when we were kids." b. "For a superficial burn, I can cover it with a clean nonadherent dressing." c. "If my child has a superficial burn, I will run cool water over it." d. "Mild soap can be used to clean a superficial burn."

a. "I guess my mom was right; she always put ice on our burns when we were kids."

The nurse is teaching parents about the care of diaper rash. The nurse would be concerned about the parents' level of understanding if they made which statement? a. "I should be certain to use fabric softener in the care of the infant's clothes." b. "I should only use ointments and creams as instructed by the health care provider." c. "I need to wash and rinse clothes thoroughly to be sure all of the detergent is washed out." d. "I should not overdress the infant."

a. "I should be certain to use fabric softener in the care of the infant's clothes."

An 8-month-old has been diagnosed with infantile eczema. At a follow-up appointment, the child's caregiver seems exhausted and angry. He explains that he has done all of the child's care because his wife is repulsed by the child's raw and uncomfortable appearance. What responses would be appropriate for the nurse to say to this caregiver? a. "That's not an uncommon reaction, although it's hard on you and on your child." b. "That's not fair to you; she should get some counseling to learn how to cope with illness better." c. "I understand her feelings. It is hard to see a child in pain sometimes." d. "He will be better soon and your family can get back to normal."

a. "That's not an uncommon reaction, although it's hard on you and on your child."

The clinic nurse is assessing a 12-year-old client. The client reports having dandruff and asks the nurse what can be done for it. Which response by the nurse is best? a. "Wash your hair with a gentle shampoo daily." b. "I will let your primary health care provider know you need prescription shampoo." c. "Apply warm baby oil to your scalp once a day for a few days." d. "Wash your hair vigorously twice a day for one week."

a. "Wash your hair with a gentle shampoo daily."

An adolescent is diagnosed with psoriasis. After speaking with the nurse about treatment options suggested by the primary health care provider, the adolescent states, "Since ultraviolet rays help, I am going to buy a tanning package so I can tan year round." How will the nurse respond? a. "Year round tanning is not what your health care provider intended. Tanning puts you at high risk for skin cancer and other problems." b. "I do not think the health care provider meant for you to tan year round. Is that exactly what your health care provider said to you?" c. "Be sure to not get burned while you are tanning. Sunburns can significantly increase your chances of getting skin cancer." d. "I know it must be tempting, especially at your age. However, please understand that a tanning salon is not a good option for your health."

a. "Year round tanning is not what your health care provider intended. Tanning puts you at high risk for skin cancer and other problems."

The nurse is caring for a child with burns in a pediatric hospital. What would be an appropriate nursing diagnosis for this client? a. Acute pain related to thermal injuries and procedures. b. Risk for aspiration related to effects of medication. c. Risk for fluid volume overload related to thermal injuries. d. Knowledge deficit related to daily care procedures in the acute care setting.

a. Acute pain related to thermal injuries and procedures.

A nurse is caring for a child with second- and third-degree (partial- and full-thickness) burns over 15% of the body. The child reports severe itching in and around the burn sites. Which action would be most appropriate for the nurse to perform? a. Administer diphenhydramine. b. Provide diversional activities. c. Turn the child every 2 hours. d. Soak the child in a colloidal bath.

a. Administer diphenhydramine.

An adolescent with tinea versicolor is admitted for treatment of the disorder. Which nursing diagnosis will the nurse identify as having the highest priority for this client? a. Disturbed body image. b. Altered nutrition. c. Pain. d. Risk for fluid volume deficit.

a. Disturbed body image.

What accurately depicts the hemodynamic changes that occur in the body within the first 24 to 48 hours after a burn? a. Hematocrit and white blood cell (WBC) counts increase. b. Hemoglobin and white blood cell (WBC) counts decrease. c. Hematocrit and white blood cell (WBC) counts decrease. d. Hematocrit increases and white blood cell (WBC) count decreases.

a. Hematocrit and white blood cell (WBC) counts increase.

A nurse completes an assessment on an 8-month-old infant seen in the pediatrician's office for a well-child visit. The nurse notes that the infant's buttocks, perineum and inner thighs are covered in a thick coating of white ointment. When questioned, the parent says the infant has a diaper rash and the ointment is to protect the infant's skin. What is the best action for the nurse to take? a. Provide instruction on how to care for a diaper rash. b. Commend the parent on addressing the infant's diaper rash. c. Tell the parent that he or she has used too much ointment. d. Explain that frequent diaper changes will prevent diaper rash.

a. Provide instruction on how to care for a diaper rash.

The nurse is caring for an infant who has impetigo and is hospitalized. Which nursing action is priority? a. The nurse follows contact precautions. b. The nurse applies topical antibiotics to the lesions. c. The nurse applies elbow restraints to the infant. d. The nurse soaks the skin with warm water.

a. The nurse follows contact precautions.

The nurse is providing education to a teen who has tinea pedis. What information should be included in the discussion? Select all that apply. a. Wear cotton socks. b. Keep feet clean and dry. c. Apply petroleum jelly to affected areas of feet. d. Rinse feet daily with a solution of equal parts water and hydrogen peroxide. e. Use talcum powder twice daily.

a. Wear cotton socks. b. Keep feet clean and dry.

The nurse is caring for a child with a tinea corporis infection involving several sites. Which information would be the most important for the nurse to include in the teaching plan for the parents? a. finishing all prescribed oral medication, even after lesions fade. b. keeping socks on before, during, and after athletic events. c. allowing the child to return to school after 3 days of treatment. d. applying oils and petroleum jelly to the affected areas.

a. finishing all prescribed oral medication, even after lesions fade.

The parents of a child diagnosed with atopic dermatitis ask the nurse, "My child has a skin disorder. I don't understand why a complete blood count (CBC) was ordered?" What is the appropriate response by the nurse? a. "This test will help in determining the type of bacteria that is causing this infection." b. "Eosinophils are a type of white blood cell that are often elevated with atopic dermatitis. These are part of the CBC and helps in making the diagnosis." c. "The complete blood count is a routine test used anytime there is an abnormal condition in the body." d. "This is just another tool to help rule out any other disorders that can be causing this skin disorder. There will be other lab tests ordered as well."

b. "Eosinophils are a type of white blood cell that are often elevated with atopic dermatitis. These are part of the CBC and helps in making the diagnosis."

A nurse is teaching a group of parents about burn safety. Which statement made by a parent requires intervention by the nurse? a. "We made a song out of 'stop, drop and roll' to teach our children fire safety." b. "I had our plumber lower our water heater temperature to 130°F (53°C). c. "I always make sure the little ones stay out of the kitchen when I am cooking." d. "We installed smoke detectors on every floor in our home."

b. "I had our plumber lower our water heater temperature to 130°F (53°C).

The nurse is caring for a child with a prescription for PO prednisone. Which statement by the child's mother would indicate a need for further education? a. "My child should take the entire prescription as prescribed by the health care provider." b. "I will give it to my child at least 1 hour before all meals." c. "I will have to watch my child closely for signs of infection." d. "Since my child has type 1 diabetes, I will need to monitor my child's blood sugar levels closely while on this medication.

b. "I will give it to my child at least 1 hour before all meals."

The nurse is caring for a 2-month-old in a pediatric clinic. The mom states she is going on vacation in Florida in a month and she is concerned about sunburn. She asks if it is okay to use a sunscreen lotion made for children. What is the correct nursing response? a. "You should not take your infant to Florida." b. "Sunscreen is not recommended until 6 months of age. Use light clothing and a hat to completely cover the child when in the sun." c. "It is okay to use a children's sunscreen as long as you avoid the face." d. "Put plenty of children's sunscreen on the infant at least 15 minutes before going outdoors, then reapply every three to four hours."

b. "Sunscreen is not recommended until 6 months of age. Use light clothing and a hat to completely cover the child when in the sun."

The parent of a 1-week-old infant is concerned with white scales that have begun to flake off the infant's scalp. The parent asks the nurse what to do to treat this. How should the nurse best respond? a. "Cradle cap (seborrhea) will resolve by itself. There is no intervention needed." b. "Your child most likely has cradle cap (seborrhea). You can care for it by cleansing the hair and scalp daily with baby shampoo and applying baby oil." c. "The infant should have a thorough shampooing every day to prevent things like this." d, "Your child most likely has dandruff. You can treat it with daily with antiseborrheic shampoo."

b. "Your child most likely has cradle cap (seborrhea). You can care for it by cleansing the hair and scalp daily with baby shampoo and applying baby oil."

An infant is seen in the emergency department with several raised red welts over the abdomen and lower extremities. The parent states that the symptoms developed suddenly over the past few hours. The infant is fussy and has a low grade temperature. What assessment is mostimportant for the nurse to perform? a. Question the parent about methods of punishment. b. Observe the infant's respiratory effort. c. Examine the lips and oral mucosa for cyanosis. d. Determine whether the child is breastfed or formula fed.

b. Observe the infant's respiratory effort.

A young child has just been admitted to the emergency department with a burn that encompasses the epidermis and the underlying dermis. From which type of burn does this child suffer? a. Fourth-degree or fat-layer burn. b. Second-degree or partial-thickness burn. c. Third-degree or full-thickness burn. d. First-degree or superficial burn.

b. Second-degree or partial-thickness burn.

The nurse is caring for a 13-year-old client who asks about acne prevention. Which would be most appropriate for the nurse to suggest? a. Pop the pimples to make them go away. b. Wash the face twice a day with a mild soap then pat dry. c. Wash the face with abrasive soaps three times a day. d. Avoid chocolate and greasy foods.

b. Wash the face twice a day with a mild soap then pat dry.

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 that involves honey-colored crusted lesions. The nurse most likely is referring to: a. seborrheic dermatitis. b. impetigo. c. miliaria rubra (heat rash). d. candidiasis.

b. impetigo.

An adolescent girl is going to be treated for a severe case of acne vulgaris. A pregnancy test should be done prior to the adolescent starting treatment with: a. erythromycin. b. isotretinoin. c. tretinoin. d. benzoyl peroxide.

b. isotretinoin.

The nurse is conducting a physical examination of a boy with erythema multiforme. Which assessment finding should the nurse expect? a. silvery or yellow-white scale plaques and sharply demarcated borders. b. lesions over the hands and feet, and extensor surfaces of the extremities with spread to the trunk. c. thick or flaky/greasy yellow scales. d. superficial tan or hypopigmented oval-shaped scaly lesions especially on upper back and chest and proximal arms.

b. lesions over the hands and feet, and extensor surfaces of the extremities with spread to the trunk.

The nurse is caring for a child with a skin disorder. The child presented with papules that progressed to vesicles with a honey-colored exudate. What treatment would the nurse expect to be ordered to treat this disorder? Select all that apply. a. warm compresses after washing with soap and water several times a day. b. regular hygiene measures. c. cool compresses to assist in removing crusts on vesicles. d. oral cephalexin. e. topical mupirocin ointment.

b. regular hygiene measures. c. cool compresses to assist in removing crusts on vesicles. e. topical mupirocin ointment.

The nurse is examining a child for indications of frostbite and notes blistering with erythema and edema. The nurse notes which degree of frostbite? a. first-degree frostbite. b. second-degree frostbite. c. fourth-degree frostbite. d. third-degree frostbite.

b. second-degree frostbite.

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. urging adequate nutritional intake. b. using appropriate hand hygiene. c. assessing temperature every 4 hours. d. obtaining a culture of the impaired skin area.

b. using appropriate hand hygiene.

A nurse is assessing a 6-month-old girl with an integumentary disorder. The nurse notes three virtually identically sized, round red circles with scaling that are symmetrically spaced on both of the girl's inner thighs. What should the nurse ask the mother? a. "Has she been exposed to poison ivy?" b. "Tell me about your family history of allergies." c. "Does she wear sleepers with metal snaps?" d. "Do you change her diapers regularly?"

c. "Does she wear sleepers with metal snaps?"

The parents of a child recently diagnosed with atopic dermatitis voice concern to the nurse that their child may develop asthma at some point. How should the nurse respond? a. "If your child starts having respiratory difficulties, be sure to let your health care provider know." b. "I am not sure why you think a skin disorder would lead to asthma?" c. "I can understand your concern. We will closely monitor your child for asthma development." d. "All children with atopic dermatitis develop both asthma and hay fever, so we will monitor your child for both conditions."

c. "I can understand your concern. We will closely monitor your child for asthma development."

An adolescent is prescribed isotretinoin. Which statement indicates that the adolescent understands the necessary precautions associated with this drug? a. "The drug might cause staining of my clothing." b. "This drug can affect my lungs so I need a chest radiograph done first." c. "I have to make sure that I do not become pregnant while taking this drug." d. "I'm going to have to have a blood count done every couple of months."

c. "I have to make sure that I do not become pregnant while taking this drug."

An adolescent client with seborrhea asks the nurse, "Why is my seborrhea so bad? Will it always be like this?" What is the best response by the nurse? a. "Seborrhea typically occurs when you wash your hair daily. How often are you washing your hair?" b. "Seborrhea can be controlled with shampoos containing selenium sulfide, ketoconazole, or tar." c. "Seborrhea tends to be worse during your teen years because of hormone levels." d. "Seborrhea is a chronic inflammatory disorder that usually persists for life."

c. "Seborrhea tends to be worse during your teen years because of hormone levels."

The nurse instructor is reviewing the integumentary system during a presentation to a group of student nurses. Which statement made by the instructor 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. "One role of the integumentary system is to distribute oxygen to the body cells." c. "The largest organ of the body helps regulate body temperature." d. "The sebaceous and sweat glands are fully functional in the infant."

c. "The largest organ of the body helps regulate body temperature."

The dermatologist treating a 16-year-old girl with a history of severe acne has ordered a pregnancy test so she can be started on a course of isotretinoin. The teen's caregiver has said that her daughter is a virgin and she refuses to allow her to have the required pregnancy testing. What would be the best action for the nurse to take? a. Speak with the teen alone to ask her if she is sexually active. If she says she is not sexually active, let the provider know that it is okay to write the prescription. b. Have the caregiver sign a permission form acknowledging that the girl has been given the drug without pregnancy testing. c. Acknowledge the caregiver's discomfort about the pregnancy testing but encourage her to allow the daughter to have the testing so that she can use the medication. d. Arrange for the daughter to have the pregnancy testing without the caregiver's knowledge.

c. Acknowledge the caregiver's discomfort about the pregnancy testing but encourage her to allow the daughter to have the testing so that she can use the medication.

A nurse is providing care to an infant who is admitted with burns over the face, neck and chest. The nurse identifies which goal as priority for planning the infant's care? a. Pain is at a tolerable level. b. Fluid balance is maintained. c. Airway remains patent. d. Wounds remain infection-free.

c. Airway remains patent.

The nurse is caring for a child admitted with second-degree (partial-thickness) burns. What is most characteristic of this type of burn? a. Skin is red and edematous. b. Pain is minimal. c. Blisters appear. d. Muscle damage occurs.

c. Blisters appear.

An 8-year-old child requires wet dressings four times a day as treatment for a skin disorder. What would be most important for the nurse to do? a. Elevate the area after performing the dressing change. b. Use a fragrance-free, dye-free soap to clean the wound. c. Premedicate the child before changing the dressing. d. Ensure that the temperature of the solution is 120°F (48.9°C).

c. Premedicate the child before changing the dressing.

Which intervention is the most beneficial for a burn client undergoing a skin graft? a. Provide pain medication on a PRN schedule as soon as pain is reported. b. Provide diversional activities for the client. c. Provide around-the-clock pain medication as soon as pain is reported. d. Provide an egg-crate mattress or gel mattress for the client to lie upon.

c. Provide around-the-clock pain medication as soon as pain is reported.

A 10-year-old has been bitten on the lower posterior arm by a dog, requiring several stitches. The child was just admitted to the hospital for 3 days of antibiotic therapy. When developing the care plan, the nurse identifies which nursing diagnoses as being the top 2 priorities? a. Knowledge deficit regarding care of wound. b. Risk for fluid volume deficit. c. Risk for infection. d. Disturbed body image. e. Impaired skin integrity.

c. Risk for infection. e. Impaired skin integrity.

The nurse is caring for a pediatric client with multiple wounds from a bike accident. What is the best method for cleansing or washing out the wound? a. Use iodine solution to wash the wound. b. Use an antibiotic wash to cleanse the wound. c. Use normal saline solution to wash the wound. d. Use sterile water to wash out the wound.

c. Use normal saline solution to wash the wound.

The nurse is educating a parent about the treatment for a child's tinea cruris. What medication class would the nurse include in the teaching plan? a. corticosteroid. b. antibiotic. c. antifungal. d. antihistamine.

c. antifungal.

The nurse is caring for a child with urticaria. What is the priority action? a. obtaining a detailed history of new foods, medications, stress, or changes in environment. b. noting whether hives are pruritic, blanch when pressed, or are migrating. c. assessing the child's airway and breathing and noting any wheezing or stridor. d. inspecting the skin and noting evidence of raised, edematous hives anywhere on the body.

c. assessing the child's airway and breathing and noting any wheezing or stridor.

The nurse is caring for a client brought to a pediatric clinic for swelling in the lower extremities with reddened skin that has undefined borders and pits slightly when pressed. What is the most likely diagnosis of the client's skin alteration? a. impetigo. b. staphylococcal scalded skin syndrome. c. cellulitis. d. cat scratch disease.

c. cellulitis.

The nurse is assessing a child who has had an open wound for the last 2 weeks with no signs of healing. The parents report they have been using over-the-counter antibiotic ointment with no signs of improvement. The child is active in football in the fall and the swim team in the winter. What disorder does the nurse suspect? a. folliculitis. b. staphylococcal scalded skin syndrome. c. community acquired MRSA. d. impetigo.

c. community acquired MRSA.

The nurse is caring for a 7-year-old with burns. Which finding would be highly suggestive of a burn induced by child abuse (child maltreatment)? a. spattering pattern. b. nonuniform pattern. c. stocking-glove pattern on hands or feet. d. splash patterns.

c. stocking-glove pattern on hands or feet.

A child is admitted to the acute care facility with a burn injury. The nurse would check the child's immunization status, specifically for which of the following? a. meningitis. b. diphtheria. c. tetanus. d. pertussis.

c. tetanus.

The nurse is conducting a primary survey of a 12-year-old child involved in a motor vehicle accident. Which assessment finding most concerns the nurse? a. burns on both of the child's hands. b. a broken tibia protruding through the skin. c. the presence of stridor. d. inability to state name.

c. the presence of stridor.

The nurse is speaking with the mother of a child diagnosed with contact dermatitis from poison ivy. Which statement by the mother indicates a need for further education? a. "When he plays in the woods again, I will make sure he wears long pants and long sleeves." b. "I will need to make sure the dog gets a bath if he goes in the woods." c. "I can buy a medicine to put on him before he goes out to prevent him from getting this again." d. "As long as he takes a shower as soon as he gets inside, he shouldn't get this again."

d. "As long as he takes a shower as soon as he gets inside, he shouldn't get this again."

The nurse is caring for a mother and newborn on a postpartum unit. The mother asks if it OK to use baby powder on newborns. Which response by the nurse would be most appropriate? a. "Baby powder can be used anytime with no concerns." b. "Baby powder may be used if sprinkled on your hand away from the baby to prevent aspiration." c. "Baby powder should not be used because so many people are allergic to the ingredients in it." d. "Baby powder should not be used on newborns because of the risk of aspiration upon application."

d. "Baby powder should not be used on newborns because of the risk of aspiration upon application."

A parent expresses a concern about white scales that have begun to flake off the 1-week-old infant's scalp. The parent asks, "What can I do to prevent this?" Which response by the nurse would be most appropriate? a. "Your child most likely has dandruff. You can treat it with daily with antiseborrheic shampoo, like Head and Shoulders." 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. There is no intervention needed and it should resolve in 1 week." d. "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. 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."

A child with a burn injury is scheduled for skin grafting. Which intervention would be most appropriate for the nurse to include in the child's plan of care? a. Provide an egg crate mattress or gel mattress for the client to lie upon. b. Administer analgesics when the child reports pain. c. Provide diversional activities for the client. d. Provide around the clock pain medication.

d. Provide around the clock pain medication.

The nurse is caring for a child with suspected child abuse (child mistreatment)-induced burns. Which assessment findings would support this? a. consistent history given by all caregivers. b. splattered-looking, small burned areas to both legs. c. 911 called immediately after the burn occurred. d. a burn to the entire right hand up to 2 cm above wrist with consistent edges.

d. a burn to the entire right hand up to 2 cm above wrist with consistent edges.

The nurse is caring for a 2-year-old boy with a burn. What finding would warrant referral to a burn unit? a. a superficial or first-degree burn on the hand. b. a superficial or first-degree burn on the chest. c. a superficial or first-degree burn on the upper arm. d. a chemical burn.

d. a chemical burn.

The nurse 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: a. curling ulcer. b. graft placement. c. wound care. d. hypovolemic shock.

d. hypovolemic shock.