Peds - Chapter 24: Nursing Care of the Child With an Integumentary Disorder
A nurse is working as part of a response team caring for children who have been involved in an elementary school fire. Which children would the nurse identify as needing a referral to a burn unit? Select all that apply. a) 9-year-old with asthma and burns to the face b) 6-year-old with burns involving the knees and hips c) 8-year-old with an inhalation injury d) 10-year-old with partial-thickness burns over 15% of the body e) 7-year-old with superficial burns over 5% of the body
• 8-year-old with an inhalation injury • 6-year-old with burns involving the knees and hips • 10-year-old with partial-thickness burns over 15% of the body • 9-year-old with asthma and burns to the face
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. What is the best nursing response? a) "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." 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 one week." d) "Your child most likely has dandruff. You can treat it with daily with antiseborrheic shampoo."
"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 is teaching about skin care for atopic dermatitis. Which statement by the parent indicates that further teaching may be necessary? 1. "I will use Vaseline or Crisco to moisturize my child's skin." 2. "A hot bath will soothe my child's itching when it is severe." 3. "I will buy cotton rather than wool or synthetic clothing for my child." 4. "I will apply a small amount of the prescribed cream after the bath."
"A hot bath will soothe my child's itching when it is severe."
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 nurse response is correct? a) "Baby powder can be used anytime with no concerns." b) "Baby powder should not be used since so many people are allergic to the ingredients in it." c) "Baby powder should not be used on newborns due to the risk of aspiration upon application." d) "Baby powder may be used if sprinkled on your hand away from the baby to prevent aspiration."
"Baby powder should not be used on newborns due to the risk of aspiration upon application."
A nurse 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. Which should the nurse ask the mother? a) "Do you change her diapers regularly?" b) "Tell me about your family history of allergies." c) "Has she been exposed to poison ivy?" d) "Does she wear sleepers with metal snaps?"
"Does she wear sleepers with metal snaps?"
The nurse is evaluating parents' understanding of atopic dermatitis. Which statement shows their understanding? a) "Atopic dermatitis follows a streptococcal infection." b) "Hydrocortisone cream may lead to kidney disease." c) "Atopic dermatitis turns to asthma later in life." d) "Flare-ups of lesions are not uncommon following therapy."
"Flare-ups of lesions are not uncommon following therapy."
A mother brings her 2-year-old son to the clinic with a bumpy rash. Which statement by the mother would lead the nurse to suspect that the child may have atopic dermatitis? a) "We just had him to the barber for his first haircut." b) "He just started swim lessons at the YMCA." c) "I feel so bad for him because he has asthma, and now he gets this rash." d) "It started as a flat red rash in between his legs."
"I feel so bad for him because he has asthma, and now he gets this rash."
A topical corticosteroid is prescribed for a child with contact dermatitis. Which statement by the mother would indicate the teaching was successful? a) "I should use the highest-potency steroid cream I can find." b) "I should apply the medicine at bedtime and rinse it off in the morning." c) "I should not cover the area with plastic wrap after applying the cream." d) "I need to shake the preparation before using it."
"I should not cover the area with plastic wrap after applying the cream."
The nurse is discussing acne vulgaris with a group of adolescents. The teenagers make the following statements regarding the topic. Which statement is the most accurate regarding acne vulgaris? a) "My next door neighbor told me that acne was caused by a fungus." b) "Sometimes I get acne when I use my sister's makeup." c) "There is a new immunization that you can get to keep from having acne." d) "My mom says I have acne because I eat too much chocolate."
"Sometimes I get acne when I use my sister's makeup."
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) "Put plenty of children's sunscreen on the infant at least 15 minutes before going outdoors, then reapply every three to four hours." d) "It is okay to use a children's sunscreen as long as you avoid the face."
"Sunscreen is not recommended until 6 months of age. Use light clothing and a hat to completely cover the child when in the sun."
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 fair to you; she should get some counseling to learn how to cope with illness better." b) "I understand her feelings. It is hard to see a child in pain sometimes." c) "That's not an uncommon reaction, although it's hard on you and on your child." d) "He will be better soon and your family can get back to normal."
"That's not an uncommon reaction, although it's hard on you and on your child."
The nurse is reviewing the integumentary system during a presentation to a group of nurses. Which statements made by the nurse is the most accurate regarding the integumentary system? a) "One role of the integumentary system is to distribute oxygen to the body cells." b) "The largest organ of the body helps regulate body temperature." c) "The integumentary system is not in place until after the child is born and then takes many years to mature." d) "The sebaceous and sweat glands are fully functional in the infant."
"The largest organ of the body helps regulate body temperature."
The nurse is caring for a 12-year-old in a pediatric clinic at a wellness checkup. The child reports having dandruff and asks the nurse what can be done for it. What is the best nursing response after a quick scalp assessment confirms the presence of dandruff? a) "Wear light-colored clothing so the flakes aren't noticeable." b) "Apply a corticosteroid cream to your scalp at night." c) "Wash your hair with an antiseborrheic shampoo daily." d) "Wash your hair vigorously twice a day for one week."
"Wash your hair with an antiseborrheic shampoo daily."
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 scrape off the crusts on his scalp with a cotton swab." c) "We can massage his head with mineral oil first and then shampoo it." 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 teaching the parents of a 6-year-old who has sustained a large laceration about providing care to the wound at home. The nurse determines that the parents need additional teaching when they state: a) "If we notice some yellowish drainage, we need to call the doctor." b) "If our son starts telling us that the pain is increasing, we need to have it checked out." c) "We should call the doctor if the wound becomes red and hot looking." d) "We need to keep the wound tightly bandaged for at least 3 days."
"We need to keep the wound tightly bandaged for at least 3 days."
A nurse providing teaching on ways to promote skin hydration for the parents of an infant with atopic dermatitis. Which response indicates a need for further teaching? a) "We should use a mild soap for sensitive skin." b) "We should use soap to clean only dirty areas." c) "We should bathe our child in hot water, twice a day." d) "We need to avoid any skin product containing perfumes, dyes, or fragrances."
"We should bathe our child in hot water, twice a day."
A 16-year-old male who diagnosed with tinea pedis questions the nurse about how he may have contracted the condition. How should the nurse respond? a) "It is unlikely you will be able to determine the cause of the infection." b) "You may have gotten the condition from a community shower or gym area." c) "You likely had an infection in another area of your body and it has spread." d) "This condition is common in individuals with lowered immunity."
"You may have gotten the condition from a community shower or gym area."
A 6-year-old child is diagnosed with tinea capitis and treatment is initiated. The nurse instructs the parents to have the child return to school within which time frame? a) 72 hours b) 24 hours c) 5 days d) 1 week
1 week
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) 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. c) Have the caregiver sign a permission form acknowledging that the girl has been given the drug without pregnancy testing. d) Arrange for the daughter to have the pregnancy testing without the caregiver's knowledge.
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 caring for a child with a wasp sting. Which nursing intervention is priority? a) Cleanse wound with mild soap and water b) Apply ice intermittently c) Administer diphenhydramine per protocol d) Remove jewelry or restrictive clothing
Administer diphenhydramine per protocol
A school-age child is brought to the office of the camp nurse with a small, superficial burn. Which action by the nurse would be the most appropriate action for the nurse to do first? a) Cover the area with a sterile bandage. b) Apply a topical anesthetic ointment. c) Administer acetaminophen. d) Apply cold compresses to the area.
Apply cold compresses to the area.
The camp nurse is caring for a child who was bitten on the leg by a dangerous spider. The child is being taken to a care provider. What is the most appropriate action for the nurse to do with this child? a) Administer pain medication. b) Apply ice to the affected area. c) Splint the leg. d) Briskly scrub the site.
Apply ice to the affected area.
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 disorder? a) Asthma b) Hemophilia c) Rheumatoid arthritis d) Otitis media
Asthma
A mother brings her 4-month-old infant to the doctor's office due to vesicular lesions that have appeared on the child's scalp and face. The mother says that the child will not stop scratching at the lesions and that she is concerned that he is having some kind of allergic reaction. What should the nurse recommend to the mother to help reduce pruritus in this child? a) Have the child retested for PKU b) Put the child on elimination diets c) Bathe the child twice a day d) Have the child undergo skin testing
Bathe the child twice a day
The nurse is caring for a child admitted with partial thickness burns. What is most characteristic of this type of burn? a) Muscle damage occurs b) Skin is red and edematous c) Pain is minimal d) Blisters appear
Blisters appear
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) Staphylococcal scalded skin syndrome b) Impetigo c) Cellulitis d) Cat scratch disease
Cellulitis Cellulitis is characterized by reddened or lilac-colored swollen skin that pits when pressed by the fingertips. Impetigo has superficial lesions that can be bulbous or nonbulbous. SSSS involves bullae that enlarge and rupture, leaving a red, scalded-looking lesion. Cat scratch disease involves a benign, subacute, chronic course of lymphadenopathy that usually resolves spontaneously in 2 to 3 months.
The nurse is conducting a physical examination of a child with severe burns. Which internal physiologic manifestation should the nurse expect to occur first? a) Insulin resistance b) Decrease in cardiac output c) Hypermetabolic response with increased cardiac output d) Increased protein catabolism
Decrease in cardiac output
The process of removing necrotic tissue in the treatment of burns is known as: a) Allograft b) Hydrotherapy c) Débridement d) Autograft
Débridement
The nurse is taking a health history of a 6-year-old girl with suspected Stevens-Johnson syndrome. During the physical examination, the nurse would expect to note which physical findings? a) Fiery red lesions, scaling in the skin folds, and satellite lesions b) Erythema multiforme with inflammatory bullae of at least two types of mucosa c) Red, raised hair follicles d) Red macules and bullous eruptions on an erythematous base
Erythema multiforme with inflammatory bullae of at least two types of mucosa
The nurse is caring for a 15-year-old boy with psoriasis. In addition to the plaques, what would the nurse expect to note? a) Fever and malaise b) Lichenification c) Hyperpigmentation d) Fissures and scaling on palms and soles
Fissures and scaling on palms and soles
The nurse is caring for a 1-year-old in a pediatric clinic. The child 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. What is a key element in the treatment regimen for this diagnosis? a) Daily oral cortisone b) Teaching the child not to scratch the "itchy" skin c) Applying topical antibiotics routinely d) Frequently rehydrating the skin
Frequently rehydrating the skin
Tinea is also called ringworm. The nurse knows that tinea is which type of infection? a) Sexually transmitted infections b) Contagious infections c) Bacterial infections d) Fungal infections
Fungal infections
What accurately depicts the hemodynamic changes that occur in the body within the first 24 to 48 hours after a burn? a) Hematocrit increases and WBC count decreases b) Hematocrit and WBC counts elevate c) Hematocrit and WBC counts decrease d) Hemoglobin and WBC counts decrease
Hematocrit and WBC counts elevate
The nurse is caring for a pediatric client in the emergency department with moderate frostbite of an extremity. Which is the most beneficial nursing intervention for this client? a) Immerse the affected part in 104°F (40°C) water for 15 to 30 minutes. b) Rub the frostbitten extremities to increase circulation to the affected area. c) Place heating pads and warmed blankets on the child's extremities and trunk. d) Apply dry heat to the extremities.
Immerse the affected part in 104°F (40°C) water for 15 to 30 minutes.
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 what information related to impetigo? a) Impetigo is highly contagious and can spread quickly. b) Impetigo cannot be treated with medication and has to run its course. c) Impetigo is usually caused because of sensitivity to pollens and molds. d) Impetigo is a sexually transmitted infection and should be reported.
Impetigo is highly contagious and can spread quickly.
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) Thick or flaky/greasy yellow scales c) Lesions over the hands and feet, and extensor surfaces of the extremities with spread to the trunk d) Superficial tan or hypopigmented oval shaped scaly lesions especially on upper back and chest and proximal arms
Lesions over the hands and feet, and extensor surfaces of the extremities with spread to the trunk
The nurse is discussing dietary intake with the parents of a 4-year-old child who has been diagnosed with atopic dermatitis. Later, the nurse notes the menu selection made by the parents for the child. Which selection indicates the need for further instruction? a) Peanut butter and jelly sandwich b) Chicken nuggets c) Tomato soup d) Carrot and celery sticks
Peanut butter and jelly sandwich
The nurse is caring for a child with a suspected fungal infection. Which test would the nurse anticipate as being ordered? a) Erythrocyte sedimentation rate (ESR) b) Patch or skin testing c) Potassium hydroxide (KOH) prep d) Culture of wound/drainage
Potassium hydroxide (KOH) prep Explanation: Potassium hydroxide (KOH) prep is indicated for identifying a fungal infection.
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) Premedicate the child before changing the dressing. c) Ensure that the temperature of the solution is 120°F.
Premedicate the child before changing the dressing.
The nurse caring for a child with a skin allergy recognizes that the highest priority in the treatment for skin allergies is aimed at: a) Controlling nausea and vomiting b) Regulating skin and body temperature c) Reducing swelling and relieving itching d) Managing pain and discomfort
Reducing swelling and relieving itching
The nurse is caring for a 10-month-old with a rash. The child's mother reports that the onset was abrupt. The nurse assesses diffuse erythema and skin tenderness with ruptured bullae in the axillary area with red weeping surface. The nurse suspects which bacterial infection? a) Folliculitis b) Non-bullous impetigo c) Scalded skin syndrome d) Impetigo
Scalded skin syndrome
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) Second degree frostbite b) Third degree frostbite c) First degree frostbite d) Fourth degree frostbite
Second degree frostbite
A 14-year-old child is diagnosed with tinea versicolor. What would the nurse expect the nurse practitioner to order? a) Diphenhydramine b) Selenium sulfide c) Oral griseofulvin d) Topical nystatin
Selenium sulfide
The nurse is caring for a 7-year-old with burns. Which finding would be highly suggestive of a child abuse-induced burn? a) Splash patterns b) Spattering pattern c) Stocking-glove pattern on hands or feet d) Nonuniform pattern
Stocking-glove pattern on hands or feet
The nurse admits a child who has sustained a severe burn. The child's immunizations are up to date. Which immunization would the child most likely be given at this time? a) Hepatitis A vaccine b) Tetanus toxoid vaccine c) Hepatitis B vaccine d) Haemophilus influenzae type B vaccine
Tetanus toxoid vaccine
In caring for a 3 ½-year-old child admitted after being severely burned, the nurse collects the following data. What finding would be most important for the nurse to report immediately? a) The child's respiratory rate is 32 breaths a minute. b) The child's pain level is a 7 on the pain scale. c) The child's hourly urinary output is 150 cc. d) The child's temperature is 101.2° F (38.4° C).
The child's respiratory rate is 32 breaths a minute.
The nurse is caring for an infant who has impetigo and is hospitalized. Which nursing intervention is the highest priority for this child? a) The nurse applies topical antibiotics to the lesions. b) The nurse applies elbow restraints to the infant. c) The nurse follows contact precautions. d) The nurse soaks the skin with warm water.
The nurse follows contact precautions.
Which intervention is the most effective in treating burn wound infections? a) Systemic intravenous antibiotics b) Topical antibiotics applied to the wound site c) Proper hand washing d) Systemic oral antibiotics
Topical antibiotics applied to the wound site
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 sterile water to wash out the wound. b) Use an antibiotic wash to cleanse the wound. c) Use normal saline solution to wash the wound. d) Use iodine solution to wash the wound.
Use normal saline solution to wash the wound.
The nurse is caring for an infant on the pediatric unit who has a very red rash in the diaper area, with red lesions scattered on the abdomen and thighs. What is the priority nursing intervention? 1. administer griseofulvin with a fatty meal 2. institute contact isolation precautions 3. apply topical antibiotic cream 4. apply topical antifungal cream
apply topical antifungal cream
The nurse is caring for a child in the emergency department who was bitten by the family dog, who is fully immunized. What is the priority nursing action? 1. administer rabies immunoglobulin 2. refer the child to a counselor 3. assess the depth and extent of the wound 4. administer a tetanus booster
assess the depth and extent of the wound
The nurse is caring for a child who has received significant partial-thickness burns to the lower body. What is the priority assessment in the first 24h after injury? 1. fluid balance 2. wound infection 3. respiratory arrest 4. separation anxiety
fluid balance
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. The nurse most likely referring to: a) miliaria rubra. b) impetigo. c) candidiasis. d) seborrheic dermatitis.
impetigo
A group of nursing students are reviewing information about atopic dermatitis. Which answers indicate that the students understand the information? Select all that apply. a) The disorder is chronic with periods of remissions. b) Scratching initiates the reaction, which then becomes pruritic. c) Changes in temperature can contribute to flare-ups. d) Excessively humid environments often lessen the severity of the reaction. e) The reaction occurs in response to specific allergens.
• The disorder is chronic with periods of remissions. • The reaction occurs in response to specific allergens. • Changes in temperature can contribute to flare-ups.
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) "My child gets diaper rash if I wash her clothes in the same detergent we use for the family." b) "The formula she drinks sometimes causes her to have a diaper rash." c) "They told me to use baby powder every time I change her so she won't get diapter rash." d) "Sometimes if I leave the diaper off and let him be in the sunshine he gets diaper rash."
"My child gets diaper rash if I wash her clothes in the same detergent we use for the family."
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 keep his fingernails short and clean." b) "We should avoid using petroleum jelly." 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 caring for a 2-year-old boy with a burn. What finding would warrant referral to a burn unit? a) A superficial burn on his chest b) A superficial burn on his hand c) A first-degree burn on the upper arm d) A chemical burn
A chemical burn
The nurse is caring for a child with burns in a pediatric hospital. What would be an appropriate nursing diagnosis for this client? a) Knowledge deficit related to daily care procedures in the acute care setting b) Acute pain related to thermal injuries and procedures c) Risk for fluid volume overload related to thermal injuries d) Risk for aspiration related to effects of medication
Acute pain related to thermal injuries and procedures
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) Tretinoin (Retin-A) b) Erythromycin c) Benzoyl peroxide (Clearasil) d) Isotretinoin (Accutane)
Isotretinoin (Accutane)
A varsity high school wrestler presents with a 'rug burn' type of rash on his shoulder that is not healing as expected, despite use of triple antibiotic cream. Two other wrestler on his team have a similar abrasion. What infection should the nurse be most concerned about, based on the history? 1. tinea cruris 2. MRSA 3. impetigo 4. tenea versicolor
MRSA
A nurse is caring for a burn patient with second and third degree burns on 15% of the body. The patient is complaining of severe itching in and around the burn sites. Which of the following is the best nursing intervention to relieve this symptom? a) Diversional activities b) Turning the patient every two hours c) Medication d) Soaking in a colloidal bath
Medication
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) Assessing temperature every 4 hours b) Urging adequate nutritional intake c) Using appropriate hand hygiene d) Obtaining a culture of the impaired skin area
Using appropriate hand hygiene
A nursing instructor is preparing a class discussion about pediatric skin variations, specifically related to differences in dark-skinned children. What information would the nurse most likely include? Select all that apply. a) Hypertrophic scarring is a common occurrence in dark-skinned children. b) Keloid formation occurs less often in dark-skinned children. c) Vesicles appear less visible in most dark-skinned children. d) Hypopigmentation often occurs after a skin condition heals. e) Papules often appear more prominent on the skin.
• Hypertrophic scarring is a common occurrence in dark-skinned children. • Hypopigmentation often occurs after a skin condition heals. • Papules often appear more prominent on the skin.
The nurse is discussing the use of over-the-counter ointments to manage a mild case of diaper rash. What ingredients should the nurse instruct the parents to look for in a compound? Select all that apply. a) Vitamin B12 b) Vitamin D c) Vitamin B6 d) Zinc e) Vitamin A
• Vitamin D • Zinc • Vitamin A
The nurse is caring for a child with a partial-thickness burn. What assessment findings would the nurse expect to observe? a) Edema with dry or waxy-looking skin b) Edema with wet blistering skin c) Peeling skin with eschar d) Reddened and leathery skin
Edema with wet blistering skin
Which intervention is the most beneficial for a burn client undergoing a skin graft? a) Provide an egg-crate mattress or gel mattress for the client to lie upon. b) Provide around-the-clock pain medication as soon as pain is reported. c) Provide diversional activities for the client. d) Provide pain medication on a PRN schedule as soon as pain is reported.
Provide around-the-clock pain medication as soon as pain is reported.
An adolescent is to receive topical retinoid therapy for his moderately severe acne. The nurse would instruct the adolescent about which adverse effects? Select all that apply. a) Dryness b) Flu-like symptoms c) Photosensitivity d) Headache e) Burning
• Dryness • Photosensitivity • Burning
When assessing an adolescent for acne, what findings would lead the nurse to identify the acne as severe? Select all that apply. a) Presence of nodules b) Facial papules c) Comedones d) Evidence of cysts e) Widespread inflammatory lesions
• Widespread inflammatory lesions • Evidence of cysts • Presence of nodules
The nurse has completed client teaching with a 16-year-old female who has been prescribed Accutane (isotretinoin) for cystic acne. Which statements indicate learning has occurred? Select all that apply. a) "It's important I get my CBC blood test when my doctor orders it." b) "I am young so I won't need to have the liver tests the pamphlet suggests." c) "This is not a drug to be used for all forms of acne. My sister has minor acne so I told her this wasn't for her." d) "As long as I use two forms of birth control I don't need to have monthly pregnancy testing." e) "If I am sexually active I need to let my doctor know."
• "It's important I get my CBC blood test when my doctor orders it." • "This is not a drug to be used for all forms of acne. My sister has minor acne so I told her this wasn't for her." • "If I am sexually active I need to let my doctor know."
The nurse is collecting data on a child with a diagnosis of atopic dermatitis. While interviewing the caregiver, the nurse will direct questions to the caregiver recognizing that which common allergens are involved in eczema? Select all that apply. a) Eggs b) Nylon c) Cotton d) Animal dander e) Oatmeal f) Cow's milk
• Cow's milk • Animal dander • Nylon
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) Assessing temperature every 4 hours b) Using appropriate hand hygiene c) Urging adequate nutritional intake d) Obtaining a culture of the impaired skin area
Using appropriate hand hygiene
The nurse is caring for a child with urticaria. What is the priority action? a) Assessing the child's airway and breathing and noting any wheezing or stridor b) Inspecting the skin, noting evidence of raised, edematous hives anywhere on the body c) Obtaining a detailed history of new foods, medications, stress, or changes in environment d) Noting whether hives are pruritic, blanch when pressed, or are migrating
Assessing the child's airway and breathing and noting any wheezing or stridor
What is the best technique to perform an assessment of the skin? a) Skin assessment involves inspection and palpation using vinyl gloves. b) Skin assessment involves inspection and palpation in a room with yellow walls and bright white light. c) Skin assessment involves inspection and palpation using latex gloves. d) Skin assessment involves inspection and palpation in a room with natural daylight.
Skin assessment involves inspection and palpation in a room with natural daylight.
When assessing an adolescent for acne, what findings would lead the nurse to identify the acne as severe? Select all that apply. a) Widespread inflammatory lesions b) Evidence of cysts c) Facial papules d) Presence of nodules e) Comedones
• Widespread inflammatory lesions • Evidence of cysts • Presence of nodules
An adolescent is prescribed isotretinoin. Which statement indicates that the adolescent understands the necessary precautions associated with this drug? a) "I'm going to have to have a blood count done every couple of months." b) "The drug might cause staining of my clothing." c) "I have to make sure that I do not become pregnant while taking this drug." d) "This drug can affect my lungs so I need a chest radiograph done first."
"I have to make sure that I do not become pregnant while taking this drug."
The nurse is caring for a 13-year-old girl with acne vulgaris and is teaching the girl about skin care. Which response by the girl indicates a need for further teaching? a) "I must use my medicine daily so that it will work." b) "I should avoid eating any kind of chocolate." c) "It is best to avoid hats and headbands." d) "I should use a humectant moisturizer."
"I should avoid eating any kind of chocolate."
The nurse is developing the plan of care for a 3-year-old child diagnosed with atopic dermatitis. Which client outcomes are common focuses for a child with this diagnosis? Select all that apply. a) Prevention of infection b) Promotion of skin hydration c) Pain management d) Maintenance of skin integrity e) Reduction in anxiety
• Promotion of skin hydration • Maintenance of skin integrity • Prevention of infection
The nurse is providing education to a teenaged boy diagnosed with impetigo. Which statement by the boy indicates the need for further education? a) "This condition is contagious." b) "I can continue to attend school while taking the prescribed antibiotics." c) "I will need to cover my son's skin lesions with bandages until it has healed." d) "It is important to remove the crusts before applying any topical medications."
"I will need to cover my son's skin lesions with bandages until it has healed."
