Prep U Chapter 21

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? "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." "Your child most likely has dandruff. You can treat it with daily with antiseborrheic shampoo, like Head and Shoulders." "How often do you bathe your infant? The infant should have a thorough shampooing every day to prevent things like this." "Your child most likely has infantile seborrheic dermatitis, or cradle cap. There is no intervention needed and it should resolve in 1 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 is concerned about the pediatric client's immune system after taking corticosteroids. Which laboratory study is the nurse most correct to assess? red blood count leukocyte count eosinophils basophils

leukocyte count

The nurse is reinforcing teaching with the caregiver of 5-year-old twins regarding urinary tract infections (UTIs). The caregiver is puzzled about why her daughter has had three urinary tract infections but her son has had none. She reports that their diets and fluid intake is similar. Which statement would be accurate for the nurse to tell this mother? "A girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily." "Girls tend to urinate less frequently than boys, making them more susceptible to UTI's." "Girls need more vitamin C than boys to keep their urinary tract healthy, so your daughter may be deficient in vitamin C." "It is unlikely that your daughter is practicing good cleaning habits after she voids."

"A girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily."

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? "I am not sure why you think a skin disorder would lead to asthma?" "I can understand your concern. We will closely monitor your child for asthma development." "If your child starts having respiratory difficulties, be sure to let your health care provider know." "All children with atopic dermatitis develop both asthma and hay fever, so we will monitor your child for both conditions."

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

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? "I guess my mom was right; she always put ice on our burns when we were kids." "If my child has a superficial burn, I will run cool water over it." "Mild soap can be used to clean a superficial burn." "For a superficial burn, I can cover it with a clean nonadherent dressing."

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

The nurse is caring for a 2-month-old infant. The parent asks if it is okay to use a sunscreen lotion made for children. Which response by the nurse would be most accurate? "It is okay to use a children's sunscreen as long as you avoid the face." "You should not bring your infant into sunny locations." "Put plenty of children's sunscreen on the infant at least 15 minutes before going outdoors, then reapply every 3 to 4 hours." "Sunscreen is not recommended until 6 months of age. Use light clothing and a hat to completely cover the child when in the sun."

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

A single male caregiver of a 14-year-old girl accompanies his daughter to her pre-high school physical. In the course of discussion about how his daughter is developing, he remarks, "She's terrific most of the time. Of course when she gets her period, she's miserable and mean, but I tell her that's just what it's like to be a woman." What would be the most appropriate response by the nurse? "PMS is a problem for a lot of women, but sometimes it's worse in the beginning. She might outgrow it." "There are nutritional and medical things she can do to lessen the symptoms; I'll give both of you information about some strategies and we'll track her for a few months." "That must be hard on you, especially because you are raising her by yourself." "That doesn't make being a woman sound very good. It would probably be easier for her if you could be more supportive."

"There are nutritional and medical things she can do to lessen the symptoms; I'll give both of you information about some strategies and we'll track her for a few months."

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? "We should avoid using petroleum jelly." "We should keep his fingernails short and clean." "We should avoid tight clothing and heat." "We need to develop ways to prevent him from scratching."

"We should avoid using petroleum jelly."

A nurse is caring for a child with a wasp sting. Which nursing intervention is a priority? Remove jewelry or restrictive clothing. Apply ice intermittently. Administer diphenhydramine per protocol. Cleanse wound with mild soap and water.

Administer diphenhydramine per protocol

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? Airway remains patent. Pain is at a tolerable level. Wounds remain infection-free. Fluid balance is maintained.

Airway remains patent.

The nurse is collecting data on a 6-year-old child admitted with acute glomerulonephritis. Which vital sign would the nurse anticipate with this child's diagnosis? Pulse rate 112 bpm Pulse oximetry 93% on room air Respirations 24 per minute Blood pressure 136/84

Blood pressure 136/84

A child is being evaluated for renal and urinary tract disease. What would the nurse expect to be ordered to evaluate the child's glomerular filtration rate? Urinalysis Creatinine clearance rate Kidneys, ureter, and bladder x-ray Computed tomography scan

Creatinine clearance rate

A school nurse is trying to prevent poststreptococcal glomerulonephritis in children. What would be the best way to prevent this? Encourage the child to take all the antibiotics if diagnosed with strep throat. Tell parents to give ibuprofen if their child has a sore throat. All children in the child's class should be tested for strep throat if one child has a positive test. Prophylactic antibiotics after strep throat are important.

Encourage the child to take all the antibiotics if diagnosed with strep throat.

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? "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." "The complete blood count is a routine test used anytime there is an abnormal condition in the body." "This test will help in determining the type of bacteria that is causing this infection." "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."

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 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? First-degree or superficial burn Second-degree or partial-thickness burn Third-degree or full-thickness burn Fourth-degree or fat-layer burn

Second-degree or partial-thickness burn

Which goal of therapy would be appropriate for a nurse to establish with a client's family and a client who has a diagnosis of enuresis? The child wakes up once during the night for a glass of water. The client wets only when involved in an activity. The client remains continent throughout the night. The parent takes the client to the bathroom at night.

The client remains continent throughout the night.

A newborn is diagnosed with hypospadias and the parents want the newborn to be circumcised. What would be the best response by the nurse? The foreskin is needed for repair. Circumcision is usually performed after 1 year of age. Circumcision with hypospadias will cause meatal stenosis. The circumcision may predispose the newborn to renal failure.

The foreskin is needed for repair.

The nurse is reviewing the causative organisms noted on laboratory reports. Which organism is transmitted solely by sexual contact? Bacillus Trichomonas Cholera bacterium Borelli

Trichomonas

A nurse is caring for a 13-year-old boy with end-stage kidney disease who is preparing to have his hemodialysis treatment in the dialysis unit. Which nursing action is appropriate? Administer his routine medications as scheduled. Take his blood pressure measurement in the extremity with the AV fistula. Withhold his routine medication until after dialysis is completed. Assess the Tenckhoff catheter site.

Withhold his routine medication until after dialysis is completed.

A group of nursing students is discussing terminology related to the genitourinary system during a post-conference setting. One of the students asks what mittelschmerz is or what it means. A classmate of this student correctly answers that mittelschmerz is: a symptom of premenstrual syndrome. the beginning of menstruation. a dull, aching abdominal pain at ovulation. a medication given to treat dysmenorrhea.

a dull, aching abdominal pain at ovulation.

The nurse is caring for a child who receives dialysis via an AV fistula. Which finding indicates an immediate need to notify the physician? presence of a bruit presence of a thrill dialysate without fibrin or cloudiness absence of a thrill

absence of a thrill

A client has just been admitted to the unit with a history of recent strep infection, hematuria, and proteinuria. Based on these findings, the nurse would suspect which condition? renal failure urinary tract infection prune belly syndrome acute glomerulonephritis

acute glomerulonephritis

The nurse is caring for a child diagnosed with hydronephrosis. Which manifestation is consistent with complications of the disorder? hypertension hypotension hypothermia tachycardia

hypertension

A 3-year-old child is scheduled for a surgery to correct undescended testes. For what postoperative consideration would the nurse want to prepare the parents? the need for complete bed rest for 10 days some discomfort at the surgery site a liquid diet for 3 days the need for maintaining a semi-Fowler positio

some discomfort at the surgery site

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. The most appropriate action by the nurse would be to: contact the necessary authorities to report a suspected case of sexual abuse. take the child to a private room and interview her regarding her sexual history and partners. take the caregiver to a private room and tell her that the child's diagnosis can only come from sexual activity. talk to the child and caregiver together and explain that the condition is often a result of a sexually transmitted infection and discuss the importance of safe sex practices.

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

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? hepatitis A vaccine hepatitis B vaccine tetanus toxoid vaccine Haemophilus influenzae type B vaccine

tetanus toxoid vaccine