Study Exam 5
An infant has presented at the clinic with impetigo. Which organism usually causes impetigo in infants? Methicillin-resistant Staphylococcus aureus (MRSA) Escherichia coli Staphylococcus aureus Group A beta hemolytic strep
Staphylococcus aureus Explanation: Staphylococcus aureus is the most common cause of impetigo in infants.
The nurse is teaching about skin care for atopic dermatitis. Which statement by the parent indicates that further teaching may be necessary? "I will use Vaseline or Crisco to moisturize my child's skin." "A hot bath will soothe my child's itching when it is severe." "I will buy cotton rather than wool or synthetic clothing for my child." "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." Hot baths should be avoided, as they are more dehydrating to the skin. Warm baths are preferred, followed by patting the child dry and rubbing on a small amount of prescribed cream, then a liberal amount of fragrance-free moisturizer. Wool clothing should be avoided in the child with atopic dermatitis.
A child has been diagnosed with atopic dermatitis. The nurse is teaching the parents about measures to control this condition. What does the nurse teach the parents? Select all that apply. "Do not use hot water to cleanse the skin." "Pat dry the skin after a bath. Do not rub." "Keep your child's nails trimmed short." "Apply prescribed moisturizer several times per day." "Use prescribed steroidal lotions every day."
"Do not use hot water to cleanse the skin." "Pat dry the skin after a bath. Do not rub." "Keep your child's nails trimmed short." "Apply prescribed moisturizer several times per day."
A child with asthma has been monitoring his peak expiratory flow rate (PEFR) and has been maintaining it within 90% of his personal best. Today, the child is experiencing symptoms and his PEFR is at 40% of his personal best. The child's mother calls the office and asks the nurse what she should do. What would the nurse instruct the mother to do first? "Have him use his low-dose steroid inhaler now and again in 15 minutes." "Have him use his short-acting bronchodilator right away." "Continue to watch his PEFR readings and call back if they go below 40%." "You need to take him to the emergency department right away."
"Have him use his short-acting bronchodilator right away." Explanation: The child's symptoms and drop in PEFR suggest a medical alert or "red" situation, indicating the need for the short-acting bronchodilator and then a trip to the office or emergency department. The child should use his short-acting bronchodilator first and then go to the physician's or nurse practitioner's office or emergency room.
When providing care for a child with herpes zoster (shingles), the parents ask the nurse how the child contracted this infectious disorder. Which response by the nurse is most appropriate? "Your child must have been exposed to someone with herpes zoster." "Children who are immunocompromised are more likely to contract shingles." "Handwashing is an effective way to prevent the spread of infectious disorders." "Herpes zoster is a reactivation of a previous varicella zoster infection."
"Herpes zoster is a reactivation of a previous varicella zoster infection."
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." "Mild soap can be used to clean a superficial burn." "If my child has a superficial burn, I will run cool water over it." "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." Explanation: Steps for providing burn care at home to a first-degree (superficial) burn include running cool water, not ice, over the burn and covering it with a nonadherent bandage after cleaning with a fragrance-free mild soap.
An adolescent is prescribed isotretinoin. Which statement indicates that the adolescent understands the necessary precautions associated with this drug? "I have to make sure that I do not become pregnant while taking this drug." "This drug can affect my lungs so I need a chest radiograph done first." "I'm going to have to have a blood count done every couple of months." "The drug might cause staining of my clothing."
"I have to make sure that I do not become pregnant while taking this drug." Explanation: Adolescent girls taking this drug who are sexually active must be on a pregnancy prevention program because the drug causes defects in fetal development. Monthly complete blood counts are required when taking isotretinoin
The nurse is caring for a 10-year-old girl with cystic fibrosis who receives pancreatic enzymes. Which comment by a parent demonstrates understanding of the instructions regarding the medication? "I should reduce the dose if she has large, malodorous stools." "I should give the enzymes before each meal or snack." "Between meals is the best time to give the enzymes." "I should stop the enzymes if my child is taking antibiotics."
"I should give the enzymes before each meal or snack." Explanation: The enzymes are necessary for appropriate digestion and absorption of food and nutrients.
The nurse has completed client teaching with a 16-year-old female who has been prescribed isotretinoin for cystic acne. Which statements indicate learning has occurred? Select all that apply. "I am young so I won't need to have the liver tests the pamphlet suggests." "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." "As long as I use two forms of birth control I don't need to have monthly pregnancy testing."
"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."
A mother calls the clinic because her 2-year-old daughter has a rectal temperature of 37.8°C (100°F). She wonders how high a fever should be before she should give medications to reduce it. What is the best response by the nurse? "All fevers should be treated to prevent seizures." "Antipyretics should be used with any rise in temperature. They can help change the course of the infection." "Give your child aspirin when her fever is above 38°C (100.4°F)." "In a normal healthy child, if your child is not uncomfortable, fevers less than 39°C (102.2°F) do not require medication."
"In a normal healthy child, if your child is not uncomfortable, fevers less than 39°C (102.2°F) do not require medication." Health care providers need to remember and to educate parents that fever is a protective mechanism the body uses to fight infection. Evidence exists that elevated body temperatures enhance various components of the immune response. Studies have shown that the use of antipyretics may actually prolong illness. Concern also exists that reducing fever may hide signs of serious bacterial illness. Aspirin should never be administered to children to reduce fever due to the risk of Reye syndrome
A child is diagnosed with varicella. The parent states the child is "just miserable" and wants to know how best to make the child feel more comfortable. Which instruction(s) would the nurse give this parent? Select all that apply. "Keep only light clothing on your child." "You can administer acetaminophen to help with fever and pain." "Keep your child's fingernails short so scratching will not disturb vesicles." "Administer prescribed topical steroid ointment to reduce inflammation." "Place the child in a soothing tepid bath."
"Keep only light clothing on your child." "You can administer acetaminophen to help with fever and pain." "Keep your child's fingernails short so scratching will not disturb vesicles." "Place the child in a soothing tepid bath."
A 6-year-old child has been diagnosed with tinea capitis. Which statement(s) by the parents demonstrate the need for further teaching? Select all that apply. "We can use selenium sulfide shampoo to decrease contagiousness." "Our child can return to school 24 hours after taking the antifungal medication." "We should have our child take the prescribed antifungal medication until symptoms have resolved." "We should wash sheets and towels in hot water to decrease the spread to other family members." "We should not expect our child to suffer hair loss."
"Our child can return to school 24 hours after taking the antifungal medication." "We should not expect our child to suffer hair loss." "We should have our child take the prescribed antifungal medication until symptoms have resolved." Explanation: Tinea capitis is a fungal infection of the scalp. The condition is contagious. Sheets and towels should be laundered in hot water to prevent the spread of the infection.
The parents of a 3-year-old child report he was exposed to pertussis 2 days ago. They are concerned and ask the nurse how long it will take until he becomes ill if he indeed contracted the infection. What response by the nurse is indicated? "The signs of disease will be noted in 1 to 3 weeks." "If your child had contracted the disease symptoms would have be noted by this time." "It normally takes about 3 weeks before symptoms begin." "If you child has contracted the illness he will become ill in about 2 weeks."
"The signs of disease will be noted in 1 to 3 weeks." Explanation: Pertussis is an acute respiratory disorder characterized by paroxysmal cough (whooping cough) and copious secretions. The disease is caused by Bordetella pertussis. The incubation period is 6 to 21 days, usually 7 to 10 days.
The nurse is reinforcing teaching with a group of caregivers of children diagnosed with asthma. Which statement best indicates an understanding of the management and treatment for this diagnosis? "The medications she takes are all in one place, ready for her to take at any time." "He knows how and even when he needs to use his peak flow meter." "We have taken the carpet out of our house and let my mom take our dog." "Even the babysitter helps us keep up the diary with her symptoms."
"We have taken the carpet out of our house and let my mom take our dog." Explanation: Families must make every effort to eliminate any possible allergens from the home. Prevention is the most important aspect in the treatment of asthma.
The nursing is caring for a hospitalized child diagnosed with varicella-zoster virus. The child's parents ask how to prevent the child's siblings from contracting the virus. Which response by the nurse is best? "We will place your child on contact and airborne precautions. It is best for the other children not to visit." "Vaccinating your other children is the only way to prevent them from contracting the virus." "As long as your other children wash their hands, they should not contract the virus." "Since this is a virus, there is nothing you can do to prevent your other children from getting it."
"We will place your child on contact and airborne precautions. It is best for the other children not to visit." Explanation: The causative agent for chickenpox is the varicella-zoster virus, which is spread through contact and airborne methods. The client should be placed on precautions and limit visitors who are at risk.
After teaching a child's parents about the different methods of distraction that can be used for pain management, which statement by the parents indicates a need for additional teaching? "We'll have her focus on her hand and count each finger slowly." "We'll read some of her favorite stories to her." "We'll have her imagine that she's at the beach this summer." "She likes to play video games, so we'll bring in some from home."
"We'll have her imagine that she's at the beach this summer." Having the child imagine that she is at the beach this summer is an example of imagery, where the child creates a mental image that is positive or pleasurable
A school-aged child is recovering from varicella. The parent calls the school nurse and states, "my child is feeling much better" and asks when the child can return to school. What information does the nurse provide the parent? "Your child may return to school when all of the lesions have crusted over." "Your child may return to school when a health care provider has given written permission." "Your child may return to school when free of any lesions." "Your child may return to school when there has been no fever for 48 hours."
"Your child may return to school when all of the lesions have crusted over."
A 1-month-old infant is admitted to the hospital to rule out sepsis. What would be your priority nursing interventions?
-Provide close monitoring, including vital signs, and initiate antibiotic therapy. -Intravenous antibiotics will be started immediately after the blood, urine, and cerebrospinal fluid cultures have been obtained. -Manage fever to promote comfort
A 12-year-old boy presents with a very sore throat and fever. On assessment you find an erythematous rash on his face that feels like sandpaper. You obtain a throat culture, which is positive for group A streptococcus. What instructions would you give the parents regarding his care at home?
-the importance of taking the antibiotic as directed and finishing all the medicine. -encourage fluids to maintain adequate hydration due to fever. -Teach parents ways to provide comfort for the child. -Discuss use of a cool mist humidifier to help soothe the child's sore throat. -Soft foods, warm liquids such as soup, or cold foods such as Popsicles may also be helpful. -Trim the child's fingernails if the rash itches to help prevent infection due to breaks in the skin
Acetaminophen dosage instructions include which of the following?. Select all that apply 10-15 mg/kg/dose no more q 6hrs 15-20mg/kg/dose no more than q 4 hrs no more 5 doses/24 hrs.
10-15 mg/kg/dose no more q4hrs no more 5 doses/24 hrs.
A child is scheduled for a bone marrow aspiration at 4 p.m. The nurse would plan to apply EMLA cream to the intended site at which time? 1:30 p.m. 3:00 p.m. 3:30 p.m. 4:00 p.m.
1:30 p.m. To ensure the effectiveness of EMLA cream for a bone marrow aspiration, which is considered a deep procedure, the nurse would apply the cream 2 to 3 hours before the time of the procedure
The nurse is assessing several children. Which child is most at risk for dysphagia? 8-year-old with fever and fatigue 7-month-old with erythematous rash 2-month-old with toxic appearance 5-year-old with epiglottitis
5-year-old with epiglottitis Explanation: The 5-year-old with epiglottitis has a sore, swollen throat placing the child at risk for dysphagia (difficulty swallowing).
The student nurse gives a presentation on the dangers of sun exposure to clients at a community health center. Which statement(s) by the attendees demonstrate that knowledge was gained from the presentation? Select all that apply. A 17-year-old adolescent states no longer using the tanning bed after attending the presentation. The parents of a 3-month-old infant report they have been using sunscreen on their infant since attending the presentation. A 16-year-old adolescent states that it "scares me to think that my cells are changing when I get a sunburn." A 16-year-old adolescent reports avoiding the sun until after 12:00 noon. A 15-year-old adolescent states always using sunscreen because "she does not want to get skin cancer like my mother did."
A 17-year-old adolescent states no longer using the tanning bed after attending the presentation. A 15-year-old adolescent states always using sunscreen because "she does not want to get skin cancer like my mother did." A 16-year-old adolescent states that it "scares me to think that my cells are changing when I get a sunburn."
The nurse is developing a teaching plan for the parents of a 12-year-old boy with cystic fibrosis. For which piece of equipment should the nurse prioritize education?
flutter valve device Explanation: A flutter valve device is used to assist with mobilization of secretions for older children and adolescents with cystic fibrosis.
Which situation would cause the nurse to become concerned about possible hearing loss? A 12-month-old who babbles incessantly, making no sense An 8-month-old who says only "da" A 3-month-old who startles easily to sound A 3-year-old who drops the letter "s"
An 8-month-old who says only "da" Infants should be babbling at the age of 8 months. Lack of babbling is an indicator of possible hearing loss.
A toddler has moderate respiratory distress, is mildly cyanotic, and has increased work of breathing, with a respiratory rate of 40. What is the priority nursing intervention? Airway maintenance and 100% oxygen by mask. 100% oxygen and pulse oximetry monitoring. Airway maintenance and continued reassessment. 100% oxygen and provision of comfort.
Airway maintenance and 100% oxygen by mask. Priorities of care for the child with respiratory distress are to clear the airway and provide oxygen supplementation.
The child has been diagnosed with asthma and the child's physician is using a stepwise approach. Rank the order in which the nurse should administer these medications as the child's condition worsens. Low-dose inhaled corticosteroid Medium-dose inhaled corticosteroid Albuterol as needed Medium-dose inhaled corticosteroid and salmeterol
Albuterol as needed Low-dose inhaled corticosteroid Medium-dose inhaled corticosteroid Medium-dose inhaled corticosteroid and salmeterol
Distraction techniques for pain include which of the following? Select all that apply Counting Repeating specific phrases or words, such as "ouch" Listening to music or singing Playing games, including video games Blowing bubbles or blowing pinwheels or party favors Listening to favorite stories Watching cartoons, television shows, or movies Playing on multimedia devices such as, tablets, iPods, iPads, iPhones; Visiting with friends Humor
All of these
Nurse's Role in Managing Procedure-Related Pain includes which of the following? Select all that apply Use intermittent infusion device or PICC for multiple samples. Opt for venipuncture in newborns instead of heel sticks if large amount needed. Use kangaroo care for newborns before and after heel stick. Provide nonnutritive sucking before the procedure. Use topical anesthetic at site of a skin or vessel puncture. Use nonpharmacologic strategies for pain relief. Prepare child/family ahead of time about the procedure. Use therapeutic hugging to secure the child. Use the smallest-gauge needle possible
All of these
When developing the plan of care for a child in pain, the nurse identifies appropriate strategies aimed at modifying which factors influencing pain? Gender Cognitive level Previous pain experiences Anticipatory anxiety
Anticipatory anxiety Situational factors such as anticipatory anxiety are those factors that interact with the child and the current situation involving the experience of pain.
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? Administer griseofulvin with a fatty meal. Institute contact isolation precautions. Apply topical antibiotic cream. Apply topical antifungal cream.
Apply topical antifungal cream. An angry red rash with satellite lesions is typical of diaper candidiasis. Topical antifungal preparations are indicated.
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? Administer rabies immunoglobulin. Refer the child to a counselor. Assess the depth and extent of the wound. Administer a tetanus booster.
Assess the depth and extent of the wound. Fully assess the extent of the wound before initiating other care. A full assessment allows the nurse to determine the next course of action.
Which measure would be most effective in aiding bronchodilation in a child with laryngotracheobronchitis? Urging the child to continue to take oral fluids Administering an oral analgesic Teaching the child to take long, slow breaths Assisting with racemic epinephrine nebulizer therapy
Assisting with racemic epinephrine nebulizer therapy Explanation: Croup is a viral infection that causes inflammation and edema of the larynx, trachea, and bronchi. One form of treatment is the use of nebulized racemic epinephrine.
The pediatric nurse knows that there are a number of anatomic and physiologic differences between children and adults. Which statement about the immune systems of infants and young children is true? Children have an increased inflammatory response. Cellular immunity is not functional in children. Passive immunity overlaps immunizations. Children have an immature immune response.
Children have an immature immune response. Explanation: Infants and young children are more susceptible to infection due to the immature responses of their immune systems.
An adolescent who is a competitive swimmer comes to the emergency department complaining of localized aching pain in his shoulder. He states, "I've been practicing really hard and long to get myself ready for my meet this weekend." The area is tender to the touch. The nurse determines that the adolescent is most likely experiencing which type of pain? Cutaneous pain Deep somatic pain Visceral pain Neuropathic pain
Deep somatic pain The adolescent recently experienced an injury to his shoulder, most likely from overuse due to swimming. His description of a dull ache and evidence of tenderness suggest deep somatic pain, which typically involves the muscles, tendons, joints, fasciae, and bones.
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? Risk for fluid volume deficit Pain Disturbed body image Altered nutrition
Disturbed body image Explanation: Tinea versicolor is a superficial tan or hypopigmented oval scaly lesions, especially on upper back and chest and proximal arms. It may take several months for pigmentation to return to normal; therefore, disturbed body image is going to be a high priority for an adolescent client.
The nurse is preparing to assess the pain of a 3-year-old child who had surgery the day before. Which pain assessment method would be most appropriate for the nurse to use? FACES pain rating scale and poker chip tool FACES pain rating scale, observation of the child, and parent report Asking the parents to rate their child's pain using the word-graphic rating scale Visual analog scale
FACES pain rating scale, observation of the child, and parent report The FACES pain rating scale is a self-report tool that can be used by children as young as 3 or 4 years of age. Self-report measures should be used in conjunction with observation and discussion with the child and family in children under 5.
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? Risk for infection Impaired skin integrity Risk for fluid volume deficit Knowledge deficit regarding care of wound Disturbed body image
Impaired skin integrity Risk for infection Explanation: The wound was not a clean wound, such as a surgical wound, so risk for infection would be a top priority. The child has impaired skin integrity from the wound and from the IV.
The community nurse receives a call from a local day care center. One of the children in the center has been diagnosed with impetigo. Which information related to impetigo will the nurse provide to the day care center? Impetigo cannot be treated with medication and has to run its course. Impetigo usually develops because of sensitivity to pollens and molds. The facility staff should wear masks until all children and adults are healthy. Impetigo is highly contagious and can spread quickly.
Impetigo is highly contagious and can spread quickly. Explanation: Impetigo is a highly contagious skin infection and can spread quickly. It usually appears as red sores on the face, especially around a child's nose and mouth, and may appear on the hands and feet.
A 6-year-old child is being treated for a parasitic infection. When reviewing results from the child's white blood cell count, which finding would be anticipated? elevated monocytes reduced neutrophil levels increased eosinophil levels reduced basophil levels
Increased eosinophil levels Explanation: Eosinophils are the first line of defense against parasitic infections and allergic reactions and will be elevated.
A nursing instructor has presented a class on the stages of an infectious disease to a group of students and asks the students to place the stages in their proper sequence from beginning to end. Place the stages in their proper sequence. Incubation Illness Prodrome Convalescence
Incubation Prodrome Illness Convalescence
Nursing students are learning about the infectious process. They correctly identify the first stage of an infectious disease to be which period? Convalescent period Prodromal period Incubation period Illness period
Incubation period
Pain Management Guide for Children:
Individualize interventions based on the amount of pain experienced and the child's characteristics, such as developmental level, temperament, previous pain experience, and coping strategies. Use nonpharmacologic and pharmacologic approaches to ease or eliminate the pain. Teach the child and family about pain relief interventions and techniques and discuss with the child and family expectations of pain management.
Compared with adults, why are infants and children at an increased risk for infection and communicable diseases? The infant has had limited exposure to disease and is losing the passive immunity acquired from maternal antibodies. The infant demonstrates an increased inflammatory response. Cellular immunity is not functional at birth. Infants have an increased risk for infection until they receive their first set of immunizations.
Infants have an increased risk for infection until they receive their first set of immunizations. The newborn displays a decreased inflammatory response to invading organisms, contributing to an increased risk for infection. Cellular immunity is generally functional at birth, and the humoral immunity system matures by encountering and then developing immunity to new diseases. Since the infant has had limited exposure to disease as well as losing the passive immunity acquired from maternal antibodies, the risk of infection is higher.
The nurse is planning an educational program on burn prevention at home. Which information should be included? Select all that apply. If drinking hot beverages while holding children, keep them in an insulated cup with a lid. Keep hot water heater temperature lower than 130°F (54.4°C). Teach children to "stop, drop and roll" if their clothes catch on fire. Keep pot handles turned in on a stove. Test bath water temperature before bathing children.
Keep pot handles turned in on a stove. Test bath water temperature before bathing children. Teach children to "stop, drop and roll" if their clothes catch on fire.
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 wrestlers on his team have a similar abrasion. What infection should the nurse be most concerned about, based on the history? tinea cruris MRSA impetigo tinea versicolor
MRSA MRSA may be nonresponsive to antibiotic ointments and is becoming common in the community, particularly among athletes.
A 7-year-old child with an earache comes to the clinic. The child's parent reports that 1 day ago the child had a fever and headache and did not want to play. When the nurse asks where it hurts, the child points to the jawline in front of the earlobe. What does the nurse expect the diagnosis will be for this child? Mumps Fifth disease Mononucleosis Measles
Mumps
A child in the clinic has a fever and reports a sore neck. Upon assessment the nurse finds a swollen parotid gland. The nurse suspects which infectious disease? Measles Whooping cough Scabies Mumps
Mumps Explanation: Mumps is an infectious disease with a primary symptom of a swollen parotid gland. It is a contagious disease spread by droplets. The child is contagious 1 to 7 days prior to the onset of the swelling and 4 to 9 days after the onset of the swelling.
Upon providing discharge instructions home after a tonsillectomy and adenoidectomy, which is most important? Note any frequent swallowing. Allow the child an age-appropriate, quiet plan. Provide acetaminophen for pain. Stress regular fluid consumption.
Note any frequent swallowing.
A 4-year-old complains of extreme pain when the tragus is touched. Though not diagnostic, this sign is most indicative of which disorder? Acute otitis media Acute tympanic effusion Otitis interna Otitis externa
Otitis externa Otitis externa, infection and inflammation of the ear canal, results in significant pain, particularly if the tragus is touched.
A group of nurses is reviewing the diagnosis of cystic fibrosis. With regard to the effect of this disease on the body, which parts of the body (besides the lungs) are most affected by this disease? Pancreas and liver Kidney and bladder Heart and blood vessels Brain and spinal cord
Pancreas and liver Explanation: The major organs affected are the lungs, pancreas, and liver.
The caregivers of a child who was diagnosed with cystic fibrosis 5 months ago report that they have been following all of the suggested guidelines for nutrition, fluid intake, and exercise, but the child has been having bouts of constipation and diarrhea. The nurse tells the caregiver to increase the amount of which substance in the child's diet? Saturated fat Calories from protein Iodized salt Pancreatic enzymes
Pancreatic enzymes Explanation: Adequate nutrition helps the child resist infections. Pancreatic enzymes must be administered with all meals and snacks. If the child has bouts of diarrhea or constipation, the dosage of enzymes may need to be adjusted
A 2-year-old has been prescribed eye patching for strabismus 6 hr/day. What teaching does the nurse provide for the mother? Try to patch 6 hr/day, but if you miss some, it is OK. Patching is necessary to strengthen vision in the weaker eye. Patching will keep the eye from turning in. Since the child is so young, patching can be delayed until school age.
Patching is necessary to strengthen vision in the weaker eye. Patching instructions must be complied with. Patching is done as early as possible to strengthen the acuity in the weaker eye while vision is still developing. Delay in strabismus treatment may lead to amblyopia and eventual blindness in one or both eyes.
What is characterized by cough and cold symptoms that progress to paroxysmal coughing spells along with copious secretions?
Pertussis
The nurse is caring for an infant who has undergone surgery for infantile glaucoma. What is the priority nursing intervention? Place the child prone postoperatively for comfort. Teach the family use of the contact lens. Place elbow restraints on the infant. Provide a mobile for optical stimulation.
Place elbow restraints on the infant. It is very important to protect the operative site after any eye surgery. Elbow restraints prevent the infant from rubbing the eyes.
The public health nurse has been asked to provide information to local child care centers on controlling the spread of infectious diseases. What is the best information the nurse can provide? The etiology of common infectious diseases Proper handwashing techniques The physiology of the immune system Why children are at a higher risk of infection than adults
Proper handwashing techniques Frequent hand washing is the single most important way to prevent the spread of infection
A neonate should be evaluated by a physician if which signs and symptoms are present? Acting fussier than normal Refusing the pacifier Rectal temperature above 38°C Mottling that is present during bathing
Rectal temperature above 38°C Neonates or young infants less than 3 months of age with a rectal temperature greater than 38°C are considered at risk for sepsis until proven otherwise and should be seen by a physician. Their immature immune system and inability to localize or handle infection put them at high risk for severe morbidity or mortality from bacterial infections
A nurse practitioner suspects that a child has scarlet fever based on which assessment finding? Severity of the sore throat Red, strawberry tongue White exudate on the tonsils An enanthematous rash
Red, strawberry tongue Explanation: The characteristic assessment finding that distinguishes scarlet fever from other disorders is the appearance of the red, strawberry tongue. Sore throat, an enanthematous and exanthematous rash, and white exudate on the tonsils are also seen with scarlet fever, but it is the strawberry tongue that helps to confirm the diagnosis.
In caring for the child with asthma, the nurse recognizes that bronchodilator medications are administered to children with asthma for which reason? Prevention of mild symptoms Relief of acute symptoms Management of chronic pain To stabilize the cell membranes
Relief of acute symptoms Explanation: Bronchodilators are used for quick relief of acute exacerbations of asthma symptoms.
A child is receiving epidural analgesia with morphine. The nurse would be alert for which of the following adverse effects? Select all that apply. Respiratory depression Pruritus Constipation Vomiting Amnesia Hematoma
Respiratory depression Pruritus Constipation Vomiting Adverse effects of morphine given epidurally include respiratory depression, constipation, pruritus, and nausea and vomiting.
During an assessment, a child exhibits an audible high-pitched inspiratory noise, a tripod stance and intercostal retractions. Using SBAR communication, the nurse notifies the health care provider and states which breath sounds that are congruent with the clinical presentation of the child? Respiratory stridor Wheezing in the bases Rales in the middle lobe Rhonchi throughout the lung
Respiratory stridor Explanation: Stridor is a high-pitched, readily audible inspiration noise that indicates an upper airway obstruction. The child presents in severe respiratory compromise and struggles to breathe
A 6-year-old child is brought to the clinic by his parents. The parents state, "He had a sore throat for a couple of days and now his temperature is over 102°F (38.9°C). He has this rash on his face and chest that looks like sunburn but feels really rough." What would the nurse suspect? Pertussis Community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA) Scarlet fever Diphtheria
Scarlet fever Explanation: Scarlet fever typically is associated with a sore throat, fever greater than 101° F (38.9° C), and the characteristic rash on the face, trunk, and extremities that looks like sunburn but feels like sandpaper.
Which electrolyte does the client with cystic fibrosis need in abundance? Chlorine Magnesium Sodium Potassium
Sodium Explanation: Dietary intake of sodium is encouraged due to increased sodium losses.
A 5-month-old infant with RSV bronchiolitis is in respiratory distress. The baby has copious secretions, increased work of breathing, cyanosis, and a respiratory rate of 78. What is the most appropriate initial nursing intervention? Attempt to calm the infant by placing him in his mother's lap and offering him a bottle. Alert the physician or nurse practitioner to the situation and ask for an order for a stat chest radiograph. Suction secretions, provide 100% oxygen via mask, and anticipate respiratory failure. Bring the emergency equipment to the room and begin bag-valve-mask ventilation.
Suction secretions, provide 100% oxygen via mask, and anticipate respiratory failure. Priorities of care for the child with respiratory distress are to clear the airway and provide oxygen supplementation. Children who experience respiratory distress often deteriorate quickly, and the nurse must be prepared in the event of respiratory failure or arrest.
What is a definitive test for cystic fibrosis? Blood culture Blood gas Complete blood count Sweat chloride
Sweat chloride Explanation: The definitive test in diagnosing cystic fibrosis is the sweat chloride test. This test is performed by stimulating a small patch of sweat glands on the inner aspect of the forearm. There must be two positive tests and clinical symptoms to confirm the diagnosis.
A 9-month-old child has been admitted to rule out sepsis. Which finding offers the most support to the presence of this disorder? The child has had 8 ounces of formula in the past 24 hours. The child cries when his mother is not in sight. The child has had 7 wet diapers in the past 24 hours. The child's birth history indicates he was born at 42 weeks' gestation.
The child has had 8 ounces of formula in the past 24 hours. Explanation: Sepsis is a systemic overresponse to infection resulting from bacteria and viruses, which are the most common fungi, viruses, rickettsia, or parasites. It can lead to septic shock, which results in hypotension, low blood flow, and multisystem organ failure. Signs of sepsis include a lack of appetite, lethargy, hypotonia, and temperature elevations.
The nurse has assessed a 6-year-old child as having respiratory distress due to swelling of the epiglottis and surrounding structures. Which signs and symptoms would support this assessment? The child is irritable and tachycardiac. The child is in tripod position. The child is pale and has vomited. The child has pale, elevated patches on the skin.
The child is in tripod position. Explanation: Inflammation and swelling of the epiglottis and surrounding structures are common in children ages 2 to 7 years. The child will attempt to improve his/her airway by sitting forward and extending the neck forward with the jaw up, in a "sniffing position" (tripod position).
A 6-year-old child is diagnosed with tinea pedis. Which prescription will the nurse question? Perform warm foot soaks daily. The child may return to school in 1 week. luliconazole cream daily for 2 weeks Cleanse the skin with antibacterial soap.
The child may return to school in 1 week. Explanation: Tinea pedis refers to a fungal infection that typically begins between the toes. The nurse would question the child being out of school for a week
The nurse is concerned that the child is developing septic shock. Which finding(s) are consistent with this condition? Select all that apply. The child's blood pressure is reduced. C-reactive protein is decreased. The child's respiratory rate is elevated. The child is pale and lethargic. White blood cell count is elevated.
The child's blood pressure is reduced. The child's respiratory rate is elevated. The child is pale and lethargic. White blood cell count is elevated.
A young girl arrives at the emergency room after being bitten by a neighbor's dog. The mother is concerned her daughter will get rabies. The nurse carefully examines and treats the bite and questions the mother and daughter about the details surrounding the dog biting her. What information would most strongly indicate a risk for rabies infection in this client? The dog belonged to a neighbor The dog was properly immunized for rabies The dog was unprovoked when he bit the girl There have been no other reported instances in the area
The dog was unprovoked when he bit the girl Explanation: An unprovoked attack is much more suggestive that the animal is rabid, rather than if the bite happens during a provoked attack.
The nurse is caring for a 7-year-old child in droplet precautions due to the diagnosis of pertussis. While visiting the child, which actions by the parents require the nurse to intervene? Select all that apply. The parents wear a respiratory mask when entering their child's room. The parents remove their personal protective equipment (PPE) at the door before exiting, then wash their hands. The parents state, "We will be sure to finish any antibiotic if our child is sent home with a prescription." The parents state, "We have been limiting our child's fluids to help decrease the amount of coughing." The parents state, "We should postpone immunizing our 5-year-old since there has been contact with the infection."
The parents state, "We should postpone immunizing our 5-year-old since there has been contact with the infection." The parents state, "We have been limiting our child's fluids to help decrease the amount of coughing."
The nurse is administering a chickenpox vaccination to a 12-month-old girl. Which concern is unique to varicella? Dehydration is caused by mouth lesions. Vitamin A is indicated for children younger than 2 years. Children with this disease need to avoid pregnant women. This disease can reactivate years later and cause shingles.
This disease can reactivate years later and cause shingles.
Which of these factors contributes to infants' and children's increased risk for upper airway obstruction as compared with adults? Underdeveloped cricoid cartilage and narrow nasal passages. Small tonsils and narrow nasal passages. Cylinder-shaped larynx and underdeveloped sinuses. Underdeveloped cricoid cartilage and smaller tongue.
Underdeveloped cricoid cartilage and narrow nasal passage Infants and children have smaller nasal passages than adults, thus making obstruction with mucus more common. The funnel shape of the larynx due to underdevelopment of the cricoid cartilage places children less than 10 years of age at increased risk of airway obstruction in the event of edema or mucus production.
Which collaborative intervention will the nurse provide when caring for an infant diagnosed with pertussis? Select all that apply. Utilize droplet and standard precautions. Administer erythromycin for 10 days. Encourage small, frequent feedings. Have suction available in the room. Restrict visitors for 48 hours of hospitalization.
Utilize droplet and standard precautions. Administer erythromycin for 10 days. Encourage small, frequent feedings. Have suction available in the room.
The nurse is caring for multiple clients on the pediatric unit. Which child will the nurse see first? a child with herpes simplex who is reporting mouth pain and pruritis a child diagnosed with chicken pox reporting nausea and malaise a child with erythema infectiosum experiencing fatigue and confusion a child diagnosed with measles experiencing photophobia and coryza
a child with erythema infectiosum experiencing fatigue and confusion Explanation: A child with erythema infectiosum experiencing fatigue and confusion is showing signs of decreased oxygenation, possibly related to aplasia of erythrocytes caused by the virus. A child with signs and symptoms of decreased oxygenation should be seen first.
A chief danger of scarlet fever is that children may develop: acute glomerulonephritis. local areas of skin necrosis. liver destruction. respiratory obstruction.
acute glomerulonephritis. Explanation: Scarlet fever infection is the result of group A streptococci. It generally starts with a throat infection (strep throat). The bacteria produce a toxin that causes the rash over the body. Because this is a streptococci-based infection, the child will need to be monitored for the development of rheumatic fever or glomerulonephritis following the illness
A nurse is assessing a neonate with sepsis. The nurse understands that most commonly the cause involves: protozoa. enterovirus. herpes virus. bacteria.
bacteria. Explanation: Neonatal sepsis can be caused by viruses such as herpes simplex or enteroviruses and by protozoa (e.g., oxoplasma gondii). However, bacteria are typically the culprits.
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. burning photosensitivity dryness flu-like symptoms headache
burning photosensitivity dryness Explanation: Adverse effects associated with topical retinoid therapy include burning, dryness, and photosensitivity.
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? applying oils and petroleum jelly to the affected areas keeping socks on before, during, and after athletic events allowing the child to return to school after 3 days of treatment finishing all prescribed oral medication, even after lesions fade
finishing all prescribed oral medication, even after lesions fade Explanation: All prescribed oral medication should be finished in order to prevent reinfection.
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 24 hours after injury? fluid balance wound infection respiratory arrest separation anxiety
fluid balance In the child with a serious burn, fluid balance is of priority importance in the first few days of care.
A child with a suspected airway obstruction is brought to the emergency room. He produces a harsh, strident sound on inspiration (stridor). Where is the obstruction likely to be located based on this information? lower trachea bronchioles pharynx in the larynx
in the larynx Explanation: When the vibrations produced as air are forced past obstructions such as mucus in the nose or pharynx, the noise produced is a snoring sound (rhonchi). If the obstruction is at the base of the tongue or in the larynx, a harsher, strident sound on inspiration (stridor) occurs. If an obstruction is in the lower trachea or bronchioles, an expiratory whistle sound (wheezing) occurs.
What would the nurse include in the teaching plan for parents and their child with a pruritic rash? Select all that apply. keeping fingernails trimmed short using warm baths to soothe the skin encouraging pressure on the skin rather than scratching using distraction to prevent scratching making sure the child's hands are clean
keeping fingernails trimmed short encouraging pressure on the skin rather than scratching using distraction to prevent scratching making sure the child's hands are clean
The nurse is conducting a physical examination of a boy with erythema multiforme. Which assessment finding should the nurse expect? thick or flaky/greasy yellow scales silvery or yellow-white scale plaques and sharply demarcated borders lesions over the hands and feet, and extensor surfaces of the extremities with spread to the trunk 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 Explanation: Erythema multiforme typically manifests in 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? peanut butter and jelly sandwich tomato soup chicken nuggets carrot and celery sticks
peanut butter and jelly sandwich Explanation: Atopic dermatitis is commonly associated with allergies to food. Common culprits may include peanuts, eggs, orange juice, and wheat-containing products.
A child is diagnosed with scarlet fever. History reveals that the child has no known drug allergies. When preparing the child's plan of care, the nurse would anticipate administering which agent as the drug of choice? erythromycin clarithromycin trimethoprim-sulfamethoxazole penicillin V
penicillin V Explanation: Penicillin V is the antibiotic of choice. In those sensitive to penicillin, erythromycin may be used.
The nurse is attempting to control the infectious process while caring for a client. The nurse changes the client's wound dressing when the dressing becomes soiled. Which link of the chain of infection is the nurse interrupting with this intervention? mode of transmission reservoir portal of exit susceptible host
reservoir Explanation: The reservoir is the place where a microorganism grows and reproduces. Dressings left unchanged leave a dark, warm, moist environment for microorganisms to thrive.
A child is diagnosed with group A streptococcal pharyngitis. The nurse would teach the parents to be alert for signs and symptoms of: osteomyelitis. impetigo. scarlet fever. pneumonia.
scarlet fever. Explanation: Group A streptococcal pharyngitis can progress to scarlet fever with the rash appearing in about 12 hours after the onset of the disease
The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which skin condition best describes pustule? small elevation of epidermis filled with a viscous fluid small, circumscribed, solid elevation of the skin discolored skin spot not elevated at the surface redness of the skin produced by congestion of the capillaries
small elevation of epidermis filled with a viscous fluid Explanation: A pustule is a small elevation of epidermis filled with pus.
A 5-year-old girl who was already admitted to the hospital for an unrelated condition suddenly becomes irritable, restless and anxious. These may be early signs of respiratory distress in a child if accompanied by: retractions. cyanosis. clubbing of fingers tachypnea.
tachypnea
The nurse is doing discharge teaching for a child who has had a tonsillectomy. The nurse tells the client and family that the child should have plenty of fluids. In addition, the nurse would explain to the child's caregiver that the child may: have severe throat pain for up to 2 weeks postoperatively; this is not a concern. vomit dark, old blood, but the caregiver should call the clinic if the child has bleeding between the fifth and seventh days postoperatively. be given ice cream and milk the first postoperative day because these foods make swallowing easier. have a painful earache around the third day postoperatively, but the earache will be gone by the fourth day.
vomit dark, old blood, but the caregiver should call the clinic if the child has bleeding between the fifth and seventh days postoperatively. Explanation: Bleeding is most often a concern within the first 24 hours following surgery and between the fifth to seventh days postoperatively.
