Chapter 15 PREP U

enzyme immunoassay (EIA) immunofluorescent assay (IFA) Western immunoblot NOT: CRP or ESR

The parents of a child voice concern to the nurse that they believe their child has Lyme disease but their physician won't do the proper testing. The nurse reviews the chart to determine if specific testing for the disease has been performed. Which tests is the nurse looking for?

The tongue has a white or red "strawberry" appearance

An 11-year-old girl arrives at the doctor's office with fever, a sore throat, chills, and malaise. A throat culture indicates scarlet fever. Which other symptom should the nurse notice in this client that clearly indicates scarlet fever?

Roseola

A 6-month-old boy is brought to the doctor's office with a high fever. The physician diagnoses the child as having a viral infection of some kind and recommends acetaminophen to reduce the fever. After 3 days, the mother returns with the child. The fever is gone, but a rash of discrete, rose-pink macules approximately 2 to 3 mm and flat with the skin surface appears. Which condition should the nurse suspect?

increased eosinophil levels

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?

Scarlet Fever

A child is diagnosed with group A streptococcal pharyngitis. The nurse would teach the parents to be alert for signs and symptoms of:

March 14

A child who developed parotid gland swelling on March 5 was diagnosed with mumps. The nurse determines that the child will no longer be contagious at which time?

March 14th

A child who developed parotid gland swelling on March 5 was diagnosed with mumps. The nurse determines that the child will no longer be contagious at which time?

118 mg

A toddler has a fever. The parent calls the clinic wanting to know the appropriate dosage of acetaminophen to give the child. The parents say the child weighs 26 lb (11.8 kg). What is the lowest dose the nurse would instruct the parent to administer to the child?

Puncturing a vein on the dorsal side of the hand

The nurse at an outpatient facility is obtaining a blood specimen from a 9-year-old girl. Which technique would most likely be used?

cefuroxime (for children younger than 8) -Doxycycline is the drug of choice for children older than 8

The 6-year-old child has been diagnosed with Lyme disease. She is allergic to penicillin. Which medication will most likely be ordered for this client?

Koplik spots

The appearance of which hallmark clinical manifestation occurs in measles?

"Handwashing is an effective way to prevent infection."

The parents ask the nurse how to prevent their child from becoming sick. Which response by the nurse is most appropriate?

azithromycin -erythromycin I. children older than 6 mo the of age

A 3-week-old infant is diagnosed with pertussis. Which antimicrobial agent would the nurse expect the physician to prescribe?

nosocomial infection

A 3-year-old girl was in the hospital for a week following open heart surgery. By the end of the week, she had contracted an infection. The nurse recognizes this type of infection as a:

Remind the child not to scratch the lesions

What information should be included in the teaching plan for a child with varicella?

The incubation period is 10-12

What is a true statement regarding measles?

Acute glomerulonephritis

A chief danger of scarlet fever is that children may develop:

"Herpes zoster is a reactivation of a previous varicella zoster infection."

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?

An 8 month old bottle fed infant with HIV

Which child will the nurse identify as at greatest risk for developing a urinary tract infection?

Scarlet fever

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?

Mumps

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?

acute glomerulonephritis.

A chief danger of scarlet fever is that children may develop:

dorsal aspect of the hand antecubital fossa

A child admitted to the pediatric unit is to have blood specimens obtained for testing. When preparing to obtain the specimens via venipuncture, which sites would the nurse likely use? Select all that apply.

press the pruritic area

The nurse is caring for a 10-year-old child with a skin rash. The nurse should include which intervention to manage the associated pruritis?

The nurse will administer oxygen

The nurse is caring for a child hospitalized with pertussis. Which nursing intervention would be the highest priority for this child?

pinworm

After teaching a class to a group of nursing students about reporting infectious diseases to the Centers for Disease Control and Prevention, the instructor determines a need for additional discussion when the students identify which infection as being reportable:

viruses

After teaching nursing students about childhood exanthems, the instructor determines that the teaching was successful when the students identify what as the primary cause?

Penicillin to prevent acute glomerulonephritis

Portal of Entry When the health care provider looks in a child's mouth during a sick-visit examination, the parent exclaims: "The tongue is bright strawberry red! It was not like that yesterday." The health care provider would most likely prescribe which medication based on the probable diagnosis?

"I can administer two baby aspirin tablets to my child every 4 to 6 hours for the fever." "Sponging my child with cold water can be a soothing way to manage the fever." "I should use a cooling fan in my child's room to keep the fever down."

The nurse is providing education to the parents of a 5-year-old with a fever. Which statements indicate the need for further instruction? Select all that apply.

use of immunocompromised drugs

The nurse is taking a health history for an 8-year-old boy who is hospitalized. Which is a risk factor for sepsis in a hospitalized child?

Red, strawberry tongue

A nurse practitioner suspects that a child has scarlet fever based on which assessment finding?

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?

asking the child if his knees hurt

A 6-year-old boy is suspected of having late-stage Lyme disease. Which assessment should the nurse use to produce findings supporting this concern?

Upper respiratory excretion

A 5-year-old girl catches the flu from a friend at day care after the friend sneezed and wiped mucus on a toy that the girl subsequently played with. In this case, what is the portal of exit in the chain of infection?

prodromal (non-specific symptoms: fever, malaise and fatigue)

A nurse is obtaining a history from the parents of a child diagnosed with an infection. The parents report that the child started running a fever a couple of days ago and that he "just didn't seem like himself." Then this morning, the child started having yellow-green discharge from the nose. The nurse would identify the child has just completed which stage of an infectious disease?

"You need to make sure to wash your hands frequently." "This condition usually resolves in about 1 week." "Try offering cold items, like popsicles for fluids."

A child is brought to the clinic by the parents because the child had a high fever. Assessment reveals vesicles on the tongue and shallow ulcers on the oral mucosa. The child is diagnosed with hand, foot and mouth disease. When teaching the parents about this infection, which information would the nurse likely include? Select all that apply.

"Your child will likely feel better within a week."

A child has been diagnosed with hand, foot and mouth disease. The child's mother wants to know how long it will take for her child to feel better. What information should be provided to the child's parent?

Neck

A child is brought to the emergency department by his parents. The parents report that he stepped on a rusty nail about a week and a half ago. The child is complaining of cramping in his jaw and some difficulty swallowing. The nurse suspects tetanus. When assessing the child, the nurse would be alert to which muscle groups being affected next?

A child reporting dark brown urine and a fine sandpaper rash -may be experiencing renal complications secondary to scarlet fever

The nurse has received the morning report on a group of pediatric clients. Which pediatric client will the nurse see first?

"Place the child in a negative-pressure room." (measles)

The nurse is assessing a child brought to the emergency department for cough, nasal discharge, and fever. During the assessment, the nurse notes raised papules with an erythematous base on the buccal mucosa and a temperature of 102.5ºF (39°C). What will the nurse do next?

Notify primary health care provider -Lyme disease is suspected

The nurse is assessing a child who presents with a history of fever, malaise, fatigue, and headache. The nurse notes a bulls-eye rash on the child's right leg. Which action will the nurse take?

a child with erythema infectiosum experiencing fatigue and confusion

The nurse is caring for multiple clients on the pediatric unit. Which child will the nurse see first?

Teaching proper administration of penicillin V.

The nurse is caring for a 5-year-old girl with scarlet fever. Which intervention will most likely be part of her care?

"Your child may return to school when all of the lesions have crusted over."

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?

urine output of 10 ml over 3 hours

The nurse is caring for a child admitted to the hospital for sepsis. Which assessment finding is the most concerning?

Don appropriate personal protective equipment (PPE).

The nurse is caring for a child with an infectious disorder and the following vital signs: temperature 103.1°F (39.5°C), pulse 106 bpm, respiratory rate 24 breath/minute, and oxygen saturation 93% on room air. The child reports pain 4/10 using the Wong-Baker FACES scale. Which nursing intervention is priority?

"Has your child had a recent fever?"

The nurse is caring for an infant brought to the clinic for a rash. The nurse notes a blanchable, rose-pink macular rash on the trunk. The nurse obtains the following vital signs: temperature 99.0°F (37°C), pulse 100 bpm, respiratory rate 22 breaths/minute, and oxygen saturation 100% on room air. Which question by the nurse will be most helpful when planning interventions?

"Fevers can be beneficial because they can slow down the growth of the bacteria or virus that may be causing the infection."

The nurse is discussing fever with the parents of a child who is in the emergency department with a temperature of 101°F (38.3°C). Which statement by a parent indicates an understanding of fevers and their management in the ill child?

"The infant is born with immunity to some diseases, but those immunities decrease over the first year of life."

The public health nurse is discussing immunizations with a group of caregivers of infants. One of the mothers asks the nurse why the child will need immunizations. Which statement would be the most appropriate for the nurse to make to this mother?

Remove urinary catheter as soon as possible. Access intravenous line using sterile technique. Clean stethoscope before and after auscultation. Administer postoperative antibiotics as prescribed. Use hand sanitizer prior to entering the child's room.

The nurse is caring for a child after surgery. Which interventions will the nurse implement to prevent a hospital-acquired infection? Select all that apply.

Ask if the animal was provoked prior to the bite (animals with rabies with bite unprovoked)

The nurse is caring for a child brought to the emergency department after an animal bite. Which action will the nurse perform first?

Obtain blood cultures

The student nurse is discussing the plan of care for a child admitted to the hospital for treatment of an infection. Which action should be taken first?

scarlet fever

A child is diagnosed with group A streptococcal pharyngitis. The nurse would teach the parents to be alert for signs and symptoms of:

penicillin V

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?

"Hand gels are actually very effective in preventing the spread of infection."

A mother voices concern to the nurse that her child should not be using alcohol-based hand gels to help prevent the spread of infection. How should the nurse respond?

Lyme disease Rocky Mountain spotted fever

A nurse is preparing a presentation for parents about common childhood infectious diseases. What conditions would the nurse include as being caused by a tick bite? Select all that apply.

Incubation period

Nursing students are learning about the infectious process. They correctly identify the first stage of an infectious disease to be which period?

reservoir

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?

a parent whose infant was diagnosed with hand-foot-mouth disease and is now lethargic -dehydration is a risk with hand-foot-mouth dx & lethargy is a symptom of dehydration

The nurse is telephone triaging multiple pediatric calls. Which telephone call will the nurse return first?

7.5 mL

The physician has ordered ibuprofen 150 mg every 6 hours as needed for a 3-year-old child for a fever greater than 38°C (100.4°F). The label of the ibuprofen bottle reads "ibuprofen oral suspension 100 mg/5 ml." How much ibuprofen liquid will the nurse administer if the child's temperature goes above 38°C (100.4°F)? Record your answer using one decimal place.

"Do not borrow deodorant or a hairbrush from each other." "Clean any cut or abrasion and cover with a dry bandage." "Cover your mouth when coughing." "Keep from touching surfaces in the locker room as much as possible." NOT: "wash your sports clothes in hot water"

The school football team has developed an outbreak of community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA). The school nurse is talking with the team to discuss how to stop the spread among the team members. Which fact(s) should the nurse teach these athletes? Select all that apply.

Have suction available in the room. Encourage small, frequent feedings. Utilize droplet and standard precautions. Administer erythromycin for 10 days.

Which collaborative intervention will the nurse provide when caring for an infant diagnosed with pertussis? Select all that apply.

Ensure immunization status is current. Use appropriate personal protective equipment. Provide information about disease transmission. Educate the child and family about infection control. NOT: administer antibiotics for all infections

Which interventions will the nurse include when caring for a child with an infectious disorder? Select all that apply.

Pertussis

While assessing a child, the nurse notes a runny nose, temperature 100.4°F (38°C), and a whoop sound when the child coughs. On which diagnosis will the nurse anticipate providing education for this family?

5th disease

A young client arrives at the clinic with a rash on the trunk and flexor surfaces of the extremities. The parent informs the nurse that the rash started a day before on the exterior surfaces of the extremities; 2 days before, the child had a really bad rash on the face. The health care provider diagnoses the child with erythema infectiosum. The nurse tells the parent that this is also known as:

The dog was unprovoked when he bit the girl

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?

an 18-month-old child receiving chemotherapy over 5 days

Which child will the nurse identify as being at greatest risk for developing a hospital-acquired infection (HAI)?

Notify the primary health care provider.

The nurse is assessing a child who presents with a history of fever, malaise, fatigue, and headache. The nurse notes a bulls-eye rash on the child's right leg. Which action will the nurse take?

the bite of a tick

When developing the plan of care for a 5-year-old boy with Rocky Mountain spotted fever, the nurse knows the cause of the illness is:

Contacting the health care provider if there is any area of inflammation that might be a bite. Inspecting the skin closely for ticks after the child plays in wooded areas. Wearing protective clothing when playing in wooded areas.

Parents bring their 9-year-old child to the clinic for a well-child visit. They are concerned because several children in the neighborhood have developed Lyme disease and ask for suggestions on what to do to reduce their child's risk. What would be appropriate for the nurse to suggest? Select all that apply.

Ensure proper dose and interval.

The nurse is preparing to administer acetaminophen to a 4-year-old child to provide comfort. Which precaution is specific to antipyretics?

proper handwashing proper handling and preparation of foods vaccination administration limiting exposure to sick persons judicious antibiotic use

The nurse is preparing to provide education on the prevention of infection to parents of children. Which intervention(s) will the nurse include? Select all that apply.

Children this young do not have mature immune systems to fight infection.

The nurse is talking to the parents of a 2-month-old infant who has been admitted to the hospital with sepsis. The parents report being confused since their older children also had the flu but they recovered without incident. What information can the nurse provide to the parents?

"We will place your child on contact and airborne precautions. It is best for the other children not to visit."

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?

after 9 days from the onset of swelling

The parent of a child with mumps calls the clinic to find out how long the child needs to stay home from school. The nurse would instruct the parent to allow the child to return to school at which time?

"The signs of disease will be noted in 1 to 3 weeks."

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 infant's temperature fell when the rash appeared.

A 6-month-old infant develops roseola. When obtaining information from the parent, what would the nurse expect the parent to report?

measles

A young client in the clinic has a rash, cough, and fever that the parent says spiked on day 5 of the rash. The client also had conjunctivitis. What illness would the nurse expect the health care provider to diagnose?

Obtain specimen before antibiotics are given.

A 10-year-old child has an unknown infection and will need to provide a urine specimen for culture and sensitivity. To assure that the sensitivity results are accurate, which step is most important?

Eosinophils

A group of nursing students are reviewing the functions of white blood cells. The students demonstrate an understanding of the information when they identify which white blood cell as responsible for combating allergic disorders?

eosinophils

A group of nursing students are reviewing the functions of white blood cells. The students demonstrate an understanding of the information when they identify which white blood cell as responsible for combating allergic disorders?

contact precautions

A nursing instructor is teaching the students about the standard and transmission-based precautions. What type of precautions require placing a client in an isolated room with limited access, wearing gloves during contact with the client and all body fluids or contaminated items, wearing two layers of protective clothing, and avoiding sharing equipment between clients?

"How long has your child had the cough and runny nose?" "When you look in your child's mouth can you see any spots or anything unusual?" "Can you describe what your child's rash looks like?" "Has your child been around any other children with measles?" NOT: has your child completed the measles vaccine series?

A parent calls the nurse triage line at the clinic. The parent is concerned and believes the preschool-aged child may have contracted rubeola. Which question(s) should the nurse ask the parent to aid in making this diagnosis? Select all that apply.

-maculopapular rash that began on the face and has spread to the rest of the body -fever -upper respiratory infection symptoms

The nurse is obtaining a health history and assessment for a child being admitted who is suspected of having measles. What signs and symptoms does the nurse expect to find during the assessment? Select all that apply.

Educate the child and parent about the procedure. Wash hands and don gloves. Swab the pharyngeal and tonsillar area. Use a tongue blade to depress the tongue. NOT: stop swabbing if the child gags or coughs

The nurse is obtaining a throat culture from a child. The nurse would include which action(s) to obtain this specimen? Select all that apply

-Wearing protective clothing when playing in wooded areas. -Inspecting the skin closely for ticks after the child plays in wooded areas. -Contacting the health care provider if there is any area of inflammation that might be a bite.

Parents bring their 9-year-old child to the clinic for a well-child visit. They are concerned because several children in the neighborhood have developed Lyme disease and ask for suggestions on what to do to reduce their child's risk. What would be appropriate for the nurse to suggest? Select all that apply.

Puncturing a vein on the dorsal side of the hand.

The nurse at an outpatient facility is obtaining a blood specimen from a 9-year-old girl. Which technique would most likely be used?

a child reporting dark brown urine and a fine sandpaper rash

The nurse has received the morning report on a group of pediatric clients. Which pediatric client will the nurse see first?

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." NOT: The parents wear a respiratory mask when entering their child's room.

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.

Allow the child to view the staff's face through the door window before entering the room. Encourage the parents to contact friends and classmates so cards can be sent and displayed. Monitor the child for changes in mood or level of aggression. Provide the child with age-appropriate games and toys for his or her room. Plan for extra time to visit the child throughout the shift between assessments and procedures. NOT: permit the immediate family to avoid wearing the gown and mask during visits in the room

The nurse is caring for a school-aged child hospitalized with an infectious disease. The child is placed on transmission-based precautions. What would the nurse include in the plan of care? Select all that apply.

Don a surgical mask. Administer ibuprofen. Monitor for fever reduction. Ask if vaccinations are current. NOT: begin airborne precautions (this is mumps-standard precautions).

While assessing a child brought to the hospital with fever and headache, the nurse notes trismus and swelling above the child's jawline. Which collaborative interventions will the nurse begin? Select all that apply.

100-150 mg 10-15 mg/kg/dose

A nurse is teaching a mother about the correct use of acetaminophen to treat her child's fever. The child weighs 22 lb (10 kg). The nurse instructs the mother to give the child a specific dose each time. The nurse would most likely identify a dose within which range?

Portal of Entry

A nursing instructor is teaching students about the chain of infection. What does the instructor tell students is responsible for allowing the pathogen to enter?

Portal of entry

A nursing instructor is teaching students about the chain of infection. What does the instructor tell students is responsible for allowing the pathogen to enter?

Encourage rest and relaxation

The mother of a 10-year-old child diagnosed with rubella asks what can be done to help her child feel better during her illness. What information can be provided?

Secondary bacterial infections of the skin can occur.

What is a true statement regarding varicella zoster virus infection?

"Make sure your child drinks plenty of nonirritating fluid."

The nurse is caring for a child diagnosed with hand-foot-mouth disease. When educating the family about this disease, which education by the nurse is most important?

swollen cervical lymph nodes red swollen pharynx body aches NOT: low grade fever, red rash on palms of hands and soles of feet

The nurse is caring for a child who is suspected of having an early onset of scarlet fever. Which clinical manifestations support this diagnosis? Select all that apply.

upper respiratory infection symptoms maculopapular rash that began on the face and has spread to the rest of the body fever NOT: clear, fluid-filled vesicle, erythematous flushing

The nurse is obtaining a health history and assessment for a child being admitted who is suspected of having measles. What signs and symptoms does the nurse expect to find during the assessment? Select all that apply.

"We need to make sure he's washing his hands frequently."

The nurse is providing teaching to the parents of a child with varicella. Which statement indicates that the parents have understood the instructions?

Remind the child not to scratch the lesions.

What information should be included in the teaching plan for a child with varicella?

Group B streptococcus

What is the leading cause of neonatal sepsis and death