🤓CHAPTER 23 PREP U
1 week
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?
"What you see on your newborn's skin is erythema toxicum neonatorum. It is a common newborn skin condition that typically resolves on its own in about 1 week. There is nothing special you will need to do for this."
A newborn has a generalized rash on the skin, which the nurse identifies as erythema toxicum neonatorum. Which information would the nurse include when explaining the condition to the newborn's parent?
"Does she wear sleepers with metal snaps?"
A nurse is assessing a 6-month-old girl with an integumentary disorder. The nurse notes three virtually identically sized, round red circles with scaling that are symmetrically spaced on both of the girl's inner thighs. What should the nurse ask the mother?
"Your child will have to remain in the office for about one-half hour after each treatment."
An 8-year-old child has had skin testing done for allergies. After a review of the results, it is decided that the child will undergo hyposensitization therapy. The parents are asking the nurse questions about the purpose of this therapy and what to expect. Which information will the nurse include when teaching the parents and child about this therapy?
Bathe with a product that is oatmeal-based
An adolescent experiencing contact dermatitis reports experiencing pruritis. What intervention will the nurse recommend to relieve the itching?
Disturbed body image
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?
Apply ice to the affected 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 health care provider. What is the most appropriate action for the nurse to do with this child?
skin scrapings
The client is scheduled to have potassium hydroxide testing performed. What will be needed to complete this test?
"Wash your hair with a gentle shampoo daily."
The clinic nurse is assessing a 12-year-old client. The client reports having dandruff and asks the nurse what can be done for it. Which response by the nurse is best?
"Has the child ever eaten shellfish before now?"
The nurse admits a 10-year-old who has just eaten lobster and has hives over much of the body. In collecting data regarding this child, which question should the nurse ask the caregiver first?
tetanus toxoid vaccine
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?
impetigo
The nurse is assessing a child who was brought into the clinic. The nurse notes honey-colored crusting on the toddler's face, as seen in the figure. The nurse recognizes this to be what type of infection?
second-degree frostbite
The nurse is examining a child for indications of frostbite and notes blistering with erythema and edema. The nurse notes which degree of frostbite?
Skin assessment involves inspection and palpation in a room with natural daylight.
What is the best technique to perform an assessment of the skin?
A child with periorbital cellulitis reports changes in vision and pain with eye movement
Which assessment finding by the nurse would warrant immediate action?
A child with periorbital cellulitis reports changes in vision and pain with eye movement.
Which assessment finding by the nurse would warrant immediate action?
Provide around-the-clock pain medication as soon as pain is reported.
Which intervention is the most beneficial for a burn client undergoing a skin graft?
Place heating pads and warmed blankets on the trunk of the body initially
A child arrives at the emergency department with moderate hypothermia and frostbite. Which action would be most appropriate for the nurse to perform?
"Does your child have any allergies to medications?"
A child has been hospitalized with a diagnosis of severe impetigo. The nurse is interviewing the family. Which question will have the greatest impact on the child's care?
tetanus
A child is admitted to the acute care facility with a burn injury. The nurse would check the child's immunization status, specifically for which of the following?
Explain that this normal mechanism keeps the infant from losing too much water through the skin
A parent brings an infant to the clinic for a well child visit. During the assessment, the parent asks the nurse why the infant never seems to sweat. What action should the nurse take?
"We need to get our child a medical alert bracelet as soon as possible in case this happens again."
A pediatric client was brought to the emergency department by the parents after experiencing extensive urticaria following consumption of a seafood dinner. Upon discharge from the facility the nurse provided client teaching. Which statement by the parents indicate learning occurred?
temperature 100.5°F (38.1°C)
An intensive care nurse has received the above hand-off report from the emergency department nurse. Thirty minutes later, the nurse assesses the child again. Which assessment finding should the nurse investigate further?
tinea capitis
The nurse is caring for a 10-year-old male in a pediatric clinic with presenting symptoms of small circular patches of hair loss on the scalp. Which skin condition does the child most likely have?
fissures and scaling on palms and soles
The nurse is caring for a 15-year-old boy with psoriasis. In addition to the plaques, what would the nurse expect to note?
The nurse follows contact precautions
The nurse is caring for an infant who has impetigo and is hospitalized. Which nursing action is priority?
antifungal
The nurse is educating a parent about the treatment for a child's tinea cruris. What medication class would the nurse include in the teaching plan?
"Flare-ups of lesions are not uncommon following therapy."
The nurse is evaluating the parents' understanding of atopic dermatitis. Which statement shows their understanding?
impetigo
The nurse is presenting an in-service to a group of nurses who will be working in a dermatology clinic. One participant asks the nurse about a bacterial skin infection that she has seen in children that involves honey-colored crusted lesions. The nurse most likely is referring to:
"I will need to cover my son's skin lesions with bandages until it has healed."
The nurse is providing education to a teenaged boy diagnosed with impetigo. Which statement by the boy indicates the need for further education?
Complete the prescribed antibiotics
A child is hospitalized with a diagnosis of severe cellulitis. The nurse is preparing the family for discharge. Which instruction is most important for the nurse to convey to the family?
infection prevention
A child is hospitalized with burns over 25% of the body. The nurse is preparing to perform a dressing change. What aspect of changing the child's dressings is most important for the nurse to consider?
Use lukewarm water with a mild soap and allow the child to remain in the tub for a short time to avoid supersaturation
A mother asks the nurse about bathing her child. Which response by the nurse would be most appropriate?
Administer diphenhydramine
A nurse is caring for a child with second- and third-degree (partial- and full-thickness) burns over 15% of the body. The child reports severe itching in and around the burn sites. Which action would be most appropriate for the nurse to perform?
Airway remains patent
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?
"Your child most likely has infantile seborrheic dermatitis, or cradle cap. You can care for it by cleansing the hair and scalp daily with baby shampoo. You can also apply baby oil to the area for 10 to 15 minutes and then rinse away the flakes."
A 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?
Apply cold compresses to the area
A school-aged child is brought to the office of the camp nurse with a small, superficial burn (first-degree burn). Which action by the nurse would be most appropriate to take first?
Wash the face twice a day with a mild soap then pat dry
The nurse is caring for a 13-year-old client who asks about acne prevention. Which would be mostappropriate for the nurse to suggest?
Administer pain medication as prescribed
The nurse is caring for a 9-year-old child with partial-thickness (second-degree) burns. The client rates the pain at an 8 on a 1 to 10 numerical pain scale. The nurse notes the client is sitting in the bed playing with toys and smiling. Which action will the nurse take?
Blisters appear
The nurse is caring for a child admitted with second-degree (partial-thickness) burns. What is mostcharacteristic of this type of burn?
Immerse the affected part in 104°F (40°C) water for 15 to 30 minutes
The nurse is caring for a pediatric client in the emergency department with moderate frostbite of an extremity. Which nursing intervention is appropriate for this client?
Provide around the clock pain medication
A child with a burn injury is scheduled for skin grafting. Which intervention would be most appropriate for the nurse to include in the child's plan of care?
"I feel so bad for him because he has asthma, and now he gets this rash."
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?
Staphylococcus aureus
An infant has presented at the clinic with impetigo. Which organism usually causes impetigo in infants?
Observe the infant's respiratory effort
An infant is seen in the emergency department with several raised red welts over the abdomen and lower extremities. The parent states that the symptoms developed suddenly over the past few hours. The infant is fussy and has a low grade temperature. What assessment is most important for the nurse to perform?
"The largest organ of the body helps regulate body temperature."
The nurse instructor is reviewing the integumentary system during a presentation to a group of student nurses. Which statement made by the instructor is the most accurate regarding the integumentary system?
community acquired MRSA
The nurse is assessing a child who has had an open wound for the last 2 weeks with no signs of healing. The parents report they have been using over-the-counter antibiotic ointment with no signs of improvement. The child is active in football in the fall and the swim team in the winter. What disorder does the nurse suspect?
frequently rehydrating the skin
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?
"I should avoid eating any kind of chocolate."
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?
"Sunscreen is not recommended until 6 months of age. Use light clothing and a hat to completely cover the child when in the sun."
The 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?
the presence of stridor
The nurse is conducting a primary survey of a 12-year-old child involved in a motor vehicle accident. Which assessment finding most concerns the nurse?
"Sometimes I get acne when I use my sister's makeup."
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?
"I guess my mom was right; she always put ice on our burns when we were kids."
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?
Bathe the child twice a day
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?
assessing the child's airway and breathing and noting any wheezing or stridor
The nurse is caring for a child with urticaria. What is the priority action?
Use normal saline solution to wash the wound
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?
"I will use rubber pants over the cloth diapers in the future."
The nurse is caring for an infant with diaper dermatitis. Which statement by the child's parent would indicate a need for further education?
"I should be certain to use fabric softener in the care of the infant's clothes."
The nurse is teaching parents about the care of diaper rash. The nurse would be concerned about the parents' level of understanding if they made which statement?
"I can't imagine how you are feeling right now, but I'm sure you had no idea frostbite could happen. We will take good care of your son."
The parents of an 8-year-old boy diagnosed with frostbite are distraught and state to the nurse, "We can't believe we didn't make our child come inside when he complained about his fingers being numb and hurting." How should the nurse respond?
full-thickness or third-degree
The nurse is assessing a child who pulled a boiling pot of soup off of the stove top. The child reports pain at a 9 on a scale of 0 to 10. The burn is red and edematous, and also shows areas of charred skin. The nurse is aware that these signs and symptoms are indicative of what kind of burn?
vesicle
The nurse is assessing the skin of a 5-year-old child and notes several lesions on the arm. The lesions are circumscribed, elevated, and pinpoint size. They contain serous fluid. How would the nurse document these findings?
"Wash your hair with an antiseborrheic shampoo daily."
The nurse is caring for a 12-year-old child who comes to the pediatric clinic for a well-child checkup. The child reports embarrassing dandruff and asks the nurse what can be done for it. A quick scalp assessment confirms the presence of dandruff. Which response by the nurse would be most appropriate when addressing the child's concern?
"Since my child just has a rash around the area of the bite there is nothing to worry about."
The nurse is caring for a child brought to the emergency department by the parents. Upon assessment the physician suspects the child has been bitten by a spider. While obtaining the nursing history of the present condition, which statement by the parent will require clarification from the nurse?
cellulitis
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 mostlikely diagnosis of the client's skin alteration?
peanut butter and jelly sandwich
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?
"As long as he takes a shower as soon as he gets inside, he shouldn't get this again."
The nurse is speaking with the mother of a child diagnosed with contact dermatitis from poison ivy. Which statement by the mother indicates a need for further education?
erythema multiforme with inflammatory bullae of at least two types of mucosa
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?
"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 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?
Provide instruction on how to care for a diaper rash
A nurse completes an assessment on an 8-month-old infant seen in the pediatrician's office for a well-child visit. The nurse notes that the infant's buttocks, perineum and inner thighs are covered in a thick coating of white ointment. When questioned, the parent says the infant has a diaper rash and the ointment is to protect the infant's skin. What is the best action for the nurse to take?
Soak the old dressing in tepid water before attempting to remove
The nurse is caring for a client with burns in a pediatric hospital. The child is scheduled to be discharged the following day and the nurse is going over discharge education with the parents. Which is the best intervention for the parents when removing an old dressing?
"I can understand your concern. We will closely monitor your child for asthma development."
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 should not cover the area with plastic wrap after applying the cream."
A topical corticosteroid is prescribed for a child with contact dermatitis. Which statement by the mother would indicate the teaching was successful?
Provide instruction on how to care for a diaper rash.[
A nurse completes an assessment on an 8-month-old infant seen in the pediatrician's office for a well-child visit. The nurse notes that the infant's buttocks, perineum and inner thighs are covered in a thick coating of white ointment. When questioned, the parent says the infant has a diaper rash and the ointment is to protect the infant's skin. What is the best action for the nurse to take?
Second-degree or partial-thickness burn
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?
finishing all prescribed oral medication, even after lesions fade
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?
"Baby powder should not be used on newborns because of the risk of aspiration upon application."
The nurse is caring for a mother and newborn on a postpartum unit. The mother asks if it OK to use baby powder on newborns. Which response by the nurse would be most appropriate?
