chapter 6 and 32
acquired immunity
occurs from exposure to the invading agent
distribution pattern
pattern of lesion distribution
poliomyelitis
permanent paralysis may occur
3 most frequent causes of contact dermatitis
plant animal metal irritants
4 major goals of atopic dermatitis management
- hydrate skin - relieve pruritis - reduce flare ups/ inflammation - relieve / control 2ndary infection
list signs of wound infection
- increased erythema especially beyond wound margin - edema - purulent exudate - odor - increased temp
3 factors that nursing interventions aim to alter when treating diaper dermatitis
- wetness - ph - fecal irritants
list 3 etiologic factors that can result in lesions of the skin in children
1. contact with injurious agents, such as infective organisms, toxic chemicals 2. hereditary factors 3. external factors - allergens 4. systemic disease - varicella, lupus, nutritional deficiencies
Immunoglobulin
A sterile solution containing antibodies from large pools of human blood plasma
Cindy is 12 years old and brought to he clinic b/c of bald spot developing on her head. Cindy wears her hair tightly braids with beads. which of the following should the nurse suspect a. alopecia from trauma b. tinea wapitis c. psoriasis d. urticaria
A
Management of brown recluse spider bite a. possible skin graft b. administration of antivenin c. applying lemon juice mixed with baking soda directly to the bite d. administering epi and corticosteorids for impending shock
A
Mary age 7, fell and sustained laceration to her chin. she was taken to the ED, where the laceration was sutured with the edge well approximated. the nurse expects the repair healing to take place by a. primary intention b. secondary intention c. 3rd intention
A
during wound healing, immature connective tissue cells migrate to the healing site and begin to secrete collagen into the meshwork space. why is this phase Called a. fibroplasia b. scar contracture c. inflammation d. scar maturation
A
primary prevention of communicable disease is best accomplished by a. immunization b. control of disease spread c. adequate water supply d. implementing good wash hand washing among hospital personal
A
Steven Johnson syndrome a. is rare and occurs most often in females b. hypersensitive rx to certain drugs c. begins with generalize rash over the entire body except for palms, soles and extensor surface d. caused by a bite from a flea
B
the most effective method for tick removal in a child is to: a. use tweezers and grasp close to the point of attachment then pull straight-out using steady even pressure b. apply mineral oil to the back of the tick and wait for it to back out c. use fingers to pull tick out with straight steady even presure d. place hot match on back of ticket and pick it up w gloves hand
A
the practioner has prescribed tretinoin cream (Retin-A) for Nancys acne. Nancy has been using the area for 2 weeks and is concerned she is not improving. Nancy tells the nurse that she has "done everything"that she was told to do and asks why is my acne no better a. it is normal for it to take weeks to months to see improvement with acne medications b. you must not be using the medication right. show me how to you apply it to your face c.acne is caused by dirt or oil on surface of the skin. you will need to increase # of times you wash these areas d. you will probably need to ask the practitioner about changing your medicine asap
A
typical tx of poison ivy contact dermatitis to the arm DOES NOT INCLUDE which of the following a. oral corticosteroids b. calamine lotion c. aveeno baths d. topical corticosteroid gel
A
which of the following does the nurse include in the educational plan when instructing parents about the use of topical corticosteroids a. do not use this cream on fungal infections b. apply thick layer of cream and rub into skin well c do not use for longer than 3 days in chronic conditions d. all the above
A
which of the following is a fungal infection that lives on the skin a. tinea corporis b. herpes simplex type 1 c. scabies d. warts
A
which of the following is most common symptom of atopic dermatitis ( eczema) a. pruritus b. lichenified plaques c. hyperpigementation d. vesicular lesions
A
which of the following is not recommended in the tx of scabies a. treat only household members who are symptomatic b. drug of choice in children and infants over 2 months is permethrin 5% cream c. all persons in close contact with affected child should be treated d. ivermectin is indicated for those who do not respond to scabicide
A
a drug used to treat children diagnosed with giardiasis is a. metronidazole (flagyl) b. amoxicillin c. erythromycin d. tetracycline
A . flagyl
Conjugate vaccine
A carrier protein with proven immunologic potential combined with a less antigenic polysaccharide antigen to enhance the type and magnitude of the immune response; Hib
Antitoxin
A solution of antibodies derived from the serum of animals immunized with specific antigens and used to confer passive immunity
Johnnys moth is called the clinic b/c Jonny has developed a rash over his entire body. 2 days ago he was prescribed amoxicillin for an ear infection and now his mother tells the nurse she thinks Johnny may have gotten a small rash with this medication when he Tok it before. which of the following would be the best intervention by the nurse at this time a. question the mother about other symptoms that Johnny may ave developed b. continue the medication and have Johnny come in tomorrow to see a practitioner. c. stop the medication and inform the practitioner d. tell the mother to given one half of the dose until Johnny can return to the clinic to see the practitioner
B
Nora has been brought to the ED by her father after having been bitten by a family dog. examination reveals 3 puncture wounds of the hand. expect therapeutic management for these wounds include a. suturing the wounds b. administering prophylactic abx c. irrigating with hydrogen peroxide d. administrating a tetanus toxoid booster. since Noras last booster was given 13 months ago
B
billy has been stung by a bee. a small reaction has occurred @ the site. what is the most appropriate action at this time a. wait until billy is at home to completely remove the stinger with forceps b. remove the stinger ASAP by scraping it off the skin c. wash area with hot water and soap d. arrange for billy to undergo skin testing
B
dog bites in children occur most often a. on upper extremities in young children b. from dogs owned by the family or by a neighbor c. from stray dogs d. in schoolyards and neighborhood parks
B
during the physical exam of a 8 year old the nurse sees a rash @ the umbilicus and surrounding area. Kevin tells the nurse that rash "comes and goes" but does itch. the nurse recognizes the rash as contact dermatitis. which of the following is most likely the cause of this rash a. insect bite b. nickel used in Kevin belt c. laundry detergent d. food allergy
B
erythema migrant is associated with which of the following conditions a. contact dermatitis b. Lyme disease c. cat scratch disease d. Steven Johnson syndrome
B
in caring for a child with frostbite, the nurse remembers that a. slow thawing is associated with less tissue necrossis b. the frostbitten part appears white or blanched, feels still and is without sensation c. rewarming produces small return of sensation with small amount of pain d. rewarming is accomplished by rubbing the injured tissue
B
jimmy age 9 years, has fallen and scraped her knee @ school. he is brought to the school nurse for tx. which of the following does the nurse recognize as being the LEAST likely to promote healing a. changing the dressing when it becomes loose/soilled b. washing the injury with hydrogen peroxide and applying a dry gauze dressing c. applying an occlusive dressing d. washing the area with mild soap and water and applying a topical abx with a nondherent dressing
B
major aims of skin treatment include all of the following except a. eliminate the cause b. obtain the accurate account of Childs symptoms c. effective tx and symptoms relief d. prevent complication
B
neurofibromatosis i. autosomal dominant genetic disorder ii. suspected cafe-au-lait spots iii suspected when infant develops axillary or inguinal freckling iv. associated with learning disabilities v. risk of being transmitted is 100% of offspring vi. therapy is limited to excision of tumors that produce pain or impair function and symptomatic management of symptoms a. I, ii, iii, iv and v b. I, ii, iii, iv and vi c. I, iii, v and vi d. ii, iii, iv, v, and vi
B
skin in an infant and small children, as compared with skin In older children and adults a. tightly bound to the dermis b. is more likely to have blister formation from an inflammatory process c. is more likely to react to a sensitizing allergen than to a primary irritant d. is less susceptible to superficial bacterial infection
B
the major goal in treatment of contact dermatitis is a. reserve the associated immunologic changes b prevent further exposure to offending substance c. educate on management of symptoms d. prevent transmission
B
the nurse is assisting billy, 10 yrs old in applying an all-purpose insect repellent that contains active ingredient DEET which of the following should be included in the discussion a. DEEt if effective against most insects and arachnids, but not ticks b. after returning indoors, treated skin needs to be washed off with soap and water before he goes to bed tonight c. deet should be applied to the whole body including the face and hands for better protection d. deet should be heavily applied and frequent reapplication is necessary
B
the nurse knows that with drug reaction rashes, which of the following is true a. it is usually localized b. it may be delayed or immediate c. it is more common with oral drugs d. it usually has no associated ysmtms
B
which of the following is true about topical therapy for acute tx of dermatologic problems a. application of heat to the area will relieve itching b. apply topical application in systemic manner following contour of body surface c. chemicals that are nonirritating to intact skin will be nonirritating to inflamed skin d. emollient action of soaks, baths or lotion increase skin irritation
B
Universal precautions
Blood and body fluid precautions designed to reduce the risk of transmission of blood-borne pathogens
Steve age 8 has been diagnosed with tinea capitis. which of the following does the nurse include in the teaching plan for Steve and his parents a. no animal-to-person transmission is associated with this infection b. Steve can continue to share hair-grooming articles with his younger brother. c. griseofulvin should be administered with high fat foods d. tx may be discontinued once symptoms subside
C
care of bacterial skin infection in children may include all the following EXCEPT a. good Hand hygiene b. change clothes daily and washing in hot water c puncturing. the surface of the pustule d. applying topical abx
C
epidermal necrosis and erythema multiforme are associated with which of the following conditions a. neurofibromatosis b. alopecia areas c. Steven-johnson syndrom d. intertrigo
C
epithelial wound healing a.begins 72 hors after woundd is incurred b. occurs by autolysis of epithelial cells from the wound center toward the wound margins c. occurs more rapidly when the skin is moist and crust free d. occurs more rapidly when the skin is allowed to dry and to form an eschar or scab
C
which of the following current beliefs about acne formation is true a. cosmetics containing lanolin and lauryl alcohol are not known to contribute to acne formation b.there is scientific research to support the theory that stress will cause acne breakout c. exposure to oils in cooking grease can be precursor to acne in adolescents working over fast food restaurant oils d. acne usually worsens with dietary intake of chocolate and other foods high in sugar
C
skin disorder assessment includes the objective data collected by inspection and palpation. which of the following is not an example of objective data a. lesion has increased erythematous margin edge b. rash appears as macules or papules c. lesion is painful and itches d. lesion is moist
C.
Cindy 8 years is brought to the clinic with a sore on her arm. she tells the nurse that she scratched it on a piece of metal at the playground about 1 week ago. which of the following signs would the nurse expect to find if the sore becomes infected a. itching at the site of sore b. rough edges around the sore c. no pain d. increased erythema, especially around the sore
D
Nancy age 16 comes to the nurse because of acne on her face and shoulders. after talking to Nancy the nurse makes a nursing diagnosis of knowledge deficit r/t proper skin care. which of the following would the nurse include in the instruction plan for Nancy a. wash area vigorously with antibacterial soal b. brush hair done on the forehead to conceal acne area c. avoid use of all cosmetics d. gently wash the area with mild soap once or 2x a day
D
billy has come in contact with poison ivy on a school picnic. the best intervention for the nurse to implement as time is to a. wash the area with strong soap and water solution b. apply calamine lotion to the area c. prevent spread by instructing billy not to scratch the lesion d. flush the area immediately with cold water
D
human bites a. are treatable at home b. do not require tetanus immunization c. should not have ice applied to the area d. should receive medical attention
D
the nurse is conducting a review of health records for incoming 5th grade students and discovers that Mary has an hx of having a severe life-threatening systemic response tot he Hymeoptera sting. which of the following is most important for the nurse to do at this time a. make sure may has an identification bracelet to alert others of the allergy b. contact Marys paeans about which hospital Mary should be taken to if a sting occurs at schoo c. talk to Mary and see if she had skin testing to confirm her allergy d. contact Marys parents and provider to obtain emergency medication for Mary to use if necessary at school
D
the nurse is conducting an educational session with Cindy and her parents on medication used for acne. which of the following is correct information i. benzyol peroxide gel has bleaching effects on bed covering and towels ii. topical clindamycin is applied only to individual lesions iii. oral contraceptivee medications contain estrogen, which will increase acne formation and should be avoided iv. tretinoin requires that Cindy protects herself from sun exposure v. oral abx s/e may include GI upset, photosensitivity, or vaginal candidacies vi. results are better if systemic abx are combined with topical abx cream vii. early intervention with topical medication may prevent development of severe acne a. I, iv and vi b. I, ii, iii and iv c. ii. iv, v vi, and vi d. I, iv, v, and vii
D
the nurse recognizes that which of the following is not indicated for use in promoting wound healing a. nutrition with sufficient protein, calories, vitamin c and d and zinc b. irrigation of wound with normal saline c. application of an occlusive dressing d.applicaiton of povidone -iodine (Betadine) solution
D
which of th following statements about use of topical therapy in the pediatric population is TRUE a. use of silver impregnanted in dressing as foam decreases the bacterial burden and bioburden of the wound and has little absorption effect in the pediatric b. application of heat provides soothing effect to reduce inflammatory processes c. use of immunomodulators is suggested as 1st line tx in children younger than 2 years d. topical immunomodulators has been linked to possible skin cancer and lymphoma in children younger than 2 years
D
which of the following foreign bodies is LEAST likely to be successful removed with tweezers a.piece of glass b. spines of cactus c. embedded needle in the foot d. all the above
D
which of the following would the nurse NOT include while educating the family about managing atopic dermatitis a. keep fingernails short b. long sleeves and long pants are recommended c. avoiding irritating products d. use fabric softeners to decrease fabric irritation
D
wound care instructions to parents should include which of the following a. use butadiene, alcohol, and hydrogen peroxide to prevent infection b. use hydrocolloid dressing that just covered the wound with little overlap c. formation of yellow gel with a fruity odor under hydrocolloid dressing is a sign of infection d.. applying topical abx after washing with mild soap and water
D
active immunity
Immune bodies are actively formed against specific antigens by having had the disease or by introducing the antigen into the individual
Droplet precautions
Designed to reduce the risk for transmission of infectious agents that are spread when large particles generated during coughing, sneezing, or talking come in contact with the conjunctiva or the mucous membrane of the nose or mouth of a susceptible person; suctioning or bronchoscopy generates these particles
contact precautions
Designed to reduce the risk for transmission of microorganisms transmitted by direct or indirect contact
Body substance isolation
Designed to reduce the risk of transmission of pathogens from moist body substances
monovalent vaccine
Designed to vaccinate against a single antigen or organism
Polyvalent vaccine
Designed to vaccinate against multiple antigens or organisms; meningococcal polysaccharide vaccine
Herpetic gingivostomatitis is associated with sexual transmission
F
diagnosis is confirmed when the live louse is observed by crawling on the scalp
F
lice is often transmitted by pets
F
t/f head lice is more common in those with poor personal hygiene
F
topical anesthetics like lidocaine can be prescribed for children who are old enough to keep drug in mouth for 2-3 minutes, then swallow the drug
F
treatment for stomatitis is aimed at relief of complications
F
when examining herpetic lesions, the nurse uses her uncovered index finger to check for cracks in skin surface
F
natural immunity
Innate Resistance to Infection
Standard precautions
Interventions that synthesize the major features of universal (blood and body fluid) precautions and body substance isolation; involve the use of barrier protection; designed for the care of all patients to reduce the risk for transmission of microorganism from both recognized and unrecognized sources of infection
Indirect contact transmission
Involves contact of a susceptible host with a contaminated intermediate object, usually an inanimate object in the patient's environment
Direct contact transmission
Involves skin-to-skin contact and physical transfer of microorganisms to a susceptible host from an infected or colonized person
Toxoid
Modified bacterial toxin that has been made nontoxic but retains its ability to stimulate the formation of antitoxin
Combination vaccine
Multiple vaccines into one parenteral form
Cocooning
Strategy of protecting infants from pertussis by vaccinating all persons who come in close contact with the infant
Herpetic gingivostomatitis is caused by herpes simplex virus, usually type 1
T
Herpetic gingivostomatitis is commonly called "cold sores" or "fever blisters"
T
aphthous stomatitis is characterized by painful, small, whitish ulcerations that heal without complication in 4-12 days
T
aphthous stomatitis may be associated with mild traumatic injury, allergies and emotional stress
T
family should be advised to wash all clothing, towels and linen in hot water
T
itching is usually the only symptom of lice
T
nits may be confused with danderuff
T
treatment consists of both pediculicide and manual removal of nits
T
treatment for children with severe casses of herpetic gingivostomatitis includes oral acyclovir
T
passive immunity
Temporary immunity obtained by transfusing immunoglobulin or antitoxins from a person or animal that has been actively immunized against the antigen
Herd immunity
The majority of the population is vaccinated and the spread of disease is stopped without the rest of the population getting vaccinated
Attenuate
To reduce the virulence of a pathogenic microorganism by treating it or cultivating it on a certain medium
Measles immunization includes which of the following? a. Given at 12-15 months of age with a second dose given at age 4-6 years of age and revaccination at 11-12 years b. Child vaccinated before 12 months of age should receive 2 additional doses beginning at 12-15 months and separated by at least 4 weeks c. Revaccination of all individuals born after 1956 who have not received 2 doses of measles vaccine after 12 months of age d. All the above
a. Given at 12-15 months of age with a second dose given at age 4-6 years of age and revaccination at 11-12 years b. Child vaccinated before 12 months of age should receive 2 additional doses beginning at 12-15 months and separated by at least 4 weeks c. Revaccination of all individuals born after 1956 who have not received 2 doses of measles vaccine after 12 months of age d. All the above
In hospitals, which of the following is the most significant source of MRSA and the major mode of transport? a. Patient to patient via the hands of the health care provider b. Patients coming in direct contact with other patients c. Failure of hospital personnel to wear face masks when working with patients in an airborne infection isolation room d. Indirect contact transmission from hospital equipment
a. Patient to patient via the hands of the health care provider
Which of the following statements about rotavirus disease or immunization against rotavirus is correct? a. Rotavirus is one of the leading causes of diarrhea in infants and young children b. Rotavirus is one of the leading causes of otitis media young children c. One vaccine for rotavirus is RotaTeq, which is approved for children 32 weeks of age or older d. Rotavirus vaccine usually causes only mild reaction, redness, and soreness
a. Rotavirus is one of the leading causes of diarrhea in infants and young children
Meningococcal conjugate vaccines (MCV4) are not recommended for which of the following populations? a. Routinely for children ages 9 months-10 years b. Children ages 2-18 years who travel to or reside in countries where N.meningitidis is hyperendemic or epidemic c. Children and adolescents 11-12 years of age d. College freshmen living in dormatories
a. Routinely for children ages 9 months-10 years
the nurse is conducting an educational session for the parents of a child diagnosed with varicella. which one of the following is not an appropriate comfort measure to include in this session? a. use aveeno bath treatment or oatmeal in bath water for added skin comfort b. use caladryl lotion on rash to decrase itching c. use hot bath water to promote skin rash healing d. keep nails short and smooth to decrease chances of infection from scratching
c. use hot bath water to promote skin rash healing
Which of the following statements about haemophilius influenzae type b (Hib) vaccine is true? a. The vaccine protects against a number of infections including bacterial meningitis, epiglottitis, bacterial pneumonia, septic arthritis, and sepsis b. The vaccine protects against the virus that produces influenza c. Only 2 doses of Hib vaccine should be given to children 15 months of age or older who have not been previously vaccinated d. Hiberix is a conjugate vaccine licensed for use in infants over the age of 2 months
a. The vaccine protects against a number of infections including bacterial meningitis, epiglottitis, bacterial pneumonia, septic arthritis, and sepsis
Standard precautions involve the use of barrier protection to prevent contamination from :a. blood b. body fluids c. mucous membranes d. all the above
a. blood b. body fluids c. mucous membranes d. all the above
clinical manifestations differentiate bacterial conjunctivitis from viral conjunctivitis. which one of the following is present with bacterial conjunctivitis but not usually found in viral conjunctivitis? a. child awakens with crusting of eyelids b. child has increase in watery drainage from eyes c. child has inflamed conjunctiva d. child has swollen eyelids
a. child awakens with crusting of eyelids
the primary prevention of communicable disease is best accomplished by a. immunization b. control of the disease spread c. adequate water supply d. implementing good hand-washing practices among hospital personnel
a. immunization
Rubella vaccine administration: a. is given as protection for the unborn children rather than for the recipient of the immunization b. is recommended for all children beginning at 4-6 years c. Is given to all pregnant women if not previously immunized d. is not given to children whose mother is currently pregnant
a. is given as protection for the unborn children rather than for the recipient of the immunization
children with pinworm infections are seen with the principal symptom of a. perianal itching b. diarrhea with blood c. evidence of small, ricelike worms in their stool and urine d. abdominal pai
a. perianal itching
Which of the following techniques is recommended to provide atraumatic care for immunization administration to infants? a. select a 1 inch needle to deposit vaccine deep into the muscle mass b. use an air bubble to clear the needle before injection c. use the deltoid muscle d. use the EMLA patch before administration
a. select a 1 inch needle to deposit vaccine deep into the muscle mass
which of the following statements about haemophils influenzae type b(hib) vaccine is true a. the vaccine protects against a number of infections including the bacterial meningitis, epiglottis, bacterial pneumonia, septic arthritis, sepsis b. the vaccine protects against the virus that produces influenza c. only 2 ones of hib vaccine should e given to children 15 months of age or older who have not been previously vaccinated d. hiberix is a conjugate vaccine licensed for use in infants over the age of 2 months
a. the vaccine protects against a number of infections including the bacterial meningitis, epiglottis, bacterial pneumonia, septic arthritis, sepsis
paresthesia
abnormal sensation such as burning or prickling
anesthesia
absence of sensation
laceration
accidental cut with either torn or jagged edges
benzoyl peroxide
antibacterial agent that inhibits growth of p. apnes
Bryan, 6 months, is starting daycare as his mother is returning to work. Bryan has had no immunizations. Which of the following statements provided by the nurse to the mother is the most appropriate at this time? a. "Since Bryan has not started his immunizations for streptococcal pneumococci yet, it is best to wait until after he gets established at daycare before beginning his injections." b. "Streptococci pneumococci are responsible for a number of bacterial infections that are especially problematic for children under 2 years of age who attend daycare. Bryan should start his series of pneumococcal vaccine right away." c. "Why has Bryan not received any immunizations? He is past due. Don't you care about his health? "d. "Pneumococcal vaccine (PCV13) is the only vaccine recommended for Bryan at this time."
b. "Streptococci pneumococci are responsible for a number of bacterial infections that are especially problematic for children under 2 years of age who attend daycare. Bryan should start his series of pneumococcal vaccine right away."
when administering vaccines a(n) ____ is considered a condition in a person that does increase the risk for a serious adverse rxn (e.g. not administering a live virus vaccine to a severely immune-compromised child)
contraindication
When administering the pertussis vaccine, the nurse recognizes which of the following as incorrect? a. Can be given any time during pregnancy b. Cannot be given to the postpartum mother who is breastfeeding c. The acellular pertussis vaccine, from the same manufacturer, is recommended for the first 3 immunizations and is given along with diphtheria and tetanus at 2, 4, and 6 months of age d. Is recommended for health care workers having close contact with infants under the age of 12 months
b. Cannot be given to the postpartum mother who is breastfeeding
The following statements are about hepatitis A, illness, or vaccination. Which of the following is true? a. The illness has a gradual onset, with often dark urine and jaundice being the only symptoms. b. The vaccine is recommended for all children between the ages of 12-23 months. c. The vaccine consists of a series of 3 injections timed 2 months apart. d. The illness is spread by all body secretions.
b. The vaccine is recommended for all children between the ages of 12-23 months.
the nurse knows, regarding pertussis, that a. the incidence has decreased in infants younger than 6m of age b. a booster vaccine (tdap) is now recommended for all children 11-18 years of age c. treatment should begin as soon as exposure is confirmed and includes the antibiotic amoxicillin d. the disease is not contagious, so close household members do not need treatment
b. a booster vaccine (tdap) is now recommended for all children 11-18 years of age
which antiviral agent is used to treat varicella infections in children at increased risk for complications associated with varicella? a. varicella-zoster immune globulin b. acyclovir c. salicylates d. steroids
b. acyclovir
Mumps immunization: a. is recommended for children ages 4 years or older b. is typically given in combination with measles and rubella c. Can be administered to infants as young as 6 months of age d. all the above
b. is typically given in combination with measles and rubella
bed bugs, although once considered to be practically nonexistent, have remerged within the past decade as troublesome. which of the following does the nurse recognize as incorrect information about bed bugs ? a. they tend to inhabit warm, dark areas such as furniture and emerge at night to feed b. they act as vectors for disease transmission c. the treatment should focus on identification, treatment of symptoms and eradication d. their bites are often misdiagnosed as scabies, spider bites, or mosquito bites
b. they act as vectors for disease transmission
open comedone
blackhead
the proper use isotrentioin 12-cis-retinoic acid (accutane) for adolescent includes i. reserving its use for severe, cystic acne that has not responded to other tx ii. limiting tx for 20 weeks iii. watching for s/e including mood changes, depression and suicidal ideations iv. watching for detrimental effects on bone mineralization v. recognizing that it is contraindicated in pregnancy and sexually active females not using contraceptive method vi. monitoring for elevated cholesterol and triglyceride level before and during tx a. I, ii, iv, and v b. I, iii, and v c. I, ii, iii, v and vi d. I, ii, iii, iv, v and vi
c
The HBsAg negative mother of Danielle, a premature infant weighing 4lbs and born 6 hrs ago, asks, "Have you already given Daniella her hepatitis B vaccine?" What is your correct response? a. "Don't worry, we will give it before she leaves the hospital." b. "Daniella is sleeping right now. I will give it as soon as she wakes up." c. "Because Daniella only weighs 4 lbs, she will not receive her vaccine until she is one month of age." d. "Because Daniella is premature and weighs only 4 lbs, she will be given 1 vaccine dose now and then she will need another in 2 months."
c. "Because Daniella only weighs 4 lbs, she will not receive her vaccine until she is one month of age."
which one of the following does the nurse recognize as contraindicated in providing comfort measures to children with communicable diseases? a. use of acetaminophen or ibuprofen for control of elevated temperature in children with varicella b. use of diphenhydramine (benadryl) or hydroxyzine (atarax) for itching c. use of aspirin to control elevated temp and/or symptoms with varicella d. use of lozenges and saline rinses in an 8yr old child with sore throat
c. use of aspirin to control elevated temp and/or symptoms with varicella
Which of the following statements about polio vaccine and immunizations is NOT correct? a. Inactivated poliovirus vaccine (IPV) is now recommended for routine childhood vaccination in the US b. Oral polio vaccine (OPV) has been associated with vaccine-associated polio paralysis c. KINRIX contains DTap, hepatitis B, and IPV and may be used only in children aged 4 years or older as the 4th dose d. The combination vaccine PEDIARIX (containing DTaP, hepatitis B, and IPV) may be used as the primary immunization beginning at 2 months
c. KINRIX contains DTap, hepatitis B, and IPV and may be used only in children aged 4 years or older as the 4th dose
Which of the following statements about varicella vaccine is correct? a. Varicella vaccine is recommended for all children regardless of past disease history b. A single dose of 0.5mL of varicella vaccine should be given by deep IM injection c. The 1st dose of varicella vaccine is recommended for children ages 12-15 months, and to ensure adequate protection, a second varicella vaccination is recommended for children 4-6 years of age d. Varicella vaccine should not be administered simultaneously with MMR
c. The 1st dose of varicella vaccine is recommended for children ages 12-15 months, and to ensure adequate protection, a second varicella vaccination is recommended for children 4-6 years of age
anne, an 8yr old has been diagnosed with giardiasis. the nurse would expect anne to have most likely been seen initially with which of the following s/s? a. diarrhea with blood in the stools b. n/v with mild fever c. abdominal cramps with intermitten loose stools d. weight loss of 5lb in past month
c. abdominal cramps with intermitten loose stools
Human papillomavirus (HPV) vaccine is recommended for all of the following populations except ;a. female adolescents to prevent HPV-related cervical cancer .b. boys and men (9-26) to reduce the likelihood of genital warts c. female preadolescents ages 7-9 d. female adolescents who are not sexually active
c. female preadolescents ages 6-8
secondary lesion
changes resulting from alteration of lesion (rubbing, scratching)
when administering vaccines a(n) ____ is considered a condition in a person that does increase the risk for a serious adverse rxn (e.g. not administering a live virus vaccine to a severely immune-compromised child) contraindication
contraindication
pertussis
cough occurs at night, and inspirations sound like crowing
cause of diaper dermatitis include prolonged contact with a. urine b. feces c. detergents d. all the above
d
Joey, 14, has recently relocated from Mexico to the US. While helping his dad do farm work, Joey suffered a laceration in the horse barn. Review of Joey's immunization record from Mexico shows that Joey has had 2 previous tetanus and diphtheria vaccine immunization shots, the last one being at the age of 6 years. Which of the following would the nurse in the ED expect to give at this time? a. TDaP b. DTap c. TD booster d. Tetanus immunoglobulin (Tig) human and TDap
d. Tetanus immunoglobulin (Tig) human and TDap
Which of the following is not an influenza vaccine recommendation? a. The vaccine is administered in early fall before the flu season begins and is repeated yearly b. Fluzone, a quadrivalent influenza vaccine, offers protection against type a and type b and is approved for vaccine use in children ages 6 months and older c. Children with severe egg allergy history should not routinely receive the influenza vaccine d. The live influenza vaccine (LAIV) form is recommended for children 2-4 years of age with a history of wheezing or asthma
d. The live influenza vaccine (LAIV) form is recommended for children 2-4 years of age with a history of wheezing or asthma
In scheduling immunizations, the nurse knows which of the following is correct? a. The beginning primary immunization for infants begins at 2 months of age b. Children who are born preterm receive only half the normal dose of each vaccine followed by the second half of the vaccine 2 weeks later c. Children who begin primary immunization at the recommended age but fail to receive all the doses by the suggested age need to begin the series again d. When there is doubt that the child will return for follow-up immunizations according to the optimum schedule, HBV vaccine, DTaP, IPV, MMR, Varicella, and Hib vaccines can be administered simultaneously at separate injection sites
d. When there is doubt that the child will return for follow-up immunizations according to the optimum schedule, HBV vaccine, DTaP, IPV, MMR, Varicella, and Hib vaccines can be administered simultaneously at separate injection sites
certain groups of children are at risk for serious complications from communicable diseases. these children do not include which of the following groups? a. children with an immunodeficiency or immunologic disorder b. children receiving steroid therapy c. children with leukemia d. children who have recently undergone a surgical procedure
d. children who have recently undergone a surgical procedure
retin-A
interrupts abnormal follicular kertinization that produces microcomedones
pruritus
itching
ecchymoses
localized red or purple discoloration
Acute vulgaris
most common skin problem during adolescene
the nurse is instructing parents on the test-tape diagnostic procedure for enterobiasis. which one of the following is included in the explanation? a. use flashlight to inspect the anal area while the child sleeps b. perform the test 2 days after the child received the first dose of antiparasitic mediation c. test all members of the family at the same time using frosted taped. collect the tape in the morning before the child has a bowel movement or bath d. collect the tape in the morning before the child has a bowel movement or bath
d. collect the tape in the morning before the child has a bowel movement or bath
assessment of which of the following is not helpful in identifying potentially communicable diseases? a. prodromal symptoms b. immunization history c. past medical hx d. family hx
d. fam hx
he general contraindication for all immunizations is; a. minor illness such as common cold b. breastfeeding c. pregnancy d. severe febrile illness
d. severe febrile illness
To prevent spread of contamination from one patient to another after procedures, the important strategy the nurse can use is to: a. follow disease-specific infection control guidelines b. wear vinyl gloves c. avoid wearing nail polish d. wash the hands routinely after each patient contact and after removing gloves
d. wash the hands routinely after each patient contact and after removing gloves
when instructing the parents caring for an infant with conjunctivitis, the nurse will include which one of the following in the plan? a. accumulated secretions are removed by wiping from outer canthus inward b. hydrogen peroxide placed on cotton swabs is helpful in removing crusts from eyelids c. compresses of warm tap water are kept in place on the eye to prevent crusting d. washcloth and towel used by the infant are kept seperate and not used by others
d. washcloth and towel used by the infant are kept seperate and not used by others
the nurse is administering immunizations to 2-month old Brian. Describe what should be documented on the medical record datevaccine namemanufacturerlot # rn administering location/siterouteconsentVIS given
date vaccine name manufacturer lot # rn administering location/site route consent VIS given
hypesthesia
diminished sensation
rubella
discrete pinkish red maculopapular rash appears on the face and then spreads downward to neck, arms, trunk and legs; greatest danger is teratogenic effect on fetus
penetrating
disruption of the skin that extends into the underlying tissue or into Body cavity
incision
division of skin made with sharp object
chronic wound
does not heal in expected time Frame and associated with complications
hyperesthesia
excessive sensitivity
avulsion
forcible pulling or extraction of tissue
comedogenesis
formation of comedones
acute wound
heals uneventfully within 2-3 weeks
When educating the public about diphtheria vaccine, the nurse recognizes which of the following as correct? i. Diphtheria vaccine is commonly administered in combination with tetanus and pertussis vaccines or DTaP and Hib vaccines for children under 7 years. ii. Diphtheria vaccine is administered with tetanus and acellular pertussis for children 11 and up .iii. Diphtheria vaccines produce absolute immunity after 3 doses. iv. Several vaccines contain diphtheria toxins (and Hib, meningococcal, pneumococcal), which confers immunity to the disease. a. i, ii, iii, iv b. i and ii c. i, ii, iii d. iii and iv
i. Diphtheria vaccine is commonly administered in combination with tetanus and pertussis vaccines or DTaP and Hib vaccines for children under 7 years .ii. Diphtheria vaccine is administered with tetanus and acellular pertussis for children 11 and up.b. i and ii
For which of the following populations is pertussis vaccine currently recommended? i. all children from 6 weeks-7th birthday ii. Children 11-12 who have completed the DTap/DTP childhood series iii. A second booster for previously immunized adolescents and adults iv. Children 7-10 who are not fully vaccinated for pertussis (did not receive 5 doses of DTap, or who received 4 doses of DTaP with the 4th dose being administered on or after the 4th birthday v. Pregnant adolescents between 27-36 weeks' gestation, if not previously protected a. i, ii, iv, and v b. i, iii, iv c. ii, iii, v d, i, ii, iii, iv
i. all children from 6 weeks-7th birthday ii. Children 11-12 who have completed the DTap/DTP childhood series iv. Children 7-10 who are not fully vaccinated for pertussis (did not receive 5 doses of DTap, or who received 4 doses of DTaP with the 4th dose being administered on or after the 4th birthday) v. Pregnant adolescents between 27-36 weeks' gestation, if not previously protecteda. i, ii, iv, v
the american academy of pediatrics has recommended vitamin a supplements for certain pediatric pts with measles. correct dosage of vitamin a and instructions to parents of these children include ;i. single oral dose of 200,000iu in children 1yr old ii. single oral dose of 100,000iu in children 6-12 months old iii. dosage may be associated with vomiting and headache for a few hours iv. safe storage of the drug to prevent accidental overdose a. i, ii, iii, and iv b. i, ii, and iv c. i, iii, and iv d. ii and iv
i. single oral dose of 200,000iu in children 1yr oldii. single oral dose of 100,000iu in children 6-12 months oldiii. dosage may be associated with vomiting and headache for a few hours iv. safe storage of the drug to prevent accidental overdose a. i, ii, iii, and iv
hospital acquired infection
infection occur when there is interaction among patients, health care personnel, equipment and bacteria
when administering vaccines a(n) ____ is a condition in a person that might increase the risk for a serious adverse rxn or that might compromise the ability of the vaccine to produce immunity
precaution
regeneration
rapid replacement by similar cells
rubeola
rash appears 3-4 days after onset and maculopapular eruption on face with gradual spread downward. koplik spots are present before rash
fifth disease
rash appears in 3 stages, stage 1 is erythema on face, chieflyy on cheeks
roseola
rash composed of rose-pink macules or maculopapules, appearing first on the trunk, then spreading to neck, face, and extremities, rash is nonpruritic
erythema
reddened area
abrasion
removal of superficial layer of skin by scraping
allodynia
sensation of pain from normally non painful stimuli
configuration and arrangement
size, shape, and arrangement of lesions or group of lesions
primary lesion
skin changes caused by causative factor
varicella
this condition has a rash that begins as macule, rapidly progressing ti papules and then vesicles, eventually breaking and forming crusts
diphtheria
tonsillar pharyngeal areas are covered in white or gray membrane, complications include myocarditis and neuritis
scarlet fever
tonsils become enlarged, edematous, reddened and covered with patches of exudate; rash is absent on face; desquamation occurs
topical antibacterial agent
used to prevent new inflammatory lesions
systemic antibiotic therapy
used with moderate to severe acne
name 2 diseases caused by varicella-zoster virus (VZV)
varicella (chickenpox) zoster (herpes zoster/shingles)
close comedones
whitehead
puncture
wound with an opening that is small compared with its depth