Peds Chapter 21: Dermatologic Disorders

A 10-year-old child presents to the ER with a large circular rash on the leg, along with a fever, headache, and achiness. What is your assessment? 1. Lyme disease 2. Eczema 3. MRSA infection 4. Spider bite

1

A camp nurse has been notified that one of the campers, who has an allergy to bee stings, has been stung. The nurse gets to the child and begins her assessment. The child is noted to have stridor and has broken out in hives over her entire body. The nurse knows that this is a medical emergency and has brought the childs medication with her to the site. What is the anticipated medication the nurse should administer at this time? 1. EpiPen 2. Benadryl 3. Tylenol 4. An antihistamine

1

A child with who has __________ should not use pediculicide shampoos. 1. Asthma 2. Cystic fibrosis 3. Latex allergies 3. Neurological disorders

1

A common area for scabies to occur on children under the age of 2 is/are the: 1. Head and neck. 2. Extremities. 3. Abdomen. 4. Buttocks.

1

A nursing student is taking care of a 2-year-old girl and notices her oxygen saturation has decreased. The patient has stridor when breathing and her hairline appears singed. The nurse should anticipate: 1. Possible intubation because of the airway being compromised. 2. This is normal for a patient after 36 hours. 3. To reposition the patient for better airway clearance. 4. This is furthering infection and may require antibiotics.

1

Chloe, a 13-year-old girl, has herpes simplex 1 on her lip. She asks the school nurse if the virus is contagious. The best answer from the school nurse is: 1. Yes, it is contagious for at least one week. 2. No, the virus is dormant in your body and is not contagious. 3. Yes, but it is past the incubation period once you see it on your skin, so it is no longer contagious. 4. No, the virus occurs because of poor hygiene.

1

Home care education for children with eczema includes: 1. Applying moisturizers 2 to 3 times a day. 2. Wearing wool and cotton clothing. 3. Keeping the environment warm and humidified. 4. None of the above

1

Pain management is required for children throughout the healing process with burns. In the emergent phase, the child may require medication during the debridement and dressing changes. What type of pain management would be appropriate at this time? 1. Opiates 2. Narcotics 3. Acetaminophen 4. Ibuprofen

1

The most common areas for infantile eczema to appear are the: 1. Face, hands, and scalp. 2. Face, feet, and abdomen. 3. Extremities only. 4. Abdomen only.

1

When treating chemical burns, the initial treatment should include: 1. Washing the area with large amounts of water. 2. Soaking the body part in cool water. 3. Using ice on the burn. 4. Applying antibiotic cream.

1

The nurse in the PICU is caring for a 4-year-old child who was in a motor vehicle accident three days ago. The child is sedated with many IV lines, a catheter, and a ventilator. The plan of care requires new positioning every three hours and indicates for the child to have a skin check done every hour. Indicate an area of concern for skin breakdown. (Select all that apply.) 1. The area around the childs mouth where the endotracheal tube is taped 2. The peri-area because of the immobility and dampness to the area 3. The IV site because of the possibility of infiltrations 4. The scapula because the child rests more comfortably on her back 5. All of the above are areas of concern for skin breakdown.

1, 2, 3

Keshia, a 10-year-old girl, was removed from a burning apartment complex and brought to the ER via the ambulance. The EMTs have reported that Keshia is struggling to breathe. The nurse knows that: (Select all that apply.) 1. There could be an inhalation injury due to the smoke. 2. She will need to be monitored on the pulse oximeter. 3. The child will need emotional support while in the ER. 4. The child should be placed on a cardiac monitor. 5. The parents should not be allowed in the room until the child is stable.

1, 2, 3, 4

A community health nurse is giving information to parents at the child health clinic about the prevention of sunburns. In planning the care session, it will be important for the nurse to include: (Select all that apply.) 1. The time of day when the sun is the brightest. 2. The length of time a child should be in the sun. 3. Applying sunscreen one time after the child goes out in the sun. 4. The fact that children with dark skin do not burn. 5. Applying sunscreen an hour before going in the sun.

1, 2, 5

A 3 month old is in the pediatric clinic for her well-child checkup. The mother states that the childs diaper area is very red and tender with some raised bumps. The doctor diagnoses the child with candida albicans and prescribes hydrocortisone for the area. The nurse is supposed to teach the mother about the signs and symptoms of possible infection and care to the area. The teaching should include all except: 1. Reporting if the sores increase in size. 2. Reporting if the sores decrease in size. 3. Reporting if the sores have purulent drainage 4. The use of a mild soap to cleanse the area at each diaper change.

2

A child has burns on the face and hands. These are classified as: 1. Partial burns. 2. Major burns. 3. Minor burns. 4. First degree burns.

2

An outbreak of impetigo has occurred in a first grade classroom. The school nurse instructs the teachers to: 1. Not work because this is not a common occurrence. 2. Disinfect surfaces. 3. Have a change of clothes for the children with the infection. 4. Have the children with the infection sit in one particular area of the room.

2

Katie is caring for a pediatric patient with extensive burns due to a house fire. She anticipates that pain medication will be administered via which route? 1. Oral 2. Intravenous 3. Intramuscular 4. Subcutaneous

2

Myoglobinuria is occurring with a child with extensive partial thickness burns. The nurse knows that this is occurring because: 1. The childs stomach has a large amount of acid and is causing the stomach to bleed. 2. It is a byproduct of the muscle damage due to the extensive burns. 3. The kidneys are failing. 4. The child has consumed a large amount of red oral fluids.

2

The nurse is instructing a 13 year old and her mother on alternative therapies for cold sores. The alternative therapies consist of: 1. Warm compresses to the lips. 2. Mouthwash with 1 teaspoon of sodium bicarbonate in slightly warm water. 3. Using lip gloss to create a barrier so that the drainage decreases. 4. None of the above is an alternative therapy for cold sores.

2

The wound nurse has prescribed the use of a hydrocolloid dressing for an abdominal wound that is not healing. The childs primary nurse knows that this type of dressing is effective because: 1. The dressing allows the child to be mobile. 2. The dressing aids in the regeneration of skin and helps the wound heal. 3. The dressing is soothing and reduces pain for the child. 4. The dressing absorbs a large amount of fluid, so the wound will heal.

2

The skin care nurse is working with the pediatric staff on ways to help reduce the number of pressure ulcers in the chronically ill child population on the floor. One nurse states that the children are coming onto the floor from home with diaper rashes. The skin care nurse knows that this can result from: (Select all that apply.) 1. Lack of communication skills from the child. 2. High acidity in the childs urine due to medications. 3. Relation to the preventative antibiotics the child takes on a daily basis. 4. The caregivers not responding to the needs of the child.

2, 3, 4

A 9 year old is in the ER. His mother has brought him because of a leg injury. The child has been diagnosed with cellulitis. The nursing plan of care would include all of the following except: 1. Vital signs, including a heart rate, should be taken every 2 to 4 hours to monitor for furthering infection. 2. Assessing perfusion to the extremity. 3. Keeping the leg in a dependent position. 4. Encouraging oral fluids.

3

A mother calls the pediatric triage nurse and states, I dont know what is on her hand. It is red with clear drainage coming out of small bumps. She got into the poison ivy patch yesterday. The nurse instructs the mother to: 1. Apply warm compresses to help reduce the pain. 2. Use a body wash, such as Dove, to help with the itching. 3. Use Calamine lotion to help with the itching. 4. Apply a thin coat of Cetaphil to help with itching.

3

An outbreak of head lice has occurred on the high school softball team. The school nurse has given handouts about therapy to kill the nits. One mother asks what the best way of going through her childs hair would be. The best response from the nurse would be: 1. Wash her hair with pediculicide shampoo and towel dry. This is a one-time treatment. 2. Use a fine-toothed comb to remove the nits when the hair is dry. 3. Make sure to wash all bedding with hot, soapy water and dry on the hot cycle after each night. This reduces the nits in her bedding. 4. Wash her hair and towel dry, then apply the RID and rinse after 10 minutes. Repeat this several times throughout the day.

3

Before starting Megan, a 15 year old, on Accutane, it is important to assess for: 1. Signs and symptoms of infection. 2. Urinary tract infections. 3. Pregnancy. 4. Sexually transmitted diseases.

3

Karen is a camp nurse and is preparing information about Lymes disease to give to the campers. Karen knows that a child could be initially infected without her knowing because: 1. The bite is so small that it is hard to with the human eye. 2. Children do not usually react to a tick bite immediately after it occurs. 3. Signs and symptoms may appear up to 32 days after the initial bite. 4. Mosquito bites and tick bites look similar, so children do not notice.

3

Seborrheic dermatitis differs from contact dermatitis because: 1. Seborrheic dermatitis is caused by fungus. 2. Seborrheic dermatitis is caused by latex. 3. The general appearance of seborrheic dermatitis is greasy with scales. 4. The general appearance of seborrheic dermatitis is raised bumps with white centers.

3

The clinic nurse has a patient arrive in the triage room with a dog bite that occurred three days ago. Which patient complaint would alert the nurse to the presence of a possible infection? 1. Puncture wounds 2. Blanching and swelling 3. Pain and purulent drainage 4. Bruising to the area

3

The nurse asks a nursing student if any systemic signs and symptoms were present when assessing a 5-year-old client. Which answer would demonstrate that the nursing student understood? 1. Itchy, red rash 2. Vesicles present 3. Fever and headache 4. Blistering

3

The nurse in the PICU is checking for areas of skin breakdown on her 4-year-old patient. The most common areas for skin breakdown in the pediatric client include all of the following except the: 1. Ears. 2. Occiput. 3. Heels. 4. Scapula.

3

The nursing instructor asks the student nurse to teach the parents tick bite prevention strategies. In evaluating the session, the instructor asks the parents what they have learning about this topic. Which statement would demonstrate what they have learned? 1. I dont know. I am not an outdoor person. 2. Avoid going outside if possible. 3. Use DEET spray on the skin. 4. All of the above

3

The rule of nines contains all of the following except: 1. Head 9 percent. 2. Anterior trunk 18 percent. 3. Posterior trunk 9 percent. 4. Each lower extremity 18 percent.

3

While doing a skin assessment, the nurse assesses for the color of a child with dark skin. The nurse knows that the best place to assess for pallor is/are the: 1. Chest. 2. Extremities. 3. Inside of cheek. 4. Fingernails.

3

A pediatric intensive care nurse is caring for a boy with superficial partial thickness burns on his lower legs and chest. Which of the following would the nurse expect to note during the emergent phase of the burn injury? (Select all that apply.) 1. A decrease in the baseline heart rate 2. An increase in blood pressure 3. Decreased body temperature 4. An elevated hematocrit 5. Decreased hemoglobin

3, 4

A 14-year-old boy is asking the nurse about how to decrease his atopic dermatitis. Which of the following statements is an appropriate teaching? 1. Wear loose cotton clothing. 2. Apply moisturizers 2 to 3 times a day. 3. Use mild soap for cleansing. 4. Keep warm and be in a moist environment while asleep.

4

A 17-year-old lifeguard presents to the health center with blistering of the skin on his back. What nursing interventions should you provide for him? 1. Cool baths and compresses 2. Additional fluids to prevent dehydration 3. Acetaminophen or Ibuprofen for pain 4. All of the above

4

A child has been diagnosed with tinea pedis. The teaching by the nurse for home care includes: 1. Not sharing shoes. 2. Changing socks daily. 3. Air the feet as much as possible. 4. All the above should be included in the teaching.

4

A child on the pediatric floor has been diagnosed with MRSA. The nurses discharge teaching should include all of the following except: 1. Good hand hygiene. 2. Completing the entire course of antibiotics. 3. Disinfecting the shower/bathtub and other surfaces. 4. Leaving the wound open so that it airs out twice a day.

4

A community health nurse is participating in a health fair. What prevention strategies can the nurse teach to prevent house fires? 1. Have a functional indoor smoke alarm. 2. Keep a fire extinguisher in the home. 3. Educate the children on fire safety. 4. All of the above

4

A lifeguard needs education regarding sunburn prevention in the future. What education needs to be provided by the nurse? 1. Apply sunscreen SPF 30 and reapply every hour. 2. A shirt should be worn while outdoors. 3. Ask the boss if you can avoid the sun from 10 to 2 p.m. 4. Choices 1 and 2

4

A mother and father have come to a baby education class at the local hospital. The nurse is teaching families about the prevention of burns. This teaching would include all the following except: 1. Not holding infants while cooking. 2. Not holding infants while heating bottles. 3. Not placing a bottle in the microwave to be heated. 4. All should be include in the teaching.

4

A mother brings her child in for a 4-week visit to the pediatrician. You observe that the child has a diaper rash. What caregiver education would you, the nurse, provide for this mother? 1. Keep diaper areas dry and change diapers frequently. 2. Air dry the diaper area as much as possible. 3. Use baby wipes to cleanse the diaper area. 4. Choices 1 and 2

4

A nurse in the PICU is caring for a 7-year-old child with burns on more than 30 percent of the body. Which statement made by the parents indicates an understanding of the severity of the burns? 1. Im glad that he doesnt have any burns on his face. 2. I feel so bad that he got burned. 3. When do you think he will be out of the ICU? 4. Nurse, is he going to make it?

4

A school nurse is teaching high school student athletes about the prevention of MRSA. The teaching should include: 1. Disinfecting sports equipment. 2. Avoiding the sharing of towels. 3. Avoiding touching the nose. 4. All are important prevention methods for MRSA.

4

Allen is sent to the school nurse because the teacher notices a lesion on his face. The school nurse examines around his month and notes that the area has a yellow crust over the top. The nurse calls Allens mother. His mother states that he was diagnosed with impetigo two days ago and has been on antibiotics since then. The nurse knows the cause for impetigo is usually: 1. A bacterial infection. 2. Staphylococcus aureus. 3. Group A beta-hemolytic streptococcus. 4. All of the above.

4

Alternative therapies may be used to treat eczema in adolescents. Which of the following is considered an alternative therapy? 1. Vitamin A 2. Vitamin B 3. Zinc 4. Calcium

4

Amber, a 10 year old, has been in fixed traction for a femur fracture for the past two weeks. Her parents are currently getting breakfast in the cafeteria. The nursing plan of care indicates that she should be moved every two hours and assess for skin breakdown. Today, Amber is refusing to move and tells the nurse I am not going to do it. The best way for the nurse to handle this situation is: 1. I will speak with the doctor to see if we can change your orders so you do not need to be moved so often. 2. We will call your mother to come back and move you. 3. I will give you 10 minutes to think about how you want to be positioned. After that, you can ring your call light, and we will move you to the position of your choosing. 4. I understand that you do not want to move today, but we have to make sure you do not get any sores on your back or leg. I will let you be for 10 minutes, and then when you ring the call light, I will come in and move you to the position of your choosing.

4

An in-service day for the pediatric nurses is focusing on the use of the Braden Q Scale. The nurses are given scenarios of when to use the scale. Which of the following situations would be an appropriate time to use the scale? 1. A child with a lack of mobility due to conscious sedation. 2. A child with a femur fracture who is refusing to eat anything but fast food. 3. A child who is physically handicapped and needs a two-person transfer from bed to wheelchair. 4. All would be appropriate times to use the Braden Q Scale.

4

An in-service for MRSA is being held for the pediatric nurses. The nurses know that which of the following is a common practice for resistant bacteria? 1. Saving leftover antibiotics for self-medication 2. Taking antibiotics for viral infections 3. Failing to take the entire prescribed regime of antibiotics 4. Taking prophylactic antibiotics

4

As the camp nurse, you have three campers who are allergic to bee stings. What is the appropriate treatment for these campers if they get stung? 1. Keep Benadryl on hand with counselors. 2. Use baking soda paste for application on the bee sting. 3. Scrape the stinger off if a bee sting occurs. 4. Keep an EpiPen on hand at all times and be able to give IM.

4

As the nurse at the pediatric call center, you give advice to parents regarding follow-up care of a laceration. The most important signs and symptoms to teach caregivers to look for are: 1. Erythema. 2. Tenderness and swelling. 3. Drainage. 4. All of the above ANS: 4

4

As the school nurse, you receive a call from a mother who says her daughter has head lice. What information should you tell her? 1. Distinguish nits from dandruff. Nits are firmly attached to the hair shaft. 2. Treat with pediculicide shampoo and repeat in seven days. 3. Toys and clothes can be tied up in a bag for two weeks. 4. All of the above

4

CA-MRSA colonization occurs most commonly in the ______ of health-care employees. 1. Eyes 2. Hands 3. Nares 4. Mouths

4

Common treatments for tick bites include all of the following except: 1. Doxycycline. 2. Citronella oil. 3. Lavender oil. 4. Calamine lotion.

4

Identify the possible nursing diagnosis for a teenager with severe acne. 1. Knowledge deficit related to hygiene 2. Self-esteem issues related to personal appearance 3. Insufficient nutrition related to skin breakouts 4. All of the above would be appropriate nursing diagnoses for the teenager.

4

The key to successful treatment of eczema is hydration of the skin. Examples of emollients are: 1. Eucerin. 2. Desitin. 3. Petroleum jelly. 4. Choices 1 and 3

4

The mother brings a 10-month-old child into the clinic due to an unusual rash that she has noted. In completing the history, the nurse should ask about: 1. The general health of the child. 2. Allergies. 3. Recent immunizations or medications. 4. All of the above.

4

The mother of a 4 year old brings her child into the clinic. Impetigo is present on the face around the mouth and nose. What information should the nurse share with the mother? 1. This is caused by staphylococcus aureus. 2. After caring for child, carefully wash your hands. 3. Administer topical antibiotics. 4. All of the above

4

The mother of a 4-year-old with impetigo wants to know if she can still take the child to day care. The nurses most appropriate response would be: 1. It is okay for her child to go to day care as long as there is no fever. 2. She can attend day care if you teach her hand washing. 3. She can attend day care as long as the lesions are covered. 4. She can attend day care as long as the lesions are crusted and removed, and she has been on antibiotics for 24 hours.

4

The mother of an 8 year old with steri-strips to the right temporal area has been receiving teaching about caring for the wound. The nurse knows that the mother understands the teaching when she states: 1. I will need to remove the stitches in two days, and then bring my child back for more steri-strips. 2. I will clean the area with peroxide and keep the steri-strips dry. 3. I will keep the sterile dressing over the wound for the next 12 hours. 4. I will leave the steri-strips alone, and they will fall off in 7 to 10 days.

4

The mother of an infant tells you how she has been treating the infants scalp. Which answer demonstrates that she needs education regarding care? 1. Washing the babys hair once a week 2. Using an antiseborrheic shampoo 3. Applying baby oil, and then gently brushing the scalp 4. Choices 2 and 3

4

The school nurse has a 6 year old enter the office with a laceration to the left leg. The area is bleeding profusely. The nurses first reaction to the situation should be to: 1. Apply a sterile dressing and antibiotic ointment to the area. 2. Apply a band-aid. 3. Irrigate the wound with normal saline. 4. Use sterile gauze to apply pressure.

4

What principles of skin care can you teach your adolescent patient regarding acne? 1. Eliminate chocolate and soda from your diet. 2. Cleanse your face gently on a daily basis. 3. Avoid oil-based cosmetics, creams, and makeup. 4. Choices 2 and 3

4

When working in the ER, how does the nurse determine whether a burn was an intentional injury? 1. Consider that the incidence of unintentional burns is 5% to 25% as reported by the World Health Organization. 2. Consider if the history is compatible with the pattern of injury. 3. Consider the childs age and development. 4. All of the above

4

Which of the categories are parts of the Braden Q scale? 1. Mobility and activity 2. Sensory perception 3. Nutrition, tissue perfusion, and oxygenation 4. All of the above

4

Which of the following interventions will assist the acute care patient in the PICU with the prevention of skin breakdown? 1. Using water-based skin moisturizers for dry skin 2. Keeping the child well oxygenated and well nourished 3. Changing positions at least every two hours 4. All of the above

4

Which of the following is characteristic of eczema? 1. Triggered by food allergies and topical irritants 2. A family history of asthma 3. No family history of asthma 4. Choices 1 and 2

4

Which of the following statements regarding atopic dermatitis is true? 1. Complementary Foods must have a delayed introduction beyond 4 to 6 months. 2. Fish in the diet before nine months reduces the risk of eczema in infants. 3. Exclusive breastfeeding for four months may delay or prevent eczema. 4. Choices 2 and 3

4

You are examining an infant under your care. While assessing the head, you note greasy and scaly areas on the scalp. What true statements can be said about this condition? 1. Called cradle cap 2. Caused by a yeast organism 3. Called kiddy crud 4. Choice 1 and 2

4