Peds Chapter 45

10. The nurse is caring for a child with widespread itching and has recommended bathing as a relief measure. After teaching the mother about this, which statement from the mother indicates a need for further instruction? A) "After bathing, I need to rub his skin everywhere to make sure he is completely dry." B) "I must make sure I use lukewarm water instead of hot water." C) "Oatmeal baths are helpful; we can add Aveeno skin relief bath treatment." D) "We should leave his skin moist before applying medication or moisturizer."

A

17. The nurse is providing care to a child with folliculitis. What would the nurse expect to administer? A) Topical mupirocin B) Oral cephalosporin C) Intravenous oxacillin D) Topical Eucerin cream

A

29. The nurse is caring for a school-age child with tinea capitis. The child has open lesions from the disease and has lost hair in the areas affected. Which nursing diagnoses would be a part of this client's care plan? Select all that apply. A) Impaired skin integrity B) Risk for infection C) Disturbed body image D) Bathing, self-care deficit E) Altered nutrition

A,B,C

19. A group of students are preparing for a class exam on skin disorders. As part of their preparation, they are reviewing information about acne vulgaris and its association with increased sebum production. The students demonstrate understanding of the information when they identify which areas as having the highest sebaceous gland activity? Select all that apply. A) Face B) Upper chest C) Neck D) Back E) Shoulders

A,B,D

1. The nurse is teaching the mother of a toddler about burn prevention. Which response by the mother indicates a need for further teaching? A) "We will leave fireworks displays to the professionals." B) "I will set our water heater at 130 degrees." C) "All sleepwear should be flame retardant." D) "The handles of pots on the stove should face inward."

B

13. A nurse is assessing the skin of a child with cellulitis. What would the nurse expect to find? A) Red, raised hair follicles B) Warmth at skin disruption site C) Papules progressing to vesicles D) Honey-colored exudate

B

15. What would the nurse include when teaching an adolescent about tinea pedis? A) "Keep your feet moist and open to the air as much as possible." B) "Dry the area between your toes really well." C) "Wear nylon or synthetic socks every day." D) "Go barefoot when you are in the locker room at school."

B

2. The nurse is providing parental teaching about home care for an 8-year-old boy with widespread sunburn on his back and shoulders. Which response indicates a need for further teaching? A) "Cool compresses may help cool the burn." B) "He should manually peel off any flaking skin." C) "Nonsteroidal anti-inflammatory drugs like ibuprofen are helpful." D) "He should avoid hot showers or baths for a couple of days."

B

20. An instructor is developing a plan for a class of nursing students on various skin disorders. When describing urticaria, what would the instructor include? A) It is a type IV hypersensitivity reaction. B) Histamine release leads to vasodilation. C) Wheals appear first followed by erythema. D) The nonpruritic rash blanches with pressure.

B

21. A nurse is inspecting the skin of a child with atopic dermatitis. What would the nurse expect to observe? A) Erythematous papulovesicular rash B) Dry, red, scaly rash with lichenification C) Pustular vesicles with honey-colored exudates D) Hypopigmented oval scaly lesions

B

22. A nurse is performing a primary survey on a child who has sustained partial thickness burns over his upper body areas. What action should the nurse take first? A) Inspect the child's skin color. B) Assess for a patent airway. C) Observe for symmetric breathing. D) Palpate the child's pulse.

B

26. A nurse is preparing a presentation for a local parent group about burn prevention and care in children. What would the nurse be least likely to include in the presentation when describing how to care for a superficial burn? A) Using cool water over the burned area until the pain lessens B) Applying ice directly to the burned skin area C) Covering the burn with a clean, nonadhesive bandage D) Giving the child acetaminophen for pain relief

B

30. A teenage girl with psoriasis tells the nurse that she is embarrassed by the plaque on her skin that she doesn't want to go to school. What is the best response by the nurse? A) "Have you been applying your medication and emollients to your skin as directed by your healthcare provider?" B) "It must be really difficult for you. Tell me how you are taking care of your skin on a daily basis." C) "Sunlight really helps the plaque areas heal. Maybe going to a tanning bed routinely will help." D) "You can't miss school because of your skin. Can you wear clothes that will cover the areas?"

B

31. The mother of a 5-year-old child with eczema is getting a check-up for her child before school starts. What will the nurse do during the visit? A) Change the bandage on a cut on the child's hand B) Assess the compliance with treatment regimens. C) Discuss systemic corticosteroid therapy. D) Assess the child's fluid volume.

B

4. The nurse is conducting a physical examination of a 9-month-old baby with a flat, discolored area on the skin. The nurse documents this as a: A) papule. B) macule. C) vesicle. D) scale.

B

8. The nurse is caring for an infant with candidal diaper rash. Which topical agent would the nurse expect the healthcare provider to order? A) Corticosteroids B) Antifungals C) Antibiotics D) Retinoids

B

9. The nurse is caring for a 15-year-old boy who has sustained burn injuries. The nurse observes the burn developing a purplish color with discharge and a foul odor. The nurse suspects which infection? A) Burn wound cellulitis B) Invasive burn cellulitis C) Burn impetigo D) Staphylococcal scalded skin syndrome

B

18. A nurse is preparing a class for parents of infants about managing diaper dermatitis. What advice would the nurse include in the presentation? Select all that apply. A) Applying topical nystatin to the diaper area B) Using a blow dryer on warm to dry the diaper area C) Refraining from using rubber pants over diapers D) Using scented diaper wipes to clean the area E) Washing the diaper area with an antibacterial soap

B,C

28. The mother of a 15-year-old girl has contacted the clinic to report that her reports the burn is mild but states her daughter is complaining of pain. After consulting with the healthcare provider, what instructions can the nurse anticipate daughter has burned the back of her hand with a curling iron. The child's mother will be recommended? Select all that apply. A) Apply a thin film of protective cocoa butter. B) Run cool water over the injured area. C) Apply ice for 15 to 20 minutes each hour until the pain subsides. D) Take acetaminophen using the manufacturer's guidelines. E) Apply a thin layer of petroleum jelly to the burned area.

B,D

11. After teaching a class about the differences in the skin of infants and adults, the nurse determines that additional teaching is necessary when the class states: A) "An infant's skin is thinner than an adult's, so substances placed on the skin are absorbed more readily." B) "The infant's epidermis is loosely connected to the dermis, increasing the risk for breakdown." C) "The infant has a lower risk for damage from ultraviolet radiation because the skin is more pigmented." D) "An infant has less subcutaneous fat, which places the infant at a higher risk for heat loss."

C

12. The nurse is preparing a class for a group of adolescents about reducing the risk of skin cancer. What information would the nurse include? A) Using a sunscreen with para-aminobenzoic acid (PABA) with an SPF of at least 10 B) Applying sunscreen at least 1 hour before going outside in the sun C) Avoiding sun exposure between the hours of 10 AM and 2 PM D) Using artificial ultraviolet (UV) tanning beds instead of sun exposure

C

14. When developing the plan of care for a child with burns requiring fluid replacement therapy, which of the following would the nurse expect to include? A) Administration of colloid initially followed by a crystalloid B) Determination of fluid replacement based on the type of burn C) Administration of most of the volume during the first 8 hours D) Monitoring of hourly urine output to achieve less than 1 mL/kg/hour

C

23. A 3-year-old child has sustained severe burns and is ordered to receive 100% oxygen. What would the nurse use to administer the oxygen A) Nasal cannula B) Venturi mask C) Nonrebreather mask D) Oxygen hood

C

25. A 4-year-old is brought to the emergency department with a burn. What would alert the nurse to the possibility of child abuse? A) Burn assessment correlates with mother's report of contact with a portable heater. B) Parents state that the injury occurred approximately 15 to 20 minutes ago. C) Clear delineations are noted between burned and nonburned skin D) The burn area appears asymmetric and nonuniform

C

27. The nurse is interviewing the mother of a 6-month-old being seen at a well- child visit. The mother reports she has used an over-the-counter topical ointment intended for adults on her child for a skin rash. What is the most appropriate response by the nurse? A) "This is dangerous so please do not do this again." B) "Why did you do that instead of contacting your healthcare provider?" C) "Children have thin skin and can absorb medications differently than adults." D) "How often do you use this medication?"

C

3. The nurse is providing care for a 14-year-old girl with severe acne. The girl expresses sadness and distress about her appearance. Which response by the nurse would be most appropriate? A) "Are you using your medicine every day?" B) "Your condition will most likely improve in a year or two." C) "Many people feel this way; I know someone who can help." D) "If you have any scarring you can undergo dermabrasion."

C

5. A nurse is caring for a 5-year-old in Bucks traction. When conducting a skin examination which area? for signs of pressure ulcers, the nurse pays particular attention to A) Sacral area B) Hip area C) Occiput D) Upper arm

C

16. A child is diagnosed with atopic dermatitis. Which laboratory test would the nurse expect the child to undergo to provide additional evidence for this condition? A) Erythrocyte sedimentation rate B) Potassium hydroxide prep C) Wound culture D) Serum immunoglobulin E (IgE) level

D

24. As part of a clinical conference with a group of nursing students, the instructor is describing the burn classification. The instructor determines that the teaching has been successful when the group identifies what as characteristic of full-thickness burns? A) Skin that is reddened, dry, and slightly swollen B) Skin appearing wet with significant pain C) Skin with blistering and swelling D) Skin that is leathery and dry with some numbness

D

6. A 6-year-old boy has been admitted to the hospital with burns. The nurse notes carbonaceous sputum. What action would be the priority? A) Determining the burn depth B) Eliciting a description of the burn C) Estimating burn extent D) Ensuring a patent airway

D

7. A nurse is caring for a 14-year-old girl who received an electrical burn. The nurse would anticipate preparing the girl for which diagnostic tests as ordered? A) Pulse oximetry B) Fiberoptic bronchoscopy C) Xenon ventilation-perfusion scanning D) Electrocardiographic monitoring

D