peds integumentary disorders prepu questions
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?
"Does your child have any allergies to medications?"
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?
Airway remains patent.
A parent is observing a nurse provide care for the parent's 2-year-old toddler who was burned in a house fire. When the nurse is finished, the parent tells the nurse "I cannot believe this has happened. I should have been able to prevent this from happening." What is the best action for the nurse to take?
Encourage the parent to talk more about feelings.
What information should be included in the teaching plan for a child with varicella?
Remind the child not to scratch the lesions.
A nursing student learning about childhood infectious diseases correctly identifies which of the following as the disease related to chickenpox, which tends to occur in older children or young adults?
herpes zoster
A nurse is providing care to a child with partial and full thickness burns over 26% of the body. In monitoring the child's output the nurse expects an output of 1 to 2 mL/kg/hr. The nurse has emptied 46 mL from the foley catheter for the past hour. The child weighs 62 lb (28 kg). What action should the nurse take?
Document the output and continue to monitor.
The most common complication of varicella is:
secondary bacterial infections.
The nurse is caring for a 2-month-old infant. What action(s) will the nurse take to help prevent skin breakdown? Select all that apply.
Assess the skin at regular intervals. Perform frequent diaper changes as appropriate. Note areas of redness on the skin.
The nurse is administering a chickenpox vaccination to a 12-month-old girl. Which concern is unique to varicella?
This disease can reactivate years later and cause shingles.
A nurse is assessing a child brought to the clinic because of swelling on one side of the face. The nurse assesses the swelling by placing a hand along the child's jawline. The nurse suspects that the child has parotitis because most of the swelling occurs at which location?
above the nurse's hand
The nurse is providing care to a 5-year-old child brought to the emergency department with a cat bite wound on the arm. While teaching the parents how to care for the wound, the child's mother asks the nurse, "Why isn't the bite being stitched closed?" Which response by the nurse would be appropriate?
"Bites from cats are likely to become infected, so it is better to leave the wound open and heal from the inside out."
When providing care for a child with herpes zoster (shingles), the parents ask the nurse how the child contracted this infectious disorder. Which response by the nurse is most appropriate?
"Herpes zoster is a reactivation of a previous varicella zoster infection."
A nurse is teaching a group of parents about burn safety. Which statement made by a parent requires intervention by the nurse?
"I had our plumber lower our water heater temperature to 130°F (53°C).
The nurse is assessing the skin of a 6-year-old child with urticaria. When interviewing the child and parents, which question would be most important for the nurse to ask?
"Is the child having any trouble breathing?"
A new parent brings the 3-month-old infant to the clinic for a well-baby check up. During the visit, the parent asks the nurse, "I know the rays from the sun can be harmful, so what should I do to protect my infant?" Which suggestion by the nurse would be most appropriate?
"The best thing to do is keep any infant under the age of 6 months out of the sun."
The nurse is teaching the parents of a child diagnosed with erythema multiforme about the condition. The nurse determines that the teaching was successful based on which statement by the parents?
"The rash should go away in about 2 weeks."
The nurse is teaching the parents of a 5-year-old child diagnosed with head lice about using permethrin. The nurse determines that the teaching was successful based on which statement by the parents?
"We need to leave the medication on for about 10 minutes before rinsing it off."
The nurse is teaching the parents of a 7-year-old child on preventing integumentary disorders. What will the nurse include in the teaching? Select all that apply.
-Apply sunscreen to your child. -Teach your child to recognize and avoid poison oak. -Teach your child to not approach strange pets without permission. -Learn to identify infestations such as lice, scabies, and bed bugs.
The nurse is caring for an 11-year-old child with a primary open skin lesion. What action(s) will the nurse include in the plan of care to prevent infection in the child? Select all that apply.
-Assess for increased warmth around the wound. -Teach hand hygiene to the child and parents. -Advise the child not to scratch the affected area.
A 30-month-old child has been discharged from the hospital after receiving treatment for second-degree (partial-thickness) burns over 6% of the body. One week later, the parent calls the nurse to say that the child has been drinking from a cup for one year, but is now constantly pulling at the mother's breast trying to nurse and refuses to drink from a cup. What is the bestway for the nurse respond?
Explain that children who have had a serious injury sometimes exhibit regressive behavior.
A child is seen in the clinic because of a rash over the face and trunk area for the past 4 days. The nurse completes an assessment and suspects the child has rubeola. Which assessment finding best supports the nurse's suspicion?
Koplik spots
When describing measles to a local parent group, the nurse explains that which of the following is the hallmark clinical manifestation?
Koplik spots
An adolescent is brought to the urgent care clinic for evaluation of the hands. The adolescent had been out snowboarding for the past several hours in 20oF (-6.7oC) temperatures. The adolescent was wearing gloves but took them off because they were wet and causing problems with holding onto the snowboard. The nurse completes an assessment and documents the findings. Based on the assessment findings above, which action would be appropriate as part of the plan of care? "states 'my hands feel numb' and reports stinging sensation in both hands. moderate swelling. skin on hands ins waxy with bluish tint and hard to the touch. no vesicles or sloughing of skin"
Placing the hands in warm water for 30 minutes
What is a true statement regarding varicella zoster virus infection?
Secondary bacterial infections of the skin can occur.
As part of a spring health fair at a local school, the nurse is presenting information for parents about treating insect stings. The nurse determines that the more teaching is needed when the parents state that they would apply which substance to provide comfort?
Topical antibiotic ointment
The nurse is inspecting the skin of a child with a rash on the lower legs and documents the above findings. Based on the findings, which question would the nurse most likely ask next? "linear lesions on both legs below knees. numerous reddened macule and pustules in linear fashion across anterior and lateral aspects of lower legs. reports intense pruritus. rash limited to lower legs"
"Was your child outside near some plants that could be poison ivy?"
A parent calls the pediatric clinic and tells the nurse that the child has developed a large rash. Which question is most important for the nurse to ask the parent?
"What more can you tell me about the rash?"
A 7-year-old child with an earache comes to the clinic. The child's parent reports that 1 day ago the child had a fever and headache and did not want to play. When the nurse asks where it hurts, the child points to the jawline in front of the earlobe. What does the nurse expect the diagnosis will be for this child?
mumps
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?
Complete the prescribed antibiotics.
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 mostimportant for the nurse to perform?
Observe the infant's respiratory effort.
A school nurse has discovered that one of the children has acquired a case of head lice. The school principal asks the nurse to write a letter that will be sent to parents explaining about head lice and measures to prevent infestation. What information is important for the nurse to include in the letter? Select all that apply.
-Children should avoid sharing personal items such as combs and hats. -Parents should inspect their child's head for nits with a fine tooth comb. -A second treatment one week after the first is recommended.
A young girl arrives at the emergency room after being bitten by a neighbor's dog. The mother is concerned her daughter will get rabies. The nurse carefully examines and treats the bite and questions the mother and daughter about the details surrounding the dog biting her. What information would most strongly indicate a risk for rabies infection in this client?
The dog was unprovoked when he bit the girl
The nurse is assessing a child with a varicella infection. The nurse would be alert for which possible complication(s)? Select all that apply.
-Secondary bacterial infection -Pneumonia -Scarring -Encephalitis
The nurse is assessing a 10-year-old child with severe burn injuries for signs of sepsis. Which finding(s) will the nurse report to the health care provider immediately? Select all that apply.
-lethargy -capillary refill greater than 3 seconds -decreased level of consciousness
The parent of a child with deep partial-thickness (second-degree) burns on the legs asks the nurse, "One of the staff told me that the dressings being used have silver in them. Why is that?" Which response by the nurse would be most appropriate?
"Dressings containing silver help prevent infection."
A 10-year-old child brought to the emergency department after being outside in the frigid weather for several hours is diagnosed with second-degree frostbite of the hands. Treatment includes rewarming the hands. When preparing the water for the rewarming process, which water temperature would be appropriate for the nurse to use?
100°F (37.8°C)
A school-aged child is recovering from varicella. The parent calls the school nurse and states, "my child is feeling much better" and asks when the child can return to school. What information does the nurse provide the parent?
"Your child may return to school when all of the lesions have crusted over."
The nurse is caring for an immunocompromised child with a primary varicella zoster infection undergoing treatment with acyclovir. What is a nursing consideration(s) while administering this therapy? Select all that apply.
-Administer 10 to 15 mg/kg. -Infuse over 1 hour. -Continue 48 hours after last new lesions appear.
The nurse is preparing to perform a dressing change for a 9-year-old child with a severe burn injury. What nonpharmacologic intervention(s) will the nurse perform to decrease pain and discomfort for the child? Select all that apply.
-Allow the child to choose means of distraction. -Provide positive feedback. -Allow the child to choose where on the body to start procedure.
The nurse is conducting a presentation for a group of parents at the local pediatric community health center. The nurse is describing the importance of immunizations to prevent common viral infections such as rubeola and rubella. As part of the presentation, the nurse describes the development of rubeola and explains the progression of signs and symptoms. Place the signs and symptoms listed below in the order that the nurse would describe them. Use all options.
-Fever -Rash -Koplik spots -Desquamation
A nurse is conducting a parenting class on infant skin care. What information should the nurse include when preparing materials on the characteristics of the skin of infants? Select all that apply.
-It is thinner and more fragile than an adult's -Substances are easily absorbed.
A child is diagnosed with varicella zoster and has been prescribed acyclovir 15 mg/kg q 8 hours IV. The child weighs 61.7 lb (28 kg). How many milligrams should the nurse administer in each dose? Record your answer using a whole number.
420
A child weighing 66 lb (30 kg) with deep partial thickness burns is receiving fluid resuscitation. The nurse is monitoring the child's urine output via Foley catheter every hour and documenting the findings on the flowsheet above. The nurse would notify the health care provider about which urine output? -60mL -56mL -72mL -80mL
56mL