Unit 5
Several children have contracted measles (rubeola) in a local school, and the nurse provides information to the mothers of the children about this communicable disease. Which statement by a mother indicates a need for further teaching?
"The symptoms increase in severity after the rash appears."
A mother brings her child to the clinic because the child has developed a rash on the trunk and scalp. The child is diagnosed with varicella. What will the nurse tell the mother about the infectious period?
"The infectious period is 1 to 2 days before the onset of the rash to 5 days after the onset of lesions and the crusting of lesions."
In planning care for a child with contact dermatitis, which concern is the highest priorityfor the child?
Pain
A child is diagnosed with scarlet fever. The nurse collects data regarding the child. Which is characteristic of scarlet fever?
Pastia's sign
A camp nurse is reinforcing instructions to the parents of the children who are attending a daytime camp for the summer. The nurse instructs the parents to check their child daily for the presence of tick bites and tells the parents that if a tick is found to do which action first?
Suffocate the tick with a substance such as nail polish.
The nurse is assisting in performing pediculosis capitis (head lice) checks. Which finding indicates that a child has a "positive" head check?
White sacs attached to the hair shafts in the occipital area
The nurse reinforces instructions regarding the use of permethrin 1% to the parents of a child who has been diagnosed with pediculosis capitis. Which statements by the parents indicate they understand the instructions? Select all that apply.
"The hair should not be shampooed for 24 hours after treatment." "The medication can be obtained over the counter in a local pharmacy." "The medication is applied to the hair after shampooing, left on for 5 to 10 minutes, and then rinsed out."
A 5-week-old infant is brought to the well-baby clinic by the mother because the mother has noted white patches in the infant's mouth. Following examination, the infant is diagnosed with oral candidiasis (thrush). Nystatin oral suspension is prescribed. The mother is concerned because she is breastfeeding the infant and asks the nurse if breastfeeding can be continued. Which response is appropriate?
"Breastfeeding can continue, but your breasts should also be treated with nystatin."
The 16-year-old client presents to the dermatology clinic with a diagnosis of acne vulgaris. The client says to the nurse, "I don't know what else to do! I wash my face twice a day. I wear noncomedogenic makeup. I shower after I work out. I guess I'm just going to have acne on my face forever." Which responses by the nurse would be appropriate? Select all that apply.
"You feel like there's nothing else you can do to cure your acne." "You seem frustrated by your acne. Please tell me what it is about your acne that is frustrating."
The nurse obtains a health history from a mother of a 15-month-old child before administering a measles, mumps, and rubella (MMR) vaccine. Which is essential information to obtain before the administration of this vaccine?
Allergy to eggs
A topical corticosteroid is prescribed by the primary health care provider for a child with atopic dermatitis (eczema). Which instruction should the nurse give the parent about applying the cream?
Apply a thin layer of cream and rub it into the area thoroughly.
A 6-month-old infant receives a diphtheria, tetanus, and acellular pertussis (DTaP) immunization at the well-baby clinic. The parent returns home and calls the clinic to report that the infant has developed swelling and redness at the site of injection. Which instruction by the nurse is appropriate?
Apply an ice pack to the injection site.
The school nurse notes that the child has a rash and suspects that it is caused by erythema infectiosum (fifth disease). The nurse bases this determination on the observation that the rash results in which appearance?
A "slapped-face" appearance
The nurse caring for a child who sustained a burn injury plans care based on which pediatric considerations associated with this injury? Select all that apply.
A delay in growth may occur after a burn injury. An immature immune system presents an increased risk of infection for infants and young children. Infants and young children are at increased risk for protein and calorie deficiency because they have smaller muscle mass and less body fat than adults.
The nurse is preparing to administer a measles, mumps, rubella (MMR) vaccine to a 15-month-old child. Before administering the vaccine, which question should the nurse ask the mother of the child?
"Is the child allergic to any antibiotics?"
A 6-month-old infant receives a diphtheria, tetanus, and pertussis (DTaP) immunization at the well-baby clinic. The mother returns home and calls the clinic to report that the infant has developed swelling and redness at the site of injection. Which is the appropriate response by the nurse?
"Apply an ice pack to the injection site."
A mother of a child brings the child to a clinic and reports that the child has a fever and has developed a rash on the neck and trunk. Roseola is diagnosed, and the mother is concerned that her other children will contract the disease. Which instruction should the nurse reinforce to the mother to prevent the transmission of the disease?
"Disease transmission is unknown."
Griseofulvin is prescribed for a child with tinea capitis. The nurse reinforces instructions to the family regarding administration of the medication. Which statement by the mother indicates a need for further teaching?
"I need to administer the medication 2 hours before meals."
An adolescent is seen in the health care clinic with complaints of chronic fatigue. On physical examination, the nurse notes that the adolescent has swollen lymph nodes. A laboratory test is performed, and the results indicate the presence of Epstein-Barr virus (mononucleosis). The nurse calls the mother of the adolescent to inform the mother of the test results and reinforces instructions regarding the care of the adolescent. Which statement by the mother indicates an understanding of the care measures?
"I need to call the primary health care provider if my child complains of abdominal pain or left shoulder pain."
The nurse reinforces instructions to the mother of a child diagnosed with pediculosis (head lice). Permethrin has been prescribed. Which statement by the mother regarding the use of the medication indicates a need for further teaching?
"I need to shampoo my child's hair, apply the medication, leave it on for 10 minutes, and then rinse it out."
The nurse is reinforcing instructions to a mother of a child with atopic dermatitis (eczema) regarding the application of topical cortisone cream to the affected skin sites. Which statement made by the mother indicates an understanding of the use of this medication?
"I need to wash the sites gently before I apply the medication."
Vacuum floors, play areas, and furniture to remove any hairs that may carry live nits.
"I understand that I need to leave the scabicide on for 4 hours before washing it off."
The nurse reviews the home care instructions with a parent of a 3-year-old with pertussis. Which statement by the parent indicates a need for further teaching?
"I understand this whooping cough is viral and I have to let it run its course."
The school nurse is visiting a kindergarten classroom to teach the students the importance of hand washing. During the teaching session the nurse notes that one girl is scratching her head. On inspection, the nurse determines that the child has pediculosis capitis. When reinforcing instructions to the mother about care of this condition, which statement by the mother indicates that she needs further teachingregarding this condition?
"I will call a carpet cleaning service to clean all my carpets in the house."
The nurse reviews measures to prevent tick bites with a parent of a child with Rocky Mountain spotted fever. Which statement by the parent indicates a need for further teaching?
"I will have my child wear dark colored clothing so the tick will not be attracted to the colors."
The nurse is reviewing instructions to a parent of a 6-year-old on how to prevent influenza. Which statement by the parent indicates a need for further teaching?
"I will not let my child play with other children who have the flu unless they are taking acetaminophen."
The nurse is teaching first aid measures to a group of adolescents about appropriate treatment for burns. The nurse should anticipate the need for further teaching when one of the adolescents makes which statement?
"It is appropriate to place butter on the burn."
The nurse assists with providing an instructional session to parents regarding impetigo. Which statement by a parent indicates the need for further teaching?
"Lesions are most often located on the arms and chest."
A mother brings her child to the health care clinic because the child has developed lesions located around the mouth and nose, and mild impetigo is diagnosed. The nurse reinforces instructions to the mother regarding care of the child. Which statement by the mother indicates the need for further teaching?
"My child will need to be treated with oral antibiotics."
Several children have contracted rubeola (measles) in a local school, and the school nurse conducts a teaching session for the parents of the school children. Which statement, if made by a parent, indicates a need for further teachingregarding this communicable disease?
"The communicable period ranges from 10 days before the onset of symptoms to 15 days after the rash appears."
The nurse reinforces home care instructions to the parents of a child hospitalized with pertussis. The child is in the convalescent stage and is being prepared for discharge. Which statement by the parents indicates a need for further teaching?
"We need to maintain respiratory precautions and a quiet environment for at least 2 weeks."
The nurse is providing discharge teaching regarding skin care to a new mother of a 2-day-old infant. Which statements by the mother demonstrate an understanding of how to care for the infant's skin? Select all that apply.
"We will apply ointments containing zinc oxide to the baby's bottom to prevent diaper rash." "To prevent diaper rash, we will change our baby's diaper as soon as he has pooped or peed."
A mother brings her 15-month-old child to the primary health care provider's office with complaints that the child has suddenly developed a bright red rash on her cheeks. She has no other symptoms and has been playing and eating as usual. Based on the appearance of the child, the nurse might suspect that the child has which communicable disease?
Fifth disease
The nurse is reviewing the immunization schedule for a child with human immunodeficiency virus (HIV) infection with the mother. Which should be a component of the instructions that the nurse reinforces to the mother?
No live virus vaccines should be administered to the child.
A child is diagnosed with infectious mononucleosis. The nurse reinforces homecare instructions to the parents about the care of the child. Which instruction should the nurse provide to the parents?
Notify the pediatrician if the child develops abdominal or left shoulder pain.
A child with rubeola (measles) is being admitted to the hospital. When preparing for the admission of the child, which precautions should be implemented? Select all that apply.
Contact Airborne
The nurse assigned to care for a child with mumps is monitoring the child for the signs and symptoms associated with the common complication of mumps. The nurse monitors for which sign/symptom that is indicative of this common complication?
Nuchal rigidity
The nurse is reinforcing instructions to the mother of a preschool child who was recently diagnosed with pediculosis capitis (head lice). Which item should be included in discussions to prevent a reinfestation?
Seal nonwashable items in a plastic bag for 2 to 3 weeks in a warm place if they cannot be vacuumed or dry cleaned.
A mother brings her 4-month-old infant to the well-baby clinic for immunizations. Which immunizations should be administered to this infant?
DTaP, Hib, IPV, pneumococcal vaccine (PCV)
The nurse of a well-baby clinic prepares to administer an immunization to a child. The mother of the child tells the nurse that the child has had a fever and is taking antibiotics. The nurse takes the child's temperature and notes that it is 101.5° F rectally. The nurse plans to take which action?
Delay the immunization.
A child is hospitalized with Rocky Mountain spotted fever (RMSF). The health record reveals documentation that the child was bitten by a tick 2 weeks ago. The child presents with complaints of headache, fever, and anorexia, and the nurse notes a rash on the palms of the hands and soles of the feet. The nurse reviews the primary health care provider's prescriptions and anticipates that which medication should be prescribed?
Doxycycline
The nurse provides instructions to the mother of a child with impetigo regarding the application of antibiotic ointment. The mother asks the nurse when the child can return to school. Which response by the nurse is appropriate?
Forty-eight hours after using the antibiotic ointment
Which home care instructions should the nurse plan to reinforce to the mother of a child with acquired immunodeficiency syndrome (AIDS)? Select all that apply.
Frequent hand washing is important. The child should avoid exposure to other illnesses. Clean up body fluid spills with bleach solution (10:1 ratio of water to bleach).
A nursing student is asked to discuss human immunodeficiency virus (HIV) during a clinical conference. The nursing student should include which correct item in the discussion?
HIV virus attacks the immune system by destroying T lymphocytes.
A 4-year-old child is being transported to the trauma center from a local community hospital for treatment of a burn injury that is estimated as covering over 40% of the body. The burns are partial- and full-thickness burns. The nurse is asked to prepare for the arrival of the child and gathers supplies anticipating that which will be prescribed initially?
Insertion of a Foley catheter
Which criterion should the nurse determine are characteristics of scabies? Select all that apply.
It appears as burrows or fine, grayish-red lines. It is transmitted by close personal contact with an infected person. It is endemic among schoolchildren and institutionalized populations. Household members and contacts of the infected child need to be treated at the same time that the child is being treated.
A child seen in the clinic is found to have rubeola (measles) and the mother asks the nurse how to care for the child. Which instruction should the nurse provide to the mother?
Keep the child in a room with dim lights.
The nurse is caring for a child who was burned in a house fire. The nurse assists in developing a plan of care for monitoring the child during the treatment for burn shock. The nurse identifies which assessment as providing the most accurate guide to determine the adequacy of fluid resuscitation?
Level of consciousness
A child is diagnosed with chicken pox. The nurse collects data regarding the child. Which finding is characteristic of chicken pox?
Macular rash on the trunk and scalp
The nurse is caring for a hospitalized child with a diagnosis of rubella (German measles). The nurse reviews the primary health care provider's progress notes and reads that the child has developed Forchheimer sign. Based on this documentation, which should the nurse expect to note in the child?
Petechiae spots located on the palate
A preschool child who was admitted to the hospital for a minor surgery develops a rash on the second day after hospitalization and is diagnosed with chicken pox (varicella). The nurse should take which action to provide safety for all children on the unit?
Place the infected child and any immunocompromised children in isolation.
The nurse in a primary health care provider's office receives a telephone call from the mother of a child who tells the nurse that the child was just stung by a bee. The mother asks the nurse for instructions regarding removal of the stinger. Which instruction should the nurse reinforce to the mother?
Remove the stinger by carefully scraping it out horizontally.
The mother of a toddler with mumps asks the nurse what she needs to watch for in her child with this disease. The nurse bases the response on the understanding that mumps is which type of communicable disease?
Respiratory disease caused by a virus involving the parotid gland
The nurse in the pediatric clinic is planning care for a 2-month-old client who has been brought to the clinic for a well-child exam and 2-month immunizations. The infant is afebrile and does not exhibit signs of a respiratory infection. The mother tells the nurse that the child developed a rash and difficulty breathing after the mother applied Neosporin ointment to a scrape on the baby's leg. The nurse knows which vaccines are safe to administer to the child? Select all that apply.
Rotavirus Hepatitis B Pneumococcal Diphtheria, tetanus, pertussis Haemophilus influenzae type b
The school nurse prepares a list of home care instructions for the parents of school children who have been diagnosed with pediculosis capitis (head lice). Which should be included in the list? Select all that apply.
Siblings may also need treatment. Grooming items such as combs and brushes should not be shared. Launder all the bedding and clothing in hot water and dry on high heat. Vacuum floors, play areas, and furniture to remove any hairs that may carry live nits.
The nurse prepares to administer a measles, mumps, and rubella (MMR) vaccine to a 5-year-old child. How should the nurse plan to administer the vaccine?
Subcutaneously in the outer aspect of the upper arm
The nurse is caring for a 4-month-old infant with respiratory syncytial virus (RSV). Several clients are being admitted to the unit and assignments are being made. The nurse should question being assigned which newly admitted clients? Select all that apply.
The 6-month old with bronchopulmonary dysplasia The 1-year-old client taking corticosteroids
A child is brought to a clinic after developing a rash on the trunk and on the scalp. The parents report that the child has had a low-grade fever, has not felt like eating, and has been generally tired. The child is diagnosed with chickenpox. Which statement by the nurse is accurate regarding chickenpox?
The communicable period is 1 to 2 days before the onset of the rash to 6 days after the onset and crusting of lesions.
An infant is suspected to be human immunodeficiency virus (HIV) positive, and the nurse provides information to the parents about the care of their infant. Which indicates to the nurse that the parents need further teachingabout the care of their HIV-positive infant?
The parents plan to use rice cereal to help with watery stools when they occur.
A parent calls the clinic nurse to schedule an appointment for her child's diphtheria, tetanus, and pertussis vaccination. The parent tells the nurse that her child had a swelling at the injection site and low-grade fever after the last diphtheria, tetanus, and pertussis (DTaP) vaccination. Which instructions should the nurse give to the parent to lessen this type of reaction to the upcoming vaccination?
To administer an appropriate dose of Tylenol 45 minutes before the appointment
The nurse is reinforcing instructions regarding the prevention of Lyme disease to a group of teenagers going on a hike in a wooded area. Which points should the nurse include in the session? Select all that apply.
Tuck pant legs into socks. Wear closed shoes when hiking. Apply insect repellent containing DEET. Cover the ground with a blanket when sitting.