Question 1

The nurse should expect to assess which causative agent in a child who has warts?
A)Bacteria
B)Fungus
C)Parasite
D)Virus

Accepted Answer

Human warts are caused by the human papillomavirus.Infection with bacteria,fungus,and parasitic organisms does not result in warts.

Question 2

Which primary treatment will the nurse implement for a child with warts?
A)Vaccination
B)Local destruction
C)Corticosteroids
D)Specific antibiotic therapy

Accepted Answer

Topical treatments include chemical cautery,which is especially useful for the treatment of warts.Local destructive therapy is individualized according to location,type,and number.Surgical removal,electrocautery,curettage,cryotherapy,caustic solutions,x-ray treatment,and laser therapies are used.Vaccination is prophylaxis for warts and is not a treatment.Corticosteroids and specific antibiotic therapy are not effective in the treatment of warts.

Question 3

The nurse should understand that Lyme disease is:
A)Difficult to prevent.
B)Easily treated with oral antibiotics in stages 1, 2, and 3.
C)Caused by a spirochete that enters the skin through a tick bite.
D)Common in geographic areas where the soil contains the mycotic spores that cause the disease.

Accepted Answer

Lyme disease is caused by Borrelia burgdorferi,a spirochete spread by ticks.The early characteristic rash is erythema migrans.Tick bites should be avoided by entering tick-infested areas with caution.Light-colored clothing should be worn to identify ticks easily.Long-sleeve shirts and long pants tucked into socks should be the attire.Early treatment of the erythema migrans (stage 1)can prevent the development of Lyme disease.It is caused by a spirochete,not mycotic spore.

Question 4

The nurse is examining 12-month-old Amy,who was brought to the clinic for persistent diaper rash.The nurse finds perianal inflammation with satellite lesions that cross the inguinal folds.This is most likely caused by:
A)Impetigo.
B)Candida albicans.
C)Urine and feces.
D)Infrequent diapering.

Accepted Answer

Candida albicans infection produces perianal inflammation and a maculopapular rash with satellite lesions that may cross the inguinal folds.Impetigo is a bacterial infection that spreads peripherally in sharply marginated irregular outlines.Eruptions involving the skin in contact with the diaper but sparing the folds are likely to be caused by chemical irritation,especially urine and feces.

Question 5

Lymphangitis ("streaking")is frequently seen in:
A)Cellulitis.
B)Folliculitis.
C)Impetigo contagiosa.
D)Staphylococcal scalded skin.

Accepted Answer

Lymphangitis is frequently seen in cellulitis.If present,hospitalization is usually required for parenteral antibiotic.Lymphangitis is not associated with folliculitis,impetigo,or staphylococcal scalded skin.

Question 6

An important nursing consideration when caring for a child with impetigo contagiosa is to:
A)Apply topical corticosteroids to decrease inflammation.
B)Carefully remove dressings so as not to dislodge undermined skin, crusts, and debris.
C)Carefully wash hands and maintain cleanliness when caring for an infected child.
D)Examine child under a Wood's lamp for possible spread of lesions.

Accepted Answer

A major nursing consideration related to bacterial skin infections such as impetigo contagiosa is to prevent the spread of the infection and complications.This is done by thorough hand washing before and after contact with the affected child.Corticosteroids are not indicated in bacterial infections.Dressings are usually not indicated.The undermined skin,crusts,and debris are carefully removed after softening with moist compresses.A Wood's lamp is used to detect fluorescent materials in the skin and hair.It is used in certain disease states such as tinea capitis.

Question 7

A mother calls the emergency department nurse because her child was stung by a scorpion.The nurse should recommend:
A)Administering antihistamine.
B)Cleansing with soap and water.
C)Keeping the child quiet and coming to emergency department.
D)Removing the stinger and applying cool compresses.

Accepted Answer

Venomous species of scorpions inject venom that contains hemolysins,endotheliolysins,and neurotoxins.The absorption of the venom is delayed by keeping the child quiet and the involved area in dependent position.Antihistamines are not effective against scorpion venom.The wound will have intense local pain.Cleansing the wound,removing the stinger,and applying cool compresses are not effective.Emergency treatment is indicated.

Question 8

Matt's mother tells the nurse that he keeps scratching the areas where he has poison ivy.The nurse's response should be based on knowing that:
A)Poison ivy does not itch and needs further investigation.
B)Scratching the lesions will not cause a problem.
C)Scratching the lesions will cause the poison ivy to spread.
D)Scratching the lesions may cause them to become secondarily infected.

Accepted Answer

Poison ivy is a contact dermatitis that results from exposure to the oil urushiol in the plant.Every effort is made to prevent the child from scratching because the lesions can become secondarily infected.The poison ivy produces localized,streaked or spotty,oozing,and painful impetiginous lesions.Itching is a common response.The lesions do not spread by contact with the blister serum or by scratching.

Question 9

A child falls on the playground and has a small laceration on the forearm.What should the school nurse do to cleanse the wound?
A)Slowly pour hydrogen peroxide over wound.
B)Soak arm in warm water and soap for at least 30 minutes.
C)Gently cleanse with sterile pad and a nonstinging povidone-iodine solution.
D)Wash wound gently with mild soap and water for several minutes.

Accepted Answer

Lacerations should be washed gently with mild soap and water or normal saline.A sterile pad is not necessary,and hydrogen peroxide and povidone-iodine should not be used because they have a cytotoxic effect on healthy cells and minimal effect on controlling infection.Soaking the arm does not effectively clean the wound.

Question 10

A father calls the clinic nurse because his 2-year-old child was bitten by a black widow spider.The nurse should advise the father to:
A)Apply warm compresses.
B)Carefully scrape off the stinger.
C)Take the child to emergency department.
D)Apply a thin layer of corticosteroid cream.

Accepted Answer

The brown recluse spider has venom that is toxic enough to be harmful.The father should take the child to the emergency department for immediate treatment.Warm compresses increase the circulation to the area and facilitate the spread of the venom.The black widow spider does not have a stinger.Corticosteroid cream has no effect on venom.

Question 11

The nurse is caring for a 7-year-old with herpes simplex virus.Which prescribed medication should the nurse expect to be included in the treatment plan?
A)Corticosteroids
B)Oral griseofulvin
C)Oral antiviral agent
D)Topical and/or systemic antibiotic

Accepted Answer

Oral antiviral agents are effective for viral infections such as herpes simplex.Corticosteroids and antibiotics are not effective for viral infections.Griseofulvin is an antifungal agent and not effective for viral infections.

Question 12

The primary clinical manifestation of scabies is:
A)Edema.
B)Redness.
C)Pruritus.
D)Maceration.

Accepted Answer

Scabies is caused by the scabies mite.The inflammatory response and intense itching occur after the host has become sensitized to the mite.This occurs approximately 30 to 60 days after initial contact.In the previously sensitized person the response occurs within 48 hours.Edema,redness,and maceration are not observed in scabies.

Question 13

A child steps on a nail and sustains a puncture wound of the foot.The most appropriate method for cleansing this wound is to:
A)Wash wound thoroughly with chlorhexidine.
B)Wash wound thoroughly with povidone-iodine.
C)Soak foot in warm water and soap.
D)Soak foot in solution of 50% hydrogen peroxide and 50% water.

Accepted Answer

Puncture wounds should be cleansed by soaking the foot in warm water and soap.Chlorhexidine,hydrogen peroxide,and povidone-iodine should not be used because they have a cytotoxic effect on healthy cells and minimal effect on controlling infection.

Question 14

The nurse is teaching parents of a 3-year-old with impetigo that they can anticipate:
A)No scarring.
B)Pigmented spots.
C)Slightly depressed scars.
D)Atrophic white scars.

Accepted Answer

Impetigo tends to heal without scarring unless a secondary infection occurs.

Question 15

Cellulitis is often caused by:
A)Herpes zoster.
B)Candida albicans.
C)Human papillomavirus.
D)Streptococcus or Staphylococcus organisms.

Accepted Answer

Streptococcus,Staphylococcus,and Haemophilus influenzae are the organisms usually responsible for cellulitis.Herpes zoster is the virus associated with varicella and shingles.Candida albicans is associated with candidiasis or thrush.Human papillomavirus is associated with various types of human warts.

Question 16

Ringworm,frequently found in schoolchildren,is caused by:
A)Virus.
B)Fungus.
C)Allergic reaction.
D)Bacterial infection.

Accepted Answer

Ringworm is caused by a group of closely related filamentous fungi that invade primarily the stratum corneum,hair,and nails.They are superficial infections that live on,not in,the skin.Virus and bacterial infection are not causative organisms for ringworm.Ringworm is not an allergic response.

Question 17

Herpes zoster is caused by the varicella virus and has an affinity for:
A)Sympathetic nerve fibers.
B)Parasympathetic nerve fibers.
C)Posterior root ganglia and the posterior horn of the spinal cord.
D)Lateral and dorsal columns of the spinal cord.

Accepted Answer

The herpes zoster virus has affinity for posterior root ganglia,the posterior horn of the spinal cord,and skin,and does not involve sympathetic or parasympathetic nerve fibers,or lateral and dorsal columns of the spinal cord.

Question 18

Rocky Mountain spotted fever is caused by the bite of a:
A)Flea.
B)Tick.
C)Mosquito.
D)Mouse or rat.

Accepted Answer

Rocky Mountain spotted fever is caused by a tick.The tick must attach and feed for at least 1 to 2 hours to transmit the disease.The usual habitat of the tick is in heavily wooded areas.Fleas,mosquitoes,mice,and rats do not transmit Rocky Mountain spotted fever.

Question 19

The management of a child who has just been stung by a bee or wasp should include the application of:
A)Cool compresses.
B)Warm compresses.
C)Antibiotic cream.
D)Corticosteroid cream.

Accepted Answer

Bee or wasp stings are initially treated by carefully removing the stinger,cleansing with soap and water,applying cool compresses,and using common household agents such as lemon juice or a paste made with aspirin and baking soda.Warm compresses are avoided.Antibiotic cream is unnecessary unless a secondary infection occurs.Corticosteroid cream is not part of the initial therapy.If a severe reaction occurs,systemic corticosteroids may be indicated.

Question 20

The only symptom of pediculosis capitis (head lice)is usually:
A)Itching.
B)Vesicles.
C)Scalp rash.
D)Localized inflammatory response.

Accepted Answer

Itching is generally the only manifestation of pediculosis capitis (head lice).Diagnosis is made by observation of the white eggs (nits)on the hair shaft.Vesicles,scalp rash,and localized inflammatory response are not symptoms of head lice.

Quiz 47: Integumentary Dysfunction

The nurse should expect to assess which causative agent in a child who has warts?

Which primary treatment will the nurse implement for a child with warts?

The nurse should understand that Lyme disease is:

The nurse is examining 12-month-old Amy,who was brought to the clinic for persistent diaper rash.The nurse finds perianal inflammation with satellite lesions that cross the inguinal folds.This is most likely caused by:

Lymphangitis ("streaking") is frequently seen in:

An important nursing consideration when caring for a child with impetigo contagiosa is to:

A mother calls the emergency department nurse because her child was stung by a scorpion.The nurse should recommend:

Matt's mother tells the nurse that he keeps scratching the areas where he has poison ivy.The nurse's response should be based on knowing that:

A child falls on the playground and has a small laceration on the forearm.What should the school nurse do to cleanse the wound?

A father calls the clinic nurse because his 2-year-old child was bitten by a black widow spider.The nurse should advise the father to:

The nurse is caring for a 7-year-old with herpes simplex virus.Which prescribed medication should the nurse expect to be included in the treatment plan?

The primary clinical manifestation of scabies is:

A child steps on a nail and sustains a puncture wound of the foot.The most appropriate method for cleansing this wound is to:

The nurse is teaching parents of a 3-year-old with impetigo that they can anticipate:

Cellulitis is often caused by:

Ringworm,frequently found in schoolchildren,is caused by:

Herpes zoster is caused by the varicella virus and has an affinity for:

Rocky Mountain spotted fever is caused by the bite of a:

The management of a child who has just been stung by a bee or wasp should include the application of:

The only symptom of pediculosis capitis (head lice) is usually: