Question 1

Herpes zoster is caused by the varicella virus and has an affinity for which of the following?
A) Sympathetic nerve fibres
B) Parasympathetic nerve fibres
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 an affinity for posterior root ganglia,the posterior horn of the spinal cord,and skin,and does not involve sympathetic or parasympathetic nerve fibres,or lateral and dorsal columns of the spinal cord.

Question 2

What is one important nursing consideration when caring for a child with impetigo contagiosa?
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 lamp for possible spread of lesions.

Accepted Answer

A major nursing goal 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 lamp is used to detect fluorescent materials in the skin and hair in certain disease states such as tinea capitis.

Question 3

What is the primary treatment for 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 the location,type,and number of warts.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 4

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

Accepted Answer

The black widow 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 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 5

What is the primary clinical manifestation of scabies?
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 a previously sensitized person,the response occurs within 48 hours.Edema,redness,and maceration are not observed in scabies.

Question 6

What kind of bite causes Rocky Mountain spotted fever?
A) A flea
B) A tick
C) A mosquito
D) A 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 trAnswermit the disease.The usual habitat of the tick is in heavily wooded areas.Fleas,mosquitos,mice,and rats do not trAnswermit Rocky Mountain spotted fever.

Question 7

What is the only symptom of pediculosis capitis (head lice)?
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.

Question 8

What is often a cause of cellulitis?
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 albicAnswer is associated with candidiasis or thrush.Human papillomavirus is associated with various types of human warts.

Question 9

Impetigo ordinarily results in which of the following outcomes?
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 10

Ringworm,frequently found in schoolchildren,is caused by which one of the following?
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.It is a superficial infection that lives on,not in,the skin.Viral and bacterial infections are not causative organisms for ringworm.Ringworm is not an allergic response.

Question 11

A child steps on a nail and sustains a puncture wound in the foot.What is the most appropriate method for cleansing this wound?
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 cleAnswered 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 12

Lymphangitis ("streaking")is frequently seen in which of the following conditions?
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 13

The treatment of a child who has just been stung by a bee or wasp should include the application of which of the following?
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,cleAnswering the site 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 to address pain and swelling.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 14

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

Accepted Answer

Candida albicAnswer 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 15

A mother calls the emergency department nurse because her child was stung by a scorpion.What should the nurse recommend?
A) Administer antihistamine.
B) Cleanse the wound with soap and water.
C) Keep the child quiet and come to the emergency department.
D) Remove the stinger and apply cool compresses.

Accepted Answer

Venomous species of scorpions inject venom that requires emergency treatment.The absorption of the venom is delayed by keeping the child quiet and the involved area below the level of the child's heart if at all possible.Antihistamines are not effective against scorpion venom.The wound will produce intense local pain.

Question 16

What causes 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 17

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 non-stinging povidone-iodine solution.
D) Wash wound with water or saline for several minutes.

Accepted Answer

Lacerations should be washed with 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 18

Mateo's mother tells the nurse that he keeps scratching the areas where he has poison ivy.How should the nurse respond?
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 must be 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 19

What should the nurse know about Lyme disease?
A) It is difficult to prevent.
B) It is easily treated with oral antibiotics in stages 1, 2, and 3.
C) It is caused by a spirochete that enters the skin through a tick bite.
D) It is 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 called erythema migrAnswer.Tick bites should be avoided by entering tick-infested areas with caution.Light-coloured clothing should be worn so that ticks can be identified easily.Long-sleeve shirts and long pants tucked into socks should be the attire.Early treatment of the erythema migrAnswer (stage 1)can prevent the development of Lyme disease.It is caused by a spirochete,not mycotic spore.

Question 20

What does treatment for herpes simplex virus (types 1 or 2)include?
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 is not effective for viral infections.

Quiz 53: Integumentary Dysfunction

Herpes zoster is caused by the varicella virus and has an affinity for which of the following?

What is one important nursing consideration when caring for a child with impetigo contagiosa?

What is the primary treatment for warts?

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

What is the primary clinical manifestation of scabies?

What kind of bite causes Rocky Mountain spotted fever?

What is the only symptom of pediculosis capitis (head lice) ?

What is often a cause of cellulitis?

Impetigo ordinarily results in which of the following outcomes?

Ringworm,frequently found in schoolchildren,is caused by which one of the following?

A child steps on a nail and sustains a puncture wound in the foot.What is the most appropriate method for cleansing this wound?

Lymphangitis ("streaking") is frequently seen in which of the following conditions?

The treatment of a child who has just been stung by a bee or wasp should include the application of which of the following?

The nurse is examining 12-month-old Amir,who was brought to the clinic for persistent diaper rash.The nurse finds perianal inflammation with satellite lesions that cross the inguinal folds.What is the most likely cause?

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

What causes warts?

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

Mateo's mother tells the nurse that he keeps scratching the areas where he has poison ivy.How should the nurse respond?

What should the nurse know about Lyme disease?

What does treatment for herpes simplex virus (types 1 or 2) include?