Question 1

A nurse is working with a child who has a chronic skin disorder consisting of many vesicles and pustules.Which nursing assessment indicates that a priority long-term goal has been met?

Accepted Answer

All options show evidence of positive outcomes.However,physical needs take priority over psychosocial needs,so absence of infection is evidence that a priority goal has been met.Secondary infection can occur due to scratching,picking,and the presence of the lesions themselves.

Question 2

A child has blood testing for possible atopic dermatitis.The parent asks why testing for IgE is done.Which response by the nurse is the most appropriate?

Accepted Answer

Atopic dermatitis is often seen in children with allergies and asthma.In those conditions,levels of IgE are elevated,so this correlation helps confirm the diagnosis if it is in question.The other answers are inaccurate.

Question 3

An adolescent is in the clinic with a few skin lesions on his thighs.The lesions have an open center with a thin crust.Which question by the nurse will aid the diagnosis of this patient's skin problem?

Accepted Answer

This lesion sounds like MRSA (methicillin-resistant Staphylococcus aureus).MRSA is common in athletes.This question would elicit the most useful information.Respiratory infection is not related.Scratching,especially at night,is characteristic of scabies.Wooded areas have ticks,which can spread Lyme disease.

Question 4

A child presents to the emergency department with cutaneous manifestations of an allergic response.Which nursing diagnosis takes priority?

Accepted Answer

Usually,actual nursing diagnoses take priority over "risk for" diagnoses,but in this case,risk for impaired airway is the priority.The child's airway can quickly become compromised due to laryngeal edema.The nurse places priority on frequent assessments of the child's airway.The other diagnoses are relevant,but not as important as the potential for compromised airway.

Question 5

A mother-baby nurse is demonstrating swaddling a neonate as a method of keeping the baby warm.The mother asks why she needs to be so careful about the baby's temperature.Which response by the nurse is the most appropriate?

Accepted Answer

Babies have thin skin,a large body surface area,scanty subcutaneous fat,and immature neurological systems.All these factors combined make it difficult for a baby to regulate his or her temperature.The other statements are not factual or informative.

Question 6

A toddler has a few vesicular lesions on his hands that rupture,producing a honey-colored,sticky exudate.Based on this assessment,which medication does the nurse teach the parents about?

Accepted Answer

This child has impetigo,which is treated in one of two ways.For limited lesions (which this child has),topical Bactroban is appropriate.For widespread lesions,Augmentin is one of the antibiotics used.Azithromycin and doxycycline are not used.

Question 7

A child has been diagnosed with scabies and the parents are taught about the use of 5% permethrin lotion (Elimite).Which statement by the parents indicates the need for further instruction?

Accepted Answer

Elimite is left on for 8 to 14 hours and then must be removed.The other statements show good understanding.

Question 8

A child in the emergency department has cellulitis on the forearm.A nursing student is preparing to administer benzathine penicillin (Bicillin LA).Which action by the nursing student warrants intervention by the staff nurse?

Accepted Answer

Bicillin LA is given by a deep intramuscular injection.This needle is used for subcutaneous injections.The other options are all correct actions the student should take.

Question 9

A student is learning about cutaneous skin reactions.Which description is correct?

Accepted Answer

An examthema is an eruption.Blistering is swelling.Pustular is raised and filled with white blood cells.Urticarial is itching.

Question 10

A teen has been taking griseofulvin (Fulvicin)for a fungal skin and scalp condition and reports that it is not working.Which action by the nurse is the most important?

Accepted Answer

The nurse should assess the teen for compliance with the medication regimen,because it takes at least 6 weeks for this medication to work.Due to the lengthy treatment time and the fact that teens are often noncompliant,this would be the nurse's first step.If the medication has been used appropriately,discussing a change would be correct.This drug is not give via IM injection.

Question 11

The pediatric clinic nurse assesses small,pink "pearl-like" lesions on the trunk of a school-aged child.Which treatment regimen does the nurse plan to teach the family about based on the assessment findings?

Accepted Answer

This child has manifestations of molluscum contagiosum,a viral infection that generally resolves on its own.Because this is contagious,the bathtub should be disinfected after the child bathes and his or her towels should not be shared.More aggressive treatment is only used for cases that do not resolve or when the lesions become infected.

Question 12

What important safety measure regarding the use of insect repellents does the nurse teach a parenting group?

Accepted Answer

Insect repellents are harsh chemicals and should be applied to the clothing of children.Spraying the product on the adult's hands and then spreading it on the face and head and exposed skin is an acceptable ways of applying insecticide to a limited amount of skin.The CDC has recently recognized some insecticides that do not contain DEET.Oil of lemon eucalyptus is safe on children over the age of 3.Although insecticides should not stay on for long periods of time,there is no strict 2-hour limit.

Question 13

A child is in the emergency department (ED)with a dog bite.After cleansing the wound and attending to the child's comfort,which action should the nurse perform next?

Accepted Answer

Animal bites are reportable injuries.The nurse has an obligation to report the bite as soon as he or she is able,as the animal control authorities may want to interview the child and parents quickly.Antibiotics are not warranted in all dog bites.Discharge teaching should be provided when the family is done in the ED.Offering the child a toy is a nice gesture that could be considered a comfort measure,but does not take priority over a legal requirement.

Question 14

A child who was visiting a wooded area on vacation presents to the doctor's office with a localized bull's-eye rash.Which action by the nurse is the most appropriate?

Accepted Answer

This child may have early Lyme disease,which is treated presumptively with Ceftin prior to obtaining laboratory results.By the time carditis and neurological involvement occur,the rash has generalized.Admission is not warranted.

Question 15

A child takes anti-inflammatory medications for a chronic condition.The mother asks the nurse why the child's cuts and scrapes seem to take so long to heal.Which response by the nurse is the most appropriate?

Accepted Answer

The first stage of healing consists of the inflammatory process,which is being hampered by this child's need to take chronic anti-inflammatory medications.Although chronic disease can affect healing,this answer is too vague to be useful.Not all sick children are anemic.Wound healing definitely would be affected in this child.

Question 16

A school-age child has been prescribed "magic mouthwash" for gingival herpes simplex type I (HSV-1)infection.The parent asks how this helps the child's condition.Which response by the nurse is the most appropriate?

Accepted Answer

"Magic mouthwash" has several recipes,but common ingredients include Benadryl,lidocaine,and Mylanta,which all help increase comfort so the child continues to eat and drink.It does not kill the virus,prevent secondary infection,or shorten the duration of the outbreak.

Question 17

An adolescent patient has acne characterized by pustules and scarring.Which teaching information is most appropriate for the nurse to give the patient and family?

Accepted Answer

Tetracycline,minocyline,and doxycycline all cause photosensitivity,so the nurse should warn the teen about sun exposure and use of tanning beds.Skin cleansing should be gentle.Although acne treatments are very drying,makeup and moisturizers should not be applied on top of the dry skin.Pregnancy tests are done prior to starting treatment with Accutane,every month during treatment,and 1 month after treatment has stopped.

Question 18

The pediatric nurse knows that which child is most likely to bite another?

Accepted Answer

Toddlers are more prone to biting due to the frustration of not being able to verbalize their feelings.

Question 19

A 20-lb (9-kg)child is having a severe allergic reaction.The school nurse has an EpiPen Jr.auto-injector containing 0.3 mg.Which action by the nurse is the most appropriate?

Accepted Answer

EpiPen Jr.auto-injectors are available in two strengths: 0.15 mg for children weighing up to 33 lb (15 kg)and one containing 0.3 mg for older children and adults.The nurse has the wrong-size injector.The most appropriate action is to call 911 to access the emergency medical system.The child does not need CPR.Because the injector is automated,you cannot change the amount that is given.

Question 20

A parent calls the pediatric clinic asking for advice on treating lice.The child has already been treated once with lindane (Qwell).Which advice from the nurse is the most appropriate?

Accepted Answer

Ovide is a safe,nontoxic lice shampoo that is very efficacious.The mother should not be told to use Qwell again; the FDA has a black box warning against using this as a first-line drug and the American Academy of Pediatrics no longer recommends it at all.There are oral medications that can be used on resistant lice,but the parent needs to try another shampoo first.Cleaning is important,but not as important as treating the lice.

Quiz 30: Caring for the Child With a Integumentary Condition

A nurse is working with a child who has a chronic skin disorder consisting of many vesicles and pustules.Which nursing assessment indicates that a priority long-term goal has been met?

A child has blood testing for possible atopic dermatitis.The parent asks why testing for IgE is done.Which response by the nurse is the most appropriate?

An adolescent is in the clinic with a few skin lesions on his thighs.The lesions have an open center with a thin crust.Which question by the nurse will aid the diagnosis of this patient's skin problem?

A child presents to the emergency department with cutaneous manifestations of an allergic response.Which nursing diagnosis takes priority?

A mother-baby nurse is demonstrating swaddling a neonate as a method of keeping the baby warm.The mother asks why she needs to be so careful about the baby's temperature.Which response by the nurse is the most appropriate?

A toddler has a few vesicular lesions on his hands that rupture,producing a honey-colored,sticky exudate.Based on this assessment,which medication does the nurse teach the parents about?

A child has been diagnosed with scabies and the parents are taught about the use of 5% permethrin lotion (Elimite) .Which statement by the parents indicates the need for further instruction?

A child in the emergency department has cellulitis on the forearm.A nursing student is preparing to administer benzathine penicillin (Bicillin LA) .Which action by the nursing student warrants intervention by the staff nurse?

A student is learning about cutaneous skin reactions.Which description is correct?

A teen has been taking griseofulvin (Fulvicin) for a fungal skin and scalp condition and reports that it is not working.Which action by the nurse is the most important?

The pediatric clinic nurse assesses small,pink "pearl-like" lesions on the trunk of a school-aged child.Which treatment regimen does the nurse plan to teach the family about based on the assessment findings?

What important safety measure regarding the use of insect repellents does the nurse teach a parenting group?

A child is in the emergency department (ED) with a dog bite.After cleansing the wound and attending to the child's comfort,which action should the nurse perform next?

A child who was visiting a wooded area on vacation presents to the doctor's office with a localized bull's-eye rash.Which action by the nurse is the most appropriate?

A child takes anti-inflammatory medications for a chronic condition.The mother asks the nurse why the child's cuts and scrapes seem to take so long to heal.Which response by the nurse is the most appropriate?

A school-age child has been prescribed "magic mouthwash" for gingival herpes simplex type I (HSV-1) infection.The parent asks how this helps the child's condition.Which response by the nurse is the most appropriate?

An adolescent patient has acne characterized by pustules and scarring.Which teaching information is most appropriate for the nurse to give the patient and family?

The pediatric nurse knows that which child is most likely to bite another?

A 20-lb (9-kg) child is having a severe allergic reaction.The school nurse has an EpiPen Jr.auto-injector containing 0.3 mg.Which action by the nurse is the most appropriate?

A parent calls the pediatric clinic asking for advice on treating lice.The child has already been treated once with lindane (Qwell) .Which advice from the nurse is the most appropriate?