Question 1

A child is bitten by a snake near a swimming pool in an area where copperhead snakes are known to inhabit, although the parents cannot describe the snake. An examination of the bite reveals a severe local reaction at the site with edema and intense pain. What will the primary care pediatric nurse practitioner do first?

Accepted Answer

The child needs immediate medical evaluation and possible administration of antivenom, which is best done at a medical center.

Question 2

A child is brought to the clinic after falling from a swing and scraping both knees and hands. An examination reveals abraded skin with oozing serous fluid and blood, along with dirt and grime from the playground surface. What will the primary care pediatric nurse practitioner do to minimize the risk of infection?

Accepted Answer

Irrigating the wounds gently with normal saline will help to remove dirt and debris, reducing the risk of infection. Povidone-iodine can be used, but it may be painful and can delay wound healing. Hydrogen peroxide and alcohol can both cause tissue damage and delay healing.

Question 3

A child has a 1-cm laceration on the forehead proximal to the hairline after running into a pole while playing sports. To minimize the risk of infection, the primary care pediatric nurse practitioner will irrigate the wound and

Accepted Answer

It is recommended to suture a wound within 6 hours of the injury to minimize the risk of infection and ensure optimal wound healing. Delaying closure or allowing the wound to heal by secondary intention may increase the risk of infection and scarring. Referral to a plastic surgeon may not be necessary for a small laceration and may delay timely wound closure.

Question 4

A child is brought to the clinic immediately after being stung by a wasp while playing in the yard. The physical examination reveals localized redness and edema at the site, along with abdominal tenderness, watery eyes, and generalized hives. What is the initial treatment?

Accepted Answer

The child is showing signs and symptoms of an anaphylactic reaction to the wasp sting, including hives, abdominal tenderness, and watery eyes. The immediate treatment for an anaphylactic reaction is intramuscular epinephrine. A glucocorticoid cream and oral diphenhydramine may be used as supportive therapy, but epinephrine is the priority in this situation. A bronchodilator treatment may be used if the child develops respiratory distress, but this is not the initial treatment.

Question 5

A school-age child steps on a nail while wearing tennis shoes and develops cellulitis in that foot. The child's immunizations are up-to-date. What antibiotic will the pediatric nurse practitioner empirically prescribe?

Accepted Answer

Ciprofloxacin is effective against Pseudomonas aeruginosa, a common organism found in puncture wounds through tennis shoes.

Question 6

The primary care pediatric nurse practitioner is preparing to close a laceration on a child's forehead using topical skin adhesive. What is the correct way to apply this product?

Accepted Answer

The correct way to apply topical skin adhesive for closing a laceration is to first hold the wound edges together and then apply the adhesive on top of the skin, not between the wound margins or with additional securing methods like surgical tape. This method ensures proper closure and healing of the wound.

Question 7

A child is bitten on one arm by a neighbor's dog. The dog is immunized against rabies and the child's last tetanus immunization was 4 years prior. The wound edges are gaping and avulsed. What is an important initial intervention when treating this injury?

Accepted Answer

Irrigation of the wound with high-pressure normal saline is crucial to reduce the risk of infection by removing debris and bacteria.

Question 8

A toddler is brought to the clinic after grabbing the hot end of his mother's curling iron. An examination reveals a pale, yellow burned area to the palm of one hand. What is true about this burn?

Accepted Answer

DThe description of a pale, yellow burned area indicates a second-degree burn, which can take up to 3 weeks to heal and may result in scarring. However, many second-degree burns can also heal without scarring within 7 to 14 days, depending on the depth and care of the wound.

Question 9

A school-age child sustained a contusion on the front of one thigh while playing football and reports some difficulty flexing the foot on the affected side. What will the primary care pediatric nurse practitioner do to treat this injury?

Accepted Answer

The answer of A school-age child sustained a contusion on...

Quiz 44: Injuries and Toxic Exposures