Deck 44: Injuries and Toxic Exposures

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?

A) Administer narcotic analgesics to provide comfort.
B) Begin treatment with oral amoxicillin-clavulanate for 5 days.
C) Clean the wound and administer tetanus prophylaxis.
D) Transport the child by ambulance to a medical center.

Answer 1

D

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?

A) Apply povidone-iodine to all areas.
B) Irrigate gently with normal saline.
C) Rinse with hydrogen peroxide.
D) Scrub the abraded areas with alcohol.

Answer 2

B

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

A) allow the wound to heal by secondary intention.
B) delay closure of the wound for several days.
C) refer the child to a plastic surgeon for wound closure.
D) suture the wound within 6 hours.

Answer 3

D

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?

A) Administer intramuscular epinephrine.
B) Apply a topical glucocorticoid cream.
C) Give oral diphenhydramine.
D) Order a bronchodilator 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?

A) Amoxicillin-clavulanate
B) Ciprofloxacin
C) Clindamycin
D) Trimethoprim-sulfamethoxazole

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?

A) Apply the adhesive between the wound margins and then hold the edges together.
B) Apply the adhesive to the wound and then secure the edges with surgical tape.
C) Have the child remain still for 15 to 20 minutes after the adhesive is applied.
D) Hold the wound edges together and apply the adhesive on top of the skin.

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?

A) Administration of rabies prophylaxis and a tetanus booster
B) Debriding and suturing the wound to prevent infection
C) Irrigation of the wounds with high-pressure normal saline
D) Reporting the animal bite to the local animal control authority

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?

A) It may take up to 3 weeks to heal with scarring likely.
B) Scarring is unlikely, with healing expected in 3 to 7 days.
C) Surgical intervention and skin grafting are usually required.
D) This type of burn usually heals without scarring in 7 to 14 days.

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?

A) Place the child on crutches and limit weight-bearing until symptoms subside.
B) Prescribe acetaminophen with hydrocodone along with NSAIDs.
C) Recommend rest, ice packs, compression, and elevation of the extremity.
D) Refer the child to an orthopedic specialist for immediate evaluation and treatment.