Deck 47: Integumentary Dysfunction

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

Answer 1

Virus

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

Answer 2

Local destruction

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.

Answer 3

Caused by a spirochete that enters the skin through a tick bite.

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.

Question 5

Lymphangitis ("streaking")is frequently seen in:

A)Cellulitis.
B)Folliculitis.
C)Impetigo contagiosa.
D)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.

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.

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.

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.

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.

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

Question 12

The primary clinical manifestation of scabies is:

A)Edema.
B)Redness.
C)Pruritus.
D)Maceration.

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.

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.

Question 15

Cellulitis is often caused by:

A)Herpes zoster.
B)Candida albicans.
C)Human papillomavirus.
D)Streptococcus or Staphylococcus organisms.

Question 16

Ringworm,frequently found in schoolchildren,is caused by:

A)Virus.
B)Fungus.
C)Allergic reaction.
D)Bacterial infection.

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.

Question 18

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

A)Flea.
B)Tick.
C)Mosquito.
D)Mouse or rat.

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.

Question 20

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

A)Itching.
B)Vesicles.
C)Scalp rash.
D)Localized inflammatory response.

Question 21

Isotretinoin (Accutane)is indicated for the treatment of acne during adolescence when:

A)Acne has not responded to other treatments.
B)The adolescent is or may become pregnant.
C)The adolescent is unable to give up foods causing acne.
D)Frequent washing with antibacterial soap has been unsuccessful.

Question 22

An effective strategy to reduce the stress of burn dressing procedures is to:

A)Give the child as many choices as possible.
B)Reassure the child that dressing changes are not painful.
C)Explain to the child why analgesics cannot be used.
D)Encourage the child to master stress with controlled passivity.

Question 23

Fentanyl and midazolam (Versed)are given before debridement of a child's burn wounds.These drugs are important to:

A)Promote healing.
B)Prevent infection.
C)Provide pain relief.
D)Limit amount of debridement that will be necessary.

Question 24

A child with extensive burns requires debridement.The nurse should anticipate that a priority goal related to this procedure is to:

A)Reduce pain.
B)Prevent bleeding.
C)Maintain airway.
D)Restore fluid balance.

Question 25

A child experiences frostbite of the fingers after prolonged exposure to the cold.Which intervention would the nurse implement first?

A)Rapid rewarming of the fingers by placing in warm water
B)Placing the hand in cool water
C)Slow rewarming by wrapping in warm cloth
D)Using an ice pack to keep cold until medical intervention is possible

Question 26

Which statement regarding atopic dermatitis (eczema)in the infant is most accurate?

A)It is easily cured.
B)It is worse in humid climates.
C)It is associated with upper respiratory tract infections.
D)It is associated with allergy with a hereditary tendency.

Question 27

Tretinoin (Retin-A)is a topical agent commonly used to treat acne.Nursing considerations with this drug include:

A)Avoiding use of sunscreen agents.
B)Using cosmetics with lanolin and petrolatum.
C)Explaining that medication should not be applied until at least 20 to 30 minutes after washing.
D)Explaining that erythema and peeling are indications of toxicity.

Question 28

A child is admitted with extensive burns.The nurse notes that there are burns on the child's lips and singed nasal hairs.The nurse should suspect that the child has:

A)A chemical burn.
B)An inhalation injury.
C)An electrical burn.
D)A hot-water scald.

Question 29

An adolescent girl is cooking on a gas stove when her bathrobe catches fire.Her father smothers the flames with a rug and calls an ambulance.She has sustained major burns over much of her body.What is important in her immediate care?

A)Wrap her in a blanket until help arrives
B)Encourage her to drink clear liquids
C)Place her in a tub of cool water
D)Remove her burned clothing and jewelry

Question 30

A toddler sustains a minor burn on the hand from hot coffee.The first action in treating this burn is to:

A)Apply ice to burned area.
B)Hold the burned area under cool running water.
C)Break any blisters with a sterile needle.
D)Clean the wound with soap and warm water.

Question 31

A high-protein diet for the child with major burns is ordered to:

A)Promote growth.
B)Improve appetite.
C)Diminish risks of stress-induced hyperglycemia.
D)Avoid protein breakdown.

Question 32

Which of the following best describes a full-thickness (third-degree)burn?

A)Erythema and pain
B)Skin showing erythema followed by blister formation
C)Destruction of all layers of skin evident with extension into subcutaneous tissue
D)Destruction injury involving underlying structures such as muscle, fascia, and bone

Question 33

The nurse is teaching a class on preventing diaper rash in newborns to a group of new parents.Which statement made by a parent indicates a correct understanding of the teaching?

A)"I should wash my infant's buttocks with soap and water every time I change the diaper."
B)"I will wash with a mild soap and water and dry thoroughly whenever my infant has a bowel movement."
C)"I should wash my infant's buttocks with soap before applying a thin layer of oil."
D)"I will apply baby oil and powder to the creases in my infant's buttocks."

Question 34

Which physiologic change causes the edema formation that occurs with burns?

A)Vasoconstriction
B)Decreased capillary permeability
C)Increased capillary permeability
D)Decreased hydrostatic pressure within capillaries

Question 35

An important consideration for the nurse when changing dressings and applying topical medication to a child's abdomen and leg burns is to:

A)Apply topical medication with clean hands.
B)Wash hands and forearms before and after dressing change.
C)If dressings adhere to the wound, soak in hot water before removal.
D)Apply dressing so that movement is limited during the healing process.

Question 36

Nursing care of the infant with atopic dermatitis focuses on:

A)Feeding a variety of foods.
B)Keeping lesions dry.
C)Preventing infection.
D)Using fabric softener to avoid rough cloth.

Question 37

Biologic dressings are applied to a child with partial-thickness burns of both legs.Nursing actions related to this include:

A)Observing wounds for bleeding.
B)Observing wounds for signs of infection.
C)Monitoring closely for signs of shock.
D)Splinting legs to prevent movement.

Question 38

The most immediate threat to life in children with thermal injuries is:

A)Shock.
B)Anemia.
C)Local infection.
D)Systemic sepsis.

Question 39

One of the first signs of overwhelming sepsis in a child with burn injuries is:

A)Seizures.
B)Bradycardia.
C)Disorientation.
D)Decreased blood pressure.

Question 40

After the acute stage and during the healing process,the primary complication from burn injury is:

A)Asphyxia.
B)Shock.
C)Renal shutdown.
D)Infection.

Question 41

The nurse is teaching parents of toddlers about animal safety.Which information should be included in the teaching session?

A)Petting dogs in the neighborhood should be encouraged to prevent fear of dogs.
B)The toddler is safe to approach an animal if the animal is chained.
C)It is permissible for your toddler to feed treats to a dog.
D)Teach your toddler not to disturb an animal that is eating.

Question 42

Where do the lesions of atopic dermatitis most commonly occur in the infant (Select all that apply)?

A)Cheeks
B)Buttocks
C)Extensor surfaces of arms and legs
D)Back
E)Trunk
F)Scalp

Question 43

The family of a 4-month-old infant will be vacationing at the beach.The best recommendation to this family is to:

A)Use sun block on the infant's nose and ear tips.
B)Use a topical sunscreen product with a sun protective factor of 15.
C)Expose the infant to the sun for 15-minute increments.
D)Keep the infant in total shade at all times.

Question 44

Which prescribed treatment should the nurse plan to implement for a child with psoriasis?

A)Antihistamines
B)Oral antibiotics
C)Topical application of calamine lotion
D)Tar and exposure to sunlight and ultraviolet light

Question 45

Which nursing intervention is the highest priority in the initial care of a child with a major burn injury?

A)Establishing and maintaining the child's airway
B)Establishing and maintaining intravenous access
C)Insertion of a catheter to monitor hourly urine output
D)Insertion of a nasogastric tube into the stomach to supply adequate nutrition

Question 46

The nurse is talking to the parents of a child with pediculosis capitis.Which should the nurse include when explaining how to manage pediculosis capitis?

A)"You will need to cut the hair shorter if infestation and nits are severe."
B)"You can distinguish viable from nonviable nits, and remove all viable ones."
C)"You can wash all nits out of hair with a regular shampoo."
D)"You will need to remove nits with an extra-fine tooth comb or tweezers."

Question 47

The community health nurse is teaching parents about prevention of the spread and reoccurrence of pediculosis (head lice).Which should the nurse include in the teaching session (Select all that apply)?

A)Dry-clean nonwashable items.
B)Spray the environment with an insecticide.
C)Seal nonwashable items in a plastic bag for 5 days.
D)Boil combs and brushes for 10 minutes.
E)Discourage sharing of personal items.

Question 48

Hydrotherapy is required to treat a child with extensive partial-thickness burn wounds.Which is the primary purpose of hydrotherapy?

A)Debride the wounds.
B)Increase peripheral blood flow.
C)Provide pain relief.
D)Destroy bacteria on the skin.

Question 49

The nurse is caring for a school-age child with a tinea capitis (ringworm)infection.The nurse should expect that therapeutic management for this child includes:

A)Administering oral griseofulvin.
B)Administering topical or oral antibiotics.
C)Applying topical sulfonamides.
D)Applying Burow's solution compresses to affected area.

Question 50

To best assess the child with severe burns for adequate perfusion,the nurse monitors:

A)Distal pulses.
B)Skin turgor.
C)Urine output.
D)Mucous membranes.

Question 51

Which should the nurse include when teaching parents about preventing childhood burn injuries (Select all that apply)?

A)Keep hot liquids out of reach.
B)Baby-proof electrical outlets.
C)Turn water heater thermostats to a maximum of 150° F.
D)Heat infant formula in the microwave.
E)Test water temperature before placing your child in the tub bath.

Question 52

A nurse is caring for a 5-year-old child with a major burn.The health care provider has written a prescription to notify the health care provider if urine output falls to or below 2 mL/kg/hr.The child weighs 55 lb.The nurse should notify the health care provider if the milliliters of urine output is at or below _____ for an hour.Record your answer as a whole number.

Question 53

The nurse is speaking with the parent of an infant with severe atopic dermatitis.What information should the nurse reinforce with the parent (Select all that apply)?

A)"You can use warm wet compresses to relieve discomfort."
B)"You will need to keep your infant's skin well hydrated by using a mild soap in the bath."
C)"You should bathe your baby in a bubble bath two times a day."
D)"You will need to prevent your baby from scratching the area by using a mild antihistamine."
E)"You can try a fabric softener in the laundry to avoid rough cloth."
F)"You should apply an emollient to the skin immediately after a bath."