Deck 30: The Child With Integumentary Dysfunction

Question 1

Ringworm, frequently found in school children, is caused by which of the following?

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

Answer 1

Fungus

Question 2

Which of the following is a firm, palpable, circumscribed elevation of the skin less than 1 cm in diameter?

A)Papule
B)Plaque
C)Nodule
D)Vesicle

Answer 2

Papule

Question 3

Which of the following is usually the only symptom of pediculosis capitis (head lice)?

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

Answer 3

Itching

Question 4

Which of the following is the primary clinical manifestation of scabies?

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

Question 5

Treatment for herpes simplex virus (type I or type II) includes which of the following?

A)Corticosteroids
B)Oral griseofulvin
C)Oral antiviral agent
D)Topical and/or systemic antibiotic

Question 6

Cellulitis is often caused by:

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

Question 7

Which of the following should the nurse include when explaining how to manage pediculosis capitis?

A)Cut hair shorter if infestation and nits are severe.
B)Distinguish viable from nonviable nits, and remove all viable ones.
C)Wash all nits out of hair with a regular shampoo.
D)Remove nits with an extra-fine tooth comb or tweezers.

Question 8

Which of the following is an 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.

Question 9

Deficiency of which of the following vitamins or minerals result in an inadequate inflammatory response?

A)A
B)B₁
C)C
D)Zinc

Question 10

A child falls on the playground and has a small laceration on the forearm. The school nurse should do which of the following 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 11

A flat, brown mole less than 1 cm. in diameter would be called a:

A)Patch.
B)Scale.
C)Macule.
D)Plaque.

Question 12

Impetigo ordinarily results in which of the following?

A)No scarring
B)Pigmented spots
C)Slightly depressed scars
D)Atrophic white scars

Question 13

Which of the following is an elevated, circumscribed skin lesion that is less than 1 cm in diameter and filled with serous fluid?

A)Cyst
B)Papule
C)Pustule
D)Vesicle

Question 14

Warts are caused by which of the following?

A)Bacteria
B)Fungus
C)Parasite
D)Virus

Question 15

A child steps on a nail and sustains a puncture wound of the foot. Which of the following 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 1/2 hydrogen peroxide and 1/2 water.

Question 16

The primary treatment for warts is which of the following?

A)Vaccination
B)Local destruction
C)Corticosteroids
D)Specific antibiotic therapy

Question 17

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 which of the following?

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 18

Therapeutic management of the child with ringworm infection would include which of the following?

A)Administer oral griseofulvin.
B)Administer topical or oral antibiotics.
C)Apply topical sulfonamides.
D)Apply Burow solution compresses to affected area.

Question 19

Lymphangitis ("streaking") is frequently seen in:

A)Cellulitis.
B)Folliculitis.
C)Impetigo contagiosa.
D)Staphylococcal scalded skin.

Question 20

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

A)Sympathetic nerve fibers
B)Parasympathetic nerve fibers
C)Posterior root ganglia and posterior horn of the spinal cord
D)Lateral and dorsal columns of the spinal cord

Question 21

Rocky Mountain spotted fever is caused by the bite of which of the following?

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

Question 22

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 which of the following?

A)Impetigo
B)Candida albicans
C)Urine and feces
D)Infrequent diapering

Question 23

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

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

Question 24

The nurse is discussing the management of atopic dermatitis (eczema) with a parent. Which of the following should be included?

A)Dress infant warmly in woolen clothes to prevent chilling.
B)Keep fingernails and toenails cut short and clean.
C)Give bubble baths instead of washing lesions with soap.
D)Launder clothes in mild detergent; use fabric softener in rinse.

Question 25

Nursing care of the infant with atopic dermatitis focuses on which of the following?

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

Question 26

Which of the following explains physiologically the edema formation that occurs with burns?

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

Question 27

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

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

Question 28

A mother calls the emergency (ER) nurse, because her child was stung by a scorpion. The nurse should recommend which of the following?

A)Administer antihistamine.
B)Cleanse with soap and water.
C)Keep child quiet and come to ER.
D)Remove stinger and apply cool compresses.

Question 29

Tretinoin (Retin-A) is a topical agent commonly used to treat acne. Nursing considerations with this drug include which of the following?

A)Avoid use of sunscreen agents.
B)Cosmetics with lanolin and petrolatum are preferred in acne.
C)Explain that medication should not be applied until at least 20 to 30 minutes after washing.
D)Explain that erythema and peeling are indications of toxicity.

Question 30

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 stinger.
C)Take child to emergency department.
D)Apply a thin layer of corticosteroid cream.

Question 31

Treatment of psoriasis often involves which of the following?

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

Question 32

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. Which of the following is also 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 33

The nurse should know that Lyme disease is which of the following?

A)Very 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

Question 34

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

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

Question 35

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 36

Atopic dermatitis (eczema) in the infant is which of the following?

A)Easily cured
B)Worse in humid climates
C)Associated with upper respiratory infections
D)Associated with allergy with a hereditary tendency

Question 37

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

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

Question 38

After the acute stage and during the healing process, the primary complication from burn injury is which of the following?

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

Question 39

A new parent asks the nurse, "How can diaper rash be prevented?" The nurse should recommend which of the following?

A)Wash with soap and water every time diaper is changed.
B)Wash with a mild soap and water and dry thoroughly whenever stooling has occurred.
C)Wash with soap before applying a thin layer of oil.
D)When changing the diaper, apply baby oil and powder the creases.

Question 40

The management 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

Question 41

Which of the following is an effective strategy to reduce the stress of burn dressing procedures?

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

Question 42

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

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

Question 43

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 44

Nitrous oxide is being administered to a child with extensive burn injuries. The purpose of this drug is to:

A)Promote healing.
B)Prevent infection.
C)Provide anesthesia.
D)Improve urinary output.

Question 45

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 46

A young child has sustained a minor burn to the foot. Which of the following is the best method to stop the burning process?

A)Apply ice to foot.
B)Apply burn ointment.
C)Cover foot with gauze dressing.
D)Hold foot under cool running water.

Question 47

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

A)Observe wounds for bleeding.
B)Observe wounds for signs of infection.
C)Monitor closely for signs of shock.
D)Splint legs to prevent movement.

Question 48

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 the arms and legs
D) Back
E) Trunk
F) Scalp

Question 49

Which of the following is an important consideration for the nurse when changing dressings and applying topical medication to a child's abdomen and leg burns?

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

Question 50

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 burned area under cool running water.
C)Break any blisters with a sterile needle.
D)Clean wound with soap and warm water.

Question 51

Which of the following is one of the first signs of overwhelming sepsis in a child with burn injuries?

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

Question 52

A child with extensive burns requires debridement. The nurse should anticipate that a priority goal related to this procedure is which of the following?

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