Deck 30: Caring for the Child With a Integumentary Condition

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?

A) Child states that he no longer gets teased at school because of his appearance.
B) Parents and child verbalize acceptance of disease process and need for medication.
C) Patient participates in sporting events and other after school-activities regularly.
D) Skin around primary lesions remains free of redness, warmth, swelling, and pain.

Answer 1

Skin around primary lesions remains free of redness, warmth, swelling, and pain.

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?

A) "High levels of IgE from an overactive immune system are treated with steroids."
B) "If we can control the levels of IgE, we can control your child's skin condition."
C) "IgE is raised in allergies and asthma, which are often seen with atopic dermatitis."
D) "These results will help us determine how your child's immune system is functioning."

Answer 2

"IgE is raised in allergies and asthma, which are often seen with atopic dermatitis."

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?

A) "Are you active in any athletics or sports?"
B) "Do you have siblings with respiratory infections?"
C) "Do you seem to scratch a lot at night?"
D) "Have you been in any wooded areas lately?"

Answer 3

"Are you active in any athletics or sports?"

Question 4

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

A) Altered comfort related to itching lesions
B) Impaired tissue integrity related to lesions
C) Knowledge deficit related to unknown condition
D) Risk for impaired airway secondary to edema

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?

A) "After being in your womb for 9 months, this is how the baby prefers to stay."
B) "Babies' immune systems are immature; any cold breeze will make them sick."
C) "Their skin is thin and they have little fat, so it's hard to control their temperature."
D) "You need to keep their temperature above what we call normal to keep them well."

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?

A) Azithromycin (Zithromax)
B) Amoxicillin/clavulanate (Augmentin)
C) Doxycycline (Vibramycin)
D) Mupirocin (Bactroban) ointment

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?

A) "Elimite goes from the nape of the neck to the toes, except on the genitals."
B) "The lotion is left on until the next day, when a bath is given."
C) "This treatment will have to be repeated 1 week after the first."
D) "We will give our child a warm soapy bath before applying the lotion."

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?

A) Instructs the family members that they must wait at least 15 minutes before leaving
B) Plans to use a 25-gauge,3/4 -inch needle to administer the medication
C) Reconstitutes the medication using sterile normal saline solution
D) Selects a large, well-defined muscle for a deep intramuscular injection

Question 9

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

A) Blistering: heat-related
B) Exanthema: an eruption
C) Pustular: contagious
D) Urticarial: round patches

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?

A) Assess for noncompliance with the regimen.
B) Discuss changing medications with the provider.
C) Prepare to administer the drug as an injection.
D) Tell the teen it takes nearly 6 months to work.

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?

A) Antibiotics twice a day for 7-10 days
B) Cleaning the bathtub after the child bathes
C) Intramuscular injection of an antibiotic
D) Topical use of tretinoin (RetinA) on lesions

Question 12

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

A) Apply repellents to the child's clothing.
B) There are no substitutes for DEET.
C) Use oil of lemon eucalyptus on babies.
D) Wash repellent off after 2 hours.

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?

A) Give a dose of antibiotic.
B) Offer the child a toy to play with.
C) Provide discharge teaching.
D) Report the bite to authorities.

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?

A) Advise parents that treatment depends on laboratory results.
B) Assess for cardiac and neurological involvement.
C) Facilitate admission to a nearby hospital.
D) Teach the parents about cefuroxime (Ceftin).

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?

A) "Chronic diseases always affect the healing process."
B) "Inflammation is the first stage of healing wounds."
C) "Sick kids tend to be anemic, which often delays healing."
D) "Wound healing would not be affected in your 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?

A) Decreases the pain so the child can eat and drink
B) Kills the virus causing the infection by suffocation
C) Prevents secondary infection of the gingiva
D) Shortens 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?

A) "Scrub your face vigorously twice a day with soap and water."
B) "Tetracycline (Sumacin) will make you more sensitive to the sun."
C) "Use good moisturizer because treatment is very drying."
D) "You need a pregnancy test every 3 months on isotretinoin (Accutane)."

Question 18

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

A) Adolescent, due to increased anger
B) No specific group is at higher risk.
C) School-aged child, due to frustration
D) Toddler, due to lack of verbal ability

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?

A) Administer the injection.
B) Begin CPR.
C) Call 911 immediately.
D) Give half the injection.

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?

A) "Be sure you are cleaning your house and linens well."
B) "Qwell is usually effective after two or three treatments."
C) "Switch to malathion (Ovide) and see if that works better."
D) "There are some oral medications your child can try."

Question 21

A nurse wishes to prevent radiant heat loss from an infant.What action is the most appropriate?

A) Apply warm blankets to the baby.
B) Cover the baby's head with a cap.
C) Place a space heater near the baby.
D) Warm and humidify the oxygen.

Question 22

A student nurse is caring for an adolescent with frostbite of the hand in the emergency department.Which action by the student would require the registered nurse to intervene?

A) Applies warm blankets to the child
B) Has the teen wear a warmed gown
C) Rubs patient's fingers to warm them
D) Takes teen's watch off of his wrist

Question 23

A nurse assesses a pressure ulcer on a child and finds full-thickness loss of the dermal layer and visible subcutaneous fat.At which stage does the nurse document this pressure ulcer to be?

A) Stage I
B) Stage II
C) Stage III
D) Stage IV

Question 24

A nurse is preparing to administer a prn medication to a 6-year-old child for pruritus.Which order should the nurse question?

A) Chlorpheniramine (Chlor-Trimeton) 2 mg every 6 hours with food
B) Cyproheptadine (Periactin) 2-4 mg every 8-12 hours
C) Diphenhydramine (Benadryl) 50 mg PO every 4-6 hours
D) Hydroxyzine (Atarax) 2 mg/kg/day in divided doses every 6-8 hours

Question 25

A child has been in the burn unit for 13 days.Which nursing assessment indicates that a priority goal has been met?

A) Decreased albumen over 5 days
B) Intake equals output for 24 hours
C) Participates in dressing changes
D) Weight gain of 0.5 kg in 1 week

Question 26

The nurse working in a community pediatric clinic knows that which are examples of secondary skin lesions?

A) Crusts
B) Scales
C) Scars
D) Ulcers
E) Wheals

Question 27

Paramedics bring a child to the emergency department with possible hypothermia.He walked to school without a coat and upon arrival he is noted to be shivering,nauseated,and uncoordinated.After removing the child's clothing,what nursing intervention does the nurse plan to implement?

A) Administer rapid IV boluses.
B) Apply a Bair Hugger.
C) Cover the child with warm blankets.
D) Start dialysis with warmed solution.

Question 28

The clinic nurse is assessing a child who had a tick bite for tick-borne disease.What assessment finding indicates to the nurse the child may have Rocky Mountain Spotted Fever and not Lyme disease?

A) Abdominal pain
B) Clear skin
C) Fever
D) Headache

Question 29

The nurse working in a pediatric burn unit explains to new registered nurses that which is the most common cause of death in burned children?

A) Hypovolemic shock
B) Infection
C) Sepsis
D) Thrombotic events

Question 30

A nurse is providing anticipatory guidance to a community parent group about burn prevention.When discussing school-age and older children,which cause of burn occurs most often in this age group?

A) Cooking and kitchen activities
B) Exposure to hot water
C) Household electrical wires
D) Touching hot appliances

Question 31

The student studying pediatric integumentary problems learns that which are functions of the skin?

A) Assists in water retention
B) Initiates tactile sensations
C) Provides physical barrier
D) Regulates temperature set point
E) Synthesizes vitamin D

Question 32

A burned patient had an escharotomy on the right anterior thigh.Which assessment finding indicates that this procedure has been effective?

A) Absence of infection in the burn
B) Compartment pressure of 42 mm Hg
C) Decreased pain in the right leg
D) Pedal pulses 3⁺/4⁺ bilaterally

Question 33

When teaching a parenting group how to prevent the most common cause of childhood burns,what action does the nurse advise?

A) Cover electrical outlets.
B) Keep children out of the kitchen.
C) Install smoke detectors.
D) Lock up household chemicals.

Question 34

A child who is intubated and on a mechanical ventilator is being transferred from the emergency department to the burn unit.Which action by the nurse takes priority?

A) Ensure an Ambu bag is at the bedside.
B) Have sedation available if needed.
C) Orient the family to the burn unit.
D) Place the patient on protective isolation.

Question 35

A nurse is caring for four patients on a general pediatric unit.The nurse identifies risk for impaired skin integrity as a nursing diagnosis for all four.Which patient's skin should the nurse assess first?

A) Adolescent 4 hours postoperative after appendectomy
B) School-age child just back from a tonsillectomy
C) Teen eating in a chair 1 week post-burn
D) Toddler with broken femur in skeletal traction

Question 36

A nurse is teaching a community parent group about signs and symptoms of Lyme disease.Which statements does the nurse include?

A) Bull's-eye rash is seen in the early stage of the disease.
B) Fatigue and headache frequently occur in the early stage.
C) Inability to bear weight is often seen in the late disease phase.
D) Lyme disease manifests 3-30 days after a tick bite.
E) Signs of meningitis are seen in the early disseminated phase.

Question 37

A child is brought to the emergency department from a house fire.She has singed eyebrows and sounds hoarse.After applying oxygen,which action by the nurse takes priority?

A) Assemble intubation equipment.
B) Gently cleanse any burn wounds.
C) Place child on a cardiac monitor.
D) Prepare to give pain medication.

Question 38

A nurse has assessed the skin of a newborn with the AWHONN Neonatal Skin Condition Score Tool and determines that her patient has a score of 3.What action by the nurse is most appropriate?

A) Document the findings and continue to monitor.
B) Elevate the child's lower extremities on pillows.
C) Implement pressure ulcer prevention measures.
D) Request a consultation by the wound care nurse.

Question 39

A student is caring for a burned child on the burn unit.The student is performing burn care.Which action by the student requires intervention by the registered nurse?

A) Applies silver nitrate (0.5% AgNO₃) to the child's face
B) Applies silver sulfadiazine (AgSD) to the child's face
C) Checks electrolyte levels before applying silver nitrate
D) Uses Sulfamylon (mafenide acetate) on child's ear burns

Question 40

The faculty member explains fungal skin diseases to a group of students.Which are the common types of this disorder?

A) Tinea capitis
B) Tinea corporis
C) Tinea cruris
D) Tinea manus
E) Tinea pedis

Question 41

A child weighing 34 kg (74.8 lb)has a burn encompassing 35% total body surface area (TBSA).Using the standard Parkland formula,the nurse calculates the child's initial 24-hour fluid requirement to be ____________________mL.

Question 42

A 10-year-old child is in the emergency department with burns on her buttocks,the backs of her thighs,and the soles of her feet.The nurse calculates this child's total body surface area (TBSA)burned as ____________________.

Question 43

An adolescent is in the emergency department with partial-thickness burns covering his right anterior thigh,his abdomen,and his right anterior arm.The nurse calculates the total body surface area (TBSA)burned as ____________________.

Question 44

A child weighing 110 lb (50 kg)was involved in a car fire at 3 p.m.She did not reach the emergency department until 5 p.m.She suffered burns over 45% of her body.How fast does the nurse program the IV pump in order to deliver the first 50% of her fluid requirements? Using the standard Parkland formula,the nurse should program the IV pump at ____________________ mL/hour.

Question 45

A child weighing 123 lb (56 kg)has been diagnosed with Rocky Mountain Spotted Fever.The nurse calculates that the correct dose,to be given twice a day,is ____________________.