Deck 30: The Child with Integumentary Dysfunction

Question 1

Tinea capitis (ringworm),frequently found in schoolchildren,is caused by a(n):

A)virus.
B)fungus.
C)allergic reaction.
D)bacterial infection.

Answer 1

fungus.

Question 2

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.

Answer 2

cool compresses.

Question 3

The nurse is taking care of a 7-year-old child with a skin rash called a papule.Which clinical finding should the nurse expect to assess with this type of skin rash?

A)A lesion that is elevated, palpable, firm and circumscribed; less than 1 cm in diameter
B)A lesion that is elevated, flat-topped, firm, rough and superficial; greater than 1 cm in diameter
C)An elevated lesion, firm, circumscribed, palpable; 1 to 2 cm in diameter
D)An elevated lesion, circumscribed, filled with serous fluid; less than 1 cm in diameter

Answer 3

A lesion that is elevated, palpable, firm and circumscribed; less than 1 cm in diameter

Question 4

The nurse is taking care of a 7-year-old child with herpes simplex virus (type 1 or 2).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 5

The nurse should expect to assess which causative agent in a child with warts?

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

Question 6

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 7

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

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

Question 8

Which nursing consideration is important 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

Parents tell the nurse that their child keeps scratching the areas where he has poison ivy.The nurse's response should be based on which knowledge?

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 10

The nurse is taking care of a 2-year-old child with a macule skin lesion.Which clinical finding should the nurse expect to assess with this type of lesion?

A)Flat, nonpalpable, and irregularly shaped lesion that is greater than 1 cm in diameter
B)Heaped-up keratinized cells, flaky exfoliation, irregular, thick or thin, dry or oily, varied in size
C)Flat, brown mole less than 1 cm in diameter
D)Elevated, flat-topped, firm, rough, superficial papule greater than 1 cm in diameter

Question 11

The nurse is conducting a staff in-service on appearance of childhood skin conditions.Lymphangitis ("streaking")is frequently seen in which condition?

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

Question 12

A child steps on a nail and sustains a puncture wound of the foot.Which 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 50% hydrogen peroxide and 50% water.

Question 13

Cellulitis is often caused by:

A)herpes zoster.
B)Candida albicans.
C)human papillomavirus.
D)Streptococcus or Staphylococcus organisms.

Question 14

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 solution compresses to affected area.

Question 15

The nurse should implement which prescribed treatment for a child with warts?

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

Question 16

The nurse is taking care of a child with scabies.Which primary clinical manifestation should the nurse expect to assess with this disease?

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

Question 17

A school-age child falls on the playground and has a small laceration on the forearm.The school nurse should do which 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 18

The nurse is teaching nursing students about childhood skin lesions.Which 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 19

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 posterior horn of the spinal cord.
D)lateral and dorsal columns of the spinal cord.

Question 20

The nurse is caring for a 5-year-old child with impetigo contagiosa.The parents ask the nurse what will happen to their child's skin after the infection has subsided and healed.Which answer should the nurse give?

A)There will be no scarring.
B)There may be some pigmented spots.
C)It is likely there will be some slightly depressed scars.
D)There will be some atrophic white scars.

Question 21

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 22

A father calls the clinic nurse because his 2-year-old child was bitten by a black widow spider.The nurse should advise which to the father?

A)Apply warm compresses.
B)Carefully scrape off stinger.
C)Take child to emergency department.
D)Apply a thin layer of corticosteroid cream.

Question 23

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 cleanse my infant's skin with a commercial diaper wipe every time I change the diaper."
B)"If my infant's buttocks become slightly red, I will expose the skin to air."
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 24

A mother calls the emergency department nurse because her child was stung by a scorpion.The nurse should recommend:

A)administering an antihistamine.
B)cleansing area with soap and water.
C)keeping the child quiet and coming to the emergency department.
D)removing the stinger and applying cool compresses.

Question 25

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(n):

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

Question 26

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

A)flea.
B)tick.
C)mosquito.
D)mouse or rat.

Question 27

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 28

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 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 29

A young child has sustained a minor burn to the foot.Which is recommended for treatment of a minor burn?

A)Apply ice to foot.
B)Apply cortisone ointment.
C)Apply an occlusive dressing.
D)Cleanse the wound with a mild soap and tepid water.

Question 30

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 31

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 32

Which 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

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

A)teaching to avoid use of sunscreen agents.
B)applying generously to the skin.
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 34

Atopic dermatitis (eczema)in the infant is:

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

Question 35

A child experiences frostbite of the fingers after prolonged exposure to the cold.Which intervention should 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 36

A toddler sustains a minor burn on the hand from hot coffee.Which is the first action the nurse should recommend in treating this burn?

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

Question 37

Which 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 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

The school nurse is conducting a class for school-age children on Lyme disease.Which is characteristic of Lyme disease?

A)Difficult to prevent
B)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 40

When is isotretinoin (Accutane)indicated for the treatment of acne during adolescence?

A)The 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 41

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 42

Which 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 43

Where do the lesions of atopic dermatitis (eczema)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 44

A child with extensive burns requires débridement.The nurse should anticipate which priority goal related to this procedure?

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

Question 45

Which 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 46

The family of a 4-month-old infant will be vacationing at the beach.Which should the nurse teach the family about exposure of the infant to the sun?

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

Question 47

Fentanyl and midazolam (Versed)are given before débridement of a child's burn wounds.Which is the rationale for administration of these medications?

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

Question 48

A nurse is teaching a parent of an infant about treatment of seborrhea dermatitis (cradle cap).Which should the nurse include in the instructions?

A)Shampoo every three days with a mild soap.
B)The hair should be shampooed with a medicated shampoo.
C)Shampoo every day with an antiseborrheic shampoo.
D)The loosened crusts should not be removed with a fine-toothed comb.

Question 49

Biologic dressings are applied to a child with partial-thickness burns of both legs.Which nursing intervention should be implemented?

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 50

The nurse is teaching parents of toddlers about animal safety.Which 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 51

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)Dryclean 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 52

Nitrous oxide is being administered to a child with extensive burn injuries.Which is the purpose of this medication?

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

Question 53

A parent of a child with major burns asks the nurse why a high-calorie and high-protein diet is prescribed.Which response should the nurse make?

A)The diet promotes growth.
B)The diet will improve appetite.
C)The diet will diminish risks of stress-induced hyperglycemia.
D)The diet will avoid protein breakdown.

Question 54

Hydrotherapy is required to treat a child with extensive partial-thickness burn wounds.Which 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 55

A school nurse assesses a case of tinea capitis (ringworm)on a 6-year-old child.Which figure depicts the characteristic lesion of tinea capitis?

A)
B)
C)
D)

Question 56

The nurse is talking to a parent of an infant with severe atopic dermatitis (eczema).Which response(s)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."

Question 57

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 in a whole number.)

Question 58

Which 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 adhere to the wound, soak in hot water before removal.
D)Apply dressing so that movement is limited during the healing process.