Deck 25: Caring for the Child With an Immunological or Infectious Condition

Question 1

A nursing faculty member is explaining the pediatric immune system to students.Which statement is correct?

A)Children are born with intact immune systems.
B)Children's immune systems develop over 1 year.
C)Immunity isn't functional until about 6 months.
D)Mothers' immunity is babies' primary line of defense.

Answer 1

Children are born with intact immune systems.

Question 2

A teenage girl is diagnosed with systemic lupus erythematosus (SLE).Which health promotion guidance is important for the nurse to provide?

A)"Acetaminophen (Tylenol)is best for daily pain."
B)"Consider adding vitamin D to your daily routine."
C)"Plan to choose a career that is sedentary."
D)"You should consider elective sterilization."

Answer 2

"Consider adding vitamin D to your daily routine."

Question 3

An HIV-positive child has low titers after a measles vaccination.She has now been exposed to the disease.Which action by the nurse is most appropriate?

A)Administer prophylactic antibiotics.
B)Place the child in protective isolation.
C)Prepare to administer immunoglobulin.
D)Repeat the vaccination as soon as possible.

Answer 3

Prepare to administer immunoglobulin.

Question 4

A 10-month-old-child is in the pediatric clinic for his eighth ear infection.Which assessment is most important for the nurse to perform on this child?

A)Ask the parent about possible allergy testing.
B)Assess the child's mouth for oral thrush.
C)Graph height and weight on the growth chart.
D)Inquire about the health of the entire family.

Question 5

A 4-month old baby was recently hospitalized with septicemia and now has a severe diaper rash.Which primary immunodeficiency disorder does the nurse suspect?

A)Antibody deficiency: B-cell disorder
B)Combined deficiency: T- and B-cell disorder
C)Complement defect disorder
D)Phagocyte defect disorder

Question 6

A child with a primary immunodeficiency disorder had postimmunization titers drawn.The titers came back low.Which explanation does the nurse give the parents?

A)"The immunizations had no effect on the child."
B)"This result indicates a hyperactive response."
C)"Vaccinations are not needed in your child."
D)"Your child's immune system did not respond."

Question 7

A nurse is providing anticipatory guidance to new parents.Which instruction by the nurse will assist the parents in maintaining physical barriers to prevent infection in their newborn?

A)Breastfeeding provides some antibodies.
B)Ensure your baby is getting enough nutrition.
C)Keep your baby away from people who are sick.
D)Wash your baby with gentle soap and dry well.

Question 8

A nurse is caring for a 5-year-old child diagnosed with Wiskott-Aldrich syndrome.When reviewing today's laboratory results,which finding does the nurse correlate with this condition?

A)Hemoglobin: 7.3 mg/dL
B)PaO2: 64 mm Hg
C)Platelet count: 6,000
D)White blood cell count: 33,000/mm3

Question 9

A parent of a child suspected of having systemic lupus erythematosus (SLE)asks why so many blood tests are being done.Which response by the nurse is the most appropriate?

A)"Many of these blood tests look for possible organ damage from SLE."
B)"SLE is a complicated disorder and is very hard to diagnose."
C)"This is a very typical pattern of diagnostic blood tests we usually do."
D)"We are also checking for other possible autoimmune diseases."

Question 10

An adolescent patient is taking combination retroviral therapy for HIV infection.He is not responding as expected.Which action by the nurse is most appropriate?

A)Asking why he does not take the medications
B)Assessing the patient for noncompliance
C)Consulting a pediatric social worker
D)Starting a simpler drug regimen for the HIV

Question 11

An HIV-positive mother wants to return to work because she is feeling well after starting therapy for her disease.She has a 10-month-old infant.What does the nurse advise her when selecting a day care or care provider for her child,who also is HIV-positive?

A)"Assess their ability to use standard precautions and properly dispose of diapers."
B)"Do not disclose the nature of your baby's disease to the day-care providers."
C)"Find out their policy on allowing children who are sick to come to day care."
D)"Find out if they consistently wear gloves for all diaper changes they perform."

Question 12

A nurse is caring for an HIV-positive child diagnosed with Pneumocystis jiroveci pneumonia who is receiving trimethoprim-sulfamethoxazole.Which finding indicates a possible complication of using this drug?

A)Hemorrhagic blisters
B)Polyuria
C)Severe headache
D)Seizures

Question 13

A nurse volunteers for a disaster relief program and has traveled to an area devastated by a natural disaster.All basic services have been disrupted.When counseling an HIV-positive mother,what is the priority for her 8-month-old infant?

A)Availability of family members to help
B)Local supplies of immunizations
C)Safety of the drinking water supply
D)Types of shelter space available

Question 14

A parent calls a pediatric information line worried about muscular dystrophy because her daughter has new onset of muscle weakness.Which question by the nurse would elicit the most useful information?

A)"Does anyone else in your house have this?"
B)"Does this seem to come and go sporadically?"
C)"Does your child have a rash on her face?"
D)"Does your daughter complain of stiffness?"

Question 15

A nursing student is learning about the immune system.Which statement about immunoglobulins is correct?

A)Adult levels of IgG are reached by the age of 6 months.
B)Children are born with adult levels of IgA.
C)IgE leads the body's attack against bacteria and viruses.
D)IgM is the first type of antibody made in response to infection.

Question 16

A patient is experiencing an anaphylactic reaction.Which action by the nurse takes priority?

A)Determine what the patient is allergic to.
B)Listen to the patient's lung sounds.
C)Maintain the patient's airway.
D)Provide oxygen at 4 L nasal cannula.

Question 17

A nurse is caring for an infant with an HIV-positive mother.Which statement made by the nursing during teaching is the most appropriate?

A)"As long as your CD4+ count is fine,you can nurse."
B)"Breastfeeding is OK if you both take zidovudine (AZT)."
C)"The HIV virus is not passed through breast milk."
D)"You should bottle feed your baby consistently."

Question 18

A patient is experiencing an anaphylactic reaction.Which IV solution does the nurse anticipate will be ordered for this patient?

A)0.45% normal saline
B)5% dextrose in water
C)0.9% normal saline
D)3% saline

Question 19

A child is receiving vaccinations at a well-baby clinic.The nurse explains to the mother that the vaccinations provide which type of immunity?

A)Active
B)Innate
C)Man-made
D)Passive

Question 20

A faculty member is discussing systemic lupus erythematosus (SLE)with a group of nursing students.Which pathophysiological process does the nurse describe as the major problem in this disorder?

A)Autoimmune process creates antigen-antibody complexes that damage tissues
B)Genetic defect linked strictly to male offspring leading to organ damage
C)Limited autoimmune process destroys tissues in specific target organs
D)Rapidly progressive disease triggered by hormonal changes such as pregnancy

Question 21

A nurse is assessing a 7-year-old who has white patches inside his mouth.Which question by the nurse would be most helpful to ask?

A)"Do you have asthma?"
B)"Do you drink milk?"
C)"How much soda do you drink?"
D)"When you do brush your teeth?"

Question 22

A child has been hospitalized with rubella.Which action by the charge nurse is most appropriate?

A)Do not allow pregnant nursing staff in the room.
B)Inform the parents that fresh produce is not allowed.
C)Place the child on contact isolation precautions.
D)Use standard precautions when caring for the child.

Question 23

The day after attending a large birthday party for a classmate,a child breaks out in a rash characteristic of chickenpox.When counseling the parents,which information is most appropriate?

A)"Inform all the parents of children at the party that your child has chickenpox."
B)"This disease is spread through respiratory droplets,so don't get too close."
C)"We can give your child a dose of varicella zoster immune globulin right away."
D)"Your child is only contagious for 3 days after the rash first appears."

Question 24

An immunocompromised child has been admitted to the hospital with Fifth's disease.Which action by the nurse is most appropriate?

A)Place the child in contact precautions.
B)Place the child in droplet precautions.
C)Place the child in protective isolation.
D)Place the child on standard precautions.

Question 25

A nurse is caring for a patient taking lamivudine (Epivir).Which laboratory test is most important for the nurse to assess?

A)CD4+ count
B)Hemoglobin
C)Platelet count
D)White blood cell count

Question 26

A patient was hospitalized 2 years ago with a resistant bacterial infection.The patient is admitted for an unrelated problem and placed on contact isolation.The parents question the need for this action.Which response by the nurse is best?

A)"It is possible that your child could still contaminate the nursing staff."
B)"It's our policy to isolate anyone who has had this infection in the past."
C)"This seems distressing for you;would you like me to call the charge nurse?"
D)"Your child may be colonized with the bacteria so we isolate until we know."

Question 27

A nurse is working with a student on the pediatric unit caring for patients in contact isolation for infectious diarrhea.Which action by the student warrants intervention by the nurse?

A)Changes gloves,performs hand hygiene after touching a contaminated site
B)Performs hand hygiene with alcohol-based rubs after caring for patients
C)Uses an alcohol-based hand sanitizer prior to putting on gloves
D)Washes her hands with soap and hot water when they are visibly soiled

Question 28

A parent calls a pediatric information line to ask about treating sinus congestion in a child.Which suggestion is not appropriate for the nurse to make to the parent?

A)Warm facial compress
B)Cool-mist steamer
C)Sine-Off sinus medication
D)Gentle nasal suctioning

Question 29

A child is hospitalized with a serious bacterial infection.Which assessment finding indicates that the goals for a priority nursing diagnosis have been met?

A)Intact skin integrity
B)Normal temperature
C)Stable weight
D)Urine output of 1 mL/kg/hour

Question 30

A child is being sent home from the doctor's office with a prescription for azithromycin (Zithromax)for presumed cat-scratch disease.Which instruction to the parents is most important?

A)"Be sure to treat your cat for fleas."
B)"Don't take this unless the scratch gets infected."
C)"Make sure he takes all of this antibiotic."
D)"You should not have cats around small children."

Question 31

A parent brings her child to the pediatric clinic and reports that the child has a rash on one side of his body that reminds her of chickenpox,but is more painful.Which medication does the nurse anticipate teaching the parent about?

A)Acyclovir (Zovirax)
B)Azathioprine (Imuran)
C)Diphenhydramine (Benadryl)
D)Intravenous immune globulin (IVIG)

Question 32

The pediatric nurse is discharging a child diagnosed with cytomegalovirus infection (CMV).Which teaching is most appropriate for this child?

A)Ensure adequate rest.
B)Keep the child isolated.
C)Offer favorite foods.
D)Provide plenty of fluids.

Question 33

The pediatric nurse explains to a nursing student about the most important role the nurse has in preventing disease.What does this role include?

A)Ensuring that immunizations are up to date in all children
B)Facilitating research on new forms of immunizations
C)Giving reminders about immunizations to parents in clinic
D)Scheduling and conducting immunization clinics

Question 34

The pediatric charge nurse receives this report on an incoming admission: a 3-year-old boy with ear and jaw pain,bilateral parotid gland swelling,and mild dehydration.Which action by the charge nurse is most appropriate?

A)Do not assign pregnant nursing staff.
B)Inform parents that sterility is common.
C)Place the child on droplet precautions.
D)Place the child on airborne precautions.

Question 35

A nurse has given an infant a vaccination.Which information is important to document specifically for this vaccination?

A)Date of next regularly scheduled immunization
B)Drug,dose,site of administration,infant's reaction
C)Parental education provided before administration
D)Vaccine information sheet given before administration

Question 36

A parent is refusing to have a child vaccinated,preferring to have the child contract the illness and develop "natural immunity." Which response by the nurse is best?

A)"I'm sure you know what is best for your baby."
B)"I'll have to report you to social work."
C)"That practice is dangerous and illegal."
D)"These diseases have many serious consequences."

Question 37

A child has been diagnosed with influenza and is prescribed oseltamivir (Tamiflu).Which instruction by the nurse is most important?

A)"Do not use aspirin with this drug."
B)"Encourage plenty of liquids."
C)"Rinse the inhaler after each use."
D)"This will cure the flu in 5 days."

Question 38

A child is seen in the emergency department after being bitten by a squirrel while playing outside.Which discharge instruction to the parents is most important?

A)"Give acetaminophen (Tylenol)for pain."
B)"Have the child rest tonight."
C)"Keep the wound clean and dry."
D)"Return here in 3 days."

Question 39

A child has been diagnosed with a localized herpes simplex virus (HSV)type 1 infection.The nurse is educating the parents on topical acyclovir (Zovirax)ointment.Which statement by the nurse is most appropriate to include during the medication teaching session?

A)"Acyclovir can shorten the outbreak."
B)"If this doesn't work we can give it IV."
C)"This medication will cure the infection."
D)"Zovirax must be used for the child's life."

Question 40

The clinic nurse is assessing a teenage girl who reports fever,chills,sore throat,and extreme fatigue during the last 2 weeks.Which focused assessment should the nurse perform?

A)Assess lymph nodes.
B)Collect buccal swabs.
C)Obtain a urinalysis.
D)Palpate the abdomen.

Question 41

The pediatric nurse explains to a student that which actions are most important in preventing and controlling infections? (Select all that apply.)

A)Administering antibiotics
B)Educating the public
C)Monitoring for outbreaks
D)Providing immunizations
E)Scheduling physical exams

Question 42

The student studying pediatric infectious diseases recognizes that the epidemiological triangle consists of which concepts? (Select all that apply.)

A)Agent
B)Communicable period
C)Environment
D)Host
E)Virulence

Question 43

An 8-year-old child is in the clinic and is diagnosed with ringworm.Which medications does the nurse anticipate teaching the child and parents about? (Select all that apply.)

A)Griseofulvin (Fulvicin)
B)Infliximab (Remicade)
C)Ketaconazole (Selenium)
D)Naproxen (Naprosyn)
E)Salicylates (Aspirin)

Question 44

The pediatric clinic nurse assesses a child who reports swallowing problems and skin changes on the hands in response to cold exposure.Which other manifestations will the nurses assess for in this child? (Select all that apply.)

A)Calcinosis
B)Fungal nail infections
C)Oral thrush
D)Sclerodactyly
E)Telangiectasias

Question 45

A nurse is caring for an HIV-positive school-age child who is moderately malnourished.Which interventions are appropriate to include in this child's plan of care? (Select all that apply.)

A)Assess the oral cavity once a shift.
B)Determine the child's food preferences.
C)Encourage adequate fluid intake.
D)Provide oral hygiene after each meal.
E)Teach the parents about tube feedings.

Question 46

The family practice nurse counsels parents to avoid giving their child salicylates for fever or mild pain.Which over-the-counter medications does the nurse warn about that contain this product? (Select all that apply.)

A)Alka-Seltzer
B)Bufferin
C)Dristan
D)Kaopectate
E)Robitussin

Question 47

The pediatric nurse is aware of the Core Strategies to reduce the spread of MRSA.Which actions do these strategies include? (Select all that apply.)

A)Assess hand-hygiene practices.
B)Implement contact precautions.
C)Rapid reporting of MRSA laboratory results
D)Recognize previously colonized patients.
E)Screen all patients for MRSA.

Question 48

A nurse is educating a community group of parents about prevention of West Nile virus.Which information does the nurse include in the teaching session? (Select all that apply.)

A)All children should be sprayed with DEET before going outside.
B)Eliminate standing water around your house,such as in birdbaths.
C)Holistic mosquito repellent,such as lavender,is very effective.
D)Long sleeves and long pants help prevent mosquito bites.
E)The peak season for this virus is late summer to early autumn.

Question 49

The nurse is caring for a 15-year-old suspected of having HIV infection.Which laboratory tests does the nurse anticipate will be ordered for this patient? (Select all that apply.)

A)ELISA antibody test
B)IgA quantification test
C)Saliva antibody test
D)Urine HIV antigen test
E)Western blot test

Question 50

A child has been hospitalized with rubeola.Which actions by the nursing staff are most important? (Select all that apply.)

A)Administer ordered antibiotics on time.
B)Assess the child for Koplik's spots.
C)Ensure the room is dark for photophobia.
D)Monitor the child for febrile seizures.
E)Report the disease to health authorities.