Question 1

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?

Accepted Answer

This girl's age and symptoms are highly suggestive of infectious mononucleosis.The nurse should assess for swollen and tender occipital and cervical lymph nodes.The nurse should not palpate the abdomen because the spleen,if enlarged,can rupture under pressure.Buccal swabs and urinalysis are not related.

Question 2

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?

Accepted Answer

Hospitalized children who have mumps require droplet precautions.There is no danger to a fetus.Sterility is possible in male children due to orchitis,but it is rare.

Question 3

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

Accepted Answer

This urine output is normal,demonstrating that the goals for the diagnosis of risk for fluid volume deficit have been met.The other outcomes are demonstrative of met goals,but do not take priority over a possible fluid volume deficit.

Question 4

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

Accepted Answer

Fifth's disease is spread through respiratory droplets,so droplet precautions are appropriate.Of course standard precautions should be used with all patients,but this is not enough in this situation.Contact and protective precautions are not needed for this disease.

Question 5

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

Accepted Answer

Lamivudine is used in children with HIV infection or AIDS.It is a nucleotide reverse transcriptase inhibitor.The CD4⁺ is the critical laboratory value to monitor in these children.

Question 6

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?

Accepted Answer

Acyclovir and penciclovir (Danavir)can be used to shorten the duration and lessen the pain of HSV infection.It is not curative.IV medication is used for disseminated infection or in children with severe immunocompromise.The medication is used during outbreaks.

Question 7

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

Accepted Answer

The most common problem for children during the convalescent phase after acute CMV infection is fatigue.The nurse teaches the parents to ensure the child gets plenty of rest.Adequate nutrition and hydration are always important and are not specific for this condition.The child does not need to be isolated.

Question 8

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

Accepted Answer

The nurse is legally required to provide the appropriate vaccine information sheet to the parent/guardian prior to administering a vaccination.The other information is important to document too,but is not specific for vaccinations.

Question 9

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

Accepted Answer

Immunizations are the cornerstone of communicable disease prevention.The most important role the nurse has related to this topic is to ensure that all children in contact with him or her have vaccinations that are up to date.The other activities can be important components of disease prevention,but are not as important.

Question 10

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?

Accepted Answer

Children with chickenpox are contagious from 1-2 days prior to the rash erupting until the time when all the lesions have crusted over,usually about 7 days.The parents of this child should inform the other parents about their children's exposure to the disease.The disease is spread via airborne and contact routes.Immune globulin can be used within 72 hours after an exposure in immunosuppressed children.

Question 11

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

Accepted Answer

The most serious consequence of rubella infection occurs prenatally; exposure in utero can lead to impairment,deafness,eye disorders,cardiac defects,and stillbirth.Pregnant staff should not enter this room.Disallowing produce is not related to this disorder.Contact precautions are not warranted; this disease is spread through the airborne route.Standard precautions are used for all patients.

Question 12

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?

Accepted Answer

This child's complaint sounds like oral thrush.Often seen in infants,it can also be caused by inhaler use in children with asthma.The other questions are not related.

Question 13

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?

Accepted Answer

This rash sounds like herpes zoster (shingles),which is treated with acyclovir.Imuran is used in autoimmune disorders.Benadryl is used for itching.IVIG is also used in immune disorders.

Question 14

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?

Accepted Answer

Common comfort measures for sinus or respiratory problems include a cool-mist steamer,decongestants,and gentle nasal suctioning.A warm facial compress would be more helpful.Sine-Off over-the-counter sinus medication contains salicylates,or aspirin compounds,which are not given to children due to the risk of Reye's syndrome.

Question 15

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?

Accepted Answer

As with any antibiotic,taking all the prescribed medication is a priority instruction.For some reason,cats with fleas have higher rates of the bacteria that causes the disease,so flea control is important.The other two instructions are not appropriate.

Question 16

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

Accepted Answer

Common side effects of Tamiflu include nausea,vomiting,GI distress,and diarrhea.The child should drink plenty of fluids to avoid dehydration.Aspirin is not used in children at all due to the risk of Reye's syndrome.Tamiflu is not given via inhaler.The medication is not curative.

Question 17

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?

Accepted Answer

Parents do have the right to refuse vaccinations,but the nurse has the responsibility of ensuring the parents have adequate information about the diseases and vaccinations.Informing the parent about possible consequences of contracting a disease is an important part of this job.The nurse should not just acquiesce and say the parent knows best without educating him or her.The other two options are threatening,and it is not illegal for a parent to opt out of vaccinations.

Question 18

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?

Accepted Answer

After caring for patients with potential or actual infectious diarrhea,hand hygiene is performed using soap and hot water.The other actions are correct.

Question 19

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?

Accepted Answer

A person who had a bout with a resistant bacteria may be colonized.Many facilities require placing such patients in isolation until this has been ruled out.This is the most factual and informative answer.Contaminating the nursing staff is not really the problem; the nursing staff spreading the organism to susceptible patients is.The nurse should provide information and not just call someone else to explain.Telling the parents that this practice is policy may be true,but does not give them any information.

Question 20

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?

Accepted Answer

This child is at risk of rabies.Because of the disease's potentially fatal course,it is imperative that the child complete the rabies vaccination series.Rabies vaccination is given on the day of exposure,and then again on days 3,7,and 14.The other instructions are not specific for this disease.

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