Question 1

Parents report their 3-year-old child appears restless at night and frequently scratches her anal area.What action by the nurse is best?

Accepted Answer

The cellophane tape test is used to diagnose pinworms.The parents place a strip of cellophane tape on the child's anus at bedtime and brings it to the clinic for microscopic evaluation.There is no need to review hygienic practices,suggest sleeping in a pajama top only,or to bring in a stool sample.

Question 2

What should be included in health teaching to prevent Lyme disease?

Accepted Answer

Insect repellant with DEET can prevent insect bites.Currently there is no vaccine available for Lyme disease.Antibiotics are used to treat,not prevent,Lyme disease.Children should be allowed to maintain normal growth and development with activities such as hiking.

Question 3

Which intervention is appropriate for a hospitalized child who has crops of lesions on the trunk that appear as a macular rash and vesicles?

Accepted Answer

The child's skin lesions are characteristic of varicella.Varicella is trAnswermitted through direct contact,droplets,and airborne particles.In the hospital setting,children with varicella should be placed in strict isolation,and on contact and airborne precautions.The purpose is to prevent trAnswermission of microorganisms by inhalation of small-particle droplet nuclei and to protect other patients and health care providers from acquiring this disease.Standard Precautions are not sufficient for this disease.Certain viral illnesses such as rubella and fifth disease are known to affect the fetus if the woman contracts the disease during pregnancy.This child appears to have varicella.Pregnancy is not a contraindication to caring for a child with varicella.However,all health care personnel should be vaccinated or show immunity to varicella.Screening visitors for immunity to measles is irrelevant.It is important to screen visitors for immunity to varicella.

Question 4

Which statement made by a parent about intervention for a child's fever shows the need for further education?

Accepted Answer

Aspirin products are avoided because of the possibility of development of Reye's syndrome.The parent should check labels on all over-the-counter products to be sure they do not contain aspirin.Ibuprofen is alright to give children.Dressing the child in light clothing and using lightweight covers will help reduce fever and promote the child's comfort.Adequate hydration will help maintain a normal body temperature.Acetaminophen is also recommended for fever in children.

Question 5

The nurse in the pediatric clinic is caring for a child and assesses this skin rash.What action by the nurse is best?

Accepted Answer

This rash is characteristic of scarlet fever.The parents should provide soft,bland food.The child is not contagious 24 hours after starting antibiotics.There is no indication the child is sick enough to need hospitalization.The parents should encourage rest.

Question 6

An adolescent has been diagnosed with the Epstein-Barr virus.What discharge information should the nurse give to the parents?

Accepted Answer

The recovery period is often lengthy and fatigue may continue,necessitating a gradual return to school activities.During the acute and recovery phases,activity restrictions,which include no contact sports or roughhousing,are implemented to protect the child's enlarged spleen from rupture.The recovery process from infectious mononucleosis is a slow and gradual one.Prolonged rest (not bedrest)is indicated during the acute stage of the illness only.

Question 7

Which statement made by an adolescent girl indicates an understanding about the prevention of sexually transmitted diseases (STDs)?

Accepted Answer

Abstinence is the only foolproof way to prevent an STD.STDs are trAnswermitted through body fluids (semen,vaginal fluids,blood).Perineal hygiene will not prevent an STD.Oral contraceptives do not protect women from contracting STDs.A condom can reduce but not eliminate an individual's chance of acquiring an STD.However,the nurse should encourage condom use 100% of the time to decrease the risk.

Question 8

Which STD should the nurse suspect when an adolescent girl comes to the clinic because she has a vaginal discharge that is white with a fishy smell?

Accepted Answer

Bacterial vaginosis is characterized by a profuse,white,malodorous (fishy smelling)vaginal discharge that sticks to the vaginal walls.Manifestations of the human papillomavirus are anogenital warts that begin as small papules and grow into clustered lesions.Infections with Trichomonas are frequently asymptomatic.Symptoms in females may include dysuria,vaginal itching,burning,and a frothy,yellowish-green,foul-smelling discharge.Many people with chlamydial infection have few or no symptoms.Urethritis with dysuria,urinary frequency,or mucopurulent discharge may indicate chlamydial infection.

Question 9

A preschooler is diagnosed with helminths.The child's mother is very upset and wants to know how her child could have contracted this illness.After obtaining a detailed history,the nurse identifies all possible transmission modes.What do they include? (Select all that apply.)

Accepted Answer

Common helminths include roundworm,pinworm,tapeworm,and hookworm.Children are frequently infected as the result of frequent hand-mouth activity (unwashed hands,nail biting,not washing hands after using the toilet)and the likelihood of fecal contamination from sandboxes (especially if dogs and cats deposit fecal material in them).Other causes include not adequately washing fruits and vegetables before eating them and drinking contaminated water.Skin-to-skin contact with other children and scratches from a cat are not trAnswermission modes for helminths.

Question 10

What should the nurse expect to observe in the prodromal phase of rubeola?

Accepted Answer

Koplik spots appear approximately 2 days before the appearance of a rash.The macular rash with rubeola appears after the prodromal stage.Petechiae on the soft palate occur with rubella.Crops of vesicles on the trunk are characteristic of varicella.

Question 11

Which action is initiated when a child has been scratched by a potentially rabid animal?

Accepted Answer

Human rabies immune globulin and the first dose of the rabies vaccine are given after exposure.TrAnswermission of rabies can occur from bites with contaminated saliva,scratches from the claws of infected animals,airborne trAnswermission in bat-infested caves,or in a laboratory setting.Rabies is fatal if no intervention is taken to prevent the disease.Human rabies immune globulin is infiltrated locally around the wound,and the other half of the dose is given intramuscularly.This is only part of the treatment after rabies exposure.The rabies vaccine is given within 48 hours of exposure and again on days 3,7,14,and 28.

Question 12

What should be included in the care for a neonate who was diagnosed with pertussis?

Accepted Answer

Erythromycin,azithromycin,or clarithromycin is given to all close contacts for the child diagnosed with pertussis.Pertussis does not affect the hemoglobin level.A complication of pertussis is not hearing impairment.Pertussis does not affect platelets.

Question 13

A child taking oral corticosteroids for asthma is exposed to varicella.The child has not had the varicella vaccine and has never had the disease.What intervention should be taken to prevent varicella from developing?

Accepted Answer

For children who are immunosuppressed (such as from corticosteroids),acyclovir is the treatment of choice to prevent infection.Action is needed due to the risk of serious complications.The varicella vaccine is a live virus vaccine and is contraindicated for an immunosuppressed child.An antibiotic is not effective in treating varicella zoster,which is a virus.

Question 14

Which statement indicates that a father understands the treatment for his child who has scarlet fever?

Accepted Answer

It is necessary to give the entire course of antibiotic for 10 to 14 days.Penicillin is the preferred treatment for any streptococcal infection.The bacteria will not be eradicated if a partial course of antibiotics is given.Treatment of scarlet fever does not include topical antibiotic cream.The child is no longer contagious after 24 hours of antibiotic therapy and can return to daycare or school.

Question 15

The mother of an infant with multiple anomalies tells the nurse that she had a viral infection in the beginning of her pregnancy.Which viral infection is associated with fetal anomalies?

Accepted Answer

The rubella virus can cross the placenta and infect the fetus,causing fetal anomalies.Measles is not associated with congenital defects.Most cases of roseola occur in children 6 to 18 months old.HSV can be trAnswermitted to the newborn infant during vaginal delivery,causing multisystem disease.It is not trAnswermitted trAnswerplacentally to the fetus during gestation.

Question 16

A parent asks the nurse how she will know whether her child has fifth disease.The nurse should advise the parent to be alert for which manifestation?

Accepted Answer

Fifth disease manifests with an intense,fiery red,edematous rash on the cheeks,which gives a "slapped cheek" appearance.The bull's-eye rash at the site of a tick bite is a manifestation of Lyme disease.Varicella is manifested as lesions in various stages of development-macule,papule,then vesicle,first appearing on the trunk and scalp.Roseola manifests as a maculopapular rash on the trunk that can last for hours or up to 2 days.

Question 17

A nurse is conducting a health education class for a group of school-age children.Which statement made by the nurse is correct about the body's first line of defense against infection in the innate immune system?

Accepted Answer

The first lines of defense in the innate immune system are the skin and intact mucous membranes.Nutritional status is an indicator of overall health,but it is not the first line of defense in the innate immune system.Immunizations provide artificial immunity or resistance to harmful diseases.Practicing good hygiene may reduce susceptibility to disease,but it is not a component of the innate immune system.

Question 18

What is the best response to a parent of a 2-month-old infant who asks when the infant should first receive the measles vaccine?

Accepted Answer

The first measles,mumps,rubella (MMR)vaccine is recommended routinely at 1 year of age.The other statements are not correct.

Question 19

How should the nurse respond to a parent who asks,"How can I protect my baby from whooping cough?"

Accepted Answer

Primary prevention of pertussis can be accomplished through administration of the pertussis vaccine.Infants do not receive maternal immunity to pertussis and are susceptible to pertussis.Pertussis is highly contagious and is associated with a high infant mortality rate.Prompt evaluation by the primary care provider for respiratory illness will not prevent pertussis.Erythromycin is used to treat pertussis.It will not prevent the disease.

Question 20

A parent brings a child to the emergency department and reports fever,foul smell coming from the throat,and a gray covering over the tonsils.What action by the nurse takes priority?

Accepted Answer

The manifestations are characteristic of diphtheria,which can cause respiratory compromise and airway obstruction.The nurse first assesses the child's respiratory status.Putting the child on a cardiac monitor and oximeter are important interventions,but first the nurse needs to assess the respiratory system.The child will need an IV,but that can be started after the respiratory assessment.

Quiz 41: The Child with an Infectious Disease