Child Health - Integumentary

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Author:
nursedaisy98
ID:
256697
Filename:
Child Health - Integumentary
Updated:
2014-04-20 10:42:06
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NCLEX RN
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Child Health
Description:
Integumentary
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  1. The nurse is monitoring a child with burns during treatment for burn shock. The nurse understands that which assessment provides the most accurate guide to determine the adequacy of fluid resuscitation? 
    1. Skin turgor 
    2. Neurological assessment 
    3. Level of edema at burn site 
    4. Quality of peripheral pulses
    2. Neurological assessment
  2. The mother of a 3-year-old child arrives at a clinic and tells the nurse that the child has been scratching the skin continuously and has developed a rash. The nurse assesses the child and suspects the presence of scabies. The nurse bases this suspicion on which finding noted on assessment of the child's skin? 
    1. Fine grayish red lines 
    2. Purple-colored lesions 
    3. Thick, honey-colored crusts 
    4. Clusters of fluid-filled vesicles
    1. Fine grayish red lines
  3. Permethrin (Elimite) is prescribed for a child with a diagnosis of scabies. The nurse should give which instruction to the parents regarding the use of this treatment? 
    1. Apply the lotion to areas of the rash only. 
    2. Apply the lotion and leave it on for 6 hours. 
    3. Avoid putting clothes on the child over the lotion. 
    4. Apply the lotion to cool, dry skin at least 30 minutes after bathing.
    4. Apply the lotion to cool, dry skin at least 30 minutes after bathing.
  4. The school nurse has provided an instructional session about impetigo to parents of the children attending the school. Which statement, if made by a parent, indicates a need for further instruction? 
    1. "It is extremely contagious." 
    2. "It is most common in humid weather." 
    3. "Lesions most often are located on the arms and chest." 
    4. "It might show up in an area of broken skin, such as an insect bite."
    3. "Lesions most often are located on the arms and chest."
  5. The clinic nurse is reviewing the health care provider's prescription for a child who has been diagnosed with scabies. Lindane has been prescribed for the child. The nurse questions the prescription if which is noted in the child's record? 
    1. The child is 18 months old. 
    2. The child is being bottle-fed. 
    3. A sibling is using lindane for the treatment of scabies. 
    4. The child has a history of frequent respiratory infections.
    1. The child is 18 months old.
  6. A topical corticosteroid is prescribed by a health care provider for a child with atopic dermatitis (eczema). Which instruction should the nurse give the parent about applying the cream? 
    1. Apply the cream over the entire body. 
    2. Apply a thick layer of cream to affected areas only. 
    3. Avoid cleansing the area before application of the cream. 
    4. Apply a thin layer of cream and rub it into the area thoroughly.
    4. Apply a thin layer of cream and rub it into the area thoroughly.
  7. The school nurse is conducting pediculosis capitis (head lice) assessments. Which finding indicates a child has a "positive" head check? 
    1. Maculopapular lesions behind the ears 
    2. Lesions in the scalp that extend to the hairline or neck 
    3. White flaky particles throughout the entire scalp region 
    4. White sacs attached to the hair shafts in the occipital area
    4. White sacs attached to the hair shafts in the occipital area
  8. The nurse caring for a child who sustained a burn injury plans care based on which pediatric considerations associated with this injury? Select all that apply. 
    1. Scarring is less severe in a child than in an adult. 
    2. A delay in growth may occur after a burn injury. 
    3. An immature immune system presents an increased risk of infection for infants and young children. 
    4. The lower proportion of body fluid to mass in a child increases the risk of cardiovascular problems. 
    5. Fluid resuscitation is unnecessary unless the burned area is more than 25% of the total body surface area. 
    6. Infants and young children are at increased risk for protein and calorie deficiency because they have smaller muscle mass and less body fat than adults.
    • 2. A delay in growth may occur after a burn injury. 
    • 3. An immature immune system presents an increased risk of infection for infants and young children. 
    • 6. Infants and young children are at increased risk for protein and calorie deficiency because they have smaller muscle mass and less body fat than adults.
  9. The nurse is developing a plan of care for a 10-year-old girl with an exacerbation of eczema. Which problem should be addressed in the care for this child? 
    1. The client is at risk for infection related to viral lesions. 
    2. The client is at risk for infection related to scratching of pruritic lesions. 
    3. The client may have poor nutritional intake related to throat edema and mouth ulcers. 
    4. The client may have a negative body image related to the presence of thick, white crusty plaques over the elbows and knees.
    2. The client is at risk for infection related to scratching of pruritic lesions.
  10. The nurse is providing a yearly summer educational session to parents in a local community. The topic of the session is prevention and treatment measures for poison ivy. The nurse instructs the parents that if the child comes into contact with poison ivy to take which action? 
    1. Immediately report to the emergency department. 
    2. Avoid becoming concerned if a rash is not noted on the skin. 
    3. Apply calamine lotion immediately to the exposed skin areas. 
    4. Shower the child immediately, lathering and rinsing the exposed skin several times.
    4. Shower the child immediately, lathering and rinsing the exposed skin several times.
  11. A 2-year-old child is admitted to a hospital burn unit with partial- and full-thickness burns involving 35% of body surface area. After admission assessment and review of the health care provider's prescriptions, the priority nursing intervention should focus on which action? 
    1. Inserting a Foley catheter 
    2. Inserting a nasogastric tube 
    3. Sedating with morphine sulfate 
    4. Restricting intravenously administered fluids
    1. Inserting a Foley catheter
  12. The nurse is counseling the young mother of a small child recently diagnosed with impetigo. The nurse should make which statement that provides the best information about impetigo? 
    1. "The main treatment while your daughter has impetigo will be to force fluids." 
    2. "Your daughter probably caught the impetigo because you don't wash her hands enough." 
    3. "There is no risk of passing impetigo to the other children once you begin the prescribed antibiotics." 
    4. "You will need to prevent any of the fluid from the blisters around your daughter's mouth from coming into contact with your other children, especially if they already have skin injuries."
    4. "You will need to prevent any of the fluid from the blisters around your daughter's mouth from coming into contact with your other children, especially if they already have skin injuries."
  13. Nursing care of the infant with eczema should focus on which action as a priority nursing intervention? 
    1. Keeping the infant content 
    2. Maintaining adequate nutrition 
    3. Applying antibiotic ointment to lesions 
    4. Preventing secondary infection of the lesions
    4. Preventing secondary infection of the lesions
  14. The nurse is estimating the body surface area of a child with a burn injury using the West nomogram. After noting the child's height (45 inches) and weight (65 lb), the nurse reads the nomogram and determines that the body surface area is approximately which number?

    1. 0.2 
    2. 1.0 
    3. 1.9 
    4. 2.0
    2. 1.0
  15. The nurse is verifying that a mother understands how to care for her infant who has thrush. Which comment by the mother would indicate that further teaching is indicated? 
    1. "I will feed my baby before I apply the medication." 
    2. "I can put the medication in my son's bottle for him to drink." 
    3. "I need to thoroughly clean all bottles and nipples after every use." 
    4. "I will slowly put the medication in each cheek of my baby's mouth."
    2. "I can put the medication in my son's bottle for him to drink."
  16. The nurse is collecting data on a child brought to the health care clinic by the mother with a 1-week-old cat scratch. While assessing the scratch the nurse notes redness, heat, swelling, and red streaking surrounding the area. The child states that the scratch hurts. Cellulitis is diagnosed. When providing home care instructions, which statement by the mother indicates a need for further teaching? 
    1. "The child should rest in bed." 
    2. "I will apply cool moist soaks every 4 hours." 
    3. "I should take the child's temperature and watch for a fever." 
    4. "The affected extremity should be elevated and immobilized."
    2. "I will apply cool moist soaks every 4 hours."
  17. A nurse reinforces instructions to the mother of a child diagnosed with pediculosis (head lice). Permethrin 1% (Nix) has been prescribed. Which statement by the mother regarding the use of the medication indicates a need for further teaching? 
    1. "I need to purchase the medication from the pharmacy." 
    2. "After rinsing out the medication, I need to avoid washing my child's hair for 24 hours." 
    3. "I need to shampoo my child's hair, apply the medication, and leave the medication on for 24 hours." 
    4. "I need to shampoo my child's hair, apply the medication, and leave it on for 10 minutes and then rinse it out."
    3. "I need to shampoo my child's hair, apply the medication, and leave the medication on for 24 hours."

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