NCLEX Style Questions for Integumentary
A school nurse is educating parents about preventing helminth infections in children. Which of the following statements indicates a need for further teaching?
A. "I will make sure my child washes their hands before eating."
B. "Walking barefoot outside is fine as long as the area looks clean."
C. "I should wash fruits and vegetables before giving them to my child."
D. "Keeping my child's fingernails short will help prevent infection."
Answer: B. "Walking barefoot outside is fine as long as the area looks clean."
Rationale:
Some helminths, such as hookworms, can penetrate the skin when a child walks barefoot in contaminated soil. Proper hygiene, washing food, and keeping nails short help prevent infections caused by pinworms, roundworms, and other parasites.
Is Impetigo contagious?
It is HIGHLY contagious
- S/Sx = formation of pustular lesions (honey colored) and nasal discharge containing organisms can erode skin
- children should stay away from school for 24 hours, soap crusts 3x a day, uchild should sleep alone, wear gloves when touching lesions
A nurse is assessing a child with suspected Kawasaki disease. Which of the following findings would most likely confirm the diagnosis?
A. High fever lasting more than 5 days, conjunctivitis, swollen hands and feet, and a rash
B. Fever, productive cough, and coarse crackles in lung bases
C. Severe joint pain, pale skin, and periorbital edema
D. Low-grade fever, weight loss, and night sweats
Answer: A. High fever lasting more than 5 days, conjunctivitis, swollen hands and feet, and a rash
Rationale:
Kawasaki disease is a systemic vasculitis characterized by prolonged fever, bilateral conjunctivitis without exudate, erythema of the hands/feet, a polymorphous rash, and cervical lymphadenopathy. It can lead to coronary artery aneurysms if untreated.
Which disease do we use high doses of aspirin for children?
Kawasaki Disease
- other medications are unable to help fever
What are the pre-procedure and post-procedure nursing care for a venogram?
Pre-Procedure: document presence and quality of pulses (close to insertion site), clear liquids for 3-4 hours, check iodine and shellfish allergies, informed consent
Post-Procedure: pressure dressing on injection site, check site frequently hematoma, bleeding, complete bed rest for 2 hours if femoral vein is used, monitor distal pulses for 4-6 hours (weak if vasospasm - mark them preop), continue IV fluids for 8-24 hours
A nurse is caring for a patient diagnosed with herpes simplex virus type 1 (HSV-1). Which statement by the patient indicates correct understanding of the condition?
A. "Once my cold sore disappears, I won’t be contagious anymore."
B. "I can prevent outbreaks by managing stress and avoiding triggers."
C. "HSV-1 only affects the mouth and never spreads to other areas."
D. "Antiviral medications will completely cure the virus."
Answer: B. "I can prevent outbreaks by managing stress and avoiding triggers."
Rationale:
HSV-1 remains dormant in the body and can reactivate due to stress, illness, or sun exposure. While antiviral medications (e.g., acyclovir, valacyclovir) help reduce the severity and frequency of outbreaks, they do not cure the virus. Cold sores are contagious even when healing.
what are symptoms of type 1 HSV
above the waist: fever, blister, cold sores, corneal lsions
can be there for a couple hours or days before lesions appear and once lesion apears clusters of fluid filled vesicles are what they look like
A child is diagnosed with rheumatic fever. The nurse understands that this condition is caused by:
A. A viral infection
B. A previous streptococcal throat infection
C. A congenital heart defect
D. An allergic reaction to penicillin
Answer: B. A previous streptococcal throat infection
Rationale:
Rheumatic fever is an inflammatory disease that develops after an untreated or inadequately treated Group A streptococcal (GAS) infection, such as strep throat. It can lead to rheumatic heart disease, affecting the heart valves.
Name the toxicity symptoms
Therapeutic Level
What to monitor for
When to hold
Digoxin
Toxicity: green, yellow halo
Dig Level: 0.8-2
Monitor potassium and sodium (affects Dig level)
Hold for
- infants less than 100HR
- children less than 70HR
- adults less than 60HR
What are the three Virchow's Triad and how many do you have to have in order to be diagnosed with VTE?
venous stasis: immobility
hypercoagulability: we see this in cancer patients
injury to venous wall (endothelial damage): direct cause
need to be characterized with 2 out of the 3
A child is diagnosed with tinea capitis. The nurse expects the provider to prescribe which of the following treatments?
A. Topical antifungal cream applied to the scalp
B. Oral griseofulvin for several weeks
C. Antiviral medication to reduce the outbreak
D. Corticosteroid ointment to reduce inflammation
Answer: B. Oral griseofulvin for several weeks
Rationale:
Tinea capitis is a fungal infection of the scalp that affects hair follicles. Oral antifungals (such as griseofulvin or terbinafine) are required for effective treatment, as topical treatments are ineffective for deep fungal infections in the hair shaft.
EXTRA: insoluble with water - take with high fat meal or with milk
If we see HSV Type 2 in a child under the age of 14 - what would we consider?
Child sexual abuse
A nurse is caring for an infant with Tetralogy of Fallot who suddenly develops cyanosis and dyspnea. Which of the following interventions should the nurse perform first?
A. Place the infant in the knee-chest position
B. Administer oxygen via nasal cannula
C. Prepare for emergency intubation
D. Administer IV fluids
Answer: A. Place the infant in the knee-chest position
Rationale:
A "tet spell" or hypercyanotic episode occurs due to decreased pulmonary blood flow. Placing the infant in a knee-chest position increases systemic vascular resistance, reducing the right-to-left shunting and improving oxygenation. Oxygen can be given, but positioning is the priority intervention.
What medication should you avoid in hemophilia and ITP?
NSAIDs
- use tylenol instead
what are the causes of heart murmurs?
Think "SPAMS"
S: stenosis of valve
P: partial obstruction
A: aneurysms
M: mitral regurgitation
S: septal defect
A nurse is educating a patient about preventing the spread of tinea corporis. Which statement by the patient indicates the need for further teaching?
A. "I should avoid sharing towels, clothing, or sports equipment."
B. "Keeping my skin dry and wearing loose clothing can help."
C. "I will stop taking my antifungal medication once the rash disappears."
D. "I should wash my hands frequently to prevent spreading the infection."
Answer: C. "I will stop taking my antifungal medication once the rash disappears."
Rationale:
Patients should complete the full course of antifungal treatment even if symptoms improve, to prevent recurrence. Tinea corporis is highly contagious, and preventing transmission includes good hygiene, avoiding shared items, and keeping the skin dry.
A child is diagnosed with ascariasis (roundworm infection). The nurse understands that the most likely cause of this infection is:
A. Consumption of undercooked pork
B. Walking barefoot in contaminated soil
C. Ingestion of food or water contaminated with roundworm eggs
D. Close contact with an infected pet
Answer: C. Ingestion of food or water contaminated with roundworm eggs
Rationale:
Roundworm infection occurs when a person ingests contaminated food, water, or soil containing Ascaris eggs. The larvae hatch in the intestines, migrate through the lungs, and return to the intestines, where they mature. Proper handwashing and washing fruits/vegetables reduce the risk of infection.
A child with sickle cell disease is admitted with vaso-occlusive crisis. Which of the following interventions is the priority?
A. Apply ice packs to affected joints
B. Encourage ambulation and active movement
C. Administer IV fluids and opioids
D. Restrict fluid intake
Answer: C. Administer IV fluids and opioids
Rationale:
Vaso-occlusive crisis leads to severe pain and dehydration, which worsens sickling of red blood cells. IV hydration helps reduce sickling, and opioids (such as morphine) are given to manage pain. Ice packs are contraindicated because they cause vasoconstriction, worsening the crisis.
What lab(s) would you monitor for IV Heparin
aPTT
(SubQ heparin - monitor platelets, Hmg, Hct)
TOF = harsh systolic murmur
PDA = continuous murmur, machinery like
Which of the following instructions should a nurse include when teaching a patient about preventing tinea pedis?
A. Walk barefoot in locker rooms to allow feet to dry naturally
B. Wear the same socks for multiple days to prevent excessive washing
C. Apply antifungal powder or spray to shoes and feet daily
D. Keep feet moist by wearing closed-toe shoes all day
Answer: C. Apply antifungal powder or spray to shoes and feet daily
Rationale:
Tinea pedis (athlete’s foot) flourishes in warm, moist environments. Applying antifungal powder or spray to the feet and shoes helps prevent fungal growth. Patients should wear breathable shoes, change socks frequently, and avoid walking barefoot in public areas to reduce the risk of infection.
A patient presents with unexplained weight loss, nausea, and mild abdominal discomfort. Stool testing confirms Taenia solium (pork tapeworm). Which intervention should the nurse anticipate?
A. Administration of albendazole or praziquantel
B. High-fiber diet and laxatives to help eliminate the parasite
C. Increased fluid intake to flush out the infection
D. Intravenous antibiotics to kill the tapeworm
Answer: A. Administration of albendazole or praziquantel
Rationale:
Tapeworm infections are treated with anthelmintic medications such as praziquantel or albendazole, which kill the parasite. A high-fiber diet may help with elimination, but medication is required to kill the tapeworm. Antibiotics are ineffective against helminths.
Which of the following heart sounds is characteristic of a patent ductus arteriosus?
A. Loud S1 with a widely split S2
B. Continuous machinery-like murmur
C. Harsh systolic murmur heard best at the left sternal border
D. Low-pitched diastolic murmur
Answer: B. Continuous machinery-like murmur
Rationale:
A PDA occurs when the fetal ductus arteriosus fails to close after birth, leading to persistent blood flow between the aorta and pulmonary artery. This causes a continuous, machine-like murmur heard best at the left upper sternal border.
What are some important teaching tools for oral iron?
- take with water or fruit juices
- take on an empty stomach (unless having GI upset)
- stool: greenish, gray, black color
- do not take with milk, caffeine, antacids or calcium supplements (take 2 hours apart)
what causes pale conjunctiva?
anemia