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Communicable diseases
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100
The nurse is careful to apply only the prescribed amount of ointment to the skin of a 2 month old because the infant’s skin, compared to the adult’s, has: a. less perfusion. b. greater moisture. c. more perspiration. d. greater absorption.
What is ANS: D The child’s skin has a dramatically greater ability to absorb than does that of the adult.
100
A group of football players is taking oral griseofulvin for tinea pedis. The school nurse cautions that while they are taking this medication they should avoid: a. citrus fruit and juice. b. eating shellfish. c. alcohol consumption. d. taking corticosteroids.
What is ANS: C Consumption of alcohol while taking griseofulvin will cause severe tachycardia.
100
An allergy to which of the following would contraindicate the use of silver sulfadiazine (Silvadene) as a topical agent for burns? a. Penicillin b. Iodine c. Tetanus immunizations d. Sulfa
What is ANS: D The use of Silvadene cream on burns is contraindicated if the patient has a sulfa allergy.
100
The nurse takes into consideration that the child most susceptible to an opportunistic infection is the one taking a(n): a. anticonvulsant. b. beta-adrenergic agent. c. antibiotic. d. corticosteroid.
What is ANS: D Steroids are immunosuppressive drugs that make the child very susceptible to opportunistic infections.
100
A parent is concerned because her son was exposed to varicella at preschool. The nurse would tell this parent that the incubation period for varicella is _____ days. a. 2 to 10 b. 4 to 14 c. 3 to 32 d. 14 to 21
What is ANS: D The incubation period for varicella is 2 to 3 weeks, usually 13 to 17 days.
200
The nurse takes into consideration that children who have been diagnosed with infantile eczema have an increased risk of: a. pneumonia. b. acne. c. sun sensitivity. d. asthma.
What is ANS: D Some children with eczema also develop asthma and hay fever–type allergies.
200
Before the 17-year-old girl starts a protocol of isotretinoin (Accutane) for her acne, the nurse should suggest that she first: a. get a prescription for oral contraceptives. b. increase the dose of present medication. c. limit intake of chocolate, cola, and peanuts. d. increase exposure to sunlight.
What is ANS: A Oral contraceptives are often prescribed for adolescents with acne. Accutane can cause birth defects, so pregnancy should be prevented
200
What would help the child with a serious burn meet nutritional needs during the subacute phase of recovery? a. Decrease calories because the child will be on bed rest and will not need as many. b. Increase calories and protein to compensate for the healing process. c. Increase fat to replace the layer of fat next to the burned skin. d. Decrease carbohydrates and starches because the pancreas is strained by the healing process.
What is ANS: B Frequent meals and snacks high in calories, protein, and iron are needed to meet the increased metabolic needs of the child with burns.
200
When the 8-year-old asks the nurse how she got the antibodies that kept her from getting whooping cough, the nurse explains that those shots: a. were borrowed antibodies from another person who had whooping cough. b. gave her a tiny case of whooping cough and then she made her own antibodies. c. strengthened antibodies she was born with. d. are only temporary borrowed antibodies and she needs to have another shot every 5 years.
What is ANS: B Vaccines contain live weakened or dead organisms not strong enough to cause disease but they stimulate the body to develop an immune reaction and antibodies. This is active acquired immunity.
200
The nurse can be assured that parents understand how long a child who has varicella is contagious when they state “My child: a. should stay home from school for 6 days after the pox appear.” b. can return to school when the rash fades.” c. must stay away from other children until all of the lesions have healed.” d. is contagious as long as he has a fever.”
What is ANS: A The child with varicella is contagious for 6 days after the appearance of the rash.
300
The appropriate technique for the application of a topical treatment for a child with eczema is to: a. apply skin lotions in a circular motion. b. apply prescribed ointments with a gloved hand. c. apply as much and as frequently as relieves the symptoms. d. choose lanolin-based ointments.
What is ANS: B The prescribed amount of ointment is usually applied to the skin by a gloved hand in long, smooth strokes. Lanolin-based preparations should be avoided because of a possible allergy to wool.
300
The nurse assesses a major burn as _____-thickness burn involving _____% of the body surface. a. partial; 10 b. partial; 12 c. full; 20 d. full; 5
What is ANS: C A full-thickness burn involving 10% or more of the body surface is considered a major burn.
300
The statement made by a parent indicating an understanding of the topical application of medications for a skin condition is: a. “I apply the medication after I give my child a bath.” b. “I rub the ointment in a circular motion over the rash.” c. “I increased the amount of cream because the rash was not improving.” d. “I use powder and cornstarch to keep the skin dry.”
What is ANS: A Absorption of topical medications is best when preparations are applied after a warm bath.
300
The nurse would document a rash that has erythematous circular raised lesions as: a. macular. b. papular. c. vesicular. d. pustular.
What is ANS: B A papule is a circular, reddened elevated area on the skin.
300
The statement made by a sexually active adolescent girl indicating an understanding of the prevention of sexually transmitted diseases is: a. “I always douche after intercourse.” b. “I think you can get a vaccination for STDs now.” c. “I insist that my partner wear a condom.” d. “I am protected because I take the pill.”
What is ANS: C The use of condoms to prevent STDs is not considered 100% effective but is recommended for sexual intercourse.
400
When the 2-day-old infant is noted to have small pustules on her skin, the nurse should: a. report it immediately because it may be a staphylococcus infection. b. keep the affected area dry and clean. c. teach the parents how to care for seborrheic dermatitis. d. chart the finding as it may be the beginning of a strawberry nevus.
What is ANS: A A staphylococcal infection can spread readily from one infant to another. Small pustules on the newborn must be reported immediately
400
9. A child had a burn evidenced by pink skin and blistering. The child complains of pain and is crying. The nurse documents the burn as: a. first-degree. b. second-degree superficial. c. second-degree deep dermal. d. third-degree.
What is ANS: B A second-degree superficial burn appears blistered, moist, and pink or red. The pain associated with this burn indicates tissue viability.
400
On the first day following a severe burn, the body’s fluid reserves have left the circulating volume and entered the interstitial space, causing massive edema. The nurse monitors the burn victim very closely for: a. increasing intracranial pressure. b. reduced urine output. c. eschar formation. d. fluid overload.
What is ANS: B With the fluid shift associated with severe burns, the nurse must be observant for the reduction of urine, an indication of altered renal function.
400
The nurse would delay the administration of DTaP when the mother says that her infant: a. has diarrhea. b. had a temperature of 40.5 C (105 F) from the previous inoculation. c. is teething. d. is traveling with her to Europe in a week.
What is ANS: B A contraindication to giving the DTaP vaccine is a 40.5 C (105 F) temperature following the previous vaccination.
400
The priority nursing diagnosis for a hospitalized infant who is HIV positive would be: a. risk for injury. b. altered nutrition. c. impaired skin integrity. d. risk for infection.
What is ANS: D The infant who is HIV positive has impaired immunologic functioning and is at high risk for infection.
500
The home health nurse discovers a family infected with pediculosis and helps the mother understand ways to start eradication of the lice, such as: a. covering the hair with Vaseline. b. applying a soda-vinegar solution to the hair. c. combing through the hair with a vinegar-water solution. d. shampooing the hair with dish detergent.
What is ANS: C Combing a vinegar and water solution through the hair with a fine-tooth comb and then shampooing is an initial step toward eradication.
500
The best first action to take when a child sustains a second-degree deep thermal burn to the hand is to: a. immerse the burned area in cold water. b. apply ice to the burned area. c. break any blisters that are present. d. apply petroleum jelly to the burned skin.
What is ANS: A First-aid treatment of a second-degree deep thermal burn is immersion of the burned area in water to halt the burning process.
500
At a 2-month well-child visit, parents ask the nurse about the red area on the infant’s neck. They tell the nurse that the mark appeared a few weeks after birth. The nurse recognizes this skin lesion as: a. a port wine nevus. b. a strawberry nevus. c. exanthem. d. intertrigo.
What is ANS: B The strawberry nevus is a common hemangioma consisting of dilated capillaries in the dermal space, which may not become apparent for a few weeks after birth.
500
The type of precautions necessary when caring for a toddler with varicella is: a. contact. b. protective. c. airborne infection. d. large droplet infection.
What is ANS: C Airborne-infection precautions are used for patients with conditions such as tuberculosis, varicella, and rubeola. Small airborne particles caught on floating dust in the room can be inhaled from anywhere in the room.
500
The mother of a newborn asked the nurse, “When will my baby get the hepatitis B vaccine?” The nurse bases a response on the knowledge that the first dose of Comvax should be given to infants born to a hepatitis B-positive mother within _____ after birth. a. 12 hours b. 2 weeks c. 1 month d. 2 months
What is ANS: A The American Academy of Pediatrics recommends that Comvax, the only thimerosal-free hepatitis B vaccine, should be used for infants born to HBsAg-positive mothers within 12 hours of birth.