PEDs Chapt 15 Nursing Care of the Child with an Infectious or Communicable Disorder QUESTIONS AND ANSWERS ALL 100% CORRECT

Document Content and Description Below

A young patient arrives at the clinic with a rash on the trunk and flexor surfaces of the extremities. The mother informs the nurse that the rash started a day before on the exterior surfaces of the e... xtremities; 2 days before, the child had a really bad rash on the face. The physician diagnoses the child with erythema infectiosum. The nurse tells the mother that this is also known as which of the following? a) Pityriasis rosea b) Fifth disease c) Enterovirus d) Rosacea Correct Answer: Fifth disease Correct Explanation: Erythema infectiosum is also known as "fifth disease." It starts with a fever, headache, and malaise. One week later, a rash appears on the face. A day later, the rash appears on the extensor surfaces of the extremities. One more day later, the rash appears on the trunk and flexor surfaces of the extremities. A child is brought to the emergency department by his parents. The parents report that he stepped on a rusty nail about a week and a half ago. The child is complaining of cramping in his jaw and some difficulty swallowing. The nurse suspects tetanus. When assessing the child, the nurse would be alert to which muscle groups being affected next? a) Legs b) Stomach c) Neck d) Arms Correct Answer: Neck Correct Explanation: Tetanus progresses in a descending fashion to other muscle groups, causing spasms of the neck, arms, legs, and stomach. The rash in roseola is pruritic. Which of the following measures would you teach the father to provide comfort? a) Discuss with the child the importance of not scratching lesions. b) Dress the child warmly to bring out the rash so that it fades quickly. c) Apply cool compresses to the skin to stop local itching. d) Administer infant aspirin every 4 hours as necessary for comfort. Correct Answer: Apply cool compresses to the skin to stop local itching. Explanation: Cool compresses can minimize pruritus. Aspirin should not be given with increased temperature (flu-like symptoms). The appearance of which hallmark clinical manifestation occurs in measles? a) Koplik spots b) Fever c) Cough d) Conjunctivitis Correct Answer: Koplik spots Correct Explanation: The hallmark of measles is the appearance of Koplik spots. Other typical symptoms include fever, conjunctivitis, and a cough. Parents usually ask when their child can return to school after having chickenpox. The correct answer would be a) as soon as all lesions are crusted. b) as soon as the temperature is normal. c) 10 days after the initial lesions appear. d) not until all lesions have completely faded. Correct Answer: as soon as all lesions are crusted. Correct Explanation: Chickenpox lesions are infectious until they crust. The nurse is teaching a group of middle school students about sexually transmitted infections (STIs). Which statement by the students indicates a need for additional teaching about condom use? a) "Don't store condoms in your wallet." b) "Put the condom on just before orgasm." c) "Putting the condom on just before insertion defeats the purpose." d) "Latex condoms provide the best protection against STIs." Correct Answer: "Put the condom on just before orgasm." Explanation: Condoms should be placed on the penis before any genital contact occurs. Latex condoms are best to protect against infection. Condoms should be applied before any genital contact occurs. Applying them at a later time decreases their effectiveness. Condoms should be stored in a cool, dry place that is away from direct sunlight. A wallet is subject to extreme changes in temperature and is an inappropriate place to store a condom. Which of the following should be included in the teaching plan for a child with varicella? a) Place the child in a warm bath for skin discomfort. b) Remind the child not to scratch the lesions. c) Utilize salt solutions to assist in healing oral lesions. d) Administer aspirin for fever. Correct Answer: Remind the child not to scratch the lesions. Correct Explanation: The teaching plan for varicella should include that the child not scratch the lesions. Acetaminophen should be administered for fever, not aspirin, due to the link with Reye syndrome. The best treatment for skin discomfort is a cool bath with soothing colloidal oatmeal every 3 to 4 hours for the first few days. The child should avoid citrus, spicy, or salty foods. Which of the following is a true statement regarding varicella zoster virus infection? a) The incubation period is 7 days. b) It is transmitted by fecal-oral route. c) It tends to be more severe in children. d) A complication of this infection includes secondary bacterial infections of the skin. Correct Answer: A complication of this infection includes secondary bacterial infections of the skin. Correct Explanation: Varicella zoster virus infection carries with it the complication of a secondary bacterial infection of the skin. The incubation period is 10 to 21 days. It is transmitted by direct contact with the vesicles and by airborne route. It tends to be more severe in adolescents and adults. A 6-year-old child is brought to the clinic by his parents. The parents state, "He had a sore throat for a couple of days and now his temperature has been over 102°F. He has this rash on his face and chest that looks like sunburn but feels really rough." Which of the following would the nurse suspect? a) Diphtheria b) Scarlet fever c) Pertussis d) Community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA) Correct Answer: Scarlet fever Correct Explanation: Scarlet fever typically is associated with a sore throat, fever greater than 101°F, and the characteristic rash on the face, trunk, and extremities that looks like sunburn but feels like sandpaper. CAMRSA is typically manifested by skin and tissue infections. Diphtheria is characterized by a sore throat and difficulty swallowing but fever is usually below 102°F. Airway obstruction is apparent. Pertussis is characterized by cough and cold symptoms that progress to paroxysmal coughing spells along with copious secretions. A child is brought to the clinic with fever, cough, and coryza. The nurse inspects the child's mouth and observes what look like tiny grains of white sand with red rings. The nurse documents this as which of the following? a) Slapped cheek appearance b) Nits c) Lymphadenopathy d) Koplik spots Correct Answer: Koplik spots Correct Explanation: Koplik spots are bright red spots with blue-white centers appearing primarily on the buccal mucosa and indicate rubeola (measles). They are often described as tiny grains of white sand surrounded by red rings. Lymphadenopathy is used to document enlargement of the lymph nodes. Slapped cheek appearance refers to the erythematous flushing associated with fifth disease. Nits refer to the adult eggs of pediculosis. A nurse is preparing a presentation for parents about common childhood infectious diseases. Which of the following would the nurse include as being caused by a tick bite? Select all that apply. a) Lyme disease b) Scabies c) Rocky Mountain Spotted Fever d) Ascariasis e) Psittacosis Correct Answer: • Lyme disease • Rocky Mountain Spotted Fever Correct Explanation: Infectious diseases caused by tick bites include Lyme disease and Rocky Mountain Spotted Fever. Psittacosis is transmitted to children by birds. Ascariasis is a roundworm infection. Scabies is a parasitic infection caused by a female mite. A group of grade-school children is going camping. As a school nurse, you would offer them which advice to prevent Lyme disease? a) "Don't approach strange animals outside the campsite." b) "Don't drink water from mountain streams while hiking." c) "Don't touch any bush without knowing what kind it is." d) "Wear jeans tucked inside your socks when in the woods." Correct Answer: "Wear jeans tucked inside your socks when in the woods." Correct Explanation: Lyme disease is prevented by measures to reduce the possibility of tick bites. The nurse is caring for an adolescent diagnosed with syphilis. The drug of choice for treating syphilis is which of the following? a) Griseofluvin b) Rocephin c) Penicillin d) Acyclovir Correct Answer: Penicillin Correct Explanation: Syphilis responds to one intramuscular injection of penicillin G benzathine; if the child is sensitive to penicillin, oral doxycycline, tetracycline, or erythromycin can be administered as alternative treatment. The nurse is caring for a 6-year-old boy with mumps. Which of the following statements by the child would cause the nurse to suspect the boy is experiencing a complication of mumps? a) "My knees are sore and stiff." b) "I keep coughing up mucus." c) "Please talk a little louder." d) "I feel wobbly when I walk." Correct Answer: "Please talk a little louder." Correct Explanation: Complications of mumps include meningoencephalitis with seizures and auditory neuritis, which can result in deafness. Joint complaints, which might suggest arthritis, are a complication of erythema infectiosum. Difficulty walking, which might suggest cerebellar ataxia, is a complication of chickenpox. Coughing, which might suggest bronchopneumonia, is a complication of rubeola. A nurse is assessing a child with a tick-borne disease. Which of the following would indicate to the nurse that the child has developed ehrlichiosis and not Rocky Mountain Spotted Fever? a) Headache b) Fever c) Absence of rash d) Malaise Correct Answer: Absence of rash Explanation: Both Rocky Mountain Spotted Fever and ehrlichiosis are manifested by fever, headache, and malaise. However, there is rarely a rash with ehrlichiosis, which helps to differentiate it from Rocky Mountain Spotted Fever. Which of the following would you expect to observe about the rash associated with chickenpox (varicella)? a) Noticeable crusts but no pruritus b) Dark red color (red hen marks) c) Various stages of lesions present at the same time d) Dark red, macular, very pruritic lesions Correct Answer: Various stages of lesions present at the same time Correct Explanation: Chickenpox lesions appear "in waves," so many stages of lesions are present at the same time. The major reservoir for MRSA is which of the following areas? a) Trachea b) Larynx c) Anterior nares d) Lungs Correct Answer: Anterior nares Correct Explanation: The major reservoir for MRSA is the lower part of the nose (anterior nares). When the physician looks in a child's mouth during a sick-visit exam, the mother exclaims: "Her tongue is bright red! It was not like that yesterday." The physician would most likely order which medication based on the probable diagnosis of scarlet fever? a) Penicillin to prevent acute glomerulonephritis b) Acetaminophen to decrease the throat pain c) Erythromycin to prevent the spread to siblings d) Steroids to decrease the inflammation Correct Answer: Penicillin to prevent acute glomerulonephritis Correct Explanation: A "strawberry tongue" is a classic sign of scarlet fever. Penicillin is prescribed to prevent the complications of acute glomerulonephritis and rheumatic fever associated with beta-hemolytic group A streptococcal infections. Which of the following is a true statement regarding measles? a) Peak outbreaks are in the summer. b) The incubation period is 8 to 12 days. c) It is transmitted by the fecal-oral route. d) Rarely is it contagious. Correct Answer: The incubation period is 8 to 12 days. Correct Explanation: The typical incubation period is 8 to 12 days. Outbreaks peak in the winter and spring. It is highly contagious and is transmitted by airborne suspended droplets. The nurse is doing an i [Show More]

Last updated: 1 year ago

Preview 1 out of 26 pages