Chapter 29: The Child With a Skin Condition My Nursing Test Banks

Chapter 29: The Child With a Skin Condition

Elsevier items and derived items 2007 by Saunders, an imprint of Elsevier Inc.

MULTIPLE CHOICE

1. The nurse is careful to apply only the prescribed amount of ointment to the skin of a 2-month-old because the infants skin, compared to the adults, has:

a.

Less perfusion

b.

Greater moisture

c.

More perspiration

d.

Greater absorption

ANS: D

The childs skin has a dramatically greater ability to absorb than does that of the adult.

DIF: Cognitive Level: Application REF: 675, Figure 29-1

OBJ: 2 TOP: Skin Comparison

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

2. 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

ANS: D

Some children with eczema also develop asthma and hay fevertype allergies.

DIF: Cognitive Level: Application REF: 680 OBJ: 4

TOP: Infantile Eczema KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

3. The appropriate technique for the application of a topical treatment for a child with eczema is:

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.

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.

DIF: Cognitive Level: Application REF: 681 OBJ: 4

TOP: Infantile Eczema KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

4. 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.

ANS: A

A staphylococcal infection can spread readily from one infant to another. Small pustules on the newborn must be reported immediately.

DIF: Cognitive Level: Analysis REF: 681 OBJ: N/A

TOP: Staphylococcal Infection KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

5. 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

ANS: C

Combing a vinegar/water solution through the hair with a fine-tooth comb and then shampooing is an initial step toward eradication.

DIF: Cognitive Level: Application REF: 685 OBJ: 5

TOP: Tinea Capitis KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

6. 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.

Changing socks often

b.

Eating shellfish

c.

Alcohol consumption

d.

Taking corticosteroids

ANS: C

Consumption of alcohol while taking griseofulvin will cause severe tachycardia.

DIF: Cognitive Level: Application REF: 679 OBJ: N/A

TOP: Tinea Capitis KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

7. Before the 17-year-old boy starts a protocol of Accutane for his acne, the nurse should instruct him to:

a.

Get a prescription for oral contraceptives.

b.

Increase the dose if his acne worsens.

c.

Limit intake of chocolate, cola, and peanuts.

d.

Increase exposure to sunlight.

ANS: A

Oral contraceptives are prescribed to young males to reduce androgens, which make the skin greasy.

DIF: Cognitive Level: Application REF: 679 OBJ: N/A

TOP: Acne Vulgaris KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

8. The nurse assesses a major burn as:

a.

Partial-thickness burn involving 25% of the body surface

b.

Partial-thickness burn involving 12% of the body surface

c.

Full-thickness burn involving 20% of the body surface

d.

Full-thickness burn involving 5% of the body surface

ANS: C

A full-thickness burn involving 10% or more of the body surface is considered a major burn.

DIF: Cognitive Level: Analysis REF: 687 OBJ: 6

TOP: Burns KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

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

ANS: B

A second-degree superficial burn appears blistered, moist, and pink or red. The pain associated with this burn indicates tissue viability.

DIF: Cognitive Level: Analysis REF: 688, Table 29-2

OBJ: 6 TOP: Burns KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

10. 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.

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.

DIF: Cognitive Level: Application REF: 715 OBJ: 6

TOP: Burns KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Reduction of Risk

11. An allergy to which of the following would contraindicate the use of Silvadene as a topical agent for burns?

a.

Penicillin

b.

Iodine

c.

Tetanus immunizations

d.

Sulfa

ANS: D

The use of Silvadene cream on burns is contraindicated if the patient has a sulfa allergy.

DIF: Cognitive Level: Analysis REF: 692, Box 29-2

OBJ: 11 TOP: Burns KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity

12. Which of the following 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.

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.

DIF: Cognitive Level: Comprehension REF: 692 OBJ: 7

TOP: Burns KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

13. 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.

ANS: A

Absorption of topical medications is best when preparations are applied after a warm bath.

DIF: Cognitive Level: Analysis REF: 681 OBJ: 9

TOP: Topical Medications KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

14. On the first day postburn the bodys 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

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.

DIF: Cognitive Level: Analysis REF: 689 OBJ: 7

TOP: Burns KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Reduction of Risk

15. At a 2-month well-child visit, parents ask the nurse about the red area on the babys neck. They tell the nurse that the mark appeared a few weeks after birth. The nurse recognizes this skin lesion as a(n):

a.

Port wine nevus

b.

Strawberry nevus

c.

Exanthum

d.

Intertrigo

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.

DIF: Cognitive Level: Comprehension REF: 677, Figure 29-3

OBJ: N/A TOP: Congenital Lesions

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

16. A mother is concerned about what might have caused a heat rash on her infant. The nurse observes tiny pinhead-sized reddened papules on the infants neck and axilla. The nurse explains the cause of this rash is most likely:

a.

Sun exposure

b.

Allergic reaction

c.

Infection

d.

Heat and moisture

ANS: D

Miliaria, or prickly heat rash, is caused by excess body heat and moisture.

DIF: Cognitive Level: Analysis REF: 677, Figure 29-5

OBJ: N/A TOP: Skin Infections

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

17. What is the correct nursing response to a mother who asks, How can I get rid of the babys cradle cap?

a.

Rub baby oil on the infants head at night and shampoo the hair the next morning.

b.

Use a brush with firm bristles to loosen the scales on the babys head several times a day.

c.

Wash the babys head every night with a dandruff-control shampoo.

d.

Lubricate the babys head every morning with a small amount of olive oil.

ANS: A

Scales may be softened by applying baby oil to the head the evening before, and shampooing the hair in the morning.

DIF: Cognitive Level: Application REF: 678 OBJ: N/A

TOP: Seborrheic Dermatitis KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

18. The statement made by a parent, indicating the need for further teaching about strategies to control itching for the infant with eczema, is:

a.

Wool is the best fabric for the babys clothing.

b.

I should avoid laundry detergents with fragrances.

c.

I put cotton gloves on the babys hands.

d.

The babys fingernails are kept short.

ANS: A

Clothing should be made of cotton. Wool is avoided because of its allergy potential.

DIF: Cognitive Level: Analysis REF: 681 OBJ: 4

TOP: Infantile Eczema KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

19. When teaching about general skin care measures that could help prevent acne, the nurse would include:

a.

Eliminate chocolate, peanuts, and cola from the diet.

b.

Wash the face with a cleansing product frequently.

c.

Plan indoor activities to avoid sun exposure.

d.

Eat a balanced diet, and get sufficient rest.

ANS: D

General hygienic measures of cleanliness, rest, and avoidance of emotional stress may help prevent exacerbations.

DIF: Cognitive Level: Application REF: 679 OBJ: 3

TOP: Acne Vulgaris KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Reduction of Risk

20. When the nurse caring for a patient with severe frostbite observes a purple flush on the hands and feet, the nurse should:

a.

Report this sign immediately

b.

Place a warm towel over the extremities

c.

Gently sponge with cool water

d.

Medicate for pain

ANS: D

A purple flush indicates the return of sensation and causes extreme pain.

DIF: Cognitive Level: Application REF: 693 OBJ: 12

TOP: Frostbite KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

21. A child is brought to the emergency department with burns on the face and chest. The nurses first priority is:

a.

Assessing respiratory status

b.

Administering pain medication

c.

Removing clothing

d.

Inserting a Foley catheter

ANS: A

Airway assessment and establishing an airway are the initial priorities.

DIF: Cognitive Level: Analysis REF: 687 OBJ: 9

TOP: Burns KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

22. The adolescent girl whose acne is being treated with an antibiotic in addition to topical applications is cautioned by the nurse to expect:

a.

Lessened effectiveness of oral contraceptives

b.

Urinary burning and frequency

c.

Breast engorgement

d.

Vaginitis

ANS: D

Antibiotic therapy can cause a monilial vaginitis.

DIF: Cognitive Level: Analysis REF: 679 OBJ: 3

TOP: Acne KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

23. When the nurse observes a tarry stool from a 16-year-old burn victim who has been in the ICU for 2 weeks, the nurse documents and reports the probable complication of:

a.

Diverticulitis

b.

Stress diarrhea

c.

Curlings ulcer

d.

Perforated bowel

ANS: C

Curlings ulcer is a complication of burn victims resulting from the stress of their trauma.

DIF: Cognitive Level: Comprehension REF: 689 OBJ: 7

TOP: Burns KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

24. A child is brought to the emergency department with severe frostbite. The body parts that should be warmed first are:

a.

Hands and arms

b.

Feet and legs

c.

Fingers and toes

d.

Head and torso

ANS: D

In extreme cases of exposure to freezing temperatures, the head and torso should be warmed before the extremities.

DIF: Cognitive Level: Application REF: 693 OBJ: 12

TOP: Frostbite KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

25. An adolescent is at the pediatricians office because he has been experiencing intense itching, particularly in the axilla and between the fingers. The itching is worse during the night and he has not been sleeping well. This symptom is associated with:

a.

Scabies

b.

Pediculosis capitis

c.

Tinea corporis

d.

Eczema

ANS: A

Intense itching, especially at night, is characteristic of scabies.

DIF: Cognitive Level: Comprehension REF: 685 OBJ: N/A

TOP: Scabies KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

MULTIPLE RESPONSE

1. To avoid diaper rash, the nurse would offer instruction to the parents to:

Select all that apply.

a.

Use emollients.

b.

Expose perineum to light and air periodically.

c.

Use disposable diapers frequently.

d.

Avoid plastic pants.

e.

Change diaper frequently.

ANS: A, B, C, D, E

Keeping the skin dry and protected with emollients, changing the diaper frequently, and avoiding plastic pants will prevent diaper rash.

DIF: Cognitive Level: Comprehension REF: 678 OBJ: N/A

TOP: Avoiding Diaper Rash KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

2. The nurse, speaking to a group of junior high school students, informs them that acne can be exacerbated by such drugs as:

Select all that apply.

a.

Steroids

b.

Dilantin

c.

Phenobarbital

d.

Aspirin

e.

Oral contraceptives

ANS: A, B, C

Long-term use of steroids, Dilantin, phenobarbital, lithium, and vitamin B12 can cause acne.

DIF: Cognitive Level: Analysis REF: 679 OBJ: 3

TOP: Acne KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

COMPLETION

1. The nurse recognizes the blisters and erythema of the hands of a person recovering from frostbite as the skin disorder called ____________________.

ANS: chilblain

DIF: Cognitive Level: Comprehension REF: 692 OBJ: 12

TOP: Chilblain KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

NOT: Rationale: After exposure to cold, blisters appear on the hands and feet that are similar to a burn. These are called chilblains.

2. The nurse differentiates a type of topical medication that is an oil-based emulsion to be used on dry skin as a(n) ____________________.

ANS: ointment

DIF: Cognitive Level: Comprehension REF: 683, Table 29-1

OBJ: 11 TOP: Ointment KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

NOT: Rationale: Ointments are oil-based emulsions that are used on dry skin.

3. A 5-year-old boy is brought to the emergency department with a second-degree burn of his entire right arm and hand, anterior trunk and genital area, and front of right thigh. The nurse assesses the BSA percentage burn as ____________________.

ANS: 26%

DIF: Cognitive Level: Application REF: 686, Figure 29-15

OBJ: 10 TOP: BSA Burn Estimation

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

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