CHAPTER 30: INTEGUMENTARY ALTERATIONS My Nursing Test Banks

CHAPTER 30: INTEGUMENTARY ALTERATIONS

MULTIPLE CHOICE

1.In addition to protecting people from the harmful effects of ultraviolet light, what else do melanocytes within the epidermis do?

a.

help with assimilation of vitamins

c.

play a role in skin lubrication

b.

are determinant of skin pigmentation

d.

assist in walling off foreign protein

ANS: B

Feedback

A

Incorrect. Melanocytes are not associated with the assimilation of vitamins.

B

Correct. In addition to protecting people from the harmful effects of ultraviolet light, melanocytes within the dermis are determinants of skin pigmentation.

C

Incorrect. Melanocytes do not play a role in skin lubrication.

D

Incorrect. Melanocytes do not have an immune function of walling off foreign protein.

PTS:1REF:p. 1138 Bacterial Infections

OBJ: Cognitive Level: Comprehension

2.A student tells the school nurse that she knows that ultraviolet light is always harmful to a person. The nurse shares with the student that ultraviolet light has some positive effects as well. Which of the following effects is the most positive effect of ultraviolet light?

a.

Absorption of ultraviolet light is necessary for the conversion of substances to vitamin D.

b.

Ultraviolet light can help tan a persons body.

c.

Ultraviolet light has a major influence on mood and can counteract the effects of major depression.

d.

Ultraviolet light helps crops grow at a more even growth rate over time.

ANS: A

Feedback

A

Correct. The absorption of ultraviolet light is necessary for the conversion of substances to vitamin D.

B

Incorrect. Ultraviolet light can tan a persons body; however, tanning is not considered a positive attribute of ultraviolet light for ones health.

C

Incorrect. While light may counteract the effects of depression, this feature is not as important as that of converting substances to vitamin D.

D

Incorrect. The impact of ultraviolet light on the growth of crops is not the most positive effect.

PTS:1REF:p. 1080 Bacterial Infections

OBJ: Cognitive Level: Comprehension

3.Why is the newborns skin more susceptible to infection during the first week of life?

a.

It is much more porous than it will be at any other time in life.

b.

The newborns skin is very thin, thinner than at any other time in life.

c.

The sweat gland system is underdeveloped in the first week.

d.

The pH of the newborns skin is relatively alkaline in the first week of life.

ANS: D

Feedback

A

Incorrect. The newborns skin is not susceptible to infection due to the skin being more porous.

B

Incorrect. The newborns skin is not susceptible to infection due to the skin being thinner.

C

Incorrect. The sweat glands are not associated with the risk of infection in the newborn.

D

Correct. During the first week of life, the newborns skin is more susceptible to infection due to the alkalinity of the skin. In time, the skin will become more acidic, which will discourage the growth of microorganisms.

PTS:1REF:p. 1083 Bacterial Infections

OBJ: Cognitive Level: Application

4.What is the classic sign of impetigo, which is typically used to diagnose this condition?

a.

red rash on the trunk

c.

tracks under the skin

b.

honey-colored crusts on the skin

d.

scratch marks near insect bites

ANS: B

Feedback

A

Incorrect. Impetigo does not typically present as a red rash on the trunk.

B

Correct. The diagnosis of impetigo is based upon the clinical presentation, which typically includes the honey-colored crusts on the skin. These crusts are considered the hallmark characteristic of impetigo.

C

Incorrect. Impetigo does not typically present as tracks under the skin.

D

Incorrect. While scratch marks and insect bites may allow the bacteria for impetigo to enter the skin, the presence of these findings does not suggest impetigo infection.

PTS:1REF:p. 1083 Bacterial Infections

OBJ: Cognitive Level: Application

5.Which of the following organisms are the ones that almost always cause bullous impetigo?

a.

Staphylococcus aureus

c.

streptococcus

b.

Escherichia coli

d.

pneumococcus

ANS: A

Feedback

A

Correct. The cause of bullous impetigo is almost always Staphylococcus aureus.

B

Incorrect. Bullous impetigo is not caused by Escherichia coli.

C

Incorrect. Bullous impetigo is not caused by streptococcus.

D

Incorrect. Bullous impetigo is not caused by pneumococcus.

PTS:1REF:p. 1083 Bacterial Infections

OBJ: Cognitive Level: Comprehension

6.The nurse working with the family of a child with impetigo will teach the family which of the following things?

a.

how to cover the skin to prevent the transfer of infection to others

b.

isolation techniques such as masking, gowning, and gloving

c.

handwashing techniques using antibacterial soap and not sharing towels and personal items

d.

how to apply the tincture of benzoin to the lesions

ANS: C

Feedback

A

Incorrect. The covering of the skin would not prevent the transfer of infection to others.

B

Incorrect. Isolation would not need to be implemented.

C

Correct. For the family of a child with impetigo, the nurse should inform the family of the need for good hygiene, including good handwashing with the use of antibacterial soap. Personal items and towels should not be shared among family members.

D

Incorrect. Instead of applying tincture of benzoin, mupirocin (Bactroban) or another topical antibiotic may be considered.

PTS:1REF:p. 1084 Bacterial Infections

OBJ: Cognitive Level: Application

7.The nurse is working with a client who has a diagnosis of cellulitis. The spouse asks the nurse: Just what is cellulitis anyway? Which of the following would be the nurses best answer?

a.

an infection in the intracellular spaces, which forces fluids into extracellular space

b.

a reaction to an intravenous injection of fluid or medication that has extravasated into the tissue

c.

a severe inflammation of cells in any area of the body that will almost always respond to anti-inflammatory drugs

d.

inflammation and infection in the loose connective tissue, which extends into the dermis; it often occurs following minor trauma

ANS: D

Feedback

A

Incorrect. Cellulitis is not an infection of the intracellular spaces, which forces fluids into extracellular tissue.

B

Incorrect. Cellulitis is not a reaction to an intravenous injection.

C

Incorrect. Cellulitis and the associated swelling are not resolved by the use of anti-inflammatory medications.

D

Correct. Cellulitis is a bacterial infection that involves the dermis and subcutaneous tissue. Subsequent inflammation and infection develop in loose connective tissue.

PTS:1REF:p. 1085 Fungal Infections

OBJ: Cognitive Level: Application

8.The nurse assessing a child with cellulitis will most often find which of the following classic symptoms?

a.

skin breakdown and areas of ulceration resulting from inflammation of cells

b.

complaint of burning and tightness in the area of the cellulitis

c.

erythema, swelling, warmth, pain, and diffuse borders of the infected area

d.

no visible signs but the child will complain of varying types of pain

ANS: C

Feedback

A

Incorrect. Skin breakdown and an area of ulceration is not a classic symptom of cellulitis.

B

Incorrect. Further, client reports of burning and tightness in the area are not considered classic symptoms of cellulitis.

C

Correct. The classic symptoms of cellulitis include erythema, swelling, warmth, and pain. Additionally, the borders of the infection will be irregular and diffuse, extended as the infection progresses.

D

Incorrect. The clients report of varying types of pain is also not considered a classic symptom.

PTS:1REF:p. 1086 Fungal Infections

OBJ: Cognitive Level: Application

9.The nurse working with a child who has cellulitis anticipates doctors orders for which of the following usual treatment regimens?

a.

whirlpool, meperidine (Demerol) or morphine sulfate, and wet to dry dressings

b.

oral antibiotics, warm compresses, immobilization, elevation of the extremity, and analgesics

c.

debridement of the wounds, antibiotic creams, dressings, and an Ace bandage

d.

incision and drainage with antibiotics placed in the wound, done as a minor surgical procedure in day surgery

ANS: B

Feedback

A

Incorrect. Working with a child who has cellulitis, the nurse will not expect doctors orders for whirlpool, meperidine (Demerol) or morphine sulfate, and wet to dry dressings.

B

Correct. The child with limited cellulitis can generally be managed on an outpatient basis with a regimen of oral antibiotics, warm compresses, immobilization and elevation of the extremity, and comfort measures.

C

Incorrect. Working with a child who has cellulitis, the nurse will not expect doctors orders for debridement of the wounds, antibiotic creams, dressings, and an Ace bandage.

D

Incorrect. Working with a child who has cellulitis, the nurse will not expect doctors orders for incision and drainage with antibiotics placed in the wound, done as a minor surgical procedure in day surgery.

PTS:1REF:p. 1086 Fungal Infections

OBJ: Cognitive Level: Application

10.The nurse is aware that children with facial cellulitis caused by Haemophilus influenza type B are at risk of developing:

a.

the flu

c.

meningitis

b.

an upper respiratory infection

d.

few problems

ANS: C

Feedback

A

Incorrect. Children with facial cellulitis caused by Haemophilus influenza type B are at risk for developing meningitis, not the flu.

B

Incorrect. Children with facial cellulitis caused by Haemophilus influenza type B are at risk for developing meningitis, not an upper respiratory infection.

C

Correct. Children with facial cellulitis caused by Haemophilus influenza type B are at risk for developing meningitis.

D

Incorrect. Children with facial cellulitis caused by Haemophilus influenza type B are at risk for developing meningitis, not a few problems.

PTS:1REF:p. 1086 Fungal Infections

OBJ: Cognitive Level: Application

11.The nurse assessing a baby finds that the baby has creamy-white plaques on the buccal mucosa and lateral borders of the tongue. What method will the nurse normally use to see if this is thrush or residual milk curds?

a.

Send a sample of the plaques to the lab for a thrush test.

b.

Scrape a sample of the plaques, and look at it under the microscope.

c.

Give the baby something acidic to drink such as sweetened lemonade.

d.

Do a simple scraping; milk curds will scrape away and thrush will not.

ANS: D

Feedback

A

Incorrect. Finding that the baby has creamy-white plaques on the buccal mucosa and lateral borders of the tongue, the nurse will not send a sample of the plaques to the lab for a thrush test.

B

Incorrect. Finding that the baby has creamy-white plaques on the buccal mucosa and lateral borders of the tongue, the nurse will not scrape a sample of the plaques, and look at it under the microscope.

C

Incorrect. Finding that the baby has creamy-white plaques on the buccal mucosa and lateral borders of the tongue, the nurse will not give the baby something acidic to drink such as sweetened lemonade.

D

Correct. Thrush is characterized by the development of creamy-white plaques on the buccal mucosa and lateral borders of the tongue. Lesions gradually become confluent and may cover the entire oral cavity. The plaques associated with thrush can be distinguished from residual milk curds by their inability to be removed from the buccal mucosa. The nurse will do a simple scraping; milk curds will scrape away and thrush will not.

PTS:1REF:p. 1087 Fungal Infections

OBJ: Cognitive Level: Application

12.The nurse will most often find intertrigo in which of the following places?

a.

the upper back and the abdominal areas

b.

the waist and any fat folds on the body

c.

the axillae, interdigital spaces, and the gluteal cleft

d.

the elbows and the hairline

ANS: C

Feedback

A

Incorrect. The nurse will not most often find intertrigo on the upper back and the abdominal areas.

B

Incorrect. The nurse will not most often find intertrigo on the waist and any fat folds on the body.

C

Correct. Candidiasis also may present as intertrigo, an erythematous skin eruption occurring on apposed skin surfaces. Apposed surfaces are those in direct contact such as the axillae and popliteal fossae. Common sites of occurrence are the axillae, interdigital spaces, and the gluteal cleft.

D

Incorrect. The nurse will not most often find intertrigo on the elbows and the hairline.

PTS:1REF:p. 1087 Integumentary Alterations

OBJ: Cognitive Level: Comprehension

13.When a breastfeeding baby is found to have thrush, which of the following should be done?

a.

Stop the breastfeeding immediately, and start on the bottle.

b.

Evaluate the mother for candidiasis of the nipple.

c.

Pump the breast, and use this milk in a bottle.

d.

Paint the babys mouth and the mothers nipples with gentian violet.

ANS: B

Feedback

A

Incorrect. Finding a breastfeeding baby has thrush, the appropriate action is not to stop the breastfeeding immediately, and start on the bottle.

B

Correct. Diagnosis of the breastfeeding infant with thrush also should include evaluation of the mother for candidiasis of the nipple.

C

Incorrect. Finding a breastfeeding baby has thrush, the appropriate action is not to pump the breast, and use this milk in a bottle.

D

Incorrect. Finding a breastfeeding baby has thrush, the appropriate action is not to paint the babys mouth and the mothers nipples with gentian violet.

PTS:1REF:p. 1088 Fungal Infections

OBJ: Cognitive Level: Application

14.When a baby has a diagnosis of thrush, the nurse anticipates an order for which of the following substances to treat the thrush?

a.

gentian violet

c.

fluconazole (Diflucan)

b.

penicillin

d.

oral nystatin (Mycostatin)

ANS: D

Feedback

A

Incorrect. When a baby is diagnosed with thrush, the nurse will not expect an order for gentian violet.

B

Incorrect. When a baby is diagnosed with thrush, the nurse will not expect an order for penicillin.

C

Incorrect. When a baby is diagnosed with thrush, the nurse will not expect an order for fluconazole (Diflucan).

D

Correct. Thrush usually responds quickly to oral nystatin suspension administered at intervals of 4 to 6 hours, to be continued for 48 hours.

PTS:1REF:p. 1088 Viral Infections

OBJ: Cognitive Level: Application

15.The nurse working with the mother of an infant who has candidal diaper dermatitis will teach the mother which of the following supportive measures to take, in addition to medication, to clear up the condition?

a.

Keep the affected area dry and exposed to air then feasible.

b.

Use a diaper cream all the time, applying it several times a day.

c.

Powder the area well after all voidings, and use cloth diapers.

d.

Apply baby lotion to the diaper area several times a day.

ANS: A

Feedback

A

Correct. Additional supportive measures include keeping the affected area dry and exposed to air then possible.

B

Incorrect. The nurse working with the mother of an infant who has candidal diaper dermatitis will not teach the mother to use a diaper cream all the time, applying it several times a day.

C

Incorrect. The nurse working with the mother of an infant who has candidal diaper dermatitis will not teach the mother to powder the area well after all voidings, and use cloth diapers.

D

Incorrect. The nurse working with the mother of an infant who has candidal diaper dermatitis will not teach the mother to apply baby lotion to the diaper area several times a day.

PTS:1REF:p. 1088 Viral Infections

OBJ: Cognitive Level: Application

16.Which of the following causes tinea infections?

a.

fomites

c.

dermatophytes

b.

mites

d.

bacterium

ANS: C

Feedback

A

Incorrect. Fomites do not cause tinea infections.

B

Incorrect. Mites do not cause tinea infections.

C

Correct. The tinea infections are caused by dermatophytes, a group of closely related fungi that invade the outer keratin layer of the skin and its appendages, the hair and nails.

D

Incorrect. Bacteria do not cause tinea infections.

PTS:1REF:p. 1089 Viral Infections

OBJ: Cognitive Level: Comprehension

17.The nurse is working with a child who has a tinea capitis infection and is taking griseofulvin. The nurse will teach the parents that this medication is best absorbed:

a.

then taken on an empty stomach

c.

then taken with foods high in fat

b.

then taken with a full glass of water

d.

then taken with the meal

ANS: C

Feedback

A

Incorrect. Working with a child who has a tinea capitis infection and is taking griseofulvin, the nurse will not teach the parents that this medication is best absorbed then taken on an empty stomach.

B

Incorrect. Working with a child who has a tinea capitis infection and is taking griseofulvin, the nurse will not teach the parents that this medication is best absorbed then taken with a full glass of water.

C

Correct. Griseofulvin, the agent most commonly used to treat tinea capitis, is better absorbed in the presence of fatty foods. Caregivers should be taught to administer the medication with foods high in fat such as peanut butter or ice cream to enhance the drugs effectiveness.

D

Incorrect. Working with a child who has a tinea capitis infection and is taking griseofulvin, the nurse will not teach the parents that this medication is best absorbed then taken with the meal.

PTS:1REF:p. 1090 Viral Infections

OBJ: Cognitive Level: Application

18.The highest incidence of warts occurs in which of the following age groups?

a.

children and adolescents

c.

middle age

b.

young adults

d.

elderly

ANS: A

Feedback

A

Correct. Although individuals of any age may get warts, the highest incidence generally occurs during childhood and adolescence.

B

Incorrect. The highest incidence of warts does not occur in young adults.

C

Incorrect. The highest incidence of warts does not occur in the middle aged.

D

Incorrect. The highest incidence of warts does not occur in the elderly.

PTS:1REF:p. 1096 Viral Infections

OBJ: Cognitive Level: Comprehension

19.The nurse is talking to parents about a wart on their childs hand. The wart does not appear to be bothering the child. The parents want to know if it should be surgically removed. Which of the following is the nurses best response?

a.

Yes, because childrens warts often spread and are hard to control.

b.

Two-thirds of warts will go away spontaneously within 2 years.

c.

Surgery is the first line of therapy, but this wart may disappear by itself.

d.

It is better to freeze the wart first before cutting it off. You can talk to the doctor about this.

ANS: B

Feedback

A

Incorrect. Advising parents asking if a wart on their childs hand should be surgically removed, the nurses best response is not to warn them that warts spread and are hard to control.

B

Correct. Approximately two-thirds of affected individuals experience spontaneous clearing of lesions within 2 years.

C

Incorrect. Advising parents asking if a wart on their childs hand should be surgically removed, the nurses best response is not surgery is the first line of therapy.

D

Incorrect. Advising parents asking if a wart on their childs hand should be surgically removed, the nurses best response is not freeze it first, then cut it off.

PTS:1REF:p. 1097 Viral Infections

OBJ: Cognitive Level: Application

20.The nurse is working with the family of a child who is bothered by a wart and tends to pick at it. The family has been trying to remove the wart with a nonprescription product. The nurse assesses to see if the family is using the correct technique with a topical agent such as Duofilm, Mediplast, or Trans-plantar to treat the wart. Which of the following statements by the family would indicate correct technique?

a.

We used an emery board to sand the wart, soaked it in warm water, applied the medication, and then dry, reapplied it to cover the whole wart.

b.

We put the topical agent on the wart and covered it with an Elastoplast bandage wrapped with an Ace bandage to prevent picking.

c.

We cut the wart off, applied the medication, and left it open to the air.

d.

We applied a strong vinegar solution and then applied the medication.

ANS: A

Feedback

A

Correct. First-line therapies include application of topical agents. Preparations such as Duofilm, Occlusal, Duoplant, Trans-Plantar, and Mediplast are available without prescription. The affected area is debrided with an emery board or pumice stone and then soaked in warm water to soften the keratin layer. The medication is applied, allowed to dry, and the reapplied as necessary to cover the entire wart. The solution may be applied once or twice daily until the wart has been removed.

B

Incorrect. Assessing the technique for wart removal using nonprescription products, the nurse will know that application without softening the keratin layer is not the most effective method.

C

Incorrect. Assessing the technique for wart removal using nonprescription products, the nurse will know that cutting the wart off before applying the medication is not the best approach.

D

Incorrect. Assessing the technique for wart removal using nonprescription products, the nurse will know that the use of vinegar is not necessary and the acid in the vinegar may interact with the nonprescription product in a nonefficacious manner.

PTS:1REF:p. 1097 Infestations

OBJ: Cognitive Level: Application

21.What percentage of children less than 5 years of age are estimated to have herpes simplex virus type I (HSV-1) antibodies?

a.

5%

c.

10%-19%

b.

9%

d.

20%-50%

ANS: D

Feedback

A

Incorrect. An estimated 20-50% of children less than 5 years of age have HSV-1 antibodies, not 5%.

B

Incorrect. An estimated 20-50% of children less than 5 years of age have HSV-1 antibodies, not 9%.

C

Incorrect. An estimated 20-50% of children less than 5 years of age have HSV-1 antibodies, not 10%-19%.

D

Correct. Primary infection with HSV-1 occurs most commonly in children. Risk of exposure is greatest before age 5, and an estimated 20-50% of children less than 5 years of age have HSV-1 antibodies.

PTS:1REF:p. 1101 Infestations

OBJ: Cognitive Level: Comprehension

22.The nurse is doing some teaching with the parents of a child with herpes simplex virus type I (HSV-1) virus. The nurse will teach that 20%-40% of those with HSV-1 infections will have recurrent infections precipitated by:

a.

alcohol or caffeine

b.

sunlight, wind, injury, or stress

c.

contact with someone else with the virus

d.

exposure to allergens

ANS: B

Feedback

A

Incorrect. The nurse will not teach that 20%-40% of those with HSV-1 infections will have recurrent infections precipitated by alcohol or caffeine.

B

Correct. Approximately 20-40% of those with primary HSV-1 infections will have recurrent infections, which may be precipitated by factors such as sunlight, wind, local injury, or emotional stress.

C

Incorrect. The nurse will not teach that 20%-40% of those with HSV-1 infections will have recurrent infections precipitated by contact with someone else with the virus.

D

Incorrect. The nurse will not teach that 20%-40% of those with HSV-1 infections will have recurrent infections precipitated by exposure to allergens.

PTS:1REF:p. 1101 Infestations

OBJ: Cognitive Level: Application

23.The nurse is preparing to take a viral culture of a lesion suspected of being herpes simplex virus type I (HSV-1) infection. How will the nurse take the culture?

a.

Swab the base of the newest lesion or the vesicular fluid, doing so within 7 days of the appearance of new lesions and within 2 days of the appearance of recurrent ones.

b.

Scrape a small amount of the lesion tissue with a tongue blade, and apply it to a slide.

c.

Use a swab to collect fluid from the center of a lesion that is still weeping, and apply this to a slide.

d.

Spray the lesion with ether, collect a specimen, and place it in a collection tube containing ether.

ANS: A

Feedback

A

Correct. Cultures are obtained by swabbing a lesson. When possible, the sample should be taken from the newest lesionwithin 7 days of appearance and within 2 days of appearance for recurrent lesions. Swabs should be taken from the base of the lesion or from vesicular fluid where more viruses are likely to be present.

B

Incorrect. Taking a viral culture of a lesion suspected of being herpes simplex virus type I (HSV-1) infection, the nurse will not take the culture by scraping a small amount of the lesion tissue with a tongue blade, and applying it to a slide.

C

Incorrect. Taking a viral culture of a lesion suspected of being herpes simplex virus type I (HSV-1) infection, the nurse will not take the culture by using a swab to collect fluid from the center of a lesion that is still weeping, and applying this to a slide.

D

Incorrect. Taking a viral culture of a lesion suspected of being herpes simplex virus type I (HSV-1) infection, the nurse will not take the culture by spraying the lesion with ether, collecting a specimen, and placing it in a collection tube containing ether.

PTS:1REF:p. 1102 Integumentary Alterations

OBJ: Cognitive Level: Application

24.Head lice are most common in which of the following groups of children?

a.

African-American children

c.

Caucasian school-aged boys

b.

children from Central and South America

d.

Caucasian school-aged girls

ANS: D

Feedback

A

Incorrect. Head lice are not most common among African-American children.

B

Incorrect. Head lice are not most common among children from Central and South America.

C

Incorrect. Head lice are not most common among Caucasian school-aged boys.

D

Correct. Head lice are most common among Caucasian school-aged girls.

PTS:1REF:p. 1103 Infestations

OBJ: Cognitive Level: Application

25.The National Pediculosis Association (2004) recommends that the nurse examining childrens hair for lice and nits should:

a.

Wear gloves at all times, and change the gloves for each new examination.

b.

Use wooden tongue depressors, discarded after each examination, to examine the childs hair.

c.

Use ungloved hands, and wash the hands carefully with soap after the examination.

d.

Use a comb to part the hair, and do not touch the hair itself with anything other than the comb.

ANS: B

Feedback

A

Incorrect. The National Pediculosis Association (2004) does not recommend that the nurse examining childrens hair for lice and nits should wear gloves.

B

Correct. The National Pediculosis Association (2004) does not recommend that the nurse examining childrens hair for lice and nits should wear gloves, instead wooden tongue depressors may be used to examine the childs hair. After the exam, the tongue depressors are to be discarded.

C

Incorrect. The National Pediculosis Association (2004) does not recommend that the nurse examining childrens hair for lice and nits should use ungloved hands, and wash the hands carefully with soap after the examination.

D

Incorrect. The National Pediculosis Association (2004) does not recommend that the nurse examining childrens hair for lice and nits should use a comb to part the hair, and do not touch the hair itself with anything other than the comb.

PTS:1REF:p. 1105 Infestations

OBJ: Cognitive Level: Application

26.The nurse examining a 1-year-old child finds some nits and lice. The nurse is aware that children of this age should be treated for nits and lice in which of the following ways?

a.

weight dosed for permethrin (Nix)

c.

manual removal of nits and lice

b.

lice shampoo diluted with water

d.

wash the hair several times a day

ANS: C

Feedback

A

Incorrect. The nurse is aware that permethrin (Nix) is not recommended for use for the 1-year-old child.

B

Incorrect. The nurse is aware that lice shampoo diluted with water is not recommended for use for the 1-year-old child.

C

Correct. The Division of Parasitic Diseases of the CDC (2004a) does not recommend use of pediculocides on children less than 2 years of age. Treatment for these children should consist of manual removal of nits and lice.

D

Incorrect. The nurse is aware that manual removal of nits and lice is superior for the 1-year-old child, not washing the hair.

PTS:1REF:p. 1106 Infestations

OBJ: Cognitive Level: Application

27.Which of the following is the most important message the nurse can give the parents of a child with head lice?

a.

Any child from any home can get pediculosis (head lice).

b.

You will have to wash the childs hair more often.

c.

Shaving the childs head would make it easier to get rid of the lice.

d.

You should not have any children over to play until you get rid of the lice.

ANS: A

Feedback

A

Correct. The nurse can help the child and caregivers understand that head lice is an infestation that is common and is not associated with cleanliness or socioeconomic status.

B

Incorrect. The most important message the nurse can give the parents of a child with head lice is not to wash the childs hair more often.

C

Incorrect. The most important message the nurse can give the parents of a child with head lice is not to shave the childs head.

D

Incorrect. The most important message the nurse can give the parents of a child with head lice is not to keep other children away.

PTS:1REF:p. 1107 Infestations

OBJ: Cognitive Level: Application

28.The nurse assessing a child finds the classic symptoms of scabies, which are:

a.

Track-like raised red areas, which burn and hurt but do not itch at all

b.

constant itching and secondary infections from itching, in addition to primary dry scaly lesions on the arms and trunk

c.

daytime itching and vesicles containing fluid in a Track-like pattern

d.

nighttime itching and minute grayish-brown, threadlike burrow tracks with a black dot at the end of the track

ANS: D

Feedback

A

Incorrect. Track-like raised red areas, which burn and hurt but do not itch at all, are not classic symptoms of scabies.

B

Incorrect. Constant itching and secondary infections from itching, in addition to primary dry scaly lesions on the arms and trunk classic are not symptoms of scabies.

C

Incorrect. Daytime itching and vesicles containing fluid in a Track-like pattern is not a classic symptom of scabies.

D

Correct. Scabies is caused by the infestation of the scabies mite, Sarcoptes scabies. Generalized pruritus, which increases at night, and a characteristic erythematous, papular rash are considered the classic symptoms of scabies. Also, minute grayish-brown, threadlike, burrow tracks with a black dot at the end of the burrow.

PTS:1REF:p. 1107 Anatomy and Physiology

OBJ: Cognitive Level: Comprehension

29.The nurse will recommend to the family of a child with scabies that every member be treated prophylactically for scabies for which of the following reasons?

a.

The incubation period is 2 to 6 weeks.

b.

Scabies is highly contagious for months.

c.

It is difficult to kill scabies.

d.

Psychologically they will feel better.

ANS: A

Feedback

A

Correct. Because of the long incubation period associated with scabies, all household members and close physical contact should be treated prophylactically.

B

Incorrect. The nurse will recommend to the family of a child with scabies that every member be treated prophylactically for scabies, but not because scabies is highly contagious for months.

C

Incorrect. The nurse will recommend to the family of a child with scabies that every member be treated prophylactically for scabies, but not because it is difficult to kill scabies.

D

Incorrect. The nurse will recommend to the family of a child with scabies that every member be treated prophylactically for scabies, but not because they will feel better psychologically.

PTS:1REF:p. 1108 Anatomy and Physiology

OBJ: Cognitive Level: Application

30.The nurse working in pediatrics will find that the majority of cases of atopic dermatitis or eczema occur in which of the following age groups?

a.

infants and young children

c.

latency age

b.

school-aged children

d.

adolescents and young adults

ANS: A

Feedback

A

Correct. Atopic dermatitis has been described as an itch that rashes. Although it can occur at any time of life, it is most common in infants and young children.

B

Incorrect. Atopic dermatitis is not most common in school-aged children.

C

Incorrect. Atopic dermatitis is not most common in latency age.

D

Incorrect. Atopic dermatitis is not most common in adolescents and young adults.

PTS:1REF:p. 1110 Anatomy and Physiology

OBJ: Cognitive Level: Comprehension

31.When developing a nursing care plan for a child with atopic dermatitis who has a nursing diagnosis of risk for infection (secondary to scratching of lesions), the nurse will most likely select which of the following interventions?

a.

Keep the environment warm.

b.

Dress the child in clothing that is light, clean, and loose.

c.

Teach the family to use antibacterial hand soap.

d.

Avoid lotions and creams.

ANS: B

Feedback

A

Incorrect. The nurse will not most likely advise the caregiver to keep the environment warm.

B

Correct. When developing a nursing care plan for a child with atopic dermatitis who has a nursing diagnosis of risk for infection (secondary to scratching of lesions), the nurse will most likely advise the caregiver to dress the child in clothing that is light, clean, and loose. Tight clothing may cause more irritation and therefore more scratching. Clean clothing will prevent further infection.

C

Incorrect. The nurse will not most likely advise the caregiver to teach the family to use antibacterial hand soap.

D

Incorrect. The nurse will not most likely advise the caregiver to avoid lotions and creams.

PTS:1REF:p. 1110 Anatomy and Physiology

OBJ: Cognitive Level: Application

MULTIPLE RESPONSE

1.Which of the following events is most often necessary to start the process of developing impetigo? Select all that apply.

a.

a scratch

c.

contact with a mite

b.

underlying skin disease

d.

an insect bite

ANS: A, D

Feedback

Correct

A disruption in the skin integrity such as from a scratch allows the introduction of bacteria through contact with an infected individual.

A disruption in the skin integrity such as from an insect bite allows the introduction of bacteria through contact with an infected individual.

Incorrect

Contact with a mite is not associated with the transmission of impetigo.

An underlying skin disease is not necessary for the process of impetigo to develop.

PTS:1REF:p. 1083 Bacterial Infections

OBJ: Cognitive Level: Application

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