Chapter 31: The Child With a Communicable Disease My Nursing Test Banks

Chapter 31: The Child With a Communicable Disease

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

MULTIPLE CHOICE

1. The nurse takes into consideration that the child most susceptible to an opportunistic infection is the one taking:

a.

Anticonvulsants

b.

A beta-adrenergic agent

c.

An antibiotic

d.

Corticosteroids

ANS: D

Steroids are immunosuppressive drugs that make the child very susceptible to opportunistic infections.

DIF: Cognitive Level: Analysis REF: Text Reference: 717

OBJ: Objective: N/A TOP: Topic: Host Resistance

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

2. 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

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.

DIF: Cognitive Level: Knowledge REF: Text Reference: 717

OBJ: Objective: 3 TOP: Topic: Types of Immunity

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

3. The nurse would document a rash that has erythematous circular raised lesions as:

a.

Macular

b.

Papular

c.

Vesicular

d.

Pustular

ANS: B

A papule is a circular, reddened elevated area on the skin.

DIF: Cognitive Level: Knowledge REF: Text Reference: 718

OBJ: Objective: 6 TOP: Topic: Rashes

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

4. The nurse would delay the administration of DTaP when the mother says that her infant:

a.

Has diarrhea

b.

Had a temperature of 105 F from the previous inoculation

c.

Is teething

d.

Is traveling with her to Europe in a week

ANS: B

A contraindication to giving the DTaP vaccine is a 105 F temperature following the previous vaccination.

DIF: Cognitive Level: Analysis REF: Text Reference: 721

OBJ: Objective: 4 TOP: Topic: Immunizations

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

5. The type of precaution that is necessary when caring for a toddler with varicella is:

a.

Contact

b.

Protective

c.

Airborne infection

d.

Large droplet infection

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.

DIF: Cognitive Level: Application REF: Text Reference: 718

OBJ: Objective: 2 TOP: Topic: Medical Asepsis and Standard Precautions

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

6. 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:

a.

2 to 10 days

b.

4 to 14 days

c.

3 to 32 days

d.

14 to 21 days

ANS: D

The incubation period for varicella is 2 to 3 weeks, usually 13 to 17 days.

DIF: Cognitive Level: Knowledge REF: Text Reference: 713, Table 31-1

OBJ: Objective: 5 TOP: Topic: Common Childhood Communicable Diseases

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

7. The nurse can be assured that parents understand how long a child who has varicella is contagious when they state:

a.

My child should stay home from school for 6 days after the pox appear.

b.

My child can return to school when the rash fades.

c.

My child must stay away from other children until all of the lesions have healed.

d.

My child is contagious as long as he has a fever.

ANS: A

The child with varicella is contagious for 6 days after the appearance of the rash.

DIF: Cognitive Level: Application REF: Text Reference: 713, Table 31-1

OBJ: Objective: 5 TOP: Topic: Common Childhood Communicable Diseases

KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

8. 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.

ANS: C

The use of condoms to prevent STDs is not considered 100% effective but is recommended for sexual intercourse.

DIF: Cognitive Level: Application REF: Text Reference: 725

OBJ: Objective: 8 TOP: Topic: Sexually Transmitted Diseases

KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

9. 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

ANS: D

The infant who is HIV-positive has impaired immunologic functioning and is at high risk for infection.

DIF: Cognitive Level: Analysis REF: Text Reference: 725

OBJ: Objective: 7 TOP: Topic: Human Immunodeficiency Virus

KEY: Nursing Process Step: Nursing Diagnosis

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

10. A parent 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-negative mother at:

a.

2 months

b.

4 months

c.

6 months

d.

1 year

ANS: B

The American Academy of Pediatrics recommends that Comvax, the only thimerosal-free hepatitis B vaccine, should be used for infants born to HBsAg-negative mothers beginning at the 2-month well-child visit.

DIF: Cognitive Level: Knowledge REF: Text Reference: 722, Figure 31-6

OBJ: Objective: 4 TOP: Topic: Immunization Schedule

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

11. The nurse would base a response to a parent about how his child got hepatitis A on the information that the child:

a.

Came in contact with infected blood

b.

Came in contact with droplets in the air

c.

Was bitten by a mosquito or a tick

d.

Ate shrimp while they were in Mexico

ANS: D

Hepatitis A results from ingestion of contaminated water or shellfish.

DIF: Cognitive Level: Comprehension REF: Text Reference: 714, Table 31-1

OBJ: Objective: 5 TOP: Topic: Common Childhood Communicable Diseases

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

12. An infant is hospitalized for RSV bronchiolitis. Which type of precautions would the nurse use when caring for the infant?

a.

Large-droplet infection precautions

b.

Airborne-infection precautions

c.

Contact precautions

d.

Protective precautions

ANS: C

Contact precautions are used when the condition transmits organisms via skin-to-skin contact or indirect touch of a contaminated fomite.

DIF: Cognitive Level: Application REF: Text Reference: 718

OBJ: Objective: 2 TOP: Topic: Medical Asepsis and Standard Precautions

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

13. A 9-year-old child hospitalized for neutropenia is placed in protective isolation. What is the most appropriate response for the nurse to make when the child asks, Why do you have to wear a gown and mask when you are in my room?

a.

Nurses and doctors wear gowns and masks because you have a condition that could be spread to others.

b.

The gown and mask are to protect you because you could get an infection very easily.

c.

Im wearing this because there are a lot of bacteria in the hospital.

d.

I might look scary but you wont need this after you have had medication for 24 hours.

ANS: B

Protective isolation is used for patients who are not communicable but have a lowered resistance and are highly susceptible to infection.

DIF: Cognitive Level: Application REF: Text Reference: 718

OBJ: Objective: 2 TOP: Topic: Protective Isolation

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

14. The nurse is planning to administer immunizations at a well-child visit when a parent reports the 18-month-old child is allergic to eggs. The vaccine that would be contraindicated is:

a.

Influenza

b.

Inactivated polio vaccine

c.

Diphtheria, tetanus, acellular pertussis

d.

Hepatitis B

ANS: A

The influenza vaccine should not be given to children who have an allergy to eggs.

DIF: Cognitive Level: Analysis REF: Text Reference: 720

OBJ: Objective: 3 TOP: Topic: Nurses Role in Immunizations-Allergy

KEY: Nursing Process Step: Planning

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

15. The nurse would choose to administer the immunization injection of:

a.

DTaP subcutaneously

b.

Hib vaccine prepared in a separate syringe

c.

Varicella intramuscularly

d.

Varicella 1 week after the MMR vaccine

ANS: B

Hib vaccine must be given in a separate syringe from other vaccines administered at the same time.

DIF: Cognitive Level: Analysis REF: Text Reference: 722, Figure 31-6

OBJ: Objective: 3 TOP: Topic: Nurses Role in Immunizations

KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

16. A child was sent to the school nurse because of a rash. The nurse noted the rash was present on the trunk, extremities, and face. The childs cheeks were bright red. The nurse is aware this type of rash is consistent with:

a.

Measles

b.

Roseola

c.

Varicella

d.

Fifth disease

ANS: D

When a child has fifth disease, the child has a generalized rash and the cheeks have a slapped cheek appearance.

DIF: Cognitive Level: Application REF: Text Reference: 713, Table 31-1

OBJ: Objective: 6 TOP: Topic: Common Childhood Communicable Diseases

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

17. The nurse determined the parent understood the information when he stated:

a.

Ill have my son wear dark clothing on his hike.

b.

We should all get the Lyme disease vaccine before our trip.

c.

Ill get a prescription for amoxicillin to take with us.

d.

We will wear long pants and long-sleeved shirts in the woods.

ANS: D

People should keep skin covered by wearing protective clothing in wooded areas to prevent tick bites.

DIF: Cognitive Level: Application REF: Text Reference: 715, Table 31-1

OBJ: Objective: 5 TOP: Topic: Common Childhood Communicable Diseases

KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

18. An adolescent is taking tetracycline for a sexually transmitted disease. The nurse would stress in the instruction about this medication to:

a.

Finish all of the medication.

b.

Get plenty of fresh air and sunlight.

c.

The medication should be taken with food.

d.

Take an antacid if the medication causes an upset stomach.

ANS: A

The nurse would teach the adolescent to take all of the prescribed medication to avoid making the microorganism resistant to tetracyclines.

DIF: Cognitive Level: Application REF: Text Reference: 724, Table 31-3

OBJ: Objective: 8 TOP: Topic: Sexually Transmitted Diseases

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

19. The nurse explains to the parents that their child is in the prodromal stage of varicella. This means that the child:

a.

Is now immune to varicella

b.

Has varicella, but has not yet broken out

c.

Is infected with varicella, but is not contagious

d.

Does not have varicella, but has been exposed to it

ANS: B

The prodromal stage is the initial stage of the communicable disease in which the child is infected and contagious, but does not yet have outward signs of the disease.

DIF: Cognitive Level: Application REF: Text Reference: 716

OBJ: Objective: 1 TOP: Topic: Prodromal Period

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

MULTIPLE RESPONSE

1. In giving care, the nurse is aware that safe handling of body substances is essential. Body substances that require safe handling are:

Select all that apply.

a.

Emesis

b.

Saliva

c.

Feces

d.

Semen

e.

Blood

ANS: A, B, C, D, E

All the options listed are considered body substances that are moist secretions capable of containing microorganisms.

DIF: Cognitive Level: Comprehension REF: Text Reference: 716

OBJ: Objective: 1 TOP: Topic: Body Substances

KEY: Nursing Process Step: Planning

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

2. The well-child clinic nurse will prepare to give a healthy 2-month-old inoculations for:

Select all that apply.

a.

DTaP

b.

Hib

c.

IPV

d.

MMR

e.

PCV

ANS: A, B, C, E

All the options are the expected inoculations of a healthy 2-month-old with the exception of MMR. Mumps, measles, rubella are not expected until the child is 1-year-old.

DIF: Cognitive Level: Application REF: Text Reference: 722, Figure 31-6

OBJ: Objective: 3 TOP: Topic: Inoculations for a 2-Month-Old

KEY: Nursing Process Step: Planning

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

COMPLETION

1. The nurse explains ____________________ test determines the childs susceptibility to tuberculosis.

ANS: Mantoux

DIF: Cognitive Level: Knowledge REF: Text Reference: 717

OBJ: Objective: 4 TOP: Topic: Mantoux

KEY: Nursing Process Step: Implementation

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

NOT: Rationale: The Mantoux is a screening test for the susceptibility to TB. An intradermal injection is given and read 3 days later. An erythema and induration of more than 5 mm is considered a positive reading.

2. The nurse uses a diagram showing how the wood tick acts as a ____________________ in the transmission of Lyme disease.

ANS: vector

DIF: Cognitive Level: Comprehension REF: Text Reference: 716

OBJ: Objective: 4 TOP: Topic: Vector

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

NOT: Rationale: A vector is an insect or animal that carries a communicable disease.

3. The school nurse recognizes the presence of macules, papules, vesicles, pustules, and scabs on the child as the particular sign of the communicable disease of ____________________.

ANS: varicella or chickenpox

DIF: Cognitive Level: Application REF: Text Reference: 713, Table 31-1

OBJ: Objective: 5 TOP: Topic: Varicella

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

NOT: Rationale: Varicella has the distinctive sign of showing several types of skin lesions at the same time.

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