Nursing Care of the Child with an Infection QUESTIONS AND ANSWERS| GRADED A

The appearance of which hallmark clinical manifestation occurs in measles? 1 Conjunctivitis 2 Koplik spots 3 Fever 4 Cough Correct Answer: 2 The hallmark symptom of measles is the appearance of Koplik spots. These occur a few days before the outbreak of the rash. They are classic in appearance, described as a red ring around white dots. They occur on the buccal mucosa generally around the first and second molars. NOT 3.1.4. Measles has fever, conjunctivitis, and a cough as prodromal symptoms, but these are not definitive for measles as they can occur with many other illnesses Koplik spots Correct Answer: small, white spots with red halo over oral mucosa; early sign of measles Rubeola Correct Answer: measles virus What information should be included in the teaching plan for a child with varicella? 1 Administer aspirin for fever. 2 Place the child in a warm bath for skin discomfort. 3 Utilize salt solutions to assist in healing oral lesions. 4 Remind the child not to scratch the lesions. Correct Answer: 4 Varicella lesions appear first on the scalp. They spread to the face, the trunk, and to the extremities. There may be various stages of the lesions present at any one time. The lesions are intensely pruritic. The teaching plan for varicella should include that the child not scratch the lesions. NOT Opening the lesions gives access for secondary infection to occur and causes scarring. 1 Acetaminophen, not aspirin, should be administered for fever due to the link with Reye syndrome. 3 The best treatment for skin discomfort is a cool bath with soothing colloidal oatmeal every 3 to 4 hours for the first few days. 2 Warm baths cause more itching and dry the skin. colloidal oatmeal Correct Answer: Aveeno Dry skin, Antipruritus (anti-itch) What is a true statement regarding measles? 1 It is transmitted by the fecal-oral route. 2 It is not contagious. 3 The incubation period is 10 to 12 days. 4 Peak outbreaks are in the summer. Correct Answer: 3 Measles is a highly contagious disease spread via droplets from the nasopharyngeal secretions. The typical incubation period is 10 to 12 days. Outbreaks peak in the winter and spring. It is communicable (contagious) 1 to 2 days before the onset of symptoms. The initial symptoms are fever, cough, coryza (inflamed nostrils) and conjunctivitis. These symptoms are followed by Koplik spots seen in the mouth. A rash develops on the head and spreads downward and outward. A nurse is assessing a neonate with sepsis. The nurse understands that most commonly the cause involves: Correct Answer: Bacteria are typically the culprits. However, neonatal sepsis can be caused by viruses such as herpes simplex or enteroviruses and by protozoa (e.g., oxoplasma gondii). The nurse is providing teaching to the parents of a child with varicella. Which statement indicates that the parents have understood the instructions? 1 "We should apply alcohol to the lesions every four hours." 2 "If he has a fever, we can give him some aspirin." 3 "The lesions should eventually form soft crusts that drain." 4 "We need to make sure that he washes his hands frequently." Correct Answer: 4 The child with varicella needs to wash his hands frequently with antibacterial soap to reduce bacterial colonization. NOT 1 A cool bath with soothing colloidal oatmeal may help the skin discomfort. Alcohol would be too drying to the skin. 2 Acetaminophen, not aspirin, should be used to reduce fever. 3 The lesions should eventually crust over. Soft crusts with drainage may suggest an infection. An adolescent girl and her caregiver present at the pediatrician's office. The adolescent reports severe abdominal pain. A diagnosis of pelvic inflammatory disease (PID) is made. The nurse notes in the child's chart that this is the third time she has been treated for PID. Which action by the nurse would be most appropriate? 1 Contact the necessary authorities to report a suspected case of sexual abuse. 2 Take the child to a private room and interview her regarding her sexual history and partners. 3 Take the caregiver to a private room and tell her that the child's diagnosis can only come from sexual activity. 4 Talk to the child and caregiver together and explain that the condition is often a result of a sexually transmitted infection and discuss the importance of safe sex practices. Correct Answer: 2 Adolescents must be made aware of the seriousness of PID, a common result of a chlamydial infection. Pelvic inflammatory disease can cause sterility in the female, primarily by causing scarring in the fallopian tubes that prohibits the passage of the fertilized ovum into the uterus. A tubal pregnancy may be the consequence of a chlamydial infection. In the male, sterility may result from epididymitis caused by a chlamydial infection. All sexual partners must be treated. Tetanus Correct Answer: Tetanus is an acute, often fatal neurologic disease caused by the toxins produced by Clostridium tetani Characterized by increased muscle tone and spasm. C. tetani spores can live anywhere but are found most commonly in soil, dust, and feces from humans or animals, such as sheep, cattle, chickens, dogs, cats, and rats. Complications associated with tetanus Correct Answer: Complications associated with tetanus include breathing problems, fractures, elevated blood pressure, dysrhythmias, clotting in the blood vessels of the lung, pneumonia, and coma. 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? 1 Neck 2 Arms 3 Legs 4 Stomach Correct Answer: 1 Tetanus progresses in a descending fashion to other muscle groups, causing spasms of the neck, arms, legs, and stomach. A group of nursing students are reviewing the functions of white blood cells. The students demonstrate an understanding of the information when they identify which white blood cell as responsible for combating allergic disorders? 1 eosinophils 2 neutrophils 3 lymphocytes 4 monocytes Correct Answer: 1 Eosinophils function to combat allergic disorders and parasitic infestations. NOT 2 Neutrophils function to combat bacterial infections. 3 Lymphocytes function to combat viral infections. 4 Monocytes function to combat severe infections 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 is over 102°F (38.9°C). He has this rash on his face and chest that looks like sunburn but feels really rough." What would the nurse suspect? 1 Scarlet fever 2 Community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA) 3 Diphtheria 4 Pertussis Correct Answer: 1 Scarlet fever typically is associated with a sore throat, fever greater than 101° F (38.9° C), and the characteristic rash on the face, trunk, and extremities that looks like sunburn but feels like sandpaper. NOT 2 CAMRSA is typically manifested by skin and tissue infections. 3 Diphtheria is characterized by a sore throat and difficulty swallowing but fever is usually below 102°F (38.9°C). Airway obstruction is apparent. 4 Pertussis is characterized by cough and cold symptoms that progress to paroxysmal coughing spells along with copious secretions Scarlet fever Correct Answer: An infection resulting from group A streptococci. It usually occurs with a group A streptococci throat infection (i.e., strep throat) or rarely streptococcal skin infection. However, in the case of scarlet fever, the bacteria produce a toxin that causes a rash. Not all children with a group A streptococci infection will develop the rash of scarlet fever. A nurse practitioner suspects that a child has scarlet fever based on which assessment finding? 1 Severity of the sore throat 2 An enanthematous rash 3 Red, strawberry tongue 4 White exudate on the tonsils Correct Answer: 3 The characteristic assessment finding that distinguishes scarlet fever from other disorders is the appearance of the red, strawberry tongue. NOT 1.2.4. Sore throat, an enanthematous and exanthematous rash, and white exudate on the tonsils are also seen with scarlet fever, but it is the strawberry tongue that helps to confirm the diagnosis CAMRSA Correct Answer: Community-Acquired MRSA (methicillin-resistant Staphylococcus aureus). An infection (super bug) spread by a community member and hasn't necessarily been to the hospital Diphtheria Correct Answer: An acute bacterial infection of the upper respiratory tract (nose, larynx, tonsils, or pharynx) The neck becomes edematous and lymphadenopathy develops. The pseudomembrane causes airway obstruction and suffocation. Pertussis Correct Answer: Pertussis is an acute respiratory disorder characterized by paroxysmal cough (whooping cough) and copious Parents bring their 9-year-old child to the clinic for a well-child visit. They are concerned because several children in the neighborhood have developed Lyme disease and ask for suggestions on what to do to reduce their child's risk. What would be appropriate for the nurse to suggest? Select all that apply. 1 Wearing protective clothing when playing in wooded areas. 2 Dressing the child in dark clothing when going outdoors. 3 Inspecting the skin closely for ticks after the child plays in wooded areas. 4 Removing ticks by rubbing them away from the skin with a credit card. 5 Contacting the health care provider if there is any area of inflammation that might be a bite. Correct Answer: 1. The nurse should teach the parents to have the child wear protective clothing and dress the child in light clothing when playing in wooded areas or going outdoors. 3 The parents should inspect the child's skin closely for ticks after being outside in wooded areas and if any ticks ar