TEST BANK For Essentials of Pediatric Nursing 4th Edition By
Kyle Carman
A nurse is assessing a neonate with sepsis. The nurse understands that most
commonly the cause involves:
Enterovirus
Protozoa
Herpes virus
Bacteria - ANSWER:Bacteria
Neonatal sepsis can be caused by viruses such as herpes simplex or enteroviruses
and by protozoa (e.g., Toxoplasma gondii). However, bacteria are typically the
culprits.
A nurse is assessing a child with a tick-borne disease. What finding would indicate to
the nurse that the child has developed ehrlichiosis and not Rocky Mountain spotted
fever?
Fever
Absence of rash
Malaise
Headache - ANSWER:Absence of rash
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.
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?
Take the child to a private room and interview her regarding her sexual history and
partners.
Contact the necessary authorities to report a suspected case of sexual abuse.
Take the caregiver to a private room and tell her that the child's diagnosis can only
come from sexual activity.
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. - ANSWER:Take the child to a private room and interview her regarding
her sexual history and partners.
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.
The nurse is caring for an adolescent diagnosed with genital herpes. The drug of
choice for treating genital herpes is:
Ceftriaxone
Penicillin
Griseofluvin
Acyclovir - ANSWER:Acyclovir
The drug acyclovir is useful in relieving or suppressing the symptoms of genital
herpes.
A child in the clinic has a fever and reports a sore neck. Upon assessment the nurse
finds a swollen parotid gland. The nurse suspects which infectious disease?
Whooping cough
Measles
Scabies
Mumps - ANSWER:Mumps
Mumps is an infectious disease with a primary symptom of a swollen parotid gland.
It is a contagious disease spread by droplets. The child is contagious 1 to 7 days prior
to the onset of the swelling and 4 to 9 days after the onset of the swelling. Pertussis
is a respiratory disorder which causes severe paroxysmal coughing which produces a
whooping sound. Measles is recognized by Koplick spots in the mouth and the classic
maculopapular rash that starts on the head and spreads downward. Scabies is a skin
condition where lice lay eggs under the skin. The rash is very puritic and is seen on
the hands, feet, and folds of the skin.
A nursing instructor is teaching the students about the standard and transmission-
based precautions. What type of precautions require placing a client in an isolated
room with limited access, wearing gloves during contact with the client and all body
fluids or contaminated items, wearing two layers of protective clothing, and avoiding
sharing equipment between clients?
Contact precautions
Airborne precautions
Standard precautions
Droplet precautions - ANSWER:Contact precautions
Contact precautions means placing the client in an isolation room with limited
access, wearing gloves during contact with the client and all body fluids, wearing two
layers of protective clothing, limiting movement of the client from the room, and
, avoiding sharing equipment between clients. Standard precautions are used with
every client. They involve good handwashing and the use of gloves for client contact.
Airborne precautions are used for diseases where small particles are dispersed in the
air. They require the client in a negative pressure room and, in addition to standard
personal protective equipment, the mask should be N95 or higher. Varicella would
need airborne precautions. Droplet precautions are used for diseases such as
pertusis which produce large droplets. They require standard precautions plus a
surgical mask, preferably with a face shield.
A 5-year-old girl catches the flu from a friend at day care after the friend sneezed
and wiped mucus on a toy that the girl played then with. In this case, what is the
portal of exit in the chain of infection?
Toy
Upper respiratory excretion
The 5-year-old girl
The friend - ANSWER:Upper respiratory excretion
The portal of exit is the route by which an organism leaves an infected child's body
to be spread to others. Organism can be carried out of the body by upper respiratory
excretions, feces, vomitus, saliva, urine, vaginal secretions, blood, or lesion
secretions. The friend would be the reservoir, which is the container or place in
which an organism grows and reproduces. The toy would be the means of
transmission. The 5-year-old girl would be the susceptible host.
The nurse is discussing fever with the parents of a child who is in the emergency
department with a temperature of 101 degrees Fahrenheit. Which statement by a
parent indicates an understanding about fevers and their management in the ill
child?
"Fevers can be beneficial because they can slow down the growth of the bacteria or
virus that may be causing the infection."
"We've had to wake him up in the night to give him more medicine to reduce his
temperature."
"My wife and I have been using cold water and washcloths on him because of the
fever."
"We've been giving him a little extra acetaminophen to help bring his fever down." -
ANSWER:"Fevers can be beneficial because they can slow down the growth of the
bacteria or virus that may be causing the infection."
Fevers can be protective and can help the body fight the infection. Fevers slow down
bacterial or viral growth. Mismanaging fevers include inappropriate dosing of
antipyretics, awakening a child at night to administer antipyretics, and using cold
water or sponging the child with alcohol to reduce the temperature.
Which child will the nurse identify as being at greatest risk for developing a hospital-
acquired infection (HAI)?
Kyle Carman
A nurse is assessing a neonate with sepsis. The nurse understands that most
commonly the cause involves:
Enterovirus
Protozoa
Herpes virus
Bacteria - ANSWER:Bacteria
Neonatal sepsis can be caused by viruses such as herpes simplex or enteroviruses
and by protozoa (e.g., Toxoplasma gondii). However, bacteria are typically the
culprits.
A nurse is assessing a child with a tick-borne disease. What finding would indicate to
the nurse that the child has developed ehrlichiosis and not Rocky Mountain spotted
fever?
Fever
Absence of rash
Malaise
Headache - ANSWER:Absence of rash
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.
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?
Take the child to a private room and interview her regarding her sexual history and
partners.
Contact the necessary authorities to report a suspected case of sexual abuse.
Take the caregiver to a private room and tell her that the child's diagnosis can only
come from sexual activity.
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. - ANSWER:Take the child to a private room and interview her regarding
her sexual history and partners.
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.
The nurse is caring for an adolescent diagnosed with genital herpes. The drug of
choice for treating genital herpes is:
Ceftriaxone
Penicillin
Griseofluvin
Acyclovir - ANSWER:Acyclovir
The drug acyclovir is useful in relieving or suppressing the symptoms of genital
herpes.
A child in the clinic has a fever and reports a sore neck. Upon assessment the nurse
finds a swollen parotid gland. The nurse suspects which infectious disease?
Whooping cough
Measles
Scabies
Mumps - ANSWER:Mumps
Mumps is an infectious disease with a primary symptom of a swollen parotid gland.
It is a contagious disease spread by droplets. The child is contagious 1 to 7 days prior
to the onset of the swelling and 4 to 9 days after the onset of the swelling. Pertussis
is a respiratory disorder which causes severe paroxysmal coughing which produces a
whooping sound. Measles is recognized by Koplick spots in the mouth and the classic
maculopapular rash that starts on the head and spreads downward. Scabies is a skin
condition where lice lay eggs under the skin. The rash is very puritic and is seen on
the hands, feet, and folds of the skin.
A nursing instructor is teaching the students about the standard and transmission-
based precautions. What type of precautions require placing a client in an isolated
room with limited access, wearing gloves during contact with the client and all body
fluids or contaminated items, wearing two layers of protective clothing, and avoiding
sharing equipment between clients?
Contact precautions
Airborne precautions
Standard precautions
Droplet precautions - ANSWER:Contact precautions
Contact precautions means placing the client in an isolation room with limited
access, wearing gloves during contact with the client and all body fluids, wearing two
layers of protective clothing, limiting movement of the client from the room, and
, avoiding sharing equipment between clients. Standard precautions are used with
every client. They involve good handwashing and the use of gloves for client contact.
Airborne precautions are used for diseases where small particles are dispersed in the
air. They require the client in a negative pressure room and, in addition to standard
personal protective equipment, the mask should be N95 or higher. Varicella would
need airborne precautions. Droplet precautions are used for diseases such as
pertusis which produce large droplets. They require standard precautions plus a
surgical mask, preferably with a face shield.
A 5-year-old girl catches the flu from a friend at day care after the friend sneezed
and wiped mucus on a toy that the girl played then with. In this case, what is the
portal of exit in the chain of infection?
Toy
Upper respiratory excretion
The 5-year-old girl
The friend - ANSWER:Upper respiratory excretion
The portal of exit is the route by which an organism leaves an infected child's body
to be spread to others. Organism can be carried out of the body by upper respiratory
excretions, feces, vomitus, saliva, urine, vaginal secretions, blood, or lesion
secretions. The friend would be the reservoir, which is the container or place in
which an organism grows and reproduces. The toy would be the means of
transmission. The 5-year-old girl would be the susceptible host.
The nurse is discussing fever with the parents of a child who is in the emergency
department with a temperature of 101 degrees Fahrenheit. Which statement by a
parent indicates an understanding about fevers and their management in the ill
child?
"Fevers can be beneficial because they can slow down the growth of the bacteria or
virus that may be causing the infection."
"We've had to wake him up in the night to give him more medicine to reduce his
temperature."
"My wife and I have been using cold water and washcloths on him because of the
fever."
"We've been giving him a little extra acetaminophen to help bring his fever down." -
ANSWER:"Fevers can be beneficial because they can slow down the growth of the
bacteria or virus that may be causing the infection."
Fevers can be protective and can help the body fight the infection. Fevers slow down
bacterial or viral growth. Mismanaging fevers include inappropriate dosing of
antipyretics, awakening a child at night to administer antipyretics, and using cold
water or sponging the child with alcohol to reduce the temperature.
Which child will the nurse identify as being at greatest risk for developing a hospital-
acquired infection (HAI)?
