Burns - 24 - Infectious Diseases and
Immunizations
The primary care pediatric nurse practitioner performs a well child examination on a
1monthold. The infant was recently discharged from the neonatal intensive care unit
after treatment with parenteral acyclovir for a neonatal herpetic infection and is currently
taking oral acyclovir. What will the nurse practitioner do to manage this infant's care?
A. Obtain regular absolute neutrophil counts.
B. Perform routine skin cultures for herpes simplex virus.
C. Reinforce the need to give acyclovir indefinitely.
D. Stop the oral acyclovir at 2 months of age. - correct answerA. Obtain regular
absolute neutrophil counts.
25. A preschoolage child is brought to clinic for evaluation of a rash. The primary care
pediatric nurse practitioner notes an intense red eruption on the child's cheeks and
circumoral pallor. What will the nurse practitioner tell the parents about this rash?
A. This rash may be a prodromal sign of rubella or roseola.
B. The child will need immunization boosters to prevent serious disease.
C. This is a benign rash with no known serious complications.
D. Expect a lacy, maculopapular rash to develop on the trunk and extremities. - correct
answerD. Expect a lacy, maculopapular rash to develop on the trunk and extremities
31. A 7yearold child whose immunizations are up to date has a fever, headache, stiff
neck, and photophobia. What course of treatment is indicated?
A. Empiric treatment with oral antibiotics or intramuscular ceftriaxone
B. Hospitalization for diagnosis and treatment with antibiotics
C. Immediate vaccination with meningococcal vaccine
D. Outpatient lab work, including a CBC and blood and CSF cultures - correct answerB.
Hospitalization for diagnosis and treatment with antibiotics
32. A schoolage child has fever of 104°F, sore throat, vomiting and malaise. The
primary care pediatric nurse practitioner observes that the tonsils, oropharynx, and
, palate are erythematous and covered with exudate; the tongue is coated and red; and
there is a red, sandpaperlike rash on the child's neck, trunk, and extremities. A rapid
strep test is positive. What will the nurse practitioner do to manage this child's illness?
A. Administer intramuscular ceftriaxone.
B. Hospitalize for further diagnostic tests.
C. Prescribe oral amoxicillin.
D. Refer to a pediatric infectious disease specialist. - correct answerC. Prescribe oral
amoxicillin.
34. The primary care pediatric nurse practitioner is examining a 2monthold infant with
fever and cough. A WBC is 14,000/mm3 and a chest radiograph is normal. The infant is
nursing well and having normal stools. What would be an appropriate next step?
A. Admitting the infant to the hospital for LP and IV antibiotics
B. Obtaining a blood culture, erythrocyte sedimentation rate, and Creactive protein
C. Performing a catheterized urinalysis to screen for leukocytes and nitrites
D. Prescribing empiric, broadspectrum antibiotics with close followup - correct answerC.
Performing a catheterized urinalysis to screen for leukocytes and nitrites
A 10monthold infant has an erythematous, fluctuant, nondraining abscess on the right
buttock after 10 days of treatment with amoxicillin for impetigo. What is the next step in
managing this infant's care?
A. Consultation with a pediatric infectious disease specialist
B. Culture of any superficial open surface wounds
C. Empiric treatment with clindamycin
D. Incision and drainage of the abscess with culture - correct answerD. Incision and
drainage of the abscess with culture
A 10monthold infant who is new to the clinic has chronic hepatitis B infection. What will
the primary care pediatric nurse practitioner do to manage this infant's disease?
A. Consult a pediatric infectious disease specialist.
B. Prescribe interferonalfa.
Immunizations
The primary care pediatric nurse practitioner performs a well child examination on a
1monthold. The infant was recently discharged from the neonatal intensive care unit
after treatment with parenteral acyclovir for a neonatal herpetic infection and is currently
taking oral acyclovir. What will the nurse practitioner do to manage this infant's care?
A. Obtain regular absolute neutrophil counts.
B. Perform routine skin cultures for herpes simplex virus.
C. Reinforce the need to give acyclovir indefinitely.
D. Stop the oral acyclovir at 2 months of age. - correct answerA. Obtain regular
absolute neutrophil counts.
25. A preschoolage child is brought to clinic for evaluation of a rash. The primary care
pediatric nurse practitioner notes an intense red eruption on the child's cheeks and
circumoral pallor. What will the nurse practitioner tell the parents about this rash?
A. This rash may be a prodromal sign of rubella or roseola.
B. The child will need immunization boosters to prevent serious disease.
C. This is a benign rash with no known serious complications.
D. Expect a lacy, maculopapular rash to develop on the trunk and extremities. - correct
answerD. Expect a lacy, maculopapular rash to develop on the trunk and extremities
31. A 7yearold child whose immunizations are up to date has a fever, headache, stiff
neck, and photophobia. What course of treatment is indicated?
A. Empiric treatment with oral antibiotics or intramuscular ceftriaxone
B. Hospitalization for diagnosis and treatment with antibiotics
C. Immediate vaccination with meningococcal vaccine
D. Outpatient lab work, including a CBC and blood and CSF cultures - correct answerB.
Hospitalization for diagnosis and treatment with antibiotics
32. A schoolage child has fever of 104°F, sore throat, vomiting and malaise. The
primary care pediatric nurse practitioner observes that the tonsils, oropharynx, and
, palate are erythematous and covered with exudate; the tongue is coated and red; and
there is a red, sandpaperlike rash on the child's neck, trunk, and extremities. A rapid
strep test is positive. What will the nurse practitioner do to manage this child's illness?
A. Administer intramuscular ceftriaxone.
B. Hospitalize for further diagnostic tests.
C. Prescribe oral amoxicillin.
D. Refer to a pediatric infectious disease specialist. - correct answerC. Prescribe oral
amoxicillin.
34. The primary care pediatric nurse practitioner is examining a 2monthold infant with
fever and cough. A WBC is 14,000/mm3 and a chest radiograph is normal. The infant is
nursing well and having normal stools. What would be an appropriate next step?
A. Admitting the infant to the hospital for LP and IV antibiotics
B. Obtaining a blood culture, erythrocyte sedimentation rate, and Creactive protein
C. Performing a catheterized urinalysis to screen for leukocytes and nitrites
D. Prescribing empiric, broadspectrum antibiotics with close followup - correct answerC.
Performing a catheterized urinalysis to screen for leukocytes and nitrites
A 10monthold infant has an erythematous, fluctuant, nondraining abscess on the right
buttock after 10 days of treatment with amoxicillin for impetigo. What is the next step in
managing this infant's care?
A. Consultation with a pediatric infectious disease specialist
B. Culture of any superficial open surface wounds
C. Empiric treatment with clindamycin
D. Incision and drainage of the abscess with culture - correct answerD. Incision and
drainage of the abscess with culture
A 10monthold infant who is new to the clinic has chronic hepatitis B infection. What will
the primary care pediatric nurse practitioner do to manage this infant's disease?
A. Consult a pediatric infectious disease specialist.
B. Prescribe interferonalfa.
