Nursing Care of Children Principles and Practice 3rd edition by Susan R. James
Nursing Care of Children Principles and Practice 3rd edition by Susan R. James
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Chapter 25: The Child with an Integumentary Alteration
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| a. | Keep the child home from school for 24 hours after initiation of antibiotic treatment. |
| b. | Clean the rash vigorously with Betadine three times a day. |
| c. | Notify the physician for any itching. |
| d. | Keep the child home from school until the lesions are healed. |
ANS: A
| Feedback | |
| A | To prevent the spread of impetigo to others, the child should be kept home from school for 24 hours after treatment is initiated. Good handwashing is imperative in preventing the spread of impetigo. |
| B | The lesions should be washed gently with a warm soapy washcloth three times a day. Washcloth should not be shared with other members of the family. |
| C | Itching is common and does not necessitate medical treatment. Rather, parents should be taught to clip the child’s nails to prevent maceration of the lesions. |
| D | The child may return to school 24 hours after initiation of antibiotic treatment. |
DIF: Cognitive Level: Comprehension REF: Text Reference: pg 790
OBJ: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance
| a. | Any medication the child is taking |
| b. | Enlarged, mobile, and nontender lymph nodes |
| c. | Child’s urinalysis results |
| d. | Recent infections or signs of infection |
ANS: D
| Feedback | |
| A | Medication history is important, but the history of recent infections is more relevant to the diagnosis. |
| B | Lymph nodes may be enlarged (lymphadenitis), but they are not mobile and are nontender. Lymphangitis may be seen, with red “streaking” of the surrounding area. |
| C | An abnormal urinalysis result is not usually associated with cellulitis. |
| D | Cellulitis may follow an upper respiratory infection, sinusitis, otitis media, or a tooth abscess. The affected area is red, hot, tender, and indurated. |
DIF: Cognitive Level: Comprehension REF: Text Reference: pg 792
OBJ: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
| a. | “I am supposed to continue the antibiotic until the redness and swelling disappear.” |
| b. | “I have been putting ice on my son’s arm to relieve the swelling.” |
| c. | “I should call the doctor if the redness disappears.” |
| d. | “I have been putting a warm soak on my son’s arm every 4 hours.” |
ANS: D
| Feedback | |
| A | The parent should not discontinue antibiotics when signs of infection disappear. To ensure complete healing, the parent should understand that the entire course of antibiotics should be given as prescribed. |
| B | A warm soak is indicated for the treatment of cellulitis. Ice will decrease circulation to the affected area and inhibit the healing process. |
| C | The disappearance of redness indicates healing and is not a reason to seek medical advice. |
| D | Warm soaks applied every 4 hours while the child is awake increase circulation to the infected area, relieve pain, and promote healing. |
DIF: Cognitive Level: Application REF: Text Reference: pg 792
OBJ: Nursing Process Step: Evaluation
MSC: NCLEX: Health Promotion and Maintenance
| a. | Give nystatin suspension with a syringe without a needle. |
| b. | Apply nystatin cream to the affected area twice a day. |
| c. | Give nystatin before the infant is fed. |
| d. | Rub nystatin suspension onto the oral mucous membranes with a gloved finger. |
ANS: D
| Feedback | |
| A | Medication may not reach the affected areas when it is squirted into the infant’s mouth. Rubbing the suspension onto the gum ensures contact with the affected areas. |
| B | Nystatin cream is used for diaper rash caused by Candida. |
| C | To prolong contact with the affected areas, the medication should be administered after a feeding. |
| D | It is important to apply the nystatin suspension to the affected areas, which is best accomplished by rubbing it onto the gums and tongue, after feedings, every 6 hours, until 3 to 4 days after symptoms have disappeared. |
DIF: Cognitive Level: Comprehension REF: Text Reference: pgs 793-794
OBJ: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance
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