Chapter 30: The Child with Integumentary Dysfunction

Chapter 30: The Child with Integumentary Dysfunction

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse is taking care of a 7-year-old child with a skin rash called a papule. Which clinical finding should the nurse expect to assess with this type of skin rash?

a.	A lesion that is elevated, palpable, firm and circumscribed; less than 1 cm in diameter
b.	A lesion that is elevated, flat-topped, firm, rough and superficial; greater than 1 cm in diameter
c.	An elevated lesion, firm, circumscribed, palpable; 1 to 2 cm in diameter
d.	An elevated lesion, circumscribed, filled with serous fluid; less than 1 cm in diameter

 

 

ANS:  A

A papule is elevated; palpable; firm; circumscribed; less than 1 cm in diameter; and brown, red, pink, tan, or bluish red. A plaque is an elevated, flat-topped, firm, rough, superficial papule greater than 1 cm in diameter. It may be coalesced papules. A nodule is elevated, 1 to 2 cm in diameter, firm, circumscribed, palpable, and deeper in the dermis than a papule. A vesicle is elevated, circumscribed, superficial, less than 1 cm in diameter, and filled with serous fluid.

 

PTS:   1                    DIF:    Cognitive Level: Understand            REF:   1011

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential

 

2. The nurse is teaching nursing students about childhood skin lesions. Which is an elevated, circumscribed skin lesion that is less than 1 cm in diameter and filled with serous fluid?

a.	Cyst
b.	Papule
c.	Pustule
d.	Vesicle

 

 

ANS:  D

A vesicle is elevated, circumscribed, superficial, less than 1 cm in diameter, and filled with serous fluid. A cyst is elevated, circumscribed, palpable, encapsulated, and filled with liquid or semisolid material. A papule is elevated; palpable; firm; circumscribed; less than 1 cm in diameter; and brown, red, pink, tan, or bluish red. A pustule is elevated, superficial, and similar to a vesicle but filled with purulent fluid.

 

PTS:   1                    DIF:    Cognitive Level: Remember            REF:   1011

TOP:   Integrated Process: Teaching/Learning

MSC:  Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential

 

3. The nurse is taking care of a 2-year-old child with a macule skin lesion. Which clinical finding should the nurse expect to assess with this type of lesion?

a.	Flat, nonpalpable, and irregularly shaped lesion that is greater than 1 cm in diameter
b.	Heaped-up keratinized cells, flaky exfoliation, irregular, thick or thin, dry or oily, varied in size
c.	Flat, brown mole less than 1 cm in diameter
d.	Elevated, flat-topped, firm, rough, superficial papule greater than 1 cm in diameter

 

 

ANS:  C

A macule is flat; nonpalpable; circumscribed; less than 1 cm in diameter; and brown, red, purple, white, or tan. A patch is a flat, nonpalpable, and irregularly shaped macule that is greater than 1 cm in diameter. Scale is heaped-up keratinized cells, flaky exfoliation, irregular, thick or thin, dry or oily, varied in size, and silver white or tan. A plaque is an elevated, flat-topped, firm, rough, superficial papule greater than 1 cm in diameter. It may be coalesced papules.

 

PTS:   1                    DIF:    Cognitive Level: Understand            REF:   1011

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential

 

4. A school-age child falls on the playground and has a small laceration on the forearm. The school nurse should do which to cleanse the wound?

a.	Slowly pour hydrogen peroxide over wound.
b.	Soak arm in warm water and soap for at least 30 minutes.
c.	Gently cleanse with sterile pad and a nonstinging povidone-iodine solution.
d.	Wash wound gently with mild soap and water for several minutes.

 

 

ANS:  D

Lacerations should be washed gently with mild soap and water or normal saline. A sterile pad is not necessary, and hydrogen peroxide and povidone-iodine should not be used because they have a cytotoxic effect on healthy cells and minimal effect on controlling infection. Soaking the arm will not effectively clean the wound.

 

PTS:   1                    DIF:    Cognitive Level: Apply                   REF:   1015

TOP:   Integrated Process: Nursing Process: Implementation

MSC:  Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential

 

5. A child steps on a nail and sustains a puncture wound of the foot. Which is the most appropriate method for cleansing this wound?

a.	Wash wound thoroughly with chlorhexidine.
b.	Wash wound thoroughly with povidone-iodine.
c.	Soak foot in warm water and soap.
d.	Soak foot in solution of 50% hydrogen peroxide and 50% water.

 

 

ANS:  C

Puncture wounds should be cleansed by soaking the foot in warm water and soap. Chlorhexidine, hydrogen peroxide, and povidone-iodine should not be used because they have a cytotoxic effect on healthy cells and minimal effect on controlling infection.

 

PTS:   1                    DIF:    Cognitive Level: Apply                   REF:   1016

TOP:   Integrated Process: Nursing Process: Implementation

MSC:  Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential