PEDIATRICS NCLEX
The nurse is monitoring a child with burns during treatment for burn
shock. The nurse understands that which assessment provides the most
accurate guide to determine the adequacy of fluid resuscitation?
A. skin turgor
B. neurological assessment
C. Level of edema at burn site
D. quality of peripheral pulses - ANSWER- B. neurological assessment
Rationale.Sensorium is an accurate guide to determine the adequacy
of fluid resuscitation. The burn injury itself does not affect the
sensorium, so the child should be alert and oriented. Any alteration
in sensorium should be evaluated further. A neurological assessment
would determine the level of sensorium in the child.
The mother of a 3 year old child arrives at a clinic and tells the nurse
that the child has been scratching the skin continuously and has
developed a rash. The nurse assesses the child and suspects the presence
of scabies. The nurse bases this suspicion on which finding noted on
assessment of the child's skin?
A. fine grayish red lines
B. Purple-colored lesions
,C. thick, honey-colored crusts
D. clusters of fluid-filled vesicles - ANSWER- A. Fine grayish red lines
Rationale. Scabies is a parasitic skin disorder caused by an
infestation of sarcoptes scabiei (itch mite). Scabies appears as
burrows of fine, grayish red, threadline lines. They may be difficult
to see if they are obscured by excoriation and inflammation. Purple-
colored lesions may indicate various disorders including systemic
conditions. Thick, honey-colored crusts are characteristic of
impetigo or secondary infections in eczema. Clusters of fluid-filled
vesicles are seen in herpesvirus infection.
Permethrin (Elimite) is prescribed for a child with a diagnosis of scabies.
The nurse should give which instruction to the parents regarding the use
of this treatment?
A. apply the lotion to areas of the rash only
B. apply the lotion and leave it on for 6 hours
C. Avoid putting clothes on the child over the lotion
D. Apply the lotion to cool, dry skin at least 30 minutes after bathing. -
ANSWER- D. Apply the lotion to cool, dry skin at least 30 minutes after
bathing.
Rationale. Permethrin is massaged thoroughly and gently into all
skin surfaces (not just the areas that have the rash) from the head to
the soles of the feet. Care should be taken to avoid contact with the
eyes. The lotion should not be applied until at least 30 minutes after
bathing and should be applied only to cool, dry skin. The lotion
should be kept on for 8-14 hours, and then the child should be given
,a bath. The child should be clothed during the 8-14 hours of
treatment contact time.
The school nurse has provided an instructional session about impetigo to
parents of the children attending the school. Which statement, if made
by a parent, indicates a need for further instruction?
A. It is extremely contagious
B. It is most common in humid weather.
C. Lesions most often are located on the arms and chest.
D. It might show up in an area o broken skin, such as an insect bite. -
ANSWER- C. Lesions most often are located on the arms and chest.
Rationale. Impetigo is a contagious bacterial infectdion of the skin
caused by beta-hemolytic streptococci or staphylococci, or both.
Impetigo is most common during hot, humid summer months.
Impetigo may begin in an area of broken skin, such as an insect bite
or atopic dermatitis. Impetigo is extremely contagious. Lesions
usually are located around the mouth and nose, but may be present
on the hands and extremities.
The clinic nurse is reviewing the health care provider's prescription for a
child who has been diagnosed with scabies. Lindane has been prescribed
for the child. The nurse questions the prescription if which is noted in
the child's record?
A. The child is 18 months old
B. The child is being bottle-fed.
C. A sibling is using lindane for the treatment of scabies
, D. The child has a history of frequent respiratory infections. -
ANSWER- A. The child is 18 months old
Rationale. Lindane is a pediculicide product that may be prescribed
to treat scabies. It is contraindicated for children younger than 2
years old because they have more permeable skin, and high systemic
absorption may occur, placing the children at risk for central
nervous system toxicity and seizures. Lindane also is used with
caution in children between the ages of 2 and 10 years. Siblings and
other household members should be treated simultaneously.
Lindane is not recommended for use by a breast-feeding woman
because the medication is secreted into breast milk.
A topical corticosteroid is prescribed by a health care provider for a
child with atopic dermatitis (eczema). Which instruction should the
nurse give the parent about applying the cream?
A. Apply the cream over the entire body.
B. Apply a thick layer of cream to affected areas only
C. Avoid cleansing the area before application of the cream
D. Apply a think layer of cream and rub it into the area thoroughly. -
ANSWER- D. Apply a think layer of cream and rub it into the area
thoroughly.
Rationale. Atopic dermatitis is a superficial inflammatory process
involving primarily the epidermis. A topical corticosteroid may be
prescribed and should be applied sparingly (thin layer) and rubbed
into the area thoroughly. The affected area should be cleaned gently
before application. A topical corticosteroid should not be applied
The nurse is monitoring a child with burns during treatment for burn
shock. The nurse understands that which assessment provides the most
accurate guide to determine the adequacy of fluid resuscitation?
A. skin turgor
B. neurological assessment
C. Level of edema at burn site
D. quality of peripheral pulses - ANSWER- B. neurological assessment
Rationale.Sensorium is an accurate guide to determine the adequacy
of fluid resuscitation. The burn injury itself does not affect the
sensorium, so the child should be alert and oriented. Any alteration
in sensorium should be evaluated further. A neurological assessment
would determine the level of sensorium in the child.
The mother of a 3 year old child arrives at a clinic and tells the nurse
that the child has been scratching the skin continuously and has
developed a rash. The nurse assesses the child and suspects the presence
of scabies. The nurse bases this suspicion on which finding noted on
assessment of the child's skin?
A. fine grayish red lines
B. Purple-colored lesions
,C. thick, honey-colored crusts
D. clusters of fluid-filled vesicles - ANSWER- A. Fine grayish red lines
Rationale. Scabies is a parasitic skin disorder caused by an
infestation of sarcoptes scabiei (itch mite). Scabies appears as
burrows of fine, grayish red, threadline lines. They may be difficult
to see if they are obscured by excoriation and inflammation. Purple-
colored lesions may indicate various disorders including systemic
conditions. Thick, honey-colored crusts are characteristic of
impetigo or secondary infections in eczema. Clusters of fluid-filled
vesicles are seen in herpesvirus infection.
Permethrin (Elimite) is prescribed for a child with a diagnosis of scabies.
The nurse should give which instruction to the parents regarding the use
of this treatment?
A. apply the lotion to areas of the rash only
B. apply the lotion and leave it on for 6 hours
C. Avoid putting clothes on the child over the lotion
D. Apply the lotion to cool, dry skin at least 30 minutes after bathing. -
ANSWER- D. Apply the lotion to cool, dry skin at least 30 minutes after
bathing.
Rationale. Permethrin is massaged thoroughly and gently into all
skin surfaces (not just the areas that have the rash) from the head to
the soles of the feet. Care should be taken to avoid contact with the
eyes. The lotion should not be applied until at least 30 minutes after
bathing and should be applied only to cool, dry skin. The lotion
should be kept on for 8-14 hours, and then the child should be given
,a bath. The child should be clothed during the 8-14 hours of
treatment contact time.
The school nurse has provided an instructional session about impetigo to
parents of the children attending the school. Which statement, if made
by a parent, indicates a need for further instruction?
A. It is extremely contagious
B. It is most common in humid weather.
C. Lesions most often are located on the arms and chest.
D. It might show up in an area o broken skin, such as an insect bite. -
ANSWER- C. Lesions most often are located on the arms and chest.
Rationale. Impetigo is a contagious bacterial infectdion of the skin
caused by beta-hemolytic streptococci or staphylococci, or both.
Impetigo is most common during hot, humid summer months.
Impetigo may begin in an area of broken skin, such as an insect bite
or atopic dermatitis. Impetigo is extremely contagious. Lesions
usually are located around the mouth and nose, but may be present
on the hands and extremities.
The clinic nurse is reviewing the health care provider's prescription for a
child who has been diagnosed with scabies. Lindane has been prescribed
for the child. The nurse questions the prescription if which is noted in
the child's record?
A. The child is 18 months old
B. The child is being bottle-fed.
C. A sibling is using lindane for the treatment of scabies
, D. The child has a history of frequent respiratory infections. -
ANSWER- A. The child is 18 months old
Rationale. Lindane is a pediculicide product that may be prescribed
to treat scabies. It is contraindicated for children younger than 2
years old because they have more permeable skin, and high systemic
absorption may occur, placing the children at risk for central
nervous system toxicity and seizures. Lindane also is used with
caution in children between the ages of 2 and 10 years. Siblings and
other household members should be treated simultaneously.
Lindane is not recommended for use by a breast-feeding woman
because the medication is secreted into breast milk.
A topical corticosteroid is prescribed by a health care provider for a
child with atopic dermatitis (eczema). Which instruction should the
nurse give the parent about applying the cream?
A. Apply the cream over the entire body.
B. Apply a thick layer of cream to affected areas only
C. Avoid cleansing the area before application of the cream
D. Apply a think layer of cream and rub it into the area thoroughly. -
ANSWER- D. Apply a think layer of cream and rub it into the area
thoroughly.
Rationale. Atopic dermatitis is a superficial inflammatory process
involving primarily the epidermis. A topical corticosteroid may be
prescribed and should be applied sparingly (thin layer) and rubbed
into the area thoroughly. The affected area should be cleaned gently
before application. A topical corticosteroid should not be applied
