TEST BANK PEDIATRIC NURSING EXAM 4 REVIEW COMPLETE
450 REAL EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS WITH DETAILED RATIONALES FOR EVERY QUESTION
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Question 1:
The nurse preceptor is discussing causes of contact dermatitis with a student
nurse. Which of the following causes listed by the student nurse requires further
teaching by the nurse preceptor?
a. Scented diaper wipes.
b. Poison ivy.
c. Laundry detergent.
d. Pollen.
Correct Answer: d
Rationale: Contact dermatitis is a Type IV delayed hypersensitivity reaction caused
by direct skin contact with an irritant or allergen. Scented diaper wipes (a), poison
ivy (b), and laundry detergent (c) are all classic triggers because they contain
chemicals, urushiol oil, or fragrances that directly irritate the skin upon contact.
Pollen (d), however, causes allergic rhinitis (hay fever) or atopic dermatitis
(eczema) via an IgE‑mediated Type I hypersensitivity reaction – it is inhaled or
touches mucous membranes, not a primary cause of contact dermatitis.
Therefore, the student needs further teaching if they list pollen as a cause of
contact dermatitis.
Question 2:
The nurse is preparing to teach a parent about how to care for a child who has
impetigo contagiosa. Which of the following should the nurse include in the
teaching plan?
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,a. Apply bactericidal ointment to lesions.
b. Give the child an antimicrobial bath twice a day.
c. The lesions will need to be covered at all times.
d. Administer salicylates for any pain.
Correct Answer: a
Rationale: Impetigo contagiosa is a highly contagious bacterial skin infection
(usually Staphylococcus aureus or Streptococcus pyogenes) that presents with
honey‑crusted lesions, most often around the nose and mouth. First‑line
treatment for localized impetigo is topical bactericidal ointment (e.g., mupirocin)
applied directly to lesions. (b) Antimicrobial baths are not standard; excessive
bathing can irritate the skin and spread infection. (c) Covering lesions at all times
is not recommended – they should be uncovered to allow drying and crusting,
which promotes healing; covering them can trap moisture and worsen infection.
(d) Salicylates (aspirin) are contraindicated in children due to the risk of Reye's
syndrome, and pain is not a prominent feature of impetigo; if needed,
acetaminophen or ibuprofen is preferred.
Question 3:
A 3‑year‑old child develops a pruritic, erythematous, vesicular rash on the
forearms after playing in the backyard. The mother reports the child brushed
against some plants. Which plant is most likely responsible?
a. Oak tree leaves
b. Poison ivy
c. Dandelions
d. Grass
Correct Answer: b
Rationale: Poison ivy contains urushiol oil, which causes a classic allergic contact
dermatitis characterized by linear streaks of vesicles and intense pruritus. Oak
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,trees, dandelions, and grass are not common causes of vesicular contact
dermatitis (though grass can cause mechanical irritation, not the classic urushiol
reaction).
Question 4:
The nurse is teaching a parent about preventing contact dermatitis from poison
ivy. Which instruction is most important?
a. Wash the skin with soap and water within 10 minutes of exposure.
b. Apply calamine lotion before exposure.
c. Take oral antihistamines daily as prophylaxis.
d. Wear long sleeves only if the child has had a previous reaction.
Correct Answer: a
Rationale: Washing with soap and water within 10–15 minutes of exposure can
remove urushiol oil before it binds to the skin and triggers the allergic reaction.
Calamine lotion is for treatment, not prevention. Antihistamines do not prevent
contact dermatitis. Long sleeves should be worn regardless of previous reaction
history because sensitization can occur at any time.
Question 5:
A child presents with a rash on the cheeks that is red, scaly, and intensely itchy.
The mother states it worsens in winter and improves with moisturizers. This
presentation is most consistent with:
a. Contact dermatitis
b. Atopic dermatitis (eczema)
c. Impetigo
d. Tinea corporis
Correct Answer: b
Rationale: Atopic dermatitis (eczema) is a chronic, pruritic inflammatory skin
condition often presenting on the cheeks, flexural areas (elbows, knees), and
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, exacerbated by dry air (winter). It improves with moisturizers. Contact dermatitis
is usually localized to the area of exposure and resolves with avoidance of the
trigger. Impetigo has honey‑crusted lesions. Tinea corporis (ringworm) presents
with annular, scaly patches with central clearing.
Question 6:
Which of the following is a common irritant that causes non‑allergic contact
dermatitis in infants?
a. Wool clothing
b. Scented diaper wipes
c. Pet dander
d. Pollen
Correct Answer: b
Rationale: Scented diaper wipes contain fragrances and preservatives that can
directly irritate an infant's sensitive skin, causing irritant contact dermatitis
(non‑allergic). Wool clothing (a) can cause mechanical irritation but is less
common as a primary irritant compared to chemicals in wipes. Pet dander and
pollen are typically allergens that cause atopic or respiratory symptoms, not
contact dermatitis.
Question 7:
The nurse is assessing a child with suspected contact dermatitis from a new
lotion. The nurse expects the rash to appear:
a. Within minutes of application
b. 24–72 hours after exposure
c. 7–10 days after exposure
d. Only after repeated exposures over months
Correct Answer: b
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