PEDS NCLEX Questions And Answers 2023 Review Update

PEDS NCLEX Questions And Answers 2023 Review Update A child falls on the playground and has a small laceration on the forearm. The school nurse should do which of the following 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. Which of the following is an important nursing consideration when caring for a child with impetigo contagiosa? a. Apply topical corticosteroids to decrease inflammation. b. Carefully remove dressings so as not to dislodge undermined skin, crusts, and debris. c. Carefully wash hands and maintain cleanliness when caring for an infected child. d. Examine child under a Wood lamp for possible spread of lesions. - ANS: C A major nursing consideration related to bacterial skin infections, such as impetigo contagiosa, is to prevent the spread of the infection and complications. This is done by thorough hand washing before and after contact with the affected child. Impetigo ordinarily results in which of the following? a. No scarring b. Pigmented spots c. Slightly depressed scars d. Atrophic white scars - ANS: A Impetigo tends to heal without scarring unless a secondary infection occurs. Ringworm, frequently found in schoolchildren, is caused by which of the following? a. Virus b. Fungus c. Allergic reaction d. Bacterial infection - ANS: B Ringworm is caused by a group of closely related filamentous fungi that invade primarily the stratum corneum, hair, and nails. They are superficial infections that live on, not in, the skin. Therapeutic management of the child with ringworm infection would include which of the following? a. Administer oral griseofulvin. b. Administer topical or oral antibiotics. c. Apply topical sulfonamides. d. Apply Burow solution compresses to affected area. - ANS: A Treatment with the antifungal agent griseofulvin is part of the treatment for the fungal disease, ringworm. Oral griseofulvin therapy frequently continues for weeks or months. John's mother tells the nurse that he keeps scratching the areas where he has poison ivy. The nurse's response should be based on which of the following? a. Poison ivy does not itch and needs further investigation. b. Scratching the lesions will not cause a problem. c. Scratching the lesions will cause the poison ivy to spread. d. Scratching the lesions may cause them to become secondarily infected. - ANS: D Poison ivy is a contact dermatitis that results from exposure to the oil urushiol in the plant. Every effort is made to prevent the child from scratching, since the lesions can become secondarily infected. Which of the following is the primary clinical manifestation of scabies? a. Edema b. Redness c. Pruritus d. Maceration - ANS: C Scabies is caused by the scabies mite. The inflammatory response and intense itching occur after the host has become sensitized to the mite. This occurs approximately 30 to 60 days after initial contact. Which of the following is usually the only symptom of pediculosis capitis (head lice)? a. Itching b. Vesicles c. Scalp rash d. Localized inflammatory response - ANS: A Itching is generally the only manifestation of pediculosis capitis (head lice). Diagnosis is made by observation of the white eggs (nits) on the hair shaft The nurse is talking to the parents of a child with pediculosis capitis. Which of the following should the nurse include when explaining how to manage pediculosis capitis? a. "You will need to cut the hair shorter if infestation and nits are severe." b. "You can distinguish viable from nonviable nits, and remove all viable ones." c. "You can wash all nits out of hair with a regular shampoo." d. "You will need to remove nits with an extra-fine tooth comb or tweezers." - ANS: D Treatment consists of the application of pediculicide and manual removal of nit cases. An extra-fine tooth comb facilitates manual removal. The management of a child who has just been stung by a bee or wasp should include the application of which of the following? a. Cool compresses b. Warm compresses c. Antibiotic cream d. Corticosteroid cream - ANS: A Bee or wasp stings are initially treated by carefully removing stinger, cleansing with soap and water, applying cool compresses, and using common household agents such as lemon juice or a paste made with aspirin and baking soda. The nurse should know that Lyme disease is which of the following? a. Difficult to prevent b. Easily treated with oral antibiotics in stages 1, 2, and 3 c. Caused by a spirochete that enters the skin through a tick bite d. Common in geographic areas where the soil contains the mycotic spores that cause the disease - ANS: C Lyme disease is caused by Borrelia burgdorferi, a spirochete spread by ticks. The early characteristic rash is erythema migrans. The nurse is examining 12-month-old Amy, who was brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with satellite lesions that cross the inguinal folds. This is most likely caused by which of the following? a. Impetigo b. Candida albicans c. Urine and feces d. Infrequent diapering - ANS: B C. albicans infection produces perianal inflammation and a maculopapular rash with satellite lesions that may cross the inguinal folds. The nurse is teaching a class on preventing diaper rash in newborns to a group of new parents. Which of the following statements made by a parent indicates a correct understanding of the teaching? a. "I should wash my infant's buttocks with soap and water every time I change the diaper." b. "I will wash with a mild soap and water and dry thoroughly whenever my infant has a bowel movement." c. "I should wash my infant's buttocks with soap before applying a thin layer of oil." d. "I will apply baby oil and powder to the creases in my infant's buttocks." - ANS: A Overwashing the skin should be avoided, especially with perfumed soaps or commercial wipes, which may be irritating. Which of the following explains physiologically the edema formation that occurs with burns? a. Vasoconstriction b. Decreased capillary permeability c. Increased capillary permeability d. Decreased hydrostatic pressure within capillaries - ANS: C With a major burn, an increase in capillary permeability occurs, allowing plasma proteins, fluids, and electrolytes to be lost. Maximal edema in a small wound occurs about 8 to 12 hours after injury. In larger injuries, the maximal edema may not occur until 18 to 24 hours. A high-protein diet for the child with major burns is ordered to: a. promote growth. b. improve appetite. c. diminish risks of stress-induced hyperglycemia. d. avoid protein breakdown. - ANS: D The diet must provide sufficient calories to meet the increased metabolic needs and enough protein to avoid protein breakdown. 2. The nurse received a report on a new admission: a 3-year-old with Kawasaki disease. Understanding the etiology and major complications of Kawasaki disease, the priority nursing intervention would be: 1. Continuous cardiovascular and oxygen saturation monitoring. 2. Vital signs every 4 hours until stable. 3. Strict intake and output monitoring hourly. 4. Begin aspirin therapy after fever has resolved. - 1 3. The nurse is assessing a 3-week-old with suspected bacterial meningitis. Isolation and respiratory precautions have already been initiated. Which clinical assessment by the nurse would warrant immediate intervention? 1. The neonate is irritable. 2. The neonate has a rectal temperature of 100.6° F (38.1°C). 3. The neonate is quieter than usual. 4. The neonate's respiratory rate is 24 breaths per minute. - 4 4. The mother of an 18-month-old is discharged from the hospital after the child has a febrile seizure secondary to exanthem subitum (roseola). On discharge, the mother asks the nurse if her 6-year-old twins will get sick. Which teaching about the transmission of roseola would be most accurate? 1. The child should be isolated in the home until the vesicles have dried. 2. The child does not need to be isolated from the older siblings. 3. Administer acetaminophen to the older siblings to prevent seizures. 4. Monitor older children for seizure development. - 1 6. Which of the following would be the priority intervention the nurse should initiate for a child suspected of having varicella (chickenpox)? 1. Contact precautions. 2. Contact and droplet respiratory precautions. 3. Droplet respiratory precautions. 4. Universal precautions and standard precautions. - 2 7. Which of the following would be the priority teaching to the parent of a child diagnosed with chickenpox (varicella) who was prescribed diphenhydramine (Benadryl) for itching? 1. Give a warm bath with mild soap before lotion application. 2. Avoid Caladryl lotion while taking diphenhydramine (Benadryl). 3. Apply Caladryl lotion generously to decrease itching. 4. Give a cool shower with mild soap to decrease itching. - 2 9. The parents of a 12-month-old male with HIV are concerned about his receiving routine immunizations. What will the nurse tell them about immunizations? 1. "Your child will not receive routine immunizations today." 2. "Your child will receive the recommended vaccines today; regular immunizations help prevent childhood illnesses." 3. "Your child is not severely immunocompromised, but I would still be concerned about his receiving them. Let's not give them today." 4. "Your child may develop infections if he gets his routine immunizations. Your child will not be immunized today." - 1 11. Expected nursing assessments of a newborn with suspected cystic fibrosis would include: 1. Observe frequency and nature of stools. 2. Provide chest physical therapy. 3. Observe for weight gain. 4. Assess parent's compliance with fluid restrictions. - 1,3 15. Which intervention should the nurse implement for a newborn diagnosed with galactosemia? 1. Eliminate all milk and lactose-containing foods. 2. Encourage breastfeeding as long as possible. 3. Encourage lactose-containing formulas. 4. Avoid feeding soy-protein formula to the newborn. - 1 16. Which statement by the parent of a newborn male diagnosed with galactosemia demonstrates successful teaching? 1. "This is a rare disorder that usually does not affect future children." 2. "Our newborn looks normal; he may not have galactosemia." 3. "Our newborn may need to take penicillin and other medications to prevent infection." 4. "Penicillin and other drugs that contain lactose as fillers need to be avoided." - 4 17. Which signs and symptoms would the nurse expect to assess in a newborn with congenital hypothyroidism?... CONTINUES...