C6 - Wong s Essentials of Pediatric Nursing 10th Edition Hockenberry Rodgers Wilson

Chapter 06: Childhood Communicable and Infectious Diseases Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition MULTIPLE CHOICE 1. Which term best describes the identification of the distribution and causes of disease, injury, or illness? a. Nursing process b. Epidemiologic process c. Community-based statistics d. Mortality and morbidity statistics ANS: B Epidemiology is the science of population health applied to the detection of morbidity and mortality in a population. It identifies the distribution and causes of diseases across a population. Nursing process is a systematic problem-solving approach for the delivery of nursing care. Morbidity and mortality statistics, along with natal rates, may provide an objective picture of a community’s health status. DIF: Cognitive Level: Remember REF: p. 157 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Health Promotion and Maintenance 2. 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. DIF: Cognitive Level: Understand REF: p. 178 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential 3. 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. DIF: Cognitive Level: Remember REF: p. 178 TOP: Integrated Process: Teaching/Learning MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential 4. 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, flattopped, firm, rough, superficial papule greater than 1 cm in diameter. It may be coalesced papules. DIF: Cognitive Level: Understand REF: p. 178 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential 5. Which nursing consideration is important 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. Corticosteroids are not indicated in bacterial infections. Dressings are usually not indicated. The undermined skin, crusts, and debris are carefully removed after softening with moist compresses. A Wood lamp is used to detect fluorescent materials in the skin and hair. It is used in certain disease states, such as tinea capitis. DIF: Cognitive Level: Understand REF: p. 177 TOP: Integrated Process: Nursing Process: Implementation MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential 6. The nurse is caring for a 5-year-old child with impetigo contagiosa. The parents ask the nurse what will happen to their child’s skin after the infection has subsided and healed. Which answer should the nurse give? a. There will be no scarring. b. There may be some pigmented spots. c. It is likely there will be some slightly depressed scars. d. There will be some atrophic white scars. ANS: A Impetigo contagiosa tends to heal without scarring unless a secondary infection occurs. DIF: Cognitive Level: Apply REF: p. 177 TOP: Integrated Process: Teaching/Learning MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential 7. What is cellulitis often caused by? a. Herpes zoster b. Candida albicans c. Human papillomavirus d. Streptococcus or Staphylococcus organisms ANS: D Streptococci, staphylococci, and Haemophilus influenzae are the organisms usually responsible for cellulitis. Herpes zoster is the virus associated with varicella and shingles. C. albicans is associated with candidiasis, or thrush. Human papillomavirus is associated with various types of human warts. DIF: Cognitive Level: Remember REF: p. 17