adaptive quiz ch 6

Question 1

Strict isolation is required for a child who is hospitalized with which infectious disease?
1
Mumps
 Correct2
Chickenpox
3
Exanthema subitum (roseola)
4
Erythema infectiosum (Fifth disease

Answer 1

Chickenpox is communicable through direct contact, droplet spread, and contaminated objects. The child hospitalized for chickenpox should therefore be strictly isolated. Mumps is transmitted by way of direct contact with saliva of an infected person and is most communicable before the onset of swelling. The transmission and cause of exanthema subitum (roseola) are unknown. Erythema infectiosum (Fifth disease) is communicable before the onset of symptoms.

Question 2

A toddler has bacterial conjunctivitis. Which medicine does the nurse expect the health care provider to order for the patient?
1
Acyclovir
2
Hydroxyzine
3
Mebendazole
 Correct4
Sodium sulfacetamide

Answer 2

Bacterial conjunctivitis is inflammation of the conjunctiva due to bacterial infection and is treated with topical antibacterial agents. Sodium sulfacetamide is a topical antibacterial agent. Acyclovir is an antiviral agent that is used to treat varicella infections. Hydroxyzine is an antipruritic medication used to treat severe itching. Mebendazole is used for the treatment of pinworms.

Test-Taking Tip: Answer every question because on the NCLEX exam, you must answer a question before you can move on to the next question.

Question 3

What can the nurse do to decrease pain when administering a haemophilus influenza type b (DTaP-Hib) vaccine and a pneumococcal conjugate vaccine (PCV)?
Correct1
Administer the DTaP-Hib vaccine before the PCV.
2
Administer the PCV before the DTaP-Hib vaccine.
3
Administer the PCV but not the DTaP-Hib vaccine.
4
Administer the PCV and DTaP-Hib vaccine simultaneously.

Answer 3

Administering the DTaP-Hib vaccine before PCV administration reduces pain caused by the PCV injection. Therefore, the nurse should administer the DTaP-Hib vaccine before the PCV. Administering the PCV before the DTaP-Hib vaccine does not reduce pain in the infant. Avoiding the DTaP-Hib vaccine can increase the risk of haemophilus influenza type b in the infant. Simultaneously administering the PCV and the DTaP-Hib vaccine does not result in pain reduction.

Question 4

What are the clinical manifestations of scarlet fever in the prodromal stage of the disease?
1
Enlarged tonsils
 Correct2
Abrupt high fever
3
Rash over the body
4
Red "strawberry tongue"

Answer 4

Abrupt high fever, vomiting, headache, chills, malaise, abdominal pain, and halitosis are clinical manifestations of scarlet fever in its prodromal stage. Enlarged tonsils and red “strawberry tongue” (enanthema) occur during the first one to two days. A body rash (exanthema) appears within 12 hours after the onset of prodromal signs.

Question 5

What is the typical mode of transmission of pertussis (whooping cough)?
1
Fecal
2
Blood
 Correct3
Droplet
4
Mucous membranes

Answer 5

The typical mode of transmission of pertussis is direct contact or the droplet route. The fecal, blood, and mucous membrane routes are typical modes of transmission of other diseases.

Test-Taking Tip: Get a good night’s sleep before an exam. Staying up all night to study before an exam rarely helps anyone. It usually interferes with the ability to concentrate.

Question 6

What is the chief complaint of patients suffering from rashes?
1
Fever
 Correct2
Itching
3
Swelling
4
Drainage

Answer 6

Itching is the chief complaint from most people with rashes. Fever, swelling, and draining do not accompany rashes as often as itching does.

Test-Taking Tip: Eat breakfast or lunch before an exam. Avoid greasy, heavy foods and overeating. This will help keep you calm and give you energy.

Question 7

What is the most important practice in reducing the transmission of diseases in the health care setting?
1
Covering one’s mouth when coughing
2
Wearing gloves while providing patient care
Correct3
Hand hygiene before and after patient care
4
Disposing needles and syringes properly

Answer 7

Hand hygiene is the best way to prevent the transmission of disease. Covering one’s mouth when coughing or sneezing will help to prevent droplet transmission, but it is not as efficient as good hand hygiene. Wearing gloves during patient care is essential but does not guarantee complete protection. Disposing needles and syringes in a rigid, puncture-resistant container is essential in helping to prevent needlestick injuries but not other modes of disease transmission

Question 8

How does the nurse refer to the period between early manifestations of the disease and its overt clinical syndrome?
1
Incubation period
 Correct2
Prodromal period
3
Desquamation period
4
Communicable period

Answer 8

The prodromal period is the interval between early manifestations of the disease and its overall clinical syndrome. The incubation period is the time from exposure to the appearance of the first symptoms. In the desquamation period, shedding of the skin occurs. The communicable period is the time when the affected child is infectious.

Test-Taking Tip: Pace yourself while taking a quiz or exam. Read the entire question and all answer choices before answering the question. Do not assume that you know what the question is asking without reading it entirely.

Question 9

What term does the nurse use to describe the interval between early manifestations of a disease and the overt clinical syndrome?
 Correct1
Prodromal period
2
Incubation period
3
Desquamation period
4
Period of communicability

Answer 9

The prodromal period is defined as the symptoms that occur between early manifestations of the disease and overt clinical symptoms. The incubation period is the time from exposure to the appearance of the first symptom. The desquamation period refers to the shedding of skin, when applicable, for a syndrome or disorder. The period of communicability describes the period when the child is infectious.

Test-Taking Tip: Start by reading each of the answer options carefully. Usually, at least one of them will be clearly wrong. Eliminate this one from consideration. Now you have reduced the number of response choices by one and improved your odds of giving a correct answer. Continue to analyze the options. If you can eliminate one more choice in a four-option question, you have reduced the odds to 50/50. While you are eliminating the wrong choices, recall often occurs. One of the options may serve as a trigger that causes you to remember what a few seconds ago had seemed completely forgotten.

Question 10

A preschooler who has giardiasis is receiving metronidazole for treatment. What should the nurse recognize as a side effect of metronidazole?
1
Constipation
2
Inflammation
3
Urine retention
4
Metallic taste in mouth

Answer 10

Metronidazole can leave a metallic taste in the mouth. Inflammation, urine retention, and constipation are side effects of other drugs.

Question 11

What characteristics of the rash should the nurse expect to find in a child with roseola infantum? Select all that apply.
1
Itchy
 Correct2
Rose-pink in color
3
Appears first on the face
 Correct4
Appears first on the trunk
 Correct5
Fades when pressure is applied

Answer 11

The nurse should be aware of how different exanthematous diseases look. In cases of roseola infantum, the rash appears as discrete rose-pink macules on the trunk first; these later spread to the neck, face, and extremities. The rash also fades when pressure is applied. The rash is usually nonpruritic (does not cause itching). In cases of measles, the rash appears on the face first.

Question 12

Which medication should the nurse most expect to find in the medication profile for a patient with a diagnosis of diphtheria?
 1
Equine antitoxin
2
Acyclovir
3
Acetaminophen
4
Diphenhydramine hydrochloride

Answer 12

Symptoms of common cold, anorexia, sore throat, and lymphadenitis indicate that the child may have diphtheria. Equine antitoxin is administered via the intravenous route to treat the child. Acyclovir is an antiviral agent used in the treatment of chickenpox. Acetaminophen is an antipyretic used for reducing fever. Diphenhydramine hydrochloride is used to manage the itching that accompanies chickenpox.

Question 13

What does the nurse recognize as having the greatest impact on the significant decline in incidence of communicable diseases of childhood?
 1
Immunizations
2
New medical treatments
3
Proper handwashing skills
4
Secondary prevention measures

Answer 13

Immunizations have resulted in a significant decline in the incidence of communicable diseases of childhood. New medical treatments help treat disease but do not reduce the incidence of them. Proper handwashing skills help reduce the spread of infection, but immunizations have the greatest impact in the decline in communicable diseases of childhood. Like handwashing, secondary prevention measures are helpful but have not had the greatest impact in the significant decline in communicable diseases of childhood.

Question 14

Which vaccines are contraindicated for children who are immunocompromised? Select all that apply.
 1
Varicella
2
Tetanus
3
Pertussis
4
Inactivated polio
5
Measles, mumps, and rubella (MMR)

Answer 14

Varicella is not recommended for children who are immunocompromised, and neither is the MMR vaccine. The tetanus, pertussis, and inactivated polio vaccines can be safely administered to immunocompromised children.

Question 15

What is the recommended age for a child to begin primary immunizations?
1
At birth
2
2 months
3
4 months
4
1 year

Answer 15

The recommended age for children to begin primary immunizations is from birth to 2 weeks, according to the Committee on Infectious Diseases of the American Academy of Pediatrics and the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC). For children who were not immunized at birth, there is a catch-up schedule on the CDC website. The ages 2 months, 4 months, and 1 year are too late and will require catch-up immunizations.

Question 16

How should the nurse instruct the parent to care for the eye of a child who has bacterial conjunctivitis?
1
Apply continuous warm compresses to the eye.
2
Apply topical corticosteroids to reduce inflammation.
3
Wipe from the outer canthus toward the opposite eye.
4
Wipe from the inner canthus downward and outward away from the opposite eye.

Answer 16

To remove secretions from the eye, the nurse should instruct the parent to wipe from the inner canthus of the eye downward and outward away from the opposite eye. Applying continuous warm compresses on the eye can promote bacterial growth. Topical corticosteroids are avoided because they reduce ocular resistance to bacteria. Wiping from the outer canthus of the eye toward the opposite eye may spread the infection to the other eye.

Question 17

Which control measures should the nurse include when teaching parents how to prevent the spread of infection at home? Select all that apply.
 Correct1
Handwashing
2
Immunizations
3
Contact precautions
 Correct4
Not sharing eating utensils
 Correct5
Covering the face when sneezing

Answer 17

Infection control measures include handwashing, not sharing eating utensils, and covering the face when sneezing. Immunizations are a primary prevention method not available in the home setting. Contact precautions are an isolation method used in the hospital to help prevent the spread of disease.

Question 18

A nurse is assessing a toddler who has a varicella infection. After taking a history, the nurse finds that the patient has undergone kidney transplantation and is being treated with immunosuppressive therapy. Which medicine should the nurse expect the health care provider to include in the patient’s treatment plan?
1
Acyclovir
2
Hydroxyzine
3
Acetaminophen
4
Diphenhydramine

Answer 18

Acyclovir is an antiviral agent. It is used to treat varicella infections in susceptible immunocompromised patients. The patient’s immunity is compromised by the immunosuppressive therapy necessary for the kidney transplant. Acyclovir is effective in decreasing the number of lesions, shortening the duration of fever, and decreasing itching, lethargy, and anorexia. Hydroxyzine is an antipruritic medication used to treat severe itching. Acetaminophen is an antipyretic agent and helpful in reducing elevated temperature. Diphenhydramine is an antipruritic agent used for the treatment of severe itching.

Question 19

Two parents bring their child in for examination. They state that the child looks pale and hasn't been eating for a while. The parents report that they have just returned from a month's vacation to a tropical country. An examination of the child's stool sample shows hookworms. What precaution for preventing the hookworm infestation does the nurse teach the parents?
1
Washing hands before eating food
2
Not consuming undercooked pork
 Correct3
Wearing shoes when playing in soil
4
Covering all food using fly covers

Answer 19

Soil contaminated with hookworm eggs can lead to hookworm infestation. The worms can enter the body by penetrating the skin. Therefore, wearing shoes is recommended as a preventive measure. Although washing hands in general is recommended before eating, hookworms are not transmitted through food or by eating undercooked pork or meat. Flies and mosquitoes do not transmit hookworms.

Question 20

The nurse works in a vaccination clinic. Which patients should receive the measles, mumps, and rubella (MMR) vaccine? Select all that apply.
 Correct1
A 12-month-old baby with the flu
 Correct2
A 14-month-old baby allergic to eggs
 Correct3
A breastfeeding mother
4
A pregnant woman in the first trimester
5
A pregnant woman in the third trimester

Answer 20

A nurse should be aware of some of the common contraindications to all the vaccines. Common cold or flu is not a contraindication to immunization, although severely ill patients should not be given any vaccines. Measles and mumps vaccines, which are grown in chick embryo tissue cultures, do not contain a significant amount of egg cross-reacting proteins. Therefore, egg allergy is not a contraindication to MMR vaccine. Similarly, breastfeeding is not a contraindication to MMR vaccine. However, MMR is a live virus vaccine that should not be given to any pregnant women, irrespective of their gestational age.

Question 21

The nurse works in a pediatric care unit. Which patients in the unit are at a high risk of developing viremia? Select all that apply.
Incorrect1
A patient who has watery diarrhea
Correct2
A patient who has late-stage blood cancer
Incorrect3
A patient who has a common cold and fever
Correct4
A patient who has an immunologic disorder
Correct5
A patient taking immunosuppressive therapy

Answer 21

Viremia is a condition in which viruses enter the bloodstream and affect the rest of the body. It occurs due to the replication of the varicella zoster virus in the blood. Patients who have leukemia, immunologic disorders, and who are receiving immunosuppressive therapy are at high risk of developing viremia. Such patients are more susceptible to viremia due to a deficiency in cellular immunity. The virus can easily enter their bodies and cause infection. Diarrhea and the common cold are not immunodeficiency-related conditions; hence, these patients are not at as high a risk of developing viremia.

Question 22

A child with human immunodeficiency virus (HIV) infection presents with a painful rash on the abdomen. The nurse learns that the child had chickenpox at a younger age. What is the most likely reason for the child's symptoms?
1
Mumps
 Correct2
Shingles
3
Measles
4
Rubella

Answer 22

Varicella zoster virus, which causes chickenpox, can remain dormant in the human body for a long time. It can get reactivated in cases of decreased immunity and stress, such as HIV infection, and it causes shingles when it gets reactivated. This appears as a painful rash localized to a single dermatome. Rashes occurring due to mumps, measles, or rubella are not painful and are not localized to a single dermatome.

Question 23

With a diagnosis of histoplasmosis, the nurse would expect to find which symptoms during the patient assessment?
1
Headache, dizziness, stiff neck, and signs of increased intracranial pressure
2
Pulmonary symptoms, such as cough, fever, chest pain, weakness, weight loss
3
Cough, fever, malaise, myalgia, headache, chest pain, and hepatosplenomegaly
Correct4
General systemic symptoms such as pallor, diarrhea, vomiting, and irregularly spiking temperature

Answer 23

The presenting symptoms of histoplasmosis include general systemic symptoms such as pallor, diarrhea, vomiting, irregularly spiking temperature, hepatosplenomegaly and pulmonary symptoms. Cryptococcosis presents with headache, dizziness, stiff neck, and signs of increased intracranial pressure. North American blastomycosis presents with pulmonary symptoms, such as cough, fever, chest pain, weakness, and weight loss. Coccidioidomycosis presents with a cough, fever, malaise, myalgia, headache, and chest pain.

Question 24

A child is admitted to the hospital for whooping cough. The plan of care indicates that the nurse should assess the patient for signs of airway obstruction. For which signs will the nurse assess the child? Select all that apply.
 Correct1
Cyanosis
2
Skin pallor
 Correct3
Apprehension in the child
4
Increased temperature
 Correct5
Increased restlessness

Answer 24

Whooping cough is a respiratory infection caused by Bordetella pertussis. Airway obstruction can occur due to the infection. Therefore, nurses are instructed to assess for signs of airway obstruction, including cyanosis, apprehension, and increased restlessness. The nurse should immediately report any of these signs. Pallor is seen in cases of shock, and an increased temperature indicates infection, not airway obstruction.

Question 25

A nurse is caring for a toddler who has severe measles. While checking the history, the nurse finds that the toddler has ophthalmologic evidence of vitamin A deficiency. The nurse is ordered to administer vitamin A supplement to the toddler. How should the nurse plan to administer the supplements in this situation?
1
Administer a higher dose to the patient.
2
Administer a single oral dose of 200,000 IU.
3
Administer a single oral dose of 100,000 IU.
Correct4
Administer a repeat dose the next day and after 4 weeks

Answer 25

Vitamin A supplementation reduces both morbidity and mortality in measles. The patient has ophthalmologic evidence of vitamin A deficiency. Therefore, the dose of vitamin A should be repeated the next day and after 4 weeks. Administration of a higher dose should be avoided, because it may lead to vomiting and headache for a few hours. A single oral dose of 200,000 IU is recommended for children who are at least 1 year old. A single oral dose of 100,000 IU is recommended for children aged between 6 and 12 months.

Question 26

The nurse is assessing a child with herpetic gingivostomatitis. The nurse wears gloves when examining the lesions. Is this nursing action necessary or unnecessary?
1
It is unnecessary, because the virus is not easily spread.
2
It is unnecessary, because the virus is sexually transmitted.
Correct3
It is necessary, because the virus can easily enter breaks in the skin.
4
It is necessary only if the nurse touches his or her own mouth after touching the child’s mouth

Answer 26

The action is necessary, because herpes simplex virus (HSV) easily enters breaks in the skin and can cause herpetic whitlow on the fingers. Gloves are always necessary, because the virus is easily spread. Herpetic gingivostomatitis is usually caused by HSV-1. HSV-2 is usually transmitted through sexual activity. The nurse should wear gloves regardless of contact with the child’s mouth and the nurse’s own mouth.