chapter 52-integumentary dysfunction

Question 1

A child falls on the playground and has a small laceration on the forearm. What should the school nurse do 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 non stinging povidone-iodine solution.
d. Wash wound with mild soap and water or saline for several minutes.

Answer 1

d

Question 2

A child steps on a nail and sustains a puncture wound in the foot. What is the most appropriate method for cleansing this wound?
a. Wash wound thoroughly with chlorhexidine.
b. Wash wound thoroughly with povidone-iodine.
c. Soak foot in warm water and soap.
d. Soak foot in solution of 50% hydrogen peroxide and 50% water.

Answer 2

C

Question 3

What is one 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. Practise good hand hygiene and maintain cleanliness when caring for an infected child.
d. Examine child under a Wood lamp for possible spread of lesions.

Answer 3

C

Question 4

Impetigo ordinarily results in which outcome?
a. No scarring
b. Pigmented spots
c. Slightly depressed scars
d. Atrophic white scars

Answer 4

A

Question 5

What is often a cause of cellulitis?
a. Herpes zoster
b. Candida albicans
c. Human papillomavirus
d. Streptococcus or Staphylococcus organisms

Answer 5

D

Question 6

Lymphangitis (“streaking”) is frequently seen in which condition?
a. Cellulitis
b. Folliculitis
c. Impetigo contagiosa
d. Staphylococcal scalded skin

Answer 6

A

Question 7

What causes warts?
a. Bacteria
b. Fungus
c. Parasite
d. Virus

Answer 7

D

Question 8

What is the primary treatment for warts?
a. Vaccination
b. Local destruction
c. Corticosteroids
d. Specific antibiotic therapy

Answer 8

B

Question 9

Herpes zoster is caused by the varicella virus and has an affinity for which structure(s)?
a. Sympathetic nerve fibres
b. Parasympathetic nerve fibres
c. Posterior root ganglia and the posterior horn of the spinal cord
d. Lateral and dorsal columns of the spinal cord

Answer 9

C

Question 10

What does treatment for herpes simplex virus (types 1 or 2) include?
a. Corticosteroids
b. Oral griseofulvin
c. Oral antiviral agent
d. Topical and/or systemic antibiotic

Answer 10

C

Question 11

Which is the cause of ringworm that is frequently found in schoolchildren?
a. Virus
b. Fungus
c. Allergic reaction
d. Bacterial infection

Answer 11

B

Question 12

A young boy’s mother tells the nurse that he keeps scratching the areas where he has poison ivy. How should the nurse respond?
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.

Answer 12

D

Question 13

What is the primary clinical manifestation of scabies?
a. Edema
b. Redness
c. Pruritus
d. Maceration

Answer 13

C

Question 14

What is the only symptom of pediculosis capitis (head lice)?
a. Itching
b. Vesicles
c. Scalp rash
d. Localized inflammatory response

Answer 14

A

Question 15

The treatment of a child who has just been stung by a bee or wasp should include which intervention?
a. Cool compresses
b. Warm compresses
c. Antibiotic cream
d. Corticosteroid cream

Answer 15

A

Question 16

A father calls the clinic nurse because his 2-year-old child was bitten by a black widow spider. What should the nurse advise the father to do?
a. Apply warm compresses.
b. Carefully scrape off the stinger.
c. Take the child to the emergency department.
d. Apply a thin layer of corticosteroid cream.

Answer 16

C

Question 17

A mother calls the emergency department nurse because her child was bit by a brown recluse spider. What should the nurse recommend?
a. Administer antihistamine.
b. Cleanse the wound with soap and water.
c. Keep the child quiet and come to the emergency department.
d. Remove the stinger and apply cool compresses.

Answer 17

C

Question 18

What kind of bite causes Rocky Mountain spotted fever?
a. A flea
b. A tick
c. A mosquito
d. A mouse or rat

Answer 18

B

Question 19

What should the nurse know about Lyme disease?
a. It is difficult to prevent.
b. It is easily treated with oral antibiotics in stages 1, 2, and 3.
c. It is caused by a spirochete that enters the skin through a tick bite.
d. It is common in geographic areas where the soil contains the mycotic spores that cause the disease.

Answer 19

C

Question 20

The nurse is examining a 12-month-old boy who was brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with satellite lesions that cross the inguinal folds. What is the most likely cause?
a. Impetigo
b. Candida albicans
c. Urine and feces
d. Infrequent diapering

Answer 20

B

Question 21

The nurse is teaching a class about preventing diaper rash in newborns to a group of new parents. Which statement made by one parent indicates he has 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 my infant with a mild soap and water and dry her thoroughly after 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.”

Answer 21

B

Question 22

Which statement is true regarding atopic dermatitis (eczema) in the infant?
a. It is easily cured.
b. It is worse in humid climates.
c. It is associated with upper respiratory tract infections.
d. It is associated with allergy with a hereditary tendency.

Answer 22

D

Question 23

Which is an appropriate nursing intervention when caring for an infant with atopic dermatitis?
a. Feed a variety of foods.
b. Keep lesions dry.
c. Prevent infection.
d. Use fabric softener to avoid rough cloth.

Answer 23

C

Question 24

Tretinoin (Retin-A) is a topical agent commonly used to treat acne. What advice should the nurse provide to patients prescribed this drug?
a. Avoid using sunscreen agents.
b. Use cosmetics with lanolin and petrolatum.
c. Explain that medication should not be applied until at least 20 to 30 minutes after washing.
d. Explain that erythema and peeling are indications of toxicity.

Answer 24

C

Question 25

When is isotretinoin (Accutane) indicated for the treatment of acne during adolescence?
a. The acne has not responded to other treatments.
b. The adolescent is or may become pregnant.
c. The adolescent is unable to give up foods causing acne.
d. Frequent washing with antibacterial soap has been unsuccessful.

Answer 25

A

Question 26

A child experiences frostbite on the fingers after prolonged exposure to the cold. What intervention should the nurse use first?
a. Rapidly rewarm the fingers by placing them in warm water.
b. Place the hand in cool water.
c. Slowly rewarm the fingers by wrapping them in a warm cloth.
d. Use an ice pack to keep fingers cold until medical intervention is possible.

Answer 26

A

Question 27

Which best describes a full-thickness (third-degree) burn?
a. Erythema and pain
b. Skin showing erythema followed by blister formation
c. Destruction of all layers of skin evident with extension into subcutaneous tissue
d. Destruction injury involving underlying structures such as muscle, fascia, and bone

Answer 27

C

Question 28

A child is admitted with extensive burns. The nurse notes that there are burns on the child’s lips and singed nasal hairs. What should the nurse suspect based on these assessment findings?
a. Chemical burn
b. Inhalation injury
c. Electrical burn
d. Hot-water scald

Answer 28

B

Question 29

Which is a physiological explanation of the edema formation that occurs with burns?
a. Vasoconstriction
b. Decreased capillary permeability
c. Increased capillary permeability
d. Decreased hydrostatic pressure within capillaries

Answer 29

C

Question 30

30. What is the most immediate threat to life in children with thermal injuries?
    a. Shock
    b. Anemia
    c. Local infection
    d. Systemic sepsis

Answer 30

A

Question 31

After the acute stage and during the healing process, what is the primary complication from a burn injury?
a. Asphyxia
b. Shock
c. Renal shutdown
d. Infection

Answer 31

D

Question 32

An adolescent girl is cooking on a gas stove when her bathrobe catches fire. Her father smothers the flames with a rug and calls an ambulance. She has sustained major burns over much of her body. What is most important in her immediate care?
a. Wrap her in a blanket until help arrives.
b. Encourage her to drink clear liquids.
c. Place her in a tub of cool water.
d. Remove her burned clothing and jewellery.

Answer 32

D

Question 33

A toddler sustains a minor burn on the hand from hot coffee. What is the first action to take in treating this burn?
a. Apply ice to burned area.
b. Hold the burned area under cool running water.
c. Break any blisters with a sterile needle.
d. Clean the wound with soap and warm water.

Answer 33

B

Question 34

Why is a high-protein diet recommended for a child with major burns?
a. It promotes growth.
b. It improves appetite.
c. It diminishes the risks of stress-induced hyperglycemia.
d. It helps prevent protein breakdown.

Answer 34

D

Question 35

Fentanyl and midazolam (Versed) are given before debridement of a child’s burn wounds. What is the purpose of these drugs?
a. To promote healing
b. To prevent infection
c. To provide pain relief
d. To limit the amount of debridement that will be necessary

Answer 35

C

Question 36

A child with extensive burns requires debridement. What is the priority of this procedure?
a. To promote healing
b. To prevent bleeding
c. To maintain the airway
d. To restore fluid balance

Answer 36

A

Question 37

Biological dressings are applied to a child with partial-thickness burns on both legs. Which nursing action is related to this procedure?
a. Observe wounds for bleeding.
b. Observe wounds for signs of infection.
c. Monitor the child closely for signs of shock.
d. Splint the child’s legs to prevent movement.

Answer 37

B

Question 38

What is one of the first signs of overwhelming sepsis in a child with burn injuries?
a. Seizures
b. Bradycardia
c. Decreased level of consciousness
d. Decreased blood pressure

Answer 38

C

Question 39

Which is an effective strategy to reduce the stress of burn dressing procedures?
a. Give the child as many choices as possible.
b. Reassure the child that dressing changes are not painful.
c. Explain to the child why analgesics cannot be used.
d. Encourage the child to master stress with controlled passivity.

Answer 39

A

Question 40

What is the most important consideration for the nurse when changing dressings and applying topical medication to a child’s abdomen and leg burns?
a. Apply topical medication with clean hands.
b. Wash hands and forearms before and after changing the dressing.
c. If dressings adhere to the wound, soak in hot water before removal.
d. Apply the dressing so that movement is limited during the healing process.

Answer 40

B

Question 41

The family of a 4-month-old infant will be vacationing at the beach. What is the best recommendation about sun exposure for this family?
a. Use sunblock on the infant’s nose and ear tips.
b. Use a topical sunscreen with a sun protective factor of 15.
c. The infant can be exposed to the sun for 15-minute increments.
d. Keep the infant in total shade at all times.

Answer 41

D

Question 42

Where do the lesions of atopic dermatitis most commonly occur on the infant?
a. Cheeks
b. Buttocks
c. Eyes
d. Back

Answer 42

A

Question 43

The nurse is talking to the parent of an infant with severe atopic dermatitis. What should the nurse reinforce for the parent?
a. “You can use warm, wet compresses to relieve discomfort.”
b. “You should apply an emollient to the skin immediately after a bath.”
c. “You should bathe your baby in a bubble bath two times a day.”
d. “You can try a fabric softener in the laundry to avoid rough cloth.”

Answer 43

B