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Pediatrics > Pediatric integumentary > Flashcards

Pediatric integumentary Flashcards

1
Q

Macule

A

Any flat, circumscribed color change in the skin > 1 cm

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2
Q

Patch

A

Any flat, circumscribed color change in the skin < 1 cm

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3
Q

Papule

A

A solid, elevated area < 1 cm in diameter whose top may be pointed, rounded, or flat

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4
Q

Plaque

A

A solid, circumscribed area > 1 cm in diameter, usually flat-topped

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5
Q

Vesicle

A

A circumscribed, elevated lesion < 1 cm in diameter and containing clear serous fluid

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6
Q

Bulla

A

A circumscribed, elevated lesion > 1 cm in diameter and containing clear serous fluid

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7
Q

Pustule

A

A vesicle containing a purulent exudate

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8
Q

Nodule

A

A deep-seated mass with indistinct borders that elevates the overlying epidermis

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9
Q

Wheal

A

A circumscribed, flat-topped, firm elevation of skin resulting from tense edema of the papillary dermis

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10
Q

When evaluating a patient for lesions, determine what the nurse practitioner recognizes as accurate.

A wheal is a depression of the skin surface caused by the thinning of one or more layers of the skin.

A vesicle is a flat, raised, or depressed area of fibrotic replacement of dermis or subcutaneous tissue.

A patch reflects a flat circumscribed color change in the skin that is greater than 1 centimeter.

A nodule is a solid, circumscribed area that is greater than 1 centimeter in diameter.

A

A patch reflects a flat circumscribed color change in the skin that is greater than 1 centimeter.

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11
Q

A newborn presents to the clinic with a vascular lesion that may or may not fade as she gets older. Establish a diagnosis.

Salmon patch

Café au lait spot

Mongolian spot

Capillary hemangioma

A

Salmon patch

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12
Q

A nurse practitioner is educating a group of students on patients presenting with neurofibromatosis. Conclude a characteristic of café au lait macules.

They appear after the first 6 months of life, and reach a peak count in the 3rd decade.

They are more common in males than females.

The macules are light brown.

Lesions usually fade spontaneously and completely resolve in adult life.

A

The macules are light brown.

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13
Q

Seborrheic dermatitis is common in both infants and adolescents. Determine what is correct regarding this condition.

It is characterized by erythematous scaly dermatitis.

It only presents in infancy.

It does not respond well to low-potency topical corticosteroids.

This condition creates erythematous scaly dermatitis accompanied by overproduction of sebum occurring in areas rich in sebaceous glands

A

This condition creates erythematous scaly dermatitis accompanied by overproduction of sebum occurring in areas rich in sebaceous glands

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14
Q

A nurse practitioner is discussing congenital melanocytic nevi with a group of nursing students. Determine the accurate statement.

Referral for an oncologist is recommended.

The lesions are often found on the trunk and limbs.

Small lesions usually measure at 10–15 centimeters.

They typically develop during adolescence.

A

The lesions are often found on the trunk and limbs.

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15
Q

Determine which characterizes lesions associated with psoriasis.

Common site of involvement is the face

Lesions with uneven coloring of black, blue, tan, and red

Irregular asymmetrical nodules with blurred borders

Round, erythematous, well-marginated plaques

A

Round, erythematous, well-marginated plaques

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16
Q

J.E. is a post-term infant with a hamartoma of differentiated cells that retain their normal function. Predict a factor that is related to the development of this hamartoma.

Prematurity

Pityriasis rosea

Degree of sun exposure during childhood

Topical steroids

A

Degree of sun exposure during childhood

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17
Q

A nurse practitioner is discussing congenital melanocytic nevi with a group of nursing students. Determine the accurate statement.

Small lesions usually measure at 10–15 centimeters.

Gant lesions usually measure at 40–60 centimeters.

They typically develop during adolescence.

Referral for an oncologist is recommended.

A

Gant lesions usually measure at 40–60 centimeters.

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18
Q

Paul presents to the clinic at age 6 weeks. The mother is complaining that Paul has a raised lesion. Predict what is consistent with a hemangioma.

Erythematous, pruritic wheal on the lower extremities

Erythematous papules and plaques on face

Lichenification at the flexor surfaces

Lesions that can appear on any part of the body

A

Lesions that can appear on any part of the body

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19
Q

Determine which characterizes lesions associated with psoriasis.

Common site of involvement is the face

Removal of plaque results in fine punctate bleeding

Irregular asymmetrical nodules with blurred borders

Lesions with uneven coloring of black, blue, tan, and red

A

Removal of plaque results in fine punctate bleeding

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20
Q

A newborn presents to the clinic with a vascular lesion that may or may not fade as she gets older. Establish a diagnosis.

Nevus flammeus

Mongolian spot

Capillary hemangioma

Café au lait spot

A

Nevus flammeus

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21
Q

A nurse practitioner is educating a group of students on patients presenting with neurofibromatosis. Conclude a characteristic of café au lait macules.

They are more common in males than females.

The macules are light brown.

The macules are more common in Caucasians than dark-skinned individuals.

They appear after the first 6 months of life, and reach a peak count in the 3rd decade.

A

The macules are light brown.

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22
Q

A nurse practitioner is educating a group of students on integumentary disorders. Establish an appropriate treatment of seborrhea in infants.

Oral steroids for severe cases

Low-potency topical corticosteroids

Topical antibiotics

High-potency topical steroids in mild cases

A

Low-potency topical corticosteroids

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23
Q

J.E. is a post-term infant with a hamartoma of differentiated cells that retain their normal function. Predict a factor that is related to the development of this hamartoma.

Presence of eosinophils

Heredity

Pityriasis rosea

Prematurity

A

Heredity

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24
Q

A 6-week-old infant is being evaluated for integumentary problems and discoloration. Determine the accurate statement regarding birthmarks.

The majority of birthmarks present as erythematous lesions that persist throughout adulthood.

Vascular birthmarks occur if blood vessels in a particular area of the skin do not form the way they should.

Birthmarks are a rare occurrence that must be evaluated for melanoma.

Pigmented birthmarks occur if blood vessels in a particular area of the skin do not form the way they should.

A

Vascular birthmarks occur if blood vessels in a particular area of the skin do not form the way they should.

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25
Q

You have diagnosed AJ with acute atopic dermatitis. Determine what is correct regarding the incidence of this condition.

AJ has an increased risk of developing splenomegaly.

AJ presents with an erythematous scaly dermatitis accompanied by an overproduction of sebum.

AJ has a condition associated with familial predisposition.

AJ has a greater chance of developing malignant melanoma in adulthood than average individuals.

A

AJ has a condition associated with familial predisposition.

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26
Q

A nurse practitioner educated a mother on the management of her toddler who was recently diagnosed with psoriasis. Establish common management of a patient with this condition.

Topical antibiotic ointment

Typically resolves without treatment

Fluocinonide 0.05% ointment twice daily

Oral antibiotics

A

Fluocinonide 0.05% ointment twice daily

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27
Q

A pediatric patient is being evaluated for a melanoma. Determine the accurate statement.

The lesions typically resolve without treatment.

Melanoma in infancy is common.

In children, it is a common benign proliferation of cells.

Melanoma in prepubertal children is rare.

A

Melanoma in prepubertal children is rare.

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28
Q

A nurse is educating a parent on burn injuries and prevention in children. Establish an accurate preventive factor.

Electrical cords and irons kept out of reach of children

Protective clothing for infants and small children

Water heater turned to less than 140 °F

Sunblock for infants under 6 months of age

A

Electrical cords and irons kept out of reach of children

29
Q

A nurse practitioner is evaluating a patient for an animal bite. A focused history is needed to determine the circumstances around the incident. Conclude what statement is reflective of the patient history.

The X-ray is negative for a fracture.

He has a full range of motion for the extremity.

The pit bull just came out of nowhere and bit his arm.

His current temperature is 98.5 F.

A

The pit bull just came out of nowhere and bit his arm.

30
Q

A nurse practitioner is evaluating a 15-year-old for a closed fist injury. Determine what is accurate for patients presenting with a closed fist injury.

Many lacerations are small, leading to the patient ignoring the injury.

Prophylactic treatment is not recommended with clenched fist injuries.

Plain radiographs should be completed with clenched-fist injuries after swelling has improved.

Clenched-fist injuries should be sutured immediately after injury.

A

Many lacerations are small, leading to the patient ignoring the injury.

31
Q

A nurse practitioner is evaluating a 15-year-old patient for cellulitis. Predict what is consistent with a diagnosis of cellulitis.

Honey-crusted lesion to extremity

Firm, white umbilicated papules on the neck

Regional lymphadenopathy

Linear pruritic raised area to extremity

A

Regional lymphadenopathy

32
Q

A nurse practitioner is educating a group of students on burn injuries. Determine the accurate statement regarding burns.

The treatment of burns depends on the location and the severity of damage.

Up to 45% of burns in children may be due to child physical abuse.

Children are commonly burned from lightning strikes.

All children with partial thickness burns require immediate hospitalization.

A

The treatment of burns depends on the location and the severity of damage.

33
Q

A nurse practitioner is evaluating a patient who presents with an animal bite. Establish an accurate statement regarding dog bites.

Ciprofloxacin is the antibiotic of choice for treatment of dog bites.

The majority of dog bites are superficial injuries.

Streptococcusis the most common organism isolated from dog bites.

In most cases, the dog is known by the victim.

A

In most cases, the dog is known by the victim.

34
Q

Sandra, age 14, is being evaluated for impetigo. Determine what is consistent with impetigo.

Impetigo is common in 14-year-olds.

Patients have honey-crusted lesions on the face.

Lesions are an allergic response to environmental factors.

Patients typically present with a fever and headache.

A

Patients have honey-crusted lesions on the face.

35
Q

A nurse practitioner is educating a group of students on patients presenting with cat bites or scratches. Establish an accurate statement when evaluating and treating a patient for cat bites or scratches.

High-pressure irrigation is recommended with isolated puncture wounds.

Cat bites are more common in girls.

First-line treatment for cat bites is doxycycline.

Prompt treatment with steroids may lead to a resolution of symptoms.

A

Cat bites are more common in girls.

36
Q

A nurse practitioner is evaluating AJ, aged 3, who acutely sustained a burn when she pulled a pot of boiling water onto herself 1 hour ago. Burns are classified according to the depth of the injury to the skin layers and the amount of area involved. Five percent of AJ’s body surface is burned, involving the epidermis and upper part of the dermis. Recommend how to treat the burn.

Irrigate the area, and apply topical antibiotics. Monitor for infection.

Apply topical emollients to affected area, and follow up in 48 hours for dressing change.

Apply warm compress to the area and give mild analgesics for comfort.

Discuss the situation with the mother, and refer for immediate treatment within the emergency department.

A

Discuss the situation with the mother, and refer for immediate treatment within the emergency department.

37
Q

A nurse practitioner is evaluating a patient who presents with an animal bite. Establish an accurate statement regarding dog bites.

Boys are bitten more often than girls.

Ciprofloxacin is the antibiotic of choice for treatment of dog bites.

Dog bites cause the majority of infections.

Streptococcusis the most common organism isolated from dog bites.

A

Boys are bitten more often than girls.

38
Q

Predict which is considered a minor burn.

A 16-year-old female presenting with inhalation injury

A 5-year-old with burns to her hands and feet

A partial thickness burn <10% TBSA in a 16-year-old

A 10-year-old with a burn that extends down the leg, from the hip to his toes

A

partial thickness burn <10% TBSA in a 16-year-old

39
Q

A 5-year-old patient is being evaluated at the clinic for cellulitis to her right lower leg. Establish a common cause of cellulitis.

Coagulase-positive Staphylococcus

Moraxella catarrhalis

Haemophilus influenzae

Bronchiectasis

A

Coagulase-positive Staphylococcus

40
Q

A nurse practitioner is evaluating a 15-year-old for a closed fist injury. Determine what is accurate for patients presenting with a closed fist injury.

Prophylactic treatment is not recommended with clenched fist injuries.

A major complication of human bite wounds is infection of the ligaments.

Clenched-fist injuries are traumatic lacerations that occur when the clenched fist of one person strikes the teeth of another.

Clenched-fist injuries should be sutured immediately after injury.

A

Clenched-fist injuries are traumatic lacerations that occur when the clenched fist of one person strikes the teeth of another.

41
Q

A nurse practitioner is evaluating AJ, aged 3, who acutely sustained a burn when she pulled a pot of boiling water onto herself 1 hour ago. Burns are classified according to the depth of the injury to the skin layers and the amount of area involved. Determine how the nurse practitioner would rate the burn if 5% of AJ’s body surface, involving the epidermis and upper part of the dermis, is burned.

She has a major superficial burn.

The burn can be identified as major partial thickness.

She has a minor partial thickness burn.

The burn is minor full thickness.

A

The burn can be identified as major partial thickness.

42
Q

A nurse practitioner is educating a group of students on burn injuries. Determine the accurate statement regarding burns.

Up to 45% of burns in children may be due to child physical abuse.

A sunburn is an example of a superficial burn.

All children with partial thickness burns require immediate hospitalization.

Simple thermal burns require diagnostic testing.

A

A sunburn is an example of a superficial burn.

43
Q

Predict which patient has a higher risk for developing impetigo.

A 5-year-old who is starting kindergarten

A 4-year-old whose family is positive for scabies

A 6-year-old with a history of asthma

A 10-year-old with a history of diabetes

A

A 4-year-old whose family is positive for scabies

44
Q

A mother is concerned regarding her child who is recovering from a dog bite. Propose a factor that increases the risk of infection following an animal bite.

Upper respiratory infection 1 month prior to the incident

History of diabetes

A bite that resulted in a superficial laceration

High school student with a fear of dogs

A

History of diabetes

45
Q

A nurse practitioner is educating a group of students on burn injuries. Determine the accurate statement regarding burns.

Up to 45% of burns in children may be due to child physical abuse.

Superficial partial thickness burns typically heal well.

All children with partial thickness burns require immediate hospitalization.

Children are commonly burned from lightning strikes.

A

Superficial partial thickness burns typically heal well.

46
Q

A nurse practitioner is evaluating a patient who presents with an animal bite. Establish an accurate statement regarding dog bites.

The majority of dog bites are superficial injuries.

Ciprofloxacin is the antibiotic of choice for treatment of dog bites.

Dog bites account for the majority of bites in pediatrics.

Streptococcusis the most common organism isolated from dog bites.

A

Dog bites account for the majority of bites in pediatrics.

47
Q

A nurse practitioner is educating a group of students on patients presenting with cat bites or scratches. Establish an accurate statement when evaluating and treating a patient for cat bites or scratches.

Prompt treatment with steroids may lead to a resolution of symptoms.

Patients bitten by a cat have a higher risk for infection.

High-pressure irrigation is recommended with isolated puncture wounds.

Prophylactic antibiotics are not recommended.

A

Patients bitten by a cat have a higher risk for infection.

48
Q

A nurse practitioner is educating a group of students on patients presenting with cat bites or scratches. Establish an accurate statement when evaluating and treating a patient for cat bites or scratches.

High-pressure irrigation is recommended with isolated puncture wounds.

Prompt treatment with steroids may lead to a resolution of symptoms.

Cat scratch disease (CSD) can occur after bites or scratches, especially from kittens.

Prophylactic antibiotics are not recommended.

A

Cat scratch disease (CSD) can occur after bites or scratches, especially from kittens.

49
Q

A nurse practitioner is evaluating AJ, aged 3, who acutely sustained a burn when she pulled a pot of boiling water onto herself 1 hour ago. Burns are classified according to the depth of the injury to the skin layers and the amount of area involved. Determine how the nurse practitioner would rate the burn if 5% of AJ’s body surface, involving the epidermis and upper part of the dermis, is burned.

The burn is minor full thickness.

She has a major superficial burn.

The partial thickness burn rating is appropriate for this patient.

She has a major full thickness burn.

A

The partial thickness burn rating is appropriate for this patient.

50
Q

A nurse practitioner is evaluating a patient for a burn. Conclude which patient would present with a superficial burn.

A 10-year-old presenting with a weeping blister after touching a hot pot

A 14-year-old presenting with a burn that is dark brown and nontender

A 3-year-old presenting with minor inflammation on her right arm after playing outside

A 5-year-old presenting with vesicles, erythema, and edema on her left arm

A

A 3-year-old presenting with minor inflammation on her right arm after playing outside

51
Q

A nurse practitioner student is educating a parent on animal bites. Predict a complication of dog bites.

Surgery for minor laceration to the leg

Necessary suturing of all dog bites

Central nervous system infection

Rabies

A

Central nervous system infection

52
Q

A nurse practitioner is educating a group of students on dermatophyte infections. Conclude what reflects an understanding of the condition.

Foot infections are much more common during childhood.

Infections of the body surfaces are most frequent during puberty.

Topical antifungal solutions and creams reduce superficial scaling.

Indirect contact with fomites through shared items rarely causes dermatophyte infections.

A

Topical antifungal solutions and creams reduce superficial scaling.

53
Q

A nurse practitioner is educating a group of students on patients presenting with tinea capitis. Predict the patient who is at an increased risk of developing tinea capitis.

A 15-year-old who shampoos daily with selenium shampoo

A 10-year-old presenting with alopecia related to chemotherapy

An 8-year-old who played with an infected pet

A patient with a previous tinea infection that was treated promptly

A

An 8-year-old who played with an infected pet

54
Q

A pediatric patient is being evaluated for tinea pedis. Predict the patient that is at risk for developing tinea pedis.

A premature infant with a recent history of tinea corporis

A 15-year-old female who wears tennis shoes

A 13-year-old who walks through the local pool area barefoot

A 2-year-old who walks barefoot at home

A

A 13-year-old who walks through the local pool area barefoot

55
Q

You are evaluating a pediatric patient for a rash and pruritus. Establish what is consistent with a diagnosis of scabies.

White flakes to the hair

Red, rubbery, vascular tumor

Erythematous papules, plaques, and vesicles

Red bumps, blisters, and small burrow marks

A

Red bumps, blisters, and small burrow marks

56
Q

Propose a characterization of lesions associated with tinea infections.

Irregular asymmetrical nodules with blurred borders

Raised lesions with distinct, symmetrical borders

Discolored (white, gray, or yellow) and brittle nails

Uneven coloring of black, blue, tan, and red lesions

A

Discolored (white, gray, or yellow) and brittle nails

57
Q

PJ presents to the clinic at age 6 years. The nurse practitioner suspects that PJ has tinea corporis. Predict the treatment or management that is indicated.

Ciclopirox

Permethrin 5%

Doxycycline

Lindane

A

Ciclopirox

58
Q

Predict the patient that is at risk for developing tinea versicolor.

An adolescent who is recovering from a surgical procedure

An infant with an underlying cardiac condition

A 10-year-old with a history of asthma

An adolescent experiencing hormonal changes

A

An adolescent experiencing hormonal changes

59
Q

Jennifer is a 5-year-old who presents to the clinic for a rash and itching. Determine a factor related to the transmission of dermatophyte infections.

School-age child

Familial tendency

Recent treatment of antibiotics

History of hypertension

A

School-age child

60
Q

A nurse practitioner is educating a group of students on tinea infections. Recommend a treatment and prevention option.

Hygiene is not a factor for most fungal infections.

Common treatment is topical antibiotics.

Do not share towels or personal items.

Scratch or lance lesions to help with healing.

A

Do not share towels or personal items.

61
Q

Predict the patient that is at risk for developing tinea versicolor.

An infant with an underlying cardiac condition

A 10-year-old who lives in hot, humid weather

A 5-year-old who traveled to a cool, dry area

An adolescent who is recovering from a surgical procedure

A

A 10-year-old who lives in hot, humid weather

62
Q

PJ presents to the clinic at age 6 years. The nurse practitioner suspects that PJ has tinea corporis. Predict the treatment or management that is indicated.

Terbinafine

Lindane

Permethrin 5%

Topical steroid ointment

A

Terbinafine

63
Q

A mother brings her 8-year-old in for evaluation of a rash that presents as a waxy, firm, papule with central umbilication. Recommend an appropriate treatment plan.

Prophylactic antibiotics should be recommended to avoid secondary infections.

Topical imiquimod is not recommended.

Cryotherapy with liquid nitrogen is recommended.

Children with molluscum contagiosum should be excluded from school.

A

Cryotherapy with liquid nitrogen is recommended.

64
Q

A nurse practitioner is educating a group of students on tinea corporis. Propose an accurate statement about tinea corporis.

It typically appears concurrently with tinea cruris.

It primarily spreads through shared clothing.

Trichophyton mentagrophyteis a primary associated organism.

Patients typically present with numerous lesions on their abdomen, legs, and feet.

A

Trichophyton mentagrophyteis a primary associated organism.

65
Q

PJ, age 6, presents to the clinic. The nurse practitioner suspects that PJ has tinea corporis. Establish a factor that increases PJ’s risk for contracting tinea corporis.

Tinea corporis is common in children with atopic dermatitis.

He is an only child.

There is increased incidence with prolonged exposure to moisture.

He shared a beach towel with his mother who is positive for tinea corporis.

A

He shared a beach towel with his mother who is positive for tinea corporis.

66
Q

Recommend a management measure or treatment for a patient with scabies.

Topical antifungal ointment to lesions

Topical application of selenium sulfide 2.5% suspension

Oral ivermectin for patients with treatment failure

Amoxicillin for 10 days

A

Oral ivermectin for patients with treatment failure

67
Q

A pediatric patient is being evaluated for tinea pedis. Predict the patient that is at risk for developing tinea pedis.

A young man who frequently works out at the gym

A 15-year-old female who wears tennis shoes

A 2-year-old who walks barefoot at home

A premature infant with a recent history of tinea corporis

A

A young man who frequently works out at the gym

68
Q

A nurse practitioner diagnosed patient WH with scabies. Determine what is consistent with a patient presenting with scabies.

Several linear curved lines approximately 4 millimeters in length with a papule at the proximal end

Several pustular erythematous, papular, pustular, and crusted lesions on the face

Polycyclic connected hypopigmented macules

Erythematous scaly dermatitis

A

Several linear curved lines approximately 4 millimeters in length with a papule at the proximal end

69
Q

Establish an accurate statement when evaluating a patient for molluscum contagiosum.

Children in daycare should be excluded to prevent transmission.

It is a fungal infection that is easily treated.

The lesions are small, dome-shaped papules with central umbilication in groups.

Untreated lesions may become darker in color prior to fading in adulthood.

A

The lesions are small, dome-shaped papules with central umbilication in groups.

Pediatrics (36 decks)

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