Chapter 43: Nursing Care of a A nurse practitioner suspects that a

Family when a Child has an child has scarlet fever based on which
assessment finding?
Infectious Disorder

  Red,  The tongue has a white or

The nurse is assessing a child who
red "strawberry" appearance
presents with a history of fever,
malaise, fatigue, and headache. The
nurse notes a bulls-eye rash on the
child's right leg. Which action will the  tongue
nurse take?

  Notify the primary health care A child is brought to the emergency

provider. department by his parents. The
parents report that he stepped on a
rusty nail about a week and a half ago.
A school-aged child with an infectious The child is complaining of cramping
disease is placed on transmission- in his jaw and some difficulty
based precautions. If the child is not swallowing. The nurse suspects
dehydrated or otherwise in distress, tetanus. When assessing the child, the
which nursing diagnosis would be nurse would be alert to which muscle
the priority? groups being affected next?

  Social isolation related to   Neck

infectivity and inability to go to
the playroom
A parent of a 6-year-old client states, "I
have heard of cases of West Nile virus
A child is diagnosed with scarlet fever. in the area. What can I do to protect
The nurse is reviewing the child's my child?" Which recommendation by
medical record, expecting which the nurse is appropriate?
medication to be prescribed for this
child?
  "Be sure to drain any standing
water in your yard."
  Penicillin V
After teaching the parents of a child   acyclovir
with chickenpox (varicella zoster), the
nurse determines that the parents
have understood the teaching when A child in the clinic has a fever and
they state that their child can return to reports a sore neck. Upon assessment
school at which time? the nurse finds a swollen parotid
gland. The nurse suspects which
infectious disease?
  After the lesions have crusted

  Mumps
A child diagnosed with AIDS comes to
the clinic for routine immunizations. In
giving immunizations to the child who A nursing instructor is describing the
has AIDS, the nurse can safely progression of signs and symptoms
administer the injectable vaccine given associated with varicella from earliest
for which disease? to latest. Place the signs and
symptoms below in the sequence that
the instructor would describe them.
  poliomyelitis
  Low-grade fever
A mother brings her 8-year-old son for   Macular rash
evaluation because of a rash on his   Papular rash
lower leg. Which finding would   Vesicle formation
support the suspicion that the child   Crusting
has Lyme disease?

Which child will the nurse identify as

  Playing in the woods about a being at greatest risk for developing a
week ago hospital-acquired infection (HAI)?

The nurse is caring for an adolescent

diagnosed with genital herpes. The   an 18-month-old child receiving
drug of choice for treating genital chemotherapy over 5 days
herpes is:
The nurse is caring for multiple clients   Koplik spots
on the pediatric unit. Which child will
the nurse see first?
The nurse is caring for a child whose
family recently emigrated from a
developing country. While completing
  a child with erythema
the admission history, the parents
infectiosum experiencing
report all the child’s immunizations
fatigue and confusion
are up to date. Which nursing action
is most appropriate?
The nurse is triaging a child diagnosed
with poliomyelitis. After ensuring
appropriate precautions are in place,   Ask parents which
what will the nurse do next? immunizations have been given.

The nurse is providing education to

  Auscultate the child's lungs.
the parents of a child diagnosed with
pinworms. Which statement
A young client arrives at the clinic with is most important for the nurse to
a rash on the trunk and flexor include in the teaching?
surfaces of the extremities. The parent
informs the nurse that the rash
started a day before on the exterior   “Make sure your child washes
surfaces of the extremities; 2 days hands before eating.”
before, the child had a really bad rash
on the face. The health care provider
diagnoses the child with erythema A nursing instructor is teaching the
infectiosum. The nurse tells the parent students about the standard and
that this is also known as: transmission-based precautions. What
type of precautions require placing a
client in an isolated room with limited
access, wearing gloves during contact
  fifth disease.
with the client and all body fluids or
contaminated items, wearing two
The appearance of which hallmark layers of protective clothing, and
clinical manifestation occurs in avoiding sharing equipment between
measles? clients?
   Contact precautions An 11-year-old girl arrives at the
doctor's office with fever, a sore
throat, chills, and malaise. A throat
A 3-year-old girl was in the hospital for culture indicates scarlet fever. Which
a week following open heart surgery. other symptom should the nurse
By the end of the week, she had notice in this client that clearly
contracted an infection. The nurse indicates scarlet fever?
recognizes this type of infection as a:
  The tongue has a white or red
"strawberry" appearance
  nosocomial (health care–
associated) infection.
The nurse is caring for an adolescent
diagnosed with genital herpes. The
The nurse is caring for a child newly drug of choice for treating genital
diagnosed with diphtheria. Which herpes is:
nursing interventions would the nurse
include in the child's plan of care?
Select all that apply.   acyclovir

 Administering antitoxin The nurse is performing a physical

intravenously examination of an 8-year-old girl who
 Monitoring for airway was bitten by her kitten. Which
obstruction assessment would lead the nurse to
 Adhering to droplet precautions suspect cat-scratch disease?
 Ensuring complete bed rest

  Swollen lymph nodes

The nurse is performing a physical
examination for a 7-year-old girl who
was bitten by a tick. What would alert A nursing instructor is teaching
the nurse to the possibility of early students about the chain of infection.
localized Lyme disease? What does the instructor tell students
is responsible for allowing the
pathogen to enter?
  Bull's-eye rash around the bite

  Portal of entry
 What information should be included
The nurse is performing a physical in the teaching plan for a child with
examination on a 9-year-old boy who varicella?
has experienced a tick bite on his
lower leg and is suspected of having
Lyme disease. Which assessment   Remind the child not to scratch
finding would the nurse expect to the lesions.
find?

  Ring-like rash on lower leg A toddler has a fever. The parent calls
the clinic wanting to know the
appropriate dosage of acetaminophen
The most common complication of
to give the child. The parents say the
varicella is:
child weighs 26 lb (11.8 kg). What is
the lowest dose the nurse would
instruct the parent to administer to
  secondary bacterial infections. the child?

The nurse is discussing medications to

be given to a child who has been   118 mg
diagnosed with oral candidiasis
(thrush). Which medication
The nurse is doing an in-service
would most likely be prescribed for
training on clinical manifestations
the child?
seen in communicable diseases.
Which skin condition best describes
erythema?
  nystatin

The nurse is providing teaching to the   redness of the skin produced

parents of a child with varicella. Which by congestion of the capillaries
statement indicates that the parents
have understood the instructions?
Infectious mononucleosis (“mono”) is
caused by which of the following?
  “We need to make sure that he
washes his hands frequently.”
  Epstein-Barr virus
  Wearing protective clothing
When providing care for a child with when playing in wooded areas.
herpes zoster (shingles), the parents  Inspecting the skin closely for
ask the nurse how the child ticks after the child plays in
contracted this infectious disorder. wooded areas.
Which response by the nurse  Contacting the health care
is most appropriate? provider if there is any area of
inflammation that might be a
bite.
  “Herpes zoster is a reactivation
of a previous varicella zoster
A 6-year-old child is brought to the
infection.”
clinic by his parents. The parents
state, "He had a sore throat for a
While assessing a child brought to the couple of days and now his
hospital with fever and headache, the temperature is over 102°F (38.9°C). He
nurse notes trismus and swelling has this rash on his face and chest
above the child’s jawline. Which that looks like sunburn but feels really
collaborative interventions will the rough." What would the nurse
nurse begin? Select all that apply. suspect?

 Don a surgical mask.   Scarlet fever

 Administer ibuprofen.
 Monitor for fever reduction.
 Ask if vaccinations are current. A nurse is promoting vaccine
administration. When instructing on
the physiological changes, which
Parents bring their 9-year-old child to statement best explains what occurs
the clinic for a well-child visit. They are in the child when vaccines are
concerned because several children in administered?
the neighborhood have developed
Lyme disease and ask for suggestions
on what to do to reduce their child's   The child develops an active
risk. What would be appropriate for
immunity.
the nurse to suggest? Select all that
apply.
The nurse is caring for a child
admitted to the hospital for sepsis.
Which assessment finding is The nurse is educating a class about
the most concerning? signs and symptoms of smallpox
(variola) that would be noted in the
first 24 hours of the prodromal phase.
  urine output of 10 ml over 3 Which signs and symptoms selected
hours by the class participants indicate
teaching was successful? Select all that
apply.
A nurse is preparing a presentation
for parents about common childhood
infectious diseases. What conditions  malaise
would the nurse include as being  headache
caused by a tick bite? Select all that  high fever
apply.  facial lesions
 abdominal pain
 Lyme disease
 Rocky Mountain spotted fever The nurse is caring for a child
diagnosed with hepatitis B. Which
system is most likely to have
A nurse is teaching parents of a child complications from this diagnosis?
with a nursing diagnosis of pain
related to pruritus from skin lesions.
Which of the following would the   gastrointestinal
nurse include in the instructions?
Select all that apply.
The nurse is caring for an 18-month-
old client experiencing a rash with
 "Keep the child's fingernails erythema and pruritic sensations.
short." Which nursing intervention
 "Bathe the child in lukewarm is most helpful in preventing further
water and baking soda." complications of the rash?
 "Have the child press on the
itching area instead of
scratching it."   Keep the client's fingernails
short.

When providing care for a child with

herpes zoster (shingles), the parents
ask the nurse how the child
contracted this infectious disorder.
Which response by the nurse
is most appropriate?

  “Herpes zoster is a reactivation

of a previous varicella zoster
infection.”