Chapter 15 ped

the physician has ordered ibuprofen 150 mg every 6 hours as needed for a 3-year-
old child for a fever greater than 38°C (100.4°F). The label of the ibuprofen bottle
reads "ibuprofen oral suspension 100 mg/5 ml." How much ibuprofen liquid will the
nurse administer if the child's temperature goes above 38°C (100.4°F)? Record your
answer using one decimal place.
7.5

The nurse is doing an in-service training on clinical manifestations seen in

communicable diseases. Which skin condition best describes pustule?
• redness of the skin produced by congestion of the capillaries
• small, circumscribed, solid elevation of the skin
• discolored skin spot not elevated at the surface
• small elevation of epidermis filled with a viscous fluid
An adolescent comes to the emergency room with high fevers, chills, rigors and
sweats. Malaria is suspected. When taking the health history, what question should
the nurse ask first?
• "Have you traveled outside North America?"
• "Are there days your symptoms are worse?"
• "When did your symptoms begin?"
• "Is anyone else in your household sick?"

TAKE ANOTHER QUIZ

The nurse is preparing to administer acetaminophen to a 4-year-old child to
provide comfort. Which precaution is specific to antipyretics?
• Check for medicine allergies.
• Take the entire course of medication.
• Ensure proper dose and interval.
• Warn of possible drowsiness.

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?
• “Your child must have been exposed to someone with herpes zoster.”
• “Herpes zoster is a reactivation of a previous varicella zoster infection.”
• “Children who are immunocompromised are more likely to contract shingles.”
 • “Handwashing is an effective way to prevent the spread of infectious disorders.”
The nurse is caring for an adolescent diagnosed with syphilis. The drug of choice for
treating syphilis is:
• griseofluvin
• ceftriaxone
• acyclovir
• penicillin

The nurse is preparing to provide education on the prevention of infection to

parents of children. Which intervention(s) will the nurse include? Select all that
apply.
• proper handwashing
• proper handling and preparation of foods
• vaccination administration
• limiting exposure to sick persons
• judicious antibiotic use

A nurse is assessing a neonate with sepsis. The nurse understands that most
commonly the cause involves:
• herpes virus.
• enterovirus.
• protozoa.
• bacteria.
The nurse at an outpatient facility is obtaining a blood specimen from a 9-year-old
girl. Which technique would most likely be used?
• Puncturing a vein on the dorsal side of the hand.
• Administering sucrose prior to beginning.
• Accessing an indwelling venous access device.
• Using an automatic lancet device on the heel.
The nurse is attempting to control the infectious process while caring for a client.
The nurse changes the client's wound dressing when the dressing becomes soiled.
Which link of the chain of infection is the nurse interrupting with this intervention?
• reservoir
• portal of exit
• mode of transmission
• susceptible host
Which child will the nurse identify as at greatest risk for developing a urinary tract
infection?
• a 6-month-old breastfed female
 • an 8-month-old bottle-fed female with HIV
• a 1-year-old formula-fed male
• a 2-year-old male with otitis media
Parents bring their 9-year-old child to the clinic for a well-child visit. They are
concerned because several children in the neighborhood have developed Lyme
disease and ask for suggestions on what to do to reduce their child's risk. What
would be appropriate for the nurse to suggest? Select all that apply.
• Wearing protective clothing when playing in wooded areas.
• Dressing the child in dark clothing when going outdoors.
• Inspecting the skin closely for ticks after the child plays in wooded areas.
• Removing ticks by rubbing them away from the skin with a credit card.
• Contacting the health care provider if there is any area of inflammation that might be a bite.
A nurse is assessing a child with a tick-borne disease. What finding would indicate
to the nurse that the child has developed ehrlichiosis and not Rocky Mountain
spotted fever?
• fever
• headache
• malaise
• absence of rash

A group of nursing students are reviewing the functions of white blood cells. The
students demonstrate an understanding of the information when they identify
which white blood cell as responsible for combating allergic disorders?
• eosinophils
• neutrophils
• lymphocytes
• monocytes
A child in the clinic has a fever and reports a sore neck. Upon assessment the nurse
finds a swollen parotid gland. The nurse suspects which infectious disease?
• measles
• mumps
• whooping cough
• scabies
The nurse is providing teaching to the parents of a child with varicella. Which
statement by the parents indicates the teaching was successful?
• “We should apply alcohol to the lesions every 4 hours.”
• “If our child has a fever, we can give them some aspirin.”
• “The lesions should eventually form soft crusts that drain.”
• “We need to make sure that our child washes their hands frequently.”
The parents of a 4-month-old diagnosed with sepsis tell the nurse that the
physician explained sepsis to them but they don't really understand it. The parents
state, "Could you please explain it to us?" What is the best response by the nurse?
• "Sepsis results in systemic inflammatory response syndrome (SIRS) due to infection."
• "The pathophysiology of sepsis is complex."
• "The infection your child has causes the release of toxins into the system, which can lead to
impaired function in the lungs, liver, and kidneys."
• "The pathogens cause an overproduction of proinflammatory cytokines. These cytokines are
responsible for the clinically observable effects of the sepsis."
An adolescent comes to the clinic and is diagnosed with syphilis. The nurse
discusses the treatment plan with the adolescent. In addition to medication, what
instruction will the nurse give the adolescent?
• The sexual partners need to be tested.
• Limit the number of sexual partners.
• Syphilis is a reportable disease.
• How the infection will progress if not treated.
The nurse is caring for an infant brought to the clinic for a rash. The nurse notes a
blanchable, rose-pink macular rash on the trunk. The nurse obtains the following
vital signs: temperature 99.0°F (37°C), pulse 100 bpm, respiratory rate 22
breaths/minute, and oxygen saturation 100% on room air. Which question by the
nurse will be most helpful when planning interventions?
• “Has your child had a recent fever?”
• “Is your child more fussy than normal?"
• “Do you have family history of seizures?”
• “Are your child’s vaccinations up to date?”
Which child will the nurse identify as being at greatest risk for developing a
hospital-acquired infection (HAI)?
• a 1-year-old receiving oral amoxicillin for otitis media
• an 18-month-old child receiving chemotherapy over 5 days
• a 2-year-old child with HIV being discharged later that day
• a 3-year-old child with malnutrition and poor weight gain
An adolescent girl and her caregiver present at the pediatrician's office. The
adolescent reports severe abdominal pain. A diagnosis of pelvic inflammatory
disease (PID) is made. The nurse notes in the child's chart that this is the third time
she has been treated for PID. Which action by the nurse would be most
appropriate?
• Contact the necessary authorities to report a suspected case of sexual abuse.
• Take the child to a private room and interview her regarding her sexual history and partners.
 • Take the caregiver to a private room and tell her that the child's diagnosis can only come from
sexual activity.
• Talk to the child and caregiver together and explain that the condition is often a result of a
sexually transmitted infection and discuss the importance of safe sex practices.
Nursing students are learning about the infectious process. They correctly identify
the first stage of an infectious disease to be which period?
• Incubation period
• Prodromal period
• Illness period
• Convalescent period
The nurse is caring for a child admitted to the hospital for sepsis. Which
assessment finding is the most concerning?
• oral temperature 102.3°F (39°C)
•
white blood cell count 18,000/mm3
• urine output of 10 ml over 3 hours
• apical heart rate 120 beats per minute
A child is brought to the clinic by the parents because the child had a high fever.
Assessment reveals vesicles on the tongue and shallow ulcers on the oral mucosa.
The child is diagnosed with hand, foot and mouth disease. When teaching the
parents about this infection, which information would the nurse likely include?
Select all that apply.
• "You need to make sure to wash your hands frequently."
• "This condition usually resolves in about 1 week."
• "The infection can continue to spread to others for about 2 to 3 weeks."
• "This infection is spread mostly through contact with urine."
• "Try offering cold items, like popsicles for fluids."
A nursing instructor is teaching the students about the standard and transmission-
based precautions. What type of precautions require placing a client in an isolated
room with limited access, wearing gloves during contact with the client and all body
fluids or contaminated items, wearing two layers of protective clothing, and
avoiding sharing equipment between clients?
• Airborne precautions
• Droplet precautions
• Contact precautions
• Standard precautions
The student nurse is discussing the plan of care for a child admitted to the hospital
for treatment of an infection. Which action should be taken first?
• Obtain blood cultures.
• Initiate antibiotic therapy.
 • Obtain urine specimen for analysis.
• Initiate intravenous therapy.

TAKE ANOTHER QUIZ

The public health nurse is discussing immunizations with a group of caregivers of

infants. One of the mothers asks the nurse why the child will need immunizations.
Which statement would be the most appropriate for the nurse to make to this
mother?
• “The infant is born with immunity to some diseases, but those immunities decrease over the first
year of life.”
• “The antibodies the fetus gets from the mother are in the placenta, so after birth they are no
longer available to the infant.”
• “The immunities that the infant is born with are not for the same diseases they will be
immunized against.”
• “Infants are unable to develop antibodies to protect them from diseases so they must be
immunized.”
The nurse is assessing a child who 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 nurse take?
• Notify the primary health care provider.
• Place the child on contact precautions.
• Obtain an electrocardiography (ECG).
• Clean the rash with rubbing alcohol.

What is the leading cause of neonatal sepsis and death?

• Neisseria meningitidis
• Group B streptococcus
• Epstein-Barr virus infection
• cytomegalovirus infection
A nurse is preparing a presentation for parents about common childhood
infectious diseases. What conditions would the nurse include as being caused by a
tick bite? Select all that apply.
• Lyme disease
• Rocky Mountain spotted fever
• Psittacosis
• Ascariasis
• Scabies
The mother of a 10-year-old child diagnosed with rubella asks what can be done to
help her child feel better during her illness. What information can be provided?
 • Encourage rest and relaxation.
• Antibiotic therapy may be initiated.
• Antiviral medications can be prescribed.
• Range of motion to prevent contractures.
A nurse practitioner suspects that a child has scarlet fever based on which
assessment finding?
• Severity of the sore throat
• An enanthematous rash
• Red, strawberry tongue
• White exudate on the tonsils
A 6-year-old child is brought to the clinic by his parents. The parents state, "He had
a sore throat for a couple of days and now his temperature is over 102°F (38.9°C).
He has this rash on his face and chest that looks like sunburn but feels really
rough." What would the nurse suspect?
• Scarlet fever
• Community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA)
• Diphtheria
• Pertussis
The parents of a 3-year-old child report he was exposed to pertussis 2 days ago.
They are concerned and ask the nurse how long it will take until he becomes ill if he
indeed contracted the infection. What response by the nurse is indicated?
• "If you child has contracted the illness he will become ill in about 2 weeks."
• "The signs of disease will be noted in 1 to 3 weeks."
• "If your child had contracted the disease symptoms would have be noted by this time."
• "It normally takes about 3 weeks before symptoms begin."
A 6-year-old child is being treated for a parasitic infection. When reviewing results
from the child's white blood cell count, which finding would be anticipated?
• elevated monocytes
• reduced basophil levels
• increased eosinophil levels
• reduced neutrophil levels

When the health care provider looks in a child's mouth during a sick-visit
examination, the parent exclaims: "The tongue is bright strawberry red! It was
not like that yesterday." The health care provider would most likely prescribe
which medication based on the probable diagnosis?
• Steroids to decrease the inflammation
• Acetaminophen to decrease the throat pain
• Penicillin to prevent acute glomerulonephritis
 • Erythromycin to prevent the spread to siblings
When caring for a child diagnosed with West Nile virus, the nurse will question
which prescription from the primary health care provider?
• amoxicillin 40 mg/kg/day orally every 8 hours
• acetaminophen every 4 to 6 hours PRN fever
• Place client on fall precautions.
• Monitor the client's cardiac status.
A 7-year-old child with an earache comes to the clinic. The child's parent reports
that 1 day ago the child had a fever and headache and did not want to play. When
the nurse asks where it hurts, the child points to the jawline in front of the earlobe.
What does the nurse expect the diagnosis will be for this child?
• Measles
• Mumps
• Mononucleosis
• Fifth disease
What is one of the most commonly reported communicable diseases in the United
States?
• gonorrhea
• syphilis
• mononucleosis
• measles
The nurse is caring for multiple clients on the pediatric unit. Which child will the
nurse see first?
• a child diagnosed with chicken pox reporting nausea and malaise
• a child with herpes simplex who is reporting mouth pain and pruritis
• a child diagnosed with measles experiencing photophobia and coryza
• a child with erythema infectiosum experiencing fatigue and confusion
A 10-year-old child has an unknown infection and will need to provide a urine
specimen for culture and sensitivity. To assure that the sensitivity results are
accurate, which step is most important?
• Ensure that the specimen is obtained from proper area.
• Collect three specimens on three different days.
• Use aseptic technique when getting the specimen.
• Obtain specimen before antibiotics are given.
A chief danger of scarlet fever is that children may develop:
• acute glomerulonephritis.
• liver destruction.
• local areas of skin necrosis.
• respiratory obstruction.
A young client arrives at the clinic with a rash on the trunk and flexor surfaces of
the extremities. The parent informs the nurse that the rash started a day before on
the exterior surfaces of the extremities; 2 days before, the child had a really bad
rash on the face. The health care provider diagnoses the child with erythema
infectiosum. The nurse tells the parent that this is also known as:
• enterovirus.
• fifth disease.
• rosacea.
• pityriasis rosea.