Wongs Essentials of Pediatric Nursing 9 Part 2 of 2 By Maryln – Test Bank

Wongs Essentials of Pediatric Nursing 9 Part 2 of 2 By Maryln – Test Bank

Chapter 14: Health Problems of Toddlers and Preschoolers

MULTIPLE CHOICE

1. Which is described as the time interval between infection or exposure to disease and appearance of initial symptoms?

a.	Incubation period
b.	Prodromal period
c.	Desquamation period
d.	Period of communicability

ANS: A

The incubation period is the interval between infection or exposure and appearance of symptoms. The prodromal period is the interval between the time when early manifestations of disease appear and the overt clinical syndrome is evident. Desquamation refers to the shedding of skin. The period of communicability is the time or times during which an infectious agent may be transferred directly or indirectly from an infected person to another person.

PTS: 1 DIF: Cognitive Level: Remember REF: 424

TOP:Integrated Process: Nursing Process: Assessment

MSC: Area of Client Needs: Physiologic Integrity

2. Airborne isolation is required for a child who is hospitalized with:

a.	mumps.
b.	chickenpox.
c.	exanthema subitum (roseola).
d.	erythema infectiosum (fifth disease).

ANS: B

Chickenpox is communicable through direct contact, droplet spread, and contaminated objects. Mumps is transmitted from direct contact with saliva of infected person and is most communicable before onset of swelling. The transmission and source of the viral infection exanthema subitum (roseola) is unknown. Erythema infectiosum (fifth disease) is communicable before onset of symptoms.

PTS: 1 DIF: Cognitive Level: Understand REF: 424

TOP:Integrated Process: Nursing Process: Implementation

MSC:Area of Client Needs: Safe and Effective Care Environment

3. Acyclovir (Zovirax) is given to children with chickenpox to:

a.	minimize scarring.
b.	decrease the number of lesions.
c.	prevent aplastic anemia.
d.	prevent spread of the disease.

ANS: B

Acyclovir decreases the number of lesions; shortens duration of fever; and decreases itching, lethargy, and anorexia. Treating pruritus and discouraging itching minimizes scarring. Aplastic anemia is not a complication of chickenpox. Strict isolation until vesicles are dried prevents spread of disease.

PTS: 1 DIF: Cognitive Level: Understand REF: 429-430

TOP:Integrated Process: Nursing Process: Implementation

MSC: Area of Client Needs: Physiologic Integrity

4. The single parent of a 3-year-old child who has just been diagnosed with chickenpox tells the nurse that she cannot afford to stay home with the child and miss work. The parent asks the nurse if some medication will shorten the course of the illness. Which is the most appropriate nursing intervention?

a.	Reassure the parent that it is not necessary to stay home with the child.
b.	Explain that no medication will shorten the course of the illness.
c.	Explain the advantages of the medication acyclovir (Zovirax) to treat chickenpox.
d.	Explain the advantages of the medication VCZ immune globulin (VariZIG) to treat chickenpox.

ANS: C

Acyclovir is effective in treating the number of lesions; shortening the duration of fever; and decreasing itching, lethargy, and anorexia. It is important the parent stay with the child to monitor fever. Acyclovir lessens the severity of chickenpox. VariZIG is given only to high-risk children.

PTS: 1 DIF: Cognitive Level: Apply REF: 429-430

TOP:Integrated Process: Teaching/Learning

MSC: Area of Client Needs: Physiologic Integrity

5. Which may be given to high-risk children after exposure to chickenpox to prevent varicella?

a.	Acyclovir (Zovirax)
b.	Varicella globulin
c.	Diphenhydramine hydrochloride (Benadryl)
d.	VCZ immune globulin (VariZIG)

ANS: D

VariZIG is given to high-risk children to prevent the development of chickenpox. Acyclovir decreases the severity, not the development, of chickenpox. Varicella globulin is not effective because it is not the immune globulin. Diphenhydramine may help pruritus but not the actual chickenpox.

PTS: 1 DIF: Cognitive Level: Understand REF: 429

TOP:Integrated Process: Nursing Process: Implementation

MSC: Area of Client Needs: Physiologic Integrity

6. Vitamin A supplementation may be recommended for the young child who has which disease?

a.	Mumps
b.	Rubella
c.	Measles (rubeola)
d.	Erythema infectiosum

ANS: C

Evidence shows vitamin A decreases morbidity and mortality in measles. Mumps is treated with analgesics for pain and antipyretics for fever. Rubella is treated similarly to mumps. Erythema infectiosum is treated similarly to mumps and rubella.

PTS: 1 DIF: Cognitive Level: Understand REF: 431

TOP:Integrated Process: Nursing Process: Implementation

MSC: Area of Client Needs: Physiologic Integrity

7. A nurse is teaching parents about caring for their child with chickenpox. The nurse should let the parents know that the child is considered to be no longer contagious when which occurs?

a.	When fever is absent
b.	When lesions are crusted
c.	24 hours after lesions erupt
d.	8 days after onset of illness

ANS: B

When the lesions are crusted, the chickenpox is no longer contagious. This may be a week after onset of disease. Chickenpox is still contagious when child has fever. Children are contagious after lesions erupt. If lesions are crusted at 8 days, the child is no longer contagious.

PTS: 1 DIF: Cognitive Level: Apply REF: 424

TOP:Integrated Process: Teaching/Learning

MSC: Area of Client Needs: Physiologic Integrity

8. A nurse is assessing a child and notes Koplik spots. In which of these communicable diseases are Koplik spots present?

a.	Rubella
b.	Measles (rubeola)
c.	Chickenpox (varicella)
d.	Exanthema subitum (roseola)

ANS: B

Koplik spots are small irregular red spots with a minute, bluish white center found on the buccal mucosa 2 days before systemic rash. Rubella occurs with rash on the face, which rapidly spreads downward. Varicella appears with highly pruritic macules, followed by papules and vesicles. Roseola is seen with rose-pink macules on the trunk, spreading to face and extremities.

PTS: 1 DIF: Cognitive Level: Apply REF: 426

TOP:Integrated Process: Nursing Process: Assessment

MSC: Area of Client Needs: Physiologic Integrity

9. Which is a common childhood communicable disease that may cause severe defects in the fetus when it occurs in its congenital form?

a.	Erythema infectiosum
b.	Roseola
c.	Rubeola
d.	Rubella

ANS: D

Rubella causes teratogenic effects on the fetus. There is a low risk of fetal death to those in contact with children affected with fifth disease. Roseola and rubeola are not dangerous to the fetus.

PTS: 1 DIF: Cognitive Level: Understand REF: 428

TOP:Integrated Process: Nursing Process: Assessment

MSC: Area of Client Needs: Physiologic Integrity

10. Which is the causative agent of scarlet fever?

a.	Enteroviruses
b.	Corynebacterium organisms
c.	Scarlet fever virus
d.	Group A β-hemolytic streptococci (GABHS)

ANS: D

GABHS infection causes scarlet fever. Enteroviruses do not cause the same complications. Corynebacterium organisms cause diphtheria. Scarlet fever is not caused by a virus.

PTS: 1 DIF: Cognitive Level: Understand REF: 428

TOP:Integrated Process: Nursing Process: Assessment

MSC: Area of Client Needs: Physiologic Integrity