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Wongs Essentials of Pediatric Nursing
Wongs Essentials of Pediatric Nursing
Wongs Essentials of Pediatric Nursing
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,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.
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.
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.
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.
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.
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
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