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Chapter 49 The Child with an Alteration in Tissue Integrity
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Chapter 49 The Child with an Alteration in Tissue Integrity
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Chapter 49: The Child with an Alteration in Tissue IntegrityTest Bank
MULTIPLE CHOICE
1. What should be included in teaching a parent about the management of small red macules
and vesicles that become pustules around the child’s mouth and cheek?
a. Keep the child home from school for 24 hours after initiation of antibiotic
treatment.
b. Clean the rash vigorously with Betadine three times a day.
c. Notify the physician for any itching.
d. Keep the child home from school until the lesions are healed.
ANS: A
Feedback
A To prevent the spread of impetigo to others, the child should be kept home from
school for 24 hours after treatment is initiated. Good handwashing is imperative
in preventing the spread of impetigo.
B The lesions should be washed gently with a warm soapy washcloth three times a
day. The washcloth should not be shared with other members of the family.
C Itching is common and does not necessitate medical treatment. Rather, parents
should be taught to clip the child’s nails to prevent maceration of the lesions.
D The child may return to school 24 hours after initiation of antibiotic treatment.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1306
OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance
2. When taking a history on a child with a possible diagnosis of cellulitis, what should be the
priority nursing assessment to help establish a diagnosis?
a. Any pain the child is experiencing
b. Enlarged, mobile, and nontender lymph nodes
c. Child’s urinalysis results
d. Recent infections or signs of infection
ANS: D
Feedback
A Pain is important, but the history of recent infections is more relevant to the
diagnosis.
B Lymph nodes may be enlarged (lymphadenitis), but they are not mobile and are
nontender. Lymphangitis may be seen with red “streaking” of the surrounding
area.
C An abnormal urinalysis result is not usually associated with cellulitis.
D Cellulitis may follow an upper respiratory infection, sinusitis, otitis media, or a
tooth abscess. The affected area is red, hot, tender, and indurated.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1307
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
, 3. Which statement made by a parent indicates an understanding about the management of a
child with cellulitis?
a. “I am supposed to continue the antibiotic until the redness and swelling disappear.”
b. “I have been putting ice on my son’s arm to relieve the swelling.”
c. “I should call the doctor if the redness disappears.”
d. “I have been putting a warm soak on my son’s arm every 4 hours.”
ANS: D
Feedback
A The parent should not discontinue antibiotics when signs of infection disappear.
To ensure complete healing, the parent should understand that the entire course
of antibiotics should be given as prescribed.
B A warm soak is indicated for the treatment of cellulitis. Ice will decrease
circulation to the affected area and inhibit the healing process.
C The disappearance of redness indicates healing and is not a reason to seek
medical advice.
D Warm soaks applied every 4 hours while the child is awake increase circulation
to the infected area, relieve pain, and promote healing.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1307
OBJ: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance
4. What should the parents of an infant with thrush (oral candidiasis) be taught about medication
administration?
a. Give nystatin suspension with a syringe without a needle.
b. Apply nystatin cream to the affected area twice a day.
c. Give nystatin before the infant is fed.
d. Swab nystatin suspension onto the oral mucous membranes after feedings.
ANS: D
Feedback
A Medication may not reach the affected areas when it is squirted into the infant’s
mouth. Rubbing the suspension onto the gum ensures contact with the affected
areas.
B Nystatin cream is used for diaper rash caused by Candida.
C To prolong contact with the affected areas, the medication should be
administered after a feeding.
D It is important to apply the nystatin suspension to the affected areas, which is
best accomplished by rubbing it onto the gums and tongue, after feedings, every
6 hours, until 3 to 4 days after symptoms have disappeared.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1308
OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance
5. With what beverage should the parents of a child with ringworm be taught to give
griseofulvin?
a. Water
b. A carbonated drink
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