TEST BANK FOR WONG'S NURSING CARE OF INFANTS
AND CHILDREN 11TH EDITION BY HOCKENBERRY
Chapter 32: The Child with
Integumentary Dysfunction
MULTIPLE CHOICE
1. The nurse is taking care of a 7-year-old child with a skin rash called a papule. Which
clinical finding should the nurse expect to assess with this type of skin rash?
a. A lesion that is elevated, palpable, firm and circumscribed; less than 1 cm in
diameter
b. A lesion that is elevated, flat-topped, firm, rough and superficial; greater than 1
cm in diameter
c. An elevated lesion, firm, circumscribed, palpable; 1 to 2 cm in diameter
d. An elevated lesion, circumscribed, filled with serous fluid; less than 1 cm in
diameter
ANS: A
A papule is elevated; palpable; firm; circumscribed; less than 1 cm in diameter; and
brown, red, pink, tan, or bluish red. A plaque is an elevated, flat-topped, firm, rough,
superficial papule greater than 1 cm in diameter. It may be coalesced papules. A
nodule is elevated, 1 to 2 cm in diameter, firm, circumscribed, palpable, and deeper in
the dermis than a papule. A vesicle is elevated, circumscribed, superficial, less than 1
cm in diameter and filled with serous fluid.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
2. The nurse is teaching nursing students about childhood skin lesions. Which is an elevated,
circumscribed skin lesion that is less than 1 cm in diameter and filled with serous fluid?
a. Cyst
b. Papule
c. Pustule
d. Vesicle
ANS: D
A vesicle is elevated, circumscribed, superficial, less than 1 cm in diameter, and filled
with serous fluid. A cyst is elevated, circumscribed, palpable, encapsulated, and filled
with liquid or semisolid material. A papule is elevated; palpable; firm; circumscribed;
less than 1 cm in diameter; and brown, red, pink, tan, or bluish red. A pustule is
elevated, superficial, and similar to a vesicle but filled with purulent fluid.
, PTS: 1 DIF: Cognitive Level: Remember
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
3. The nurse is taking care of a 2-year-old child with a macule skin lesion. Which clinical
finding should the nurse expect to assess with this type of lesion?
a. Flat, nonpalpable, and irregularly shaped lesion that is greater than 1 cm in
diameter
b. Heaped-up keratinized cells, flaky exfoliation, irregular, thick or thin, dry or oily,
varied in size
c. Flat, brown mole less than 1 cm in diameter
d. Elevated, flat-topped, firm, rough, superficial papule greater than 1 cm in diameter
ANS: C
A macule is flat; nonpalpable; circumscribed; less than 1 cm in diameter; and brown,
red, purple, white, or tan. A patch is a flat, nonpalpable, and irregularly shaped
macule that is greater than 1 cm in diameter. Scale is heaped-up keratinized cells,
flaky exfoliation, irregular, thick or thin, dry or oily, varied in size, and silver white or
tan. A plaque is an elevated, flat-topped, firm, rough, superficial papule greater than 1
cm in diameter. It may be coalesced papules.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
4. A school-age child falls on the playground and has a small laceration on the forearm. The
school nurse should do which to cleanse the wound?
a. Slowly pour hydrogen peroxide over wound.
b. Soak arm in warm water and soap for at least 30 minutes.
c. Gently cleanse with sterile pad and a nonstinging povidone-iodine solution.
d. Wash wound gently with mild soap and water for several minutes.
ANS: D
Lacerations should be washed gently with mild soap and water or normal saline. A
sterile pad is not necessary, and hydrogen peroxide and povidone-iodine should not be
used because they have a cytotoxic effect on healthy cells and minimal effect on
controlling infection. Soaking the arm will not effectively clean the wound.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
5. A child steps on a nail and sustains a puncture wound of the foot. Which is the most
appropriate method for cleansing this wound?
a. Wash wound thoroughly with chlorhexidine.
b. Wash wound thoroughly with povidone-iodine.
c. Soak foot in warm water and soap.
d. Soak foot in solution of 50% hydrogen peroxide and 50% water.
, ANS: C
Puncture wounds should be cleansed by soaking the foot in warm water and soap.
Chlorhexidine, hydrogen peroxide, and povidone-iodine should not be used because
they have a cytotoxic effect on healthy cells and minimal effect on controlling
infection.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
6. Which nursing consideration is important when caring for a child with impetigo
contagiosa?
a. Apply topical corticosteroids to decrease inflammation.
b. Carefully remove dressings so as not to dislodge undermined skin, crusts, and
debris.
c. Carefully wash hands and maintain cleanliness when caring for an infected child.
d. Examine child under a Wood lamp for possible spread of lesions.
ANS: C
A major nursing consideration related to bacterial skin infections, such as impetigo
contagiosa, is to prevent the spread of the infection and complications. This is done by
thorough hand washing before and after contact with the affected child.
Corticosteroids are not indicated in bacterial infections. Dressings are usually not
indicated. The undermined skin, crusts, and debris are carefully removed after
softening with moist compresses. A Wood lamp is used to detect fluorescent materials
in the skin and hair. It is used in certain disease states, such as tinea capitis.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
7. The nurse is caring for a 5-year-old child with impetigo contagiosa. The parents ask the
nurse what will happen to their childs skin after the infection has subsided and healed.
Which answer should the nurse give?
a. There will be no scarring.
b. There may be some pigmented spots.
c. It is likely there will be some slightly depressed scars.
d. There will be some atrophic white scars.
ANS: A
Impetigo contagiosa tends to heal without scarring unless a secondary infection
occurs.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
8. Cellulitis is often caused by:
a. herpes zoster.
