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Silvestri Chapter 38 Ed#562

Silvestri Chapter 38 Ed#562

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Published by Linda Kuglarz

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Published by: Linda Kuglarz on Oct 14, 2008
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Silvestri, 3/e, ISBN 1-1460-0052-6Chapter 038 (edited file)—"Communicable Diseases and Acquired Immunodeficiency Syndrome"10/14/08, Page 1 of 10, 0 Figure(s), 0 Table(s), 7 Box(es)
38: Communicable Diseases andAcquired Immunodeficiency Syndrome
PRACTICE QUESTIONS
1. A child with rubeola (measles) is being admitted to the hospital. In preparing for theadmission of the child, the nurse plans to institute which precaution for this child?1. Contact2. Enteric3. Respiratory4. ProtectiveAnswer: 3Rationale: Rubeola is transmitted via airborne particles or direct contact with infectious droplets.Respiratory precautions are required and a mask is worn by those in contact with the child.Gowns and gloves are not indicated. Articles that are contaminated should be bagged andlabeled. Options 1, 2, and 4 are not indicated in rubeola.Test-Taking Strategy: Use the process of elimination. Recalling that rubeola is transmitted viathe airborne route will direct you to option 3. Review the route of transmission and therapeuticmanagement of rubeola if you had difficulty with this question.Level of Cognitive Ability: ApplicationClient Needs: Safe, Effective Care EnvironmentIntegrated Process: Nursing Process/PlanningContent Area: Child HealthReferences: McKinney, E., James, S., Murray, S., & Ashwill, J. (2005).
Maternal-child nursing 
(2nd ed.). St. Louis: Elsevier, p. 1020.Wong, D., & Hockenberry, M. (2003).
 Nursing care of infants and children
(7th ed.). St. Louis:Mosby, p. 655.2. Several children have contracted rubeola (measles) in a local school and the school nurseconducts a teaching session for the mothers of the schoolchildren. Which statement made by amother indicates a need for further teaching regarding this communicable disease?1. “Respiratory symptoms such as a very runny nose, cough, and fever occur before thedevelopment of a rash.”2. “Small blue-white spots with a red base may appear in the mouth.”3. “The rash usually begins behind the ears and spreads downward toward the feet.”4. “The communicable period ranges from 10 days before the onset of symptoms to 15 daysafter the rash appears.”Answer: 4Rationale: The communicable period for rubeola ranges from 4 days before to 5 days after therash appears, mainly during the prodromal (catarrhal) stage. Options 1, 2, and 3 are accuratedescriptions of rubeola. The small blue-white spots found in this communicable disease arecalled Koplik spots. Option 4, the incorrect option, describes the incubation period for rubella,not rubeola.
 
Silvestri, 3/e, ISBN 1-1460-0052-6Chapter 038 (edited file)—"Communicable Diseases and Acquired Immunodeficiency Syndrome"10/14/08, Page 2 of 10, 0 Figure(s), 0 Table(s), 7 Box(es)
Test-Taking Strategy: Note the key words,
need for further teaching 
. These words indicate afalse response question and that you need to select the incorrect client statement. Remember thatthe communicable period for rubeola ranges from 4 days before to 5 days after the rash appears.Review the clinical manifestations associated with rubeola if you had difficulty with thisquestion.Level of Cognitive Ability: ComprehensionClient Needs: Health Promotion and MaintenanceIntegrated Process: Teaching/LearningContent Area: Child HealthReference: Price, D., & Gwin, J. (2005).
Thompson’s pediatric nursing 
(9th ed.). Philadelphia:W.B. Saunders, p. 254.3. A mother of a 15-month-old child brings the child to the clinic and reports that the child has afever and has developed a rash on the neck and trunk. Roseola is diagnosed, and the mother isconcerned that her other children will contract the disease. The nurse provides which instructionto the mother regarding prevention of transmission of the disease?1. The disease is transmitted through the urine and feces, so the other children should use aseparate bathroom.2. Disease transmission is unknown.3. The disease is transmitted through the respiratory tract, so the child should be isolated fromthe other children as much as possible.4. The disease is transmitted by contact with body fluids, so any items contaminated with bodyfluids need to discarded in a separate receptacle.Answer: 2Rationale: The method of transmission of roseola is unknown. Options 1, 3, and 4 are notcorrect transmission routes of roseola.Test-Taking Strategy: Use the process of elimination. Eliminate options 1 and 4 first becausethey are similar. From the remaining options, recall that the method of transmission of roseola isunknown. Review the characteristics of roseola if you had difficulty with this question.Level of Cognitive Ability: ApplicationClient Needs: Health Promotion and MaintenanceIntegrated Process: Teaching/LearningContent Area: Child HealthReference: Price, D., & Gwin, J. (2005).
Thompson’s pediatric nursing 
(9th ed.). Philadelphia:W.B. Saunders, p. 254.4. The nurse provides instructions regarding respiratory precautions to the mother of a child withmumps. The mother asks the nurse about the length of time required for the respiratory precautions. The nurse tells the mother that:1. Respiratory isolation in not necessary.2. Mumps is not transmitted by the respiratory system.3. Respiratory precautions are indicated during the period of communicability.4. Respiratory precautions are indicated for 18 days following the onset of parotid swelling.Answer: 3Rationale: Mumps is transmitted via direct contact or droplet spread from an infected person and
 
Silvestri, 3/e, ISBN 1-1460-0052-6Chapter 038 (edited file)—"Communicable Diseases and Acquired Immunodeficiency Syndrome"10/14/08, Page 3 of 10, 0 Figure(s), 0 Table(s), 7 Box(es)
 possibly by contact with urine. Respiratory precautions are indicated during the period of communicability. Options 1, 2, and 4 are incorrect.Test-Taking Strategy: Use the process of elimination. Options 1 and 2 can be eliminated first because they are similar. From the remaining options, select option 3, because it is the umbrella(global option), and addresses communicability. Also, the time frame indicated in option 4seems rather lengthy. Review the infectious period related to mumps if you had difficulty withthis question.Level of Cognitive Ability: ApplicationClient Needs: Safe, Effective Care EnvironmentIntegrated Process: Teaching/LearningContent Area: Child HealthReference: Price, D., & Gwin, J. (2005).
Thompson’s pediatric nursing 
(9th ed.). Philadelphia:W.B. Saunders, p. 255.Wong, D., & Hockenberry, M. (2003).
 Nursing care of infants and children
(7th ed.). St. Louis:Mosby, p. 657.5. The mother brings her 6-year-old child to the clinic because the child has developed a rash onthe trunk and on the scalp. The mother reports that the child has had a low-grade fever, has notfelt like eating, and has been generally tired. The child is diagnosed with chickenpox, and themother inquires about the communicable period associated with chickenpox. The nurse plans to base the response on which of the following?1. The communicable period is unknown.2. The communicable period is 1 to 2 days before the onset of the rash to 6 days after the onsetand crusting of lesions.3. The communicable period is 10 days before the onset of symptoms to 15 days after the rashappears.4. The communicable period ranges from 2 weeks or less up to several months.Answer: 2Rationale: The communicable period for chickenpox is 1 to 2 days before the onset of the rashto 6 days after the onset and crusting of lesions. In roseola, the communicable period isunknown. Option 3 describes rubella. Option 4 describes diphtheria.Test-Taking Strategy: Use the process of elimination. Option 1 can be easily eliminated first.Eliminate options 3 and 4 next because the time frames in these two options seem rather lengthyand are similar. If you had difficulty with this question, review the communicable period for chickenpox.Level of Cognitive Ability: ApplicationClient Needs: Safe, Effective Care EnvironmentIntegrated Process: Teaching/LearningContent Area: Child HealthReference: Price, D., & Gwin, J. (2005).
Thompson’s pediatric nursing 
(9th ed.). Philadelphia:W.B. Saunders, p. 250.6. The nurse reinforces home care instructions to the parents of a child hospitalized with pertussis who is in the convalescent stage and is being prepared for discharge. Which statement by the parents indicates a need for further instructions?

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