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Silvestri Chapter 35 Ed#55F

Silvestri Chapter 35 Ed#55F

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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 035 (edited file)—"Integumentary Disorders"10/14/08, Page 1 of 6, 1 Figure(s), 0 Table(s), 3 Box(es)
35: Integumentary Disorders
PRACTICE QUESTIONS
1. Corticream is prescribed by the physician for a child with atopic dermatitis (eczema) and thenurse instructs the mother how to apply the cream. The nurse tells the mother to:1. Avoid cleansing the area before applying the cream2. Apply the cream over the entire body3. Apply a thin layer of cream and rub into the area thoroughly4. Apply a thick layer of cream in affected areas onlyAnswer: 3Rationale: Corticream is a topical corticosteroid. It should be applied sparingly and rubbed intothe area thoroughly. The affected area should be cleansed gently before application. It shouldnot be applied over extensive areas. Systemic absorption is more likely to occur with extensiveapplication.Test-Taking Strategy: Use the process of elimination. Eliminate options 1 because it does notmake sense to avoid cleansing an affected area. Eliminate option 2 because cream should beapplied only to the area that is affected. Eliminate option 4 because of the words “thick” and“only.” Review the procedure for application of this cream if you had difficulty with thisquestion.Level of Cognitive Ability: ApplicationClient Needs: Health Promotion and MaintenanceIntegrated Process: Teaching/LearningContent Area: Child HealthReference: Skidmore-Roth, L. (2005).
Mosby’s drug guide for nurses
(6th ed.). St. Louis:Mosby, p. 999.2. A nurse assists in providing an instructional session to parents regarding impetigo. Whichstatement by a parent indicates a need for further instruction?1. “It is most common in humid weather.”2. “It begins in an area of broken skin, such as an insect bite.”3. “It is extremely contagious.”4. “Lesions are most often located on the arms and chest.”Answer: 4Rationale: Impetigo is most common during hot, humid summer months. It begins in an area of  broken skin, such as an insect bite. It may be caused by
Staphylococcus aureus
, group A beta-hemolytic streptococci, or a combination of these bacteria. It is extremely contagious. Lesionsare usually located around the mouth and nose, but may be present on the extremities.Test-Taking Strategy: Use the process of elimination and note the key words,
indicates a need  for further instruction
. These words indicate a false response question and that you need toselect the incorrect client statement. Recalling that the lesions are most commonly locatedaround the mouth and nose will direct you to option 4. Review this disorder if you had difficultywith this question.Level of Cognitive Ability: ComprehensionClient Needs: Health Promotion and Maintenance
 
Silvestri, 3/e, ISBN 1-1460-0052-6Chapter 035 (edited file)—"Integumentary Disorders"10/14/08, Page 2 of 6, 1 Figure(s), 0 Table(s), 3 Box(es)
Integrated Process: Teaching/LearningContent Area: Child HealthReference: Price, D., & Gwin, J. (2005).
Thompson’s pediatric nursing 
(9th ed.). Philadelphia:W.B. Saunders, p. 133.3. A nurse provides instructions to the mother of a child with impetigo regarding the applicationof antibiotic ointment and the mother asks the nurse when the child can return to school. Thenurse tells the mother that the child can return to school:1. Twenty-four hours after using antibiotic ointment2. Forty-eight hours after using antibiotic ointment3. One week after using antibiotic ointment4. Ten days after using antibiotic ointmentAnswer: 2Rationale: The child should not attend school for 24 to 48 hours after the initiation of systemicantibiotics or 48 hours after using antibiotic ointment. The school should be notified of thediagnosis. Therefore, options 1, 3, and 4 are incorrect.Test-Taking Strategy: Use knowledge related to the administration of antibiotics to answer thequestion. Eliminate options 3 and 4 first because the time frames are closely related and rather lengthy. Note the key word,
ointment 
, in the question; this should assist in directing you tooption 2. Review the treatment measures for impetigo if you had difficulty with this question.Level of Cognitive Ability: ApplicationClient Needs: Safe, Effective Care EnvironmentIntegrated Process: Nursing Process/ImplementationContent Area: Child HealthReference: McKinney, E., James, S., Murray, S., & Ashwill, J. (2005).
Maternal-child nursing 
(2nd ed.). St. Louis: Elsevier, p. 366.4. A nurse provides instructions regarding the use of permethrin 1% (Nix) to the parents of achild diagnosed with pediculosis (head lice). Which statement by a parent indicates a need for further instruction?1. “The medication can be obtained over the counter in a local pharmacy.”2. “The medication is applied to the hair after shampooing and left on for 24 hours.”3. “The medication is applied to the hair after shampooing, left on for 10 minutes, and thenrinsed out.”4. “The hair should not be shampooed for 24 hours following treatment.”Answer: 2Rationale: Permethrin 1% is an over-the-counter antilice product that kills both lice and eggswith one application and has residual activity for 10 days. It is applied to the hair after shampooing and left for 10 minutes before rinsing out. The hair should not be shampooed for 24hours after the treatment.Test-Taking Strategy: Use the process of elimination and note the key words,
need for further instruction
. These words indicate a false response question and that you need to select theincorrect client statement. Recalling the treatment for the use of this medication will direct youto option 2. Review this treatment if you had difficulty with this question.Level of Cognitive Ability: ComprehensionClient Needs: Safe, Effective Care Environment
 
Silvestri, 3/e, ISBN 1-1460-0052-6Chapter 035 (edited file)—"Integumentary Disorders"10/14/08, Page 3 of 6, 1 Figure(s), 0 Table(s), 3 Box(es)
Integrated Process: Teaching/LearningContent Area: Child HealthReference: Leifer, G. (2003).
 Introduction to maternity and pediatric nursing 
(4th ed.).Philadelphia: W.B. Saunders, p. 712.5. A nurse prepares a list of home care instructions for the parents of school children diagnosedwith pediculosis (head lice). Which of the following is included in the list?1. Use antilice sprays on all bedding and furniture2. Take all bedding and linens to the cleaners to be dry cleaned3. Boil combs and brushes in hot water for 2 hours4. Vacuum floors, play areas, and furniture to remove any hairs that might carry live nitsAnswer: 4Rationale: Antilice sprays are unnecessary. Additionally, they should never be used on a child.Bedding and linens should be washed with hot water and dried on a hot setting. Items thatcannot be washed should be dry cleaned or sealed in plastic bags in a warm place for 3 weeks.Combs and brushes should be boiled or soaked in antilice shampoo or hot water for 15 minutes.Thorough home cleaning is necessary to remove any remaining lice or nits.Test-Taking Strategy: Use the process of elimination. Eliminate option 1, knowing that antilicesprays should not be used. Knowing that bedding and linens can be washed will eliminate option2. The time for boiling in option 3 is rather lengthy; therefore, eliminate this option. Reviewhome care instructions regarding pediculosis if you had difficulty with this question.Level of Cognitive Ability: ApplicationClient Needs: Safe, Effective Care EnvironmentIntegrated Process: Nursing Process/ImplementationContent Area: Child HealthReference: Price, D., & Gwin, J. (2005).
Thompson’s pediatric nursing 
(9th ed.). Philadelphia:W.B. Saunders, p. 279.6. A mother of a 3-year-old child tells the nurse that the child has been continuously scratchingthe skin and has developed a rash. The nurse inspects the child and suspects the presence of scabies if which of the following is observed?1. Clusters of fluid-filled vesicles2. Fine threadlike lines3. Purple-colored lesions4. Thick, honey-colored crustsAnswer: 2Rationale: Scabies appears as burrows or fine, grayish, thread-like lines. They may be difficultto see if they are obscured by excoriation and inflammation. Clusters of fluid-filled vesicles areseen in herpes virus. Thick, honey-colored crusts are characteristic of impetigo. Purple-coloredlesions may be indicative of various disorders, including systemic conditions.Test-Taking Strategy: Use the process of elimination. Recalling that scabies infestation produces burrows will assist in directing you to option 2. Review the characteristics of scabies if you had difficulty with this question.Level of Cognitive Ability: ComprehensionClient Needs: Physiological IntegrityIntegrated Process: Nursing Process/Data Collection

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