Test Bank for Wong’s Essentials of Pediatric Nursing, 11th Edition, Marilyn J.

Hockenb

Test Bank for Wong’s Essentials of Pediatric

Nursing, 11th Edition, Marilyn J. Hockenberry, Cheryl
C Rodgers David Wilson

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Chapter 06: Childhood Communicable and Infectious Diseases
Evolve Resources for Wong’s Essentials of Pediatric Nursing, 11th Edition

MULTIPLE CHOICE

1. Which nursing consideration is important when caring for a child with impetigo?
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 when caring for an infected child.
d. Implement airborne precautions.
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.

DIF: Cognitive Level: Understand

TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential

2. The nurse would expect to assess which causative agent in a child with warts?
a. Bacteria
b. Fungus
c. Parasite
d. Virus
ANS: D
Human warts are caused by the human papillomavirus. Infection with bacteria, fungus, and
parasites does not result in warts.

DIF: Cognitive Level: Understand TOP: Integrated Process: Nursing Process:

Assessment
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential

3. Shingles are caused by which virus?

a. Varicella zoster virus
b. Cytomegalovirus
c. Parvovirus
d. Coxsackie virus
ANS: A
 The varicella zoster virus causes two distinct diseases: varicella and herpes zoster or
shingles. Cytomegalovirus is a common virus however, it can cause organ damage in
newborns born with this CMV with the most common being hearing loss. Human
parvovirus infects and lyses red blood cell precursors, thus interrupting the production of
red blood cells. Coxsackie virus is a nonpolio enterovirus and can cause the hand-foot-
and- mouth disease.

DIF: Cognitive Level: Understand TOP: Integrated Process: Nursing Process:

Assessment
MSC: Area of Client Needs: Physiological Integrity: Physiological Adaptation

4. Which causes Enterobius vermicularis (pinworm)?

a. Virus
b. Parasite
c. Allergic reaction
d. Bacterial infection
ANS: B
Enterobiasis or pinworm infection is a common, contagious, parasitic infestation found
mainly in children. Severe itching is caused by the pinworm. Bacterial and viral
microorganisms are not associated with Enterobiasis.

DIF: Cognitive Level: Understand TOP: Integrated Process: Nursing Process:

Assessment
MSC: Area of Client Needs: Physiological Integrity: Physiological Adaptation

5. Parents tell the nurse that their child keeps scratching the areas where he has bed bugs. The
nurse’s response would be based on which statement?
a. The parasitic bugs do not cause itching and needs further investigation.
b. Scratching the lesions will not cause a problem.
c. Scratching the lesions will cause the bed bugs to spread.
d. Scratching the lesions may cause them to become secondarily infected.
ANS: D
Intense urticaria may occur with bed bugs which may cause secondary infections from
itching. There is no evidence that scratching will cause the bed bugs to spread.

DIF: Cognitive Level: Apply TOP: Integrated Process: Teaching/Learning

MSC: Area of Client Needs: Health Promotion and Maintenance

6. 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.
 DIF: Cognitive Level: Understand
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Safe and Effective Care Environment

7. 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 minimize
scarring. Aplastic anemia is not a complication of chickenpox. Strict isolation until
vesicles are dried prevents spread of disease.

DIF: Cognitive Level: Understand

TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiologic Integrity

8. 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.

DIF: Cognitive Level: Understand

TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiologic Integrity

9. In which 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.

DIF: Cognitive Level: Apply TOP: Integrated Process: Nursing Process:

Assessment
 MSC: Area of Client Needs: Physiologic Integrity

10. Which is a common childhood communicable disease that may cause severe defects in the
fetus when it occurs during pregnancy?
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.

DIF: Cognitive Level: Understand TOP: Integrated Process: Nursing Process:

Assessment
MSC: Area of Client Needs: Physiologic Integrity

11. Which is the causative agent of scarlet fever?

a. Enteroviruses
b. Corynebacterium organisms
c. Scarlet fever virus
d. Group A -hemolytic streptococci (GABHS)

ANS: D
GABHS infection causes scarlet fever. Enteroviruses do not cause the same complications.
Corynebacterium organisms cause diphtheria. Scarlet fever is not caused by a virus.

DIF: Cognitive Level: Understand TOP: Integrated Process: Nursing Process:

Assessment
MSC: Area of Client Needs: Physiologic Integrity

12. A parent reports to the nurse that her child has inflamed conjunctivae of both eyes with
purulent drainage and crusting of the eyelids, especially on awakening. These
manifestations suggest
a. viral conjunctivitis.
b. allergic conjunctivitis.
c. bacterial conjunctivitis.
d. conjunctivitis caused by foreign body.
ANS: C
Bacterial conjunctivitis has these symptoms. Viral or allergic conjunctivitis has watery
drainage. Foreign body causes tearing and pain, and usually only one eye is affected.

DIF: Cognitive Level: Analyze TOP: Integrated Process: Nursing Process:

Evaluation
MSC: Area of Client Needs: Physiologic Integrity

13. Which is an important nursing consideration when caring for a child with herpetic
gingivostomatitis (HGS)?
a. Apply topical anesthetics before eating.
b. Drink from a cup, not a straw.
 c. Wait to brush teeth until lesions are sufficiently healed.
d. Explain to parents how this is sexually transmitted.
ANS: A
Treatment for HGS is aimed at relief of pain. Drinking bland fluids through a straw helps
avoid painful lesions. Mouth care is encouraged with a soft toothbrush. HGS is usually
caused by herpes simplex virus type 1, which is not associated with sexual transmission.

DIF: Cognitive Level: Apply

TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiologic Integrity

14. A parent has asked the nurse about how her child can be tested for pinworms. The nurse
responds by stating that which is the most common test for diagnosing pinworms in a
child?
a. Lower gastrointestinal (GI) series
b. Three stool specimens, at intervals of 4 days
c. Observation for presence of worms after child defecates
d. Tape test prior to defecating
ANS: D
Laboratory examination of substances containing the worm, its larvae, or ova can identify
the organism. Most are identified by examining fecal smears from the stools of persons
suspected of harboring the parasite. Fresh specimens are best for revealing parasites or
larvae. Lower GI series is not helpful for diagnosing enterobiasis. Stool specimens are not
necessary to diagnose pinworms. Worms will not be visible after child defecates.

DIF: Cognitive Level: Understand TOP: Integrated Process: Teaching/Learning

MSC: Area of Client Needs: Physiologic Integrity

15. A nurse is admitting a child to the hospital with a diagnosis of giardiasis. Which
medication would the nurse expect to be prescribed?
a. Metronidazole (Flagyl)
b. Amoxicillin clavulanate (Augmentin)
c. Clarithromycin (Biaxin)
d. Prednisone (Orapred)
ANS: A
The drugs of choice for treatment of giardiasis are metronidazole (Flagyl), tinidazole
(Tindamax), and nitazoxanide (Alinia). These are classified as antifungals. Amoxicillin
and clarithromycin are antibiotics that treat bacterial infections. Prednisone is a steroid and
is used as an anti-inflammatory medication.

DIF: Cognitive Level: Apply TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Physiologic Integrity

16. A mother tells the nurse that she does not want her infant immunized because of the
discomfort associated with injections. Which would the nurse explain?
a. This cannot be prevented.
b. Infants do not feel pain as adults do.
c. This is not a good reason for refusing immunizations.
d. A topical anesthetic, EMLA, can be applied before injections are given.
Test Bank for Wong’s Essentials of Pediatric Nursing, 11th Edition, Marilyn J. Hockenb

ANS: D
Several topical anesthetic agents can be used to minimize the discomfort associated with
immunization injections. These include EMLA (eutectic mixture of local anesthetic) and
vapor coolant sprays. Pain associated with many procedures can be prevented and
minimized by using the principles of atraumatic care. With preparation, the injection site
can be properly anesthetized to decrease the amount of pain felt by the infant. Infants have
the neural pathways to feel pain. Numerous research studies have indicated that infants
perceive and react to pain in the same manner as do children and adults. The mother
should be allowed to discuss her concerns and the alternatives available. This is part of the
informed consent process.

DIF: Cognitive Level: Apply TOP: Integrated Process: Teaching/Learning

MSC: Area of Client Needs: Health Promotion and Maintenance

MULTIPLE RESPONSE

1. The nurse is taking care of a 7-year-old child with severe herpetic gingivostomatitis
(HGS). Which prescribed medication would the nurse expect to be included in the
treatment plan? (Select all that apply.)
a. Corticosteroids
b. Oral metronidazole
c. Oral antiviral agent
d. Systemic antibiotic
e. Topical anesthetic
ANS: C, E
Topical anesthetics are used as needed to provide pain relief. Treatment for children with
severe cases may include antiviral agents such as acyclovir. HGS is a virus therefore
antibiotics such as metronidazole are not effective. Corticosteroids are not a standard
treatment for HGS.

DIF: Cognitive Level: Apply TOP: Integrated Process: Caring

MSC: Area of Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies

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