Nokea
A child has been sent to the school nurse with pruritus and honey-colored crusts on the lower lip and chin. The nurse believes these lesions most likely are caused by which condition?
- A. chickenpox.
- B. impetigo.
- C. shingles.
- D. herpes simplex type I.
Correct Answer: B
Rationale: Impetigo is seen at all ages but is particularly common in children. The crust is honey-colored and easily removed and is associated with pruritus. The disease is highly contagious and spreads by contact. Chickenpox and shingles are characterized by vesicles and are not honey-colored. Herpes simplex type I is also known as 'cold sores' or 'fever blisters'. Lesions are generally located around and in the mouth.
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A school nurse assesses a child who has an erythematous circular patch of vesicles on her scalp with alopecia and report spain and pruritus. For which reason will the nurse use a Woods lamp?
- A. To dry out the lesions.
- B. To reduce the pruritus.
- C. To kill the fungus.
- D. To cause fluorescence of the infected hairs.
Correct Answer: D
Rationale: Tinea capitis is commonly known as ringworm of the scalp. Microsporum audouinii is the major fungal pathogen. The use of the diagnostic Woods lamp causes the infected hairs to turn a brilliant blue green. The Woods lamp does not dry out lesions, reduce pruritus or kill fungus.
Which is a nursing intervention and patient teaching item for the treatment of head lice and scabies?
- A. Clothing, linens, and bath articles thoroughly cleaned in hot water
- B. Stress nature and transmission of the disease
- C. Special carbohydrate diet to promote healing
- D. Complete isolation from the public
- E. removal of pets from the home
Correct Answer: A,B
Rationale: Identify involved contacts while stressing importance of preventing transmission of disease. Washable and clothing items should be cleaned in hot water to prevent reinfection. No special diet is required. Isolation is not necessary once medical management is completed. It is not necessary to remove pets from the home.
A patient, age 37, sustained partial- and full-thickness burns to 26% of the body surface area. When would the greatest fluid loss resulting from the burns occur?
- A. Within 12 hours after burn trauma
- B. 24 to 36 hours after burn trauma
- C. 36 to 48 hours after burn trauma
- D. 48 to 72 hours after burn trauma
Correct Answer: A
Rationale: In a burn injury, usually the greatest fluid loss occurs within the first 12 hours.
What is the last intervention for a hospitalized severely burned victim during the emergent phase?
- A. Tetanus prophylaxis.
- B. Insert Foley catheter.
- C. Insert nasogastric tube.
- D. Establish airway.
- E. Administer analgesics.
- F. Initiate fluid therapy.
Correct Answer: A,
Rationale: The priority of care should proceed from the establishment of an airway,initiation of fluid therapy,insertion of Foley and NG tube administration of analgesics and tetanus prophylaxis."
A patient has sustained a burn injury following a house fire. Which finding indicates the need to observe the patient for airway complications?
- A. Bradypnea
- B. Singed nasal hairs
- C. Burns to the upper arms
- D. Intercostal retractions
- E. Grunting noted with respiration
Correct Answer: B,D,E
Rationale: A patient who has sustained a burn injury should be monitored for airway complications if the patient has singed nasal hairs, intercostal retractions or grunting respirations. Tachypnea, not bradypnea, is a finding suggestive of potential airway complications. A patient with burns to the face, neck and upper chest requires further observation.