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The nurse is examining an infant, age 10 months, who was brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with satellite lesions. What is the most likely cause?
- A. Impetigo
- B. Urine and feces
- C. Candida albicans infection
- D. Infrequent diapering
Correct Answer: C
Rationale: C. albicans infection produces perianal inflammation and a maculopapular rash with satellite lesions that may cross the inguinal folds. Impetigo is a bacterial infection that spreads peripherally in sharply marginated, irregular outlines. Eruptions involving the skin in contact with the diaper but sparing the folds are likely to be caused by chemical irritation, especially urine and feces, and may be related to infrequent diapering.
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What is most descriptive of atopic dermatitis (AD) (eczema) in an infant?
- A. Easily cured
- B. Worse in humid climates
- C. Associated with hereditary allergies
- D. Related to upper respiratory tract infections
Correct Answer: C
Rationale: AD is a type of pruritic eczema that usually begins during infancy and is associated with allergy with a hereditary tendency. Approximately 50% of children with AD develop asthma. AD can be controlled but not cured. Manifestations of the disease are worse when environmental humidity is lower. AD is not associated with respiratory tract infections.
The nurse is discussing the management of atopic dermatitis (eczema) with a parent. What should be included?
- A. Dress infant warmly to prevent chilling.
- B. Keep the infants fingernails and toenails cut short and clean.
- C. Give bubble baths instead of washing lesions with soap.
- D. Launder clothes in mild detergent; use fabric softener in the rinse.
Correct Answer: B
Rationale: The infants nails should be kept short and clean and have no sharp edges. Gloves or cotton socks can be placed over the childs hands and pinned to the shirt sleeves. Heat and humidity increase perspiration, which can exacerbate the eczema. The child should be dressed properly for the climate. Synthetic material (not wool) should be used for the childs clothing during cold months. Baths are given as prescribed with tepid water, and emollients such as Aquaphor, Cetaphil, and Eucerin are applied within 3 minutes. Soap (except as indicated), bubble bath oils, and powders are avoided. Fabric softener should be avoided because of the irritant effects of some of its components.
Rickets is caused by a deficiency in what?
- A. Vitamin A
- B. Vitamin C
- C. Folic acid and iron
- D. Vitamin D and calcium
Correct Answer: D
Rationale: Fat-soluble vitamin D and calcium are necessary in adequate amounts to prevent rickets. No correlation exists between rickets and folic acid, iron, or vitamins A and C.
What is an important nursing responsibility when dealing with a family experiencing the loss of an infant from sudden infant death syndrome (SIDS)?
- A. Discourage the parents from making a last visit with the infant.
- B. Make a follow-up home visit to the parents as soon as possible after the childs death.
- C. Explain how SIDS could have been predicted and prevented.
- D. Interview the parents in depth concerning the circumstances surrounding the childs death.
Correct Answer: B
Rationale: A competent, qualified professional should visit the family at home as soon as possible after the death. Printed information about SIDS should be provided to the family. Parents should be allowed and encouraged to make a last visit with their child. SIDS cannot always be prevented or predicted, but parents can take steps to reduce the risk (e.g., supine sleeping, removing blankets and pillows from the crib, and not smoking). Discussions about the cause only increase parental guilt. The parents should be asked only factual questions to determine the cause of death.
Which term refers to the relative lactase deficiency observed in preterm infants of less than 34 weeks of gestation?
- A. Congenital lactase deficiency
- B. Primary lactase deficiency
- C. Secondary lactase deficiency
- D. Developmental lactase deficiency
Correct Answer: D
Rationale: Developmental lactase deficiency refers to the relative lactase deficiency observed in preterm infants of less than 34 weeks of gestation. Congenital lactase deficiency occurs soon after birth after the newborn has consumed lactose-containing milk. Primary lactase deficiency, sometimes referred to as late-onset lactase deficiency, is the most common type of lactose intolerance and is manifested usually after 4 or 5 years of age. Secondary lactase deficiency may occur secondary to damage of the intestinal lumen, which decreases or destroys the enzyme lactase.