When giving instructions to a parent whose child has scabies, what should the nurse include?
- A. Treat all family members if symptoms develop.
- B. Be prepared for symptoms to last 2 to 3 weeks.
- C. Carefully treat only areas where there is a rash.
- D. Notify practitioner so an antibiotic can be prescribed.
Correct Answer: B
Rationale: The mite responsible for the scabies will most likely be killed with the administration of medications. It will take 2 to 3 weeks for the stratum corneum to heal. That is when the symptoms will abate. Initiation of therapy does not wait for clinical symptom development. All individuals in close contact with the affected child need to be treated. Permethrin, a scabicide, is the preferred treatment and is applied to all skin surfaces.
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Treatment for herpes simplex virus (type 1 or 2) includes which?
- A. Corticosteroids
- B. Oral griseofulvin
- C. Oral antiviral agent
- D. Topical or systemic antibiotic
Correct Answer: C
Rationale: Oral antiviral agents are effective for viral infections such as herpes simplex. Corticosteroids, antibiotics, and griseofulvin (an antifungal agent) are not effective for viral infections.
A mother tells the nurse that she does not want her infant immunized because of the discomfort associated with injections. What should 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 can be applied before injections are given.
Correct Answer: D
Rationale: To minimize the discomfort associated with intramuscular injections, a topical anesthetic agent can be used on the injection site. These include EMLA (eutectic mixture of local anesthetic) and vapor coolant sprays. Pain associated with many procedures can be prevented or minimized by using the principles of atraumatic care. Infants have neural pathways that will indicate 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.
The school reviewed the pediculosis capitis (head lice) policy and removed the no nit requirement. The nurse explains that now, when a child is found to have nits, the parents must do which before the child can return to school?
- A. No treatment is necessary with the policy change.
- B. Shampoo and then trim the childs hair to prevent reinfestation.
- C. The child can remain in school with treatment done at home.
- D. Treat the child with a shampoo to treat lice and comb with a fine-tooth comb every day until nits are eliminated.
Correct Answer: C
Rationale: Many children have missed significant amounts of school time with no nit policies. The child should be appropriately treated with a pediculicide and a fine-tooth comb. The environment needs to be treated to prevent reinfestation. The treatment with the pediculicide will kill the lice and leave nit casings. Cutting the childs hair is not recommended; lice infest short hair as well as long. With a no nit policy, treating the child with a shampoo to treat lice and combing the hair with a fine-tooth comb every day until nits are eliminated is the correct treatment. The policy change recognizes that most nits do not become lice.
What often causes cellulitis?
- A. Herpes zoster
- B. Candida albicans
- C. Human papillomavirus
- D. Streptococci or staphylococci
Correct Answer: D
Rationale: Streptococci, staphylococci, and Haemophilus influenzae are the organisms usually responsible for cellulitis. Herpes zoster is the virus associated with varicella and shingles. C. albicans is associated with candidiasis, or thrush. Human papillomavirus is associated with various types of human warts.
What is the primary treatment for warts?
- A. Vaccination
- B. Local destruction
- C. Corticosteroids
- D. Specific antibiotic therapy
Correct Answer: B
Rationale: Local destructive therapy is individualized according to location, type, and number; surgical removal, electrocautery, curettage, cryotherapy, caustic solutions, x-ray treatment, and laser therapies are used. Vaccination is prophylaxis for warts, not a treatment. Corticosteroids and specific antibiotic therapy are not effective in the treatment of warts.
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