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Flashcards in Chapter 14 Deck (10):

What is described as the time interval between early manifestations of a disease and the overt clinical syndrome?
a. Incubation period
b. Prodromal period
c. Desquamation period
d. Period of communicability

Ans: B
The prodromal period is defined as the symptoms that occur between early manifestations of the disease and overt clinical symptoms.
The incubation period is the time from exposure to the appearance of the first symptom.
The desquamation period refers to the shedding of skin when applicable for a syndrome or disorder.
The period of communicability describes the period when the child is infectious.


The nurse is concerned with the prevention of communicable disease. Primary prevention results from
a. Immunizations
b. Early diagnosis
c. Strict isolation
d. Treatment of disease

Ans: A
Communicable diseases are prevented through immunizations, which constitute primary prevention.
Early diagnosis can prevent the spread of communicable disease by initiating treatment and isolation if necessary; this would be considered secondary prevention.
Strict isolation would be considered part of the treatment regimen and would constitute tertiary prevention, which is the prevention of complications or sequelae.
Treatment of disease would not prevent communicable disease.


The school nurse is concerned about an outbreak of chickenpox because two children at the school have cancer and are immunodeficient from chemotherapy. The most appropriate recommendation by the school nurse is that
a. no precautions necessary.
b. Acyclovir (Zovirax) should be taken to minimize the symptoms of chickenpox.
c. Varicella–zoster immune globulin (VZIG) to prevent chickenpox.
d. temporarily stopping chemotherapy will allow the immune system to recover.

Ans: C
VZIG is an antibody to the virus that causes chickenpox. Administration of VZIG can prevent development of the disease in immunocompromised children secondary to chemotherapy.
Chickenpox can be a life-threatening event for a child who is immunocompromised and must be addressed.
Acyclovir is effective in reducing the number of lesions from chickenpox, but in immunodeficient children the disease itself should be prevented.
The administration of VZIG does not place the child at any greater risk; therefore, there is no need to stop chemotherapy.


The most appropriate comfort intervention for a child with itching related to chickenpox is
a. encourage frequent warm baths.
b. give aspirin or acetaminophen (Tylenol).
c. apply thick coat of pramoxine (Caladryl) lotion over open lesions.
d. give an antipruritic medication such as diphenhydramine (Benadryl).
e. apply thick coat of pramoxine (Caladryl) lotion over open lesions.

Ans: D
Antipruritic medicines such as diphenhydramine are useful for severe itching, which interferes with sleep and may contribute to secondary infection.
Cool baths, not warm ones, are recommended for relief of itching secondary to chickenpox.
Neither drug provides antipruritic effects, nor should aspirin ever be given to children with chickenpox, because there is an increased risk of developing Reye syndrome.
Caladryl lotion, which contains diphenhydramine, should be applied sparingly, not in thick coats, over open lesions to minimize absorption.


What is the causative agent for erythema infectiosum (fifth disease)?
a. Paramyxovirus
b. Human parvovirus B19
c. Human herpesvirus type 6
d. Group A β-hemolytic streptococcus

Ans: B
Human parvovirus B19 is the causative agent of fifth disease.
Paramyxovirus causes mumps.
Human herpesvirus types 1 and 2 are the major causes of herpetic infections in humans.
Group A β-hemolytic streptococcus is the causative agent for scarlet fever.


An important nursing intervention in the care of a child with bacterial conjunctivitis is
a. intermittent warm, moist compresses to remove crusts on the eye area.
b. oral antihistamines to minimize itching.
c. continuous warm compresses to relieve discomfort.
d. application of optic corticosteroids to reduce inflammation.

Ans: A
The eye should be kept clean. Intermittent warm, moist compresses can soften the crusting for easier removal, maintaining the cleanliness of the eye.
Antihistamines are not usually necessary for bacterial conjunctivitis.
Continuous warm compresses would promote bacterial growth.
Antibiotics are the treatment of choice for bacterial infections; optic corticosteroids are not warranted.


The nurse is assessing a child with herpetic gingivostomatitis. The nurse wears gloves when examining the lesions. This nursing action is
a. unnecessary because the virus is sexually transmitted.
b. unnecessary because the virus is not easily spread.
c. necessary only if the nurse touches his or her own mouth after touching the child's mouth.
d. necessary because virus can easily enter breaks in the skin.

Ans: D
HSV easily enters breaks in the skin and can cause herpetic whitlow on the fingers.
Herpetic gingivostomatitis is usually caused by herpes simplex virus (HSV) 1. HSV 2 is usually transmitted through sexual activity.
Gloves are always necessary because the virus is easily spread.
Gloves are always necessary because the virus is easily spread.


Which statement best represents infectious mononucleosis?
a. Human herpesvirus type 2 is the principal cause.
b. Herpes-like Epstein-Barr virus is the principal cause.
c. Diagnosis is established by a complete blood count, which reveals a characteristic leukopenia.
d. Diagnosis is established by clinical manifestations because diagnostic tests cannot confirm the diagnosis.

Ans: B
Herpes-like Epstein-Barr virus accounts for most cases of mononucleosis.
Herpes-like Epstein-Barr virus is the principal cause of mononucleosis.
A complete blood count in an adolescent with mononucleosis would indicate a lymphocytic leukocytosis with atypical lymphs, not leukopenia.
The monospot test is a highly specific test for mononucleosis.


Which statement is correct about young children who report sexual abuse by one of their parents?
a. They may exhibit various behavioral manifestations.
b. In most cases, the child has fabricated the story.
c. Their stories are not believed unless other evidence is apparent.
d. They should be able to retell the story the same way to another person.

Ans: A
There is no diagnostic profile of the child who is being sexually abused. Many different behavioral manifestations may be exhibited, from outward sexual behaviors with others to withdrawal and introversion.
It is never appropriate to assume that a child has fabricated the story of sexual abuse. Adults are reluctant to believe children, and sexual abuse often goes unreported.
Physical examination is normal in approximately 80% of abused children.
The child will usually try to protect their parents and may accept responsibility for the act.


A child is brought to the emergency department after falling down the basement stairs. On assessment, what findings may cause the nurse to suspect child abuse? (Select all that apply.)
a. The child’s bruises are located only on the right arm and leg.
b. The child is brought to the emergency department by an unrelated adult.
c. The child has a history of a broken arm last year from falling off a swing.
d. The child’s caregiver is anxious that the child get immediate medical attention.
e. The child has red, green, and yellow bruises on more than one plane of the body.

Ans: B, E