QWO (51)

B. Calling the doctor if the child's fever lasts more than 36 hours C. Ensuring fluid intake to prevent dehydration D. Observing for changes in alertness resulting from brain damageCorrect answer: C Reason: Teaching the mother to en s ure fluid intake is importan a t b i b r b e . c c o a m u / t s e e s t fever can cau s e dehydration. The child should be dressed lightly. There is no need to call the doctor unless the child's fever lasts more than 3 to 5 days or the fever is greater than 105ºF. A rapid rise to a high fever can cause a febrile convulsion, but it does not lead to brain damage. #QSN Format:Multiple Choice #CHP 37: Nursing Care of the Child With an Infectious or Communicable Disorder Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potentia a l birb Integrated Process: Nursing Process REF: Page.1285 4. After teaching a mother how to remove a tick from her 6-year- a o b l ir d b.c b o o m y /t ' e s st arm, the NR determines that additional teaching is needed when the mother makes what statement? A. "I'll protect my fingers with a paper towel." B. "I'll grasp the tick and pull it away quickly." C. "I should put the tick in a plastic bag in the freezer." D. "I need to grasp the tick close to the child's skin." Correct answer: B Reason: Grasping the tick and pulling it away quickly would indicate the need for additional teaching. When removing a tick, the mother s hould u s e fine-t ipp e a b d i r b t w .c o e m e / z t e e s r t s w hile protecting her fingers with a tissue, paper towel, or latex gloves. The mother should grasp the tick as close to the skin as possible and pull upward with steady, even pressure. Once removed, the mother should place the tick in a sealable plastic bag in the freezer in case the child becomes sick and identification of the tick is needed. #QSN Format:Multiple Choice #CHP 37: Nursing Care of the Child With an Infectious or Communicable Disorder Cognitive Level: Understand Client Needs: Health Promotion and Maintenance Integrated Process: Teaching/Learning REF: Page.1316 5. The NR is performing a physical examination of an 8-year-old girl who was bitten by her kitten. Which assessment would lead the NR to suspect cat-scratch disease? A. Swollen lymph nodes B. Strawberry tongue C. Infected tonsils D. Swollen neck

Correct answer: A Reason: Lymph nodes, especially under the arms, can become painful and swollen due to cat- s cratch di s ea s e. S tra w berry tongue is typical of s carlet fever. Infe a c b t i r e b d .c o t m o / n t e s s i t l s and an edematou s neck are symptoms of diphtheria. #QSN Format:Multiple Choice #CHP 37: N ur s ing Care of the Child With an Infectiou s or Co m a b m i r b u . c n o i m c / a t e b s l t e D i s order Cognitive Level: Apply Client Needs: Physiological Integrity: Physiological Adaptation Integrated Process: Nursing Process REF: Page.1314 6. A group of nursing students are reviewing the six links in the chain of infection and the nur s ing implication s for each. The s tudent s demon s trate unde rs ta a n b d ir b i . n c g om o / t f e s t t he information w hen they identify which precaution as helping to break the chain of infection to the susceptible host? A. Keeping linens dry and clean B. Maintaining skin integrity C. Washing hands frequently D. Coughing into a handkerchief Correct answer: B Reason: Maintaining the integrity of the child's skin and mucous membranes is a precaution that will break the chain of infection at the susceptible host. Keeping linens dry and clean is a precaution to take at the re s ervoir link. Wa s hing hand s frequentl y a b b ir b re . c a o k m s /t e t s h t e chain at the mode of transmission. Coughing into a handkerchief is a precaution for the portal of exit. #QSN Format:Multiple Choice #CHP 37: N ur s ing Care of the Child With an Infectiou s or Co m a b m i r b u . c n o i m c / a t e b s l t e D i s order Cognitive Level: Understand Client Needs: Safe, Effective Care Environment: Safety and Infection Control Integrated Process: Teaching/Learning REF: Page.1288 7. The NR is performing a physical examination on a 9-year-old boy who has experienced a tick bite on hi s lo w er leg and is s u s pected of having Lyme di s ea s a e b . ir W b.co h m ic /t h est a ss e ss ment finding would the NR expect to find? A. Swelling in the neck B. Confusion and anxiety C. Ring-like rash on lower leg D. Hypersalivation Correct answer: C Reason: A ring-like rash at the site of the tick bite is characteristic for Lyme disease. Swelling in the neck is a symptom of mumps. Confusion, anxiety, and hypersalivation are symptoms of rabies.