Health Problems of Toddlers and Preschoolers

1. Which of the following is described as the time interval between infection or exposure to disease and appearance of initial symptoms?
a. Incubation period
b. Prodromal period

c. Desquamation period
d. Period of communicability

ANS: A
The incubation period is the interval between infection or exposure and appearance of symptoms.

DIF: Cognitive Level: Comprehension REF: Page 454
TOP: Integrated Process: Nursing Process: Assessment
MSC: AreaofClientNeeds:PhysiologicIntegrity:ReductionofRiskPotential

2. Strict isolation is required for a child who is hospitalized with: a. mumps.

b. chickenpox.
c. exanthema subitum (roseola).
d. erythema infectiosum (fifth disease).

ANS: B
Chickenpox is communicable through direct contact, droplet spread, and contaminated objects.

DIF: Cognitive Level: Comprehension REF: Page 455
TOP: Integrated Process: Nursing Process: Implementation
MSC: AreaofClientNeeds:SafeandEffectiveCareEnvironment:Safetyand Infection Control (Transmission Precautions)

3. Acyclovir (Zovirax) is given to children with chickenpox to: a. minimize scarring.
b. decrease the number of lesions.
c. prevent aplastic anemia.

d. prevent spread of the disease. ANS: B

Test Bank 14-2

Acyclovir decreases the number of lesions; shortens duration of fever; and decreases itching, lethargy, and anorexia.

DIF: Cognitive Level: Comprehension REF: Page 464
TOP: Integrated Process: Nursing Process: Implementation
MSC: AreaofClientNeeds:PhysiologicIntegrity:PharmacologicandParenteral Therapies

4. The single parent of a 12-year-old child who has just been diagnosed with chickenpox tells the nurse that she cannot afford to stay home with the child and miss work. The parent asks the nurse if some medication will shorten the course of the illness. Which of the following is the most appropriate nursing intervention?
a. Reassure the parent that it is not necessary to stay home with the child.
b. Explain that no medication will shorten the course of the illness.
c. Explain the advantages of the medication acyclovir to treat chickenpox.
d. Explain the advantages of the medication varicella-zoster immune globulin

(VZIG) to treat chickenpox.

ANS: C
Acyclovir is effective in treating the number of lesions; shortening the duration of fever; and decreasing itching, lethargy, and anorexia.

DIF: Cognitive Level: Comprehension REF:
TOP: Integrated Process: Teaching/Learning
MSC: AreaofClientNeeds:PhysiologicIntegrity:PharmacologicandParenteral Therapies

5. Which of the following may be given to high-risk children after exposure to chickenpox to prevent varicella?
a. Acyclovir
b. V aricella globulin

c. Diphenhydramine hydrochloride d. VZIG

ANS: D
VZIG is given to high-risk children to prevent the development of chickenpox.

DIF: Cognitive Level: Comprehension REF: Page 464
TOP: Integrated Process: Nursing Process: Implementation
MSC: AreaofClientNeeds:PhysiologicIntegrity:PharmacologicandParenteral Therapy

6. Vitamin A supplementation may be recommended for the young child who has which of the following?
a. Mumps
b. Rubella

c. Measles (rubeola)
Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

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Test Bank 14-3

d. Erythema infectiosum

ANS: C
Evidence shows vitamin A decreases morbidity and mortality in measles.

DIF: Cognitive Level: Comprehension REF: Page 464
TOP: Integrated Process: Nursing Process: Implementation
MSC: AreaofClientNeeds:PhysiologicIntegrity:PharmacologicandParenteral Therapies

7. When is a child with chickenpox considered to be no longer contagious? a. When fever is absent
b. When lesions are crusted
c. 24 hours after lesions erupt

d. 8 days after onset of illness

ANS: B
When the lesions are crusted, the chickenpox is no longer contagious. This may be a week after onset of disease.

DIF: Cognitive Level: Comprehension REF: Page 455
TOP: Integrated Process: Nursing Process: Assessment
MSC: AreaofClientNeeds:PhysiologicIntegrity:ReductionofRiskPotential

8. In which of these communicable diseases are Koplik spots present? a. Rubella

b. Measles (rubeola)
c. Chickenpox (varicella)
d. Exanthema subitum (roseola)

ANS: B
Koplik spots are small irregular red spots with a minute, bluish white center found on the buccal mucosa 2 days before systemic rash.

DIF: Cognitive Level: Comprehension REF: Page 459
TOP: Integrated Process: Nursing Process: Assessment
MSC: AreaofClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation

9. Which of the following is a common childhood communicable disease that may cause severe defects in the fetus when it occurs in its congenital form?
a. Erythema infectiosum
b. Roseola

c. Rubeola d. Rubella

ANS: D
Rubella causes teratogenic effects on the fetus.

Test Bank 14-4

DIF: Cognitive Level: Comprehension REF: Page 461
TOP: Integrated Process: Nursing Process: Problem Identification
MSC: AreaofClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation

10. Which of the following is the causative agent of scarlet fever? a. Enteroviruses

b. Corynebacterium organisms
c. Scarlet fever virus
d. Group A β-hemolytic streptococci (GABHS)

ANS: D
GABHS infection causes scarlet fever.

DIF: Cognitive Level: Comprehension REF: Page 462
TOP: Integrated Process: Nursing Process: Assessment
MSC: AreaofClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation

11. A parent reports to the nurse that her child has inflamed conjunctivae of both eyes with purulent drainage and crusting of the eyelids, especially on awakening. These manifestations suggest:
a. viral conjunctivitis.

b. allergic conjunctivitis.
c. bacterial conjunctivitis.
d. conjunctivitis caused by foreign body.

ANS: C
Bacterial conjunctivitis has these symptoms.

DIF: Cognitive Level: Comprehension REF:
TOP: Integrated Process: Teaching/Learning
MSC: AreaofClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation

12. Which of the following is an important nursing consideration when caring for a child with herpetic gingivostomatitis (HGS)?
a. Apply topical anesthetics before eating.
b. Drink from a cup, not a straw.

c. Wait to brush teeth until lesions are sufficiently healed. d. Explain to parents how this is sexually transmitted.

ANS: A
Treatment for HGS is aimed at relief of pain.

DIF: Cognitive Level: Analysis REF: Page 465
TOP: Integrated Process: Nursing Process: Implementation
MSC: AreaofClientNeeds:PhysiologicIntegrity:BasicCareandComfort

13. The most common test for diagnosing pinworms in a child is which of the following?

Page 465

Test Bank 14-5

Lower gastrointestinal (GI) series
Three stool specimens, at intervals of 4 days
Observation for presence of worms after child defecates
Tape placed in perianal area in the morning as soon as child awakens

ANS: D
Transparent tape is used to collect pinworms and their eggs from the perianal area in the morning before the child defecates or bathes.

DIF: Cognitive Level: Comprehension REF: Page 469
TOP: Integrated Process: Nursing Process: Implementation
MSC: AreaofClientNeeds:PhysiologicIntegrity:ReductionofRiskPotential

14. The nurse suspects that a child has ingested some type of poison. Which of the following clinical manifestations would be most suggestive that the poison was a corrosive product?
a. Tinnitus

b. Disorientation
c. Stupor, lethargy, coma
d. Edema of lips, tongue, pharynx

ANS: D
Edema of lips, tongue, and pharynx indicates a corrosive ingestion.

DIF: Cognitive Level: Analysis REF: Page 471
TOP: Integrated Process: Nursing Process: Assessment
MSC: AreaofClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation

15. A young boy is found squirting lighter fluid into his mouth. His father calls the emergency department. The nurse taking the call should know that the primary danger is which of the following?
a. Hepatic dysfunction

b. Dehydration secondary to vomiting c. Esophageal stricture and shock
d. Bronchitis and chemical pneumonia

ANS: D
Lighter fluid is a hydrocarbon. The immediate danger is aspiration.

DIF: Cognitive Level: Application REF: Page 471
TOP: Integrated Process: Nursing Process: Diagnosis
MSC: AreaofClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation

16. Which of the following is a clinical manifestation of acetaminophen poisoning? a. Hyperpyrexia

b. Hepatic involvement
c. Severe burning pain in stomach
d. Drooling and inability to clear secretions

Test Bank 14-6

ANS: B
Hepatic involvement is the third stage of acetaminophen poisoning.

DIF: Cognitive Level: Comprehension REF: Page 471
TOP: Integrated Process: Nursing Process: Assessment
MSC: AreaofClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation

17. Acute salicylate (ASA, aspirin) poisoning results in which of the following? a. Chemical pneumonitis
b. Hepatic damage
c. Retractions and grunting

d. Disorientation and loss of consciousness

ANS: D
ASA poisoning causes disorientation and loss of consciousness.

DIF: Cognitive Level: Comprehension REF: Page 472
TOP: Integrated Process: Nursing Process: Assessment
MSC: AreaofClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation

18. A young child has just arrived at the emergency department after ingestion of aspirin at home. The practitioner has ordered activated charcoal. The nurse administers charcoal in which of the following ways?

Administer through a nasogastric tube because the child will not drink it because

of the taste.

Serve in a clear plastic cup so the child can see how much has been drunk.
Give half of the solution, and then give the other half in 1 hour.
Serve in an opaque container with a straw.

ANS: D
Although the activated charcoal can be mixed with a flavorful beverage, it will be black and resemble mud. When it is served in an opaque container, the child does not have any preconceived ideas about its being distasteful.

DIF: Cognitive Level: Analysis REF: Page 473
TOP: Integrated Process: Nursing Process: Implementation
MSC: AreaofClientNeeds:PhysiologicIntegrity:PharmacologicandParenteral Therapy

19. Which of the following is the most frequent source of acute childhood lead poisoning?

a. Folk remedies
b. Unglazed pottery
c. Lead-based paint
d. Cigarette butts and ashes

Test Bank 14-7

Lead-based paint in houses built before 1978 is the most frequent source of lead poisoning.

DIF: Cognitive Level: Comprehension REF: Page 476
TOP: Integrated Process: Nursing Process: Assessment
MSC: AreaofClientNeeds:PhysiologicIntegrity:ReductionofRiskPotential

20. Chelation therapy for lead poisoning is initiated when a child’s blood level is: a. 10 to 14 g/dl.

b. 15 to 19 g/dl. c. 20 to 44 g/dl. d. >45 g/dl.

ANS: D
Chelation therapy is initiated if the child’s blood level is greater than 45 g/dl.

DIF: Cognitive Level: Comprehension REF: Page 478
TOP: Integrated Process: Nursing Process: Implementation
MSC: AreaofClientNeeds:PhysiologicIntegrity:ReductionofRiskPotential

21. Which of the following describes a child who is abused by the parent(s)? a. Unintentionally contributes to the abusing situation
b. Belongs to a low socioeconomic population
c. Is healthier than the nonabused siblings

d. Abuses siblings in the same way as child is abused by the parent(s)

ANS: A
Child’s temperament, position in the family, additional physical needs, activity level, or degree of sensitivity to parental needs unintentionally contributes to the abusing situation.

DIF: Cognitive Level: Comprehension REF: Page 481
TOP: Integrated Process: Nursing Process: Assessment
MSC: AreaofClientNeeds:PsychosocialIntegrity:AbuseandNeglect

22. A common characteristic of those who sexually abuse children is which of the following?

a. Pressure victim into secrecy
b. Are usually unemployed and unmarried
c. Are unknown to victims and victims’ families
d. Have many victims that are each abused only once

ANS: A
Sex offenders may pressure the victim into secrecy regarding the activity as a “secret between us” that other people may take away if they find out.

DIF: Cognitive Level: Comprehension REF: Page 482 TOP: Integrated Process: Nursing Process: Assessment

Test Bank 14-8

MSC: AreaofClientNeeds:PsychosocialIntegrity:AbuseandNeglect

23. A 3-month-old infant dies shortly after arrival to the emergency department. The infant has subdural and retinal hemorrhages but no external signs of trauma. The nurse should suspect:
a. unintentional injury.

b. shaken-baby syndrome.
c. sudden infant death syndrome (SIDS). d. congenital neurologic problem.

ANS: B
Shaken-baby syndrome causes internal bleeding but may have no external signs.

DIF: Cognitive Level: Comprehension REF: Page 481
TOP: Integrated Process: Nursing Process: Problem Identification MSC: AreaofClientNeeds:PsychosocialIntegrity:AbuseandNeglect

24. Probably the most important criterion on which to base the decision to report suspected child abuse is which of the following?
a. Inappropriate parental concern for the degree of injury
b. Absence of parents for questioning about child’s injuries

c. Inappropriate response of child
d. Incompatibility between the history and injury observed

ANS: D
Conflicting stories about the “accident” are the most indicative red flags of abuse.

DIF: Cognitive Level: Comprehension REF: Page 486
TOP: Integrated Process: Nursing Process: Problem Identification MSC: AreaofClientNeeds:PsychosocialIntegrity:AbuseandNeglect

OTHER

1. Place in order the correct sequence for emergency treatment of poisoning in a child. a. Locate the poison.
b. Assess the child.
c. Prevent absorption of poison.

d. Terminate exposure to the toxic substance.

ANS:
b, d, a, c
b. The initial step in treating poisonings is to assess child, treat immediate life- threatening conditions, and initiate cardiopulmonary resuscitation (CPR) if indicated. d. Terminating the exposure to the toxic substance is the second step.
a. Locating the poison for identification is the third step.
c. Preventing absorption of poison is the fourth step.

Test Bank 14-9

DIF: Cognitive Level: Analysis REF: Page 470
TOP: Integrated Process: Nursing Process: Implementation
MSC: AreaofClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation