Question:
A child sustained a "full-thickness" burn injury. This type injury involves tissue
destruction down to the:
epidermis.
dermis.
subcutaneous tissue. Correct
internal organs.
Explanation:
A full-thickness burn involves all skin layers, including the epidermis, dermis, and the
subcutaneous tissue and fat. Muscles and tendons may be involved. A superficial
thickness burn involves the epidermis only. A superficial partial thickness burn involves
the epidermis and the dermis. A deep thickness burn involves the entire layer of dermis,
and is more severe than a superficial partial thickness burn.
Question:
A child was involved in a vehicular accident and sustained burns on the lower
extremities. Examination reveals a dry, waxy, whitish appearance of both lower legs and
some visualization of the tibialis anterior. This type of burn would be classified as a:
superficial thickness burn.
superficial partial thickness burn.
deep partial thickness burn.
full thickness burn. Correct
Explanation:
Types of burn injuries are chemical, electric, radiation, or thermal and are classified by
the depth of damaged skin it caused. Full thickness burns involve the destruction of all
skin elements with coagulation of subdermal plexus, muscle, and or tendons. Symptoms
of superficial partial thickness burns include: moist areas that are red to ivory white in
color, blisters forming almost immediately, and painful to touch. Since the pain
receptors are intact, pain is perceived. Superficial thickness burns appear erythematous
without blisters and usually have local pain. Deep partial thickness burns have a dry
waxy, whitish appearance and resemble full thickness burns. Sometimes grafts are
needed.
Question:
The earliest recognizable clinical manifestation(s) of cystic fibrosis in an infant is:
History of poor intestinal absorption
Foul smelling, frothy, greasy stools
Meconium ileus
Salty taste on the skin Correct
Explanation:
The signs and symptoms of cystic fibrosis (CF) vary from person to person and over
time. Sometimes there will be few symptoms and other times, symptoms may become
more severe. One of the first signs of CF that parents may notice is that their baby's
,skin tastes salty when kissed, or the baby doesn't pass stool when first born. Most of the
other signs and symptoms of CF happen later. They're related to how CF affects the
respiratory, digestive, or reproductive systems of the body.
Question:
An infant presents with a rash in the diaper area. Which description likely indicates
candidal diaper rash?
Red, moist, maculopapular patch with poorly defined borders in diaper area
Bright red, moist patches with sharply demarcated borders, some loose scales noted
in the diaper area Correct
Moist, thin-roofed vesicles with a thin, erythematous base noted in the diaper area
Erythematous and symmetric rash noted in the diaper area
Explanation:
Candidiasis is characteristic of a rash appearing with bright red, moist patches with
sharply demarcated borders, with some loose scales noted in the diaper area. Red,
moist, maculopapular patch with poorly defined borders in diaper area is diaper
dermatitis. Moist, thin-roofed vesicles with a thin, erythematous base noted in the
diaper area would be consistent with impetigo. Hives appear as erythematous and
symmetric and can be generalized over the body including the diaper area.
Question:
Examination of a child who experienced a burn from a curling iron on the forearm
appears red without blistering but is painful to touch. This type of burn would be
classified as a:
superficial thickness burn. Correct
superficial partial thickness burn.
deep partial thickness burn.
full thickness burn.
Explanation:
Types of burn injuries are chemical, electric, radiation, or thermal and are classified by
the depth of damaged skin. Superficial thickness burns appear erythematous without
blisters and usually have local pain. Symptoms of superficial partial thickness burns
include: moist areas that are red to ivory white in color, blisters forming almost
immediately, and painful to touch. Since the pain receptors are intact, pain is perceived.
Deep partial thickness burns have a dry waxy, whitish appearance and resemble full
thickness burns. Sometimes grafts are needed. Full thickness burns involve the
destruction of all skin elements with coagulation of subdermal plexus, muscle, and or
tendons.
Question:
A small child sustained burns to the posterior trunk and posterior surface of both arms.
According to the "Rule of Nines" for small children, what percentage of the total body
surface area was involved?
9%.
18%.
27%. Correct
32.5%.
,Explanation:
The "Rule of Nines" assigns percentage of body surface area burned based on the
location of the burn. The percentages are as follows: head and neck = 18%, anterior
and posterior chest = 18% each, arms (anterior and posterior) = 4.5% each, legs
(anterior and posterior) = 6.7% each, and perineum = 1%. For this example, 18% for
posterior trunk plus 9% for arms = 27%.
Question:
If a newborn is suspected of having congenital hypothyroidism, which clinical
manifestation would be evident?
Prematurity
Hyperthermia
Hyperactivity
Enlarged anterior fontanel Correct
Explanation:
Infants with congenital hypothyroidism are usually born at term or after term. Most
practitioners now depend on the screening test in newborns to diagnose this condition
since the symptoms or signs take time to develop. The symptoms of congenital
hypothyroidism may include some of the following: puffy face, coarse facial features,
enlarged anterior fontanel, thick protruding tongue, poor feeding, constipation or
reduced stooling, prolonged jaundice, decreased activity with hypotonia, hypothermia
and cool and pale skin, goiter, birth defects (e.g., heart valve abnormality), poor weight
gain due to poor appetite, and swollen hands, feet and genitals.
Question:
A child has a maculopapular, blotchy rash and on examination of his mouth, red
eruptions with white centers on the buccal mucosa are visualized. These eruptions are
called:
rubella spots.
aphthous ulcers.
Pastia's spots.
Koplik spots. Correct
Explanation:
Koplik spots are seen with measles. They are small, white spots (often on a reddened
background) that occur on the inside of the cheeks early in the course of red measles,
rubeola. Pastia's spots are pink or red lines that are formed of confluent petechiae found
in skin creases and are seen in patients who have scarlet fever. Aphthous ulcers are
recurrent small, round, or ovoid ulcers with circumscribed margins, erythematous
haloes, and yellow or gray floors occurring in the mouth.
Question:
When suspecting pediculosis capitis, the chief complaint is:
itching. Correct
hives.
alopecia.
vesicles.
, Explanation:
With pediculosis capitis (lice), itching is the most common symptom and is caused by an
allergic reaction. Lice will bite the skin in order to feed on the infected person's blood.
Saliva from these bites causes the allergic reaction and itching. The lice lay eggs that
eventually hatch which causes more irritation. Vesicles, fluid filled lesions, are not
usually seen in this condition. Alopecia may be seen with tinea capitis.
Question:
A reddish blue, irregularly shaped, solid and spongy mass of blood vessels that may be
present at birth and enlarge during the first 10 to 15 months is characteristic of a:
cavernous hemangioma. Correct
strawberry mark.
telangiectasia.
port-wine stain.
Explanation:
A cavernous hemangioma appears as a reddish blue, irregularly shaped, solid and
spongy mass of blood vessels. It may be present at birth, may enlarge during the first
10 to 15 months, and will not involute spontaneously. A port-wine stain is a large, flat,
macular dark red or purplish patch covering the scalp or face, frequently along the
distribution of cranial nerve V and intensifies with crying, exertion, or exposure to heat
or cold. A strawberry mark is a type of hemangioma that has a raised bright red area
with well-defined borders about 2 to 3 cm in diameter. It does not blanch with pressure.
Telangiectasia are caused by vascular dilation and are permanently dilated blood
vessels that are visible on the skin surface.
Question:
The infant with the lowest risk of developing elevated levels of bilirubin is the one who:
is feeding poorly or whose feedings are delayed for several hours.
has developed a cephalhematoma.
is the second birth to an Rh negative mother.
breast feeds within the first hour of life. Correct
Explanation:
The infant who is fed early will be less likely to retain meconium and reabsorb bilirubin
from the intestines back into the circulation. Additionally, lack of adequate intestinal
flora hinders excretion of conjugated bilirubin so by feeding soon after birth, this speeds
up the development of bacteria and creation of good intestinal flora. The other choices
are all examples of situations that increase the risk for jaundice in the newborn.
Question:
A seven- year -old is suspected of having conduct disorder. Which one of the following
topics should the nurse practitioner include in the assessment history?
Stuttering
Animal abuse Correct
Worrying excessively about mother
Refusing to perform chores
Explanation:
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