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Full file at http://testbank360.eu/test-bank-child-health-nursing-2nd-edition-ballBall 2e Test Bank 1. Vernix caseosa covers a newborn’s skin in utero and has the following properties: (Select all that apply.) 1. Anti-infective 2. Anti-oxidant 3. Moisturizer 4. Wound-healing 5. Anti-diarrheal 6. Skin-toughening Answer: 1, 2, 3, 4 Rationale: 1. Vernix caseosa is composed of shed cells, serving to cover and protect the fetus from amniotic fluid and urine. Vernix caseosa has properties of anti-infection, anti-oxidants, and moisturizer, and includes wound-healing agents. 2. Vernix caseosa is composed of shed cells, serving to cover and protect the fetus from amniotic fluid and urine. Vernix caseosa has properties of anti-infection, anti-oxidants, and moisturizer, and includes wound-healing agents. 3. Vernix caseosa is composed of shed cells, serving to cover and protect the fetus from amniotic fluid and urine. Vernix caseosa has properties of anti-infection, anti-oxidants, and moisturizer, and includes wound-healing agents. 4. Vernix caseosa is composed of shed cells, serving to cover and protect the fetus from amniotic fluid and urine. Vernix caseosa has properties of anti-infection, anti-oxidants, and moisturizer, and includes wound-healing agents. 5. Vernix caseosa is composed of shed cells, serving to cover and protect the fetus from amniotic fluid and urine. Vernix caseosa has properties of anti-infection, anti-oxidants, and moisturizer, and includes wound-healing agents. It does not have anti-diarrheal properties. 6. Vernix caseosa is composed of shed cells, serving to cover and protect the fetus from amniotic fluid and urine. Vernix caseosa has properties of anti-infection, anti-oxidants, and moisturizer, and includes wound-healing agents. It does not toughen skin.

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Full file at http://testbank360.eu/test-bank-child-health-nursing-2nd-edition-ballBall 2e Test Bank Cognitive Level: Comprehension Client Need: Physiological Integrity Nursing Process: Assessment Learning Outcome 36-1 Describe important differences in the anatomy and physiology of the skin of infant, child and adolescent. 2. An infant has thin skin and little subcutaneous fat. Which of the following could be a result of these properties of an infant? 1. Increased absorption of harmful medications and chemical substances 2. Decreased absorption of topical medications 3. Retaining heat for longer periods of time 4. Easily regulated body temperature Answer: 1 Rationale: 1. Thin skin and less subcutaneous fat cause the infant to have an increased absorption of harmful chemical substances and topical medications. Doses will need to be adjusted accordingly. 2. Thin skin and less subcutaneous fat cause the infant to have an increased absorption of harmful chemical substances and topical medications. Doses will need to be adjusted accordingly. 3. Thin skin and less subcutaneous fat cause the infant to become easily chilled, to lose heat rapidly, and to have difficulty regulating body temperature. They have an increased absorption of harmful chemical substances and topical medications. 4. Thin skin and less subcutaneous fat cause the infant to become easily chilled, to lose heat rapidly, and to have difficulty regulating body temperature. They have an increased absorption of harmful chemical substances and topical medications. Cognitive Level: Application Client Need: Physiological Integrity Nursing Process: Assessment

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Full file at http://testbank360.eu/test-bank-child-health-nursing-2nd-edition-ballBall 2e Test Bank Learning Outcome 36-1 Describe important differences in the anatomy and physiology of the skin of infant, child and adolescent. 3. The nurse is examining a 12-month-old who was brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with bright red, scaly plaques and small papules. Satellite lesions are also present. This is most likely caused by which of the following? 1. Impetigo (staph) 2. Candida albicans (yeast) 3. Urine and feces 4.

Infrequent diapering

Answer: 2 Rationale: 1. Even though diaper dermatitis can be caused by impetigo, urine, feces, and infrequent diapering, the lesions and persistent characteristics are common for Candida. 2. Candida albicans is frequently the underlying cause of severe diaper rash. When a primary or secondary infection with Candida albicans occurs, the rash has bright red, scaly plaques with sharp margins. Small papules and pustules might be seen, along with satellite lesions. 3. Urine and feces can cause diaper dermatitis, but the persistence and characteristics of the lesions are common for Candida. 4. Infrequent diapering, along with urine and feces, can cause diaper dermatitis, but the persistence and characteristics of the lesions are common for Candida. Cognitive Level: Analysis Client Need: Health Promotion and Maintenance Nursing Process: Assessment Learning Outcome 36-2 Identify the characteristics of different skin lesions by their cause, including those caused by irritants, drug reactions, infestation, infection, and injury. 4. The school nurse is conducting pediculosis capitis (head lice) checks. Which of the

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Full file at http://testbank360.eu/test-bank-child-health-nursing-2nd-edition-ballBall 2e Test Bank following findings would indicate a “positive� head check? 1. White, flaky particles throughout the entire scalp region 2. Maculopapular lesions behind the ears 3. Lesions on the scalp that extend to the hairline or neck 4. Silver/white sacs attached to the hair shafts in the occipital area Answer: 4 Rationale: 1. Lice and nits must be distinguished from dandruff, which appears as white flaky particles. 2. Lesions might be present from itching, but the positive sign of head lice is evidence of nits. 3. Lesions might be present from itching, but the positive sign of head lice is evidence of nits. 4. Evidence of pediculosis capitis includes silver/white sacs (nits) that are attached to the hair shafts, frequently in the occiput area. Cognitive Level: Application Client Need: Health Promotion and Maintenance Nursing Process: Assessment Learning Outcome 36-2 Identify the characteristics of different skin lesions by their cause, including those caused by irritants, drug reactions, infestation, infection, and injury. 5. Which of the following is characteristic of the inflammation phase of wound healing? 1. Wound contraction and inward movement of the wound edge 2. Clot formation to seal the wound 3. Decreased blood flow and capillary permeability, causing swelling 4. Regeneration of destroyed cells Answer: 2 Rationale: 1. Wound contraction and inward movement of the wound edge occur during the reconstruction phase of wound healing.

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Full file at http://testbank360.eu/test-bank-child-health-nursing-2nd-edition-ballBall 2e Test Bank 2. Clot formation to seal the wound with fibrin and trapped cells and platelets occurs during the inflammation phase of wound healing, in the first 3–5 days. 3. Increased blood flow to the area and increased capillary permeability occur, causing swelling and inflammation. 4. Regeneration of destroyed cells occurs in the reconstruction phase of wound healing. Cognitive Level: Comprehension Client Need: Physiological Integrity Nursing Process: Assessment Learning Outcome 36-3 Describe the stages of wound healing. 6. From the list below, identify causes of delayed or dysfunctional wound healing. Select all that apply. 1. Predisposing chronic condition, such as diabetes 2. Hypoxemia 3. Hypervolemia 4. Overweight or obesity 5. Prolonged infection 6. Corticosteroid therapy Answer: 1, 2, 5, 6 Rationale: 1. Conditions such as diabetes affect circulating blood volume, and are known to affect healing. 2. Hypoxemia makes tissues susceptible to infection due to insufficient oxygenation. 3. Hypovolemia, not hypervolemia, would inhibit inflammation due to low circulating blood volume. 4. Overweight and obesity themselves might not affect wound healing. However, poor nutrition without proper protein and calorie intake will affect healing. 5. Prolonged infection can affect healing and cause excessive scarring. 6. Corticosteroid therapy or other immunocompromising therapy will prevent macrophages from migrating to the site of injury, and suppress epithelialization.

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Full file at http://testbank360.eu/test-bank-child-health-nursing-2nd-edition-ballBall 2e Test Bank Cognitive Level: Comprehension Client Need: Health Promotion and Maintenance Nursing Process: Assessment Learning Outcome 36-3 Describe the stages of wound healing. 7. The nurse is planning care for a 3-month-old infant with eczema. Which of the following would take top priority in this infant’s care? 1. Maintaining adequate nutrition 2. Keeping the baby content 3. Preventing infection of lesions 4. Applying antibiotics to lesions Answer: 3 Rationale: 1. Maintaining adequate nutrition is important, but not as high a priority. Due to impaired skin barrier function and cutaneous immunity, an infant with eczema is at greater risk for the development of skin infection. 2. Keeping the infant content is not as high a priority as is prevention of infection. An infant with eczema is at a greater risk for the development of skin infection. 3. Nursing care should focus on preventing infection of lesions. Due to impaired skin barrier function and cutaneous immunity, an infant with eczema is at greater risk for the development of skin infections by organisms. 4. Antibiotics are not routinely applied to the lesions, since the lesions are not related to infection. However, impaired skin barrier function and cutaneous immunity place the infant at greater risk for the development of skin infection. Cognitive Level: Analysis Client Need: Physiological Integrity Nursing Process: Planning Learning Outcome 36-4 Plan nursing interventions for the child with a chronic skin disorder. 8. A child has eczema. Which of the following would be an appropriate nursing

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Full file at http://testbank360.eu/test-bank-child-health-nursing-2nd-edition-ballBall 2e Test Bank intervention to include in the care of this child? 1. Applying hydrocortisone ointment 1% per order 2. Applying nystatin topical ointment per order 3. Applying lotrimin ointment per order 4. Applying silvadene cream per order Answer: 1 Rationale: 1. Topical corticosteroids are used to reduce inflammation when the child has eczema. Hydrocortisone 1% is usually the drug of choice. 2. Nystatin and lotrimin ointments are used to treat fungal infections. Topical corticosteroids, such as hydrocortisone 1%, are used to reduce inflammation in the child with eczema. 3. Nystatin and lotrimin ointments are used to treat fungal infections. Topical corticosteroids, such as hydrocortisone 1%, are used to reduce inflammation in the child with eczema. 4. Silvadene cream is used for burns. Topical corticosteroids, such as hydrocortisone 1%, are used to reduce inflammation in the child with eczema. Cognitive Level: Application Client Need: Physiological Integrity Nursing Process: Implementation Learning Outcome 36-4 Plan nursing interventions for the child with a chronic skin disorder. 9. The nurse is teaching a group of adolescents about care for acne vulgaris. Which of the following should be included in this teaching session? Select all that apply. 1. Wash skin with mild soap and water twice a day. 2. Use astringents and vigorous scrubbing. 3. Avoid picking or squeezing the lesions. 4. Apply tretinoin (Retin-A) liberally. 5. Avoid sun exposure if on tetracycline. Answer: 1, 3, 5

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Full file at http://testbank360.eu/test-bank-child-health-nursing-2nd-edition-ballBall 2e Test Bank Rationale: 1. The adolescent should be taught to wash skin with mild soap and water twice a day, to avoid picking or squeezing acne lesions, and to avoid sun exposure if on tetracycline. 2. Using astringents and scrubbing vigorously can exacerbate acne. 3. The adolescent should be taught to wash skin with mild soap and water twice a day, to avoid picking or squeezing acne lesions, and to avoid sun exposure if on tetracycline. 4. Tretinoin (Retin-A) should be applied sparingly (pea-size doses). 5. The adolescent should be taught to wash skin with mild soap and water twice a day, to avoid picking or squeezing acne lesions, and to avoid sun exposure if on tetracycline. Cognitive Level: Application Client Need: Health Promotion and Maintenance Nursing Process: Implementation Learning Outcome: 36-5 Develop an education plan for adolescents with acne to promote self-care. 10. An infant, aged 2 months, has a Candidal diaper rash. Which of the following medications will the nurse most likely apply to this rash? 1.

Bacitracin ointment

2.

Hydrocortisone ointment

3.

Desitin

4.

Nystatin given topically and orally

Answer: 4 Rationale: 1. Bacitracin is for an infection caused by staphylococcus. 2. Moderate diaper rash is treated with hydrocortisone ointment. 3. Mild diaper rash is treated with a barrier such as Desitin. 4. Diaper candidiasis is treated with an antifungal cream (nystatin). An oral antifungal agent may be given to clear the candidiasis from the intestines.

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Full file at http://testbank360.eu/test-bank-child-health-nursing-2nd-edition-ballBall 2e Test Bank Cognitive Level: Application Client Need: Physiological Integrity Nursing Process: Implementation Learning Outcome 36-6 Describe the nursing care for the child with acute skin disorders, including dermatitis, infectious disorders, infestations, and injuries to the skin. 11. A child has been hospitalized with a severe case of impetigo contagiosa. What antibiotic will the nurse expect to be prescribed? 1. Dicloxacillin (Pathocil) 2. Rifampin (Rifadin) 3. Sulfamethoxazole and trimethoprim (Bactrim) 4. Metronidazole (Flagyl) Answer: 1 Rationale: 1. A systemic antibiotic will be given for severe impetigo because it is a bacterial infection. Dicloxacillin is used in treatment of skin and soft tissue infections. It is specific for treating staphylococcal infections. 2. Rifampin is an antitubercular agent. Dicloxacillin is used to treat skin and soft tissue infections, and is specific for treating staphylococcal infections. 3. Sulfamethoxazole and trimethoprim are used as prophylaxis against Pneumocystis carinii pneumonia (PCP), and therefore would not be effective in this case. Dicloxacillin is used to treat skin and soft-tissue infections, and is specific for treating staphylococcal infections. 4. Metronidazole is used to treat anaerobic and protozoic infections, and would not be effective against staphylococcal skin and soft tissue infections. Dicloxacillin would be the better choice. Cognitive Level: Application Client Need: Physiological Integrity Nursing Process: Planning Learning Outcome 36-6 Describe the nursing care for the child with acute skin disorders, including dermatitis, infectious disorders, infestations, and injuries to the skin.

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Full file at http://testbank360.eu/test-bank-child-health-nursing-2nd-edition-ballBall 2e Test Bank 12. An infant has a severe case of oral thrush (Candida albicans). Which of the following is the priority nursing diagnosis for this infant? 1. Activity Intolerance related to oral thrush 2. Ineffective Airway Clearance related to mucus 3. Ineffective Infant Feeding Pattern related to discomfort 4. Ineffective Breathing Pattern related to oral thrush Answer: 3 Rationale: 1. Activity intolerance is not usually associated with oral thrush. An infant with oral thrush might refuse to nurse or feed because of discomfort and pain. Prompt recognition and treatment are necessary so that a normal feeding pattern can be resumed. 2. Ineffective airway clearance is not usually associated with oral thrush. An infant with oral thrush might refuse to nurse or feed because of discomfort and pain. Prompt recognition and treatment are necessary so that a normal feeding pattern can be resumed. 3. An infant with oral thrush might refuse to nurse or feed because of discomfort and pain. Prompt treatment is necessary so the infant can resume a normal feeding pattern. 4. Ineffective breathing pattern is not usually associated with oral thrush. An infant with oral thrush might refuse to nurse or feed because of discomfort and pain. Prompt recognition and treatment are necessary so that a normal feeding pattern can be resumed. Cognitive Level: Analysis Client Need: Health Promotion and Maintenance Nursing Process : Diagnosis Learning Outcome 36-6 Describe the nursing care for the child with acute skin disorders, including dermatitis, infectious disorders, infestations, and injuries to the skin. 13. Parents understand the teaching a nurse has done with regard to care of their child

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Full file at http://testbank360.eu/test-bank-child-health-nursing-2nd-edition-ballBall 2e Test Bank with tinea capitis (ringworm of the scalp) if they state: 1.

“We will give the griseofulvin on an empty stomach.”

2.

“We’re glad ringworm isn’t transmitted from person to person.”

3.

“Once the lesion is gone, we can stop the griseofulvin.”

4.

“We will give the griseofulvin with milk or peanut butter.”

Answer: 4 Rationale: 1. Parents are advised to give oral griseofulvin with fatty foods such as milk or peanut butter to enhance absorption. It should not be given on an empty stomach. 2. All members of the family and household pets should be assessed for fungal lesions, because person-to-person transmission is common. 3. The medication must be used for the entire prescribed period, even if the lesions are gone. 4. Parents are advised to give oral griseofulvin with fatty foods such as milk or peanut butter to enhance absorption. Cognitive Level: Analysis Client Need: Health Promotion and Maintenance Nursing Process: Evaluation Learning Outcome 36-6 Describe the nursing care for the child with acute skin disorders, including dermatitis, infectious disorders, infestations, and injuries to the skin. 14. A nurse is applying a 5% permethrin lotion to a toddler with scabies. Which of the following describes the best way to apply this lotion? 1. Apply the lotion to the scalp only. 2. Apply the lotion over the entire body from the chin down, as well as on the scalp and forehead. 3. Apply the lotion only on the areas with evidence of scabies activity. 4. Apply the lotion only to the hands. Answer: 2 Rationale: 1. Treatment of scabies involves application of a scabicide, such as 5% permethrin

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Full file at http://testbank360.eu/test-bank-child-health-nursing-2nd-edition-ballBall 2e Test Bank lotion, over the entire body from the chin down, as well as the scalp and forehead. 2. Treatment of scabies involves application of a scabicide, such as 5% permethrin lotion, over the entire body from the chin down. The scabicide is also applied to the scalp and forehead of younger children, avoiding the rest of the face. 3. Treatment of scabies involves application of a scabicide, such as 5% permethrin lotion, over the entire body from the chin down, as well as the scalp and forehead. 4. Treatment of scabies involves application of a scabicide, such as 5% permethrin lotion, over the entire body from the chin down, including the scalp and forehead. Cognitive Level: Application Client Need: Health Promotion and Maintenance Nursing Process: Implementation Learning Outcome 36-6 Describe the nursing care for the child with acute skin disorders, including dermatitis, infectious disorders, infestations, and injuries to the skin. 15. A child has sustained a severe burn. Place the following nursing interventions in the order of what would be done for this child when the medical team arrived on the scene. 1. Start intravenous fluids. 2. Provide for relief of pain. 3. Establish an airway. 4. Place a Foley catheter. Answer: 3, 1, 2, 4 Rationale: The first step in burn care is to ensure that the child has an airway, is breathing, and has a pulse. Due to the severity of the burn, establishing IV access and starting resuscitation fluids would be next; then the area of pain should be addressed, followed by the insertion of a Foley catheter. Nursing Process: Implementation Client Need: Safe, Effective Care Management Cognitive Level: Analysis Learning Outcome 36-7 Develop a nursing care plan for the child with a full-thickness burn injury.

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Full file at http://testbank360.eu/test-bank-child-health-nursing-2nd-edition-ballBall 2e Test Bank 16. A child has sustained a minor burn. Which of the following should be included in increased amounts in the child’s diet? 1. Fats 2. Protein 3. Minerals 4. Carbohydrates Answer: 2 Rationale: 1. A high-calorie, high-protein diet is best to meet the increased nutritional requirements for healing. 2. Parents should be taught that management of a minor burn requires a high-calorie, high-protein diet. This is necessary to meet the increased nutritional requirements of healing. 3. A high-calorie, high-protein diet is required to meet the increased nutritional requirements for healing. 4. The family should be taught that a high-calorie, high-protein diet is best to meet the increased nutritional requirements for healing. Cognitive Level: Application Client Need: Health Promotion and Maintenance Nursing Process: Implementation Learning Outcome 36-7 Develop a nursing care plan for the child with a full-thickness burn injury. 17. Which of the following would be the priority nursing diagnosis during the acute phase of burn injury for a child who has a third-degree circumferential burn of the right arm? 1. Infection, risk for 2. Altered Tissue Perfusion, risk for 3. Altered Nutrition: Less Than Body Requirements, risk for 4. Impaired Physical Mobility Answer: 2

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Full file at http://testbank360.eu/test-bank-child-health-nursing-2nd-edition-ballBall 2e Test Bank Rationale: 1. When the burn is circumferential, blood flow can become restricted due to edema, and can result in tissue hypoxia; therefore, the priority diagnosis is Altered Tissue Perfusion, risk for to the extremity. Risk of infection would be a secondary priority in this case. 2. Circumferential burns can restrict blood flow due to edema, resulting in tissue hypoxia. Altered tissue perfusion to the extremity is the greatest risk, and therefore the priority diagnosis. 3. Infection, nutrition, and mobility would have secondary priority in this case. 4. Impaired physical mobility is a secondary priority for the child with a circumferential burn. Edema to the area can result in restricted blood flow and tissue hypoxia, making the priority diagnosis Altered Tissue Perfusion, risk for. Cognitive Level: Analysis Client Need: Safe, Effective Care environment Nursing Process: Diagnosis Learning Outcome 36-7 Develop a nursing care plan for the child with a full-thickness burn injury. 18. Which of the following is the most common complication seen in children during the recovery-management phase of burn treatment? 1. Shock 2. Metabolic acidosis 3. Burn-wound infection 4. Asphyxia Answer: 3 Rationale: 1. Shock is not the most common complication during the recovery-management phase of burn treatment. Infection of the burned area is a frequent complication. 2. Metabolic acidosis is not common in the recovery-management phase of burn treatment. Infection of the burned area is a frequent complication. 3. Infection of the burned area is a frequent complication in the recovery-management

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Full file at http://testbank360.eu/test-bank-child-health-nursing-2nd-edition-ballBall 2e Test Bank phase. A goal of burn-wound care is protection from infection. 4. Asphyxia is not a common complication during the recovery-management phase of burn treatment. Infection of the burned area is a frequent complication. Cognitive Level: Analysis Client Need: Physiological Integrity Nursing Process: Assessment Learning Outcome 36-7 Develop a nursing care plan for the child with a full-thickness burn injury. 19. The nurse explains to the parents of a child with a severe burn that wearing an elastic pressure garment (Jobst stocking) during the rehabilitative stage can help with the prevention of: 1. Poor circulation. 2. Hypertrophic scarring. 3. Pain. 4. Formation of thrombus in the burn area. Answer: 2 Rationale: 1. The Jobst pressure garments are used to prevent or minimize the development of hypertrophic scarring and contractures. 2. During the rehabilitation stage, Jobst stockings or pressure garments are used to reduce development of hypertrophic scarring and contractures. 3. The Jobst stockings or pressure garments do not prevent pain. They are used to prevent development of hypertrophic scarring and contractures. 4. The elastic pressure garments are used to prevent development of hypertrophic scarring and contractures. They do not prevent the formation of thrombus in the burn area. Cognitive Level: Application Client Need: Physiological Integrity Nursing Process: Planning Learning Outcome 36-7 Develop a nursing care plan for the child with a full-thickness

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Full file at http://testbank360.eu/test-bank-child-health-nursing-2nd-edition-ballBall 2e Test Bank burn injury. 20. Nursing care of the child with a snake bite involves assessment of the child for initial and progressive signs of envenomation. Which of the following is the priority nursing action at this time? 1. Assess the need for emergency breathing interventions. 2. Assess neurovascular status and vital signs. 3. Assess pain and the child’s response to pain medication. 4. Measure the circumference of the extremity containing the bite every 20–30 minutes. 5. Assess immunization status. Answer: 1 Rationale: 1. Emergency intervention for airway, breathing, and circulation take priority, and has a high probability of occurrence. 2. Vital signs and neurovascular status of the distal extremities should be monitored, but do not take priority over airway, breathing, and circulation. 3. Pain medication will need to be given and the response to the treatment monitored; however, this should not take priority over airway, breathing, and circulation. 4. In order to track progression in swelling and response to treatment, the extremity with the bite is measured every 20–30 minutes. However, this does not take priority over airway, breathing, and circulation. 5. Immunization status is important information to obtain, but the more immediate need is for airway, breathing, and circulation. Cognitive Level: Analysis Client Need: Physiological Integrity Nursing Process: Assessment Learning Outcome 36-8 Identify preventive strategies to reduce the risk of injury from burns, hypothermia, bites, and stings.

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Full file at http://testbank360.eu/test-bank-child-health-nursing-2nd-edition-ballBall 2e Test Bank 21. The nurse is teaching the parents of a small child strategies to prevent insect bites and stings. Which statement made by the parents indicates a need for further teaching? 1. “If my child wears bright colors and floral prints when outdoors, she will blend in with the surroundings, and the stinging insects will not sting her.” 2. “My child should avoid heavy colognes, perfumes, and soaps, so that insects are not attracted to them.” 3. “We should remove any items with standing water from our yard and surrounding area to prevent mosquito reproduction.” 4. “My child can use insect repellent containing DEET of 10% or less.” Answer: 1 Rationale: 1. Bright-colored clothing and floral prints attract the insects. White and light-colored clothing should be worn. 2. Heavy colognes, perfumes, soaps, and detergents resemble flowers and plants, and will attract the stinging insects. 3. Standing water is a breeding ground for mosquitoes. Rid yards of all bird baths, stagnant pools, any standing water that mosquitoes could use for breeding. 4. DEET is an appropriate insect repellent, and can be used in children. A concentration of 10% or less is recommended due to neurotoxic effects at greater concentrations. Cognitive Level: Analysis Client Need: Physiological Integrity Nursing Process: Evaluation Learning Outcome 36-8 Identify preventive strategies to reduce the risk of injury from burns, hypothermia, bites, and stings.

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Test bank child health nursing 2nd edition ball