A toddler is diagnosed with streptococcal based impetigo.
After teaching the parents about this condition and its treatment, the nurse determines that the teaching was successful based on which statement?
"The steroids should treat the sores pretty well.”.
"We need to make sure we finish up the entire antibiotic prescription.”.
"We should change the dressing on the sores every day.”.
"We need to stop our child from sucking their thumb.”.
The Correct Answer is B
Choice A rationale
Impetigo is a bacterial skin infection caused by Staphylococcus aureus or Streptococcus pyogenes. Steroids have immunosuppressive properties and can exacerbate bacterial infections by hindering the body’s ability to fight off the pathogens. Therefore, steroid creams are contraindicated and would not effectively treat the sores, as they would likely worsen the condition and delay healing.
Choice B rationale
The statement indicates an understanding of the importance of completing the full course of antibiotics to eradicate all of the bacteria. Discontinuing the medication prematurely can lead to antibiotic resistance and a recurrence of the infection, as some of the bacteria may survive and proliferate. Finishing the entire prescription ensures complete elimination of the pathogens.
Choice C rationale
Impetigo sores should not be covered with a tight dressing, as this can trap moisture and heat, creating an ideal environment for bacterial growth and proliferation. While the sores should be kept clean and dry, covering them daily with an occlusive dressing is generally not recommended. This can worsen the infection and hinder the drying and healing process.
Choice D rationale
Impetigo is highly contagious, but it is primarily spread through direct contact with the sores. While thumb sucking could potentially transfer bacteria from the hands to the face, it is not the primary route of transmission or a specific treatment concern. The focus should be on proper hand hygiene and avoiding scratching or picking at the lesions, which is the main way the infection spreads.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
A station of +1 cm indicates the presenting part is below the ischial spines. The ischial spines are the anatomical landmark used to determine station. A measurement of +1 cm signifies a descent of 1 cm past this landmark, not above it. A measurement of -1 cm would be 1 cm above the ischial spines.
Choice B rationale
The station is at 0 when the presenting part is at the level of the ischial spines. This indicates that the widest part of the fetal head has passed through the pelvic inlet and is now engaged. A station of +1 is a further descent past this point, not at the same level.
Choice C rationale
A station of +1 means the presenting part, in this case, the vertex, has descended 1 cm past the level of the ischial spines. The ischial spines are the narrowest part of the pelvis, and a positive station indicates fetal descent through this point and into the midpelvis, which is a progression of labor.
Choice D rationale
The presenting part entering the pelvic inlet is typically associated with a station of -2 or -3, prior to engagement. A station of +1 means the fetus is well past the inlet and has descended through the midpelvis, indicating that engagement has already occurred.
Choice E rationale
The presenting part is on the perineum at a much lower station, typically a +4 or +5, which is when crowning occurs. A station of +1 indicates that the presenting part is in the midpelvis, still needing to descend further before reaching the perineum for delivery.
Correct Answer is D
Explanation
Choice A rationale
This response is dismissive and does not address the patient's concerns. Providing accurate information empowers the patient to make informed decisions about their health. The nurse should always address patient concerns and provide education, especially when it relates to their birth experience and future reproductive health. Failing to do so can erode trust and negatively impact the patient-provider relationship.
Choice B rationale
This statement is an oversimplification and potentially inaccurate. The feasibility of a vaginal birth after a cesarean section (VBAC) depends on several factors, including the type of uterine incision. A classical vertical incision, for instance, is a strong contraindication due to a significantly increased risk of uterine rupture in subsequent pregnancies. The nurse must provide a more nuanced and accurate explanation.
Choice C rationale
This is an incorrect and potentially harmful statement. A previous cesarean section does not automatically preclude a future vaginal delivery. A vaginal birth after cesarean (VBAC) is a viable option for many individuals, particularly those who had a low transverse uterine incision. The decision is based on a careful assessment of risks and benefits with the patient's provider.
Choice D rationale
This statement is the most accurate and scientifically grounded response. The type of uterine incision is the most significant factor determining the safety of a future vaginal delivery. A low transverse incision has a lower risk of rupture during a trial of labor, making VBAC a safe option for many. A classical (vertical) incision, conversely, carries a high risk of uterine rupture, necessitating a repeat cesarean.
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