The clinic nurse receives a call from a parent of a 10-year-old who reports that their child just returned from summer camp and has developed an expanding circular red rash on the arm. The parent asks the nurse which over-the-counter (OTC) product is safe to use. How should the nurse respond?
Encourage the parent to come to the clinic if the child develops a fever.
Instruct the parent to apply an antihistamine ointment for one week.
Offer reassurance that OTC corticosteroid creams are safe and effective.
Explain the need for the child to have an immediate medical evaluation.
The Correct Answer is D
Choice A reason: Encouraging the parent to come to the clinic if the child develops a fever is not the best response that the nurse can give. This is because a fever may indicate a serious infection, such as Lyme disease, that requires prompt treatment. The nurse should not wait for the child to develop a fever before advising the parent to seek medical attention.
Choice B reason: Instructing the parent to apply an antihistamine ointment for one week is not the best response that the nurse can give. This is because an antihistamine ointment may not be effective for a fungal infection, such as ringworm, or a bacterial infection, such as Lyme disease, that may cause a circular rash. The nurse should not recommend any OTC product without knowing the exact cause of the rash.
Choice C reason: Offering reassurance that OTC corticosteroid creams are safe and effective is not the best response that the nurse can give. This is because corticosteroid creams may worsen a fungal infection, such as ringworm, or mask the symptoms of a bacterial infection, such as Lyme disease, that may cause a circular rash. The nurse should not recommend any OTC product without knowing the exact cause of the rash.
Choice D reason: Explaining the need for the child to have an immediate medical evaluation is the best response that the nurse can give. This is because a circular rash can be a sign of a serious condition, such as Lyme disease, that requires urgent diagnosis and treatment. The nurse should inform the parent that the rash may not be ringworm, as many people assume, and that it may be caused by a tick bite or another factor. The nurse should also advise the parent to avoid touching or scratching the rash and to keep it clean and dry until the child sees a doctor.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Encouraging the parents to rest when possible is not the first intervention that the nurse should instruct the mother to implement. While it is important for the parents to take care of themselves, the priority is to address the child's needs and comfort.
Choice B reason: Making a list of foods that the child likes is not the first intervention that the nurse should instruct the mother to implement. While it is important to maintain the child's nutrition and hydration, the child may not have an appetite due to the fever and inflammation caused by Kawasaki disease.
Choice C reason: Placing the child in a quiet environment is the first intervention that the nurse should instruct the mother to implement. This is because Kawasaki disease causes irritability and sensitivity to light and sound in the child. A quiet environment can help reduce the child's stress and discomfort.
Choice D reason: Applying lotion to hands and feet is not the first intervention that the nurse should instruct the mother to implement. While it is important to moisturize the skin and prevent cracking and infection, the lotion may not relieve the child's pain and inflammation.
Correct Answer is D
Explanation
Choice A reason: Recommending that the parent bring the child in for immediate evaluation is not the best response by the nurse. This may cause unnecessary anxiety and expense for the parent and the child. Albuterol is a bronchodilator that relaxes the muscles in the airways and increases air flow to the lungs. It is used to treat or prevent bronchospasm, or narrowing of the airways, in people with asthma or chronic obstructive pulmonary disease (COPD). It is also used to prevent exercise-induced bronchospasm. It is a quick-relief medication that can be used as needed when the child has difficulty breathing.
Choice B reason: Advising the parent that over-use of the medication may cause chronic bronchitis is not the best response by the nurse. This is not true and may discourage the parent from giving the medication to the child when needed. Chronic bronchitis is a type of COPD that causes inflammation and mucus production in the airways. It is usually caused by smoking or exposure to air pollution, not by albuterol. Albuterol does not cause chronic bronchitis, but it can help relieve the symptoms of bronchospasm in people who have it.
Choice C reason: Confirming that the medication helps to reduce airway inflammation is not the best response by the nurse. This is not accurate and may confuse the parent. Albuterol does not reduce airway inflammation, but it relaxes the muscles around the airways so that they open up and the child can breathe more easily. Albuterol is not an anti-inflammatory medication, but a bronchodilator. Anti-inflammatory medications, such as corticosteroids, are used to prevent or reduce inflammation in the airways, but they are not quick-relief medications like albuterol.
Choice D reason: Assuring the parent that they are using the medication correctly is the best response by the nurse. This shows that the nurse understands the purpose and the proper use of albuterol and that the nurse supports the parent's decision to give the medication to the child when needed. The nurse should also educate the parent on how to use the inhaler device correctly, how to monitor the child's symptoms and peak flow, and when to seek medical attention if the child's condition worsens.
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