The nurse is assessing a 4-year-old client with eczema. The child's skin is dry and scaly, and the parent reports that the child frequently scratches the lesions on the skin to the point of causing bleeding. Which guideline is indicated for care of this child?

Apply baby lotion to the skin twice daily.

Keep the nails trimmed short.

Allow the child to wear only 100% cotton clothing.

Bathe the child daily with bath oil.

Answer and Explanation

The Correct Answer is B

A. While applying lotion can help keep the skin moisturized, it may not prevent scratching or bleeding from lesions.

B. Keeping the nails trimmed short is essential to prevent the child from scratching the lesions, which can lead to further irritation and potential infection. Short nails reduce the risk of breaking the skin and causing bleeding.

C. While cotton clothing is less irritating and may help manage eczema, ensuring that the child does not scratch the lesions is more critical in this scenario.

D. Daily baths can be beneficial, but they should not be done excessively as they can further dry the skin. Bath oils may help, but they do not directly address the issue of scratching.

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Correct Answer is A

Explanation

A. Instituting droplet precautions is crucial to prevent the spread of COVID-19, especially since the client may be positive and symptomatic. Placing the client in a private room ensures the safety of others in the healthcare facility.

B. While informing others about potential exposure is important, it does not address immediate safety and infection control measures.

C. Starting an IV infusion for antiviral drugs may be appropriate after a positive test but does not take precedence over isolation measures.

D. Counseling family members to monitor for symptoms is helpful but is secondary to ensuring that the client is safely managed in the emergency department.

A. A resting respiratory rate of 35 breaths/min. B. Flaring of the nares. C. Diaphragmatic respirations. D. Bilateral bronchial breath sounds.

Correct Answer is B

Explanation

A. A resting respiratory rate of 35 breaths/min is within the normal range for a 4-month-old infant and does not indicate distress.

B. Flaring of the nares is a sign of respiratory distress, indicating increased work of breathing and the infant's effort to obtain more oxygen.

C. Diaphragmatic respirations are common in infants and do not necessarily indicate distress unless accompanied by other signs.

D. Bilateral bronchial breath sounds can be normal and do not specifically indicate acute respiratory distress.

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The nurse is assessing a 4-year-old client with eczema. The child's skin is dry and scaly, and the parent reports that the child frequently scratches the lesions on the skin to the point of causing bleeding. Which guideline is indicated for care of this child?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A 4-month-old infant is brought to the clinic by a parent with symptoms of a runny nose, a slight fever and cough for the last two days. Which finding should alert the nurse that the child is in acute respiratory distress?

Correct Answer is B

Explanation

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