You are teaching a student nurse how to apply a medicated cream to an infant's buttocks. You explain that a plastic diaper can:
Cause maceration
Diminish absorption
Have no effect on absorption
Increase absorption
The Correct Answer is B
Topical medication absorption in infants is influenced by skin permeability, occlusion, and moisture retention. Occlusive materials such as plastic diapers alter drug pharmacokinetics by affecting transepidermal absorption, potentially modifying therapeutic effectiveness or drug exposure levels.
Rationale:
A. Plastic diapers do not primarily cause maceration in the context of medicated cream application. Maceration results from prolonged moisture exposure, not the diaper material itself. While occlusion may contribute to moisture retention, the main pharmacologic concern is altered drug absorption rather than tissue breakdown.
B. Plastic diapers act as an occlusive barrier, reducing evaporation and altering skin hydration. This can either increase or decrease drug penetration depending on formulation, but commonly they reduce intended drug efficacy control by interfering with predictable absorption and distribution across the skin surface.
C. Plastic diapers do not have no effect on absorption. Occlusion significantly modifies cutaneous pharmacokinetics by increasing hydration of the stratum corneum, which changes permeability. Therefore, assuming no effect is physiologically inaccurate in pediatric topical drug administration.
D. Plastic diapers generally increase rather than simply diminish or have no effect on absorption due to occlusive hydration effects. However, in clinical teaching contexts, the key concern is that they alter predictable absorption, making drug delivery less controlled and potentially inconsistent.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Toddlers (1–3 years) are in the autonomy vs shame and doubt stage, characterized by parallel play rather than cooperative interaction. Developmental social play evolves gradually from solitary to parallel play in toddlers before true cooperative play emerges in the preschool period.
Rationale:
A. Older children can model behavior, but toddlers primarily engage in parallel play, not interactive learning through peers. Introducing older children does not address the developmental limitation in cooperative play skills at this age.
B. Cooperative play typically emerges between 3–5 years, during the preschool stage. A 2-year-old is expected to engage in parallel play rather than sharing goals or structured interaction, making this response developmentally accurate.
C. Time-out is a behavioral management strategy, not an explanation for developmental social limitations. A 2-year-old’s limited peer interaction reflects normal development, not misbehavior requiring punishment.
D. Parental modeling is important for general behavior development, but it does not directly explain the absence of cooperative peer play. Toddlers learn mainly through imitation and parallel activity, not structured social modeling.
Correct Answer is C
Explanation
School-age children (6–12 years) are in Erikson’s stage of industry vs inferiority, with increasing independence, curiosity, and peer-driven activity. Cognitive development often includes incomplete risk appraisal, leading to overconfidence, risk-taking behavior, and increased susceptibility to accidental injury.
Rationale:
A. Inability to read labels is not typical for school-age children. Basic literacy develops during this stage, and poisoning risk is more related to curiosity and improper supervision rather than reading inability alone.
B. Reduced interest in family opinions reflects adolescent psychosocial development, not school-age children. This stage is still strongly influenced by family guidance, so this option does not explain injury risk in this age group.
C. School-age children commonly overestimate physical abilities, leading to risky behaviors such as climbing, cycling, or sports activities beyond safe limits. This cognitive misjudgment increases exposure to trauma and accidental injury significantly.
D. School-age children are highly capable of safety education and learning rules. They are not too young to be taught hazard avoidance. Injury risk is not due to inability to understand danger but due to overconfidence and experimentation.
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