The nurse is caring for an infant who has impetigo and is hospitalized. Which nursing intervention is the highest priority for this child?
The nurse applies elbow restraints to the infant.
The nurse soaks the skin with warm water.
The nurse follows contact precautions.
The nurse applies topical antibiotics to the lesions.
The Correct Answer is C
A. The nurse applies elbow restraints to the infant:
The use of elbow restraints is not a standard intervention for impetigo. Restraints are typically used for specific medical reasons, such as preventing the infant from interfering with medical equipment or procedures. It is not the highest priority in managing impetigo.
B. The nurse soaks the skin with warm water:
Soaking the skin with warm water can help in keeping the affected areas clean and promoting healing, but it is not the highest priority when considering the prevention of the spread of impetigo.
C. The nurse follows contact precautions:
Following contact precautions is the highest priority when dealing with impetigo. Since impetigo is highly contagious, implementing contact precautions, such as wearing appropriate PPE, is crucial to prevent the spread of the infection within the hospital setting.
D. The nurse applies topical antibiotics to the lesions:
Applying topical antibiotics is an important part of the treatment for impetigo. It helps to eliminate the bacterial infection and promote healing. However, while important, it is not the highest priority compared to preventing the spread of the infection through contact precautions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Teaching the child to take long, slow breaths:
While teaching slow breathing techniques can be helpful in managing anxiety and promoting a sense of calm, it may not directly address the underlying airway inflammation and bronchodilation needed in acute laryngotracheobronchitis.
B. Assisting with racemic epinephrine nebulizer therapy:
Racemic epinephrine is a medication that contains epinephrine, a bronchodilator. Nebulizer therapy with racemic epinephrine helps reduce airway inflammation, allowing for bronchodilation and improved breathing. This is a common intervention for managing acute respiratory distress in conditions like croup.
C. Administering an oral analgesic:
Oral analgesics, such as pain medications, can provide relief from discomfort or pain, but they do not directly address the bronchodilation needed for conditions like acute laryngotracheobronchitis.
D. Administering a corticosteroid:
Corticosteroids have anti-inflammatory properties and can help reduce swelling and inflammation in the airways. By doing so, they contribute to bronchodilation and improved breathing in conditions like croup. Corticosteroids are often used as part of the treatment plan for acute laryngotracheobronchitis.
Correct Answer is D
Explanation
A. Approximately 18 lbs. 6 oz.:
This option represents an overestimation of the expected weight. Doubling the birth weight of 8 lbs. 2 oz. would be 16 lbs. 4 oz., so this choice is higher than the expected weight.
B. Approximately 14 lbs. 8 oz.:
This option represents an underestimation of the expected weight. Doubling the birth weight of 8 lbs. 2 oz. would be 16 lbs. 4 oz., so this choice is lower than the expected weight.
C. Approximately 24 lbs. 4 oz.:
This option represents a significant overestimation of the expected weight. Doubling the birth weight of 8 lbs. 2 oz. would be 16 lbs. 4 oz., so this choice is much higher than the expected weight.
D. Approximately 16 lbs. 4 oz.:
This option is the correct estimate based on doubling the birth weight of 8 lbs. 2 oz. It accurately reflects the expected weight of a 6-month-old child according to developmental milestones.
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