1. A 4 year old is admitted to your unit with a severe case of impetigo. It is important the nurse follows _______________ while providing care to this patient:
A. Droplet precautions
B. Standard precautions only
C. Contact precautions
D. Airborne precaution
The answer is C. The nurse will follow contact precautions, which includes following standard precautions as well. Impetigo is a HIGHLY contagious skin infection. Therefore, the nurse should always wear a gown and gloves when providing care to the patient to prevent transmission of the infection.
2. You’re providing education to a group of parents about impetigo. Which statement is CORRECT about this disease?
A. “It tends to affect the preadolescent and adolescent population.”
B. “Cases of impetigo most likely to occur during the summer when the weather is warm.”
C. “Most cases of impetigo are not contagious.”
D. “Impetigo is caused by a mite parasite.”
The answer is B. This is the only correct statement about impetigo. All the other statements are FALSE.
3. Select all the most common infectious agents that cause impetigo:
A. Sacroptes scabiei
B. Staphylococcus aureus
C. Klebsiella pneumoniae
D. Haemophilus influenzae
E. Streptococcus pyogenes
F. Listeria monocytogenes
The answers are: B and E. These are the two types of bacteria that tend to cause impetigo….staphylococcus aureus and streptococcus pyogenes.
4. A 2 year old with impetigo is ordered topical antibiotic ointment. You’re teaching the child’s mother how to apply the ointment. Which action by the mother during application of the ointment requires you to re-educate the parent?
A. The mother washes her hands before and after the application of the ointment.
B. The mother applies a layer of ointment directly over the crust of the lesion.
C. The mother uses warm water and antibacterial soap to cleanse the lesions prior to application of ointment.
D. The mother uses a cotton swab to apply the ointment.
The answer is B. It is very important to REMOVE any crust from the lesion BEFORE applying antibiotic ointment to the lesion. This allows the ointment to come into contact with the skin, which is where the bacteria reside. To remove the crust, use warm water and antibacterial soap. All the other options are correct.
5. Impetigo tends to be most commonly found on:
A. Mouth
B. Ears
C. Nose
D. Torso
E. Toes
The answers are A and C. Impetigo most commonly tends to be found on the face like the mouth and nose. It can be found on the hands, arms, and legs.
6. A parent brings her child into the clinic due to skin lesions that fail to heal. The lesions are red, reported to be itchy, and exhibit exudate. You suspect the child may have impetigo. What is a hallmark finding with this condition?
A. Round patches with light pink centers
B. Short grey lines on the skin
C. Silver colored scales over the lesions
D. Yellow crusts over the lesions
The answer is D. Yellow crusted over lesions are a hallmark of impetigo. Option A is a hallmark found with ringworm (tinea corporis), Option C is psoriasis, and Option B is scabies.
7. A child has impetigo and is being treated with oral antibiotics. The father asks when the child can be allowed to return to school. Your answer is:
A. After 72 hours from the start of the treatment
B. After 24 hours from the start of the treatment
C. After 48 hours from the start of the treatment
D. After 1 week from the start of the treatment
The answer is B. Impetigo is highly contagious. Therefore, if the child is taking oral antibiotics for the treatment of this condition they are no longer contagious after 24 hours from the start of treatment. If the child was using topical antibiotic ointment for the treatment of this condition, they would no longer be contagious after 48 hours from the start of treatment. Therefore, the child can return to school after being on oral antibiotics for 24 hours.
8. A child with impetigo has a 24 month old sister at home. What will you be sure to include in your teaching to the parents about this condition?
A. Keep the child’s nails short
B. Separate towels and other linens used by the child
C. Wash hands with antibacterial soap regularly
D. Prevent the child from scratching the lesions
E. Vacuum carpets and furniture regularly
F. Store stuffed animals and toys in plastic bags for 5 days
The answers are A, B, C and D. Impetigo is contagious and can be spread to other family members. Therefore, the child with the lesions should have their nails cut short to prevent scratching and spreading the infection. In addition, the child’s towels, linens, toys etc. should be separated from other family members until the lesions are healed and wash hands regularly with antibacterial soap. Option E represents steps on how to prevent the spreading of lice, and option F represents the steps on how to prevent the spread of scabies.
