Nursing Elites

1. A child is admitted to the hospital for hypercalcemia and is placed on diuretic therapy. Which diuretic would the nurse expect to administer?

• A. Furosemide (Lasix)
• B. Hydrochlorothiazide (Aquazide)
• C. Spironolactone (Aldactone)
• D. Mannitol (Osmitrol)

Correct answer: A

Rationale: Furosemide (Lasix) is a loop diuretic that acts on the ascending loop of Henle in the kidney to increase calcium excretion. In the setting of hypercalcemia, where there is an elevated level of calcium in the blood, Furosemide can help promote the elimination of excess calcium through the urine, thereby aiding in the management of hypercalcemia.

2. A parent of an infant with congenital hypothyroidism is receiving teaching from a nurse. Which of the following statements should the nurse include in the teaching?

• A. Your child will need to take medication for a few months
• B. You will need to give your child the medication every other day
• C. Your child will need to take the medication until age 10
• D. Your child will need to take the medication for life

Correct answer: D

Rationale: The correct answer is D. Congenital hypothyroidism requires lifelong medication to manage the condition effectively. The nurse should emphasize to the parent that their child will need to take the medication for life to ensure proper thyroid hormone levels and prevent complications associated with hypothyroidism.

3. Which statement best reflects a top-down approach to the evaluation process?

• A. OT focuses on evaluating the child's poor performance in hand skills
• B. OT conducts an assessment to determine a motor age for fine motor and gross motor skills
• C. OT initiates by interviewing the family about routines, interests, and daily habits
• D. OT starts by assessing muscle tone, postural control, and range of motion

Correct answer: C

Rationale: A top-down evaluation approach in occupational therapy begins with understanding the child's daily life, family routines, interests, and habits to ensure that the therapy provided is relevant and meaningful within the child's natural environment. By initiating the evaluation process with family interviews to gather contextual information, the occupational therapist gains a comprehensive view of the child's life, which allows for a more holistic and client-centered approach. Choice A focuses solely on the child's poor performance in hand skills, which is more characteristic of a bottom-up approach. Choice B mentions determining a motor age, which is not necessarily aligned with a top-down assessment. Choice D emphasizes physical assessments like muscle tone and range of motion, which are important but do not capture the essence of a top-down approach that considers the child's environment and routines.

4. A neonate with a meningomyelocele is scheduled for surgery in the morning. Which nursing action is appropriate for this neonate?

• A. Applying a diaper to prevent contamination of the sac
• B. Positioning the newborn in a side-lying position
• C. Encouraging the mother to hold the newborn because she will not be able to pick him up after surgery
• D. Positioning the newborn in a prone position

Correct answer: D

Rationale: Positioning the newborn in a prone position is appropriate for a neonate with a meningomyelocele before surgery. Placing the newborn in this position helps prevent pressure on the sac, reducing the risk of damaging it and promoting optimal surgical outcomes. Applying a diaper (choice A) may not be recommended as it can increase pressure on the sac. Positioning the newborn in a side-lying position (choice B) or encouraging the mother to hold the newborn (choice C) are not ideal actions before surgery as they do not address the specific needs of a neonate with a meningomyelocele.

5. A preschool-age child is admitted to the hospital with acute postinfectious glomerulonephritis (APIGN). Which is the priority nursing diagnosis for this child?

• A. Risk for Injury related to hypertension.
• B. Altered Growth and Development related to chronic disease.
• C. Risk for Infection related to hypertension.
• D. Fluid Volume Excess related to decreased plasma filtration.

Correct answer: A

Rationale: The priority nursing diagnosis for a preschool-age child with acute postinfectious glomerulonephritis (APIGN) is 'Risk for Injury related to hypertension' due to the potential complications such as hypertensive encephalopathy. Hypertension poses an immediate threat to the child's well-being, making it crucial to address the risk for injury associated with elevated blood pressure as the top priority.

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