Nursing Elites

1. During a well-child visit, a nurse is assessing a three-year-old toddler. Which of the following manifestations should the nurse report to the provider?

• A. Blood pressure 90/50
• B. Respiratory rate 45/min
• C. Weight 14.5 kg or 32 lb
• D. Heart rate 110/min

Correct answer: B

Rationale: A respiratory rate of 45/min is above the expected reference range for a 3-year-old toddler and may indicate respiratory dysfunction or acute respiratory distress. It is essential for the nurse to report this finding promptly to the healthcare provider for further evaluation and intervention.

2. Before administering a live virus vaccine to a patient taking a glucocorticoid medication, what action should the nurse take?

• A. Continue screening and administer the vaccine if appropriate
• B. Note the contraindication but administer the vaccine regardless
• C. Note the contraindication and clarify the order with the healthcare provider
• D. Withhold the vaccine and inform the department of health

Correct answer: C

Rationale: The correct action for the nurse to take when a patient on glucocorticoid medication is to note the contraindication and clarify the order with the healthcare provider. Glucocorticoids can suppress the immune response, potentially reducing the effectiveness of vaccines. Therefore, it is crucial to consult with the healthcare provider to assess the risks and benefits of administering a live virus vaccine in such circumstances. Administering a live virus vaccine to a patient taking glucocorticoids can increase the risk of developing a viral infection, making it essential to seek guidance from the healthcare provider before proceeding.

3. What will the nurse caution the parents of a child who has had a nephrectomy that he will have to avoid?

• A. Contact sports
• B. Horseback riding
• C. Alcohol
• D. Diuretic medications

Correct answer: A

Rationale: Children who have only one kidney should avoid contact sports to prevent injury to that remaining organ.

4. A caregiver is learning about administering digoxin to a toddler. Which statement by the caregiver indicates an understanding of the teaching?

• A. I will mix the medication with a small amount of juice.
• B. I will give the medication with meals.
• C. I will give a second dose if my child vomits.
• D. I will give my child water after giving the medication.

Correct answer: D

Rationale: The correct statement is D because giving the child water after administering digoxin helps ensure the medication is swallowed properly. Mixing the medication with juice (choice A) may affect its absorption. Giving the medication with meals (choice B) may interfere with its effectiveness. Administering a second dose if the child vomits (choice C) is not recommended as it may lead to an overdose.

5. How do models of practice help therapists engage in sound therapeutic reasoning?

• A. They provide structure to guide thinking
• B. They address theory but not practice
• C. They predict the outcome of intervention
• D. They examine physical characteristics of the child

Correct answer: A

Rationale: Models of practice help therapists engage in sound therapeutic reasoning by providing a structured framework to guide their thinking process. These models offer a systematic approach that assists therapists in organizing their thoughts and decision-making processes during therapy sessions. By following a specific model, therapists can ensure they consider all relevant factors and make informed therapeutic choices, leading to effective interventions and better outcomes for their clients.

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