Nursing Elites

1. During a developmental screening, a 4-year-old child is asked to perform a task. Which of the following tasks should the nurse expect the child to perform?

• A. Draw a stick figure with seven body parts
• B. Draw a circle
• C. Identify right from left hand
• D. Tie their shoelaces

Correct answer: B

Rationale: At 4 years old, children are typically able to draw a circle, which is a developmental milestone for their age. Drawing a stick figure with specific body parts might be beyond their developmental level, identifying right from left hand can be challenging, and tying shoelaces requires more advanced motor skills.

2. Which of the following statements best describes the benefit of using an occupation-centered practice model?

• A. Addresses the unique value of occupation
• B. Provides intervention protocols
• C. Provides specific intervention activities
• D. Addresses children's limitations in skills

Correct answer: A

Rationale: An occupation-centered practice model focuses on the unique value of engaging in meaningful and purposeful activities, known as occupations. By addressing the significance of occupation in an individual's life, this model emphasizes the importance of activities that hold personal meaning and relevance. Understanding and incorporating the value of occupation can lead to more client-centered and holistic interventions that promote health and well-being. Choice B is incorrect as the model emphasizes the value of occupations, not just intervention protocols. Choice C is incorrect as the model is centered around the value of occupations, not just specific intervention activities. Choice D is incorrect as the model is not primarily focused on addressing children's limitations in skills, but rather on the significance of engaging in meaningful activities.

3. A nurse is teaching a parent of a child who has type 1 diabetes mellitus. Which of the following statements by the parent indicates an understanding of the teaching?

• A. I will notify my child's school about his condition.
• B. I will encourage my child to eat a carbohydrate snack if his blood glucose is low.
• C. I will rotate injection sites each time I give my child insulin.
• D. I will ensure my child receives the flu vaccine every year.

Correct answer: C

Rationale: The nurse should instruct the parent to rotate injection sites to prevent tissue damage and improve insulin absorption.

4. 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.

5. Which statement by an 18-year-old woman vaccinated with Gardasil indicates that more teaching is necessary?

• A. This vaccination will cure the HPV infection I got when I was 16.
• B. I will still need to have a routine Pap screen performed.
• C. Gardasil can prevent genital warts in males and females.
• D. This drug does not protect against all types of HPV.

Correct answer: A

Rationale: The correct answer is A because Gardasil does not cure existing HPV infections. Gardasil is a preventive vaccine and does not treat existing infections. Choice B is correct as regular Pap screenings are still necessary even after vaccination. Choice C is also correct as Gardasil can prevent genital warts. Choice D is correct as Gardasil does not protect against all types of HPV. Therefore, option A is the statement that indicates the need for more teaching.

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