Nursing Elites

1. When preparing an adolescent for a lumbar puncture, which of the following actions should the nurse take?

• A. Place a cardiac monitor on the adolescent prior to the procedure
• B. Apply topical analgesic cream to the site one hour prior to the procedure
• C. Keep the adolescent in a semi-Fowler's position for 4 hours following the procedure
• D. Restrict fluids for 2 hours following the procedure

Correct answer: B

Rationale: The correct action for the nurse when preparing an adolescent for a lumbar puncture is to apply topical analgesic cream to the site one hour before the procedure. This helps reduce pain experienced during the lumbar puncture, making the procedure more comfortable for the adolescent. Placing a cardiac monitor on the adolescent is not necessary for a lumbar puncture. Keeping the adolescent in a semi-Fowler's position for 4 hours following the procedure is not a standard practice after a lumbar puncture. Restricting fluids for 2 hours following the procedure is not a requirement for a lumbar puncture preparation.

2. Which statement made by a parent of a child with nephrotic syndrome indicates an understanding of discharge teaching?

• A. I will make sure he gets his measles vaccine as soon as he gets home.
• B. He can stop taking his medication next week.
• C. I should check his urine for protein when he goes to the bathroom.
• D. He should eat a low-protein diet for the next few weeks.

Correct answer: C

Rationale: In nephrotic syndrome, monitoring urine for protein is essential as it helps track the child's condition. Checking urine for protein should be done as part of the discharge teaching to keep a record of the child's urinary proteins and to monitor the effectiveness of the treatment plan. It is crucial for parents to understand this aspect of care to ensure proper management of the child's condition. Choices A, B, and D are incorrect because getting a measles vaccine, stopping medication prematurely, and following a low-protein diet are not directly related to monitoring the child's condition and managing nephrotic syndrome.

3. Why is it important to share information with the family about why you are asking certain things as you evaluate the child?

• A. It helps them to understand the role of occupational therapy
• B. It establishes your goals with the family up front
• C. It communicates your level of expertise to the family
• D. It allows them to understand your point of view

Correct answer: A

Rationale: Sharing information with the family about the reasons for your questions is crucial as it helps them comprehend the purpose and role of occupational therapy in the evaluation process. This transparency fosters trust, collaboration, and empowers families to actively engage in the therapy journey. Choice B is incorrect because while it is essential to establish goals with the family, the focus here is on sharing information about the evaluation process. Choice C is incorrect as the main purpose is not to showcase expertise but rather to involve the family in understanding the assessment. Choice D is incorrect as the primary goal is not for the family to understand your point of view, but rather the purpose of the evaluation within the occupational therapy context.

4. Which statement fosters cultural competence?

• A. Treat everyone the same regardless of their culture
• B. Provide an outline of your beliefs as a starting point
• C. Acknowledge and respond to influences of cultural beliefs in the intervention plan
• D. Ask the family to outline how their beliefs will influence therapy

Correct answer: C

Rationale: Cultural competence involves recognizing and considering the impact of cultural beliefs on individuals. By acknowledging and responding to these cultural influences in the intervention plan, professionals can tailor their approach effectively and respectfully. This approach helps build trust, enhances communication, and improves outcomes in culturally diverse settings.

5. 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.

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