Nursing Elites

1. A nurse is providing dietary teaching to the parent of a school-age child with cystic fibrosis. Which of the following statements should the nurse make?

• A. You should offer your child high-protein meals and snacks throughout the day
• B. Your child should decrease dietary fats to less than 10% of their caloric intake
• C. Your child will need to take a 1-gram sodium chloride tablet daily throughout their lifetime
• D. You should calculate your child's carbohydrate needs based on their daily activities

Correct answer: A

Rationale: The parent should provide a well-balanced diet that is high in protein and calories for a child with cystic fibrosis. This diet helps meet the child's increased energy requirements. Offering high-protein meals and snacks throughout the day is essential to ensure adequate nutrition and energy intake for children with cystic fibrosis. Choices B, C, and D are incorrect because children with cystic fibrosis actually need a higher fat intake for proper absorption of fat-soluble vitamins, sodium chloride supplementation is not a general recommendation for all children with cystic fibrosis, and carbohydrate needs are usually based on maintaining adequate weight and growth rather than daily activities.

2. The patient with bipolar disorder is being treated with lithium and has a new prescription for captopril for hypertension. The combination of these two drugs makes which assessment particularly important?

• A. Potassium level
• B. Lithium level
• C. Creatinine level
• D. Blood pressure

Correct answer: B

Rationale: When captopril, an ACE inhibitor, is combined with lithium, it can lead to lithium accumulation. Therefore, monitoring lithium levels is crucial to prevent toxicity. While ACE inhibitors like captopril can cause hyperkalemia, renal insufficiency, and hypotension, the risk of these effects is not increased by the combination of lithium and captopril.

3. Why should a healthcare professional take time to get to know the things a family does together, their weekly routine, and an explanation of family dynamics?

• A. Involvement in the family is central to best practice
• B. It is not necessary, but it is beneficial
• C. To gather demographic information for documentation purposes
• D. To assess if they have values that align with the practitioner's

Correct answer: A

Rationale: Understanding the activities, routines, and dynamics of a family is crucial for a healthcare professional to provide holistic care. By gaining insight into the family's lifestyle and relationships, the professional can tailor interventions that are better integrated into the family's daily life, fostering more effective therapy outcomes and enhancing the overall quality of care provided. Choice A is the correct answer because involvement in the family is indeed central to best practice in healthcare. Choices B, C, and D are incorrect because simply gathering demographic information, assessing values alignment, or considering it as optional fails to recognize the importance of understanding the family dynamics for effective care delivery.

4. A toddler in the emergency department has partial thickness burns on his right arm. Which of the following actions should the nurse take?

• A. Insert a nasogastric tube
• B. Initiate prophylactic antibiotic therapy
• C. Cleanse the affected area with mild soap and water
• D. Apply a topical corticosteroid to the affected area

Correct answer: C

Rationale: When a toddler has partial thickness burns, the nurse should cleanse the affected area with mild soap and water. This action helps remove any loose tissue that could lead to infection and prepares the area for appropriate wound care. Inserting a nasogastric tube (Choice A) is not indicated for a toddler with burns. Initiating prophylactic antibiotic therapy (Choice B) is not necessary for partial thickness burns unless there are signs of infection. Applying a topical corticosteroid (Choice D) is not recommended for initial management of burns as it can delay wound healing.

5. How does an occupational therapist use clinical guidelines to inform practice with children and youth?

• A. Modify guidelines to fit the specific environment
• B. Establish systems to monitor outcomes
• C. Select the most recent guidelines without considering the client
• D. Consider guidelines that fit one's clientele and environment

Correct answer: C

Rationale: When using clinical guidelines to inform practice with children and youth, it is crucial for occupational therapists to not solely rely on the most recent guidelines but to consider the individual needs and contexts of each client. Selecting guidelines based solely on recency without considering the specific client can lead to ineffective or inappropriate interventions.

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