Nursing Elites

1. A parent of a preschooler is being taught by a nurse about administering ear drops. Which of the following statements by the parent indicates an understanding of the teaching?

• A. I will straighten my child's ear canal by pulling it upward and backward.
• B. I will administer the ear drops immediately after removing them from the refrigerator.
• C. I will pull the ear lobe down and back before administering the ear drops.
• D. I will massage my child's ear after administering the ear drops.

Correct answer: D

Rationale: Correct administration of ear drops includes massaging the child's ear after administering the drops to facilitate proper absorption of the medication. This action helps ensure the effectiveness of the treatment. Choices A, B, and C are incorrect. Choice A describes incorrect positioning of the ear canal, choice B mentions incorrect storage of the ear drops, and choice C describes an incorrect technique for administering ear drops.

2. A nurse is providing teaching to the guardian of an infant about home safety. Which of the following statements by the guardian indicates an understanding of the teaching?

• A. I will place my baby on her stomach to sleep
• B. I will put a small pillow in my baby's crib
• C. I will keep my baby's crib away from the radiator
• D. I will use a drop-side crib for my baby

Correct answer: C

Rationale: The nurse should instruct the guardian to keep the baby�s crib away from the radiator to prevent burns.

3. 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.

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. The patient taking warfarin for prevention of deep vein thrombosis has an INR of 1.2. Which action by the nurse is most appropriate?

• A. Administer IV push protamine sulfate
• B. Continue with the current prescription.
• C. Prepare to administer Vitamin K
• D. Call healthcare provider to increase the dose

Correct answer: D

Rationale: An INR level of 1.2 is below the therapeutic range (2-3) for warfarin therapy. Therefore, the nurse should contact the healthcare provider to discuss the need for an increased dose to achieve the desired therapeutic range and prevent deep vein thrombosis effectively. Administering IV push protamine sulfate is used to reverse the effects of heparin, not warfarin. Continuing with the current prescription without addressing the subtherapeutic INR level may not effectively prevent deep vein thrombosis. Administering Vitamin K is indicated for warfarin overdose leading to excessive anticoagulation, not for a subtherapeutic INR level that is below the target range.

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