Nursing Elites

1. An 80-year-old patient with a history of renal insufficiency was recently started on cimetidine. Which assessment finding indicates that the patient may be experiencing an adverse effect of the medication?

• A. Pain with urination
• B. New onset disorientation to time and place
• C. HR changes from a baseline of 70-80bpm to 110-120bpm
• D. #ERROR!

Correct answer: B

Rationale: The correct answer is B: New onset disorientation to time and place. Cimetidine can cause adverse effects on the CNS system, especially in elderly patients with renal or hepatic impairment. This may manifest as confusion, hallucinations, lethargy, restlessness, or seizures. Pain with urination (choice A) is not typically associated with cimetidine use, and HR changes (choice C) are more likely related to other factors. Choice D is not a valid option.

2. Which statement best describes the recommended approach to increase participation as the focus of intervention with children and youth?

• A. Remediate areas of concern and the child's limitations
• B. Intervene with family and friends to interact differently with the child
• C. Promote the child's strengths and allow the child to accommodate challenges
• D. Evaluate the child's areas of competence and achievement, along with challenges

Correct answer: D

Rationale: The recommended approach to intervention with children and youth focuses on evaluating the child's areas of competence and achievement, along with challenges. By understanding the child's strengths and competencies, interventions can be tailored to build upon these existing positive attributes. This approach fosters a positive self-image and encourages further development by capitalizing on the child's strengths.

3. A healthcare professional is preparing for the delivery of a newborn with a known diaphragmatic hernia defect. Which equipment should the professional have on hand for the delivery?

• A. Bag-valve-mask system
• B. Sterile gauze and saline
• C. Soft arm restraints
• D. Endotracheal tube

Correct answer: D

Rationale: An endotracheal tube is crucial for managing the airway of a newborn with a diaphragmatic hernia. In this condition, there may be respiratory distress due to incomplete development of the diaphragm, allowing abdominal organs to move into the chest cavity and compress the lungs. The endotracheal tube helps in securing the airway and providing respiratory support if needed until definitive treatment can be initiated.

4. 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.

5. 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.

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