Nursing Elites

1. Marge is a 2-year-old girl who does not sit and eat at mealtimes but rather brings food to many rooms, eats a few bites, and drops it. Her parents report that she is a 'fussy eater.' Marge is significantly below weight for her age. She does not have any oral motor structure abnormalities, but eats only certain foods with the same texture. Which intervention strategy would be best to address the environmental context?

• A. Prolong mealtimes and eliminate all snacks
• B. Provide high-calorie snacks and meals at the table throughout the day
• C. Allow Marge to eat whenever and wherever she wants in the house
• D. Require Marge to eat everything on her plate and at snack

Correct answer: B

Rationale: In the case of Marge, who exhibits selective eating habits and struggles with weight gain, providing high-calorie snacks and meals at the table throughout the day can be an effective intervention. This strategy can help increase her food intake in a structured environment, promoting healthier eating habits and potentially addressing her below-average weight status. Choice A, prolonging mealtimes and eliminating all snacks, may not be the best approach as it could lead to more food refusal and stress during meals. Choice C, allowing Marge to eat whenever and wherever she wants in the house, may further enable her selective eating behavior and hinder progress. Choice D, requiring Marge to eat everything on her plate and at snack, can create a negative mealtime environment and may not address the underlying causes of her eating habits. Therefore, providing high-calorie snacks and meals at designated times offers a balanced approach to support Marge's nutritional needs and overall well-being.

2. When teaching a parent of a child with contact dermatitis, which instruction should the nurse include?

• A. Apply a thick layer of antibiotic ointment to the affected area.
• B. Rub the skin vigorously with a towel to dry it.
• C. Keep the child's skin dry.
• D. Apply a thin layer of corticosteroid cream to the affected area.

Correct answer: D

Rationale: The correct instruction for a child with contact dermatitis is to apply a thin layer of corticosteroid cream to the affected area. Corticosteroid cream helps reduce inflammation and itching associated with contact dermatitis. It is important to avoid using antibiotic ointment or rubbing the skin vigorously, as these can worsen the condition. Keeping the child's skin dry is generally a good practice, but in the case of contact dermatitis, corticosteroid cream application is more beneficial.

3. Which physical assessment technique should be omitted when caring for a 2-year-old child diagnosed with Wilms' tumor?

• A. Performing range-of-motion exercises on lower extremities
• B. Palpating the abdomen
• C. Assessing for bowel sounds
• D. Percussing ankle and knee reflexes

Correct answer: B

Rationale: Palpating the abdomen should be omitted when caring for a 2-year-old child diagnosed with Wilms' tumor because it could disturb the tumor and potentially cause the malignancy to spread. The other assessment techniques are safe to perform and provide valuable information about the child's condition. Range-of-motion exercises help assess mobility and joint health, assessing for bowel sounds is important to monitor gastrointestinal function, and percussing ankle and knee reflexes can help evaluate neurological responses.

4. During an assessment, a healthcare professional is evaluating an infant with pneumonia. Which of the following findings should be the priority for the healthcare professional to report to the provider?

• A. Nasal flaring
• B. WBC count of 11,300
• C. Diarrhea
• D. Abdominal distension

Correct answer: A

Rationale: When assessing an infant with pneumonia, the priority finding to report to the provider is nasal flaring. Nasal flaring indicates acute respiratory distress, which can be a life-threatening condition requiring immediate intervention. Monitoring and addressing respiratory distress take precedence over other symptoms or laboratory results in this situation.

5. Which of the following is not a model centered on occupation?

• A. Canadian Model of Occupational Performance and Engagement
• B. Person-Environment-Occupation-Participation
• C. Biomechanical
• D. Model of Human Occupation

Correct answer: C

Rationale: The correct answer is C, the Biomechanical model. This model focuses on the physical aspects of performance rather than occupation. The Canadian Model of Occupational Performance and Engagement, Person-Environment-Occupation-Participation, and Model of Human Occupation are all occupation-centered models used in occupational therapy. The Biomechanical model is more focused on the physical aspects of movement and performance rather than the broader concept of occupation.

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