Nursing Elites

1. The mother of a 5-year-old child taking prednisone for nephrotic syndrome tells the nurse he needs to get immunizations to enter kindergarten. What does the nurse clarify about receiving immunizations while on prednisone?

• A. Can interfere with the treatment for nephrosis.
• B. Require that the child have antibiotic coverage.
• C. Can be given in smaller, divided doses.
• D. Should be delayed.

Correct answer: D

Rationale: No vaccinations or immunizations should be administered while the disease is active and during immunosuppressive therapy.

2. What side effect should the nurse include in the parent teaching for a child prescribed a baclofen pump for cerebral palsy?

• A. Diarrhea
• B. Hypertonia
• C. Hypotonia
• D. Restlessness

Correct answer: C

Rationale: When a child is prescribed a baclofen pump for cerebral palsy, one of the common side effects to include in parent teaching is hypotonia. Baclofen, a muscle relaxant, can lead to decreased muscle tone, resulting in hypotonia. It is important for parents to be aware of this potential side effect and know how to respond accordingly.

3. Which model of practice emphasizes the child's subjective experience of their abilities?

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

Correct answer: B

Rationale: The Model of Human Occupation (MOHO) emphasizes the child's subjective experience of their abilities, focusing on their motivation, roles, habits, and routines. It considers how these factors influence their occupational performance. MOHO helps occupational therapists understand how a child's perceptions of their abilities impact their engagement in meaningful activities and occupations.

4. Which urinary diversion procedure is the least damaging to the body image of the adolescent?

• A. Urostomy
• B. Ileal conduit
• C. Nephrostomy
• D. Suprapubic placement

Correct answer: B

Rationale: The correct answer is B: Ileal conduit. The ileal conduit diverts urine to the colon, and the urine is excreted with the feces. Unlike urostomy, nephrostomy, and suprapubic placement, the ileal conduit does not require an external appliance, which can be less damaging to an adolescent's body image.

5. In the morning, a healthcare professional receives change-of-shift report on four pediatric clients, each of whom has some form of fluid-volume excess. Which of the children should the healthcare professional see first?

• A. The child with tachypnea and pulmonary congestion
• B. The child with hepatomegaly and normal respiratory rate
• C. The child with dependent and sacral edema and regular pulse
• D. The child with periorbital edema and normal respiratory rate

Correct answer: A

Rationale: The child with tachypnea and pulmonary congestion should be seen first. Tachypnea indicates an increased respiratory rate, a sign of possible respiratory distress. Pulmonary congestion suggests fluid accumulation in the lungs, posing a serious risk to respiratory function. Immediate attention is crucial in this case. Choice B is incorrect as hepatomegaly alone does not indicate an acute issue requiring immediate attention. Choices C and D, while showing signs of fluid-volume excess, do not present the same level of respiratory compromise as tachypnea and pulmonary congestion, making them lower priority.

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