Nursing Elites

1. The healthcare provider is preparing medication instructions for a child who has undergone a kidney transplant and is prescribed cyclosporine. The parents ask the provider about the reason for the cyclosporine. Which rationale for this medication should the healthcare provider include in the response?

• A. Suppress rejection
• B. Decrease pain
• C. Improve circulation
• D. Boost immunity

Correct answer: A

Rationale: Cyclosporine is used to suppress the immune system and prevent rejection of the transplanted kidney. It helps to reduce the risk of the body attacking and rejecting the new organ. This medication is crucial in ensuring the success of the kidney transplant by keeping the immune system in check.

2. The caregiver is teaching a parent of a young child with a newly diagnosed seizure disorder. The child is prescribed valproic acid (Depakote) for control of seizures. Which parental statement indicates the need for further education?

• A. I will not use carbonated beverages to dilute his medication.
• B. I will give his medication with food to minimize gastrointestinal upset.
• C. I will not let him chew his tablet.
• D. I will bring him to the physician's office for regular blood work to check his blood levels.

Correct answer: B

Rationale: The correct answer is B. Valproic acid should be administered with food to reduce the risk of gastrointestinal upset. Giving it on an empty stomach may increase the likelihood of adverse effects. The other statements are correct: A - Carbonated beverages should not be used to dilute the medication, C - The tablet should not be chewed, and D - Regular blood work is necessary to monitor valproic acid levels and potential side effects.

3. Before administering a live virus vaccine to a patient taking a glucocorticoid medication, what action should the nurse take?

• A. Continue screening and administer the vaccine if appropriate
• B. Note the contraindication but administer the vaccine regardless
• C. Note the contraindication and clarify the order with the healthcare provider
• D. Withhold the vaccine and inform the department of health

Correct answer: C

Rationale: The correct action for the nurse to take when a patient on glucocorticoid medication is to note the contraindication and clarify the order with the healthcare provider. Glucocorticoids can suppress the immune response, potentially reducing the effectiveness of vaccines. Therefore, it is crucial to consult with the healthcare provider to assess the risks and benefits of administering a live virus vaccine in such circumstances. Administering a live virus vaccine to a patient taking glucocorticoids can increase the risk of developing a viral infection, making it essential to seek guidance from the healthcare provider before proceeding.

4. Which frame of reference emphasizes techniques to teach children movement that resemble coaching?

• A. Motor control/motor learning
• B. Rehabilitation
• C. Biomechanical
• D. Ayres' sensory integration

Correct answer: A

Rationale: The correct frame of reference that emphasizes techniques to teach children movement resembling coaching is Motor control/motor learning. This approach focuses on improving movement skills through techniques that are similar to coaching methods. It helps children develop and refine their motor skills in a structured and goal-oriented manner. Rehabilitation, Biomechanical, and Ayres' sensory integration have different emphases and objectives in therapy, making them incorrect choices for this question.

5. A 4-year-old child is admitted to the hospital secondary to dehydration. Laboratory tests indicate a high hemoglobin and hematocrit, and the serum sodium is below normal levels. Which condition does the nurse suspect based on the current data?

• A. Hypernatremia
• B. Metabolic acidosis
• C. Hypotonic dehydration
• D. Isotonic dehydration

Correct answer: C

Rationale: The correct answer is hypotonic dehydration. The combination of high hemoglobin and hematocrit with low serum sodium indicates hypotonic dehydration. In this condition, there is an excess of solutes relative to water, leading to higher red blood cell concentration (elevated hemoglobin and hematocrit) and low serum sodium levels.

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