Nursing Elites

1. What will the nurse caution the parents of a child who has had a nephrectomy that he will have to avoid?

• A. Contact sports
• B. Horseback riding
• C. Alcohol
• D. Diuretic medications

Correct answer: A

Rationale: Children who have only one kidney should avoid contact sports to prevent injury to that remaining organ.

2. Which statement best describes the use of activity or task analysis?

• A. A foundational tool in occupational therapy for over a century
• B. A technique used to evaluate motor deficits in pediatrics
• C. Recently applied in some areas of pediatric occupational therapy
• D. A tool used exclusively by occupational therapy practitioners

Correct answer: A

Rationale: The correct answer is A: 'A foundational tool in occupational therapy for over a century.' Activity or task analysis has been a fundamental method in occupational therapy for a long time. It involves breaking down activities or tasks into smaller components to understand the skills required and identify areas of difficulty. This process helps occupational therapists develop effective intervention strategies to improve a client's ability to perform daily activities independently. Choices B, C, and D are incorrect because activity or task analysis is not limited to evaluating motor deficits in pediatrics, recently applied only in some areas of pediatric occupational therapy, or exclusively used by occupational therapy practitioners. It is a widely used and established method in the field of occupational therapy.

3. A toddler is admitted to the surgical unit for a planned closure of a temporary colostomy. Which medical prescription should the nurse question?

• A. Clear liquids today, NPO tomorrow
• B. Type and cross-match for 1 unit of packed red blood cells
• C. Rectal temperatures every 4 hours
• D. Start an intravenous line with D5NS at 20 mL per hour

Correct answer: C

Rationale: The correct answer is C. Rectal temperatures should be avoided in a toddler with a colostomy due to the risk of injury. Choices A, B, and D are appropriate medical prescriptions for a toddler undergoing colostomy closure. Choice A ensures the toddler's intake of clear liquids before being made NPO, choice B prepares for possible blood transfusion needs, and choice D initiates intravenous hydration with D5NS at an appropriate rate.

4. Which medication is most likely to cause serious respiratory depression as a potential adverse reaction?

• A. Morphine
• B. Pentazocine
• C. Hydrocodone
• D. Nalmefene

Correct answer: A

Rationale: Morphine, as a strong opioid agonist, has the highest likelihood of causing serious respiratory depression due to its potent effects on the central nervous system. While Pentazocine and Hydrocodone can also cause respiratory depression, they are less likely to do so compared to morphine. Nalmefene, an opioid antagonist, is used to reverse respiratory depression caused by opioids rather than causing it.

5. The nurse is providing care for a pediatric client in the emergency department (ED) with a diagnosis of decreased level of consciousness (LOC) secondary to increased intracranial pressure (ICP). Which healthcare provider order should the nurse question?

• A. Passive range-of-motion exercises to promote hip flexion
• B. Oxygen at 2 L nasal cannula to maintain saturation above 95%
• C. Hourly vital signs and neurologic checks
• D. Elevate head of bed 30 degrees

Correct answer: A

Rationale: In a pediatric client with increased intracranial pressure (ICP) and decreased level of consciousness (LOC), passive range-of-motion exercises to promote hip flexion should be questioned as they can potentially increase intracranial pressure. This action may not be safe for the client's condition. The other options are appropriate interventions for managing a pediatric client with increased ICP and decreased LOC.

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