Nursing Elites

1. Which clinical manifestation should a nurse monitor for when assessing a pediatric client diagnosed with a basilar skull fracture?

• A. Periorbital ecchymosis
• B. Subdural hematoma
• C. Protruding bone
• D. Epidural hematoma

Correct answer: A

Rationale: Periorbital ecchymosis, also known as raccoon eyes, is a classic sign of a basilar skull fracture. It presents as bruising around the eyes due to blood collecting in the tissues. Monitoring for periorbital ecchymosis is crucial in assessing a pediatric client with a basilar skull fracture because it can indicate the presence of this serious injury.

2. A healthcare professional is reviewing the laboratory results of a child who has nephrotic syndrome. Which of the following findings should the professional expect?

• A. Hypoalbuminemia
• B. Hyperkalemia
• C. Polyuria
• D. Hyperglycemia

Correct answer: A

Rationale: In nephrotic syndrome, there is excessive loss of protein in the urine, leading to hypoalbuminemia. This results in decreased oncotic pressure, causing fluid to shift into the interstitial spaces, leading to edema. Hyperkalemia, polyuria, and hyperglycemia are not typically associated with nephrotic syndrome.

3. Which strategy is most likely to promote positive behavior in children?

• A. Providing flexible instructions with no consequences
• B. Limiting opportunities until the child performs adequately
• C. Improving the child's competence and creating a positive environment
• D. Setting strict rules with punishments for misbehavior

Correct answer: C

Rationale: Improving the child's competence and creating a positive environment is the most effective strategy to promote positive behavior in children. This approach focuses on enhancing the child's skills and abilities while fostering a supportive and encouraging atmosphere. By empowering the child and surrounding them with positivity, they are more likely to exhibit positive behaviors as they feel competent, valued, and motivated. This strategy emphasizes support and reinforcement over punitive measures, leading to long-lasting behavioral improvements.

4. 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.

5. Which parental statement at the end of a teaching session by the nurse indicates correct understanding of colostomy stoma care for the infant client?

• A. We will change the colostomy bag with each wet diaper.
• B. We will expect a moderate amount of bleeding after cleansing the area around the stoma.
• C. We will watch for skin irritation around the stoma.
• D. We will use adhesive enhancers when we change the bag.

Correct answer: C

Rationale: Choosing option C, 'We will watch for skin irritation around the stoma,' demonstrates understanding of proper colostomy stoma care. Monitoring for skin irritation is crucial as it can indicate issues such as leakage, improper sealing, or infection. Options A, B, and D are incorrect. Changing the colostomy bag with each wet diaper (option A) is unnecessary unless indicated by a healthcare provider to prevent skin breakdown. Expecting bleeding after cleansing (option B) is not normal and may signal a problem that requires medical attention. Using adhesive enhancers (option D) should be done based on specific recommendations and not necessarily with every bag change.

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