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. 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.

3. Why is it important to share information with the family about why you are asking certain things as you evaluate the child?

• A. It helps them to understand the role of occupational therapy
• B. It establishes your goals with the family up front
• C. It communicates your level of expertise to the family
• D. It allows them to understand your point of view

Correct answer: A

Rationale: Sharing information with the family about the reasons for your questions is crucial as it helps them comprehend the purpose and role of occupational therapy in the evaluation process. This transparency fosters trust, collaboration, and empowers families to actively engage in the therapy journey. Choice B is incorrect because while it is essential to establish goals with the family, the focus here is on sharing information about the evaluation process. Choice C is incorrect as the main purpose is not to showcase expertise but rather to involve the family in understanding the assessment. Choice D is incorrect as the primary goal is not for the family to understand your point of view, but rather the purpose of the evaluation within the occupational therapy context.

4. What is functional behavior analysis?

• A. Systematic observation of behavior
• B. Standardized assessment
• C. Multiple choice examination
• D. Parent-teacher questionnaire

Correct answer: A

Rationale: Functional behavior analysis involves systematically observing behavior to understand its function and context. It focuses on identifying the antecedents and consequences that maintain or influence behavior. This systematic observation helps in determining patterns, triggers, and maintaining factors of behavior. Standardized assessments (choice B) involve using specific tools or tests to measure a person's performance or behavior but do not focus on observation. Multiple choice examinations (choice C) and parent-teacher questionnaires (choice D) are not synonymous with functional behavior analysis as they do not involve direct observation of behavior for analysis.

5. Parents are speaking with the urologist about their son's undescended testicle. Which statement by the child's father causes the nurse to determine he understands the information presented?

• A. An undescended testicle can reduce fertility.
• B. The testicle usually descends spontaneously during the first month of life.
• C. Surgical correction reduces the risk for testicular tumors.
• D. The optimal time to surgically correct the condition is at diagnosis.

Correct answer: A

Rationale: The correct answer is A because an undescended testicle can reduce fertility. Even after surgical correction (orchiopexy), fertility rates may be reduced, especially when one testis remains undescended. The statement in choice B is incorrect as the testicle should have descended into the scrotum by the time the infant is 4-6 months old. While choice C is true that surgical correction can reduce the risk of testicular tumors, the question focuses on the father's understanding of the information presented, which is better reflected in choice A. Choice D is incorrect because the optimal time for surgical correction of an undescended testicle is typically around 6-18 months of age, not necessarily at the time of diagnosis.

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