Nursing Elites

1. Which of the following statements best describes the benefit of using an occupation-centered practice model?

• A. Addresses the unique value of occupation
• B. Provides intervention protocols
• C. Provides specific intervention activities
• D. Addresses children's limitations in skills

Correct answer: A

Rationale: An occupation-centered practice model focuses on the unique value of engaging in meaningful and purposeful activities, known as occupations. By addressing the significance of occupation in an individual's life, this model emphasizes the importance of activities that hold personal meaning and relevance. Understanding and incorporating the value of occupation can lead to more client-centered and holistic interventions that promote health and well-being. Choice B is incorrect as the model emphasizes the value of occupations, not just intervention protocols. Choice C is incorrect as the model is centered around the value of occupations, not just specific intervention activities. Choice D is incorrect as the model is not primarily focused on addressing children's limitations in skills, but rather on the significance of engaging in meaningful activities.

2. The healthcare provider is planning care for a patient receiving morphine sulfate via a patient-controlled analgesia pump. Which intervention may be required due to a potential adverse effect of this drug?

• A. Administering a cough suppressant
• B. Inserting a Foley catheter
• C. Administering an anti-diarrheal
• D. Monitoring urinary output

Correct answer: B

Rationale: Morphine can lead to urinary retention and urinary hesitancy. If a patient shows signs of bladder distention or inability to void, the healthcare provider should be notified, and urinary catheterization may be necessary. Administering a cough suppressant or an anti-diarrheal is not typically required to address adverse effects of morphine. Liver function tests (LFTs) are not directly related to the potential adverse effects of morphine on the urinary system.

3. A 6-year-old child with daytime enuresis complains of dysuria and urgency. What does the nurse recognize these signs and symptoms indicate?

• A. Urinary tract infection
• B. Nephrotic syndrome
• C. Acute glomerulonephritis
• D. Vesicoureteral reflux

Correct answer: A

Rationale: The signs and symptoms of dysuria and urgency in a child with daytime enuresis typically indicate a urinary tract infection (UTI). These symptoms, along with urinary frequency and pain during urination, are common manifestations of a UTI in children. Nephrotic syndrome is characterized by edema, proteinuria, hypoalbuminemia, and hyperlipidemia, rather than dysuria and urgency. Acute glomerulonephritis presents with hematuria, proteinuria, hypertension, and oliguria, not dysuria and urgency. Vesicoureteral reflux can lead to recurrent UTIs but does not directly cause dysuria and urgency.

4. Which parental statement indicates correct understanding of preventive techniques for heat-related illnesses when children exercise?

• A. Wearing dark clothing during exercise is not recommended.
• B. Water is the preferred fluid for fluid replenishment.
• C. During activity, stopping for fluids every 15 to 20 minutes is essential.
• D. Hydration should be maintained throughout the exercise session.

Correct answer: C

Rationale: The correct preventive technique for heat-related illnesses during exercise is to stop for fluids every 15 to 20 minutes to prevent dehydration and maintain hydration levels. This practice helps regulate body temperature and prevent heat-related complications. Choice A is incorrect as wearing light-colored, loose-fitting clothing is recommended to reflect sunlight and allow better air circulation. Choice B is incorrect as while water is important, a sports drink containing electrolytes may be more beneficial for longer exercise sessions. Choice D is incorrect as it does not emphasize the importance of regular fluid intake during exercise to prevent dehydration.

5. Which statement best reflects a top-down approach to the evaluation process?

• A. OT focuses on evaluating the child's poor performance in hand skills
• B. OT conducts an assessment to determine a motor age for fine motor and gross motor skills
• C. OT initiates by interviewing the family about routines, interests, and daily habits
• D. OT starts by assessing muscle tone, postural control, and range of motion

Correct answer: C

Rationale: A top-down evaluation approach in occupational therapy begins with understanding the child's daily life, family routines, interests, and habits to ensure that the therapy provided is relevant and meaningful within the child's natural environment. By initiating the evaluation process with family interviews to gather contextual information, the occupational therapist gains a comprehensive view of the child's life, which allows for a more holistic and client-centered approach. Choice A focuses solely on the child's poor performance in hand skills, which is more characteristic of a bottom-up approach. Choice B mentions determining a motor age, which is not necessarily aligned with a top-down assessment. Choice D emphasizes physical assessments like muscle tone and range of motion, which are important but do not capture the essence of a top-down approach that considers the child's environment and routines.

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