Nursing Elites

1. What side effect should the nurse include in the parent teaching for a child prescribed a baclofen pump for cerebral palsy?

• A. Diarrhea
• B. Hypertonia
• C. Hypotonia
• D. Restlessness

Correct answer: C

Rationale: When a child is prescribed a baclofen pump for cerebral palsy, one of the common side effects to include in parent teaching is hypotonia. Baclofen, a muscle relaxant, can lead to decreased muscle tone, resulting in hypotonia. It is important for parents to be aware of this potential side effect and know how to respond accordingly.

2. The patient taking warfarin for prevention of deep vein thrombosis has an INR of 1.2. Which action by the nurse is most appropriate?

• A. Administer IV push protamine sulfate
• B. Continue with the current prescription.
• C. Prepare to administer Vitamin K
• D. Call healthcare provider to increase the dose

Correct answer: D

Rationale: An INR level of 1.2 is below the therapeutic range (2-3) for warfarin therapy. Therefore, the nurse should contact the healthcare provider to discuss the need for an increased dose to achieve the desired therapeutic range and prevent deep vein thrombosis effectively. Administering IV push protamine sulfate is used to reverse the effects of heparin, not warfarin. Continuing with the current prescription without addressing the subtherapeutic INR level may not effectively prevent deep vein thrombosis. Administering Vitamin K is indicated for warfarin overdose leading to excessive anticoagulation, not for a subtherapeutic INR level that is below the target range.

3. When educating a parent of a child with HIV, which statement indicates an understanding of the teaching?

• A. I will notify my child's school about their condition.
• B. I will give my child the prescribed antiretroviral medication at regular intervals.
• C. I will expect my child to receive yearly immunizations.
• D. I will bring my child in for yearly skin testing.

Correct answer: B

Rationale: The correct answer is B because ensuring the child receives the prescribed antiretroviral medication at regular intervals is crucial in maintaining therapeutic levels and preventing drug resistance in a child with HIV. Choices A, C, and D are incorrect because notifying the school about the condition, expecting yearly immunizations, and bringing the child in for yearly skin testing do not directly address the essential aspect of medication adherence, which is fundamental in managing HIV in children.

4. Which of the following is not a model centered on occupation?

• A. Canadian Model of Occupational Performance and Engagement
• B. Person-Environment-Occupation-Participation
• C. Biomechanical
• D. Model of Human Occupation

Correct answer: C

Rationale: The correct answer is C, the Biomechanical model. This model focuses on the physical aspects of performance rather than occupation. The Canadian Model of Occupational Performance and Engagement, Person-Environment-Occupation-Participation, and Model of Human Occupation are all occupation-centered models used in occupational therapy. The Biomechanical model is more focused on the physical aspects of movement and performance rather than the broader concept of occupation.

5. A patient taking sildenafil (Viagra) asks a nurse what action to take if priapism occurs. Which response should the nurse provide?

• A. Take an additional half-strength dose of sildenafil
• B. The condition usually resolves in 12 hours or less
• C. Wait until the following day and notify the doctor
• D. Seek emergency help, because permanent damage can occur

Correct answer: D

Rationale: Patients experiencing priapism from sildenafil should seek immediate medical attention. Priapism is a serious condition where an erection lasts longer than 4 hours, and if left untreated, it can lead to irreversible damage to the penile tissue, potentially causing permanent erectile dysfunction. Therefore, prompt intervention is crucial to prevent long-term complications.

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