Nursing Elites

1. How does an occupational therapist use clinical guidelines to inform practice with children and youth?

• A. Modify guidelines to fit the specific environment
• B. Establish systems to monitor outcomes
• C. Select the most recent guidelines without considering the client
• D. Consider guidelines that fit one's clientele and environment

Correct answer: C

Rationale: When using clinical guidelines to inform practice with children and youth, it is crucial for occupational therapists to not solely rely on the most recent guidelines but to consider the individual needs and contexts of each client. Selecting guidelines based solely on recency without considering the specific client can lead to ineffective or inappropriate interventions.

2. A nurse is providing discharge teaching to the parent of a child who has juvenile idiopathic arthritis. Which of the following statements should the nurse include?

• A. Encourage the child to sleep for 8 hours each night.
• B. Perform range-of-motion exercises once per week.
• C. Give your child NSAIDs on a regular schedule.
• D. Apply heat to the child's affected joints twice daily.

Correct answer: C

Rationale: The nurse should instruct the parent to give the child NSAIDs on a regular schedule to maintain therapeutic levels and control pain.

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 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.

5. A child with suspected bacterial meningitis is under the care of a nurse. Which action should the nurse prioritize?

• A. Administer antibiotics as prescribed.
• B. Maintain the child on NPO status.
• C. Monitor the child's intake and output.
• D. Implement seizure precautions.

Correct answer: D

Rationale: The priority action for a child with suspected bacterial meningitis is to implement seizure precautions. Meningitis can lead to increased intracranial pressure, which may trigger seizures. By implementing seizure precautions, such as padding the side rails of the bed and ensuring a clear environment, the nurse aims to prevent injury during a potential seizure episode, prioritizing the child's safety. Administering antibiotics as prescribed is essential in treating bacterial meningitis, but seizure precautions take precedence due to the immediate risk of injury. Maintaining NPO status and monitoring intake and output are important aspects of care but are not the priority when considering the risk of seizures.

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