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. While auscultating the lungs of an adolescent with asthma, what should the nurse identify the sound as?

• A. Biots respiration
• B. Chaney-Stokes respiration
• C. Tachypnea
• D. Bradypnea

Correct answer: C

Rationale: The nurse should identify the sound heard during auscultation as tachypnea, which is characterized by a rapid, regular breathing pattern. In the case of an adolescent with asthma, tachypnea can be indicative of increased work of breathing due to airway constriction and inflammation. Biots respiration (choice A) is characterized by an irregular pattern of breathing with periods of apnea. Chaney-Stokes respiration (choice B) is a pattern of breathing characterized by alternating periods of deep, rapid breathing followed by periods of apnea. Bradypnea (choice D) refers to an abnormally slow breathing rate, which is not typically associated with asthma exacerbation.

3. As a result of opioid administration, a child's respirations are slow and shallow. Which should the nurse anticipate when assessing the child's arterial blood gas?

• A. Increased PCO2 and respiratory acidosis
• B. Decreased PCO2 and respiratory alkalosis
• C. Low pH and low PCO2
• D. High pH and high PCO2

Correct answer: A

Rationale: When a child's respirations are slow and shallow due to opioid administration, it results in hypoventilation. This leads to retaining carbon dioxide, indicated by an increased PCO2 level on arterial blood gas analysis, and subsequently causes respiratory acidosis due to the buildup of CO2 in the blood. Therefore, choice A, 'Increased PCO2 and respiratory acidosis,' is the correct answer. Choices B, C, and D are incorrect because slow and shallow respirations would not lead to decreased PCO2 or respiratory alkalosis (choice B), low pH and low PCO2 (choice C), or high pH and high PCO2 (choice D).

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. What is an initial sign of nephrosis that the nurse might note in a child?

• A. Raspberry-like rash
• B. Periorbital edema
• C. Temperature elevation
• D. Abdominal pain

Correct answer: B

Rationale: In nephrotic syndrome, edema is a common symptom that is generalized and not easily noticeable, even by parents. However, an early sign that can be assessed by the nurse is periorbital edema, which refers to swelling around the eyes. This can be an initial indicator of nephrosis and may prompt further evaluation and intervention.

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