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. Which statement regarding the human papillomavirus vaccine (Gardasil) is true?

• A. Gardasil is administered in a two-dose series.
• B. Gardasil provides protection against chlamydia.
• C. Gardasil is recommended for males and females.
• D. Gardasil becomes effective after the first dose.

Correct answer: C

Rationale: Gardasil is recommended for both males and females to protect against HPV and related conditions such as genital warts and certain cancers. It is essential for both genders to receive the vaccine to prevent the spread of HPV and its associated health risks.

3. A neonate with a meningomyelocele is scheduled for surgery in the morning. Which nursing action is appropriate for this neonate?

• A. Applying a diaper to prevent contamination of the sac
• B. Positioning the newborn in a side-lying position
• C. Encouraging the mother to hold the newborn because she will not be able to pick him up after surgery
• D. Positioning the newborn in a prone position

Correct answer: D

Rationale: Positioning the newborn in a prone position is appropriate for a neonate with a meningomyelocele before surgery. Placing the newborn in this position helps prevent pressure on the sac, reducing the risk of damaging it and promoting optimal surgical outcomes. Applying a diaper (choice A) may not be recommended as it can increase pressure on the sac. Positioning the newborn in a side-lying position (choice B) or encouraging the mother to hold the newborn (choice C) are not ideal actions before surgery as they do not address the specific needs of a neonate with a meningomyelocele.

4. 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.

5. 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.

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