Nursing Elites

1. Why is it important to share information with the family about why you are asking certain things as you evaluate the child?

• A. It helps them to understand the role of occupational therapy
• B. It establishes your goals with the family up front
• C. It communicates your level of expertise to the family
• D. It allows them to understand your point of view

Correct answer: A

Rationale: Sharing information with the family about the reasons for your questions is crucial as it helps them comprehend the purpose and role of occupational therapy in the evaluation process. This transparency fosters trust, collaboration, and empowers families to actively engage in the therapy journey. Choice B is incorrect because while it is essential to establish goals with the family, the focus here is on sharing information about the evaluation process. Choice C is incorrect as the main purpose is not to showcase expertise but rather to involve the family in understanding the assessment. Choice D is incorrect as the primary goal is not for the family to understand your point of view, but rather the purpose of the evaluation within the occupational therapy context.

2. 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.

3. A healthcare professional is planning care for an infant who has a colostomy. Which of the following actions should the healthcare professional take?

• A. Change the ostomy pouch every day.
• B. Use baby wipes to clean the stoma.
• C. Avoid using soap to clean the stoma.
• D. Apply barrier ointment to the skin around the stoma.

Correct answer: D

Rationale: When caring for an infant with a colostomy, it is essential to apply barrier ointment to the skin around the stoma. This helps in preventing skin breakdown and irritation caused by exposure to stool or urine. Changing the ostomy pouch as needed, using appropriate cleaning supplies such as warm water and mild soap (avoiding harsh chemicals like alcohol), and ensuring gentle cleaning of the stoma with a soft cloth or gauze are also important steps in colostomy care. Using baby wipes may not be recommended as they can contain chemicals that may irritate the sensitive skin around the stoma.

4. When teaching a parent of a child with hemophilia, which of the following instructions should the nurse include?

• A. Administer aspirin for pain.
• B. Avoid administering NSAIDs.
• C. Restrict physical activities.
• D. Apply heat to joints.

Correct answer: B

Rationale: The correct answer is B: 'Avoid administering NSAIDs.' Hemophilia is a condition where blood does not clot properly. NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) can increase the risk of bleeding in individuals with hemophilia. Therefore, it is crucial for the parent to avoid giving their child NSAIDs for pain management to prevent exacerbating bleeding tendencies. Choice A is incorrect because aspirin, like NSAIDs, can also increase the risk of bleeding. Choice C is incorrect because physical activities should not be restricted but rather managed to prevent injuries that could lead to bleeding. Choice D is incorrect because applying heat to joints can worsen bleeding in individuals with hemophilia.

5.

• A. Take medication on a full stomach
• B. Change positions slowly
• C. The drug may cause the urine to be very dilute
• D. Carbidopa has many adverse effects

Correct answer: B

Rationale: Postural hypotension is common early in treatment, so the patient should be instructed to change positions slowly. Administration with meals should be avoided, if possible, because food delays the absorption of the levodopa component. If the patient is experiencing side effects of nausea and vomiting, administration with food may be considered. The levodopa component may darken urine. Carbidopa has no adverse effects of its own.

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