Nursing Elites

1. A 9-month-old infant who is not sitting independently has been diagnosed with ataxic cerebral palsy (CP). Which clinical manifestations would the nurse expect to see in the baby?

• A. Hypotonia and muscle instability
• B. Hypertonia and persistence of primitive reflexes
• C. Tremors and exaggerated posturing
• D. Hemiplegia and hypertonia

Correct answer: A

Rationale: In ataxic cerebral palsy, the characteristic features include hypotonia (low muscle tone) and muscle instability. These manifestations contribute to the infant's difficulty in achieving independent sitting. Hypertonia (increased muscle tone) and persistence of primitive reflexes, as mentioned in option B, are more commonly associated with other types of cerebral palsy like spastic CP. Tremors and exaggerated posturing (option C) are not typical features of ataxic CP. Hemiplegia (paralysis of one side of the body) and hypertonia (increased muscle tone) mentioned in option D are more commonly seen in other types of cerebral palsy, such as spastic CP.

2. A healthcare provider is assessing a child with acute lymphocytic leukemia. Which of the following findings is the priority for the healthcare provider to report?

• A. Bruising
• B. Petechiae
• C. Elevated WBC count
• D. Elevated platelet count

Correct answer: B

Rationale: The priority finding to report for a child with acute lymphocytic leukemia is petechiae. Petechiae indicate a low platelet count, which increases the risk of bleeding. Therefore, the healthcare provider should promptly report petechiae to initiate appropriate interventions to prevent bleeding complications.

3. Which statement should the nurse include in the teaching plan for a patient being started on levodopa/carbidopa (Sinemet) for newly diagnosed Parkinson�s disease?

• 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.

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. During an assessment, an infant is suspected to have intussusception. Which of the following findings should the nurse expect?

• A. Currant jelly stools
• B. Projectile vomiting
• C. Scaphoid abdomen
• D. Frequent stools

Correct answer: A

Rationale: Intussusception is a condition where one segment of the intestine telescopes into another, causing obstruction. The classic presentation includes currant jelly stools, which are a mixture of blood and mucus due to the sloughing of the intestinal mucosa. This finding is a result of the compromised blood supply to the affected area and is a key characteristic associated with intussusception.

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