Nursing Elites

1. A child is being treated for dehydration with intravenous fluids. The child currently weighs 13 kg and is estimated to have lost 7% of his normal body weight. The nurse is double-checking the IV rate the healthcare provider prescribed. The formula the healthcare provider used was for maintenance fluids: 1000 mL for 10 kg of body weight plus 50 mL for every kilogram over 10 for 24 hours. Replacement fluid is the percentage of lost body weight × 10 per kg of body weight. According to the calculation for maintenance plus replacement fluid, which hourly IV rate will the nurse implement for 24 hours?

• A. 88 mL/hr
• B. 86 mL/hr
• C. 81 mL/hr
• D. 83 mL/hr

Correct answer: B

Rationale: For 13 kg, the maintenance fluid is 1150 mL (1000 mL for first 10 kg + 3*50 mL for the remaining 3 kg). Replacement fluid is 910 mL (0.07 * 13000 mL). Total fluid is 2060 mL, divided by 24 hours is 86 mL/hr.

2. 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.

3. 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.

4. 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.

5. Which is NOT one of the functions of challenging behaviors?

• A. Avoiding a situation
• B. Escaping from an undesired object or event
• C. to make others happy
• D. Sensory functions

Correct answer: C

Rationale: Challenging behaviors often serve functions related to avoiding, escaping, obtaining, or sensory needs. The question is asking for the function that does not typically apply to challenging behaviors. Choices A, B, C, and D align with the common functions associated with challenging behaviors. Therefore, 'E' is the correct answer as it does not represent a typical function of challenging behaviors.

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