Nursing Elites

1. A child receives a vaccine for MMR. Six hours after the injection, the child’s parent reports local soreness, erythema, lethargy, and a fever of 101°F to a nurse. Which action should the nurse take?

• A. Give instructions on relieving symptoms with acetaminophen
• B. Seek emergency help, because these symptoms are signs of anaphylactic reaction
• C. Tell the parent that a live vaccine will cause a mild case of measles
• D. Obtain and fill out a Vaccine Adverse Event Report form

Correct answer: A

Rationale: Low-grade fever, malaise, and muscle aches are common reactions. Acetaminophen usually alleviates these problems. MMR is a live vaccine but it is attenuated or completely avirulent and does not cause measles in healthy children, only immunocompromised children.

2. The nurse is unsuccessful in inserting a nasogastric tube for a newborn client. The nurse suspects the newborn has esophageal atresia/tracheoesophageal (EA/TE) fistula. Which nursing action is appropriate while waiting for the healthcare provider to further assess the neonate?

• A. Position the newborn in a semi-Fowler position.
• B. Allow the newborn to stay in the nursery for observation.
• C. Offer the newborn pacifier for comfort.
• D. Wrap the newborn in blankets and place in an incubator.

Correct answer: A

Rationale: Positioning the newborn in a semi-Fowler position is appropriate as it helps prevent aspiration in suspected EA/TE fistula. This position helps reduce the risk of regurgitation and aspiration of gastric contents. Placing the newborn in a semi-Fowler position promotes the drainage of secretions and reduces the risk of complications while awaiting further assessment by the healthcare provider.

3. Difficulties with eating, sleeping, playing, repetitive or difficult behaviors, and paying attention may all be caused in part by which of the following?

• A. Cognitive delays
• B. Lack of motivation for mastery
• C. Sensory processing challenges
• D. Imitation deficits

Correct answer: C

Rationale: Sensory processing challenges can affect various aspects of a child's daily life, including eating, sleeping, playing, behavior, and attention. These challenges can lead to difficulties in processing sensory information, which may manifest in different behaviors and impact their overall functioning.

4. 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.

5. A parent of a child with celiac disease is receiving teaching from a nurse. Which of the following statements should the nurse make?

• A. You should give your child vitamin supplements that contain iron.
• B. Your child will need a gluten-free diet.
• C. Your child should consume large amounts of dietary fiber.
• D. Your child can resume eating whole wheat bread.

Correct answer: B

Rationale: The correct answer is B. Celiac disease requires a strict gluten-free diet to manage the condition effectively. Gluten-containing foods like wheat, barley, and rye must be avoided to prevent intestinal damage and symptoms in individuals with celiac disease. Therefore, the nurse should emphasize the importance of a gluten-free diet to the parent of the child with celiac disease.

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