Nursing Elites

1. Following a child's return from exploratory surgery due to a gunshot wound to the abdomen, which nursing intervention should be excluded from the plan of care?

• A. Immediate initiation of oral feedings
• B. Assessment of the surgical site
• C. Administration of opioid narcotics for pain management
• D. Visitation at the bedside

Correct answer: A

Rationale: Immediate initiation of oral feedings should be excluded from the plan of care post-abdominal surgery due to the risk of bowel complications like paralytic ileus or anastomotic leak. Starting oral feedings immediately can increase these risks and hinder healing. It is crucial to wait until bowel function returns and the patient shows signs of tolerance before introducing oral feedings. Assessment of the surgical site is necessary to monitor for any signs of infection or complications. Administration of opioid narcotics for pain management is essential for ensuring the patient's comfort post-surgery. Visitation at the bedside provides emotional support and can aid in the patient's recovery. Therefore, the correct answer is to exclude immediate initiation of oral feedings.

2. A 6-year-old child with daytime enuresis complains of dysuria and urgency. What does the nurse recognize these signs and symptoms indicate?

• A. Urinary tract infection
• B. Nephrotic syndrome
• C. Acute glomerulonephritis
• D. Vesicoureteral reflux

Correct answer: A

Rationale: The signs and symptoms of dysuria and urgency in a child with daytime enuresis typically indicate a urinary tract infection (UTI). These symptoms, along with urinary frequency and pain during urination, are common manifestations of a UTI in children. Nephrotic syndrome is characterized by edema, proteinuria, hypoalbuminemia, and hyperlipidemia, rather than dysuria and urgency. Acute glomerulonephritis presents with hematuria, proteinuria, hypertension, and oliguria, not dysuria and urgency. Vesicoureteral reflux can lead to recurrent UTIs but does not directly cause dysuria and urgency.

3. The healthcare provider should question an order for glucocorticoids in the treatment of a patient with what condition?

• A. Systemic fungal infection
• B. Diabetes Mellitus
• C. Myasthenia Gravis
• D. Glaucoma

Correct answer: A

Rationale: Glucocorticoids are contraindicated in the treatment of a patient with systemic fungal infection or in patients receiving live vaccines due to their immunosuppressive effects. Glucocorticoids can exacerbate fungal infections by suppressing the immune response. While caution is advised in patients with diabetes mellitus, myasthenia gravis, and glaucoma, the presence of a systemic fungal infection warrants questioning the use of glucocorticoids to prevent worsening of the fungal infection.

4. Which statement fosters cultural competence?

• A. Treat everyone the same regardless of their culture
• B. Provide an outline of your beliefs as a starting point
• C. Acknowledge and respond to influences of cultural beliefs in the intervention plan
• D. Ask the family to outline how their beliefs will influence therapy

Correct answer: C

Rationale: Cultural competence involves recognizing and considering the impact of cultural beliefs on individuals. By acknowledging and responding to these cultural influences in the intervention plan, professionals can tailor their approach effectively and respectfully. This approach helps build trust, enhances communication, and improves outcomes in culturally diverse settings.

5. Which model of practice emphasizes the child's subjective experience of their abilities?

• A. Occupational Adaptation
• B. Model of Human Occupation
• C. Person-Environment-Occupation-Performance Model
• D. Canadian Model of Occupational Performance and Engagement

Correct answer: B

Rationale: The Model of Human Occupation (MOHO) emphasizes the child's subjective experience of their abilities, focusing on their motivation, roles, habits, and routines. It considers how these factors influence their occupational performance. MOHO helps occupational therapists understand how a child's perceptions of their abilities impact their engagement in meaningful activities and occupations.

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