Nursing Elites

1. A nurse is planning care for a school-age child who has thrombocytopenia. Which of the following interventions should the nurse include in the plan?

• A. Administer aspirin as needed for fever.
• B. Avoid venipunctures whenever possible.
• C. Encourage the child to participate in contact sports.
• D. Administer ibuprofen for pain.

Correct answer: B

Rationale: The correct answer is B: 'Avoid venipunctures whenever possible.' Thrombocytopenia is a condition characterized by a low platelet count, which can lead to an increased risk of bleeding. Venipunctures can cause bleeding in these patients; therefore, they should be avoided whenever possible. Choice A is incorrect because aspirin should be avoided in patients with thrombocytopenia as it can further increase the risk of bleeding due to its antiplatelet effects. Choice C is incorrect because participating in contact sports can also increase the risk of injury and bleeding in a child with thrombocytopenia. Choice D is incorrect as ibuprofen, like aspirin, can also increase the risk of bleeding and should be avoided in these patients.

2. The nurse is reviewing the prescriber�s orders and notes that omeprazole has been order for a patient admitted with acute coronary syndrome (ACS). The nurse should be concerned if this medication is combined with which medication noted on the patient�s record.

• A. Aspirin 81mg daily
• B. Clopidogrel (Plavix) 75mg daily
• C. Heparin 5000 units subQ q12hrs
• D. Metoprolol 50mg q8hrs

Correct answer: B

Rationale: For patients who lack risk factors for GI bleeding, combined use of clopidogrel with a PPI, may reduce the effects of clopidogrel without offering any real benefits and thus should be avoided.

3. The caregiver is providing care to a pediatric client diagnosed with inflammatory bowel disease, who is prescribed daily prednisone. Which caregiver statement regarding administration of this drug indicates correct understanding of the teaching provided by the healthcare provider?

• A. I will administer this medication between meals.
• B. I will administer this medication at bedtime.
• C. I will administer this medication one hour before meals.
• D. I will administer this medication with meals.

Correct answer: D

Rationale: The correct answer is D. Prednisone should be administered with meals to reduce gastrointestinal upset. Taking prednisone with food helps to minimize stomach irritation and other gastrointestinal side effects associated with the medication.

4. Which frame of reference emphasizes techniques to teach children movement that resemble coaching?

• A. Motor control/motor learning
• B. Rehabilitation
• C. Biomechanical
• D. Ayres' sensory integration

Correct answer: A

Rationale: The correct frame of reference that emphasizes techniques to teach children movement resembling coaching is Motor control/motor learning. This approach focuses on improving movement skills through techniques that are similar to coaching methods. It helps children develop and refine their motor skills in a structured and goal-oriented manner. Rehabilitation, Biomechanical, and Ayres' sensory integration have different emphases and objectives in therapy, making them incorrect choices for this question.

5. Why should a healthcare professional take time to get to know the things a family does together, their weekly routine, and an explanation of family dynamics?

• A. Involvement in the family is central to best practice
• B. It is not necessary, but it is beneficial
• C. To gather demographic information for documentation purposes
• D. To assess if they have values that align with the practitioner's

Correct answer: A

Rationale: Understanding the activities, routines, and dynamics of a family is crucial for a healthcare professional to provide holistic care. By gaining insight into the family's lifestyle and relationships, the professional can tailor interventions that are better integrated into the family's daily life, fostering more effective therapy outcomes and enhancing the overall quality of care provided. Choice A is the correct answer because involvement in the family is indeed central to best practice in healthcare. Choices B, C, and D are incorrect because simply gathering demographic information, assessing values alignment, or considering it as optional fails to recognize the importance of understanding the family dynamics for effective care delivery.

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