Nursing Elites

1. A school-age child is 4 hours postoperative following perforated appendicitis repair. Which of the following actions should the nurse take?

• A. Maintain the child on a clear liquid diet for 48 hours.
• B. Administer antibiotics for 7 days.
• C. Apply warm compresses to the surgical site every 4 hours.
• D. Keep the child on NPO status for 24 hours.

Correct answer: B

Rationale: Administering antibiotics for 7 days is essential postoperatively to prevent infections and complications in a child who underwent perforated appendicitis repair. This helps in reducing the risk of secondary infections and promoting healing. Clear liquid diets, warm compresses, and prolonged fasting are not the primary interventions indicated in this scenario.

2. A caregiver is teaching a parent of a child with a new prescription for ferrous sulfate tablets. Which of the following instructions should the caregiver include in the teaching?

• A. Give the medication with milk.
• B. Take the medication on an empty stomach.
• C. Avoid giving the medication with orange juice.
• D. Brush the child's teeth after administration.

Correct answer: D

Rationale: It is important for the caregiver to instruct the parent to brush the child's teeth after administering ferrous sulfate to prevent staining of the teeth. Iron in ferrous sulfate can cause teeth discoloration, so brushing the child's teeth after taking the medication helps prevent this side effect.

3. How do activity observation and analysis support pediatric occupational therapy intervention?

• A. Grading is based on standard protocols for the specific activity.
• B. Preparatory activities are selected to efficiently build specific skills without the need for further design considerations.
• C. Activity synthesis integrates the results to identify alternate ways of performing activities.
• D. Usual modifications for the identified activity are implemented.

Correct answer: C

Rationale: Activity observation and analysis support pediatric occupational therapy intervention by synthesizing information obtained through observation to identify alternative methods of performing activities. This process assists in intervention planning by exploring different approaches to help children achieve their occupational therapy goals effectively.

4. A 4-year-old child is admitted to the hospital secondary to dehydration. Laboratory tests indicate a high hemoglobin and hematocrit, and the serum sodium is below normal levels. Which condition does the nurse suspect based on the current data?

• A. Hypernatremia
• B. Metabolic acidosis
• C. Hypotonic dehydration
• D. Isotonic dehydration

Correct answer: C

Rationale: The correct answer is hypotonic dehydration. The combination of high hemoglobin and hematocrit with low serum sodium indicates hypotonic dehydration. In this condition, there is an excess of solutes relative to water, leading to higher red blood cell concentration (elevated hemoglobin and hematocrit) and low serum sodium levels.

5. A healthcare professional is planning care for an infant with hyperbilirubinemia receiving phototherapy. Which of the following actions should the healthcare professional include in the plan?

• A. Dress the infant in light, breathable clothing.
• B. Turn and reposition the infant every 4 hours.
• C. Offer the infant frequent, small feedings.
• D. Avoid using lotions on the infant's skin.

Correct answer: B

Rationale: Turning and repositioning the infant every 4 hours is essential to prevent pressure sores and ensure uniform exposure to phototherapy. This practice helps prevent skin breakdown and ensures the effectiveness of the phototherapy in treating hyperbilirubinemia. Dressing the infant in light, breathable clothing (Choice A) is generally a good practice but not directly related to the effectiveness of phototherapy. Offering frequent, small feedings (Choice C) is important for infant nutrition but does not directly impact the phototherapy. Avoiding lotions on the infant's skin (Choice D) is recommended to prevent interference with the phototherapy but is not the most critical action to include in the care plan.

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