Nursing Elites

1. A healthcare professional is planning care for an infant who has a colostomy. Which of the following actions should the healthcare professional take?

• A. Change the ostomy pouch every day.
• B. Use baby wipes to clean the stoma.
• C. Avoid using soap to clean the stoma.
• D. Apply barrier ointment to the skin around the stoma.

Correct answer: D

Rationale: When caring for an infant with a colostomy, it is essential to apply barrier ointment to the skin around the stoma. This helps in preventing skin breakdown and irritation caused by exposure to stool or urine. Changing the ostomy pouch as needed, using appropriate cleaning supplies such as warm water and mild soap (avoiding harsh chemicals like alcohol), and ensuring gentle cleaning of the stoma with a soft cloth or gauze are also important steps in colostomy care. Using baby wipes may not be recommended as they can contain chemicals that may irritate the sensitive skin around the stoma.

2. A nurse is caring for a school-age child with primary nephrotic syndrome who is taking prednisone. After 1 week of treatment, which manifestation indicates to the nurse that the medication is effective?

• A. Decreased edema
• B. Increased abdominal girth
• C. Decreased appetite
• D. Increased protein in the urine

Correct answer: A

Rationale: In a child with nephrotic syndrome, the presence of edema is due to fluid retention caused by protein loss in the urine. Prednisone, a corticosteroid, helps reduce inflammation and decrease the loss of protein in the urine, leading to a decrease in edema. Therefore, decreased edema is an indication that the prednisone treatment is effective in managing the nephrotic syndrome. Increased abdominal girth would indicate fluid retention and worsening of the condition. Decreased appetite is a nonspecific symptom and not a direct indicator of prednisone efficacy. Increased protein in the urine would indicate ongoing renal impairment and the ineffectiveness of the treatment.

3. While caring for four different pediatric clients, which child is at the highest risk for dehydration?

• A. 7-year-old child with migraine headaches
• B. 4-year-old child with a broken arm
• C. 2-year-old child with cellulitis of the left leg
• D. 18-month-old child with tachypnea

Correct answer: D

Rationale: The 18-month-old child with tachypnea is at the highest risk for dehydration due to increased insensible water loss associated with rapid breathing.

4. Which of the following is not a model centered on occupation?

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

Correct answer: C

Rationale: The correct answer is C, the Biomechanical model. This model focuses on the physical aspects of performance rather than occupation. The Canadian Model of Occupational Performance and Engagement, Person-Environment-Occupation-Participation, and Model of Human Occupation are all occupation-centered models used in occupational therapy. The Biomechanical model is more focused on the physical aspects of movement and performance rather than the broader concept of occupation.

5. Prior to hydrotherapy treatment for wound debridement following a burn injury, which of the following actions should be taken?

• A. Apply topical antimicrobial ointment to the child's wound
• B. Place a mesh gauze dressing over the child's wound
• C. Administer an analgesic to the child
• D. Initiate prophylactic antibiotic therapy for the child

Correct answer: C

Rationale: Corrected Rationale: Prior to hydrotherapy for wound debridement, it is crucial to administer an analgesic to the preschooler. The procedure is known to be extremely painful, and providing analgesia or sedation is essential to manage the discomfort and pain experienced by the child during the treatment. Choice A is incorrect because applying topical antimicrobial ointment is not a pre-procedural requirement but rather a post-procedure wound care step. Choice B is incorrect as placing a mesh gauze dressing does not address the pain management aspect. Choice D is also incorrect as prophylactic antibiotic therapy is not the primary intervention needed before hydrotherapy for wound debridement.

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