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. When teaching a parent of a child with contact dermatitis, which instruction should the nurse include?

• A. Apply a thick layer of antibiotic ointment to the affected area.
• B. Rub the skin vigorously with a towel to dry it.
• C. Keep the child's skin dry.
• D. Apply a thin layer of corticosteroid cream to the affected area.

Correct answer: D

Rationale: The correct instruction for a child with contact dermatitis is to apply a thin layer of corticosteroid cream to the affected area. Corticosteroid cream helps reduce inflammation and itching associated with contact dermatitis. It is important to avoid using antibiotic ointment or rubbing the skin vigorously, as these can worsen the condition. Keeping the child's skin dry is generally a good practice, but in the case of contact dermatitis, corticosteroid cream application is more beneficial.

3. Which statement best describes the use of activity or task analysis?

• A. A foundational tool in occupational therapy for over a century
• B. A technique used to evaluate motor deficits in pediatrics
• C. Recently applied in some areas of pediatric occupational therapy
• D. A tool used exclusively by occupational therapy practitioners

Correct answer: A

Rationale: The correct answer is A: 'A foundational tool in occupational therapy for over a century.' Activity or task analysis has been a fundamental method in occupational therapy for a long time. It involves breaking down activities or tasks into smaller components to understand the skills required and identify areas of difficulty. This process helps occupational therapists develop effective intervention strategies to improve a client's ability to perform daily activities independently. Choices B, C, and D are incorrect because activity or task analysis is not limited to evaluating motor deficits in pediatrics, recently applied only in some areas of pediatric occupational therapy, or exclusively used by occupational therapy practitioners. It is a widely used and established method in the field of occupational therapy.

4. A healthcare provider is assessing an infant who has hydrocephalus and is 6 hours postoperative following placement of a ventriculoperitoneal shunt. Which of the following findings should the provider report to the healthcare provider?

• A. Decreased urine output
• B. Temperature of 37.5 degrees C (99.5 degrees F)
• C. Heart rate 130/min
• D. Leakage of cerebrospinal fluid

Correct answer: D

Rationale: The provider should report the leakage of cerebrospinal fluid to the healthcare provider as it may indicate shunt malfunction or infection, requiring immediate attention to prevent complications. Decreased urine output, a temperature of 37.5 degrees C, and a heart rate of 130/min are common postoperative findings and may not be directly related to shunt function. While these findings should still be monitored, they do not require immediate reporting like cerebrospinal fluid leakage.

5. A patient with Parkinson’s disease who takes levodopa/carbidopa (Sinemet) comes to the clinic for a semi-annual physical examination. Which question is the most important for that nurse to ask?

• A. Have you noticed any swelling in your feet?
• B. Are you having vivid dreams or hallucination?
• C. Have you noticed any changes in your stool?
• D. Have you had your flu vaccine?

Correct answer: B

Rationale: Patients taking levodopa/carbidopa (Sinemet) are at increased risk for the psychiatric side effects of levodopa, including visual hallucinations, vivid dreams, nightmares, and paranoid ideation. The other questions are not directly related to problems that are likely to occur with this drug.

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