Nursing Elites

1. A patient taking isotretinoin (Accutane) for acne vulgaris. Which statement indicates that the patient teaching has been effective?

• A. I should use a reliable form of birth control.
• B. I will stop taking the drug if my skin is dry.
• C. It is important to increase intake of vitamin A.
• D. I do not need to use sunblock while taking Accutane.

Correct answer: A

Rationale: The correct answer is A. Isotretinoin is highly teratogenic, which means it can cause birth defects. Therefore, it is crucial for patients, especially females of childbearing potential, to use effective forms of birth control to prevent pregnancy while taking this medication. This is a key component of patient teaching to ensure the safe use of isotretinoin. Choice B is incorrect because discontinuing isotretinoin abruptly can lead to a flare-up of acne. Choice C is incorrect because increasing vitamin A intake can be harmful due to the risk of hypervitaminosis A. Choice D is incorrect because isotretinoin makes the skin more sensitive to sunlight, so sunblock is essential to prevent sunburn and skin damage.

2. What is the next food texture after 'soft and bite-sized pieces of meltable and soft-solid foods'?

• A. Regular
• B. Liquidized
• C. Puréed
• D. Minced and Moist

Correct answer: A

Rationale: After mastering soft and bite-sized pieces, children typically progress to regular table foods.

3. When teaching parents of a school-aged child with a new diagnosis of osteomyelitis of the tibia, which statement by the parents indicates an understanding of the teaching?

• A. My child will have a cast until healing is complete.
• B. My child will receive antibiotics for several weeks.
• C. My child can return to playing sports once he is discharged.
• D. My child needs to be in contact isolation.

Correct answer: B

Rationale: The correct answer is B. Osteomyelitis of the tibia typically requires antibiotic therapy for at least 4 weeks. Surgery may be necessary if the infection does not respond to antibiotics. Weight-bearing should be avoided with osteomyelitis to prevent complications. Choices A, C, and D are incorrect because a cast until healing, returning to sports immediately, and contact isolation are not primary management strategies for osteomyelitis.

4. How do models of practice help therapists engage in sound therapeutic reasoning?

• A. They provide structure to guide thinking
• B. They address theory but not practice
• C. They predict the outcome of intervention
• D. They examine physical characteristics of the child

Correct answer: A

Rationale: Models of practice help therapists engage in sound therapeutic reasoning by providing a structured framework to guide their thinking process. These models offer a systematic approach that assists therapists in organizing their thoughts and decision-making processes during therapy sessions. By following a specific model, therapists can ensure they consider all relevant factors and make informed therapeutic choices, leading to effective interventions and better outcomes for their clients.

5. The healthcare provider is caring for a 9-month-old infant who just returned from the postanesthesia care unit (PACU) after a shunt placement for hydrocephalus. Which healthcare provider prescription should the nurse question?

• A. Vital signs and neurologic checks hourly
• B. Small, frequent formula feedings
• C. Elevate the head of the bed
• D. Daily head circumference measurements

Correct answer: C

Rationale: Elevating the head of the bed in a child with hydrocephalus can potentially increase intracranial pressure. This can be counterproductive and may lead to complications after shunt placement surgery. Keeping the head of the bed flat or slightly elevated is often recommended to optimize cerebral perfusion and reduce the risk of increased intracranial pressure.

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