Nursing Elites

1. 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.

2. A nurse is providing dietary teaching to the parent of a school-age child with cystic fibrosis. Which of the following statements should the nurse make?

• A. You should offer your child high-protein meals and snacks throughout the day
• B. Your child should decrease dietary fats to less than 10% of their caloric intake
• C. Your child will need to take a 1-gram sodium chloride tablet daily throughout their lifetime
• D. You should calculate your child's carbohydrate needs based on their daily activities

Correct answer: A

Rationale: The parent should provide a well-balanced diet that is high in protein and calories for a child with cystic fibrosis. This diet helps meet the child's increased energy requirements. Offering high-protein meals and snacks throughout the day is essential to ensure adequate nutrition and energy intake for children with cystic fibrosis. Choices B, C, and D are incorrect because children with cystic fibrosis actually need a higher fat intake for proper absorption of fat-soluble vitamins, sodium chloride supplementation is not a general recommendation for all children with cystic fibrosis, and carbohydrate needs are usually based on maintaining adequate weight and growth rather than daily activities.

3. 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.

4. When caring for a child with hyponatremia, a nurse delegates care to a licensed vocational nurse (LVN) and instructs the LVN to promptly report which clinical manifestation?

• A. Seizures
• B. Respiratory distress
• C. Hyperthermia
• D. Bradycardia

Correct answer: A

Rationale: Seizures are a significant concern in severe hyponatremia as they indicate potential neurological complications and the need for urgent intervention to prevent further harm to the child. Prompt reporting of seizures allows for timely assessment and appropriate treatment to ensure the child's safety and well-being.

5. A nurse is planning care to address nutritional needs for a preschooler with cystic fibrosis. Which interventions should the nurse include in plans?

• A. Administer pancreatic enzymes 2 hours after meals.
• B. Monitor and adjust the use of pancreatic enzymes if steatorrhea develops.
• C. Encourage adequate fluid intake based on the child's needs.
• D. Increase fat content in the child's diet to 40% of total calories.

Correct answer: D

Rationale: Increasing fat content in the diet is essential for meeting the high energy needs of a child with cystic fibrosis. Cystic fibrosis impairs the absorption of nutrients, particularly fats, so increasing the fat content in the child's diet to 40% of total calories helps ensure adequate caloric intake. This intervention can help maintain the child's nutritional status and support growth and development.

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