Nursing Elites

1. Mary is excited to work with the family of a friend with whom she has lost contact. Mary hopes the family will be able to connect her with her friend and is looking forward to hearing about her friend. At the next session, she asks the mother many questions about her friend and they spend a lot of time discussing their home town, etc. Which statement describes this scenario?

• A. It is not therapeutic: The relationship serves no purpose
• B. It is therapeutic: Therapist, child, and family have a reciprocal caring relationship
• C. It is not therapeutic: Mary is benefiting, but not the child and family
• D. It is therapeutic: Both parties are benefiting in the relationship

Correct answer: C

Rationale: In this scenario, Mary's focus on her own needs and interests by asking the mother about her lost friend and hometown indicates a lack of therapeutic benefit for the child and family. Effective therapy should prioritize the needs and goals of the child and family, not the therapist's personal desires or connections. Therefore, this interaction is not therapeutic as it fails to address the primary purpose of the therapy, which is to benefit the child and family. Choice A is incorrect because while the relationship may not be therapeutic, it does serve a purpose for Mary. Choice B is incorrect as there is no indication of a reciprocal caring relationship in this scenario. Choice D is incorrect as the focus is primarily on Mary's personal interests, rather than mutual benefit in the therapeutic relationship.

2. Which is NOT one of the functions of challenging behaviors?

• A. Avoiding a situation
• B. Escaping from an undesired object or event
• C. to make others happy
• D. Sensory functions

Correct answer: C

Rationale: Challenging behaviors often serve functions related to avoiding, escaping, obtaining, or sensory needs. The question is asking for the function that does not typically apply to challenging behaviors. Choices A, B, C, and D align with the common functions associated with challenging behaviors. Therefore, 'E' is the correct answer as it does not represent a typical function of challenging behaviors.

3. When teaching a school-age child and the parent how to administer insulin, which of the following instructions should the nurse include?

• A. Store the insulin in the refrigerator after each use.
• B. Rotate injection sites each time you give the injection.
• C. You should give the insulin at room temperature.
• D. Administer the insulin within 30 minutes of each meal.

Correct answer: C

Rationale: It is essential to give insulin at room temperature to prevent discomfort during administration. Cold insulin can cause stinging and pain, which can be avoided by allowing the insulin to reach room temperature before administration. Storing insulin in the refrigerator is correct for long-term storage, but it should be brought to room temperature before use. Rotating injection sites is important to prevent lipohypertrophy, a condition characterized by fatty lumps that can develop if injections are consistently given in the same area. Administering insulin within 30 minutes of a meal is generally recommended to match the insulin peak action with the peak glucose levels after eating, but giving insulin at room temperature is more crucial to ensure comfort and proper absorption.

4. A healthcare professional is preparing to administer a vaccine to a child who has hemophilia. Which of the following actions should the healthcare professional take?

• A. Administer the vaccine subcutaneously
• B. Administer the vaccine intramuscularly
• C. Use a 1-inch needle
• D. Apply pressure to the site for 1 to 2 minutes

Correct answer: B

Rationale: Administering the vaccine intramuscularly to a child with hemophilia is preferred to reduce the risk of bleeding. Hemophiliac individuals have a decreased ability to form blood clots, and administering vaccines intramuscularly reduces the risk of bleeding compared to subcutaneous administration. Using an appropriate needle length and applying pressure to the site post-injection are important steps, but choosing the intramuscular route is crucial in this case to minimize bleeding complications.

5. A child is admitted to the hospital for hypercalcemia and is placed on diuretic therapy. Which diuretic would the nurse expect to administer?

• A. Furosemide (Lasix)
• B. Hydrochlorothiazide (Aquazide)
• C. Spironolactone (Aldactone)
• D. Mannitol (Osmitrol)

Correct answer: A

Rationale: Furosemide (Lasix) is a loop diuretic that acts on the ascending loop of Henle in the kidney to increase calcium excretion. In the setting of hypercalcemia, where there is an elevated level of calcium in the blood, Furosemide can help promote the elimination of excess calcium through the urine, thereby aiding in the management of hypercalcemia.

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