Nursing Elites

1. The patient is receiving a heparin infusion for the treatment of pulmonary embolism. Which assessment finding is most likely related to an adverse effect of heparin?

• A. HR of 60 bpm
• B. BP of 160/88
• C. Discolored urine
• D. Inspiratory wheezing

Correct answer: C

Rationale: The primary and most serious adverse effect of heparin is bleeding. However, discolored urine can indicate bleeding into the urinary tract, which is a potential adverse effect of heparin therapy. While changes in heart rate (HR) and blood pressure (BP) can occur due to various reasons, discolored urine specifically points towards a potential adverse effect related to heparin therapy.

2. Which urinalysis result should the nurse anticipate for a child admitted with acute glomerulonephritis?

• A. Bacteriuria and increased specific gravity
• B. Hematuria and proteinuria
• C. Proteinuria and decreased specific gravity
• D. Bacteriuria and hematuria

Correct answer: B

Rationale: In acute glomerulonephritis, the glomeruli become inflamed, leading to the leakage of red blood cells (hematuria) and proteins (proteinuria) into the urine. These are hallmark findings in this condition due to the damage to the glomerular filtration barrier. Bacteriuria, the presence of bacteria in the urine, is not typically associated with acute glomerulonephritis unless there is a concurrent urinary tract infection. Specific gravity may be normal or decreased due to the loss of proteins in the urine, rather than increased. Therefore, the correct anticipated urinalysis result for a child with acute glomerulonephritis is hematuria and proteinuria.

3. Which menu choices for a child diagnosed with renal failure and experiencing hyperkalemia indicate the need for further instruction by the nurse?

• A. Carrots and green, leafy vegetables
• B. Spaghetti and meat sauce with breadsticks
• C. Hamburger on a bun and cherry gelatin
• D. Chips, cold cuts, and canned foods

Correct answer: A

Rationale: Carrots and green, leafy vegetables are high in potassium, which should be avoided in hyperkalemia. Therefore, this choice requires further instruction by the nurse to prevent exacerbating the child's condition.

4. A 6-year-old child with daytime enuresis complains of dysuria and urgency. What does the nurse recognize these signs and symptoms indicate?

• A. Urinary tract infection
• B. Nephrotic syndrome
• C. Acute glomerulonephritis
• D. Vesicoureteral reflux

Correct answer: A

Rationale: The signs and symptoms of dysuria and urgency in a child with daytime enuresis typically indicate a urinary tract infection (UTI). These symptoms, along with urinary frequency and pain during urination, are common manifestations of a UTI in children. Nephrotic syndrome is characterized by edema, proteinuria, hypoalbuminemia, and hyperlipidemia, rather than dysuria and urgency. Acute glomerulonephritis presents with hematuria, proteinuria, hypertension, and oliguria, not dysuria and urgency. Vesicoureteral reflux can lead to recurrent UTIs but does not directly cause dysuria and urgency.

5. 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.

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