Nursing Elites

1. The nurse is reviewing the home medication list with the patient. The nurse recognizes that hydrochlorothiazide is used primarily for which condition?

• A. Hypertension
• B. Edema
• C. Diabetes insipidus
• D. Protection against postmenopausal osteoporosis

Correct answer: A

Rationale: Hydrochlorothiazide is primarily indicated for hypertension (HTN). Thiazides like hydrochlorothiazide are commonly the first-line treatment for hypertension. While hydrochlorothiazide can be used for edema, diabetes insipidus, and postmenopausal osteoporosis to some extent, its main use and efficacy lie in managing hypertension.

2. Which statement best reflects a top-down approach to the evaluation process?

• A. OT focuses on evaluating the child's poor performance in hand skills
• B. OT conducts an assessment to determine a motor age for fine motor and gross motor skills
• C. OT initiates by interviewing the family about routines, interests, and daily habits
• D. OT starts by assessing muscle tone, postural control, and range of motion

Correct answer: C

Rationale: A top-down evaluation approach in occupational therapy begins with understanding the child's daily life, family routines, interests, and habits to ensure that the therapy provided is relevant and meaningful within the child's natural environment. By initiating the evaluation process with family interviews to gather contextual information, the occupational therapist gains a comprehensive view of the child's life, which allows for a more holistic and client-centered approach. Choice A focuses solely on the child's poor performance in hand skills, which is more characteristic of a bottom-up approach. Choice B mentions determining a motor age, which is not necessarily aligned with a top-down assessment. Choice D emphasizes physical assessments like muscle tone and range of motion, which are important but do not capture the essence of a top-down approach that considers the child's environment and routines.

3. A child has Wilms' tumor and is scheduled for surgery. Which of the following actions should the nurse include in the plan of care?

• A. Palpate the child's abdomen daily for tumor size.
• B. Reposition the child frequently.
• C. Prepare the child for chemotherapy.
• D. Avoid palpating the abdomen.

Correct answer: D

Rationale: Palpating the abdomen of a child with Wilms' tumor should be avoided to prevent the risk of rupturing the tumor and spreading cancer cells. This action is crucial to maintain the child's safety and prevent potential complications before surgery.

4. Which statement is true regarding playful children?

• A. They exhibit flexible problem-solving.
• B. They have low intelligence scores.
• C. They need clear rules and directions to succeed.
• D. They do not perform well in school.

Correct answer: A

Rationale: The correct statement is that playful children exhibit flexible problem-solving. Playful children often engage in creative and imaginative thinking, allowing them to approach problems in unique ways. This fosters better problem-solving abilities compared to those who may be more rigid in their thinking. Choice B is incorrect as there is no direct correlation between being playful and having low intelligence scores. Choice C is incorrect as playful children may thrive in environments that encourage creativity rather than rigid rules. Choice D is incorrect as being playful does not necessarily equate to poor academic performance.

5. The patient with bipolar disorder is being treated with lithium and has a new prescription for captopril for hypertension. The combination of these two drugs makes which assessment particularly important?

• A. Potassium level
• B. Lithium level
• C. Creatinine level
• D. Blood pressure

Correct answer: B

Rationale: When captopril, an ACE inhibitor, is combined with lithium, it can lead to lithium accumulation. Therefore, monitoring lithium levels is crucial to prevent toxicity. While ACE inhibitors like captopril can cause hyperkalemia, renal insufficiency, and hypotension, the risk of these effects is not increased by the combination of lithium and captopril.

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