Nursing Elites

1. The therapist engages a teen in a game of cards to improve his hand skills for schoolwork. Which statement best reflects this session?

• A. Playfulness as an approach
• B. Play as an occupation
• C. Play as a tool
• D. Play as a reward

Correct answer: C

Rationale: The correct answer is 'Play as a tool.' In this session, the therapist is using play as a tool to integrate therapeutic goals into a playful activity, which helps engage the teen and improve specific skills, in this case, hand skills for schoolwork.

2. 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.

3. A nurse is providing discharge teaching to the parent of a school-age child who has moderate persistent asthma. Which of the following instructions should the nurse include?

• A. You should give your child his salmeterol inhaler every 4 hours when he is having an acute episode of wheezing.
• B. You should monitor your child's weight weekly while he is receiving inhaled corticosteroid therapy.
• C. Pulmonary function tests will be performed every 12 to 24 months to evaluate how your child is responding to therapy.
• D. When using the peak expiratory flow meter, record your child's average of three readings.

Correct answer: C

Rationale: The nurse should inform the parent that the child will need pulmonary function tests every 12 to 24 months to assess lung function and response to treatment. These tests help evaluate the presence of lung disease, monitor disease progression, and assess the effectiveness of the current therapeutic regimen in managing asthma. Choice A is incorrect as salmeterol is not used for acute wheezing episodes but rather for long-term maintenance. Choice B is incorrect because weight monitoring is not directly related to inhaled corticosteroid therapy for asthma. Choice D is incorrect as peak expiratory flow meter readings should be recorded as instructed, not averaged.

4. What type of mode best describes Kasey's approach when meeting with the principal to change the cafeteria to better accommodate her client with difficulty eating in a noisy and distracting environment?

• A. Collaborating
• B. Instructing
• C. Advocating
• D. Encouraging

Correct answer: C

Rationale: Advocating best describes Kasey's approach in this scenario. Advocating involves presenting stories, research, and ideas to support and champion for a specific cause or individual, in this case, advocating for changes to better meet the child's needs in the cafeteria. Collaborating involves working together with others towards a common goal, instructing involves providing guidance or directions, and encouraging involves giving support or motivation, none of which fully capture Kasey's proactive and supportive advocacy actions in this context.

5. An 80-year-old patient with a history of renal insufficiency was recently started on cimetidine. Which assessment finding indicates that the patient may be experiencing an adverse effect of the medication?

• A. Pain with urination
• B. New onset disorientation to time and place
• C. HR changes from a baseline of 70-80bpm to 110-120bpm
• D. #ERROR!

Correct answer: B

Rationale: The correct answer is B: New onset disorientation to time and place. Cimetidine can cause adverse effects on the CNS system, especially in elderly patients with renal or hepatic impairment. This may manifest as confusion, hallucinations, lethargy, restlessness, or seizures. Pain with urination (choice A) is not typically associated with cimetidine use, and HR changes (choice C) are more likely related to other factors. Choice D is not a valid option.

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