Nursing Elites

1. What is functional behavior analysis?

• A. Systematic observation of behavior
• B. Standardized assessment
• C. Multiple choice examination
• D. Parent-teacher questionnaire

Correct answer: A

Rationale: Functional behavior analysis involves systematically observing behavior to understand its function and context. It focuses on identifying the antecedents and consequences that maintain or influence behavior. This systematic observation helps in determining patterns, triggers, and maintaining factors of behavior. Standardized assessments (choice B) involve using specific tools or tests to measure a person's performance or behavior but do not focus on observation. Multiple choice examinations (choice C) and parent-teacher questionnaires (choice D) are not synonymous with functional behavior analysis as they do not involve direct observation of behavior for analysis.

2. Which statement most reflects the observation that the infant sleeps soundly, awakens on his own, and maintains a quiet alert state?

• A. This is atypical behavior and should be addressed
• B. The infant should remain on high alert when awake
• C. This shows the infant is making neurological gains
• D. The family is disrupting the child's sleep patterns

Correct answer: C

Rationale: A quiet alert state in infants indicates positive neurological development. It showcases the infant's ability to regulate sleep-wake cycles and maintain an optimal state for learning and interaction. Therefore, observing an infant who sleeps soundly, awakens on his own, and stays in a quiet alert state is a reassuring sign of neurological gains and healthy development. Choice A is incorrect as it misinterprets normal behavior as atypical. Choice B is incorrect as it suggests the infant should be on high alert, which is not developmentally appropriate. Choice D is incorrect as it falsely blames the family for disrupting the child's sleep patterns, whereas the scenario described indicates positive neurological growth.

3. 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.

4. Which clinical manifestations should the nurse anticipate when assessing a child admitted to the hospital unit with a diagnosis of minimal change nephrotic syndrome (MCNS)?

• A. Massive proteinuria, hypoalbuminemia, and edema
• B. Hematuria, bacteriuria, and weight gain
• C. Decreased urine specific gravity and increased urinary output
• D. Gross hematuria, albuminuria, and fever

Correct answer: A

Rationale: Minimal change nephrotic syndrome (MCNS) is characterized by massive proteinuria, hypoalbuminemia, and edema. Proteinuria results from the loss of proteins, particularly albumin, in the urine, leading to hypoalbuminemia. The low oncotic pressure due to hypoalbuminemia causes fluid to shift into the interstitial spaces, resulting in edema. These clinical manifestations are classic signs of MCNS and help differentiate it from other renal conditions.

5. The healthcare provider discussed strategies with a parent to prevent a recurrence of urinary tract infection in the child. Which statement made by the parent indicates a need for further teaching?

• A. My daughter should wash and wipe the perineal area from front to back.
• B. I am only going to have my daughter wear cotton underwear.
• C. It is acceptable to take frequent bubble baths.
• D. She needs to drink lots of fluids and void frequently.

Correct answer: C

Rationale: The statement 'It is acceptable to take frequent bubble baths' indicates a need for further teaching. Oils in bubble bath and similar products can irritate the urethra, potentially leading to recurrent urinary tract infections. The other choices are correct: wiping from front to back helps prevent the spread of bacteria, wearing cotton underwear promotes breathability and reduces moisture, and drinking fluids and voiding frequently help flush out bacteria.

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