Nursing Elites

1. What is the priority nursing action when preparing a neonate born with a gastroschisis defect for transport to a pediatric hospital for corrective surgery?

• A. Covering the exposed intestines with sterile moist gauze
• B. Wrapping the newborn warmly in two or three blankets
• C. Providing sterile water feeding to maintain hydration during transport
• D. Allowing the parents of the newborn to see their child prior to transport

Correct answer: A

Rationale: The priority nursing action when preparing a neonate born with a gastroschisis defect for transport is to cover the exposed intestines with sterile moist gauze. This action helps prevent infection and keeps the tissue viable during transportation to the pediatric hospital for corrective surgery.

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. The caregiver is providing care to a pediatric client diagnosed with inflammatory bowel disease, who is prescribed daily prednisone. Which caregiver statement regarding administration of this drug indicates correct understanding of the teaching provided by the healthcare provider?

• A. I will administer this medication between meals.
• B. I will administer this medication at bedtime.
• C. I will administer this medication one hour before meals.
• D. I will administer this medication with meals.

Correct answer: D

Rationale: The correct answer is D. Prednisone should be administered with meals to reduce gastrointestinal upset. Taking prednisone with food helps to minimize stomach irritation and other gastrointestinal side effects associated with the medication.

4. What is the most important statement to include when teaching a patient who is prescribed metronidazole (Flagyl)?

• A. Take the medication with food.
• B. Avoid alcohol consumption.
• C. If you experience a metallic taste in your mouth, call your doctor.
• D. You can stop taking the medication once you feel better.

Correct answer: B

Rationale: The most crucial statement to include when teaching a patient prescribed metronidazole (Flagyl) is to avoid alcohol consumption. Mixing metronidazole and alcohol can lead to a disulfiram-like reaction, causing severe symptoms such as nausea, vomiting, and headache. Therefore, it is essential to emphasize to the patient the importance of abstaining from alcohol while taking this medication to prevent adverse reactions.

5. Which statement should the nurse include in the teaching plan for a patient being started on levodopa/carbidopa (Sinemet) for newly diagnosed Parkinson�s disease?

• A. Take medication on a full stomach
• B. Change positions slowly
• C. The drug may cause the urine to be very dilute
• D. Carbidopa has many adverse effects

Correct answer: B

Rationale: Postural hypotension is common early in treatment, so the patient should be instructed to change positions slowly. Administration with meals should be avoided, if possible, because food delays the absorption of the levodopa component. If the patient is experiencing side effects of nausea and vomiting, administration with food may be considered. The levodopa component may darken urine. Carbidopa has no adverse effects of its own.

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