Nursing Elites

1. During a home care visit for an infant diagnosed with gastroesophageal reflux, which parental action observed requires intervention by the nurse?

• A. The infant's formula is mixed with rice cereal.
• B. The mother positions the infant in a high Fowler position while feeding.
• C. After feeding, the infant is placed in a car seat.
• D. The mother administers ranitidine (Zantac) to the infant using a syringe.

Correct answer: C

Rationale: Placing an infant diagnosed with gastroesophageal reflux in a car seat after feeding can increase the risk of reflux and aspiration. The semi-upright or high Fowler position is recommended to help reduce reflux symptoms during feeding. Adding rice cereal to formula can help thicken it and reduce reflux episodes. Administering ranitidine using a syringe is a common method of oral medication administration. Therefore, the action of placing the infant in a car seat after feeding is the one that requires intervention due to the increased risk it poses.

2. Why is it important to share information with the family about why you are asking certain things as you evaluate the child?

• A. It helps them to understand the role of occupational therapy
• B. It establishes your goals with the family up front
• C. It communicates your level of expertise to the family
• D. It allows them to understand your point of view

Correct answer: A

Rationale: Sharing information with the family about the reasons for your questions is crucial as it helps them comprehend the purpose and role of occupational therapy in the evaluation process. This transparency fosters trust, collaboration, and empowers families to actively engage in the therapy journey. Choice B is incorrect because while it is essential to establish goals with the family, the focus here is on sharing information about the evaluation process. Choice C is incorrect as the main purpose is not to showcase expertise but rather to involve the family in understanding the assessment. Choice D is incorrect as the primary goal is not for the family to understand your point of view, but rather the purpose of the evaluation within the occupational therapy context.

3. A patient is receiving glucocorticoids for the treatment of rheumatoid arthritis. The patient complains of having a headache. Which ordered medication should the nurse administer?

• A. Aspirin
• B. Acetaminophen
• C. Ibuprofen
• D. Naproxen Sodium (Aleve)

Correct answer: B

Rationale: When a patient is already receiving glucocorticoids for rheumatoid arthritis and complains of a headache, it is essential to consider the potential interactions and side effects of additional medications. Aspirin and NSAIDs like ibuprofen and naproxen sodium can increase the risk of gastrointestinal irritation and ulceration when used concurrently with glucocorticoids. Acetaminophen is a safer choice in this scenario for managing the patient's headache without exacerbating the gastrointestinal issues associated with the use of glucocorticoids. Acetaminophen does not have the same gastrointestinal side effects as aspirin, ibuprofen, or naproxen sodium, making it the most appropriate option for headache relief in this case.

4. A nurse is planning care to address nutritional needs for a preschooler with cystic fibrosis. Which interventions should the nurse include in plans?

• A. Administer pancreatic enzymes 2 hours after meals.
• B. Monitor and adjust the use of pancreatic enzymes if steatorrhea develops.
• C. Encourage adequate fluid intake based on the child's needs.
• D. Increase fat content in the child's diet to 40% of total calories.

Correct answer: D

Rationale: Increasing fat content in the diet is essential for meeting the high energy needs of a child with cystic fibrosis. Cystic fibrosis impairs the absorption of nutrients, particularly fats, so increasing the fat content in the child's diet to 40% of total calories helps ensure adequate caloric intake. This intervention can help maintain the child's nutritional status and support growth and development.

5. A 7-year-old child with acute glomerulonephritis has gross hematuria and has been confined to bed. What is the most appropriate nursing intervention for this child?

• A. Providing activities for the child on restricted activity
• B. Feeding the child a protein-restricted diet
• C. Carefully handling edematous extremities
• D. Observing the child for evidence of hypotension

Correct answer: A

Rationale: The most appropriate nursing intervention for a 7-year-old child with acute glomerulonephritis experiencing gross hematuria and bed rest is to provide activities for the child on restricted activity. It is important to keep the child engaged in light activities to prevent boredom and maintain some level of physical and mental well-being. Feeding a protein-restricted diet (Choice B) is not typically indicated in this scenario unless ordered by a healthcare provider to manage kidney function. Carefully handling edematous extremities (Choice C) is important in conditions like nephrotic syndrome but is not directly related to providing appropriate care for a child with acute glomerulonephritis. Observing the child for evidence of hypotension (Choice D) is important in general nursing care but is not the most immediate or specific intervention needed for a child with acute glomerulonephritis experiencing gross hematuria and bed rest.

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