Nursing Elites

1. 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.

2. A healthcare provider at an urgent care clinic is assessing an adolescent client who has an upper respiratory tract infection. Which of the following findings should the provider recognize as a manifestation of pertussis?

• A. Inflamed throat with exudate
• B. Purulent eye drainage
• C. Dry, hacking cough
• D. Koplik spots on buccal mucosa

Correct answer: C

Rationale: The correct answer is C: 'Dry, hacking cough.' A dry, hacking cough is a classic manifestation of pertussis. Pertussis typically presents with symptoms of an upper respiratory tract infection, starting with a persistent, severe, and uncontrollable cough that can worsen at night. This cough is often followed by a high-pitched 'whoop' sound as the patient tries to catch their breath, hence the term 'whooping cough.' In contrast, options A, B, and D are not typically associated with pertussis. Inflamed throat with exudate may suggest a bacterial throat infection like streptococcal pharyngitis, purulent eye drainage is more indicative of a bacterial conjunctivitis, and Koplik spots on the buccal mucosa are specific to measles. Therefore, recognizing the dry, hacking cough as a manifestation of pertussis is crucial for early identification and appropriate management of the disease.

3. A nurse is caring for a school-age child with primary nephrotic syndrome who is taking prednisone. After 1 week of treatment, which manifestation indicates to the nurse that the medication is effective?

• A. Decreased edema
• B. Increased abdominal girth
• C. Decreased appetite
• D. Increased protein in the urine

Correct answer: A

Rationale: In a child with nephrotic syndrome, the presence of edema is due to fluid retention caused by protein loss in the urine. Prednisone, a corticosteroid, helps reduce inflammation and decrease the loss of protein in the urine, leading to a decrease in edema. Therefore, decreased edema is an indication that the prednisone treatment is effective in managing the nephrotic syndrome. Increased abdominal girth would indicate fluid retention and worsening of the condition. Decreased appetite is a nonspecific symptom and not a direct indicator of prednisone efficacy. Increased protein in the urine would indicate ongoing renal impairment and the ineffectiveness of the treatment.

4. A healthcare provider is planning care for a child with hyperkalemia. Which manifestation associated with the documented hyperkalemia requires immediate intervention by the healthcare provider?

• A. Hyperthermia
• B. Respiratory distress
• C. Seizures
• D. Cardiac arrhythmias

Correct answer: D

Rationale: In hyperkalemia, cardiac arrhythmias are the most critical and life-threatening manifestation that requires immediate intervention. Hyperkalemia can lead to dangerous heart rhythm disturbances, potentially resulting in cardiac arrest. Prompt treatment is essential to stabilize the heart rhythm and prevent life-threatening complications. Hyperthermia, respiratory distress, and seizures are not typically associated with hyperkalemia and should be addressed, but cardiac arrhythmias pose the most urgent risk to the patient's life.

5. The patient taking spironolactone (Aldactone) makes a statement indicating effective teaching. Which statement shows understanding of the teaching?

• A. I will use salt substitutes to lower my sodium intake
• B. I will increase my intake of foods that are high in potassium
• C. I will call my doctor if I begin having menstrual irregularities
• D. I will take this medication at bedtime each evening

Correct answer: C

Rationale: The correct answer is C because spironolactone is a potassium-sparing diuretic that can cause endocrine effects like menstrual irregularities. Therefore, the patient recognizing the need to report such changes indicates effective teaching. Choices A and B are incorrect as salt substitutes and high-potassium foods should be avoided with spironolactone. Choice D is also incorrect because diuretics, including spironolactone, are ideally taken in the morning to prevent disturbances in sleep due to nocturia.

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