Nursing Elites

1. A woman asks, "How much alcohol can I safely drink while pregnant?"? The nurse's best response is:

• A. "The amount of alcohol that is safe during pregnancy is unknown."?
• B. "Consuming one or two beers or glasses of wine a day is considered safe for a healthy pregnant woman."?
• C. "Drinking three or more drinks on any given occasion is the only harmful type of drinking during pregnancy."?
• D. "You can have a drink to help you relax and get to sleep at night."?

Correct answer: A

Rationale: The correct answer is, "The amount of alcohol that is safe during pregnancy is unknown."? This response is appropriate because there is no known safe amount of alcohol consumption during pregnancy. Consuming any amount of alcohol during pregnancy can pose risks to the developing fetus, leading to conditions like fetal alcohol syndrome, which is a combination of mental and physical abnormalities in infants. Choices B, C, and D are incorrect. Choice B suggests that consuming one or two drinks a day is safe during pregnancy, which is not supported by current medical guidelines. Choice C incorrectly states that only drinking three or more drinks on any given occasion is harmful, when in reality, any amount of alcohol can be harmful to the fetus. Choice D is inappropriate as it suggests that having a drink to relax and sleep is acceptable during pregnancy, which is not the case.

2. Using clich�s in therapeutic communication leads the client to:

• A. viewing the nurse as less understanding.
• B. accepting themselves as human.
• C. self-disclosing.
• D. feeling discounted.

Correct answer: D

Rationale: The use of clich�s in therapeutic communication is commonly construed by the client as the nurse's lack of understanding, involvement, and caring, which can lead the client to feel demeaned and discounted. Choice A is incorrect because clich�s do not make the client view the nurse as less understanding but rather as lacking depth in communication. Choice B is incorrect as clich�s do not directly lead the client to accepting themselves as human. Choice C is incorrect because clich�s usually hinder self-disclosure rather than encourage it.

3. When planning care of a client who has been diagnosed with Amphetamine Abuse, the nurse should use the knowledge that:

• A. Amphetamines increase energy by increasing dopamine levels at neural synapses.
• B. Amphetamines have a low risk of tolerance or addiction.
• C. Amphetamines produce a 10-20-second rush followed by a 2-4-hour high.
• D. Addiction to barbiturates and amphetamines is rare because they have opposite effects.

Correct answer: A

Rationale: The correct answer is that amphetamines increase energy by increasing dopamine levels at neural synapses. Amphetamines cause the release of norepinephrine and dopamine from storage vesicles into the synapse, leading to increased stimulation. It is important to note that clear patterns of tolerance and withdrawal have not been described with amphetamines. Choice B is incorrect as prolonged or excessive use of amphetamines can lead to psychosis, indicating a potential for addiction. Choice C is incorrect as the duration of the effects of amphetamines is typically longer than 2-4 hours. Choice D is incorrect as addiction to amphetamines is not rare; in fact, drug cravings are common and can lead to relapse, indicating a significant risk of addiction.

4. A client with schizophrenia says, 'I'm away for the day ... but don't think we should play "? or do we have feet of clay?' Which alteration in the client's speech does the nurse document?

• A. Neologism
• B. Word salad
• C. Clang association
• D. Associative looseness

Correct answer: D

Rationale: The correct answer is 'Associative looseness.' In the provided speech, the client shows associative looseness by making loose connections between phrases without a clear logical link. Clang association involves rhyming words without regard for their meaning. Neologism refers to made-up words with specific meaning to the client, and word salad is a jumble of words that lack coherence either to the listener or the client. Understanding these speech patterns associated with schizophrenia is crucial in identifying the specific alteration in speech displayed by the client in this scenario.

5. Which of the following roommates would be most suitable for the client with myasthenia gravis?

• A. A client with hypothyroidism
• B. A client with Crohn's disease
• C. A client with pyelonephritis
• D. A client with bronchitis

Correct answer: A

Rationale: The most suitable roommate for the client with myasthenia gravis is the client with hypothyroidism because they are quiet. A client with Crohn's disease (choice B) would be up to the bathroom frequently due to gastrointestinal issues, which could disturb the roommate with myasthenia gravis. A client with pyelonephritis (choice C) suffering from a kidney infection will need to urinate frequently, causing disturbances. A client with bronchitis (choice D) will be coughing, potentially disrupting the rest and quiet environment needed by a roommate with myasthenia gravis to manage their symptoms effectively.

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