Nursing Elites

1. A 12-year-old male is brought to his primary care provider to determine whether sexual abuse has occurred. The mother states, 'Because there is no permanent physical damage, he does not need any more treatment.' The nurse's response should be based on which of the following pieces of information?

• A. Male victims of sexual abuse can have long-term psychological problems.
• B. Survivors of male sexual abuse might become confused about their sexual identity.
• C. Unless treated, all male sex abuse survivors grow up to abuse other children.
• D. All children who have been sexually abused have the same needs, regardless of gender.

Correct answer: B

Rationale: Male children are sexually abused nearly as often as female children. Perpetrators are usually men but can be women. Needs of male children who have been sexually abused might be different from the needs of female survivors. Male survivors might respond in anger, question their sexuality, use alcohol and other drugs, and might try to prove their masculinity by performing daring acts. It is crucial for the nurse to consider these potential outcomes, making choice B the correct answer. Choice A is incorrect because male victims of sexual abuse can indeed have long-term psychological problems, so the nurse should be aware of this issue. Choice C is incorrect as not all male sex abuse survivors grow up to abuse other children, which is a misconception. Choice D is incorrect because the needs of children who have been sexually abused can vary based on various factors, including gender, so it is important to consider individual differences.

2. In which age group does the highest incidence of child abuse occur?

• A. Birth-3 years old
• B. 4-6 years old
• C. 6-10 years old
• D. More than 10 years old

Correct answer: A

Rationale: The correct answer is 'Birth-3 years old.' Children between birth and 3 years of age have the highest rates of victimization (at 16 per 1,000 children). This age group is most vulnerable due to their dependency and inability to report or protect themselves effectively. Child abuse can occur at any age, but statistics show that infants and toddlers are at the highest risk due to their developmental stage and reliance on caregivers. Choices B, C, and D are incorrect because while child abuse can happen at any age, the prevalence is highest among children in the 0-3 age group.

3. What is the primary goal of family education?

• A. symptom reduction
• B. improved quality of life
• C. increased knowledge about mental illness
• D. improved caregiving skills

Correct answer: B

Rationale: The primary goal of family education is to improve the quality of life. Family education aims to enhance the overall well-being and functioning of both the individual with the condition and their family members. While increased knowledge about mental illness may be a beneficial outcome, it is not the primary objective of family education. Symptom reduction is more commonly associated with psychoeducation rather than family education. Improving caregiving skills is a component of family education, but the primary focus is on improving the quality of life for everyone involved in the caregiving process.

4. A complication of total parenteral nutrition (TPN) is the development of cholestasis. What is this condition?

• A. an inflammatory process of the extrahepatic bile ducts
• B. an arrest of the normal flow of bile
• C. an inflammation of the gallbladder
• D. the formation of gallstones

Correct answer: B

Rationale: Cholestasis due to TPN administration is an intrahepatic process that interrupts the normal flow of bile. It is characterized by a reduction or stoppage of bile flow. Choice A, an inflammatory process of the extrahepatic bile ducts, refers to cholangitis, not cholestasis. Choice C, an inflammation of the gallbladder, describes cholecystitis, a different condition. Choice D, the formation of gallstones, is not correct as cholestasis is about the flow of bile, not the formation of gallstones.

5. A client with acute leukemia develops a low white blood cell count. In addition to the institution of isolation, the nurse should:

• A. Request that foods be provided in sealed single-serving packages
• B. Ask the client to wear a mask when visitors are present
• C. Prep IV sites with mild soap and water and alcohol
• D. Provide foods in sealed single-serving packages

Correct answer: D

Rationale: For a client with acute leukemia and a low white blood cell count, preventing exposure to food contaminants is crucial due to immune suppression. Providing foods in sealed single-serving packages helps reduce the risk of contamination. Choice B is incorrect as it introduces the potential of infection from visitors. Choice A, suggesting disposable utensils, is not as effective as sealed containers in preventing food contamination. Choice C, using alcohol for prepping IV sites, is less suitable due to its drying effect and potential for skin breakdown, making sealed packages a better option for food safety.

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