Nursing Elites

1. The client with cholecystitis is being instructed about dietary choices. Which meal best meets the dietary needs of this client?

• A. Steak, baked beans, and a salad
• B. Broiled fish, green beans, and an apple
• C. Pork chops, macaroni and cheese, and grapes
• D. Avocado salad, milk, and angel food cake

Correct answer: B

Rationale: Clients with cholecystitis, which is inflammation of the gallbladder, should follow a low-fat diet to reduce symptoms. Broiled fish, green beans, and an apple (Option B) is the most suitable choice as it is low in fat. Steak, baked beans, and a salad (Option A) provide a high amount of fat and protein, which may exacerbate symptoms of cholecystitis. Pork chops, macaroni and cheese, and grapes (Option C) and avocado salad, milk, and angel food cake (Option D) contain high-fat foods that are not recommended for individuals with cholecystitis. Therefore, Option B is the most appropriate choice for a client with cholecystitis.

2. A 16-month-old child has just been admitted to the hospital. As the nurse assigned to this child enters the hospital room for the first time, the toddler runs to the mother, clings to her, and begins to cry. What would be the initial action by the nurse?

• A. Arrange to change client care assignments.
• B. Explain that this behavior is expected.
• C. Discuss the appropriate use of 'time-out'.
• D. Explain that the child needs extra attention.

Correct answer: B

Rationale: The correct answer is to explain that this behavior is expected. During normal development, fear of strangers becomes prominent beginning around age 6-8 months. Such behaviors include clinging to parents, crying, and turning away from the stranger. These fears and behaviors extend into the toddler period and may persist into preschool. Changing client care assignments (Choice A) is not necessary as the child's behavior is developmentally appropriate. Discussing the appropriate use of 'time-out' (Choice C) is not relevant in this situation as the child is displaying normal attachment behavior, not misbehavior. Explaining that the child needs extra attention (Choice D) may not be necessary as the child is likely seeking comfort from the familiar presence of the mother, which is a typical response in a stressful situation like being in a hospital environment.

3. Which of the following is an example of passive aggression?

• A. Clenched fists
• B. Yelling
• C. Jealousy
• D. Intimidation

Correct answer: C

Rationale: Passive aggression involves expressing negative feelings indirectly, such as through subtle actions or behaviors. While choices A, B, and D involve more direct and aggressive expressions of anger, jealousy is an example of passive aggression where negative emotions are subtly displayed without openly confronting the issue. Jealousy can manifest as resentment, envy, or possessiveness, and is a common form of passive aggression in interpersonal relationships.

4. What initial treatment would the nurse expect for a preschool-aged child experiencing severe fear of the dark?

• A. Prescription medication
• B. Mental health counseling
• C. Cognitive behavioral therapy
• D. Repetition of brave statements

Correct answer: D

Rationale: Repetition of brave statements is an effective initial treatment for preschool-aged children with severe fear of the dark. This technique involves encouraging the child to repeat positive and reassuring statements to themselves to build confidence and reduce fear. Prescription medication is not typically the first-line approach for this type of fear in children due to potential side effects and safety concerns. Mental health counseling and cognitive behavioral therapy may be considered if the fear persists or is severe, but they are usually not the initial treatments for preschool-aged children with fear of the dark.

5. Which of the following actions is most appropriate when working with a client who is extremely angry?

• A. Place a light hand on the client's shoulder to convey understanding
• B. Maintain close proximity to build trust
• C. Temporarily change the subject if the client's behavior is escalating
• D. Close the door to the room to ensure privacy

Correct answer: C

Rationale: When dealing with an angry client, it is crucial to employ techniques that can help de-escalate the situation or ensure safety while providing care. If the client's behavior is escalating or they are fixating on a particular topic that is fueling their anger, it is advisable to temporarily change the subject. This technique can serve as a distraction from the initial trigger, allowing the client to refocus their thoughts and emotions. Placing a hand on the client's shoulder may not be well-received as physical touch can escalate the situation. Maintaining close proximity might be perceived as confrontational rather than building trust. Closing the door for privacy is important but may not directly address the client's anger or help in de-escalation.

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