Nursing Elites

1. A 52-year-old woman is preparing to have her father move into her home after his discharge from the hospital. Which of the following subjects should the discharge planning nurse prioritize when preparing the woman for her new caregiving role?

• A. The availability and scope of community resources
• B. The importance of her own self-care and techniques for maximizing it
• C. Assertiveness training to ensure she can set limits
• D. Management of finances

Correct answer: B

Rationale: The correct answer is B. It is crucial for the discharge planning nurse to prioritize the importance of the woman's self-care and provide techniques for maximizing it. When taking on a caregiving role, the caregiver's well-being is essential to ensure effective care for the patient. While community resources (choice A) are important, the immediate focus should be on self-care. Assertiveness training (choice C) and financial management (choice D) are also significant but not as critical as self-care for the caregiver in this scenario.

2. A nurse is reading a journal article about life expectancy and various cultural groups. The article describes statistics, stating that a baby born to a black American couple has a life expectancy lower than that of a baby born to a white American couple. The article goes on to describe the life expectancy as the babies get older. Which finding would the nurse most likely identify as reflecting the life expectancy of the baby born to the black American couple by the seventh decade?

• A. Beginning to equal that of similarly aged white elders
• B. Exceeding that of similarly aged white older adults
• C. Dropping to less than half that of similarly aged white older adults
• D. Rising above that of white older adults until age 75 and then dropping

Correct answer: A

Rationale: Historically, black Americans have experienced a lower standard of living and less access to health care than their white counterparts, leading to a lower life expectancy. However, by the seventh decade of life, survival rates for black individuals begin to equal that of similarly aged white individuals. Choice B is incorrect as it indicates a higher life expectancy for black individuals, which is not supported by the information provided. Choice C is incorrect as it suggests a drastic decrease in life expectancy for black individuals, which is not in line with the trend described. Choice D is incorrect as it implies a temporary increase in life expectancy for black individuals until age 75, which is not supported by the information that survival rates begin to equal by the seventh decade.

3. How might the nursing home's social worker help Ms. O's friends in visiting her?

• A. The social worker should defer to the nursing staff
• B. Help her friends find easier transportation
• C. Tell her to make friends at the dialysis center
• D. Ask other residents' families to bring her friends with them

Correct answer: B

Rationale: The correct answer is B. Ms. O's friends, who are elderly and cannot drive, ride buses to visit her. The social worker can help by finding easier transportation options for them. Not having family around, friends' visits can significantly impact Ms. O's well-being. It may be challenging for the friends to ask for help themselves, so the social worker can reach out to volunteer groups for assistance. Making friends at the dialysis center might not be feasible due to the nature of treatments. Asking other residents' families to bring her friends could burden them further and might deter them from helping. It's important to consider the friends' convenience and emotional support for Ms. O.

4. During a family meeting that the nurse organized during an older adult's discharge planning from the hospital, there is visible animosity between the son and daughter of the patient. What should the nurse's initial response be to the apparent family dysfunction?

• A. Teach the patient's children alternative methods of interaction.
• B. Encourage the family to choose one spokesperson to represent all the children.
• C. Organize separate meetings with the son and with the daughter.
• D. Assess the family history and the nature of the son and daughter's relationship.

Correct answer: D

Rationale: The correct initial response for the nurse in this situation is to assess the family history and the nature of the son and daughter's relationship. By gathering data and identifying factors contributing to the dysfunction, the nurse can better understand the underlying issues and dynamics at play. Teaching alternative methods of interaction (Choice A) may not address the root cause of the animosity. Encouraging one spokesperson for the family (Choice B) may overlook individual concerns. Organizing separate meetings (Choice C) may not provide a holistic view of the family dynamics and may not address the issues affecting the family unit as a whole. Therefore, assessing the family history and relationship dynamics is essential for effective intervention and resolution of the family dysfunction.

5. Which of the following statements most accurately captures an aspect of contemporary family caregiving in the United States?

• A. Women typically spend more time caring for aging parents than they did for their own children.
• B. The most common pattern of care involves an older man providing in-home care for his wife.
• C. The majority of care is now provided by public and private agencies rather than family members.
• D. A residential or institutional environment is now the most common venue for caregiving.

Correct answer: A

Rationale: The correct answer is A. Today, on average, women spend more time providing care for their aging parents than they did for their own children. While some men provide care for their wives, it is not the most common pattern. Family members, rather than public or private agencies, still provide the majority of care in a non-institutional environment, making option C incorrect. Also, caregiving in a residential or institutional environment is not the most common venue, thus choice D is inaccurate.

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