Nursing Elites

1. A 57-year-old woman is recently widowed. She states, 'I will never be able to learn how to manage the finances. My husband did all of that.' Select the nurse's response that could help raise the client's self-esteem.

• A. "You feel inadequate because you have never learned to balance a checkbook."?
• B. "You should have insisted your husband teach you about the finances."?
• C. "You are strong and will learn how to manage your finances after a while."?
• D. "Why don't you take a class in basic finance from the local college?"?

Correct answer: C

Rationale: The nurse can raise the client's self-esteem by acknowledging the client's feelings and providing positive reinforcement. Choice C shows empathy and support by recognizing the client's strength and potential to learn. This response encourages the client to believe in her abilities and instills confidence. Choices A and B may come across as judgmental or critical, which can further lower the client's self-esteem. Choice D, while offering a solution, does not address the client's emotional needs or provide direct reassurance about her capabilities.

2. Upon arrival at the emergency room, the client presents with severe burns to the left arm, hands, face, and neck. What action should take priority?

• A. Starting an IV
• B. Applying oxygen
• C. Obtaining blood gases
• D. Medicating the client for pain

Correct answer: B

Rationale: In a client with severe burns to the face and neck, airway assessment and supplemental oxygen are crucial. Therefore, applying oxygen is the priority to ensure adequate oxygenation for the client. This intervention takes precedence over other actions to stabilize the client's condition. Starting an IV for fluid resuscitation is the next appropriate step following ensuring oxygenation (Choice A). While pain management is important, it is a secondary priority after ensuring oxygenation and fluid resuscitation, making medicating the client for pain a later intervention (Choice D). Obtaining blood gases (Choice C) is not the immediate priority in this scenario and would typically be ordered by the healthcare provider based on the client's condition and response to initial interventions.

3. When assisting a client in gaining insight into anxiety, what should the nurse do?

• A. Help the client relate anxiety to specific triggers.
• B. Ask the client to describe events that precede increased anxiety.
• C. Instruct the client to practice relaxation techniques.
• D. Confront the client's resistive behavior.

Correct answer: B

Rationale: To assist a client in gaining insight into anxiety, it is crucial to identify triggers or events that lead to increased anxiety. This approach helps the client recognize causal factors contributing to their anxiety, promoting self-awareness and understanding. Choice A is incorrect because it should focus on triggers rather than specific behaviors. Choice C is incorrect as it emphasizes managing anxiety through relaxation techniques rather than understanding its roots. Choice D is incorrect as it addresses resistive behavior rather than exploring the causes of anxiety.

4. During the history assessment of an 80-year-old client, which statement made by the client might indicate a possible fluid and electrolyte imbalance?

• A. "My skin is always so dry."?
• B. "I often use a laxative for constipation."?
• C. "I have always liked to drink a lot of iced tea."?
• D. "I sometimes have a problem with dribbling urine."?

Correct answer: B

Rationale: The correct answer is "I often use a laxative for constipation." Frequent use of laxatives can lead to diarrhea and electrolyte loss, indicating a possible fluid and electrolyte imbalance. Statements A, C, and D are not directly related to fluid and electrolyte imbalance. Statement A about dry skin may suggest dehydration, but it is less specific to electrolyte imbalance than the frequent use of laxatives. Statement C about drinking a lot of iced tea could potentially relate to fluid intake, but it doesn't directly indicate an imbalance. Statement D about dribbling urine is more indicative of a potential urinary issue rather than a fluid and electrolyte imbalance.

5. 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.

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