Nursing Elites

1. A client asks a nurse, 'Do you think I should move back home after this procedure?' and the nurse responds by saying, 'Do you think you should move back home?' What type of therapeutic communication is the nurse representing?

• A. Observation
• B. Reflection
• C. Summarizing
• D. Validating

Correct answer: B

Rationale: The nurse is demonstrating the therapeutic communication technique of reflection. In this scenario, the nurse is redirecting the question back to the client, encouraging them to explore their thoughts and feelings about the situation. Reflection involves restating a statement or question in a way that prompts the client to consider their own answers, fostering self-awareness and insight. Observation involves stating facts, summarizing involves condensing information, and validating involves confirming the client's feelings or experiences, none of which are demonstrated in this interaction.

2. A physician is explaining a procedure to a patient that may cure her recurring Staph infection. The doctor explains how the procedure is done, what to expect, the odds of the procedure curing the infection, and possible side effects and risks. The physician is:

• A. Preparing the patient to give informed consent.
• B. Protecting HIPAA by listing all the steps of the procedure with the risks involved.
• C. Not required to inform the patient of any alternative therapies.
• D. None of the above.

Correct answer: A

Rationale: The correct answer is preparing the patient to give informed consent. Giving informed consent is the process of providing a patient with all necessary information about a medical procedure, including how it's done, what to expect, the likelihood of success, and potential risks and side effects. This allows the patient to make an informed decision about their treatment. Protecting HIPAA (Health Insurance Portability and Accountability Act) involves safeguarding patient health information and is not directly related to the scenario described. It is important for physicians to inform patients of any alternative therapies available to them to ensure they have all relevant information to make a decision regarding their treatment. Therefore, choice C, 'Not required to inform the patient of any alternative therapies,' is incorrect. Choice D, 'None of the above,' is incorrect as the physician is indeed preparing the patient for informed consent.

3. A nurse caring for a pediatric client shows little concern when the parents attempt to speak with her about their daughter's illness. When approached by the nurse manager about her behavior, the nurse responds by saying, 'I don't want to get involved. It doesn't matter what I do anyway; my work does not make much of a difference.' This nurse is exhibiting which of the following characteristics?

• A. Objectivity
• B. Depersonalization
• C. Procrastination
• D. Disruption

Correct answer: B

Rationale: The correct answer is 'Depersonalization.' A nurse who distances themselves from clients to avoid emotional involvement is displaying depersonalization. This behavior is often seen in nurses experiencing burnout due to stress. Depersonalization can stem from low morale, moral distress, and may serve as a defense mechanism to cope with stress and emotional exhaustion. It is a way to shield oneself from feeling overwhelmed by the burdens of caring for others. Choice A, 'Objectivity,' is incorrect because objectivity involves maintaining a neutral and unbiased perspective, which is not the case here. Choice C, 'Procrastination,' is incorrect as it refers to delaying tasks, not emotional distancing. Choice D, 'Disruption,' is irrelevant to the scenario described and does not align with the nurse's behavior of detachment and lack of concern.

4. You are caring for an infant who is just about 12 months old. Which assessment data is normal for the infant at this age?

• A. The infant had doubled their birth weight at twelve months.
• B. The infant had tripled their birth weight at twelve months.
• C. The mother reports that the infant is drinking 60 mLs per kilogram of its body weight.
• D. The infant had grown � inch since last month.

Correct answer: A

Rationale: The normal assessment data for the infant at 12 months of age is that the infant has doubled their birth weight at 12 months of age. The mother's reports that the infant is drinking 60 mLs per kilogram of its body weight and the fact that the infant had grown � inch since last month are not normal assessment data. Infants are fed breast milk or formula every two to four hours with a total daily intake of 80 to 100 mLs per kilogram of body weight. As the neonate grows, they gain five to seven ounces during the first six months and then they double their birth weight during the first year; the head circumference increases a half inch each month for six months and then two tenths of an inch until the infant is one year of age. Similarly, the height or length of the newborn increases an inch a month for the first 6 months and then 1/2 inch a month until the infant is 1 year of age.

5. A teacher brings a 5-year-old child to the school nurse because of a bruise under her eye. When asked about the bruise, the child responds, 'my daddy did it.' What is the nurse's initial action in this situation?

• A. Allow the child to return to class and monitor for future events that are suggestive of abuse
• B. Call the parent and request an explanation for the bruises
• C. Call the police and ask for a warrant for the parent's arrest
• D. Notify the school administrator

Correct answer: D

Rationale: In cases of suspected child abuse, the priority for the school nurse is to notify the school administrator immediately. The school administrator can then collaborate with the nurse to follow established protocols for reporting suspected abuse to the appropriate authorities. All suspicions or allegations of child abuse must be handled with sensitivity and in compliance with state laws and school policies. All other options, such as allowing the child to return to class without further action, directly contacting the parent, or involving the police without proper investigation, could potentially compromise the safety and well-being of the child and may not adhere to legal requirements for reporting suspected abuse.

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