Nursing Elites

1. A client had a first-trimester abortion and has been unable to function for 3 months. Which type of grief is the client experiencing?

• A. Complex bereavement
• B. Anticipatory
• C. Disenfranchised
• D. Complicated

Correct answer: C

Rationale: The client is experiencing disenfranchised grief. Disenfranchised grief refers to grief over a loss that is not socially recognized or acknowledged. In this case, grief after an abortion falls into this category. It can lead to prolonged emotional distress as the loss may not be openly acknowledged or supported by others. Complex bereavement is characterized by dysfunctional grieving that extends beyond 12 months. Anticipatory grief occurs when the loss is expected or predictable, allowing individuals to start the grieving process before the actual loss. Complicated grief is marked by an inability to progress through the grief stages, leading to intense feelings of depression, anger, and emptiness, often coupled with a preoccupation with the deceased.

2. Which defense mechanism is considered a conscious measure used to cope with anxiety?

• A. Undoing
• B. Projection
• C. Suppression
• D. Intellectualization

Correct answer: C

Rationale: The correct answer is Suppression. Suppression is a conscious defense mechanism in which an individual intentionally avoids thinking about disturbing problems, wishes, feelings, or experiences. It is a way to cope with anxiety by actively pushing aside unwanted thoughts or emotions. Undoing, on the other hand, is an unconscious defense mechanism where one uses words or behaviors to symbolically make amends for unacceptable thoughts or actions. Projection is also an unconscious defense mechanism involving falsely attributing one's own unacceptable impulses to others. Intellectualization, another unconscious defense mechanism, involves using intellect or thinking to avoid dealing with emotionally charged feelings.

3. Which instruction should the nurse provide to a preschool-age client to prevent altered growth and development?

• A. Trust
• B. Empathy
• C. Impulse control
• D. Problem-solving

Correct answer: C

Rationale: Teaching a preschool-age child and their parents about the importance of impulse control is essential to prevent the risk of altered growth and development. Preschool-age children are at a stage where they are developing self-regulation skills, so teaching them to manage their impulses can help in their overall growth and development. Trust is a critical concept taught during infancy to foster secure attachments. Empathy is crucial for parents of toddlers to understand their child's emotions. Problem-solving skills are typically emphasized for school-age children to enhance cognitive development.

4. A female client with frequent urinary tract infections (UTIs) asks the nurse to explain her friend's advice about drinking a glass of juice daily to prevent future UTIs. Which response is best for the nurse to provide?

• A. Orange juice has vitamin C that deters bacterial growth.
• B. Apple juice is the most useful in acidifying the urine.
• C. Cranberry juice stops pathogens' adherence to the bladder.
• D. Grapefruit juice increases absorption of most antibiotics.

Correct answer: C

Rationale: The correct answer is 'Cranberry juice stops pathogens' adherence to the bladder.' Cranberry juice maintains urinary tract health by reducing the adherence of Escherichia coli bacteria to cells within the bladder. This helps prevent UTIs. Options A, B, and D are incorrect because orange juice with vitamin C, apple juice for urine acidification, and grapefruit juice for antibiotic absorption do not have the same proven effectiveness in preventing UTIs as cranberry juice does.

5. Which approach would the healthcare provider use when managing the care of a client diagnosed with generalized anxiety disorder (GAD)?

• A. Creating an anxiety-free environment for the client
• B. Assisting the client with the development of healthy, adaptive coping mechanisms
• C. Avoiding triggers that produce anxiety in the client
• D. Providing reinforcement that the client's anxiety issues can be eliminated

Correct answer: B

Rationale: The healthcare provider would assist the client with the development of healthy, adaptive coping mechanisms. GAD is characterized by the maladaptive use of worrying as a coping mechanism. The ultimate goal is for the healthcare provider to help the client replace the ineffective worrying with effective, healthy coping mechanisms. Creating an anxiety-free environment is not feasible or recommended; the goal is to help the client learn to deal with anxiety in a healthy manner. While identifying triggers is important, avoiding all triggers that produce anxiety is often impractical. Providing reinforcement that anxiety issues can be eliminated is not appropriate as anxiety is a normal human experience that needs to be managed effectively rather than eliminated completely.

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