Nursing Elites

1. A client undergoing presurgical testing before a total abdominal hysterectomy says to the nurse, 'After I have this surgery I know my husband will never come near me again.' Which response would the nurse give?

• A. You're underestimating how your husband will respond to your surgery.
• B. You're concerned about the effect on your sexual relations.
• C. You're worried that the surgery will change how others see you.
• D. You're concerned about how your husband will respond to your surgery.

Correct answer: D

Rationale: The correct response acknowledges the client's expressed concern about her husband's reaction to the surgery, encouraging further discussion without imposing the nurse's assumptions. Choice A reframes the client's concern to focus on the husband's response, aligning more closely with the client's stated worry. Choice B makes an assumption about the client's concerns regarding sexual relations, which may not be the primary focus of her statement. Choice C shifts the attention to how others perceive the client, deviating from the client's specific reference to her husband's reaction, thus not addressing the client's main concern.

2. 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.

3. A client has just died, and their son states, 'She was the most wonderful mother. There was no one who was a better mother than she was. She was perfect.' Which stage of grief is this son experiencing?

• A. Denial
• B. Anger
• C. Idealization
• D. Shock

Correct answer: C

Rationale: The son is experiencing the idealization stage of grief. During this stage, individuals tend to idealize the deceased person and remember them in a highly positive light, overlooking any negative aspects. This idealization serves as a coping mechanism to deal with the loss. Choice A, Denial, is incorrect as denial involves refusing to accept the reality of the loss. Choice B, Anger, is incorrect as it involves feelings of resentment and frustration. Choice D, Shock, is incorrect as shock is the initial reaction to the loss and is different from idealizing the deceased individual.

4. A female client who is undergoing infertility testing is taught how to examine her cervical mucus. After listening to the instructions, the client says, 'That sounds gross. I don't think I can do it.' Which conclusion would the nurse make from this statement?

• A. The client is unduly fastidious.
• B. The client feels that having a baby is not that important.
• C. The client may be uncomfortable with performing manual examination of the genitals.
• D. The client is afraid that she is the cause of the infertility.

Correct answer: C

Rationale: The client's statement expressing discomfort with the procedure indicates a potential unease with performing a manual examination of her genitals. It is not uncommon for individuals to feel uncomfortable or anxious about such intimate procedures. The nurse should explore this further with the client to address any concerns or fears. The option stating that the client is unduly fastidious lacks evidence and is not supported by the client's statement. The assumption that the client does not value having a baby is not warranted based on the given statement. While self-blame is a common emotional response in cases of infertility, the client's statement does not directly suggest this as the primary concern in this scenario.

5. A client injured in a motor vehicle accident was brought to the emergency department and taken immediately for a scan. The client's family arrives and asks about the client's condition. Which response would the nurse provide?

• A. Please do not worry; everything will be all right.
• B. I am sorry; I do not have any information about the client.
• C. You will have to wait for the primary health care provider.
• D. Please wait; I will update you as soon as I have any information.

Correct answer: D

Rationale: In this situation, the most appropriate response for the nurse to provide to the client's family is to assure them that they will be updated as soon as there is relevant information available. This response not only acknowledges the family's concern but also demonstrates the nurse's commitment to keeping them informed. Option A, providing false reassurances, is not advisable as it may impact the family's ability to cope with potential bad news. Option B, stating that the nurse has no information, is not helpful and can cause distress. Option C, directing the family to the primary health care provider, is not ideal as the nurse should strive to communicate directly with the family to establish trust and provide support.

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