Nursing Elites

1. A client with suspected renal disease is to undergo a renal biopsy. The nurse plans to include which statement in the teaching session?

• A. "You will be positioned lying down during the examination procedure."?
• B. "Portions of the procedure will cause pain or discomfort."?
• C. "You may be given anesthesia during the procedure."?
• D. "You should refrain from eating or drinking before the procedure."?

Correct answer: B

Rationale: The correct answer is to inform the client that portions of the renal biopsy procedure can cause pain or discomfort, particularly when the sample is being withdrawn. This prepares the client for any unpleasant sensations during the procedure. Answer A is incorrect because the client will be positioned lying down, not sitting up, during the exam, so this information is not relevant to include in the teaching session. Answer C is incorrect as anesthesia is commonly used to numb the area for a renal biopsy, reducing pain, so the client can expect to receive anesthesia. Answer D is incorrect because clients are usually instructed to refrain from eating or drinking for a period before the procedure to prevent any complications during the biopsy, not simply before the study.

2. Using clich�s in therapeutic communication leads the client to:

• A. viewing the nurse as less understanding.
• B. accepting themselves as human.
• C. self-disclosing.
• D. feeling discounted.

Correct answer: D

Rationale: The use of clich�s in therapeutic communication is commonly construed by the client as the nurse's lack of understanding, involvement, and caring, which can lead the client to feel demeaned and discounted. Choice A is incorrect because clich�s do not make the client view the nurse as less understanding but rather as lacking depth in communication. Choice B is incorrect as clich�s do not directly lead the client to accepting themselves as human. Choice C is incorrect because clich�s usually hinder self-disclosure rather than encourage it.

3. The nurse is caring for a client scheduled for a surgical repair of a sacular abdominal aortic aneurysm. Which assessment is most crucial during the preoperative period?

• A. Assessment of the client's level of anxiety
• B. Evaluation of the client's exercise tolerance
• C. Identification of peripheral pulses
• D. Assessment of bowel sounds and activity

Correct answer: C

Rationale: The most crucial assessment during the preoperative period for a client scheduled for surgical repair of a sacular abdominal aortic aneurysm is the identification of peripheral pulses. This is essential because during surgery, the aorta will be clamped, potentially affecting blood circulation to the kidneys and lower extremities. Monitoring peripheral pulses helps assess circulation to the lower extremities, ensuring adequate perfusion. While assessing the client's anxiety level (choice A) is important, it is not as critical as monitoring peripheral pulses in this case. Evaluating exercise tolerance (choice B) is not typically recommended preoperatively for this specific condition. Assessing bowel sounds and activity (choice D) is also relevant but takes a lower priority compared to identifying peripheral pulses in this scenario.

4. The client with a myocardial infarction comes to the nurse's station stating that he is ready to go home because there is nothing wrong with him. Which defense mechanism is the client using?

• A. Rationalization
• B. Denial
• C. Projection
• D. Conversion reaction

Correct answer: B

Rationale: The correct answer is B: Denial. The client displaying denial refuses to acknowledge the reality of having a myocardial infarction. Rationalization (choice A) involves making excuses for behavior, not denying a condition. Projection (choice C) is attributing one's thoughts or feelings to others, not denying an illness. Conversion reaction (choice D) is converting psychological distress into physical symptoms, which is not evident in this scenario. Therefore, denial is the defense mechanism being used in this situation.

5. Which intervention should the nurse take first to assist a woman who states that she feels incompetent as the mother of a teenage daughter?

• A. Recommend that she discipline her daughter more strictly and consistently.
• B. Make a list of things she can do to help improve her husband.
• C. Assist the mother to identify what she believes is preventing her success and what she can do to improve.
• D. Explore with the mother what the daughter can do to improve her behavior.

Correct answer: C

Rationale: The priority intervention for a mother who feels incompetent in parenting a teenage daughter is to assist her in identifying the factors contributing to her feelings of inadequacy and help her develop better coping and mothering skills. This approach focuses on addressing the mother's emotional needs and empowering her to improve her situation. Option A is incorrect as it focuses on the daughter's discipline, which may not be the root cause of the mother's feelings. Option B is irrelevant as it focuses on improving her husband, not her parenting skills. Option D is incorrect as it shifts the focus solely to the daughter's behavior, neglecting the mother's emotional needs and self-improvement.

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