Nursing Elites

1. A corporate executive works 60-80 hours a week. The client is experiencing some physical signs of stress. The nurse teaches the client biofeedback techniques. This is an example of which of the following health-promotion interventions?

• A. structure
• B. relaxation technique
• C. time management
• D. regular exercise

Correct answer: C

Rationale: The correct answer is 'relaxation technique.' Biofeedback techniques are a form of relaxation technique that can help individuals quiet the mind, release tension, and counteract responses to stress. Teaching biofeedback techniques to the client aims to promote relaxation and stress management. Choice A, 'structure,' does not directly relate to teaching biofeedback techniques. Choice C, 'time management,' focuses on organizing tasks efficiently, not on relaxation techniques. Choice D, 'regular exercise,' although beneficial for overall health, is not specifically related to the teaching of biofeedback techniques for stress relief.

2. The mother of a newborn child is very upset. The child has a cleft lip and palate. The type of crisis this mother is experiencing is:

• A. reactive.
• B. maturational.
• C. situational.
• D. adventitious.

Correct answer: C

Rationale: The mother is experiencing a situational crisis as the unexpected birth of a child with a cleft lip and palate has placed her in a challenging situation she did not anticipate. This type of crisis is triggered by specific events and circumstances. Choice A, reactive, implies responding to a stressor after it has occurred, which is not the case here. Choice B, maturational, refers to stress related to developmental stages, not to external events like the child's condition. Choice D, adventitious, involves crises resulting from events outside one's control, such as natural disasters, which do not apply in this scenario.

3. Why might the physician order antibiotics to be given through the central venous access device (CVAD) rather than through a peripheral IV line if the CVAD becomes infected?

• A. To prevent infiltration of the peripheral line
• B. To reduce the pain and discomfort associated with antibiotic administration in a small vein
• C. To lessen the chance of an allergic reaction to the antibiotic
• D. To attempt to eliminate microorganisms in the catheter and prevent having to remove it

Correct answer: D

Rationale: When a patient's central venous access device (CVAD) becomes infected, administering antibiotics through the line is essential to attempt to eliminate microorganisms within the catheter. The goal is to prevent the necessity of removing the catheter, which might be required if the infection persists. Choice A, 'To prevent infiltration of the peripheral line,' is incorrect as the priority is addressing the catheter infection, not preventing issues with a peripheral line. Choice B, 'To reduce the pain and discomfort associated with antibiotic administration in a small vein,' is not relevant to the rationale for choosing the CVAD for antibiotic administration. Choice C, 'To lessen the chance of an allergic reaction to the antibiotic,' is also incorrect as the main focus is managing the catheter-associated infection rather than allergy prevention.

4. An infant weighs 7 pounds at birth. What is the expected weight by 1 year of age?

• A. 10 pounds
• B. 12 pounds
• C. 18 pounds
• D. 21 pounds

Correct answer: D

Rationale: A birth weight of 7 pounds typically triples by the age of 1 year, resulting in an expected weight of 21 pounds. This significant weight gain is a normal growth pattern for infants as they usually experience rapid growth in the first year of life. Choices A, B, and C are incorrect because they do not account for the usual growth rate of an infant in the first year. Infants commonly triple their birth weight by the age of 1, making 21 pounds the expected weight.

5. The nurse suspects an elderly client has been the victim of abuse. The client denies abuse and declines assistance. The nurse's next action should be to:

• A. respect the client's decision to refuse assistance.
• B. report the incident to the authorities.
• C. arrange an appointment with the client's family.
• D. educate the client about available services.

Correct answer: D

Rationale: In cases where elderly clients deny abuse and refuse assistance, it is crucial for the nurse to respect their autonomy while also ensuring their safety. Educating the client about available services is the appropriate action as it empowers the client with information without imposing any decisions on them. It allows the client to make informed choices regarding their well-being. Reporting the incident to the authorities (Choice B) may be necessary if there is immediate danger, but in this scenario, the client denies abuse. Arranging an appointment with the client's family (Choice C) may not be appropriate without the client's consent or in cases where the family might be involved in the abuse. Simply doing nothing (Choice A) is not the best course of action as the nurse should still provide support and resources to the client.

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