Nursing Elites

1. A female high school teacher who was a child of alcoholic parents seeks counseling at the community health clinic because of depression over a student who was killed by a drunk driver. After several weeks of counseling, which client behavior is the best indicator that the client is coping well with anxiety related to the student’s death?

• A. Signs a safety contract with the nurse agreeing not to hurt herself or others
• B. Confronts her parents about the hurt she felt as a child of alcoholic parents
• C. Becomes the faculty sponsor for Students Against Drunk Driving (SADD)
• D. Describes her feelings about the student’s death in detail

Correct answer: C

Rationale: Becoming the faculty sponsor for Students Against Drunk Driving (SADD) is the best indicator that the client is coping well with anxiety related to the student’s death. This choice demonstrates active involvement in preventing similar tragedies, showing that the client is channeling her emotions into positive action and advocacy. Option A, signing a safety contract, is important for safety but does not directly address coping with the anxiety related to the student's death. Option B, confronting her parents about past hurt, may be beneficial for personal growth but does not directly reflect coping with the current situation. Option D, describing feelings in detail, is a positive step in therapy but does not necessarily indicate coping well with the anxiety related to the student's death.

2. After receiving treatment for anorexia, a student asks the school nurse for permission to work in the school cafeteria as part of the school’s work-study program. What action should the nurse take?

• A. Recommend assignment to the receptionist's office.
• B. Suggest that the student work in the athletic department.
• C. Refer the student to a psychiatrist for further discussion.
• D. Determine the parents' opinion of the work assignment.

Correct answer: A

Rationale: Clients with anorexia are often fixated on food and exercise, which can exacerbate their condition. By recommending assignment to the receptionist's office, the nurse provides an environment that minimizes exposure to food-related triggers. Working in the cafeteria may intensify the student's preoccupation with food, making it an unsuitable choice. Referring the student to a psychiatrist without exploring less triggering work options first may not be necessary. Determining the parents' opinion is important, but in this context, the focus should be on selecting a work environment that supports the student's recovery.

3. A male hospital employee is pushed out of the way by a female employee because of an oncoming gurney. The pushed employee becomes very angry and swings at the female employee. Both employees are referred for counseling with the staff psychiatric nurse. Which factor in the pushed employee’s history is most related to the reaction that occurred?

• A. Is worried about losing his job to a woman.
• B. Tortured animals as a child.
• C. Was physically abused by his mother.
• D. Hates to be touched by anyone.

Correct answer: C

Rationale: The correct answer is 'C: Was physically abused by his mother.' The pushed employee's aggressive reaction can be attributed to his history of physical abuse. Research suggests that individuals who have experienced physical abuse may exhibit heightened aggressive responses due to trauma and learned behavior. Choices A, B, and D are incorrect: A is a stereotype-based assumption that does not have a direct correlation with the aggressive behavior observed; B, torturing animals, is concerning behavior but not directly linked to the aggressive response in this scenario; D, hating to be touched, is not the most relevant factor considering the situation described.

4. An adolescent with anorexia nervosa is participating in a cognitive-behavioral therapy (CBT) program. Which behavior indicates that the therapy is effective?

• A. Client adheres to a meal plan and gains weight.
• B. Client discusses the impact of the disorder on family.
• C. Client expresses a desire to change behavior.
• D. Client reduces the frequency of binge eating.

Correct answer: A

Rationale: In treating anorexia nervosa with cognitive-behavioral therapy (CBT), the primary goals are to normalize eating behaviors and achieve weight restoration. Therefore, adherence to a meal plan and weight gain are crucial indicators of treatment effectiveness. While discussing the impact of the disorder on the family (Choice B) can be beneficial for therapy, it may not directly indicate the effectiveness of CBT in treating anorexia nervosa. Expressing a desire to change behavior (Choice C) is a positive step, but actual behavioral changes such as adhering to a meal plan are more indicative of progress. Reducing the frequency of binge eating (Choice D) is more relevant for other eating disorders like bulimia nervosa, not anorexia nervosa.

5. The RN is providing education about strategies for a safety plan for a female client who is a victim of intimate partner violence. Which strategies should be included in the safety plan? (SOA)

• A. Purchase a gun for protection.
• B. Establish a code with family and friends to signal violence.
• C. Take a self-defense course focused on protection.
• D. Prepare a bag with extra clothes for self and children.

Correct answer: B

Rationale: Establishing a code with family and friends is crucial in situations of intimate partner violence as it allows discreet communication for help without alerting the abuser. Having a pre-prepared bag with essentials like extra clothes is important to facilitate a quick exit if necessary. Purchasing a gun is not a recommended safety strategy as it can escalate violence and pose more danger. While taking a self-defense course focused on protection is beneficial, it is essential to avoid courses that emphasize retaliation, as they can increase the risk and escalate violence.

Similar Questions