Nursing Elites

1. A Hispanic patient complains of abdominal cramping caused by empacho. Which action should the nurse take first?

• A. Ask the patient what treatments are likely to help
• B. Massage the patient's abdomen until the pain subsides.
• C. Administer prescribed medications to decrease the cramping
• D. Offer to contact a curandero(a) for a visit to the patient

Correct answer: A

Rationale: When a Hispanic patient presents with abdominal cramping related to empacho, it is crucial for the nurse to first understand the patient's cultural beliefs and preferences before initiating any interventions. In the case of a culture-bound syndrome like empacho, it is essential to acknowledge and respect the patient's cultural background. While options like administering medications, arranging a visit by a curandero(a), or providing massage may have potential benefits, assessing the patient's beliefs ensures that interventions are culturally sensitive and aligned with the patient's values. By engaging the patient in a discussion about potential treatments, the nurse can gather valuable information to tailor care effectively, promoting trust and collaboration in the healthcare process. This patient-centered approach enhances the quality of care and fosters a culturally competent nursing practice. Therefore, asking the patient about preferred treatments is the most appropriate initial action to address the patient's condition effectively.

2. The client finds a client crying behind a locked bathroom door. The client will not open the door. Which action should the nurse implement first?

• A. Instruct an unlicensed assistive personnel (UAP) to stay and keep talking to the client.
• B. Sit quietly in the client's room until the client leaves the bathroom.
• C. Allow the client to cry alone and leave the client in the bathroom.
• D. Talk to the client and attempt to find out why the client is crying.

Correct answer: D

Rationale: The nurse's first concern should be for the client's safety, so an immediate assessment of the client's situation is needed. Option D is the correct choice as it involves directly addressing the client's emotional state and attempting to understand the reason for the distress. In a vulnerable situation like this, the nurse should take the lead in assessing and communicating with the client. Option A is incorrect as it would delegate the responsibility to someone else when the nurse should be the one to initiate the assessment. Option B is inappropriate as it does not actively address the client's emotional needs or safety. Option C is also incorrect because leaving the client alone without further assessment could potentially endanger the client's well-being.

3. A client is discussing his personal feelings of self-esteem and self-concept with a nurse. Which of the following questions is most appropriate for assessing the client's personal identity?

• A. What is your educational background?
• B. Are your parents still living?
• C. What do you like about your life right now?
• D. Where do you see yourself in 10 years?

Correct answer: C

Rationale: When assessing a client's personal identity, it is essential for the nurse to inquire about aspects related to the client's self-perception and self-worth. Asking about what the client likes about his current life helps to explore his positive self-perceptions and areas of contentment. This question encourages the client to reflect on his present circumstances and identify aspects that contribute to his sense of personal identity. Choices A, B, and D are not as relevant for assessing personal identity as they focus on educational background, parental status, and future aspirations, respectively, rather than directly addressing the client's current self-perception and identity.

4. Which response would the nurse make when a client moans softly, 'Oh no, I'm next. They couldn't protect him, and they can't protect me,' after learning a recently discharged client committed suicide?

• A. ''The other person was a lot sicker than you are.''
• B. 'You seem to be afraid that you'll hurt yourself.''
• C. 'That was different. He was at home, but you're here.''
• D. 'There's no need to worry. You have a better support system.''

Correct answer: B

Rationale: The nurse would make the statement, 'You seem to be afraid that you'll hurt yourself.' This response acknowledges the client's emotional distress and opens up the opportunity for the client to discuss their feelings, showing empathy and understanding. Choice A, 'The other person was a lot sicker than you are,' dismisses the client's emotions and fails to address the underlying fear of self-harm. Choice C, 'That was different. He was at home, but you're here,' invalidates the client's concerns and does not encourage further discussion. Choice D, 'There's no need to worry. You have a better support system,' offers false reassurance and does not address the client's expressed fear, missing an opportunity for therapeutic communication.

5. What is a common reason why clients abuse alcohol?

• A. To blunt reality
• B. To precipitate euphoria
• C. To promote social interaction
• D. To stimulate the central nervous system

Correct answer: A

Rationale: Clients often abuse alcohol to blunt reality. Alcohol, by depressing the central nervous system and distorting or altering reality, can reduce anxiety. It is not primarily used to precipitate euphoria; instead, it may lead to mood swings, impaired judgment, and aggressive behavior. While alcohol can be used as a social lubricant, individuals with alcohol use disorder often drink in isolation. Moreover, excessive alcohol consumption can result in inappropriate and aggressive behaviors that hinder social interactions. It's important to note that alcohol is a depressant, unlike stimulants such as amphetamines and cocaine.

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