Nursing Elites

1. A mother complains to the nurse that her 3-year-old child refuses to go to preschool. The child rarely interacts and avoids playing with other children. Which statement would the nurse provide?

• A. Do not be concerned because all toddlers behave this way.
• B. Ask the teacher to push the child to speak up and open up to the other kids.
• C. Set boundaries and supervise the child closely.
• D. Give your child time to get acquainted and warm up to the new environment.

Correct answer: D

Rationale: According to the mother's description, the child is a slow-to-warm-up child. These children are uneasy in new situations or with unfamiliar people. The nurse would educate the mother to give the child time to be more familiar with the new environment. All toddlers do not behave in the same manner. A slow-to-warm-up child should not be pressured to do anything against his or her wishes. Setting boundaries and closely supervising the child is not the best approach for a child who needs time to adapt. Asking the teacher to push the child to open up can create more anxiety and stress for the child, which is not recommended.

2. Which factor is most critical for a single mother of 2 children who recently lost her job and does not know what to do?

• A. Developmental history of children
• B. Available situational supports
• C. Underlying unconscious conflict
• D. Willingness to restructure lifestyle

Correct answer: B

Rationale: In a crisis intervention, the priority is to identify available situational supports, such as family, friends, community resources, and social services, that can help the single mother and her children during this difficult time. Understanding the developmental history of the children may be important to assess their needs, but it is not the most critical factor in this immediate crisis. Exploring underlying unconscious conflicts is more suited for long-term therapy rather than crisis intervention. While the willingness to restructure lifestyle may eventually be necessary, the immediate focus should be on finding support systems to address the current crisis.

3. A teenager begins to cry while talking with the nurse about the problem of not being able to make friends. Which is the correct therapeutic nursing intervention?

• A. Sitting quietly with the client
• B. Telling the client that crying is not helpful
• C. Suggesting that the client play a board game
• D. Recommending how the client can change this situation

Correct answer: A

Rationale: The correct therapeutic nursing intervention in this situation is sitting quietly with the client. This approach conveys empathy, acceptance, and a willingness to listen, which can help the teenager feel supported and understood. It is important for the nurse to create a safe space for the client to express their emotions without judgment. Telling the client that crying is not helpful dismisses their feelings and can hinder the therapeutic relationship. Suggesting a board game as a distraction may prevent the client from fully exploring and addressing their emotions about the issue. Recommending how the client can change the situation may be premature at this stage, as the priority is to provide emotional support and establish trust before delving into problem-solving.

4. Which priority action would the nurse manager use to help the nurse who may be experiencing burnout?

• A. Transfer the nurse to another unit in the facility.
• B. Help the nurse choose a position on a low-stress unit.
• C. Encourage the nurse to attend educational programs.
• D. Help the nurse identify personal responses to job stress.

Correct answer: D

Rationale: The correct priority action for the nurse manager to help a nurse experiencing burnout is to assist the nurse in identifying personal responses to job stress. This involves recognizing work stressors in the environment and evaluating coping strategies to determine their effectiveness. While transferring the nurse to another unit could be a solution, the initial focus should be on self-awareness and coping strategies. Choosing a position on a low-stress unit and attending educational programs can be beneficial in reducing burnout, but they are not the primary steps to address burnout when it occurs.

5. Which implemented strategies would not be effective in preventing post-traumatic stress in the nursing staff?

• A. Providing breaks to the staff whenever needed
• B. Encouraging the staff to work for more than 12 hours per day
• C. Encouraging the staff to encourage and support their coworkers
• D. Asking the staff and managers to talk about their feelings with each other

Correct answer: B

Rationale: To prevent post-traumatic stress in the nursing staff, it is crucial to avoid overworking them. Encouraging staff to work for more than 12 hours per day can lead to burnout and increased stress levels, thus exacerbating post-traumatic stress. Providing breaks whenever needed is essential to ensure rest and rejuvenation during demanding shifts. Encouraging staff to support and uplift their coworkers can create a positive work environment, fostering resilience against stress. Additionally, promoting open communication by asking staff and managers to discuss their feelings can facilitate emotional processing and mutual support, ultimately reducing the risk of post-traumatic stress.

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