Nursing Elites

1. A client is having difficulty applying for a job due to panic and anxiety. A nurse is helping by pretending to be the job supervisor while the client practices answering questions during an imaginary interview. This technique is an example of:

• A. Reinforcement
• B. Presenting reality
• C. Role playing
• D. Summarizing

Correct answer: C

Rationale: Role-playing is the correct answer. It involves practicing appropriate behaviors during imaginary scenarios that simulate real-life situations. In this scenario, the nurse is helping the client prepare for a job interview by acting as the job supervisor. Role-playing allows the client to practice and develop strategies to cope with anxiety and panic during the actual interview. Reinforcement (Choice A) involves providing consequences to strengthen a behavior. Presenting reality (Choice B) involves helping the client differentiate between real and unreal experiences. Summarizing (Choice D) involves condensing information. In this context, role-playing is the most appropriate technique to address the client's anxiety and panic related to job interviews.

2. Which intervention would the nurse use to provide emotional support for a resident in a nursing home who recently immigrated from another country?

• A. Offer choices consistent with the resident's heritage.
• B. Assist the resident in adjusting to the nursing home culture.
• C. Ensure that the resident is treated respectfully like the other residents.
• D. Correct any misconceptions the resident may have about appropriate health practices.

Correct answer: A

Rationale: When providing emotional support to a resident in a nursing home who recently immigrated from another country, it is essential for the nurse to offer choices that align with the resident's heritage. This approach respects the resident's cultural beliefs and practices, promoting a sense of familiarity and comfort. Assisting the resident in adjusting to the nursing home culture is important but may not address the specific emotional support needed. While ensuring that the resident is treated respectfully is crucial, offering choices consistent with the resident's heritage goes a step further by acknowledging and valuing the resident's cultural background. Correcting any misconceptions about health practices is essential, but in this context, emotional support through cultural sensitivity takes precedence.

3. What factor is likely the reason a woman with bipolar disorder, manic episode, rarely eats?

• A. Feelings of guilt
• B. Need to control others
• C. Desire for punishment
• D. Excessive physical activity

Correct answer: D

Rationale: During a manic episode of bipolar disorder, individuals often experience hyperactivity and an inability to stay still. This hyperactivity can manifest as excessive physical activity, which can prevent them from eating regularly. The correct answer is 'Excessive physical activity' because it directly relates to the woman's lack of appetite during the manic episode. Feelings of guilt, the need to control others, and the desire for punishment are not typically associated with eating difficulties in individuals with bipolar disorder during a manic episode. Clients in a manic episode usually have heightened energy levels and may engage in activities that exhaust them, leading to a decreased focus on eating.

4. A client asks the nurse, 'Should I tell my partner that I just found out I'm human immunodeficiency virus (HIV) positive?' Which is the nurse's most appropriate response?

• A. Do not tell your partner unless asked.
• B. This is a decision you alone can make.
• C. You are having difficulty deciding what to say.
• D. Tell your partner that you don't know how you became sick.

Correct answer: C

Rationale: The most appropriate response for the nurse in this situation is to acknowledge the client's struggle in deciding what to communicate to their partner. By stating 'You are having difficulty deciding what to say,' the nurse validates the client's feelings and encourages further discussion. Option A is incorrect as it suggests withholding information unless asked, which may not align with ethical principles of honesty and transparency in relationships. Option B, while acknowledging the client's autonomy, does not provide direct support or guidance. Option D is inappropriate as it involves dishonesty by suggesting telling the partner an untruthful reason for the illness.

5. Which dysfunction of the reproductive system is associated with anorexia nervosa in females?

• A. Galactorrhea
• B. Gynecomastia
• C. Amenorrhea
• D. Premenstrual dysphoric disorder

Correct answer: C

Rationale: Amenorrhea (cessation of menses) is associated with anorexia nervosa in females due to endocrine imbalances resulting from depleted fat stores. Galactorrhea is a milky discharge from the nipples unrelated to normal breast milk production. Gynecomastia is swelling of breast tissue in males. Premenstrual dysphoric disorder occurs about 1 week before menses and includes mood swings, depression, fatigue, bloating, overeating, and difficulty focusing, resolving when menstruation starts. In the context of anorexia nervosa, the primary concern is the disruption of the menstrual cycle due to low body weight, leading to amenorrhea.

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