Nursing Elites

1. After a client undergoes a left lower lobe lung resection for lung cancer, which post-operative measure would typically be included in the plan?

• A. Closed chest drainage
• B. A tracheostomy
• C. A mediastinal tube
• D. Percussion vibration and drainage

Correct answer: A

Rationale: After a lung resection, such as the removal of the left lower lobe for lung cancer, closed chest drainage is a common post-operative measure to help drain any excess air or fluid from the chest cavity. A tracheostomy is not typically needed for this procedure, so choice B is incorrect. Similarly, a mediastinal tube is not routinely inserted following a left lower lobe lung resection, making choice C incorrect. Percussion vibration and drainage are not indicated for this type of surgery, so choice D is also incorrect. Therefore, the correct answer is closed chest drainage.

2. What is the profile of an individual who engages in domestic violence?

• A. from a minority culture in a low-income group.
• B. from a majority culture in a middle-income group.
• C. one who was never allowed to compete as a child.
• D. from any walk of life, race, income group, or profession.

Correct answer: D

Rationale: Individuals who engage in domestic violence come from various backgrounds and cannot be stereotyped based on demographic factors like culture, income, or race. Research shows that perpetrators of domestic abuse can be found in any walk of life, regardless of their race, income group, or profession. It is important to note that the majority of domestic violence cases involve male perpetrators and female victims, but the profile of the abuser is not limited to specific demographic features. Therefore, the correct answer is that individuals who engage in domestic violence can come from any walk of life, race, income group, or profession. Choices A and B are incorrect as they wrongly associate domestic violence with specific cultural or income groups. Choice C is incorrect as there is no evidence to support the claim that being disallowed to compete as a child leads to domestic violence.

3. The new mother asks why her baby has lost weight since he was born. The best explanation of the weight loss is:

• A. The baby is dehydrated due to polyuria.
• B. The baby is hypoglycemic due to lack of glucose.
• C. The baby is allergic to the formula the mother is giving him.
• D. The baby can lose up to 10% of weight due to meconium stool, loss of extracellular fluid, and initiation of breastfeeding.

Correct answer: D

Rationale: After birth, newborns can lose weight due to meconium stool, loss of extracellular fluid, and the initiation of breastfeeding. This weight loss is a normal and expected physiological process, and infants can lose up to 10% of their birth weight during this period. There is no indication of dehydration (polyuria), hypoglycemia (lack of glucose), or allergy to the formula as reasons for weight loss in newborns. Therefore, answers A, B, and C are incorrect. Answer D provides the most accurate explanation for the observed weight loss in the newborn.

4. During a well-baby check of a 6-month-old infant, the nurse notes abrasions and petechiae of the palate. The nurse should:

• A. inquire about the possibility of sexual abuse.
• B. ask about the types of foods the child is eating.
• C. request to see the type of bottle used for feedings.
• D. question the parent about objects the child plays with.

Correct answer: A

Rationale: The correct answer is to inquire about the possibility of sexual abuse. Injuries to the soft palate such as bruising, abrasions, and petechiae can be signs of sexual abuse in infants. While oral sex may not leave significant physical evidence, these findings should raise suspicion. Option A is correct as it focuses on addressing potential abuse. Options B, C, and D are incorrect because the child's diet, the type of bottle used for feedings, and play objects are not likely related to the observed injuries. The presence of oral injuries suggests considering sexual abuse rather than other factors.

5. In a brief treatment program for a client who was raped, what is a realistic short-term goal?

• A. Identify all psychosocial problems.
• B. Eliminate the client's enticing behaviors.
• C. Resolve feelings of trauma and fear.
• D. Verbalize feelings about the event.

Correct answer: D

Rationale: In this scenario, a realistic short-term goal for the client who was raped and starting a brief treatment program is to verbalize feelings about the event. This goal promotes the expression of emotions, which is crucial in the healing process. Identifying all psychosocial problems is too broad and not typically achievable in a brief treatment program. Eliminating the client's enticing behaviors is not a suitable short-term goal as the focus should be on emotional recovery. While resolving feelings of trauma and fear is important, verbalizing feelings about the event is a more specific and achievable goal in the short term.

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