Nursing Elites

1. After 5 years of unprotected intercourse, a childless couple comes to the fertility clinic. The husband tells the nurse that his parents have promised to make a down payment on a house for them if his wife gets pregnant this year. Which response would the nurse provide?

• A. ''This must be very difficult for you with this added pressure.''
• B. 'Having a child is a decision you should make without your parents' input.''
• C. 'You're lucky. It's nice that your parents are making such a generous offer.''
• D. ''Five years without a pregnancy is a long time. You were right to come to the fertility clinic.''

Correct answer: A

Rationale: The correct response acknowledges the emotional challenge the couple is facing due to the added pressure of the incentive from the husband's parents. By expressing empathy and understanding, the nurse encourages the couple to open up about their feelings and concerns. Choice B is not the best response as it dismisses the husband's situation and fails to address the emotional impact of the added pressure. Choice C focuses on the parents' offer rather than the couple's emotional state, which is not the primary concern in this situation. Choice D, mentioning the duration of infertility, may come across as insensitive and may hinder open communication by potentially making the couple feel judged or discouraged.

2. The mother of an infant in the neonatal intensive care unit expresses concern about her infant. Which nursing intervention best facilitates mother-infant bonding?

• A. Asking the mother to change her baby's diaper
• B. Assuring the mother that her baby is receiving excellent care
• C. Encouraging the mother to touch her baby whenever possible
• D. Keeping the mother informed about the care the nursing staff is providing her baby

Correct answer: C

Rationale: Encouraging the mother to touch her baby whenever possible is the best intervention to promote mother-infant bonding, especially when the infant is too ill to be held. Physical touch is a powerful way to establish a connection. Mother-infant bonding is a gradual process and encouraging touch can help initiate this bond. Asking the mother to change her baby's diaper is not the most appropriate action to promote bonding in this scenario. Assuring the mother about the care her baby is receiving is important but does not directly enhance bonding. Keeping the mother informed about the care her baby is receiving is crucial, but it alone does not actively foster bonding between the mother and infant.

3. During her shift at the hospital, a nurse receives a stern reprimand from a physician over something over which she had no control. The nurse does not respond. When she returns home that evening, she sees her children's toys all over the floor, gets mad, and begins to yell at them. Which form of defense mechanism is this nurse using?

• A. Symbolization
• B. Suppression
• C. Displacement
• D. Projection

Correct answer: C

Rationale: Displacement is the process of redirecting feelings or impulses from one person to another. In this scenario, the nurse chose not to respond to the physician, but instead displaced her negative emotions onto her children, who are less threatening and more vulnerable. This defense mechanism allowed her to express her anger in a safer outlet. Symbolization involves representing unconscious feelings or impulses through symbols, not redirecting them. Suppression is the conscious effort to push unwanted thoughts or feelings out of awareness, not displacing them onto others. Projection involves attributing one's thoughts or emotions to someone else, which is not evident in this case.

4. The nurse is teaching an obese client, newly diagnosed with arteriosclerosis, about reducing the risk of a heart attack or stroke. Which health promotion brochure is most important for the nurse to provide to this client?

• A. Monitoring Your Blood Pressure at Home
• B. Smoking Cessation as a Lifelong Commitment
• C. Decreasing Cholesterol Levels Through Diet
• D. Stress Management for a Healthier You

Correct answer: C

Rationale: The most important health promotion brochure to provide to an obese client newly diagnosed with arteriosclerosis is one focused on decreasing cholesterol levels through diet. Arteriosclerosis is significantly influenced by excess dietary fat, especially saturated fat and cholesterol. Monitoring blood pressure at home, while important, does not directly address the underlying cause of arteriosclerosis. Smoking cessation and stress management are crucial for overall cardiovascular health, but lowering cholesterol through diet takes precedence in this scenario.

5. Which of the following is an advantage of working with psychiatric clients in a group setting?

• A. Clients assist each other through therapeutic interventions with the support of a nurse
• B. Clients can receive peer support and feedback in a safe and controlled environment
• C. Clients can share experiences and coping strategies while maintaining confidentiality
• D. Clients learn from others when their behaviors are inappropriate in a safe and trusting environment

Correct answer: D

Rationale: Group therapy is a valuable approach in mental health treatment. Working with psychiatric clients in a group setting offers various benefits. Clients in a group setting can learn from others when their behaviors are inappropriate in a safe and trusting environment. This environment allows individuals to express thoughts and feelings without fear of judgment or criticism, fostering a supportive atmosphere. Through interactions with peers, clients can gain insight into their own behaviors and learn alternative ways of coping. Choice A is incorrect as the presence and support of a nurse are typically important in group therapy sessions. Choice B is incorrect as group settings provide structure and rules to ensure a safe space for clients to express themselves. Choice C is incorrect as maintaining confidentiality is crucial in group therapy to build trust and encourage open sharing.

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