Nursing Elites

1. An 18-year-old male patient informs the nurse that he isn't sure if he is homosexual because he is attracted to both genders. The nurse establishes a trusting relationship with the patient by saying:

• A. Don't worry. It's just a phase you will grow out of.
• B. Those are abnormal impulses. You should seek therapy.
• C. At your age, it is normal to be curious about both genders.
• D. Having questions about sexuality is normal. Have you noticed any changes in the way this makes you feel about yourself?

Correct answer: C

Rationale: It is important for the nurse to validate the patient's concerns and provide a supportive environment. By acknowledging that it is normal for young adults to have questions about sexuality, the nurse helps the patient feel understood and accepted. This response encourages further discussion and exploration of the patient's feelings without judgment. Choice A dismisses the patient's concerns and implies that his feelings are not valid. Choice B stigmatizes the patient's feelings by labeling them as abnormal and suggests therapy without proper assessment. Choice D addresses the patient's feelings but lacks the validation and reassurance present in the correct answer, which is essential in building a trusting relationship with the patient.

2. A nurse caring for a pediatric client shows little concern when the parents attempt to speak with her about their daughter's illness. When approached by the nurse manager about her behavior, the nurse responds by saying, 'I don't want to get involved. It doesn't matter what I do anyway; my work does not make much of a difference.' This nurse is exhibiting which of the following characteristics?

• A. Objectivity
• B. Depersonalization
• C. Procrastination
• D. Disruption

Correct answer: B

Rationale: The correct answer is 'Depersonalization.' A nurse who distances themselves from clients to avoid emotional involvement is displaying depersonalization. This behavior is often seen in nurses experiencing burnout due to stress. Depersonalization can stem from low morale, moral distress, and may serve as a defense mechanism to cope with stress and emotional exhaustion. It is a way to shield oneself from feeling overwhelmed by the burdens of caring for others. Choice A, 'Objectivity,' is incorrect because objectivity involves maintaining a neutral and unbiased perspective, which is not the case here. Choice C, 'Procrastination,' is incorrect as it refers to delaying tasks, not emotional distancing. Choice D, 'Disruption,' is irrelevant to the scenario described and does not align with the nurse's behavior of detachment and lack of concern.

3. A client is refusing to undergo any more treatments in the hospital and wants to leave against medical advice. When the nurse requests the client to sign an AMA order, the client refuses and leaves. What is the next action of the nurse?

• A. Call security to hold the client until he signs the order
• B. Notify the physician to convince the client to stay
• C. Speak with the client's spouse to persuade him to stay
• D. Allow the client to leave and document the refusal in his chart

Correct answer: D

Rationale: The nurse cannot force the client to stay in the hospital to receive treatment or to sign an AMA order. It is essential to respect the client's autonomy and decision-making capacity. While involving security or pressuring the client through the physician or spouse may seem like options, they are not appropriate in this situation. The nurse should allow the client to leave if they are competent to make that decision, document the refusal in the client's chart to ensure all actions are appropriately documented, and follow institutional policies for patients leaving against medical advice.

4. You are creating a teaching plan for a patient with newly diagnosed migraine headaches. Which key item should NOT be included in the teaching plan?

• A. Avoid foods that contain tyramine, such as alcohol and aged cheese.
• B. Avoid drugs such as Tagamet, nitroglycerin, and Nifedipine.
• C. Continue taking estrogen as prescribed by your physician.
• D. A potential side effect of medications is rebound headache.

Correct answer: C

Rationale: The correct answer is C: Continue taking estrogen as prescribed by your physician. Medications such as estrogen supplements may actually trigger a migraine headache attack. Fluctuations in estrogen, such as before or during menstrual periods, pregnancy, and menopause, seem to trigger headaches in many women. Choices A and B are important to include in the teaching plan for a patient with migraines as avoiding foods containing tyramine and certain drugs can help prevent migraine triggers. Choice D is also relevant as it is essential for the patient to be aware of potential side effects of medications, including rebound headaches.

5. Who among the following individuals wrote a medical code of ethics?

• A. Hammurabi
• B. Thomas Percival
• C. Hippocrates
• D. All of the above

Correct answer: D

Rationale: All of the above individuals contributed to the development of medical ethics. Hammurabi created the earliest known code around 2500 BC. Hippocrates, known for the principle 'Do no harm,' emphasized ethical practices in medicine. Thomas Percival, a physician interested in sociological medicine, authored a Code of Medical Ethics in 1803, which influenced modern medical ethics. Therefore, the correct answer is 'All of the above.' Choices A, B, and C are incorrect because each of them individually wrote a medical code of ethics, making 'All of the above' the most inclusive and accurate answer.

Similar Questions