Nursing Elites

1. During a school screening, a nurse notices small bruises on the anterior and posterior ribs of an 8-year-old Asian child. The nurse should ask the child:

• A. if the family practices coining
• B. who performs coinings
• C. if the child has fallen
• D. how long the child has been abused

Correct answer: A

Rationale: The correct answer is to ask if the family practices coining. In Asian cultures, coining is a traditional practice believed to draw infections from the body. It involves rubbing a heated coin on the chest and torso, which can cause bruising similar to what the nurse noticed on the child's ribs. This question is important to differentiate between cultural practices and potential child abuse. Choices B, C, and D are incorrect because assuming abuse without considering cultural practices can lead to misinterpretation and inappropriate actions. It's crucial for healthcare providers to be culturally sensitive and gather all relevant information before making conclusions.

2. Support-system enhancement includes all of the following except:

• A. determining the barriers to using support systems.
• B. discussing ways to help others who are concerned.
• C. exploring life problems of the support-team members.
• D. involving spouse, family, and friends in the care and planning.

Correct answer: C

Rationale: Support-system enhancement involves various strategies to strengthen the support system. Determining the barriers to using support systems, discussing ways to help others who are concerned, and involving spouse, family, and friends in the care and planning are all essential aspects of enhancing the support system. However, exploring the life problems of the support-team members is not directly related to enhancing the support system. This approach could potentially invade personal boundaries and may not be necessary for improving the support system, making it the correct answer in this case. Therefore, option C is the correct answer as it does not align with the appropriate methods of support-system enhancement.

3. The client is scheduled for a Tensilon test to check for Myasthenia Gravis. Which medication should be kept available during the test?

• A. Atropine sulfate
• B. Furosemide
• C. Prostigmin
• D. Promethazine

Correct answer: A

Rationale: During a Tensilon test to check for Myasthenia Gravis, Atropine sulfate should be kept available as it is the antidote for Tensilon and is administered to manage cholinergic crises that may occur during the test. Atropine sulfate helps counteract the excessive stimulation of the parasympathetic nervous system caused by Tensilon. Furosemide (choice B) is a diuretic and not related to managing Tensilon-induced crises. Prostigmin (choice C) is used to treat Myasthenia Gravis itself, not for managing the effects of Tensilon. Promethazine (choice D) is an antiemetic and antianxiety agent, which is not necessary for a Tensilon test. Therefore, Atropine sulfate (choice A) is the correct medication to have available during a Tensilon test, making choices B, C, and D incorrect in this context.

4. In which age group does the highest incidence of child abuse occur?

• A. Birth-3 years old
• B. 4-6 years old
• C. 6-10 years old
• D. More than 10 years old

Correct answer: A

Rationale: The correct answer is 'Birth-3 years old.' Children between birth and 3 years of age have the highest rates of victimization (at 16 per 1,000 children). This age group is most vulnerable due to their dependency and inability to report or protect themselves effectively. Child abuse can occur at any age, but statistics show that infants and toddlers are at the highest risk due to their developmental stage and reliance on caregivers. Choices B, C, and D are incorrect because while child abuse can happen at any age, the prevalence is highest among children in the 0-3 age group.

5. How can the nurse best communicate to a client that he or she has been listening?

• A. restating the main feeling or thought the client has expressed
• B. making a judgment about the client's problem
• C. offering a leading question such as, 'And then what happened?'
• D. saying, 'I understand what you're saying.'

Correct answer: A

Rationale: The best way for the nurse to communicate to a client that he or she has been listening is by restating the main feeling or thought the client has expressed. Restating helps the client validate the nurse's understanding of the communication, demonstrating active listening skills. Making judgments about the client's problem, as suggested in Choice B, can hinder effective communication by introducing bias and potential misinterpretation. Offering a leading question like in Choice C is not ideal for confirming understanding; it rather seeks more information. Choice D, simply saying 'I understand what you're saying,' may not convey active listening as effectively as restating the client's main feelings or thoughts, as it lacks the validation component present in restating.

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