Nursing Elites

1. When assessing a client's self-expectations about weight loss, which question is most appropriate?

• A. "What makes you think you can change your eating habits?"?
• B. "How do you feel about losing weight?"?
• C. "How important is it that you lose weight?"?
• D. "What do you think is a realistic weekly weight loss for you?"?

Correct answer: D

Rationale: When assessing a client's self-expectations about weight loss, it is crucial to inquire about what the client considers a realistic weekly weight loss goal. This question helps in understanding the client's perception and expectations regarding the weight loss journey, enabling the establishment of achievable goals. Choices A, B, and C do not directly address the aspect of setting realistic goals for weight loss. While questioning about changing eating habits, feelings about losing weight, or the importance of weight loss are relevant, they do not specifically focus on setting achievable goals, which is essential for effective weight management.

2. A health care worker is concerned about a new mother being overwhelmed by caring for her infant. The health care worker should:

• A. immediately contact child protective services
• B. provide the mother with literature about child care
• C. consult a therapist to help the mother work out her fears
• D. refer the mother to parenting classes

Correct answer: D

Rationale: Prevention of child abuse is centered on teaching parents how to care for their child and cope with the demands of infant care. Parenting classes can help build self-confidence, self-esteem, and coping skills. Parents benefit by understanding the developmental needs of their children, while learning how to manage their home environment more effectively. The classes also increase the parents' social contacts and teach about community resources. Contacting child protective services (Choice A) is not appropriate in this scenario as there is no indication of abuse or neglect. Providing literature (Choice B) may not be as effective as parenting classes in addressing the mother's concerns. Consulting a therapist (Choice C) may be beneficial for underlying mental health issues, but parenting classes specifically focus on child care and coping skills, making Choice D the most suitable option in this situation.

3. After the client discusses her relationship with her father, the nurse says, "Tell me whether I am understanding your relationship with your father. You feel dominated and controlled by him?"? This is an example of:

• A. verbalizing the implied.
• B. seeking consensual validation.
• C. encouraging evaluation.
• D. suggesting collaboration.

Correct answer: B

Rationale: Seeking consensual validation is the correct answer. Consensual validation is a technique used to check one's understanding of what the client has said. It involves confirming with the client whether the nurse's interpretation aligns with the client's feelings or thoughts. This process helps build rapport, trust, and a shared understanding between the nurse and the client. Verbalizing the implied (choice A) refers to expressing the underlying or implicit meaning of a client's statement. Encouraging evaluation (choice C) involves prompting the client to assess or judge a situation. Suggesting collaboration (choice D) entails proposing working together with the client on a shared goal, which is not the primary focus in the scenario provided.

4. The nurse is preparing a client for surgery. Which item is most important to remove before sending the client to surgery?

• A. Hearing aid
• B. Contact lenses
• C. Wedding ring
• D. Artificial eye

Correct answer: B

Rationale: The correct answer is B: Contact lenses. It is crucial to remove contact lenses before surgery to prevent corneal drying, especially with non-extended wear lenses. Leaving the hearing aid or artificial eye in place does not pose harm to the client during surgery. While wedding rings are typically covered with tape, leaving them on is acceptable. Therefore, choices A, C, and D are incorrect in this scenario.

5. The physician has ordered sodium warfarin (Coumadin) for the client with thrombophlebitis. The order should be entered to administer the medication at:

• A. 900
• B. 1200
• C. 1700
• D. 2100

Correct answer: C

Rationale: Sodium warfarin is typically administered in the late afternoon, around 1700 hours. This timing allows for accurate bleeding times to be drawn in the morning. Administering it at 0900 (choice A) would not align with this schedule and may affect the monitoring of bleeding times. Choice B (1200) is midday, which is not the recommended time for sodium warfarin administration. Choice D (2100) is in the evening, which is also not ideal. Therefore, the correct time for administering sodium warfarin is 1700 (choice C).

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