Nursing Elites

1. An elderly man has relied on one of his sons for his care. Now the son has become very involved with a religion other than the one in which he was raised. As a result, he now refuses to help his father. What can a nurse do to help in this family situation?

• A. Set up a family conference that includes the son
• B. Bring in help from other family members or outside
• C. Insist that the son help, along with other family members
• D. Ask the family's own spiritual adviser to intervene

Correct answer: A

Rationale: In this complex family situation, it is essential to approach the issue with sensitivity and understanding. Setting up a family conference that includes the son is the most appropriate action for the nurse to take. While it may seem challenging, there is a possibility that involving the son in a family discussion can help him understand the impact of his actions on his father and the rest of the family. By including him in the conversation, the son may realize the importance of his role in caring for his father. Insisting that the son help, along with other family members, could lead to resistance and further alienation. Asking the family's spiritual adviser to intervene may not be effective if the son is rebelling against the family's religion. If the family conference does not yield positive results, then bringing in help from other family members or an outside caregiver may become necessary to ensure the elderly man receives the care he needs.

2. An older adult client tells the nurse that blockage of qi in one of the body's meridians is causing severe headaches. The health care provider has diagnosed migraines and has prescribed a triptan drug. Which action would be most appropriate for the nurse to implement?

• A. Suggest that the prescribed medicine may stimulate the flow of qi
• B. Explain the vasoconstrictive and serotonin-moderating action of triptan
• C. Instruct the client to take as many doses as needed for relief
• D. Caution the client that the headaches will grow worse if the client fails to take the medication

Correct answer: A

Rationale: Qi is the life force that circulates through the body in invisible pathways called meridians. In this scenario, the client believes that the blockage of qi is causing severe headaches. While explaining the scientific principles underlying the drug action could be valuable, it's crucial to consider the client's belief system. Therefore, the most appropriate response is to suggest that the prescribed medicine may stimulate the flow of qi, aligning with the client's perspective. Choice B, explaining the vasoconstrictive and serotonin-moderating action of triptan, does not address the client's concerns about qi blockage. Choice C, instructing the client to take as many doses as needed, can lead to potential medication misuse. Choice D, cautioning the client about worsening headaches without medication, may induce fear and hinder effective communication with the client.

3. Mr. K has dementia. Having a good deal of money, he has a private room at Haven Nursing Home. He is a retired industrialist whose children and current wife are already squabbling bitterly over his estate. During visits, they often get into shouting matches that disturb the other residents and Mr. K himself. How should an administrator handle this family?

• A. Emphasize that they must behave civilly when visiting
• B. Have them set up separate visiting schedules
• C. Ask them to stay away
• D. Close Mr. K's door when they visit

Correct answer: B

Rationale: There is little an administrator can do about this dysfunctional family's behavior, but Mr. K should not be upset by it, and the other residents deserve to be protected from shouting. By setting up separate visiting schedules, the family can continue to provide needed support for their husband and father. If they accidentally visit at the same time, the door can be kept closed until they leave.

4. To receive government funding, a county hospital must provide demographic statistics on its client population. When selecting the box labeled Hispanic on the forms, what characteristic of the client population would a worker consider?

• A. immigrant workers who entered the United States and their descendants
• B. immigrants who have a Spanish accent
• C. native Spanish-speaking people living in the United States
• D. persons with brown skin and dark hair

Correct answer: C

Rationale: The correct answer is C because the term 'Hispanic' includes Spanish-speaking individuals from various countries like Spain, Cuba, Mexico, and Puerto Rico. It is essential to understand that Hispanic does not solely refer to individuals with brown skin, dark hair, or those with a Spanish accent. Therefore, choices A, B, and D do not accurately represent the characteristic of the client population that would be classified as Hispanic.

5. What is a standard of care?

• A. A relationship in which a nurse has assumed responsibility for the care of a patient
• B. A policy or procedure established by a health care agency or professional association
• C. The norm for what a reasonable individual would do in a similar circumstance
• D. A public law that, if violated, can result in liability for the nurse

Correct answer: C

Rationale: A standard of care is the level of care that a reasonably prudent person with similar training and experience would provide in a similar circumstance. Choice A is incorrect because it describes the nurse-patient relationship. Choice B is incorrect as it refers to specific policies or procedures. Choice D is incorrect as it describes a law rather than the expected level of care.

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