Nursing Elites

1. 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.

2. A nurse is reviewing the client population of a local community health center and identifying the health care needs of the group. The nurse decides to develop a screening program for hypertension. Which client population would the nurse most likely be working with?

• A. A seniors' group based at a Jewish community center.
• B. A Native American reservation/Canadian aboriginal reserve.
• C. A predominantly Chinese-American neighborhood.
• D. A minimum-security prison serving young, rehabilitating offenders.

Correct answer: B

Rationale: Hypertension is disproportionately high among Native American/First Nations clients. This condition is not noted to be a major health problem among Jewish Americans, prisoners, or Americans of Chinese ancestry. Developing a screening program for hypertension in a Native American reservation/Canadian aboriginal reserve would be most appropriate based on the prevalence of the condition in this population.

3. As a daughter and mother are extremely close emotionally, they made a pact years ago never to put the mother in a nursing home. Now, the physical demands of caregiving are becoming too great. What is the best way a nurse can help the daughter?

• A. Persuade her to admit her mother to a nursing home
• B. Aid her in finding help with in-home care
• C. Praise her success in being a good daughter and keeping her promise
• D. Point out her mistaken altruism

Correct answer: B

Rationale: In this situation, the best course of action for the nurse is to aid the daughter in finding help with in-home care. Persuading her to admit her mother to a nursing home would likely cause guilt and emotional distress due to their pact. Praise alone may not address the current physical caregiving challenges. Pointing out her 'mistaken altruism' could be seen as insensitive and unhelpful. Providing practical assistance in finding in-home care can alleviate the physical demands on the daughter while still honoring the emotional commitment they made.

4. Which of the following statements by family caregivers would the nurse consider most indicative of elder abuse?

• A. Mom can't handle her own money anymore, so I've had to take over her banking.
• B. When my dad starts wandering around the house, I give him sleeping pills until he calms down and falls asleep in his chair.
• C. My mother says she wants me to do everything for her, but I think it's better if she keeps on doing everything she's still capable of.
• D. I get so frustrated because my father used to be so competent, and now he can't even use a toilet.

Correct answer: B

Rationale: The correct answer is B. The statement 'When my dad starts wandering around the house, I give him sleeping pills until he calms down and falls asleep in his chair' is most indicative of elder abuse as it involves the inappropriate use of chemical restraints. This practice can harm the elderly and is considered a form of abuse. Choices A, C, and D do not demonstrate elder abuse. Choice A may be a responsible action depending on the circumstances, choice C reflects a positive philosophy of care, and choice D expresses frustration but does not constitute abuse.

5. What is the most important advantage of an advance directive?

• A. Such a directive indicates how medical decisions are to be made in case a patient is unable to communicate their wishes.
• B. It spares the family the burden of making significant decisions for a patient regarding terminal care.
• C. It ensures that a person's property is distributed according to their wishes after death, avoiding legal complications.
• D. It allows individuals to appoint a guardian for themselves in case of incapacity, without involving the court system.

Correct answer: B

Rationale: An advance directive, or living will, is a legal document that specifies an individual's preferences for medical treatment if they are unable to communicate their wishes. The most important advantage of an advance directive is that it spares the family from having to make challenging decisions about terminal care on behalf of the patient. Choice A is incorrect because advance directives pertain to healthcare decisions, not property matters. Choice C is incorrect as it refers to a will for property distribution, which is a different legal document. Choice D is incorrect as advance directives are not related to appointing guardians but rather focus on healthcare decision-making.

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