Nursing Elites

1. In the United States, several definitions of death are currently being used. The definition that uses apnea testing and pupillary responses to light is termed:

• A. whole brain death.
• B. heart-lung death.
• C. circulatory death.
• D. higher brain death.

Correct answer: A

Rationale: The correct answer is 'whole brain death.' Most protocols for determining whole brain death require two separate clinical examinations, including the induction of painful stimuli, pupillary responses to light, oculovestibular testing, and apnea testing. This comprehensive approach ensures that all functions of the brain, including the brainstem, are evaluated to confirm the absence of brain function. Choices B and D are incorrect as they do not reflect the specific tests required for determining whole brain death. Choice C, 'circulatory death,' does not involve the evaluation of brain function and is not a current definition of death in the United States.

2. A two-year-old has been in the hospital for 3 weeks and has seldom seen family members due to isolation precautions. Which of the following hospitalization changes is most likely to be occurring?

• A. Guilt
• B. Trust
• C. Separation anxiety
• D. Shame

Correct answer: C

Rationale: The correct answer is 'Separation anxiety.' Separation anxiety is a common response in young children when they are separated from their primary caregivers for extended periods. In this case, the two-year-old being in the hospital for three weeks and not being able to see family members due to isolation precautions can trigger separation anxiety. 'Guilt' is a feeling of responsibility for wrongdoing, which is not the most likely change occurring in this scenario. 'Trust' involves reliance and confidence in others, not typically associated with prolonged separation from family. 'Shame' is a negative emotion related to feeling disgrace, which is not the most appropriate response in this hospitalization situation.

3. A 10-month-old child is brought to the Emergency Department because he is difficult to awaken. The nurse notes bruises on both upper arms. These findings are most consistent with

• A. wearing clothing that is too small for the child
• B. the child being shaken
• C. falling while learning to walk
• D. parents trying to awaken the child

Correct answer: B

Rationale: The correct answer is 'the child being shaken.' Children who are shaken are frequently grasped by both upper arms, leading to bruises in that area. The presentation of a difficult-to-awaken child with bruises on the upper arms is highly concerning for non-accidental trauma, such as abusive shaking. Symptoms of brain injury associated with shaking include a decreased level of consciousness. Choices A, C, and D are less likely because the combination of a child being difficult to awaken and bruises on both upper arms is highly suggestive of non-accidental trauma rather than benign causes like ill-fitting clothing, falling while learning to walk, or parents trying to awaken the child.

4. A client has been taking alprazolam (Xanax) for four years to manage anxiety. The client reports taking 0.5 mg four times a day. Which statement indicates that the client understands the nurse's teaching about discontinuing the medication?

• A. "I can drink alcohol now that I am decreasing my Xanax."?
• B. "I should not take another Xanax pill. Here is what is left of my last prescription."?
• C. "I should take three pills per day next week, then two pills for one week, then one pill for one week."?
• D. "I can expect to be sleepy for several days after stopping the medicine."?

Correct answer: C

Rationale: Explanation: When discontinuing alprazolam (Xanax) after long-term use, it is crucial to taper the dosage gradually to prevent withdrawal symptoms. The correct statement indicates an understanding of this by planning a structured decrease in dosage over time. Choice A is incorrect as drinking alcohol while decreasing Xanax can be dangerous and is not recommended. Choice B is incorrect as abruptly stopping Xanax is not safe and can lead to withdrawal symptoms. Choice D is incorrect as expecting to be sleepy for several days after stopping the medication does not address the need for a gradual tapering process to avoid withdrawal symptoms.

5. Which statement reflects a primary belief of psychiatric mental health nursing?

• A. Most people have the potential to change and grow.
• B. Every person is worthy of dignity and respect.
• C. Human needs are individual to each person.
• D. Some behaviors have no meaning and cannot be understood.

Correct answer: B

Rationale: The correct answer reflects a primary belief of psychiatric mental health nursing, which is that every person is worthy of dignity and respect. This belief forms the foundation of providing holistic and compassionate care in mental health nursing. While it is true that most people have the potential to change and grow, this choice does not directly address a core belief of mental health nursing. Human needs being individual to each person is a general principle of nursing care but does not specifically capture a primary belief in psychiatric mental health nursing. The statement that some behaviors have no meaning and cannot be understood contradicts the fundamental principle that all behavior has meaning and can be understood from the client's perspective in psychiatric mental health nursing.

Similar Questions