Nursing Elites

1. Mrs. Owens is the 81-year-old mother of Jonathan, who is 54 years old. Jonathan has had schizophrenia since he was 16 years old. Which of Mrs. Owens's concerns is likely to predominate?

• A. "Will my retirement funds outlast me?"?
• B. "Who will handle my funeral arrangements?"?
• C. "What will become of Jonathan when I am gone?"?
• D. "How can I communicate effectively with Jonathan's physician?"?

Correct answer: C

Rationale: The most prominent concern for Mrs. Owens is likely what will happen to her son, Jonathan, after she passes away. While retirement fund sustainability is important, it is not likely to be her primary concern. Funeral arrangements, although significant, are secondary to the welfare of her son with schizophrenia. The question of how to communicate with Jonathan's physician is less likely to be a predominant concern since Mrs. Owens has likely already addressed this issue over the 38 years of managing her son's care.

2. The nurse is preparing a client for mammography. To prepare the client for a mammogram, the nurse should tell the client:

• A. To omit creams, powders, or deodorants before the exam
• B. To restrict fat intake for 1 week before the test
• C. That mammography replaces the need for self-breast exams
• D. That mammography requires a higher dose of radiation than an x-ray

Correct answer: A

Rationale: The client undergoing a mammogram should be instructed to omit deodorants or powders beforehand because they can interfere with the imaging results. Answer A is correct as it aligns with the preparation needed before a mammogram to ensure accurate results. Answer B is incorrect because there is no requirement for fat intake restrictions before a mammogram. Answer C is incorrect because mammography does not replace the necessity of self-breast exams; both are crucial for maintaining breast health. Answer D is incorrect because a mammogram does not require higher doses of radiation than an x-ray. In fact, mammography uses a low dose of radiation to create images for breast examination.

3. Social support systems include all of the following except:

• A. call-in help lines
• B. emotional assistance provided by others
• C. community support groups
• D. use of coping skills and verbalization for anger management

Correct answer: D

Rationale: Social support systems involve external sources of support like call-in help lines, emotional assistance from others, and community support groups. These external resources provide individuals with assistance and comfort. Coping skills and verbalization for anger management are personal strategies that individuals use to manage emotions internally. While these skills can be beneficial, they are not considered part of external social support systems.

4. When discussing the patterns of use of alcohol and other drugs, which piece of information should the nurse include?

• A. Lifetime prevalence and intensity of alcohol use are greater in men than in women.
• B. Caucasians report higher levels of alcohol use than African Americans or Hispanics.
• C. Overuse of alcohol and other drugs increases into the mid-20s, then levels off and decreases with age.
• D. Heavy use is more common in lower socioeconomic groups due to affordability.

Correct answer: C

Rationale: The correct answer is that overuse of alcohol and other drugs increases into the mid-20s, then levels off and decreases with age. Recent research indicates that alcohol and illicit drug use tends to rise into the mid-20s and then decline with age. Choices A and B are incorrect because lifetime prevalence and intensity of alcohol use are greater in men than in women, and Caucasians do not report higher levels of alcohol use compared to African Americans or Hispanics. Choice D is incorrect because heavy use is more common in lower socioeconomic groups due to factors like stress, coping mechanisms, and availability, not just affordability.

5. The new mother asks why her baby has lost weight since he was born. The best explanation of the weight loss is:

• A. The baby is dehydrated due to polyuria.
• B. The baby is hypoglycemic due to lack of glucose.
• C. The baby is allergic to the formula the mother is giving him.
• D. The baby can lose up to 10% of weight due to meconium stool, loss of extracellular fluid, and initiation of breastfeeding.

Correct answer: D

Rationale: After birth, newborns can lose weight due to meconium stool, loss of extracellular fluid, and the initiation of breastfeeding. This weight loss is a normal and expected physiological process, and infants can lose up to 10% of their birth weight during this period. There is no indication of dehydration (polyuria), hypoglycemia (lack of glucose), or allergy to the formula as reasons for weight loss in newborns. Therefore, answers A, B, and C are incorrect. Answer D provides the most accurate explanation for the observed weight loss in the newborn.

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