Nursing Elites

1. Over a period of several weeks, one male participant of a socialization group at a community day care center for the elderly monopolizes most of the group's time and interrupts others when they are talking. What is the best action for the nurse to take in this situation?

• A. Talk to the participant outside the group about his behavior during group meetings.
• B. Remind the participant to allow others in the group a chance to talk.
• C. Allow the group to handle the problem.
• D. Ask the participant to join another group.

Correct answer: C

Rationale: Allowing the group to handle the situation is the best action as it promotes group dynamics and empowerment, especially since the group is in the working phase. Talking to the participant individually (A) might be seen as manipulative. Reminding the participant (B) can come across as dictatorial and may not address the underlying issue. Asking the participant to join another group (D) does not address the problem at hand and avoids the opportunity for growth and conflict resolution within the current group.

2. An older female adult who lives in a nursing home is loudly demanding that the nurse call her son who has been deceased for five years. Which intervention should the nurse implement?

• A. Assist the client in making the phone call.
• B. Remind the client about her son's passing.
• C. Escort the client to a private area.
• D. Direct the client to a new activity.

Correct answer: D

Rationale: In this situation, the most appropriate intervention is to direct the client to a new activity. This approach can help redirect the client's attention, distract her from the distressing request, and engage her in a more positive interaction. Choice A could exacerbate the client's distress by attempting to make the impossible call, and reminding the client about her son's passing (Choice B) may increase her emotional distress. Escorting the client to a private area (Choice C) does not address the underlying issue and may not effectively manage the situation.

3. A client with generalized anxiety disorder (GAD) is prescribed buspirone (BuSpar). The client asks how long it will take for the medication to start working. What is the nurse's best response?

• A. You should start feeling better within a few days.
• B. It may take 2 to 4 weeks before you notice an improvement.
• C. Buspirone works immediately to reduce anxiety symptoms.
• D. You will need to take this medication for at least a year.

Correct answer: B

Rationale: The correct answer is B. Buspirone typically takes 2 to 4 weeks to become fully effective. It is essential to inform the client that it may take some time before they notice an improvement. Choice A is incorrect because buspirone does not work immediately. Choice C is also incorrect as buspirone does not provide immediate relief. Choice D is incorrect as it suggests a longer duration of treatment than necessary.

4. The wife of a male client recently diagnosed with schizophrenia asks the nurse, 'What exactly is schizophrenia? Is my husband all right?' Which response is best for the nurse to provide to this family member?

• A. It sounds like you're worried about your husband. Let's sit down and talk.
• B. It is a chemical imbalance in the brain that causes disorganized thinking.
• C. Your husband will be just fine if he takes his medications regularly.
• D. I think you should talk to your husband's psychologist about this question.

Correct answer: B

Rationale: The best response for the nurse to provide to the wife of the client diagnosed with schizophrenia is to offer factual information. Choice B is the correct answer as it explains that schizophrenia is a mental disorder characterized by a chemical imbalance in the brain that causes disorganized thinking. This response provides a simple and accurate explanation of the condition. Choices A, C, and D are incorrect because they do not directly address the wife's question about what schizophrenia is. Choice A focuses on emotional support rather than providing information about the disorder. Choice C gives false reassurance without addressing the nature of schizophrenia. Choice D deflects the question by suggesting the wife speak to the psychologist, missing an opportunity to educate and support the family member.

5. A client with borderline personality disorder tells the nurse, 'You're the only one who understands me. The other nurses don't care about me.' Which response by the nurse is most appropriate?

• A. Why do you feel that way about the other nurses?
• B. The other nurses care about you too.
• C. I am here to help you just like the other nurses.
• D. Let's talk about why you feel this way.

Correct answer: C

Rationale: The most appropriate response is 'I am here to help you just like the other nurses' (C). This response sets boundaries and avoids reinforcing the client's splitting behavior, which is common in borderline personality disorder. Choices A and D may unintentionally reinforce the splitting by focusing on the negative perception of other nurses. Choice B might be perceived as dismissive because it contradicts the client's feelings of being understood only by the nurse.

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