Nursing Elites

1. What would be an appropriate nursing response when a mother reports that her 16-month-old toddler has an earache?

• A. Maybe the toddler is just teething.
• B. I will check her ear for an ear infection.
• C. Are you sure the toddler is really in pain?
• D. Please describe what the toddler is doing to indicate she is in pain.

Correct answer: B

Rationale: The appropriate nursing response would be to assess the toddler's ear to determine if there is indeed an ear infection causing the earache. It is crucial to provide timely and suitable care for the child's pain and discomfort. Checking for an ear infection is a necessary step in evaluating the source of the toddler's earache. Choice A is incorrect as it assumes the earache is due to teething without proper assessment. Choice C questions the mother's report rather than focusing on the child's condition. Choice D is not as direct and focused as directly examining the ear for a possible infection.

2. When a nurse is performing a health interview on a patient with a language barrier and no interpreter is available, which of the following is the best example of an appropriate question for the nurse to ask?

• A. Do you take medicine?
• B. Do you sterilize the bottles?
• C. Do you have nausea and vomiting?
• D. You have been taking your medicine, haven't you?

Correct answer: A

Rationale: The best example of an appropriate question for the nurse to ask in this situation is 'Do you take medicine?' This question is clear, simple, and focused on one topic at a time, which is essential when there is a language barrier and no interpreter available. It follows the recommendation to use simple words, avoid medical jargon, contractions, and pronouns in such situations. Choices B, C, and D involve more complex language, unrelated topics, or assumptions about the patient's actions, making them less suitable for effective communication in this context.

3. When recording the childhood illnesses of a patient who denies having had any, which note by the nurse would be most accurate?

• A. Patient denies usual childhood illnesses.
• B. Patient states he was a 'very healthy' child.
• C. Patient states sister had measles, but he didn't.
• D. Patient denies measles, mumps, rubella, chickenpox, pertussis, and strep throat.

Correct answer: D

Rationale: Choice D is the most accurate note by the nurse as it lists specific childhood illnesses commonly experienced by children. By documenting that the patient denies having had these specific illnesses, the healthcare provider establishes a clear medical history record regarding these common childhood illnesses. This detailed documentation is essential for providing comprehensive care and evaluating potential risks or complications associated with these illnesses in the future. Choices A, B, and C are not as accurate as they do not provide a comprehensive list of common childhood illnesses that are routinely evaluated by healthcare providers. Choice A is too vague, Choice B focuses on the patient's perception of their health rather than specific illnesses, and Choice C only mentions measles, lacking the breadth of information provided in Choice D.

4. During an interview, a parent of a hospitalized child is sitting in an open position. As the interviewer begins to discuss his son's treatment, however, he suddenly crosses his arms against his chest and crosses his legs. This would suggest that the parent is:

• A. just changing positions.
• B. more comfortable in this position.
• C. tired and needs a break from the interview.
• D. uncomfortable talking about his son's treatment.

Correct answer: D

Rationale: The parent's sudden change in body language from an open position to crossing arms and legs suggests discomfort or defensiveness, particularly when discussing his son's treatment. This closed-off position indicates a lack of willingness to share information and potentially signals discomfort with the topic being discussed. Choice A is incorrect as the abrupt shift in body language indicates more than just a change in position. Choice B is incorrect because crossing arms and legs typically signal defensiveness or discomfort rather than comfort. Choice C is incorrect as there are specific body language cues indicating discomfort rather than just fatigue.

5. The healthcare professional is reviewing concepts of cultural aspects of pain. Which statement is true regarding pain?

• A. All individuals will behave the same way when in pain.
• B. Just as individuals vary in their perceptions of pain, they will also vary in their expressions of pain.
• C. Cultural norms play a significant role in determining pain tolerance, as it is always biologically determined.
• D. A patient's expression of pain is largely dependent on the amount of tissue injury associated with the pain.

Correct answer: B

Rationale: Patients vary in their perceptions of pain, which can be influenced by cultural factors, personal experiences, and psychological aspects. As a result, individuals will also vary in how they express their pain. Cultural norms, social environment, and individual differences all play a role in how pain is experienced and communicated. Therefore, it is important for healthcare professionals to recognize and respect these variations in order to provide appropriate pain management and support for patients. Choice A is incorrect because individuals do not behave the same way when in pain. Choice C is incorrect because pain tolerance is not solely biologically determined; cultural norms and individual differences also influence it. Choice D is incorrect because a patient's expression of pain can be influenced by various factors beyond the amount of tissue injury, such as emotional state and cultural beliefs.

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