Nursing Elites

1. The mother of a toddler asks the nurse when she will know that her child is ready to start toilet training. The nurse tells the mother that which observation is a sign of physical readiness?

• A. The child no longer has temper tantrums.
• B. The child can remove his or her own clothing.
• C. The child has been walking for 2 years.
• D. The child can eat using a fork and knife.

Correct answer: B

Rationale: Signs of physical readiness for toilet training include the child's ability to remove his or her own clothing. This ability indicates the child has developed the necessary fine motor skills to manage clothing during toilet training. The other choices are incorrect because temper tantrums, walking for a specific period, and using utensils are not indicators of physical readiness for toilet training.

2. How does the family carry out its health care functions?

• A. The family provides very little preventive health care to its members at home.
• B. The family provides preventive health care to its members at home.
• C. The family pays for most health services.
• D. The family decides when and where to hospitalize its members.

Correct answer: B

Rationale: Families play a crucial role in providing preventive health care to their members at home. This includes activities such as promoting healthy lifestyles, ensuring vaccinations, scheduling regular check-ups, and intervening early when health issues arise. Therefore, the correct answer is that the family provides preventive health care to its members at home. Choices A, C, and D are incorrect because families are expected to actively engage in preventive health care practices rather than providing very little preventive care, solely paying for health services, or making hospitalization decisions. The focus is on the proactive role of families in maintaining the health of their members.

3. A nurse is supervising a student in preparing the physical environment for an interview with a client. Which action by the student is correct?

• A. Setting the room temperature at a comfortable level
• B. Placing a chair for the client across from the nurse's desk
• C. Providing seating for the client so that the client faces a strong light
• D. Setting up seating so that the client and nurse are not at eye level

Correct answer: A

Rationale: When preparing the physical environment for an interview with a client, it is crucial to ensure the client's comfort. Setting the room temperature at a comfortable level is essential for the client's well-being. Additionally, providing privacy, sufficient lighting, and removing distractions are crucial factors. It is recommended to maintain a distance of around 4 to 5 feet between the client and the nurse. Seating should be arranged so that the client and nurse are at eye level to facilitate effective communication and prevent barriers. Placing a chair across from the nurse's desk may create a physical barrier, positioning the client to face a strong light can be uncomfortable and distracting, and setting up seating so that the client and nurse are not at eye level may impede effective communication.

4. After breast reconstruction secondary to breast cancer, the nurse should recognize which of the following expected client outcomes as evidence of a favorable response to nursing interventions related to disturbed body image?

• A. maintaining adequate tissue perfusion
• B. demonstrating behaviors that reduce fears
• C. restored body integrity
• D. remaining free of infection

Correct answer: C

Rationale: The correct answer is 'restored body integrity.' This outcome is crucial in addressing disturbed body image following breast reconstruction. Restored body integrity reflects a positive perception of one's body after surgery, contributing to improved body image. Choices A, 'maintaining adequate tissue perfusion,' are more related to physiological outcomes and are not directly linked to body image concerns. Choice B, 'demonstrating behaviors that reduce fears,' is associated with anxiety management, not body image. Choice D, 'remaining free of infection,' pertains to preventing infections and does not directly address body image concerns.

5. A pregnant client asks a nurse about the use of noninvasive acupressure as a complementary alternative therapy to relieve nausea. The nurse provides which instruction?

• A. It is safe to try any type of complementary alternative therapy to relieve nausea
• B. The physician or nurse-midwife needs to provide a prescription for acupressure devices
• C. Devices that apply pressure alone are available over the counter
• D. Complementary alternative therapies should not be used during pregnancy

Correct answer: C

Rationale: The correct answer is 'Devices that apply pressure alone are available over the counter.' Acupressure over the Neiguan acupuncture point can be used as a complementary alternative therapy to relieve nausea during pregnancy. It can be performed with devices that apply pressure alone, which are available over the counter. Acupressure devices that apply electrical impulses over this point require a prescription. It is not safe to try any type of complementary alternative therapy during pregnancy, as some may be harmful to the mother and fetus. Therefore, the nurse should instruct the client about the availability of over-the-counter pressure devices for acupressure, which are generally safe to use.

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