Nursing Elites

1. The client is a 35-year-old multiparous individual scheduled for a tubal ligation. The nurse assesses the client's emotional response to the planned procedure. Which factor in the client's history will contribute to the healthy resolution of any emotional problem associated with sterilization?

• A. Belief that the surgery will relieve her monthly dysmenorrhea
• B. Knowledge that her partner does not want to have any more children
• C. Feeling that her family is complete and she now has the children she planned for
• D. Recovery from her previous complicated birth and a desire to avoid another birth

Correct answer: C

Rationale: The correct answer is feeling that her family is complete and she now has the children she planned for. Many couples in their 30s who feel that their families are complete choose sterilization as their method of contraception. Sterilization by means of tubal ligation should not be expected to have an effect on dysmenorrhea. The decision to undergo sterilization should be the individual's own choice and should not be influenced by others, including partners. Decisions regarding sterilization should ideally be made when the individual is not under stress, such as after recovery from a previous complicated birth. Therefore, the key factor contributing to a healthy resolution of emotional issues related to sterilization is the feeling of family completeness and achieving the planned number of children.

2. Which risk factor for suicide is considered the most lethal?

• A. History of alcohol and drug abuse
• B. Previous high-lethality suicide attempts
• C. Recent withdrawal from friends
• D. Disturbance of family dynamics

Correct answer: B

Rationale: The correct answer is 'Previous high-lethality suicide attempts.' This is the most lethal risk factor as it indicates that the individual has previously attempted suicide in a manner that could lead to death. This history increases the likelihood of future attempts. While substance abuse, like alcohol and drug use, is a significant risk factor for suicide, it is not considered the most lethal. Withdrawal from friends or social isolation can contribute to suicide risk but is not as directly deadly as high-lethality attempts. Disturbance of family dynamics can also be a stressor but does not represent the immediate lethality associated with a history of high-lethality suicide attempts.

3. Jerry is a 55-year-old veteran who has been admitted after a motor vehicle accident with multiple injuries. His friend reported that he had been using synthetic marijuana prior to the accident, and that he also sees a psychiatrist at the VA hospital for an unknown diagnosis. He stated that Jerry sometimes gets "hyper"? for no reason, starts "ranting"? and becomes violent. Of the following, which general psychiatric disorder is characterized by a pattern of aggression or violence that includes irritability, agitation, and violent behavior during manic or psychotic episodes?

• A. Schizophrenia
• B. Post-traumatic stress disorder (PTSD)
• C. Bipolar disorder
• D. Delusional disorder

Correct answer: C

Rationale: Bipolar disorder is characterized by a pattern of aggression or violence that includes irritability, agitation, and violent behavior during manic or psychotic episodes. This disorder is highly co-morbid with substance use, which can worsen the prognosis. While schizophrenia may involve aggression, it is not typically associated with mood episodes like mania that characterize bipolar disorder. Post-traumatic stress disorder (PTSD) is primarily characterized by re-experiencing traumatic events, avoidance behaviors, and hyperarousal, but not the distinct mood episodes seen in bipolar disorder. Delusional disorder is characterized by fixed false beliefs without the mood changes seen in bipolar disorder. Therefore, the correct answer is Bipolar disorder.

4. A term used to describe members of the same group based on physiological characteristics, such as skin color or body structure, is known as:

• A. Ethnicity
• B. Culture
• C. Race
• D. Minority

Correct answer: C

Rationale: The correct term used to describe members of the same group based on physiological characteristics, such as skin color or body structure, is 'Race.' Race categorizes people based on physical traits like skin color. Ethnicity refers to shared cultural characteristics, traditions, language, and heritage, not physical attributes. Culture encompasses the values, beliefs, behaviors, and practices shared by a group. 'Minority' refers to a smaller number or part compared to the whole, not specifically based on physiological characteristics.

5. Which factor is most critical for a single mother of 2 children who recently lost her job and does not know what to do?

• A. Developmental history of children
• B. Available situational supports
• C. Underlying unconscious conflict
• D. Willingness to restructure lifestyle

Correct answer: B

Rationale: In a crisis intervention, the priority is to identify available situational supports, such as family, friends, community resources, and social services, that can help the single mother and her children during this difficult time. Understanding the developmental history of the children may be important to assess their needs, but it is not the most critical factor in this immediate crisis. Exploring underlying unconscious conflicts is more suited for long-term therapy rather than crisis intervention. While the willingness to restructure lifestyle may eventually be necessary, the immediate focus should be on finding support systems to address the current crisis.

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