Nursing Elites

1. The nurse is caring for a Native American patient who has traditional beliefs about health and illness. Which action by the nurse is most appropriate?

• A. Avoid asking questions unless the patient initiates the conversation.
• B. Ask the patient whether it is important that cultural healers are contacted.
• C. Explain the usual hospital routines for meal times, care, and family visits.
• D. Obtain further information about the patient's cultural beliefs from a family member.

Correct answer: B

Rationale: When caring for a patient with traditional health beliefs, it is essential to respect and address their cultural practices. Asking the patient whether it is important to involve cultural healers, such as a shaman, aligns with providing culturally sensitive care. Avoiding asking questions unless initiated by the patient may hinder effective communication and understanding of the patient's needs. Consulting a family member for cultural beliefs assumes that all family members share the same beliefs, which may not be accurate. Additionally, the patient's personal beliefs should be prioritized over family input. Explaining hospital routines without considering the patient's cultural preferences may lead to a lack of patient-centered care. Therefore, the most appropriate action is to inquire about the patient's preference regarding cultural healers.

2. What is the similarity between the stage-crisis theory proposed by Havighurst and the psychosocial development theory formulated by Erikson?

• A. Based on developmental tasks
• B. Incorporate eight stages of development
• C. Based on changes in a person's thoughts and emotions
• D. Emphasize that a child's growth is directed by individual gene activity

Correct answer: A

Rationale: Both Havighurst's stage-crisis theory and Erikson's psychosocial development theory are grounded in the concept of developmental tasks. They both emphasize that successful completion of specific tasks at various life stages is crucial for healthy development. While Erikson's theory consists of eight stages of psychosocial development, Havighurst's theory comprises six stages. The idea that a child's growth is guided by individual gene activity is attributed to Gesell's theory, not Havighurst or Erikson. The emphasis on changes in a person's thoughts, emotions, and behaviors shaping beliefs about morality aligns with moral development theory, not specifically with Havighurst's or Erikson's theories.

3. The client prepares to insert a nasogastric tube in a client with hyperemesis who is awake and alert. Which intervention(s) is(are) correct?

• A. Place the client in a high Fowler position.
• B. Assist the client in assuming a left side-lying position.
• C. Measure the tube from the tip of the nose to the xiphoid process.
• D. Assist the client in flexing the neck forward to facilitate tube insertion.

Correct answer: A

Rationale: The correct intervention during nasogastric tube insertion in an awake and alert client is to place them in a high Fowler position (A). Left side-lying position (B) is more suitable for unconscious or obtunded clients. When measuring the tube length, it should be from the tip of the nose to behind the ear, and then from behind the ear to the xiphoid process (C). Assisting the client in flexing the neck forward (D) is appropriate to facilitate tube insertion rather than extending the neck back, which may lead to complications. Proper positioning and measurements are crucial to prevent complications and ensure successful nasogastric tube placement.

4. What step should be taken when administering ear drops to an adult client?

• A. Place the client in a side-lying position.
• B. Hold the dropper 1 cm above the ear canal.
• C. Place a cotton ball into the outermost canal.
• D. Pull the auricle down and back.

Correct answer: A

Rationale: The correct step when administering ear drops to an adult client is to place the client in a side-lying position (A). This position allows for easier administration of the drops and helps prevent spillage. The dropper should be held approximately 1 cm (� inch) above the ear canal (B) to ensure accurate delivery of the medication. Placing a cotton ball into the outermost canal (C) is unnecessary and may interfere with the absorption of the ear drops. Pulling the auricle down and back (D) is a technique used for children younger than 3 years old to straighten the ear canal, but it is not necessary for adults and may cause discomfort.

5. When developing Jerry's plan of care, which of the following would NOT be helpful to include?

• A. Limiting choices
• B. Providing structure
• C. Encouraging patient input
• D. Ensuring availability of PRN medications

Correct answer: A

Rationale: Limiting choices would not be helpful in Jerry's plan of care. Providing options, even if among limited choices, offers the patient a sense of independence rather than imposing control. Providing structure is crucial, especially in transitioning from a psychiatric to a medical-surgical unit. Encouraging patient input in identifying triggers and effective methods for managing aggressive impulses is essential for empowerment and individualized care. Ensuring the availability and prompt delivery of PRN medications gives the patient a sense of control and security, assuring access to necessary medication when needed.

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