Nursing Elites

1. The nurse is discussing the term subculture with a student nurse. Which statement by the nurse would best describe subculture?

• A. "Fitting as many people as possible into the majority culture."?
• B. "Identifying small groups of people who do not want to be identified with the larger culture."?
• C. "Singling out groups of people who suffer differential and unequal treatment as a result of cultural variations."?
• D. "Recognizing groups of people within a culture with shared characteristics that are not common to all members of the culture."?

Correct answer: D

Rationale: A subculture refers to a group of people within a larger culture who share distinct beliefs, values, or attitudes that are not universal among all members of the larger culture. Subcultures can emerge based on factors such as ethnicity, religion, education, occupation, age, and gender. The correct answer describes the concept of a subculture accurately. Choices A, B, and C are incorrect because they do not capture the essence of a subculture. Fitting people into the majority culture, identifying small groups who distance themselves from the larger culture, or singling out individuals facing differential treatment do not define subculture. Subcultures represent specific groups with shared characteristics that differentiate them from the broader cultural norms.

2. During a client interview, which of the following leading questions should the nurse avoid asking?

• A. What medication do you take at home?
• B. You are really excited about the plastic surgery, aren't you?
• C. Were you aware I've had this same type of surgery?
• D. What would you like to talk about?

Correct answer: B

Rationale: The nurse should avoid asking leading questions during a client interview as they can influence the client's response. Option B is a leading question as it suggests an expected response from the client, potentially biasing the information provided. This can lead to inaccurate data collection and subsequent errors in diagnostic reasoning. Choices A, C, and D are open-ended questions that encourage the client to provide unbiased information and allow for a more comprehensive assessment.

3. In which situation would the nurse use bimanual palpation technique?

• A. Palpating the thorax of an infant
• B. Palpating the kidneys and uterus
• C. Assessing pulsations and vibrations
• D. Assessing the presence of tenderness and pain

Correct answer: B

Rationale: Bimanual palpation involves using both hands to envelop or capture specific body parts or organs like the kidneys, uterus, or adnexa. This technique is particularly useful for assessing the size, shape, consistency, and mobility of deep organs like the kidneys and uterus. Palpating the thorax of an infant (Choice A) is usually done with a different technique like gentle, single-handed palpation. Assessing pulsations and vibrations (Choice C) and assessing tenderness and pain (Choice D) typically do not require the use of bimanual palpation, making Choices A, C, and D incorrect.

4. The nurse is preparing to perform a physical assessment. The correct action by the nurse is reflected by which statement?

• A. Performs the examination from both sides of the bed.
• B. Examines tender or painful areas last to help relieve the patient's anxiety.
• C. Follows a flexible examination sequence, considering the patient's age and condition.
• D. Organizes the assessment to ensure that the patient does not change positions too often.

Correct answer: D

Rationale: The nurse should organize the assessment to minimize the patient's need to change positions frequently, ensuring efficiency and comfort. It is essential to perform the examination from both sides of the bed to facilitate a comprehensive assessment. Examining tender or painful areas last can help reduce patient discomfort and anxiety. The examination sequence should be flexible, taking into account the patient's age, condition, and specific needs. This approach allows for a tailored and patient-centered assessment, optimizing the quality of care provided.

5. The client starting an exercise program will progress to walking a 20-minute mile in one month.

• A. Client will walk quickly three times a day
• B. Client will be able to walk a mile
• C. Client will have no alteration in breathing during the walk
• D. Client will progress to walking a 20-minute mile in one month

Correct answer: D

Rationale: Outcome statements must be written in behavioral terms and identify specific, measurable client behaviors. They are stated in terms of the client with an action verb that, under identified conditions, will achieve the desired behavior. Choice A lacks specificity and does not mention a target time or goal. Choice B is vague and does not provide a specific target for improvement. Choice C focuses on a negative outcome (no alteration) rather than a positive goal. The correct answer, Choice D, is specific, measurable, and time-bound, making it a suitable outcome statement for a client starting an exercise program.

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