Nursing Elites

1. When communicating with a patient who has a hearing impairment, what technique would be most beneficial?

• A. Determine the communication method he prefers.
• B. Avoid using facial and hand gestures as they can be degrading to most hearing-impaired individuals.
• C. Request a sign language interpreter before meeting to facilitate communication.
• D. Speak loudly and with exaggerated facial movement, as this helps with lip reading.

Correct answer: A

Rationale: When communicating with a patient who has a hearing impairment, it is crucial to determine the preferred communication method, whether it involves signing, lip reading, or writing. By directly asking the patient for their preferred method of communication, the healthcare provider can ensure effective and respectful interaction tailored to the individual's specific needs and preferences. Option B is incorrect because using facial and hand gestures can actually aid in communication for some individuals with hearing impairments. Option C is not always necessary and may not be the preferred method for all patients. Option D is incorrect because speaking loudly and with exaggerated facial movements is not necessary and may not be preferred by the patient.

2. Before a child undergoes a tonsillectomy, what information should the nurse collect?

• A. The child's birth weight
• B. The age at which they crawled
• C. Whether they have had the measles
• D. Reactions to previous hospitalizations

Correct answer: D

Rationale: Before a child undergoes a tonsillectomy, it is crucial for the nurse to gather information on the child's reactions to previous hospitalizations. This data helps in assessing potential fears or anxiety and in providing the necessary support and preparation for the upcoming tonsillectomy. Understanding the child's past reactions is vital for ensuring their comfort and well-being during the hospital admission and procedure. The other options provided are not directly relevant to the child's upcoming tonsillectomy procedure. Birth weight (Choice A) is not typically a factor considered before a tonsillectomy. The age at which a child crawled (Choice B) is a developmental milestone but not pertinent to the tonsillectomy. Having had measles (Choice C) is important for overall health history but not specifically crucial before a tonsillectomy.

3. An elderly Mexican-American woman with traditional beliefs has been admitted to an inpatient care unit. A culturally-sensitive nurse would:

• A. contact the hospital administrator about the best course of action.
• B. automatically get a curandero for her because it is not culturally appropriate for her to request one.
• C. further assess the patient's cultural beliefs and offer the patient assistance in contacting a curandero or priest if she desires.
• D. ask the family what they would like to do because Mexican-Americans traditionally give control of decisions to their families.

Correct answer: C

Rationale: When caring for a patient with traditional beliefs, especially one belonging to a culture like Mexican-American where folk or religious healers are important, a culturally-sensitive nurse should assess the patient's beliefs and preferences. By offering assistance in contacting a curandero or priest, the nurse acknowledges and respects the patient's cultural practices and provides holistic care that aligns with the patient's values. This approach helps build trust and ensures the patient receives care that is culturally appropriate and respectful. Choice A is incorrect as contacting the hospital administrator may not directly address the patient's cultural needs. Choice B is inappropriate as assuming the patient needs a curandero without assessment disregards individual preferences. Choice D is incorrect because while family involvement is valued in Mexican-American culture, the primary focus should be on the patient's individual preferences and autonomy.

4. During an interview, the interviewer is using open-ended questions. Which of the following statements are true regarding open-ended questions? Select all that apply.

• A. They elicit cold facts.
• B. They allow for self-expression.
• C. They build and enhance deviation from topic
• D. They leave interactions neutral.

Correct answer: B

Rationale: Open-ended questions are designed to encourage the interviewee to express themselves freely, leading to more detailed and insightful responses. These questions help build rapport by showing interest in the interviewee's thoughts and feelings. By allowing for self-expression, open-ended questions facilitate a deeper and more meaningful conversation, making them a valuable tool in conducting interviews. Choice A is incorrect because open-ended questions aim to gather detailed and subjective information, not just cold facts. Choice D is incorrect as open-ended questions often lead to more engaging interactions rather than leaving them neutral.

5. 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.

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