Nursing Elites

1. The nurse is reviewing a depressed client's history from an earlier admission. Documentation of anhedonia is noted. The nurse understands that this finding refers to:

• A. Reports of difficulty falling and staying asleep
• B. Expression of persistent suicidal thoughts
• C. Lack of enjoyment in usual pleasures
• D. Reduced senses of taste and smell

Correct answer: C

Rationale: The correct answer is C: Lack of enjoyment in usual pleasures. Anhedonia is the inability to feel pleasure in normally pleasurable activities. Choice A, reports of difficulty falling and staying asleep, is more indicative of insomnia rather than anhedonia. Choice B, expression of persistent suicidal thoughts, is related to suicidal ideation and not anhedonia. Choice D, reduced senses of taste and smell, is more associated with disturbances in the sense of taste and smell, not anhedonia.

2. As a community health nurse engaged in the process of community empowerment, which action is essential for you to take?

• A. Gathering data from the community
• B. Making decisions for people in the community
• C. Forming partnerships with people in the community
• D. Accepting responsibility for people’s actions

Correct answer: C

Rationale: In the process of community empowerment, forming partnerships with people in the community is essential. This fosters collaboration, engagement, and shared decision-making, enabling the community to identify its needs, resources, and priorities. Gathering data from the community (Choice A) is important for understanding the community's health status but forming partnerships goes beyond data collection by actively involving community members in decision-making. Making decisions for people in the community (Choice B) undermines empowerment as it takes away their autonomy and control. Accepting responsibility for people’s actions (Choice D) is not synonymous with empowerment and can lead to disempowerment by creating dependency rather than fostering self-reliance and self-determination.

3. All of the following are objectives of FHSIS EXCEPT:

• A. To complete the clinical picture of chronic diseases and describe their natural history
• B. To provide a standardized, facility-level database that can be accessed for more in-depth studies
• C. To minimize recording and reporting burden, allowing more time for patient care and promotive activities
• D. To ensure that data reported are useful and accurate and are disseminated in a timely and easy-to-use fashion

Correct answer: A

Rationale: The correct answer is A. Completing the clinical picture of chronic diseases and describing their natural history is not an objective of FHSIS. The objectives of FHSIS include providing a standardized, facility-level database for more in-depth studies (B), minimizing recording and reporting burden to allow more time for patient care and promotive activities (C), and ensuring that reported data are useful, accurate, and disseminated in a timely and easy-to-use manner (D). Therefore, A is the exception among the listed objectives.

4. When providing nursing care to a client receiving oxygen therapy via a nasal cannula, which of the following interventions would be appropriate?

• A. Ensure that adequate mist is supplied
• B. Inspect the nares and ears for skin breakdown
• C. Lubricate the tips of the cannula before insertion
• D. Maintain sterile technique when handling the cannula

Correct answer: B

Rationale: The correct answer is to inspect the nares and ears for skin breakdown. This is important because the nasal cannula can cause skin breakdown due to prolonged use and friction. Ensuring that the skin is intact helps prevent complications. Choice A is incorrect as oxygen therapy via a nasal cannula does not involve mist. Choice C is incorrect as lubricating the tips of the cannula is not a standard practice and may lead to complications. Choice D is incorrect because while cleanliness is important, maintaining sterile technique is not necessary for handling a nasal cannula in this context.

5. A 19-year-old client is paralyzed in a car accident. Which statement used by the client would indicate to the nurse that the client was using the mechanism of 'suppression'?

• A. "I don't remember anything about what happened to me."
• B. "I'd rather not talk about it right now."
• C. "It's all the other guy's fault! He was going too fast."
• D. "My mother is heartbroken about this."

Correct answer: B

Rationale: The correct answer is B because the statement "I'd rather not talk about it right now" indicates that the client is consciously choosing to avoid discussing the distressing issue, which aligns with the mechanism of suppression. Choice A does not involve active avoidance but rather memory loss, which is not suppression. Choice C involves blaming others, which is a defense mechanism known as projection. Choice D involves expressing emotions rather than avoiding them, which does not align with suppression.

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