Nursing Elites

1. A parent of a young child says, 'I'm so upset! The doctor prescribed an antidepressant!' Which response is best?

• A. Tell me more about what's bothering you.'
• B. Weren't you told about the need for the medication?'
• C. I'll notify the healthcare provider about your concerns.'
• D. 'Maybe the medication is for attention deficit disorder.'

Correct answer: A

Rationale: The best response in this situation is to express empathy and encourage the parent to share more about their concerns. Option A ('Tell me more about what's bothering you.') allows the nurse to show understanding and gather more information to address the parent's distress effectively. Option B ('Weren't you told about the need for the medication?') is confrontational and may make the parent defensive, hindering effective communication. Option C ('I'll notify the healthcare provider about your concerns.') is premature; the nurse should first assess the parent's feelings before deciding on further actions. Option D ('Maybe the medication is for attention deficit disorder.') assumes without clarification, which is not appropriate; the nurse should validate the prescription before suggesting alternative reasons.

2. What is a priority goal of involuntary hospitalization of the severely mentally ill client?

• A. Re-orientation to reality
• B. Elimination of symptoms
• C. Protection from harm to self or others
• D. Return to independent functioning

Correct answer: C

Rationale: The priority goal of involuntary hospitalization of severely mentally ill clients is to ensure protection from harm to self or others. Involuntary hospitalization is often necessary for individuals who are deemed dangerous to themselves or others or who are considered gravely disabled. Re-orientation to reality, elimination of symptoms, and return to independent functioning are important aspects of mental health care but are not the primary goals of involuntary hospitalization. The main focus during involuntary hospitalization is to address safety concerns and prevent harm.

3. Which implemented strategies would not be effective in preventing post-traumatic stress in the nursing staff?

• A. Providing breaks to the staff whenever needed
• B. Encouraging the staff to work for more than 12 hours per day
• C. Encouraging the staff to encourage and support their coworkers
• D. Asking the staff and managers to talk about their feelings with each other

Correct answer: B

Rationale: To prevent post-traumatic stress in the nursing staff, it is crucial to avoid overworking them. Encouraging staff to work for more than 12 hours per day can lead to burnout and increased stress levels, thus exacerbating post-traumatic stress. Providing breaks whenever needed is essential to ensure rest and rejuvenation during demanding shifts. Encouraging staff to support and uplift their coworkers can create a positive work environment, fostering resilience against stress. Additionally, promoting open communication by asking staff and managers to discuss their feelings can facilitate emotional processing and mutual support, ultimately reducing the risk of post-traumatic stress.

4. After informing an older client that an IV line needs to be inserted, the client becomes very apprehensive, loudly verbalizing a dislike for all healthcare providers and nurses. How should the nurse respond?

• A. Ask the client to remain quiet so the procedure can be performed safely.
• B. Concentrate on completing the insertion as efficiently as possible.
• C. Calmly reassure the client that the discomfort will be temporary.
• D. Tell the client a joke as a means of distraction from the procedure.

Correct answer: C

Rationale: The nurse should respond with a calm demeanor to help reduce the client's apprehension. By calmly reassuring the client that the discomfort from the procedure will be temporary, the nurse acknowledges the client's feelings and provides comfort. This response shows empathy and understanding, which can help build trust. Asking the client to remain quiet may escalate the situation and not address the client's underlying concerns. Concentrating solely on completing the insertion efficiently may overlook the client's emotional needs and may increase their anxiety. Telling a joke may not be appropriate in this serious situation and could be perceived as insensitive, failing to address the client's emotional distress effectively.

5. While receiving a preoperative enema, a client starts to cry and says, 'I'm sorry you have to do this messy thing for me.' Which is the nurse's best response?

• A. I don't mind it.'
• B. 'You seem upset.'
• C. 'This is part of my job.'
• D. 'Nurses get used to this.'

Correct answer: B

Rationale: The nurse's best response in this situation is to acknowledge the client's emotional state, as it shows empathy and encourages further expression of feelings. Choice A, 'I don't mind it,' dismisses the client's emotions and does not address the underlying issue. Choice C, 'This is part of my job,' focuses on the task rather than the client's emotional needs. Choice D, 'Nurses get used to this,' minimizes the client's feelings and lacks empathy. By selecting choice B, 'You seem upset,' the nurse acknowledges the client's distress and opens the door for further communication and support.

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