Nursing Elites

1. What are the three major sequential maturational crises for females?

• A. puberty, pregnancy, and menopause.
• B. death of a spouse, menopause, and childbirth.
• C. rape, divorce, and menarche.
• D. dating, engagement, and separation.

Correct answer: A

Rationale: The three major sequential maturational crises affecting females are puberty, pregnancy, and menopause. Puberty signifies the beginning of menarche, the first menstrual period. Pregnancy is a transformative experience with long-lasting effects on a woman's life. Menopause marks the end of menstrual cycles. These milestones are well-documented in research and are significant events in a woman's life. Nurses play a vital role in supporting females through these stages. Choices B, C, and D are incorrect as they do not accurately represent the recognized sequential maturational crises in a female's life.

2. A client goes to the mental health center for difficulty concentrating, insomnia, and nightmares. The client reports being raped as a child. The nurse should assess the client for further signs of:

• A. generalized anxiety disorder.
• B. schizophrenia.
• C. post-traumatic stress disorder.
• D. bipolar disorder.

Correct answer: C

Rationale: Given the history of childhood sexual abuse and the presenting symptoms of difficulty concentrating, insomnia, and nightmares, the nurse should assess the client for post-traumatic stress disorder (PTSD). Childhood sexual abuse is strongly associated with adult-onset depression and an increased risk for PTSD. Individuals with PTSD may exhibit re-experiencing symptoms such as flashbacks, nightmares, and heightened reactions to trauma triggers. They may also display emotional numbing, avoidance behaviors, and increased arousal symptoms like difficulty sleeping and hypervigilance. Generalized anxiety disorder (Choice A) is characterized by excessive worry and anxiety about various events or activities, not necessarily tied to a specific trauma. Schizophrenia (Choice B) is a severe mental disorder characterized by distortions in thinking, perception, emotions, and behavior, unrelated to the traumatic event described. Bipolar disorder (Choice D) involves mood swings between depressive and manic episodes, and its symptoms differ from those typically seen in PTSD.

3. The difference between spirituality and religion is that spirituality is:

• A. a belief about a higher power.
• B. an individual's relationship with a higher power.
• C. organized worship.
• D. a belief in an invisible energy or ideal.

Correct answer: B

Rationale: The correct answer is 'an individual's relationship with a higher power.' Spirituality is more about personal connection, beliefs, and experiences related to a higher power or force, whereas religion is often associated with organized practices, rituals, and doctrines within a specific faith community. Choice A is incorrect as spirituality goes beyond just believing in a higher power; it encompasses a personal connection. Choice C, 'organized worship,' is incorrect because spirituality can exist outside formal religious settings. Choice D is incorrect as it oversimplifies spirituality as merely a belief in an invisible energy or ideal, missing the relational aspect with a higher power.

4. A family member of a client with a diagnosis of Schizophrenia asks about the prognosis. The nurse's response is based on the knowledge that schizophrenia:

• A. affects both genders equally.
• B. is a chronic, deteriorating disease with periods of remission.
• C. is usually diagnosed in early adulthood.
• D. does not have a clear protective hormone effect delaying diagnosis.

Correct answer: B

Rationale: The correct answer is B: 'is a chronic, deteriorating disease with periods of remission.' While choices A, C, and D contain some truths about schizophrenia, they do not directly address the prognosis aspect of the question. Schizophrenia can affect both men and women equally, is typically diagnosed in early adulthood, and does not have a known protective hormone effect that delays diagnosis. Choice B accurately reflects the chronic and fluctuating nature of the disease, which is essential for understanding its long-term course.

5. A client asks the nurse if all donor blood products are cross-matched with the recipient to prevent a transfusion reaction. Which of the following always requires cross-matching?

• A. packed red blood cells
• B. platelets
• C. plasma
• D. granulocytes

Correct answer: A

Rationale: Corrected Rationale: Packed red blood cells contain antigens and antibodies that must be matched between the donor and recipient to prevent transfusion reactions. Platelets, plasma, and granulocytes do not contain red blood cells, so they do not require cross-matching. Platelets are matched based on ABO compatibility, while plasma and granulocytes are not routinely cross-matched as they lack red cell antigens.

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