Nursing Elites

1. Toilet training occurs in the anal stage of Freud’s psychosexual development. This is equivalent to Erikson’s:

• A. Trust vs. Mistrust
• B. Autonomy vs. Shame and Doubt
• C. Initiative vs. Guilt
• D. Industry vs. Inferiority

Correct answer: A

Rationale: The correct answer is A: Trust vs. Mistrust. In Freud's psychosexual development theory, the anal stage is where toilet training occurs, focusing on issues of control and independence. This stage is parallel to Erikson's Trust vs. Mistrust stage, where infants learn to trust or mistrust their caregivers based on the consistency of care they receive. Choices B, C, and D are incorrect as they correspond to different stages in Erikson's psychosocial development theory, not related to toilet training or the anal stage of Freud's theory.

2. If it is determined that a child is being physically abused by a parent, what would be the most important goal for the nurse to establish with the family?

• A. The child and any siblings will reside in a secure environment
• B. The family will feel at ease in their relationship with the counselor
• C. The family will gain insight into their abusive behavior patterns
• D. The mother will learn to apply verbal discipline with her children

Correct answer: A

Rationale: The primary objective when dealing with cases of child abuse is to ensure the safety of the child and any siblings. This means creating a secure environment free from harm, which is why choice 'A' is the correct answer. While choices 'B', 'C', and 'D' might be subsequent steps in a comprehensive plan to deal with the situation, they are not the immediate priority. Understanding abusive behavioral patterns or improving the relationship with the counselor will not directly lead to the child's safety. Likewise, teaching the mother to apply verbal discipline doesn't guarantee the child's safety if the abusive behavior continues. Therefore, these options are not the most important initial goal.

3. Each of the following accurately describes aspects of the dietary reference intakes (DRIs) published by the Food and Nutrition Board of the Institute of Medicine (IOM) except one. Which one is the exception?

• A. The DRIs replace the older recommended daily allowances.
• B. Current DRIs attempt to estimate required nutrients to improve long-term health.
• C. DRIs specifically address individuals whose requirements are affected by a disease state.
• D. The DRIs attempt to establish maximum safe levels of tolerance for nutrients.

Correct answer: C

Rationale: The correct answer is C. DRIs do not specifically address individuals with disease states; they are intended for the general healthy population. Choice A is correct because DRIs indeed replace the older recommended daily allowances. Choice B is correct as current DRIs aim to estimate required nutrients to enhance long-term health. Choice D is accurate as DRIs also attempt to establish maximum safe levels of tolerance for nutrients.

4. Which individual would be at the greatest risk for deficiencies in water-soluble vitamins?

• A. An individual who regularly consumes fruits and vegetables.
• B. An individual with a high intake of dairy products.
• C. An individual who consumes a diet high in processed foods.
• D. An individual who frequently eats organ meats.

Correct answer: C

Rationale: The correct answer is 'An individual who consumes a diet high in processed foods.' Processed foods are often deficient in water-soluble vitamins such as vitamin C and B vitamins, which can lead to deficiencies. On the other hand, fruits, vegetables, and organ meats are rich sources of these vitamins, so individuals who consume these regularly are less likely to develop deficiencies. While dairy products do contain some water-soluble vitamins, they are not depleted as quickly as they are in a diet high in processed foods, making a deficiency less likely.

5. A nurse is developing a plan of care for a client who has anorexia nervosa. Which of the following actions should the nurse include in the plan?

• A. Encourage the client to participate in developing a system of rewards.
• B. Arrange for someone to remain with the client for 30 minutes after meals.
• C. Offer the client a selection of beverages at each meal.
• D. Inform the client that a weight gain of 2.3 kg per week is expected.

Correct answer: A

Rationale: Encouraging the client to participate in developing a system of rewards is an essential part of the plan of care for a client with anorexia nervosa. This action can help motivate and engage the client in their treatment plan, promoting a sense of achievement and progress. Choice B, arranging for someone to remain with the client for 30 minutes after meals, may not address the underlying issues related to anorexia nervosa and could potentially disrupt the client's independence. Choice C, offering a selection of beverages at each meal, is not directly related to addressing the client's condition of anorexia nervosa. Choice D, informing the client about an expected weight gain, could increase anxiety and may not be appropriate without considering the client's individual progress and readiness.

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