Nursing Elites

1. What is the primary goal of family education?

• A. symptom reduction
• B. improved quality of life
• C. increased knowledge about mental illness
• D. improved caregiving skills

Correct answer: B

Rationale: The primary goal of family education is to improve the quality of life. Family education aims to enhance the overall well-being and functioning of both the individual with the condition and their family members. While increased knowledge about mental illness may be a beneficial outcome, it is not the primary objective of family education. Symptom reduction is more commonly associated with psychoeducation rather than family education. Improving caregiving skills is a component of family education, but the primary focus is on improving the quality of life for everyone involved in the caregiving process.

2. A hospitalized client has just been informed that he has terminal cancer. He says to the nurse, 'There must be some mistake in the diagnosis.' The nurse determines that the client is demonstrating which of the following?

• A. denial
• B. anger
• C. bargaining
• D. acceptance

Correct answer: A

Rationale: The correct answer is denial. In this scenario, the client's statement indicates denial, which is a common reaction in K�bler-Ross's Stages of Grieving. Denial involves the refusal to accept or believe that a loss, such as a terminal illness diagnosis, is happening. Choices B, C, and D are incorrect: Anger involves feelings of resentment or frustration; Bargaining is an attempt to negotiate or make deals to avoid the situation; Acceptance is the final stage where the individual comes to terms with the reality of the situation.

3. Which of the following describes the stages of domestic violence in an intimate relationship?

• A. happiness, crisis, angry outburst, intervention
• B. honeymoon period, escalation of stress, outburst, reconciliation
• C. acting out and making up
• D. peace and calm, angry outburst, peace and calm, denial

Correct answer: B

Rationale: The correct answer is B: 'honeymoon period, escalation of stress, outburst, reconciliation.' A pattern of behavior known as the cycle of abuse involves these stages. It starts with a honeymoon phase, followed by a buildup of stress, an outburst which may involve violence, and then reconciliation. This cycle is commonly observed in domestic violence situations. Choices A, C, and D do not accurately represent the stages of domestic violence in intimate relationships. Choice A mixes positive and negative elements, while choice C simplifies the complex dynamics of domestic violence. Choice D repeats 'peace and calm' inappropriately and includes 'denial,' which is not typically a stage in the cycle of abuse.

4. Which laboratory test would be the least effective in diagnosing a myocardial infarction?

• A. AST
• B. Troponin
• C. CK-MB
• D. Myoglobin

Correct answer: A

Rationale: AST, choice A, would be the least effective in diagnosing a myocardial infarction as it is not specific for this condition. Troponin, CK-MB, and myoglobin (choices B, C, and D) are more specific markers for myocardial infarction. Troponin is considered the gold standard due to its cardiac specificity. CK-MB is also specific to the heart, and its isoenzyme levels elevate post-heart damage. Myoglobin, although elevated in myocardial infarction, is not as specific as troponin and CK-MB and can also increase in conditions like burns and muscle trauma. Therefore, AST is the least effective choice for diagnosing a myocardial infarction.

5. James returns home from school angry and upset because his teacher gave him a low grade on an assignment. After returning home from school, he kicks the dog. This coping mechanism is known as:

• A. denial
• B. suppression
• C. displacement
• D. fantasy

Correct answer: C

Rationale: The correct answer is 'displacement.' Displacement is a defense mechanism where emotions or impulses are transferred from their original source to a substitute target. In this scenario, James is displacing his anger from his teacher onto the dog. Choice A, 'denial,' involves refusing to acknowledge an unpleasant reality. Choice B, 'suppression,' is the conscious effort to push unwanted thoughts out of awareness. Choice D, 'fantasy,' refers to imagining scenarios that fulfill one's desires but are not based in reality.

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