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. Which of the following clients should refrain from therapy with the thiazide diuretic hydrochlorothiazide?

• A. a client with renal impairment
• B. a client with hypertension
• C. a client with diabetes mellitus, type II
• D. a client with renal calculi (kidney stones)

Correct answer: C

Rationale: The correct answer is a client with diabetes mellitus, type II. Thiazide diuretics like hydrochlorothiazide can cause metabolic abnormalities, including elevated blood glucose levels. This increase is linked to diuretic-induced potassium deficiency, which reduces insulin secretion, leading to higher plasma glucose levels. Thiazides are commonly used in clients with renal impairment and hypertension. Moreover, thiazides decrease calcium excretion, reducing the risk of renal calculi, so it is not contraindicated for clients with kidney stones. Therefore, clients with diabetes mellitus, type II should avoid therapy with hydrochlorothiazide due to the potential adverse effects on blood glucose levels.

3. When assessing a client for risk of hyperphosphatemia, which piece of information is most important for the nurse to obtain?

• A. A history of radiation treatment in the neck region
• B. A history of recent orthopedic surgery
• C. A history of minimal physical activity
• D. A history of the client's food intake

Correct answer: A

Rationale: The correct answer is a history of radiation treatment in the neck region. Previous radiation to the neck may have damaged the parathyroid glands, which are crucial for calcium and phosphorus regulation. This damage can lead to disruptions in phosphorus levels, increasing the risk of hyperphosphatemia. Choices B, C, and D are not as directly related to phosphorus regulation. Orthopedic surgery, minimal physical activity, and food intake are more closely associated with calcium levels rather than phosphorus regulation. Therefore, it is essential for the nurse to focus on obtaining information about a history of radiation treatment in the neck region when assessing the risk of hyperphosphatemia in a client.

4. After experiencing a traumatic event like losing a child due to poisoning, a client tells the nurse, 'I don’t want to make any new friends right now.' This is an example of which of the following indicators of stress?

• A. emotional indicator
• B. spiritual indicator
• C. sociocultural indicator
• D. intellectual indicator

Correct answer: C

Rationale: The correct answer is C: sociocultural indicator. In this situation, the client's reluctance to make new friends after experiencing a traumatic event like losing a child due to poisoning reflects a change in their social behavior, which is influenced by sociocultural factors. This response indicates how stress can impact a person's relationships and social interactions. Choice A, emotional indicator, is incorrect because the client's statement is more related to social interactions than emotional expression. Choice B, spiritual indicator, is incorrect as the given scenario does not directly involve spiritual beliefs or practices. Choice D, intellectual indicator, is also incorrect as the client's statement does not reflect cognitive or intellectual changes but rather social aspects affected by the stressful event.

5. A 12-year-old male is brought to his primary care provider to determine whether sexual abuse has occurred. The mother states, 'Because there is no permanent physical damage, he does not need any more treatment.' The nurse's response should be based on which of the following pieces of information?

• A. Male victims of sexual abuse can have long-term psychological problems.
• B. Survivors of male sexual abuse might become confused about their sexual identity.
• C. Unless treated, all male sex abuse survivors grow up to abuse other children.
• D. All children who have been sexually abused have the same needs, regardless of gender.

Correct answer: B

Rationale: Male children are sexually abused nearly as often as female children. Perpetrators are usually men but can be women. Needs of male children who have been sexually abused might be different from the needs of female survivors. Male survivors might respond in anger, question their sexuality, use alcohol and other drugs, and might try to prove their masculinity by performing daring acts. It is crucial for the nurse to consider these potential outcomes, making choice B the correct answer. Choice A is incorrect because male victims of sexual abuse can indeed have long-term psychological problems, so the nurse should be aware of this issue. Choice C is incorrect as not all male sex abuse survivors grow up to abuse other children, which is a misconception. Choice D is incorrect because the needs of children who have been sexually abused can vary based on various factors, including gender, so it is important to consider individual differences.

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