Nursing Elites

1. Which behavior is most typical for clients with borderline personality disorder?

• A. Arrogant
• B. Eccentric
• C. Impulsive
• D. Dependent

Correct answer: C

Rationale: The correct answer is 'Impulsive.' Clients with borderline personality disorder often exhibit impulsive, potentially self-damaging behaviors. Arrogance is more characteristic of narcissistic personality disorder, eccentric behavior aligns with schizotypal personality disorder, and dependent behavior is typical of dependent personality disorder. Therefore, the key feature of borderline personality disorder is impulsivity.

2. A client who has been on hemodialysis for 2 years communicates in an angry, critical manner and does not adhere to the prescribed medications and diet. Which explanation for the client's behavior would be useful to consider in planning care?

• A. An attempt to punish the nursing staff
• B. A constructive method of accepting reality
• C. A defense against underlying depression and fear
• D. An effort to maintain life and to live it as fully as possible

Correct answer: C

Rationale: The client's angry, critical communication and non-adherence to treatment suggest underlying emotional struggles. The behavior is likely a defense mechanism against feelings of depression and fear. It is essential to consider that the client's actions are not intentionally aimed at punishing others but rather a manifestation of internal distress. Option A is incorrect as the behavior is not about punishing the nursing staff. Option B is incorrect because the behavior is not a constructive way of accepting reality but rather a maladaptive coping mechanism. Option D is incorrect as the behavior is not primarily driven by an effort to maintain life but rather by emotional distress.

3. Which of the following is an age-related developmental task for a 68-year-old client?

• A. Dealing with loss of friends
• B. Commitment to parenthood
• C. Setting career goals
• D. Solidification of sense of self

Correct answer: A

Rationale: As individuals age, they face various developmental tasks unique to that stage of life. For a 68-year-old client, dealing with the loss of friends becomes a significant aspect of their development. This age group often experiences the passing of peers and friends, leading to feelings of loneliness and the need to adjust to a changing social circle. Commitment to parenthood (Choice B) is more relevant to younger adults in their child-rearing years. Setting career goals (Choice C) is typically associated with early to mid-career stages rather than later in life. Solidification of sense of self (Choice D) is a task that is more commonly associated with earlier adulthood when individuals are establishing their identity. Therefore, the most appropriate developmental task for a 68-year-old client is dealing with the loss of friends.

4. A client diagnosed with sexual dysfunction states, 'Well, I guess my sex life is over.' Which response would the nurse use as a reply?

• A. I'm sorry to hear that.'
• B. 'Oh, you have a lot of good years left.'
• C. 'You are concerned about your sex life?'
• D. 'Have you asked your primary health care provider about that?'

Correct answer: C

Rationale: The response 'You are concerned about your sex life?' explores the meaning of the statement and allows further expression of concern. It shows empathy and encourages the client to elaborate on their feelings. Choice A, 'I'm sorry to hear that,' does not prompt the client to share more about their concerns and may close off communication. Choice B, 'Oh, you have a lot of good years left,' lacks empathy and understanding of the client's emotions, diverting the focus from the client's feelings. Choice D, 'Have you asked your primary health care provider about that?' shifts the responsibility away from the nurse and may not address the client's emotional needs, potentially making them feel dismissed or embarrassed to seek help.

5. The client with cholecystitis is being instructed about dietary choices. Which meal best meets the dietary needs of this client?

• A. Steak, baked beans, and a salad
• B. Broiled fish, green beans, and an apple
• C. Pork chops, macaroni and cheese, and grapes
• D. Avocado salad, milk, and angel food cake

Correct answer: B

Rationale: Clients with cholecystitis, which is inflammation of the gallbladder, should follow a low-fat diet to reduce symptoms. Broiled fish, green beans, and an apple (Option B) is the most suitable choice as it is low in fat. Steak, baked beans, and a salad (Option A) provide a high amount of fat and protein, which may exacerbate symptoms of cholecystitis. Pork chops, macaroni and cheese, and grapes (Option C) and avocado salad, milk, and angel food cake (Option D) contain high-fat foods that are not recommended for individuals with cholecystitis. Therefore, Option B is the most appropriate choice for a client with cholecystitis.

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