Nursing Elites

1. Which behavior would the nurse recognize as developmentally atypical in preschoolers?

• A. Thumb sucking during stress
• B. Feeling guilty for behaving inappropriately
• C. Feeling happy if there is a newborn in the family
• D. Curiosity about their surroundings

Correct answer: Feeling happy if there is a newborn in the family

Rationale: The correct answer is feeling happy if there is a newborn in the family. Preschoolers are more likely to exhibit feelings of stress and jealousy rather than happiness with the arrival of a new baby in the family. Thumb sucking and bed-wetting are common behaviors displayed by preschoolers during times of stress. Guilt typically arises in children when they perceive that they have not behaved appropriately. Preschoolers are known to be naturally curious about their surroundings, showing an interest in exploring and learning about the environment around them. Therefore, feeling happy with the birth of a new baby is developmentally atypical for preschoolers.

2. While planning care for a 2-year-old hospitalized child, which situation would the nurse most likely expect to affect the behavior?

• A. Strange bed and surroundings.
• B. Separation from parents.
• C. Presence of other toddlers.
• D. Unfamiliar toys and games.

Correct answer: Separation from parents.

Rationale: The correct answer is 'Separation from parents.' Separation anxiety is most evident from 6 months to 30 months of age. It is the greatest stress imposed on a toddler by hospitalization. If separation is avoided, young children have a tremendous capacity to withstand other stress. Choices A, C, and D are incorrect because while strange bed and surroundings, presence of other toddlers, and unfamiliar toys and games may contribute to some level of stress or discomfort, the separation from parents is the primary factor affecting the behavior of a 2-year-old hospitalized child.

3. A new mother with class II heart disease tells the nurse that she is afraid her heart condition will prevent her from caring for her baby at home when she is discharged. How would the nurse respond?

• A. Suggest that the client arrange for help at home
• B. Ask the client to describe her concerns more fully
• C. Tell the client to speak to her primary health care provider about her concerns
• D. Recommend that the client schedule times when family members can assist her

Correct answer: Ask the client to describe her concerns more fully

Rationale: When a client expresses fear or concern, it is essential for the nurse to first explore and understand the client's feelings and worries. Asking the client to describe her concerns more fully allows the nurse to gather more information, which is crucial in providing appropriate support and guidance. Suggesting that the client arrange for help at home is presumptuous and may not align with the client's preferences or resources. Telling the client to speak to her primary health care provider shifts the responsibility and does not directly address the client's immediate fears. Recommending that she schedule times when family members can assist her assumes the availability and willingness of family members without addressing the client's emotional needs and fears directly.

4. What is the best intervention for a client with borderline personality disorder?

• A. Establishing clear boundaries
• B. Exploring vocational possibilities
• C. Discussing feelings of victimization
• D. Spending 1 to 2 hours per day with the client

Correct answer: Establishing clear boundaries

Rationale: The best intervention for a client with borderline personality disorder is to establish clear boundaries. Individuals with this disorder struggle with impulsivity and have difficulty recognizing and respecting boundaries in their relationships. By establishing clear boundaries, it helps provide structure and consistency to the client, aiding in their treatment and management of the disorder. Exploring vocational possibilities may be important at some point, but it is not the priority intervention for managing borderline personality disorder. Discussing feelings of victimization, while common, may not be as effective initially due to the client's lack of insight and resistance. Spending 1 to 2 hours per day with the client may not be as productive as shorter, more focused interactions that are geared towards boundary reinforcement.

5. Which priority action would the nurse manager use to help the nurse who may be experiencing burnout?

• A. Transfer the nurse to another unit in the facility.
• B. Help the nurse choose a position on a low-stress unit.
• C. Encourage the nurse to attend educational programs.
• D. Help the nurse identify personal responses to job stress.

Correct answer: Help the nurse identify personal responses to job stress.

Rationale: The correct priority action for the nurse manager to help a nurse experiencing burnout is to assist the nurse in identifying personal responses to job stress. This involves recognizing work stressors in the environment and evaluating coping strategies to determine their effectiveness. While transferring the nurse to another unit could be a solution, the initial focus should be on self-awareness and coping strategies. Choosing a position on a low-stress unit and attending educational programs can be beneficial in reducing burnout, but they are not the primary steps to address burnout when it occurs.

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