Nursing Elites

1. Which initial response would the nurse make to a 67-year-old man with type 2 diabetes who sadly confides in the nurse that he has been unable to have an erection for several years?

• A. 'At your age, sex isn't that important.''
• B. ''That is a natural occurrence at your age.''
• C. ''You sound upset about not being able to have an erection.''
• D. 'Maybe it's time for you to speak to your primary health care provider about this.''

Correct answer: C

Rationale: The correct response is, 'You sound upset about not being able to have an erection.' When a client discloses personal information, the nurse should respond in a non-judgmental manner to encourage further communication and gather more details. This response demonstrates empathy and understanding, opening the door for the patient to express his feelings and concerns. Choice A, 'At your age, sex isn't that important,' is dismissive and fails to address the client's emotions or concerns, potentially hindering open communication. Choice B, 'That is a natural occurrence at your age,' provides inaccurate information as the inability to have an erection is not considered a normal part of aging. Choice D, 'Maybe it's time for you to speak to your primary health care provider about this,' while important eventually, should not be the initial response as the nurse should first explore the client's feelings and concerns before discussing potential referrals or interventions.

2. Which of the following is an example of passive aggression?

• A. Clenched fists
• B. Yelling
• C. Jealousy
• D. Intimidation

Correct answer: C

Rationale: Passive aggression involves expressing negative feelings indirectly, such as through subtle actions or behaviors. While choices A, B, and D involve more direct and aggressive expressions of anger, jealousy is an example of passive aggression where negative emotions are subtly displayed without openly confronting the issue. Jealousy can manifest as resentment, envy, or possessiveness, and is a common form of passive aggression in interpersonal relationships.

3. A nurse is assigned to care for a close friend in the hospital setting. Which action should the nurse take first when given the assignment?

• A. Notify the friend that all medical information will be kept confidential.
• B. Explain the relationship to the charge nurse and ask for reassignment.
• C. Approach the client and ask if the assignment is uncomfortable.
• D. Accept the assignment but protect the client's confidentiality.

Correct answer: B

Rationale: When a nurse is assigned to care for a close friend, it is essential to maintain professional boundaries to ensure the best care for the client and the nurse. The most appropriate action for the nurse to take first is to explain the relationship to the charge nurse and ask for reassignment (B). This is important to avoid potential conflicts of interest and maintain objectivity in the care provided. Option A, notifying the friend about confidentiality, may not address the underlying issue of the conflict of interest. Option C, asking the client if the assignment is uncomfortable, may not be appropriate as it puts the client in a difficult position. Option D, accepting the assignment but protecting the client's confidentiality, does not address the conflict of interest and potential ethical issues that may arise from caring for a close friend.

4. Which is a true statement regarding stress related disorders?

• A. Stress related disorders are only caused by stress
• B. Symptoms of stress related disorders would not exist if the client was not experiencing stress
• C. Stress related disorders are also called psycho-physiologic disorders
• D. None of the above

Correct answer: C

Rationale: The correct answer is that stress related disorders are also called psycho-physiologic disorders. These disorders have a physiologic basis for their development, but stress can exacerbate the symptoms. While stress plays a significant role in these disorders, they are not solely caused by stress. Choice A is incorrect as stress is a contributing factor rather than the sole cause. Choice B is incorrect because symptoms of stress related disorders can persist even when the individual is not actively experiencing stress. Choice D is incorrect as there is a true statement among the choices, which is that stress related disorders are also known as psycho-physiologic disorders.

5. A female client who is undergoing infertility testing is taught how to examine her cervical mucus. After listening to the instructions, the client says, 'That sounds gross. I don't think I can do it.' Which conclusion would the nurse make from this statement?

• A. The client is unduly fastidious.
• B. The client feels that having a baby is not that important.
• C. The client may be uncomfortable with performing manual examination of the genitals.
• D. The client is afraid that she is the cause of the infertility.

Correct answer: C

Rationale: The client's statement expressing discomfort with the procedure indicates a potential unease with performing a manual examination of her genitals. It is not uncommon for individuals to feel uncomfortable or anxious about such intimate procedures. The nurse should explore this further with the client to address any concerns or fears. The option stating that the client is unduly fastidious lacks evidence and is not supported by the client's statement. The assumption that the client does not value having a baby is not warranted based on the given statement. While self-blame is a common emotional response in cases of infertility, the client's statement does not directly suggest this as the primary concern in this scenario.

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