Nursing Elites

1. 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.

2. Which of the following services is not typically part of family consultation?

• A. assisting with vocational rehabilitation
• B. providing information about the client's illness
• C. teaching effective communication
• D. helping families solve problems

Correct answer: A

Rationale: In family consultation, the primary focus is on helping families address their emotions, enhance communication skills, and resolve issues. Assisting with vocational rehabilitation involves a different scope beyond the typical objectives of family consultation. While providing information about the client's illness, teaching effective communication, and aiding families in problem-solving are common in family consultation to promote understanding, healthy dynamics, and conflict resolution.

3. A primary belief of psychiatric mental health nursing is:

• A. Most people have the potential to change and grow.
• B. Every person is worthy of dignity and respect.
• C. Human needs are individual to each person.
• D. Some behaviors have no meaning and cannot be understood.

Correct answer: B

Rationale: The correct answer is that every person is worthy of dignity and respect. This is a fundamental principle in psychiatric mental health nursing, emphasizing the importance of treating individuals with dignity and respect regardless of their condition. This belief forms the basis of establishing a therapeutic nurse-client relationship. Choice A is a positive belief, but the primary focus in psychiatric mental health nursing is on respecting the worth and dignity of each individual. Choice C is related to understanding individual human needs but does not encompass the core value of dignity and respect. Choice D is incorrect as psychiatric nursing emphasizes the importance of interpreting and understanding all behaviors as meaningful expressions of the client's experience.

4. A 50-milliliter (ml) bolus of normal saline fluid is ordered by the physician. The physician wants it to infuse in 30 minutes. The nurse should set the pump rate at:

• A. 100 ml per hour for one hour.
• B. 60 ml per hour for one-half hour
• C. 120 ml per hour for one hour.
• D. 50 ml per hour for one hour.

Correct answer: A

Rationale: To infuse a 50 ml bolus in 30 minutes, the rate should be calculated as follows: 50 ml / 30 min = 100 ml per hour. Therefore, the correct answer is to set the pump rate at 100 ml per hour for one hour. Choice A is the correct rate based on the calculation. Choices B, C, and D all provide incorrect rates that do not match the physician's order. Choice B would only deliver 30 ml in 30 minutes, not the ordered 50 ml. Choice C would deliver 120 ml in one hour, which is 20 ml more than ordered. Choice D would only provide 25 ml over 30 minutes, not the full 50 ml prescribed.

5. A client tells the nurse that his wife's nagging really gets on his nerves. He asks the nurse to talk with her about her nagging during their family session tomorrow afternoon. Which of the following responses is the most therapeutic for the client?

• A. "Tell me more specifically about her complaints."?
• B. "Can you think of reasons why she might nag you so much?"?
• C. "I'll help you think about how to bring this up yourself tomorrow afternoon."?
• D. "Why do you want me to initiate this in tomorrow's session rather than you?"?

Correct answer: C

Rationale: The most therapeutic response is to empower the client to address the issue himself. By offering assistance in thinking about how to bring up the topic during the family session, the nurse is promoting the client's autonomy and communication skills. This response encourages the client to take an active role in resolving the situation. Choices A and B focus on the wife's behavior, which is not the immediate concern during this interaction. Choice D challenges the client's request and shifts the responsibility back to the client, potentially hindering progress and discouraging open communication.

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