Nursing Elites

1. Which of the following family interactions would the nurse most likely interpret as being atypical?

• A. Mr. R states that he and his brother always had a cordial, though somewhat distant, relationship but that they are now quite close.
• B. Mrs. D describes being a grandparent as 'having all the benefits of having children without the headaches and responsibilities.'
• C. Mr. and Mrs. N had a tumultuous relationship for decades but now appear more at ease with one another.
• D. Mr. A states that his ideal living situation would be himself and his adult son and daughter all under the same roof.

Correct answer: D

Rationale: The correct answer is D. While marital reconciliation, rekindled relationships with siblings, and satisfaction in the role of grandparent are common phenomena among older adults, it is less common for parents and children to see cohabitation as an ideal situation or first preference. Choices A, B, and C reflect common positive family dynamics experienced by older adults, such as improved relationships with siblings, contentment in the grandparent role, and easing of marital tensions over time. On the other hand, choice D stands out as atypical as it suggests an unconventional living arrangement where adult children live with their parent, which is less commonly preferred by older adults.

2. A nurse who works in an inner-city clinic provides care for a large number of older black clients. Which health promotion activity best reflects the specific health needs of this population?

• A. A blood sugar and blood pressure monitoring program
• B. An education session on the positive health effects of good nutrition
• C. A screening mammography campaign for older black women
• D. A program that teaches black men the importance of prostate health screening

Correct answer: A

Rationale: The correct answer is A. Diabetes and hypertension are prevalent among older black adults. Regular blood sugar and blood pressure monitoring are crucial in managing these conditions. While education on good nutrition, screening mammography, and prostate health screening are important health promotion activities, they do not directly address the specific health needs of this population. Therefore, a blood sugar and blood pressure monitoring program would best reflect the health needs of the older black clients in this inner-city clinic.

3. As a daughter and mother are extremely close emotionally, they made a pact years ago never to put the mother in a nursing home. Now, the physical demands of caregiving are becoming too great. What is the best way a nurse can help the daughter?

• A. Persuade her to admit her mother to a nursing home
• B. Aid her in finding help with in-home care
• C. Praise her success in being a good daughter and keeping her promise
• D. Point out her mistaken altruism

Correct answer: B

Rationale: In this situation, the best course of action for the nurse is to aid the daughter in finding help with in-home care. Persuading her to admit her mother to a nursing home would likely cause guilt and emotional distress due to their pact. Praise alone may not address the current physical caregiving challenges. Pointing out her 'mistaken altruism' could be seen as insensitive and unhelpful. Providing practical assistance in finding in-home care can alleviate the physical demands on the daughter while still honoring the emotional commitment they made.

4. Following a recent lawsuit that implicated one of their colleagues, the nursing staff at an assisted-living facility are especially aware of the need to safeguard themselves legally. Which of the following measures should the nurses take? Select one that does not apply.

• A. Investigate whether their liability insurance is sufficient
• B. Ensure that work performed by unlicensed care staff under their supervision is adequate
• C. Avoid admitting residents who have living wills or advance directives
• D. Assess the competence of employees under their supervision

Correct answer: C

Rationale: Denying admission to residents with living wills or advance directives is not a legal safeguard measure and may be considered discriminatory. Measures like investigating liability insurance adequacy, ensuring adequate work by unlicensed staff, and assessing employee competence are all valid ways for nurses to protect themselves legally. These measures help in ensuring proper care, reducing risks, and maintaining a high standard of practice.

5. What is a standard of care?

• A. A relationship in which a nurse has assumed responsibility for the care of a patient
• B. A policy or procedure established by a health care agency or professional association
• C. The norm for what a reasonable individual would do in a similar circumstance
• D. A public law that, if violated, can result in liability for the nurse

Correct answer: C

Rationale: A standard of care is the level of care that a reasonably prudent person with similar training and experience would provide in a similar circumstance. Choice A is incorrect because it describes the nurse-patient relationship. Choice B is incorrect as it refers to specific policies or procedures. Choice D is incorrect as it describes a law rather than the expected level of care.

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