Nursing Elites

1. 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.

2. In which age group does the highest incidence of child abuse occur?

• A. Birth-3 years old
• B. 4-6 years old
• C. 6-10 years old
• D. More than 10 years old

Correct answer: A

Rationale: The correct answer is 'Birth-3 years old.' Children between birth and 3 years of age have the highest rates of victimization (at 16 per 1,000 children). This age group is most vulnerable due to their dependency and inability to report or protect themselves effectively. Child abuse can occur at any age, but statistics show that infants and toddlers are at the highest risk due to their developmental stage and reliance on caregivers. Choices B, C, and D are incorrect because while child abuse can happen at any age, the prevalence is highest among children in the 0-3 age group.

3. The child with seizure disorder is being treated with Dilantin (phenytoin). Which of the following statements by the patient's mother indicates to the nurse that the patient is experiencing a side effect of Dilantin therapy?

• A. "She is very irritable lately."?
• B. "She sleeps quite a bit of the time."?
• C. "Her gums look too big for her teeth."?
• D. "She has gained about 10 pounds in the last 6 months."?

Correct answer: C

Rationale: The correct answer is '"Her gums look too big for her teeth."?' Hyperplasia of the gums is a known side effect associated with Dilantin therapy. Option A, '"She is very irritable lately,"?' is not a typical side effect of Dilantin. Option B, '"She sleeps quite a bit of the time,"?' is a common side effect of Dilantin but not specific to gum hyperplasia. Option D, '"She has gained about 10 pounds in the last 6 months,"?' is not typically associated with Dilantin therapy and is unrelated to the question.

4. What is an effective intervention for a client diagnosed with Obsessive-Compulsive Disorder?

• A. Discussing the repetitive actions.
• B. Insisting the client not perform the repetitive act.
• C. Informing the client that the act is not necessary.
• D. Encouraging daily exercise.

Correct answer: D

Rationale: An effective intervention for a client diagnosed with Obsessive-Compulsive Disorder is encouraging daily exercise. Obsessive-Compulsive Disorder is an anxiety disorder, and exercise can help release emotional energy, limit the time available for maladaptive behaviors, and direct the client's attention outward. Discussing the repetitive actions (choice A) may reinforce the behavior by providing attention to it. Insisting the client not to perform the repetitive act (choice B) can increase anxiety and resistance, as abruptly stopping the behavior may be challenging. Informing the client that the act is not necessary (choice C) may not address the underlying anxiety and could invalidate the client's experiences, leading to increased distress. Encouraging daily exercise is a proactive intervention that can help manage symptoms of Obsessive-Compulsive Disorder by addressing core features of the disorder and promoting overall well-being.

5. A home health nurse is planning for her daily visits. Which client should the home health nurse visit first?

• A. A client with AIDS being treated with Foscarnet
• B. A client with a fractured femur in a long leg cast
• C. A client with laryngeal cancer with a laryngectomy
• D. A client with diabetic ulcers on the left foot

Correct answer: C

Rationale: The correct answer is the client with laryngeal cancer who had a laryngectomy. This client is at risk for airway obstruction due to the surgical procedure, making it a priority visit. Clients with AIDS (choice A), a fractured femur (choice B), and diabetic ulcers (choice D) do not have immediate life-threatening conditions that require urgent attention compared to a client with a recent laryngectomy.

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