Nursing Elites

1. Which response would the nurse make when a client moans softly, 'Oh no, I'm next. They couldn't protect him, and they can't protect me,' after learning a recently discharged client committed suicide?

• A. ''The other person was a lot sicker than you are.''
• B. 'You seem to be afraid that you'll hurt yourself.''
• C. 'That was different. He was at home, but you're here.''
• D. 'There's no need to worry. You have a better support system.''

Correct answer: B

Rationale: The nurse would make the statement, 'You seem to be afraid that you'll hurt yourself.' This response acknowledges the client's emotional distress and opens up the opportunity for the client to discuss their feelings, showing empathy and understanding. Choice A, 'The other person was a lot sicker than you are,' dismisses the client's emotions and fails to address the underlying fear of self-harm. Choice C, 'That was different. He was at home, but you're here,' invalidates the client's concerns and does not encourage further discussion. Choice D, 'There's no need to worry. You have a better support system,' offers false reassurance and does not address the client's expressed fear, missing an opportunity for therapeutic communication.

2. A client who is in a late stage of pancreatic cancer intellectually understands the terminal nature of the illness. Which behaviors indicate the client is emotionally accepting the impending death?

• A. Revising the client's will and planning a visit to a friend
• B. Alternating between crying and talking openly about death
• C. Seeking second, third, and fourth medical opinions
• D. Refusing to follow treatments and stating they won't help anyway

Correct answer: A

Rationale: Revising the will and planning a visit to a friend are indicative of emotional acceptance of impending death as they demonstrate realistic, productive, and constructive ways of using the remaining time. Alternating between crying and talking openly about death may suggest depression rather than acceptance. Seeking multiple medical opinions shows disbelief, denial, or desperation rather than acceptance. Refusing treatments and stating they won't help reflects anger and hopelessness, not acceptance.

3. Which term describes what an adolescent client is experiencing when she says to the nurse who has been caring for her, 'You're just like my mother; I hate you'?

• A. Insight
• B. Universality
• C. Transference
• D. Identification

Correct answer: C

Rationale: Transference occurs when a client unconsciously assigns feelings and attitudes originally associated with another important person in the client's life. In this scenario, the adolescent client is projecting emotions connected to her mother onto the nurse. This client's statement does not demonstrate insight but rather reflects the mechanism of transference. Universality refers to the sense that one is not alone in any situation, which is not evident in the client's statement. Identification is a defense mechanism where an individual takes on characteristics of someone considered admirable, which is not the case in this situation.

4. What is the priority nursing action to assist an anxious father in his concern about not bonding with his newborn?

• A. Encouraging the father to participate in a parenting class
• B. Providing time for the father to be alone with and get to know the baby
• C. Offering the father a demonstration on newborn diapering, feeding, and bathing
• D. Allowing time for the father to ask questions after viewing a film about a new baby

Correct answer: B

Rationale: The priority nursing action to assist an anxious father in his concern about not bonding with his newborn is providing time for the father to be alone with and get to know the baby. Time alone provides the opportunity for paternal-infant attachment and bonding, which can help reduce the father's anxiety. Encouraging the father to participate in a parenting class, although helpful, does not directly address the immediate need for bonding. Offering a demonstration on newborn care tasks like diapering, feeding, and bathing may not effectively address the father's anxiety at that moment, as he may not be ready to absorb such information. Allowing time for the father to ask questions after viewing a film about a new baby is a simplistic approach that may not adequately address the emotional needs and concerns of the father regarding bonding with his newborn.

5. The nurse is teaching an obese client, newly diagnosed with arteriosclerosis, about reducing the risk of a heart attack or stroke. Which health promotion brochure is most important for the nurse to provide to this client?

• A. Monitoring Your Blood Pressure at Home
• B. Smoking Cessation as a Lifelong Commitment
• C. Decreasing Cholesterol Levels Through Diet
• D. Stress Management for a Healthier You

Correct answer: C

Rationale: The most important health promotion brochure to provide to an obese client newly diagnosed with arteriosclerosis is one focused on decreasing cholesterol levels through diet. Arteriosclerosis is significantly influenced by excess dietary fat, especially saturated fat and cholesterol. Monitoring blood pressure at home, while important, does not directly address the underlying cause of arteriosclerosis. Smoking cessation and stress management are crucial for overall cardiovascular health, but lowering cholesterol through diet takes precedence in this scenario.

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