Nursing Elites

1. Which type of environment would be most suitable for a confused client?

• A. Familiar
• B. Variable
• C. Challenging
• D. Stimulating

Correct answer: A

Rationale: The most appropriate environment for a confused client is a familiar one. A familiar environment provides security and safety, reducing stress for the confused client. Confused individuals struggle to adapt to constant changes, making a variable environment unsuitable. A challenging environment would likely increase anxiety and frustration in a confused client. Similarly, a stimulating environment could overwhelm the confused client, exacerbating their confusion.

2. According to the CDC, which of the following age groups is most likely to meet the criteria for major depression?

• A. 18-24 years
• B. 25-34 years
• C. 35-44 years
• D. 45-64 years

Correct answer: D

Rationale: According to the CDC, individuals aged 45-64 years are most likely to meet the criteria for major depression. While patients in the 18-24 year age group are more likely to report symptoms of depression, when it comes to major depression, the prevalence is higher in the 45-64 year age group. Choices A, B, and C are incorrect because the CDC indicates that major depression is most prevalent in the 45-64 year age group.

3. Which of the following mental health situations is considered a psychiatric emergency?

• A. Seasonal Affective Disorder (SAD)
• B. Depression with melancholic features
• C. Major depressive episode with psychotic features
• D. Bipolar depression

Correct answer: C

Rationale: A major depressive episode with psychotic features is considered a psychiatric emergency because it poses a significant risk to the individual's safety. Psychotic features in depression can include hallucinations, delusions, or other severe symptoms that require immediate intervention. While Seasonal Affective Disorder (SAD) and depression with melancholic features are serious conditions, they do not inherently represent an acute emergency that necessitates immediate hospitalization. Bipolar depression, although severe, does not inherently involve psychotic symptoms that would classify it as a psychiatric emergency requiring immediate intervention. It's crucial to recognize the urgency and severity of major depressive episodes with psychotic features to ensure appropriate and timely treatment.

4. Which action by a client who requires an above-the-knee amputation for peripheral arterial disease best indicates emotional readiness for the surgery?

• A. Explains the goals of the procedure
• B. Displays few signs of anticipatory grief
• C. Participates in learning perioperative care
• D. Verbalizes acceptance of permanent dependency needs

Correct answer: C

Rationale: Participating actively in learning self-care demonstrates emotional acceptance of the need for surgery and readiness for planning post-surgery. Explaining the goals of the procedure may reflect intellectual readiness but not necessarily emotional readiness. A client who shows few signs of anticipatory grief may be suppressing emotions or in denial, which can hinder the emotional readiness. Verbalizing acceptance of permanent dependency needs suggests the client may require further education and emotional support, as it may not reflect a healthy emotional readiness for the surgery.

5. A staff nurse expresses frustration that a Native American patient always has several family members at the bedside. Which action by the charge nurse is most appropriate?

• A. Remind the nurse that family support is important to this family and patient.
• B. Have the nurse explain to the family that too many visitors will tire the patient.
• C. Suggest that the nurse ask family members to leave the room during patient care.
• D. Ask about the nurse's personal beliefs about family support during hospitalization.

Correct answer: D

Rationale: The first step in providing culturally competent care is to understand one's own beliefs and values related to health and health care. Asking the nurse about personal beliefs will help achieve this step. Reminding the nurse that this cultural practice is important to the family and patient will not decrease the nurse's frustration. The remaining responses, such as suggesting that the nurse ask family members to leave the room or having the nurse explain to the family that too many visitors will tire the patient, are not culturally appropriate for this patient.

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