Nursing Elites

1. A client arrives at an occupational health clinic after being struck by lightning while working in a truck bed. The client is alert but reports feeling faint. Which assessment will the nurse perform first?

• A. Pulse characteristics
• B. Open airway
• C. Entrance and exit wounds
• D. Cervical spine injury

Correct answer: A

Rationale: Assessing pulse characteristics is the priority in this situation due to the potential impact of lightning as a form of electrical current, which can cause irregular heart rhythms. It is crucial to evaluate the pulse rate and regularity to assess for adequate circulation and potential cardiac issues. Since the client is alert and talking, the airway is likely patent, making assessing the airway less urgent. Entrance and exit wounds and cervical spine injury assessments should follow the evaluation of pulse characteristics to ensure proper circulation and prioritize life-threatening issues first. Checking the pulse first will guide further interventions and help in determining the client's hemodynamic status.

2. Which priority action would the nurse manager use to help the nurse who may be experiencing burnout?

• A. Transfer the nurse to another unit in the facility.
• B. Help the nurse choose a position on a low-stress unit.
• C. Encourage the nurse to attend educational programs.
• D. Help the nurse identify personal responses to job stress.

Correct answer: D

Rationale: The correct priority action for the nurse manager to help a nurse experiencing burnout is to assist the nurse in identifying personal responses to job stress. This involves recognizing work stressors in the environment and evaluating coping strategies to determine their effectiveness. While transferring the nurse to another unit could be a solution, the initial focus should be on self-awareness and coping strategies. Choosing a position on a low-stress unit and attending educational programs can be beneficial in reducing burnout, but they are not the primary steps to address burnout when it occurs.

3. A 30-year-old woman is scheduled for a total abdominal hysterectomy due to noninvasive endometrial cancer. The nurse anticipates the client may have difficulty adjusting emotionally to this type of surgery. Which concern would be the cause of this anticipated difficulty?

• A. Change in femininity
• B. Body image changes
• C. Diminished sexual desire
• D. Slow recovery

Correct answer: A

Rationale: The correct answer is 'Change in femininity.' The removal of the uterus can lead to changes in how some women perceive themselves sexually as it is a reproductive organ. In this young client, there may be heightened feelings of loss of femininity and reproductive potential. Body image changes could occur but are more likely with surgeries involving obvious external changes. Diminished sexual desire is unlikely in a premenopausal woman unless she has specific concerns. Slow recovery is not expected in an otherwise healthy 30-year-old woman undergoing this surgery.

4. Which defense mechanism is considered a conscious measure used to cope with anxiety?

• A. Undoing
• B. Projection
• C. Suppression
• D. Intellectualization

Correct answer: C

Rationale: The correct answer is Suppression. Suppression is a conscious defense mechanism in which an individual intentionally avoids thinking about disturbing problems, wishes, feelings, or experiences. It is a way to cope with anxiety by actively pushing aside unwanted thoughts or emotions. Undoing, on the other hand, is an unconscious defense mechanism where one uses words or behaviors to symbolically make amends for unacceptable thoughts or actions. Projection is also an unconscious defense mechanism involving falsely attributing one's own unacceptable impulses to others. Intellectualization, another unconscious defense mechanism, involves using intellect or thinking to avoid dealing with emotionally charged feelings.

5. The parents of a child often try to persuade their preschooler to touch their pet dog to reduce the child's fear of dogs. Instead, the child's fears and anxiety increase. Which advice would the nurse suggest to help overcome their child's fear?

• A. Ask the child to touch the dog's back gently.
• B. Keep the child away from dogs for a few years.
• C. Let the child watch other children playing with dogs.
• D. Bring in a pet cat to familiarize the child with animals.

Correct answer: C

Rationale: To help the child overcome their fear of dogs, the nurse should recommend letting the child watch other children playing with dogs. This approach allows the child to observe interactions with dogs in a safe environment, gradually building comfort and familiarity. Encouraging the child to touch the dog's back gently may increase fear and anxiety, as it could be overwhelming for the child. Keeping the child away from dogs for a few years does not address the fear directly and may not help the child overcome it. Bringing in a pet cat, while introducing the child to animals, does not specifically target the fear of dogs and may not effectively reduce the fear and anxiety associated with dogs.

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