Nursing Elites

1. A 65-year-old female client is experiencing postmenopausal bleeding. Which type of physician should this client be encouraged to see?

• A. a radiologist
• B. a gynecologist
• C. a physiatrist
• D. an oncologist

Correct answer: B

Rationale: A gynecologist is the appropriate physician for this scenario as they specialize in treating and managing diseases of the female reproductive system, including postmenopausal bleeding. Postmenopausal bleeding can indicate serious conditions such as endometrial cancer, which a gynecologist can evaluate and manage. A radiologist primarily evaluates X-rays and imaging studies, not directly involved in managing gynecological issues. A physiatrist is a specialist in physical medicine and rehabilitation, not related to gynecological concerns. An oncologist specializes in diagnosing and treating cancer, which is not the primary concern in this case of postmenopausal bleeding.

2. The patient is inquiring about the use of a PCA pump for pain management. Which statement by the patient indicates a need for additional education?

• A. "I will continue to report my pain score during assessments."?
• B. "I understand that there is a maximum dose per hour that I can receive regardless of how many times I press the button."?
• C. "I believe this new PCA pump will finally alleviate my back pain."?
• D. "I have more control over when and how much medication I receive."?

Correct answer: C

Rationale: The correct answer is, "I believe this new PCA pump will finally alleviate my back pain."? This statement indicates a need for additional education as it reflects an unrealistic expectation regarding pain management. It is essential for the patient to understand that while a PCA pump can provide effective pain relief, it may not completely eliminate pain. Option A is correct as it demonstrates the patient's understanding of the importance of reporting pain scores for proper pain management. Option B is correct as it shows the patient's awareness of the maximum dose limits to prevent overdose. Option D is correct as it highlights the patient's understanding of the control they have over their medication administration.

3. When working with multicultural populations, the nurse should consider all of the following when planning care for a client with an altered sexuality pattern except:

• A. some Hispanic and Native-American cultures are very open when discussing sexuality.
• B. some cultures view the postpartum period as a state of impurity.
• C. some women in the African-American culture view childbearing as a validation of their femaleness.
• D. some Native-American women believe monthly menstruation maintains physical well-being and harmony.

Correct answer: A

Rationale: When working with multicultural populations, it is essential to understand cultural variations in beliefs and practices related to sexuality. While it is true that some cultures view the postpartum period as a state of impurity and that some women in the African-American culture view childbearing as a validation of their femaleness, the statement 'some Hispanic and Native-American cultures are very open when discussing sexuality' is incorrect. In reality, many cultures, including Hispanic and Native-American cultures, are sometimes hesitant to discuss sexuality. For example, some Navajos, Hispanics, and Orthodox Jews may consider the postpartum period as impure, leading to seclusion of women until the end of bleeding, marked by a ritual bath. Additionally, many Native-American women believe in the importance of monthly menstruation for physical well-being and harmony. Therefore, the statement about Hispanic and Native-American cultures being very open about discussing sexuality is not accurate in the context of working with multicultural populations.

4. According to Erik Erikson's developmental theory, which choice is a developmental task of the middle adult?

• A. Redefining self-perception and capacity for intimacy
• B. Making decisions concerning career, marriage, and parenthood
• C. Providing guidance during interactions with his children
• D. Verbalizing readiness to assume parental responsibilities

Correct answer: C

Rationale: According to Erikson's developmental theory, the primary developmental task of the middle adult is to achieve generativity. Generativity is the willingness to care for and guide others. Middle adults can achieve generativity with their own children or the children of close friends or through guidance in social interactions with the next generation. Providing guidance during interactions with his children aligns with this developmental task. Choices A, B, and D are not specific to the middle adult stage as they are tasks associated with young adults. Redefining self-perception and capacity for intimacy, making decisions concerning career, marriage, and parenthood, and verbalizing readiness to assume parental responsibilities are all developmental tasks of the young adult according to Erikson's theory.

5. During an interview, what action should a nurse conducting an interview with a client take to collect subjective data?

• A. Takes minimal notes to avoid impeding observation of the client's nonverbal behaviors
• B. Takes a great deal of notes to allow the client to continue at his or her own pace as the nurse records what he or she is saying
• C. Takes notes because this allows the nurse to break eye contact with the client, which may increase the client's level of comfort
• D. Takes notes to allow the nurse to shift attention away from the client, which may make the nurse more comfortable

Correct answer: A

Rationale: During an interview, a nurse should minimize note-taking to focus on the client and not impede the conversation. Taking minimal notes allows the nurse to effectively observe the client's nonverbal behaviors, which provide valuable subjective data. Option B, taking many notes, is incorrect as it can distract the nurse from the client's cues and hinder interaction. Option C, taking notes to break eye contact, is incorrect as it may decrease the client's comfort level and disrupt communication. Option D, taking notes to shift attention away from the client, is incorrect as it diminishes the client's importance and may make them uncomfortable during sensitive discussions. Therefore, the correct approach is for the nurse to take minimal notes, ensuring effective observation of the client's nonverbal behaviors while collecting subjective data.

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