Nursing Elites

1. After a needle stick occurs while removing the cap from a sterile needle, which action should the nurse take?

• A. Complete an incident report.
• B. Select another sterile needle.
• C. Disinfect the needle with an alcohol swab.
• D. Notify the supervisor of the department immediately.

Correct answer: B

Rationale: After a needle stick, the needle is considered contaminated and should be discarded. The nurse should select another sterile needle to use. Completing an incident report is not necessary in this situation because the needle was sterile when the nurse was stuck and not in contact with any other person's body fluids. Notifying the supervisor immediately is not required as the situation can be managed by selecting a new needle. Disinfecting the needle with an alcohol swab is not recommended as it does not meet the standards of safe practice and infection control.

2. After giving birth to her third child, a client tearfully says to the nurse, 'How much more can I give of myself?' Which principle would the nurse consider in the care of any new mother?

• A. It is easier to adjust to the first child than to later ones.
• B. Feeling anger and resentment toward a child is pathological.
• C. Some parents experience feelings of being overwhelmed by multiple children.
• D. Parents usually have inborn feelings of love and acceptance of their children.

Correct answer: C

Rationale: A parent's feeling of being overwhelmed by multiple children is a normal response. It is vital to help parents realize this as a means of easing feelings of guilt and shame. The first child causes the greatest amount of adjustment in one's life. It is common for parents to feel anger and resentment toward their children at times due to the challenges of parenting. Stating that parents usually have inborn feelings of love and acceptance of their children is a false generalization and may not hold true for everyone. Therefore, the most appropriate principle for the nurse to consider in this situation is that some parents may experience feelings of being overwhelmed by multiple children.

3. A 5-year-old child has been recently admitted to the hospital. According to Erik Erikson's psychosocial development stages, the child is in which stage?

• A. Trust vs. mistrust
• B. Initiative vs. guilt
• C. Autonomy vs. shame and doubt
• D. Intimacy vs. isolation

Correct answer: B

Rationale: The correct answer is 'Initiative vs. guilt.' According to Erik Erikson's psychosocial development stages, children aged 3-6 years old are in the stage of initiative versus guilt. During this stage, children begin to assert their power and control over the environment. They develop a sense of purpose and direction, but may also experience feelings of guilt if they believe their actions have caused harm or conflict. Choices A, C, and D are incorrect. 'Trust vs. mistrust' is the first stage for infants, 'Autonomy vs. shame and doubt' is the second stage for toddlers, and 'Intimacy vs. isolation' is a stage that occurs later in adulthood.

4. An increase in the neurotransmitter dopamine is associated with which of the following illnesses?

• A. Schizophrenia
• B. Depression
• C. Alzheimer's disease
• D. Anxiety

Correct answer: A

Rationale: An increase in the neurotransmitter dopamine is associated with schizophrenia. Dopamine dysregulation is linked to some symptoms of schizophrenia, such as hallucinations and delusions. Depression (choice B) is more commonly associated with abnormalities in serotonin and norepinephrine. Alzheimer's disease (choice C) is primarily characterized by deficits in acetylcholine and other neurotransmitters. Anxiety disorders (choice D) are often linked to imbalances in neurotransmitters like serotonin, norepinephrine, and GABA, rather than dopamine.

5. Which action often triggers an episode of violence or aggression in a patient with a psychiatric diagnosis involving violent behavior?

• A. Obtaining a history
• B. Asking for input into care
• C. Enforcing rules
• D. Taking a walk

Correct answer: C

Rationale: Enforcing rules is often a trigger for patients with psychiatric diagnoses involving violent behavior. Limit-setting or denying patient demands can be perceived as control and intimidation, leading to aggressive responses. Nursing staff must respond calmly and professionally to prevent escalation. Avoiding such patients or matching their emotions can worsen the situation. Therefore, enforcing rules can provoke violent episodes in these patients.

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