Nursing Elites

1. A 32-year-old female frequently comes to her primary care provider with vague complaints of headache, abdominal pain, and trouble sleeping. In the past, the physician has dutifully prescribed medication, but little else. Which of the following comments by the nurse to the physician is appropriate?

• A. "Often women who are victims of domestic violence suffer vague symptoms such as abdominal pain."?
• B. "Often women become offended if asked about their safety in relationships."?
• C. "It is mandatory that all women be questioned about domestic violence."?
• D. "How would you feel to know that her partner is beating her and you didn't ask?"?

Correct answer: A

Rationale: The correct answer is, "Often women who are victims of domestic violence suffer vague symptoms such as abdominal pain."? There is a well-documented correlation between vague symptoms like abdominal pain and battered woman syndrome. It is crucial for healthcare providers to inquire about potential domestic violence when presented with such symptoms. Choice B is incorrect as studies show that women are not generally offended by appropriately phrased questions about their safety in relationships. While it is not mandatory to question all women about domestic violence, it is advisable to at least ask a screening question regarding safety. Choice D is inappropriate as it uses a shaming tactic, which is not constructive and may create a hostile work environment. It's important for healthcare professionals to approach sensitive topics like domestic violence with empathy and professionalism.

2. A health care worker is concerned about a new mother being overwhelmed by caring for her infant. What should the health care worker do?

• A. Immediately contact child protective services.
• B. Provide the mother with literature about child care.
• C. Consult a therapist to help the mother work out her fears.
• D. Refer the mother to parenting classes.

Correct answer: D

Rationale: When a health care worker is concerned about a new mother being overwhelmed by caring for her infant, the best course of action is to refer the mother to parenting classes. Prevention of child abuse is focused on educating parents on how to care for their child and handle the demands of infant care. By attending parenting classes, the mother can build self-confidence, self-esteem, and coping skills. Parenting classes help parents understand the developmental needs of their children and learn effective ways to manage their home environment. Additionally, these classes provide parents with increased social contacts and knowledge about community resources. Contacting child protective services (choice A) should not be the immediate action as there is no indication of abuse. Providing literature about child care (choice B) may not be as effective as hands-on parenting classes. Consulting a therapist (choice C) may be beneficial, but addressing parenting skills through classes is more appropriate in this scenario.

3. Due to a high census, it has been necessary for a number of clients to be transferred to other units within the hospital. Which client should be transferred to the postpartum unit?

• A. A 66-year-old female with gastroenteritis
• B. A 40-year-old female with a hysterectomy
• C. A 27-year-old male with severe depression
• D. A 28-year-old male with ulcerative colitis

Correct answer: B

Rationale: The best client to transfer to the postpartum unit is the 40-year-old female with a hysterectomy. The nurses on the postpartum unit will be knowledgeable about postoperative care and can manage any complications related to the surgery. Choices A and D would be more appropriately cared for on a medical-surgical unit due to their conditions. Choice C should be transferred to a psychiatric unit for specialized care related to severe depression.

4. All of the following are common reasons that nurses are reluctant to delegate except:

• A. lack of self-confidence
• B. desire to maintain authority
• C. confidence in subordinate
• D. getting trapped in the 'I can do it better myself' mindset

Correct answer: C

Rationale: If a delegator has confidence in their subordinates and believes a task will be performed correctly, they are more likely to delegate. Reasons nurses may be reluctant to delegate include their own lack of self-confidence, the desire to maintain authority, and getting trapped in the 'I can do it better myself' mindset. Therefore, 'confidence in subordinate' is the exception as it actually encourages delegation. The other choices are common barriers to delegation in healthcare settings.

5. The mother of a newborn child is very upset. The child has a cleft lip and palate. The type of crisis this mother is experiencing is:

• A. reactive.
• B. maturational.
• C. situational.
• D. adventitious.

Correct answer: C

Rationale: The mother is experiencing a situational crisis as the unexpected birth of a child with a cleft lip and palate has placed her in a challenging situation she did not anticipate. This type of crisis is triggered by specific events and circumstances. Choice A, reactive, implies responding to a stressor after it has occurred, which is not the case here. Choice B, maturational, refers to stress related to developmental stages, not to external events like the child's condition. Choice D, adventitious, involves crises resulting from events outside one's control, such as natural disasters, which do not apply in this scenario.

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