Nursing Elites

1. A client who has been told she needs a hysterectomy for cervical cancer reports being upset about being unable to have a third child. Which action would the nurse take?

• A. Evaluate her willingness to pursue adoption.
• B. Encourage her to focus on her own recovery.
• C. Emphasize that she does have two children already.
• D. Ensure that other treatment options for her are explored.

Correct answer: D

Rationale: In this scenario, the nurse should ensure that other treatment options for the client are explored. While a hysterectomy may be necessary for cervical cancer, conservative management options like cervical conization and laser treatment may allow for future pregnancies. It is crucial for the nurse to inform the client of all available treatment choices. Evaluating the client's willingness to pursue adoption is not directly addressing the client's concerns about fertility. Encouraging the client to focus on her own recovery and emphasizing that she already has two children dismiss the client's distress over not being able to have a third child, which is important to acknowledge in a sensitive manner.

2. Which behavior would the nurse recognize as developmentally atypical in preschoolers?

• A. Thumb sucking during stress
• B. Feeling guilty for behaving inappropriately
• C. Feeling happy if there is a newborn in the family
• D. Curiosity about their surroundings

Correct answer: C

Rationale: The correct answer is feeling happy if there is a newborn in the family. Preschoolers are more likely to exhibit feelings of stress and jealousy rather than happiness with the arrival of a new baby in the family. Thumb sucking and bed-wetting are common behaviors displayed by preschoolers during times of stress. Guilt typically arises in children when they perceive that they have not behaved appropriately. Preschoolers are known to be naturally curious about their surroundings, showing an interest in exploring and learning about the environment around them. Therefore, feeling happy with the birth of a new baby is developmentally atypical for preschoolers.

3. Which of the following is an age-related developmental task for a 68-year-old client?

• A. Dealing with loss of friends
• B. Commitment to parenthood
• C. Setting career goals
• D. Solidification of sense of self

Correct answer: A

Rationale: As individuals age, they face various developmental tasks unique to that stage of life. For a 68-year-old client, dealing with the loss of friends becomes a significant aspect of their development. This age group often experiences the passing of peers and friends, leading to feelings of loneliness and the need to adjust to a changing social circle. Commitment to parenthood (Choice B) is more relevant to younger adults in their child-rearing years. Setting career goals (Choice C) is typically associated with early to mid-career stages rather than later in life. Solidification of sense of self (Choice D) is a task that is more commonly associated with earlier adulthood when individuals are establishing their identity. Therefore, the most appropriate developmental task for a 68-year-old client is dealing with the loss of friends.

4. The nurse is administering the 0900 medications to a client who was admitted during the night. Which client statement indicates that the nurse should further assess the medication order?

• A. At home, I take my pills at 8:00 am.
• B. It costs a lot of money to buy all of these pills.
• C. I get so tired of taking pills every day.
• D. This is a new pill I have never taken before.

Correct answer: D

Rationale: The client stating, 'This is a new pill I have never taken before,' is the correct answer as it indicates a potential discrepancy in the medication order. This statement requires further assessment to ensure the medication is correct, verify if it is a new prescription or a different manufacturer, and determine if the client needs additional instructions. While the timing of medication administration (option A) is important, it may not be as critical as ensuring the accuracy of the medication being administered. Option B, regarding the cost of pills, is relevant for discharge planning but does not directly impact the immediate administration of the medication. Option C, expressing tiredness from taking pills daily, may warrant discussion on adherence or side effects but does not raise immediate concerns about the specific medication being administered.

5. A client who is at 28 weeks' gestation and in active labor is crying. She says, 'I just know that this baby is going to die. What's the use of doing all this to save it?' Which explanation would interpret the client's statements?

• A. She is depressed and needs gentle, positive support during labor.
• B. She is experiencing anticipatory grief and withdrawing from bonding.
• C. She is in need of emotional support to help her cope with the impending birth.
• D. She is struggling to cope with the birth by using the word 'it.'

Correct answer: B

Rationale: The client's statement indicates anticipatory grief, where she is preparing for a potential loss. This grief is not necessarily about the literal death of the baby but about the loss of the anticipated healthy full-term baby. The client may not be ready to bond with the reality of a preterm baby. Providing gentle, positive support is essential to help her cope with her feelings, as firm support may come across as dismissive. Sedation is not appropriate as it could hinder the client's emotional processing. Allowing the client to express her emotions and work through anticipatory grieving is crucial. The use of the word 'it' reflects the client's emotional struggle and is not the primary issue at hand.

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