Nursing Elites

1. A daughter of a Chinese-speaking client approaches the nurse and asks multiple questions while maintaining direct eye contact. Which culturally related concept would the daughter's behavior reflect?

• A. Prejudice
• B. Stereotyping
• C. Assimilation
• D. Ethnocentrism

Correct answer: C

Rationale: The correct answer is assimilation. Assimilation involves incorporating the behaviors of a dominant culture. In this scenario, maintaining eye contact is characteristic of the American or Canadian culture and not of Asian cultures. Prejudice is a negative belief about another person or group and does not characterize this behavior. Stereotyping is the perception that all members of a group are alike, which is not demonstrated by the daughter's behavior. Ethnocentrism is the perception that one's beliefs are superior to those of others, which is not evident in this situation.

2. Which nurse statement defines boundaries in the orientation phase of the nurse-client relationship when talking to a depressed client who has just been admitted to the psychiatric unit?

• A. ''Tell me about the relationship that you have with your mother and father.''
• B. ''Hello! I'm Nurse Andrea. I'll introduce you around and help you settle in.''
• C. ''What is the main thing that you would like to work on during therapy?'
• D. ''I understand that you have been depressed. What can you tell me about that?'

Correct answer: B

Rationale: In the orientation phase of the nurse-client relationship, setting boundaries involves establishing the nurse's role and responsibilities while maintaining a professional distance. Option B demonstrates a clear boundary by introducing the nurse and offering assistance with settling in, which is appropriate for the initial phase of building rapport with the client. Choices A, C, and D delve into personal or therapeutic topics that are more suitable for the working phase of the relationship when the client's goals and problems are being addressed. Asking about the client's family relationships (Choice A), therapy focus (Choice C), or delving into the client's depression (Choice D) would be more relevant in later stages of the therapeutic process, once trust and rapport have been established during the orientation phase.

3. Which defense mechanism would the nurse conclude a female client with obsessive-compulsive disorder, who washes her hands more than 20 times a day, is using to ease anxiety?

• A. Undoing
• B. Projection
• C. Introjection
• D. Displacement

Correct answer: A

Rationale: The correct answer is 'Undoing.' Undoing is a defense mechanism where the individual tries to negate a previous act to relieve guilt or anxiety. In this case, the client washing her hands excessively is trying to 'undo' perceived contamination or guilt associated with not washing. Projection (choice B) involves attributing one's own unacceptable thoughts or impulses to others, which is not demonstrated in this scenario. Introjection (choice C) is the process of internalizing beliefs or values of others, which is also not applicable in this context. Displacement (choice D) involves redirecting emotions from one target to another, which does not align with the client's behavior of handwashing as a response to anxiety in this case.

4. 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.

5. Which characteristic usually results in a behavior being viewed and accepted as normal?

• A. Fits within standards accepted by one's society
• B. Helps the person reduce the need for coping skills
• C. Allows the person to express feelings and thoughts
• D. Facilitates achievement of short-term and long-term goals

Correct answer: A

Rationale: Behaviors that align with the standards accepted by a society are generally viewed as normal. Societal norms and values play a significant role in defining what is considered normal behavior. Choices B, C, and D may be important aspects of an individual's functioning, but they do not solely determine whether a behavior is viewed as normal. Coping skills, expressions of feelings, and goal achievement can vary in their cultural context and societal acceptance, therefore they are not definitive indicators of normalcy.

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