Nursing Elites

1. When a woman is having her first child, she is experiencing which type of crisis event?

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

Correct answer: B

Rationale: A maturational crisis occurs when an individual reaches a new stage of development, such as becoming a parent for the first time, and needs to develop new coping strategies to adapt to this change. Situational crises (Choice A) arise from external sources, not developmental milestones. Adventitious crises (Choice C) are caused by external events like natural disasters and are not related to personal development stages. Reactive crises (Choice D) are responses to specific stressors and are not associated with developmental milestones like becoming a parent for the first time.

2. The client is taking prednisone 7.5mg po each morning to treat his systemic lupus erythematosus. Which statement best explains the reason for taking the prednisone in the morning?

• A. There is less chance of forgetting the medication if taken in the morning.
• B. There will be less fluid retention if taken in the morning.
• C. Prednisone is absorbed best with the breakfast meal.
• D. Morning administration mimics the body's natural secretion of corticosteroid.

Correct answer: D

Rationale: Taking corticosteroids in the morning mimics the body's natural release of cortisol, which follows a diurnal pattern with higher levels in the morning. This timing helps regulate the body's inflammatory response and minimizes potential side effects. Answer A is not the primary reason for morning dosing, as adherence concerns can be addressed through other means. Answer B is incorrect since fluid retention is not influenced by the timing of prednisone administration. Answer C is also incorrect as prednisone absorption is not significantly affected by whether it is taken with breakfast or not.

3. How can the nurse best communicate to a client that he or she has been listening?

• A. restating the main feeling or thought the client has expressed
• B. making a judgment about the client's problem
• C. offering a leading question such as, 'And then what happened?'
• D. saying, 'I understand what you're saying.'

Correct answer: A

Rationale: The best way for the nurse to communicate to a client that he or she has been listening is by restating the main feeling or thought the client has expressed. Restating helps the client validate the nurse's understanding of the communication, demonstrating active listening skills. Making judgments about the client's problem, as suggested in Choice B, can hinder effective communication by introducing bias and potential misinterpretation. Offering a leading question like in Choice C is not ideal for confirming understanding; it rather seeks more information. Choice D, simply saying 'I understand what you're saying,' may not convey active listening as effectively as restating the client's main feelings or thoughts, as it lacks the validation component present in restating.

4. Which of the following is not one of the three universal spiritual needs?

• A. meaning and purpose
• B. love and relatedness
• C. forgiveness
• D. God's permission

Correct answer: D

Rationale: The three universal spiritual needs are meaning and purpose, love and relatedness, and forgiveness. These needs are commonly recognized across various belief systems and cultures. While the concept of God may be central to many religions, 'God's permission' is not considered a universal spiritual need. Seeking 'God's permission' is more specific to certain religious practices rather than a universally acknowledged spiritual need. Therefore, the correct answer is 'God's permission.' Choices A, B, and C are correct as they align with the generally accepted universal spiritual needs.

5. Which of the following roommates would be most suitable for the client with myasthenia gravis?

• A. A client with hypothyroidism
• B. A client with Crohn's disease
• C. A client with pyelonephritis
• D. A client with bronchitis

Correct answer: A

Rationale: The most suitable roommate for the client with myasthenia gravis is the client with hypothyroidism because they are quiet. A client with Crohn's disease (choice B) would be up to the bathroom frequently due to gastrointestinal issues, which could disturb the roommate with myasthenia gravis. A client with pyelonephritis (choice C) suffering from a kidney infection will need to urinate frequently, causing disturbances. A client with bronchitis (choice D) will be coughing, potentially disrupting the rest and quiet environment needed by a roommate with myasthenia gravis to manage their symptoms effectively.

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