Nursing Elites

1. A client is being assessed by a nurse for increased anxiety, restlessness, and insomnia. Which of the following interventions is the first priority for the nurse?

• A. Administer anti-anxiety medications as prescribed by the healthcare provider
• B. Engage in a conversation with the client regarding methods to enhance rest and sleep
• C. Escort the client to a private room and stay with them
• D. Review the client's medical history to determine previous treatment for these issues

Correct answer: C

Rationale: The first priority when dealing with a client experiencing potential mental health issues is to ensure their safety. Taking the client to a private room helps to reduce external stimuli and staying with them ensures constant monitoring and support. This intervention can prevent any escalation of anxiety or restlessness and promote a sense of security for the client. Engaging in a conversation about improving rest and sleep is important but ensuring immediate safety takes precedence. Administering medications should only be done after the client's safety is assured. Reviewing the client's medical history, while important, is not the immediate priority when the client is exhibiting acute symptoms of anxiety and restlessness.

2. The parents of a child often try to persuade their preschooler to touch their pet dog to reduce the child's fear of dogs. Instead, the child's fears and anxiety increase. Which advice would the nurse suggest to help overcome their child's fear?

• A. Ask the child to touch the dog's back gently.
• B. Keep the child away from dogs for a few years.
• C. Let the child watch other children playing with dogs.
• D. Bring in a pet cat to familiarize the child with animals.

Correct answer: C

Rationale: To help the child overcome their fear of dogs, the nurse should recommend letting the child watch other children playing with dogs. This approach allows the child to observe interactions with dogs in a safe environment, gradually building comfort and familiarity. Encouraging the child to touch the dog's back gently may increase fear and anxiety, as it could be overwhelming for the child. Keeping the child away from dogs for a few years does not address the fear directly and may not help the child overcome it. Bringing in a pet cat, while introducing the child to animals, does not specifically target the fear of dogs and may not effectively reduce the fear and anxiety associated with dogs.

3. During a scheduled health maintenance visit, which common source of stress for a 6-year-old client would the nurse include in the teaching session?

• A. Wanting to be first
• B. Demanding privacy
• C. Having a desire to be like an idol
• D. Being more selective with playmates

Correct answer: A

Rationale: A common source of stress for a 6-year-old school-age client is competition, such as wanting to be first or the best (winning). This aspect can create stress for a 6-year-old as they navigate social interactions and activities. Therefore, the nurse would address this issue during the teaching session at the health maintenance visit. Demanding privacy, having a desire to be like an idol, and being more selective with playmates are characteristics more commonly associated with 7-year-old clients, not typically seen in the stressors of a 6-year-old. Understanding age-appropriate stressors is crucial for providing tailored education and support in pediatric care.

4. What action would the nurse take for a 4-year-old child who is called to the operating room for a planned myringotomy?

• A. Removing the child's undergarments
• B. Placing the child's toys on the bedside table
• C. Allowing the child to climb onto the stretcher
• D. Having the parents accompany the child to the operating suite

Correct answer: D

Rationale: The correct action is to have the parents accompany the child to the operating suite. Current practice encourages parents to stay with the child as long as possible to reduce stress related to a frightening experience. Removing the child's undergarments is usually not necessary for a myringotomy procedure. Placing the child's toys on the bedside table is important, especially a favorite one, for comfort until sedation is induced. Allowing the child to climb onto the stretcher may not be safe or appropriate as the child is too young to do so independently.

5. The mother of an infant in the neonatal intensive care unit expresses concern about her infant. Which nursing intervention best facilitates mother-infant bonding?

• A. Asking the mother to change her baby's diaper
• B. Assuring the mother that her baby is receiving excellent care
• C. Encouraging the mother to touch her baby whenever possible
• D. Keeping the mother informed about the care the nursing staff is providing her baby

Correct answer: C

Rationale: Encouraging the mother to touch her baby whenever possible is the best intervention to promote mother-infant bonding, especially when the infant is too ill to be held. Physical touch is a powerful way to establish a connection. Mother-infant bonding is a gradual process and encouraging touch can help initiate this bond. Asking the mother to change her baby's diaper is not the most appropriate action to promote bonding in this scenario. Assuring the mother about the care her baby is receiving is important but does not directly enhance bonding. Keeping the mother informed about the care her baby is receiving is crucial, but it alone does not actively foster bonding between the mother and infant.

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