Nursing Elites

1. A client with stage IV lung cancer is 3 days postoperative following a wedge resection. The client states, “I told myself that I would go through with the surgery and quit smoking, if I could just live long enough to attend my child’s wedding.” Based on the Kubler-Ross model, which stage of grief is the client experiencing?

• A. Anger
• B. Denial
• C. Bargaining
• D. Acceptance

Correct answer: C

Rationale: The client is in the bargaining stage of grief according to the Kubler-Ross model. In this stage, individuals negotiate for more time to achieve specific goals or fulfill desires. The client's statement about quitting smoking to attend their child's wedding reflects this bargaining behavior. Anger (choice A) is characterized by frustration and resentment, denial (choice B) involves avoidance of reality, and acceptance (choice D) signifies coming to terms with the situation, none of which align with the client's current mindset of bargaining.

2. In planning care for a premature infant with respiratory distress syndrome, nursing actions are based on the fact that the most likely cause of this problem stems from the infant's inability to

• A. Stabilize alveolar surface tension
• B. Maintain alveolar surface tension
• C. Promote normal pulmonary blood flow
• D. Regulate intra-cardiac pressure

Correct answer: B

Rationale: The correct answer is B: Maintain alveolar surface tension. Respiratory distress syndrome in premature infants is often caused by a deficiency in surfactant, a substance that helps maintain alveolar surface tension. Without adequate surfactant, the alveoli collapse, making it difficult for the infant to oxygenate effectively. Choices A, C, and D are incorrect because stabilizing alveolar surface tension is not the issue, promoting normal pulmonary blood flow and regulating intra-cardiac pressure are not directly related to the pathophysiology of respiratory distress syndrome in premature infants.

3. When admitting an older adult client who is Hispanic, which of the following cultural considerations should the nurse include when developing the plan of care?

• A. The Hispanic culture views late adulthood as a time of wisdom and experience
• B. The Hispanic culture expects adult children to care for older adult parents
• C. The Hispanic culture identifies the eldest female family member as the decision maker
• D. The Hispanic culture expects individuals to make their own decisions when death is imminent

Correct answer: B

Rationale: In Hispanic culture, there is an expectation that adult children will care for their older parents, emphasizing a strong family support system. This cultural value highlights the importance of filial piety and respect for elders within the family structure. Choice A is incorrect because Hispanic culture generally values late adulthood as a time of wisdom and experience, not a negative time. Choice C is incorrect as Hispanic culture typically involves collective family decision-making rather than assigning decision-making solely to the eldest female member. Choice D is incorrect as Hispanic culture values family support and involvement in end-of-life decisions rather than individual decision-making.

4. A client appears upset about the IV catheter insertion but does not communicate it to the nurse after being informed about the prescribed IV fluids. Which of the following is an appropriate nursing response?

• A. Ignore the client’s discomfort
• B. Reassure the client without addressing concerns
• C. Is there something about this procedure that concerns you?
• D. Proceed with the procedure

Correct answer: C

Rationale: The appropriate nursing response in this situation is to ask the client if there are any concerns about the procedure. By doing so, the nurse acknowledges the client's distress and opens up a dialogue to address any anxieties or misconceptions. Option A is incorrect as ignoring the client’s discomfort can lead to increased anxiety and potential harm. Option B is not ideal as reassuring the client without addressing specific concerns may not alleviate the client's distress. Option D is incorrect because proceeding with the procedure without addressing the client's unspoken concerns can further escalate the client's distress.

5. A nurse offers pain medication to a client who is postoperative before ambulation. The nurse understands that this aspect of care delivery is an example of which of the following ethical principles?

• A. Fidelity
• B. Autonomy
• C. Justice
• D. Beneficence

Correct answer: D

Rationale: The correct answer is D: Beneficence. Beneficence involves actions intended to benefit the client, such as providing pain relief. In this scenario, the nurse is demonstrating beneficence by offering pain medication to alleviate the client's discomfort and promote their well-being. Fidelity (A) relates to being faithful to agreements and commitments, autonomy (B) refers to respecting a client's right to make decisions about their care, and justice (C) involves fairness and equal treatment. While these ethical principles are important in healthcare, the situation described primarily exemplifies the principle of beneficence.

Similar Questions