Nursing Elites

1. When the caregiver of a child asks the nurse for reassurance about their child’s condition, which of the following responses should the nurse make?

• A. “I think your child is getting better. What have you noticed?”
• B. “I’m sure everything will be okay. It just takes time to heal.”
• C. “I’m not sure what’s wrong. Have you asked the doctor about your concerns?”
• D. “I understand you’re concerned. Let’s discuss what concerns you specifically.”

Correct answer: D

Rationale: When providing reassurance to a caregiver about their child’s condition, it's essential to acknowledge their concern and address it specifically. Response D demonstrates empathy and a willingness to discuss the caregiver's specific concerns, which can help in providing accurate information and support to them. Choices A and B provide general reassurance without addressing the caregiver's specific concerns, which may not alleviate their worries effectively. Choice C deflects the question back to the caregiver and suggests consulting the doctor without directly engaging with the caregiver's worries, which may not offer the needed support and reassurance.

2. What principle about patient communication should guide a nurse's fear of 'saying the wrong thing' to a patient?

• A. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation.
• B. Patients are more interested in talking to you than listening to what you have to say, so they are not likely to be offended.
• C. Considering the patient's history, there is little chance that the comment will do any actual harm.
• D. Most people with a mental illness have, by necessity, developed a high tolerance for forgiveness.

Correct answer: A

Rationale: Effective patient communication is guided by the principle that patients value genuine acceptance, respect, and concern from their caregivers. This approach helps to build trust and fosters effective communication, enhancing the nurse-patient relationship. Choice B is incorrect because patients value both talking and listening in effective communication. Choice C is incorrect because a nurse should always consider the impact of their words on the patient, regardless of the patient's history. Choice D is incorrect as it generalizes about people with mental illness and forgiveness, which is not directly relevant to patient communication.

3. When a patient is diagnosed with major depressive disorder, which nursing diagnosis should be the priority?

• A. Imbalanced nutrition: less than body requirements
• B. Risk for suicide
• C. Disturbed sleep pattern
• D. Ineffective coping

Correct answer: B

Rationale: The priority nursing diagnosis for a patient diagnosed with major depressive disorder is 'Risk for suicide.' This is the priority as it addresses the immediate risk of self-harm in individuals suffering from major depressive disorder. Monitoring and intervening to prevent self-harm take precedence over other nursing diagnoses in this scenario.

4. Which symptom is most indicative of posttraumatic stress disorder (PTSD)?

• A. Persistent low mood
• B. Frequent nightmares
• C. Hallucinations
• D. Compulsive behaviors

Correct answer: B

Rationale: Frequent nightmares are a hallmark symptom of posttraumatic stress disorder (PTSD). Individuals with PTSD often experience intrusive and distressing nightmares related to the traumatic event they have experienced. These nightmares can contribute to sleep disturbances and further exacerbate the individual's overall psychological distress. Persistent low mood, hallucinations, and compulsive behaviors are not specific symptoms of PTSD and are more commonly associated with other mental health conditions such as depression, psychotic disorders, and obsessive-compulsive disorder respectively.

5. Carolina is surprised when her patient does not show for a regularly scheduled appointment. When contacted, the patient states, ‘I don’t need to come see you anymore. I have found a therapy app on my phone that I love.’ How should Carolina respond to this news?

• A. That sounds exciting; would you be willing to visit and show me the app?
• B. At this time, there is no real evidence that the app can replace our therapy.
• C. I am not sure that is a good idea right now; we are so close to progress.
• D. Why would you think that is a better option than meeting with me?

Correct answer: A

Rationale: Carolina should respond with openness and curiosity to maintain a positive therapeutic relationship. By showing interest in the patient's new therapy method and inviting them to share the app, Carolina demonstrates a willingness to explore alternative approaches while also ensuring the patient feels heard and valued in their decision-making process. Choice B is incorrect because it dismisses the patient's choice without exploring it further. Choice C focuses more on Carolina's concerns rather than engaging with the patient's decision. Choice D comes off as defensive and may make the patient feel misunderstood or judged.

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