Nursing Elites

1. A twenty-one-year-old man suffered a concussion, and the MD ordered an MRI. The patient asks, 'Will they allow me to sit up during the MRI?' The correct response by the nurse should be:

• A. "I will have to talk to the doctor about letting you sit upright during the test."?
• B. "You will be positioned in the reverse Trendelenburg position to maximize the view of the brain."?
• C. "The radiologist will let you know."?
• D. "You will have to lie down on your back during the test."?

Correct answer: D

Rationale: The correct answer is to inform the patient that they will have to lie down on their back during the MRI. This positioning is necessary for the scan to obtain accurate images of the brain. Choice A is incorrect because the decision on the positioning during the MRI is typically determined by the imaging protocol and not subject to negotiation during the test. Choice B is incorrect as the reverse Trendelenburg position is not commonly used during MRI scans. Choice C is incorrect because the radiologist does not usually make decisions on patient positioning during the MRI; it is predetermined by the imaging requirements.

2. After experiencing a traumatic event like losing a child due to poisoning, a client tells the nurse, 'I don’t want to make any new friends right now.' This is an example of which of the following indicators of stress?

• A. emotional indicator
• B. spiritual indicator
• C. sociocultural indicator
• D. intellectual indicator

Correct answer: C

Rationale: The correct answer is C: sociocultural indicator. In this situation, the client's reluctance to make new friends after experiencing a traumatic event like losing a child due to poisoning reflects a change in their social behavior, which is influenced by sociocultural factors. This response indicates how stress can impact a person's relationships and social interactions. Choice A, emotional indicator, is incorrect because the client's statement is more related to social interactions than emotional expression. Choice B, spiritual indicator, is incorrect as the given scenario does not directly involve spiritual beliefs or practices. Choice D, intellectual indicator, is also incorrect as the client's statement does not reflect cognitive or intellectual changes but rather social aspects affected by the stressful event.

3. 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.

4. An elderly client denies that abuse is occurring. Which of the following factors could be a barrier for the client to admit being a victim?

• A. knowledge that elder abuse is rare
• B. personal belief that abuse is deserved
• C. lack of developmentally appropriate screening tools
• D. fear of reprisal or further violence if the incident is reported

Correct answer: D

Rationale: One of the significant barriers for elderly clients to admit being victims of abuse is the fear of reprisal or further violence if the incident is reported. Elderly individuals may be afraid of the consequences of reporting abuse, such as retaliation or increased violence from the abuser. This fear can prevent them from disclosing their victimization. Choices A and C are incorrect as knowledge of the rarity of elder abuse and the availability of appropriate screening tools do not directly impact the client's willingness to admit abuse. Choice B, personal belief that abuse is deserved, may be a factor for some individuals but is not as common or impactful as the fear of reprisal or further violence.

5. A 57-year-old woman is recently widowed. She states, "I will never be able to learn how to manage the finances. My husband did all of that."? Select the nurse's response that could help raise the client's self-esteem.

• A. "You feel inadequate because you have never learned to balance a checkbook."?
• B. "You should have insisted your husband teach you about the finances."?
• C. "You are strong and will learn how to manage your finances after a while."?
• D. "I believe in your strength to learn how to manage your finances in time."?

Correct answer: C

Rationale: The nurse should aim to boost the client's self-esteem by providing positive reinforcement. By stating, "You are strong and will learn how to manage your finances after a while,"? the nurse acknowledges the client's strength and capability, encouraging her to believe in herself. Choice A is incorrect as it focuses on the client's inadequacy rather than empowering her. Choice B places unnecessary blame on the client for not taking action in the past. Choice D, though positive, slightly alters the nurse's original phrase, making choice C the most appropriate response to uplift the client's self-esteem.

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