Nursing Elites

1. What is an effective intervention for a client diagnosed with Obsessive-Compulsive Disorder?

• A. Discussing the repetitive actions.
• B. Insisting the client not perform the repetitive act.
• C. Informing the client that the act is not necessary.
• D. Encouraging daily exercise.

Correct answer: D

Rationale: An effective intervention for a client diagnosed with Obsessive-Compulsive Disorder is encouraging daily exercise. Obsessive-Compulsive Disorder is an anxiety disorder, and exercise can help release emotional energy, limit the time available for maladaptive behaviors, and direct the client's attention outward. Discussing the repetitive actions (choice A) may reinforce the behavior by providing attention to it. Insisting the client not to perform the repetitive act (choice B) can increase anxiety and resistance, as abruptly stopping the behavior may be challenging. Informing the client that the act is not necessary (choice C) may not address the underlying anxiety and could invalidate the client's experiences, leading to increased distress. Encouraging daily exercise is a proactive intervention that can help manage symptoms of Obsessive-Compulsive Disorder by addressing core features of the disorder and promoting overall well-being.

2. Incidences of child abuse appear to be higher in the African-American community and might be explained by:

• A. the increased number of single-parent households in African-American communities
• B. more single-parent households in African-American communities
• C. stricter child-rearing practices in African-American households
• D. a higher occurrence of rage in African Americans

Correct answer: B

Rationale: Child abuse is often associated with lower socioeconomic status and single-parent households due to increased stress and fewer support systems. Choice A is correct as single-parent households can face more challenges leading to a higher risk of child abuse. Choice B is the correct answer as it aligns with the risk factors associated with child abuse. Choice C is incorrect because there is no direct correlation between stricter child-rearing practices and child abuse rates. Choice D is incorrect because attributing child abuse to a higher occurrence of rage in African Americans is a stereotype and lacks evidence.

3. The nurse is caring for a client scheduled for a surgical repair of a sacular abdominal aortic aneurysm. Which assessment is most crucial during the preoperative period?

• A. Assessment of the client's level of anxiety
• B. Evaluation of the client's exercise tolerance
• C. Identification of peripheral pulses
• D. Assessment of bowel sounds and activity

Correct answer: C

Rationale: The most crucial assessment during the preoperative period for a client scheduled for surgical repair of a sacular abdominal aortic aneurysm is the identification of peripheral pulses. This is essential because during surgery, the aorta will be clamped, potentially affecting blood circulation to the kidneys and lower extremities. Monitoring peripheral pulses helps assess circulation to the lower extremities, ensuring adequate perfusion. While assessing the client's anxiety level (choice A) is important, it is not as critical as monitoring peripheral pulses in this case. Evaluating exercise tolerance (choice B) is not typically recommended preoperatively for this specific condition. Assessing bowel sounds and activity (choice D) is also relevant but takes a lower priority compared to identifying peripheral pulses in this scenario.

4. A nurse notes that an elderly client suddenly does not keep appointments and is not wearing appropriate clothing. Which statement by the client raises the suspicion of financial abuse?

• A. "I am having difficulty paying for this new antibiotic the physician prescribed."?
• B. "I am a little short on cash since my daughter moved in to help me."?
• C. "I have not felt like shopping since the weather has gotten worse."?
• D. "People do not realize how difficult it is to make ends meet on a fixed income."?

Correct answer: B

Rationale: The correct answer is B: "I am a little short on cash since my daughter moved in to help me."? This statement raises suspicion of financial abuse as it suggests a recent change in financial circumstances after the daughter moved in. Financial abuse in elderly clients can be indicated by sudden unexplained financial deficits or changes, such as difficulty paying for necessities despite previously being able to do so. Choices A, C, and D do not directly imply a recent financial change due to external factors, making them less indicative of potential financial abuse. Option B is the most concerning statement that warrants further investigation into possible financial exploitation.

5. When the nurse who was not promoted first read the memo and learned that the other nurse had received the promotion, she left the room in tears. This behavior is an example of:

• A. conversion.
• B. regression
• C. introjection.
• D. rationalization

Correct answer: B

Rationale: Crying is a regressive behavior. The ego returned to an earlier, comforting, and less-mature way of behaving in the face of disappointment. Regression involves reverting to an earlier stage of development to cope with stress or conflict. In this scenario, the nurse regressed to a childlike state by crying when faced with the disappointment of not getting the promotion, demonstrating regression as a defense mechanism. Conversion involves transforming anxiety into a physical symptom. Introjection involves unconsciously identifying intensely with another person. Rationalization involves unconsciously creating acceptable explanations to justify unacceptable ideas, actions, or feelings. Therefore, the correct answer is regression as it aligns with the nurse's behavior of regressing to a childlike state by crying due to the disappointment of not receiving the promotion.

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