Nursing Elites

1. James returns home from school angry and upset because his teacher gave him a low grade on an assignment. After returning home from school, he kicks the dog. This coping mechanism is known as:

• A. denial
• B. suppression
• C. displacement
• D. fantasy

Correct answer: C

Rationale: Displacement is the transference of emotions, such as anger, to a substitute target that may be less threatening. In this scenario, James redirects his anger from the teacher to the dog. Denial is refusing to acknowledge an aspect of reality. Suppression is consciously putting aside unwanted thoughts or feelings. Fantasy involves imagining unrealistic scenarios. Therefore, in this case, the correct answer is displacement as James displaces his anger towards the dog.

2. When questioning an elder about suspected abuse, how should the nurse keep the questions?

• A. Nonjudgmental.
• B. Probing.
• C. Confrontational.
• D. Indirect.

Correct answer: A

Rationale: When questioning an elder about suspected abuse, the nurse should keep the questions nonjudgmental. This approach helps the elder feel safe and more willing to share information. Probing questions might be perceived as invasive, confrontational questions can lead to defensiveness and denial, and indirect questions may not elicit the necessary information, resulting in confusion or misinterpretation.

3. An elderly client is diagnosed with ovarian cancer. She has surgery followed by chemotherapy with fluorouracil (Adrucil) IV. What should the nurse do if she notices crystals and cloudiness in the IV medication?

• A. Discard the solution and order a new bag
• B. Warm the solution
• C. Continue the infusion and document the finding
• D. Discontinue the medication

Correct answer: A

Rationale: Crystals in the solution are not normal and should not be administered to the client. Discarding the solution and ordering a new bag is the correct action to ensure the client's safety. Warming the solution, as suggested in answer B, will not resolve the issue of crystals and cloudiness, which could potentially harm the client. Continuing the infusion, as in answer C, could pose a risk to the client due to the presence of abnormal substances. Answer D, discontinuing the medication, would typically require a doctor's order and should be done after discarding the contaminated solution.

4. A client goes to the mental health center for difficulty concentrating, insomnia, and nightmares. The client reports being raped as a child. The nurse should assess the client for further signs of:

• A. generalized anxiety disorder.
• B. schizophrenia.
• C. post-traumatic stress disorder.
• D. bipolar disorder.

Correct answer: C

Rationale: Given the history of childhood sexual abuse and the presenting symptoms of difficulty concentrating, insomnia, and nightmares, the nurse should assess the client for post-traumatic stress disorder (PTSD). Childhood sexual abuse is strongly associated with adult-onset depression and an increased risk for PTSD. Individuals with PTSD may exhibit re-experiencing symptoms such as flashbacks, nightmares, and heightened reactions to trauma triggers. They may also display emotional numbing, avoidance behaviors, and increased arousal symptoms like difficulty sleeping and hypervigilance. Generalized anxiety disorder (Choice A) is characterized by excessive worry and anxiety about various events or activities, not necessarily tied to a specific trauma. Schizophrenia (Choice B) is a severe mental disorder characterized by distortions in thinking, perception, emotions, and behavior, unrelated to the traumatic event described. Bipolar disorder (Choice D) involves mood swings between depressive and manic episodes, and its symptoms differ from those typically seen in PTSD.

5. Fat emulsions are frequently administered as a part of total parenteral nutrition. Which statement is true regarding fat emulsions?

• A. They have a high energy-to-fluid-volume ratio.
• B. Even though hypertonic, they are well tolerated.
• C. They are a basic solution due to the addition of sodium hydroxide (NaOH).
• D. The pH is alkaline, making them compatible with most medications.

Correct answer: A

Rationale: The correct statement is that fat emulsions have a high energy-to-fluid-volume ratio. Fat emulsions are formulated in 10%, 20%, and 30% solutions and supply 1.1, 2, and 3 kilocalories, respectively, for each milliliter. In comparison, a milliliter of 5% dextrose only supplies 0.17 kilocalories. Choices B, C, and D are incorrect. Choice B is false because fat emulsions are essentially pH neutral and isotonic, not hypertonic. Choice C is incorrect because fat emulsions are not basic solutions; they are essentially pH neutral. Choice D is incorrect as fat emulsions are not alkaline; they are pH neutral, making them compatible with most medications.

Similar Questions