Nursing Elites

1. The best definition of communication is:

• A. the sending and receiving of messages.
• B. the effect of sending verbal messages.
• C. an ongoing, interactive form of transmitting transactions.
• D. the use of message variables to send information.

Correct answer: C

Rationale: Communication is defined as an ongoing, interactive form of transmitting transactions. It involves a dynamic process of sending (encoding) and receiving (decoding) messages while being influenced by the experiences and perceptions of both the sender and receiver. This process is interactive and occurs within an environment, shaping individuals' self-concept, identity, and relationships. The correct answer captures the complexity and interactive nature of communication. Choice A, 'the sending and receiving of messages,' is too simplistic and does not encompass the interactive nature of communication. Choice B, 'the effect of sending verbal messages,' focuses solely on verbal communication and overlooks non-verbal forms. Choice D, 'the use of message variables to send information,' emphasizes technical aspects rather than the interactive and transactional nature of communication.

2. When helping a client gain insight into anxiety, the nurse should:

• A. help the client relate anxiety to specific triggers.
• B. ask the client to describe events that precede increased anxiety.
• C. encourage the client to practice relaxation techniques.
• D. address the client's resistive behavior.

Correct answer: B

Rationale: When assisting a client in gaining insight into anxiety, it is crucial to explore the events that lead to increased anxiety. By asking the client to describe these events, the nurse can help the client recognize patterns and triggers, leading to a better understanding of their anxiety. Option A is incorrect because it refers to triggers rather than exploring the events leading to anxiety. Option C is incorrect as it focuses on relaxation techniques rather than delving into the root causes of anxiety. Option D is inappropriate as addressing resistive behavior may not foster a supportive therapeutic environment for the client.

3. A client has been taking alprazolam (Xanax) for four years to manage anxiety. The client reports taking 0.5 mg four times a day. Which statement indicates that the client understands the nurse's teaching about discontinuing the medication?

• A. "I can drink alcohol now that I am decreasing my Xanax."?
• B. "I should not take another Xanax pill. Here is what is left of my last prescription."?
• C. "I should take three pills per day next week, then two pills for one week, then one pill for one week."?
• D. "I can expect to be sleepy for several days after stopping the medicine."?

Correct answer: C

Rationale: Explanation: When discontinuing alprazolam (Xanax) after long-term use, it is crucial to taper the dosage gradually to prevent withdrawal symptoms. The correct statement indicates an understanding of this by planning a structured decrease in dosage over time. Choice A is incorrect as drinking alcohol while decreasing Xanax can be dangerous and is not recommended. Choice B is incorrect as abruptly stopping Xanax is not safe and can lead to withdrawal symptoms. Choice D is incorrect as expecting to be sleepy for several days after stopping the medication does not address the need for a gradual tapering process to avoid withdrawal symptoms.

4. An adult who had been abused as a child is discussing the group therapy program. Which statement indicates that the client has gained insight?

• A. "I think I was a lonely child because I could not tell anyone about my abuse."?
• B. "I am now aware of how deep-seated my anger is. Before, I did not realize I was angry."?
• C. "The program has given me the courage to tell my mother how I felt about her role in my hurt."?
• D. "There are so many people just like me, who are just normal people that had bad things happen to them."?

Correct answer: B

Rationale: The correct answer demonstrates insight gained by the client regarding their emotional state. Recognizing deep-seated anger that was previously unrecognized indicates progress in understanding their emotions and the impact of past abuse. Choice A reflects a sense of loneliness due to an inability to share about the abuse, which does not directly address emotional insight. Choice C shows progress in addressing relationships but does not specifically relate to emotional awareness. Choice D acknowledges shared experiences but does not reflect personal emotional growth or insight.

5. The client is admitted with chronic obstructive pulmonary disease. Blood gases reveal pH 7.36, CO2 45, O2 84, HCO3 28. The nurse would assess the client to be in:

• A. Uncompensated acidosis
• B. Compensated alkalosis
• C. Compensated respiratory acidosis
• D. Uncompensated metabolic acidosis

Correct answer: C

Rationale: The client is experiencing compensated respiratory acidosis. The pH is within the normal range but is lower than 7.40, indicating acidity. The elevated CO2 level and low O2 level suggest respiratory involvement. The slightly elevated HCO3 level indicates a compensatory mechanism. In respiratory acidosis, the pH will be inversely related to the CO2 and bicarb levels, with elevated CO2 and HCO3 levels contributing to acidosis. Choices A, B, and D are incorrect because they do not align with the presented blood gas values and the compensatory response observed in this case.

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