Nursing Elites

1. What can the nurse instruct the mother of a teething 9-month-old infant to relieve discomfort?

• A. Rub the infant's gums with baby aspirin dissolved in water.
• B. Obtain an over-the-counter (OTC) topical medication for gum pain relief.
• C. Schedule an appointment with a dentist for a dental evaluation.
• D. Give the infant cool liquids or a Popsicle and hard foods such as dry toast.

Correct answer: D

Rationale: Teething in infants can cause discomfort, but it is a normal process. Symptoms may include nighttime awakening, daytime restlessness, excess drooling, and temporary loss of appetite. The recommended approach to relieve teething discomfort includes providing cool liquids, a Popsicle, or hard foods like dry toast for chewing. These items can help soothe the infant's gums. Rubbing the gums with baby aspirin dissolved in water is not recommended as it can be harmful. OTC topical medications are unnecessary for teething discomfort. Scheduling a dental evaluation is not required solely for teething. It's important to avoid home remedies like baby aspirin and opt for safer options like cool liquids. If necessary, acetaminophen (Tylenol) can be used under healthcare provider guidance to alleviate discomfort.

2. The licensed practical nurse is working with a registered nurse and a patient care assistant. Which of the following clients should be cared for by the registered nurse?

• A. A client 2 days post-appendectomy
• B. A client 1 week post-thyroidectomy
• C. A client 3 days post-splenectomy
• D. A client 2 days post-thoracotomy

Correct answer: D

Rationale: The correct answer is a client 2 days post-thoracotomy because this client is the most critical and requires the expertise of a registered nurse. Clients A and B are stable and ready for discharge after their respective surgeries (appendectomy and thyroidectomy). Client C, who is 3 days post-splenectomy, is also stable enough to be cared for by a licensed practical nurse as they are in a stable condition and do not have immediate critical needs. Therefore, the registered nurse should care for the client 2 days post-thoracotomy due to the critical nature of the procedure and the immediate postoperative care required.

3. A two-year-old has been in the hospital for 3 weeks and has seldom seen family members due to isolation precautions. Which of the following hospitalization changes is most likely to be occurring?

• A. Guilt
• B. Trust
• C. Separation anxiety
• D. Shame

Correct answer: C

Rationale: The correct answer is 'Separation anxiety.' Separation anxiety is a common response in young children when they are separated from their primary caregivers for extended periods. In this case, the two-year-old being in the hospital for three weeks and not being able to see family members due to isolation precautions can trigger separation anxiety. 'Guilt' is a feeling of responsibility for wrongdoing, which is not the most likely change occurring in this scenario. 'Trust' involves reliance and confidence in others, not typically associated with prolonged separation from family. 'Shame' is a negative emotion related to feeling disgrace, which is not the most appropriate response in this hospitalization situation.

4. What is a common characteristic of individuals who become batterers?

• A. Grew up in a loving, secure home.
• B. Was an only child.
• C. Was physically or psychologically abused.
• D. Admits they have a problem with anger.

Correct answer: C

Rationale: The correct answer is 'Was physically or psychologically abused.' Research indicates that many individuals who become batterers have a history of being abused themselves. This cycle of abuse can influence their behavior as adults. Choice A is incorrect because growing up in a loving home does not necessarily prevent someone from becoming a batterer. Choice B is incorrect as being an only child is not a determining factor in becoming a batterer. Choice D is incorrect because while admitting to anger issues is a positive step, it is not a common characteristic of individuals who become batterers.

5. A client reports that he is 'talking to the voices.' The nurse observes this behavior. The nurse's next action should be:

• A. touching the client to help him return to reality
• B. leaving the client alone until reality returns
• C. asking the client to describe what is happening
• D. telling the client there are no voices

Correct answer: A

Rationale: When a client reports talking to voices, the nurse should engage in a gentle touch to help the client return to reality. It is important for the nurse to acknowledge the client's experience and attempt to redirect them gently. Touch can provide grounding and connection. Asking the client to describe what is happening can be overwhelming and might exacerbate the situation. Leaving the client alone may not be safe or therapeutic as the client may need support. Telling the client there are no voices denies their reality and is not helpful in managing their experience.

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