Nursing Elites

1. The nurse is assessing a young client who presents with recurrent gastrointestinal disorders. On further assessment, the nurse learns that the client is experiencing job-related pressures. Which is the most important nursing intervention for this client?

• A. Educate the client on managing stress.
• B. Teach the client to maintain a balanced diet.
• C. Instruct the client to have regular health checkups.
• D. Ask the client to use sunscreen when working outdoors.

Correct answer: A

Rationale: The most important nursing intervention for a client experiencing job-related pressures and recurrent gastrointestinal disorders is to educate the client on managing stress. Stress is a lifestyle risk factor that can impact both mental health and physical well-being. It is associated with various illnesses, including gastrointestinal disorders. Teaching the client to maintain a balanced diet is important for preventive care and health promotion but is not the priority in this scenario. While instructing the client to have regular health checkups is essential for overall health maintenance, addressing the root cause of stress is crucial in this case. Asking the client to use sunscreen when working outdoors is important for sun protection and skin cancer prevention but not directly related to the client's job-related stress and gastrointestinal issues.

2. Which of the following is a typical assessment finding of a 24-year-old female with anorexia nervosa?

• A. Weight loss of more than 2% body fat
• B. Frequent binge-eating episodes followed by induced vomiting
• C. A history of poor academic performance and mediocre achievements
• D. Lack of menstruation

Correct answer: D

Rationale: The correct answer is D: Lack of menstruation. Amenorrhea, or lack of menstruation, is a common occurrence in individuals with anorexia nervosa. The induced starvation from anorexia can disrupt hormone levels, leading to menstrual irregularities. This hormonal imbalance can result in amenorrhea, which can have long-term consequences such as osteoporosis and infertility. Choices A, B, and C are incorrect. Weight loss of more than 2% body fat may be a consequence of anorexia but is not a specific assessment finding. Frequent binge-eating episodes followed by induced vomiting are more characteristic of bulimia nervosa, not anorexia nervosa. A history of poor academic performance and mediocre achievements is not a typical assessment finding related to anorexia nervosa symptoms.

3. What approach should the nurse use when a manipulative client who uses acting-out behaviors asks the nurse to talk while the nurse is orienting a new client to the unit?

• A. Suggest that the client requesting attention speak with another staff member.
• B. Leave the new client, saying, 'I'll talk with the other client until things calm down.'
• C. Introduce the two clients and suggest that the client join them on a tour of the facility.
• D. Say to the interrupting client, 'I'll be back to talk with you after I orient this new client.'

Correct answer: D

Rationale: The nurse should respond to the manipulative client who uses acting-out behaviors by setting realistic limits on behavior without rejecting the client. Therefore, the correct approach is to say to the interrupting client, 'I'll be back to talk with you after I orient this new client.' This response acknowledges the client's request while prioritizing the needs of the new client and setting appropriate boundaries. Choices A, B, and C are incorrect. Suggesting that the client speak with another staff member would be a rejection of the client, not the behavior. Leaving the new client to attend to the manipulative client would encourage further manipulation and disrupt the orientation process for the new client. Introducing the two clients and suggesting a tour is inconsistent with setting limits and does not address the manipulative behavior being displayed.

4. The parents of a child often try to persuade their preschooler to touch their pet dog to reduce the child's fear of dogs. Instead, the child's fears and anxiety increase. Which advice would the nurse suggest to help overcome their child's fear?

• A. Ask the child to touch the dog's back gently.
• B. Keep the child away from dogs for a few years.
• C. Let the child watch other children playing with dogs.
• D. Bring in a pet cat to familiarize the child with animals.

Correct answer: C

Rationale: To help the child overcome their fear of dogs, the nurse should recommend letting the child watch other children playing with dogs. This approach allows the child to observe interactions with dogs in a safe environment, gradually building comfort and familiarity. Encouraging the child to touch the dog's back gently may increase fear and anxiety, as it could be overwhelming for the child. Keeping the child away from dogs for a few years does not address the fear directly and may not help the child overcome it. Bringing in a pet cat, while introducing the child to animals, does not specifically target the fear of dogs and may not effectively reduce the fear and anxiety associated with dogs.

5. An adolescent reports irregularity in menses. Her mother complains that her child often fears gaining weight, has poor caloric intake, and has a distorted self-image. Which could be the reason for irregular menses?

• A. Bulimia
• B. Anorexia
• C. Orthorexia
• D. Binge eating disorder

Correct answer: B

Rationale: The correct answer is 'Anorexia.' Anorexia is characterized by a lack of caloric intake motivated by a strong fear of gaining weight, leading to poor nutrition and potential irregular menses. Bulimia involves binge eating followed by compensatory behaviors. Orthorexia is characterized by an obsession with eating only healthy or 'pure' foods. Binge eating disorder is characterized by consuming large amounts of high-calorie food in a short period.

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