Nursing Elites

1. The client with Parkinson's disease spends over 1 hour to dress for scheduled therapies. What is the most appropriate action for the nurse to take in this situation?

• A. Ask family members to dress the client
• B. Encourage the client to dress more quickly
• C. Allow the client the time needed to dress
• D. Demonstrate methods on how to dress more quickly

Correct answer: C

Rationale: The most appropriate action for the nurse is to allow the client the time needed to dress. Patients with Parkinson's disease may experience difficulties with activities of daily living due to their condition. Allowing the client sufficient time to dress promotes independence and dignity, which are essential aspects of patient-centered care. Asking family members to dress the client may undermine the client's autonomy and self-esteem. Encouraging the client to dress more quickly may lead to frustration and feelings of inadequacy. Demonstrating methods on how to dress more quickly may not address the underlying challenges the client faces and could be perceived as insensitive or dismissive of the client's needs.

2. A client tells the nurse he is fearful of planned surgery because of evil thoughts about a family member. What is the best initial response by the nurse?

• A. Call a chaplain
• B. Deny the feelings
• C. Cite recovery statistics
• D. Listen to the client

Correct answer: D

Rationale: The correct answer is to listen to the client. Listening allows the nurse to establish therapeutic communication, understand the client's fears and concerns, provide emotional support, and help alleviate anxiety. Calling a chaplain (Choice A) may be appropriate if the client requests spiritual support but should not be the initial response. Denying the feelings (Choice B) is dismissive and can hinder trust and communication. Citing recovery statistics (Choice C) is irrelevant and does not address the client's immediate emotional needs.

3. From January 1 to 15, 1996, there were 8 cases of Tetanus neonatorum in San Lazaro Hospital. There were two deaths. What is the case fatality ratio of this disease?

• A. 20%
• B. 30%
• C. 28%
• D. 25%

Correct answer: D

Rationale: The case fatality ratio is calculated as (deaths/cases) * 100. In this case, there were 2 deaths out of 8 cases. Therefore, the calculation is (2/8) * 100 = 25%. Choices A, B, and C are incorrect as they do not match the correct calculation.

4. A Hispanic client confides in the nurse that she is concerned that staff may give her newborn the 'evil eye.' The nurse should communicate to other personnel that the appropriate approach is to

• A. Touch the baby after looking at him
• B. Talk very slowly while speaking to him
• C. Avoid touching the child
• D. Look only at the parents

Correct answer: A

Rationale: In some Hispanic cultures, touching the baby after looking at them is believed to prevent the 'evil eye.' Respecting this cultural belief can help build trust and comfort with the client. Choices B, C, and D are incorrect as they do not address the specific cultural concern raised by the client. Talking slowly or avoiding touching the child does not relate to the belief in the 'evil eye.' Similarly, focusing only on the parents does not address the client's worry about the newborn receiving the 'evil eye.'

5. A 6-month-old infant who is being treated for developmental dysplasia of the hip has been placed in a hip spica cast. The nurse should teach the parents to

• A. Gently rub the skin with a cotton swab to relieve itching
• B. Place the favorite books and push-pull toys in the crib
• C. Check every few hours for the next day or 2 for swelling in the baby's feet
• D. Turn the baby with the abduction stabilizer bar every 2 hours

Correct answer: C

Rationale: The correct answer is to check every few hours for the next day or 2 for swelling in the baby's feet. Swelling in the baby's feet could indicate compromised circulation due to the cast, and frequent checks are necessary to ensure that there are no complications. Choices A, B, and D are incorrect because rubbing the skin with a cotton swab, placing favorite items in the crib, and turning the baby with the abduction stabilizer bar do not address the potential issue of compromised circulation and swelling in the baby's feet.

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