Nursing Elites

1. When caring for an elderly client and providing education, which of the following would be the least appropriate for the nurse to do?

• A. The nurse speaks loudly.
• B. The nurse allows additional time after each instruction to allow the client to process.
• C. The nurse provides supplemental written resources.
• D. The nurse breaks up the education into multiple shorter sessions.

Correct answer: A

Rationale: Speaking loudly is inappropriate when caring for an elderly client. It is essential to assess the client for a hearing impairment and provide appropriate assistance if needed. Elderly clients may require more time to process information due to slower reaction times, benefit from shorter sessions as they fatigue easily, and can absorb supplemental written resources effectively. Therefore, speaking loudly may not be conducive to effective communication and may not cater to the specific needs of the elderly client, unlike the other options provided.

2. A nurse is assisting with developing a plan of care for an older client to help maintain an adequate sleep pattern. Which action should the nurse suggest be included in the plan?

• A. Encouraging bedtime reading or listening to music
• B. Encouraging at least one daytime nap
• C. Discouraging the use of a nightlight at bedtime
• D. Discouraging social interaction, particularly at bedtime

Correct answer: A

Rationale: To help maintain an adequate sleep pattern in older clients, it is essential to include activities that promote relaxation and a conducive sleep environment. Encouraging bedtime reading or listening to music can help the client unwind and prepare for sleep. Daytime naps should be discouraged to ensure a better nighttime sleep. Social interaction, especially positive interactions, can be beneficial and should not be discouraged. The use of a nightlight can create a safe and comfortable environment for the client, so it should not be discouraged unless specifically contraindicated.

3. The nurse is assessing the dental status of an 18-month-old child. How many teeth should the nurse expect to examine?

• A. 6
• B. 8
• C. 12
• D. 16

Correct answer: C

Rationale: An 18-month-old child should have approximately 12 teeth. Children typically start getting teeth around 6 months of age. By subtracting 6 from the number of months in the child's age, you can calculate the expected number of teeth. For an 18-month-old child, 18 - 6 = 12 teeth. Therefore, the correct answer is 12 teeth. Choices A, B, and D are incorrect because they do not align with the expected dental development in an 18-month-old child.

4. In conducting a health screening for 12-month-old children, the nurse expects them to have been immunized against which of the following diseases?

• A. measles, polio, pertussis, hepatitis B
• B. diphtheria, pertussis, polio, tetanus
• C. rubella, polio, pertussis, hepatitis A
• D. measles, mumps, rubella, polio

Correct answer: B

Rationale: By 12 months of age, children should have received vaccines for diphtheria, pertussis, polio, and tetanus (DTaP and IPV). The correct answer is B as it includes these vaccines that are typically administered in the first year of life. Measles, mumps, and rubella (MMR) vaccination usually begins at 12 months of age but is not expected to be completed by this time. Choices A and C are incorrect as they include diseases that are not part of the routine immunization schedule for a 12-month-old child.

5. A nurse is providing information to a group of pregnant clients and their partners about the psychosocial development of an infant. Using Erikson's theory of psychosocial development, the nurse tells the group that infants have which developmental need?

• A. Must have needs ignored for short periods to develop a healthy personality
• B. Need to rely on the fact that their needs will be met
• C. Need to experience frustration, so it is best to allow an infant to cry for a while before meeting his or her needs
• D. Need to tolerate a great deal of frustration and discomfort to develop a healthy personality

Correct answer: B

Rationale: According to Erikson's theory of psychosocial development, infants struggle to establish a sense of basic trust rather than a sense of basic mistrust in their world, their caregivers, and themselves. If provided with consistent satisfying experiences that are delivered in a timely manner, infants come to rely on the fact that their needs are met and that, in turn, they will be able to tolerate some degree of frustration and discomfort until those needs are met. This sense of confidence is an early form of trust and provides the foundation for a healthy personality. Therefore, options A, C, and D are incorrect as they do not align with Erikson's theory that emphasizes the importance of infants trusting that their needs will be met.

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