Nursing Elites

1. The healthcare provider is using Cognitive-Behavioral methods of pain control and knows that these methods can be expected to do all the following except:

• A. completely relieve all pain.
• B. provide benefit by restoring the client's sense of self-control.
• C. help the client to control symptoms.
• D. help the client actively participate in his or her care.

Correct answer: A

Rationale: Cognitive-Behavioral methods of pain control aim to provide benefit by restoring the client's sense of self-control, helping the client to control symptoms, and encouraging the client to actively participate in their care. However, these methods are not intended to completely relieve all pain. These interventions focus on perception and thought, aiming to influence how one interprets events and bodily sensations. Therefore, the correct answer is that they cannot completely relieve all pain, as pain relief is often a multifaceted approach that may require additional interventions beyond Cognitive-Behavioral methods. Choices B, C, and D are correct as Cognitive-Behavioral methods are designed to empower the individual in managing their pain and improving their overall well-being.

2. During surgery, it is found that a client with adenocarcinoma of the rectum has positive peritoneal lymph nodes. What is the next most likely site of metastasis?

• A. brain
• B. bone
• C. liver
• D. mediastinum

Correct answer: C

Rationale: In cases of adenocarcinoma of the rectum with positive peritoneal lymph nodes, the most likely site of metastasis is the liver. Colon tumors commonly spread through the lymphatics and portal vein to the liver. While metastasis to the brain, bone, or mediastinum is possible, the liver is typically the first to be affected due to the anatomical pathways involved in colorectal cancer metastasis. Therefore, the correct answer is the liver. Metastasis to the brain, bone, or mediastinum would be less likely at this stage of colorectal cancer progression.

3. Which of the following foods might a client with hypercholesterolemia need to decrease intake of?

• A. broiled catfish
• B. hamburgers
• C. wheat bread
• D. fresh apples

Correct answer: B

Rationale: A client with hypercholesterolemia should decrease their intake of foods high in cholesterol. Hamburgers, being red meat, have a high cholesterol content, hence should be decreased in the diet. Broiled catfish, wheat bread, and fresh apples are not high in cholesterol, so there is no need to decrease their intake. Broiled catfish is a lean source of protein, wheat bread is a complex carbohydrate, and fresh apples are a good source of fiber and vitamins. Therefore, hamburgers are the correct choice to decrease intake for a client with hypercholesterolemia.

4. The nurse is educating a teenage female about preventing the transmission of genital herpes. Which of the following statements should the nurse include?

• A. "Do not sit on toilet seats without protection."?
• B. "Oral sex can transmit the virus."?
• C. "This infection can be transmitted via intercourse even when you do not feel ill."?
• D. "Try to drink plenty of fluids after sex to flush the reproductive tract."?

Correct answer: C

Rationale: Genital herpes can be transmitted through oral, genital, and anal sex. It is crucial to educate the patient that the infection can be transmitted via intercourse even when asymptomatic to prevent its spread. Choice A is incorrect as sitting on toilet seats without protection does not transmit genital herpes. Choice B is incorrect because oral sex can transmit the virus. Choice D is also incorrect as drinking fluids after sex does not prevent the transmission of genital herpes.

5. Common problems for supervisors include all of the following except:

• A. the supervisor facilitates development of staff members
• B. the supervisor micromanages staff members
• C. the supervisor wants to control the style in which a staff member correctly performs a task
• D. the supervisor does not delegate

Correct answer: A

Rationale: Common problems for supervisors include micromanaging staff members, wanting to control the style in which a staff member performs a task, and not delegating tasks effectively. These behaviors can hinder team building and overall effectiveness. Facilitating the development of staff members, on the other hand, is a positive attribute for a supervisor as it helps in nurturing the skills and growth of the team members. Therefore, the correct answer is 'the supervisor facilitates development of staff members' as this is not a common problem but a desirable quality in a supervisor.

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