Nursing Elites

1. The occupational health nurse is working with a female employee who was just notified that her child was involved in a motor vehicle accident (MVA) and taken to the hospital. The employee states, “I can’t believe this. What should I do?” Which response is best for the nurse to provide in this crisis?

• A. Tell me what you think should be done.
• B. How serious was the collision?
• C. What do you think you should do?
• D. Call for transportation to the hospital.

Correct answer: D

Rationale: In a crisis situation where the female employee's child is involved in a motor vehicle accident (MVA) and taken to the hospital, the most appropriate response for the nurse is to provide immediate practical assistance. Calling for transportation to the hospital ensures that the employee can quickly reach her child in need of urgent medical attention. The other options (A, B, and C) do not address the immediate need for assistance and may not provide the necessary support required in such a critical situation.

2. A woman brings her 48-year-old husband to the outpatient psychiatric unit and describes his behavior to the admitting nurse. She states that he has been sleepwalking, cannot remember who he is, and exhibits multiple personalities. The nurse knows that these behaviors are often associated with:

• A. Post-traumatic stress disorder.
• B. Panic disorder.
• C. Dissociative identity disorder.
• D. Obsessive-compulsive disorder.

Correct answer: C

Rationale: The correct answer is C: Dissociative identity disorder. Dissociative identity disorder (DID) is characterized by the presence of two or more distinct personality states or identities, along with memory gaps beyond ordinary forgetfulness. The description of the husband sleepwalking, not recognizing his identity, and exhibiting multiple personalities aligns with the symptoms of DID. Post-traumatic stress disorder (PTSD) (Choice A) involves re-experiencing traumatic events, panic disorder (Choice B) is characterized by recurrent panic attacks, and obsessive-compulsive disorder (OCD) (Choice D) involves obsessions and compulsions. These conditions do not typically present with the specific symptoms described in the scenario.

3. A female high school teacher who was a child of alcoholic parents seeks counseling at the community health clinic because of depression over a student who was killed by a drunk driver. After several weeks of counseling, which client behavior is the best indicator that the client is coping well with anxiety related to the student’s death?

• A. Signs a safety contract with the nurse agreeing not to hurt herself or others
• B. Confronts her parents about the hurt she felt as a child of alcoholic parents
• C. Becomes the faculty sponsor for Students Against Drunk Driving (SADD)
• D. Describes her feelings about the student’s death in detail

Correct answer: C

Rationale: Becoming the faculty sponsor for Students Against Drunk Driving (SADD) is the best indicator that the client is coping well with anxiety related to the student’s death. This choice demonstrates active involvement in preventing similar tragedies, showing that the client is channeling her emotions into positive action and advocacy. Option A, signing a safety contract, is important for safety but does not directly address coping with the anxiety related to the student's death. Option B, confronting her parents about past hurt, may be beneficial for personal growth but does not directly reflect coping with the current situation. Option D, describing feelings in detail, is a positive step in therapy but does not necessarily indicate coping well with the anxiety related to the student's death.

4. A client in the emergency department presents with confusion, disorientation, and agitation after drinking alcohol. Which diagnostic test should the nurse anticipate to assess for potential complications?

• A. Complete blood count (CBC)
• B. Electrolyte panel
• C. Liver function tests
• D. Urinalysis

Correct answer: B

Rationale: The correct answer is an electrolyte panel. When a client presents with confusion, disorientation, and agitation after drinking alcohol, it indicates potential complications such as electrolyte imbalances. Monitoring electrolyte levels is crucial in these cases to detect and address abnormalities that may result from alcohol intake. While a complete blood count (choice A) may provide some valuable information, it is not the primary test to assess for alcohol-related complications presenting with these symptoms. Liver function tests (choice C) are more specific for assessing liver damage due to chronic alcohol use rather than immediate complications. Urinalysis (choice D) may help detect some issues but is not the most appropriate initial test to assess for potential complications in this scenario.

5. A teenager who has lost 20 pounds in the last three months is admitted to the hospital with hypotension and tachycardia. The client reports irregular menses and hair loss. Which intervention is most important for the nurse to include in the client’s plan of care?

• A. Initiate caloric and nutritional therapy.
• B. Implement behavioral modification therapy.
• C. Evaluate the client for low self-esteem.
• D. Record daily weights and graph trends.

Correct answer: A

Rationale: The client presents with evidence of anorexia nervosa resulting from self-starvation, which is a life-threatening condition. Providing nutrition and calories is the priority intervention so that the risk of electrolyte imbalance and severe dehydration can be reduced. Behavioral modification therapy (Choice B) may be beneficial in the long term but is not the priority in this acute situation. Evaluating for low self-esteem (Choice C) may be part of the nursing assessment but does not address the immediate life-threatening issues. Recording daily weights and graphing trends (Choice D) is important for monitoring progress but does not address the critical need for nutritional therapy in this case.

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