Nursing Elites

1. When the nurse who was not promoted first read the memo and learned that the other nurse had received the promotion, she left the room in tears. This behavior is an example of:

• A. conversion.
• B. regression
• C. introjection.
• D. rationalization

Correct answer: B

Rationale: Crying is a regressive behavior. The ego returned to an earlier, comforting, and less-mature way of behaving in the face of disappointment. Regression involves reverting to an earlier stage of development to cope with stress or conflict. In this scenario, the nurse regressed to a childlike state by crying when faced with the disappointment of not getting the promotion, demonstrating regression as a defense mechanism. Conversion involves transforming anxiety into a physical symptom. Introjection involves unconsciously identifying intensely with another person. Rationalization involves unconsciously creating acceptable explanations to justify unacceptable ideas, actions, or feelings. Therefore, the correct answer is regression as it aligns with the nurse's behavior of regressing to a childlike state by crying due to the disappointment of not receiving the promotion.

2. Client self-determination is the primary focus of:

• A. malpractice insurance
• B. nursing's advocacy for clients
• C. confidentiality
• D. health care

Correct answer: B

Rationale: Client self-determination refers to the right of clients to make their own decisions about their health care. Nursing's advocacy for clients focuses on upholding this right by supporting and respecting the autonomy and self-determination of clients. This advocacy ensures that clients are empowered to participate in decision-making regarding their health. Confidentiality, while essential, is about maintaining the privacy of client information. Malpractice insurance is a protective measure for professionals in case of errors or negligence. Health care, though crucial for enabling client self-determination, is a broad term encompassing various services and not the primary focus when discussing the client's right to autonomy.

3. The nurse is caring for a client scheduled for a surgical repair of a sacular abdominal aortic aneurysm. Which assessment is most crucial during the preoperative period?

• A. Assessment of the client's level of anxiety
• B. Evaluation of the client's exercise tolerance
• C. Identification of peripheral pulses
• D. Assessment of bowel sounds and activity

Correct answer: C

Rationale: The most crucial assessment during the preoperative period for a client with a sacular abdominal aortic aneurysm scheduled for surgical repair is the identification of peripheral pulses. During surgery, the aorta will be clamped, potentially affecting blood circulation to the kidneys and lower extremities. Therefore, it is essential for the nurse to assess peripheral pulses and monitor the return of circulation to the lower extremities postoperatively. Assessing the client's level of anxiety (Choice A) is important but not as crucial as ensuring adequate circulation. Evaluating exercise tolerance (Choice B) is not recommended preoperatively for this situation. Assessing bowel sounds and activity (Choice D) is of lesser concern compared to the critical need to monitor peripheral circulation.

4. What are appropriate nursing strategies to assist a client in maintaining a sense of self?

• A. Addressing the client by their first name when interacting with them
• B. Treating the client with dignity
• C. Explaining procedures to the client regardless of their attentiveness
• D. Encouraging the use of personal items to foster a sense of identity

Correct answer: B

Rationale: Maintaining a sense of self is crucial for clients in healthcare settings. Treating the client with dignity is a fundamental nursing principle that helps preserve the client's self-worth and identity. Addressing the client by their first name when interacting with them is a way to show respect, but it alone may not significantly contribute to maintaining their sense of self. Explaining procedures to the client, regardless of their attentiveness, is essential for informed consent and autonomy, empowering them in their care. Encouraging the use of personal items can foster a sense of identity as these items often hold personal significance and emotional value for the client, thus supporting their sense of self; therefore, discouraging their use would be counterproductive in maintaining a client's sense of self.

5. During a well-baby check of a 6-month-old infant, the nurse notes abrasions and petechiae of the palate. The nurse should:

• A. inquire about the possibility of sexual abuse.
• B. ask about the types of foods the child is eating.
• C. request to see the type of bottle used for feedings.
• D. question the parent about objects the child plays with.

Correct answer: A

Rationale: The correct answer is to inquire about the possibility of sexual abuse. Injuries to the soft palate such as bruising, abrasions, and petechiae can be signs of sexual abuse in infants. While oral sex may not leave significant physical evidence, these findings should raise suspicion. Option A is correct as it focuses on addressing potential abuse. Options B, C, and D are incorrect because the child's diet, the type of bottle used for feedings, and play objects are not likely related to the observed injuries. The presence of oral injuries suggests considering sexual abuse rather than other factors.

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