Nursing Elites

1. When assessing the mental status of a young school-aged child, which action would be important for the nurse to take?

• A. Listen to the parents' description of the child's behavior.
• B. Compare the child's function from one occasion to another.
• C. Engage the parents in a discussion about the child's feelings.
• D. Determine the child's mental status through direct questioning.

Correct answer: B

Rationale: To accurately assess the mental status of a young school-aged child, it is crucial for the nurse to compare the child's function over time. This approach allows for a more objective evaluation of the child's mental status. While listening to the parents' description of the child's behavior can provide valuable insights, it may be biased and subjective. Engaging parents in discussions about the child's feelings is important for overall understanding but may not directly assess the child's mental status. Directly questioning the child about their mental status can be threatening and may lead to anxiety, making it a less optimal approach compared to observing and comparing the child's function over time.

2. Which of the following individuals is at the highest risk of suicide?

• A. An 80-year-old man who lost his wife last year
• B. A 36-year-old woman whose former neighbor committed suicide
• C. A 40-year-old married businessman
• D. A 46-year-old former alcoholic who has been sober for 12 years

Correct answer: A

Rationale: The correct answer is an 80-year-old man who lost his wife last year. Certain factors increase the risk of suicide, such as recent loss of a loved one, in this case, the man's wife. The elderly are a high-risk group due to factors like social isolation, physical health issues, and bereavement. While experiencing a loss can affect anyone, the combination of age, loss of a spouse, and the associated emotional impact elevates the risk significantly. The other choices are not at the highest risk of suicide. A former alcoholic who has been sober for 12 years has taken steps towards recovery, reducing the immediate risk. A 40-year-old married businessman and a 36-year-old woman whose former neighbor committed suicide do not have the same level of immediate risk as the elderly man who recently lost his wife.

3. The parents tell the nurse that their preschooler often awakes from sleep screaming in the middle of the night. The preschooler is not easily comforted and screams if the parents try to restrain the child. What should the nurse instruct the parents to do?

• A. Always read a story to the child before bedtime.
• B. Intervene only if necessary to protect the child from injury.
• C. Discuss counseling options with the primary health care provider.
• D. Try to wake the child and ask the child to describe the dream.

Correct answer: B

Rationale: Waking up screaming from sleep at night indicates sleep terrors. The nurse would advise the parents to observe the child and intervene only if there is a risk for injury. Reading a story before bedtime helps calm the child before sleeping, but it does not ensure that the child will not have a sleep terror. There is no need for professional counseling because sleep terrors are a common phenomenon in preschool-age children. Trying to wake the child and asking the child to describe the dream is not appropriate as the child is not aware of anybody's presence during a sleep terror, and this may cause the child to scream and thrash more.

4. Which activity would be most beneficial for a school-age client diagnosed with a chronic illness to enhance a sense of accomplishment?

• A. Wearing make-up
• B. Making up missed work
• C. Participating in sports activities
• D. Participating in creative activities

Correct answer: B

Rationale: Making up missed work is an essential activity that can help a school-age client diagnosed with a chronic illness feel a sense of accomplishment. By catching up on missed work, the child can regain a sense of control and productivity, which can be empowering during a challenging time. Wearing make-up is more related to personal grooming and self-expression, which may not directly contribute to a sense of accomplishment in this context. Participating in sports activities is beneficial for peer relationships and physical health but may not address the immediate need for accomplishment in the academic setting. Engaging in creative activities fosters cognitive development but may not directly address the sense of achievement associated with completing academic tasks.

5. Which characteristic usually results in a behavior being viewed and accepted as normal?

• A. Fits within standards accepted by one's society
• B. Helps the person reduce the need for coping skills
• C. Allows the person to express feelings and thoughts
• D. Facilitates achievement of short-term and long-term goals

Correct answer: A

Rationale: Behaviors that align with the standards accepted by a society are generally viewed as normal. Societal norms and values play a significant role in defining what is considered normal behavior. Choices B, C, and D may be important aspects of an individual's functioning, but they do not solely determine whether a behavior is viewed as normal. Coping skills, expressions of feelings, and goal achievement can vary in their cultural context and societal acceptance, therefore they are not definitive indicators of normalcy.

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