Nursing Elites

1. When working with multicultural populations, the nurse should consider all of the following when planning care for a client with an altered sexuality pattern except:

• A. some Hispanic and Native-American cultures are very open when discussing sexuality.
• B. some cultures view the postpartum period as a state of impurity.
• C. some women in the African-American culture view childbearing as a validation of their femaleness.
• D. some Native-American women believe monthly menstruation maintains physical well-being and harmony.

Correct answer: A

Rationale: When working with multicultural populations, it is essential to understand cultural variations in beliefs and practices related to sexuality. While it is true that some cultures view the postpartum period as a state of impurity and that some women in the African-American culture view childbearing as a validation of their femaleness, the statement 'some Hispanic and Native-American cultures are very open when discussing sexuality' is incorrect. In reality, many cultures, including Hispanic and Native-American cultures, are sometimes hesitant to discuss sexuality. For example, some Navajos, Hispanics, and Orthodox Jews may consider the postpartum period as impure, leading to seclusion of women until the end of bleeding, marked by a ritual bath. Additionally, many Native-American women believe in the importance of monthly menstruation for physical well-being and harmony. Therefore, the statement about Hispanic and Native-American cultures being very open about discussing sexuality is not accurate in the context of working with multicultural populations.

2. When obtaining a health history on a menopausal woman, which information should a nurse recognize as a contraindication for hormone replacement therapy?

• A. family history of stroke
• B. ovaries removed before age 45
• C. frequent hot flashes and/or night sweats
• D. unexplained vaginal bleeding

Correct answer: D

Rationale: When obtaining a health history on a menopausal woman, unexplained vaginal bleeding should be recognized as a contraindication for hormone replacement therapy. This is because it can be a sign of underlying issues that need to be addressed before starting hormone therapy. A family history of stroke is not a contraindication for hormone replacement therapy unless the woman herself has a history of stroke or blood-clotting events. Ovaries removed before age 45 is not a contraindication for hormone replacement therapy. Frequent hot flashes and/or night sweats can be relieved by hormone replacement therapy; therefore, they are not contraindications.

3. A nurse assisting with data collection notes that the client exhibits rapid, involuntary oscillating movements of the eyeball when looking at the nurse. The nurse documents this finding using which term?

• A. Ptosis
• B. Nystagmus
• C. Scleral icterus
• D. Exophthalmos

Correct answer: B

Rationale: When a nurse observes rapid, involuntary oscillating movements of the eyeball in a client, this is described as nystagmus. Nystagmus appears as a fine oscillating movement, most notable around the iris. It is important to assess for nystagmus when evaluating ocular muscle weakness. Mild nystagmus at extreme lateral gaze is considered normal; nystagmus in any other position is not. Ptosis refers to a drooping of the eyelid, not rapid eye movements. Scleral icterus is the yellowing of the sclera up to the cornea, indicating jaundice, not related to eye movements. Exophthalmos is a noticeable protrusion of the eyeball, typically seen in hyperthyroidism, not associated with rapid oscillating eye movements.

4. A nurse is reading the report from the registered nurse for an initial home visit to a client with chronic obstructive pulmonary disease. The client was recently discharged from the hospital. Which type of database does the nurse read that contains this information from the client?

• A. Episodic
• B. Follow-up
• C. Emergency
• D. Complete

Correct answer: D

Rationale: The correct answer is 'Complete.' A complete database includes a full health history and physical examination, providing a comprehensive overview of the client's current and past health status. This type of database establishes a baseline for future assessments, making it essential for the nurse's initial home visit to understand the client's health needs thoroughly post-hospital discharge. It is typically gathered in primary care settings like clinics, private practices, college health services, women's health care agencies, visiting nurse agencies, or community health agencies. An episodic database focuses on a specific short-term issue or body system, which is not comprehensive enough for the initial home visit after hospital discharge. A follow-up database is used to monitor a known problem at regular intervals, not suitable for an initial assessment. An emergency database is swiftly collected during urgent situations, often while lifesaving measures are being carried out, and is not relevant for a post-hospital discharge home visit.

5. A nurse in a day-care setting is planning play activities for 2- and 3-year-old children. Which toys are most appropriate for these activities?

• A. Finger paints and card games
• B. Blocks and push-pull toys
• C. Videos and cutting-and-pasting toys
• D. Simple board games and puzzles

Correct answer: B

Rationale: The most appropriate toys for 2- and 3-year-old children in a day-care setting are blocks and push-pull toys. Toddlers enjoy objects of different textures like clay, sand, finger paints, and bubbles, as well as push-pull toys, large balls, and sand and water play. They also like activities such as blocks, painting, coloring with large crayons, large puzzles, and playing with trucks or dolls. Finger paints and card games may be more suitable for older children. Videos and cutting-and-pasting toys are generally more appropriate for preschoolers. Blocks and push-pull toys are beneficial for young children as they help in developing fine motor skills, hand-eye coordination, spatial awareness, and creativity. These toys also encourage imaginative play and problem-solving, making them ideal choices for toddlers.

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