Nursing Elites

1. Which approach is best to use with a client who is angry and agitated?

• A. Confront the client about the behavior.
• B. Turn on the television to distract the client.
• C. Maintain a calm, consistent approach with the client.
• D. Explain to the client why the behavior is unacceptable.

Correct answer: C

Rationale: When dealing with an angry and agitated client, it is crucial to maintain a calm and consistent approach. Consistency allows the client to predict the caregiver's behavior, which can help reduce their anxiety and agitation. Confronting the client about their behavior may escalate the situation and increase their anger. Using distractions like turning on the television is not addressing the underlying issue and may not be effective in calming the client. Explaining to the client why their behavior is unacceptable is not suitable in the moment of agitation, as the client may not be in a state to attend to logical explanations and perceived criticisms should be avoided to prevent further escalation.

2. 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.

3. When performing a return demonstration of using a gait belt for a female patient with right-sided weakness, which observation indicates that the caregiver has learned the correct procedure?

• A. Standing on the female patient's strong side, the caregiver is ready to hold the gait belt if any evidence of weakness is observed.
• B. Standing on the female patient's weak side, the caregiver provides security by holding the gait belt from the back.
• C. Standing behind the female patient, the caregiver provides balance by holding both sides of the gait belt.
• D. Standing slightly in front and to the right of the female patient, the caregiver guides her forward by gently pulling on the gait belt.

Correct answer: B

Rationale: When assisting a patient with right-sided weakness using a gait belt, the caregiver must stand on the weak side of the patient to provide optimal support and security. By standing on the weak side and holding the gait belt from the back, the caregiver can effectively prevent falls and guide the patient's movements. This position allows for better control over the patient's balance. Standing on the strong side (option A) does not offer the necessary support if the patient leans towards the weak side. Standing behind the patient and holding both sides of the gait belt (option C) does not provide focused support to the weak side. Standing slightly in front and to the right (option D) may not offer adequate assistance to prevent falls on the weak side, making it an incorrect choice.

4. Why is it important for the nurse to inform the family about the client's situation?

• A. To decrease the client's anxiety
• B. To help the family better adapt to necessary role changes
• C. To improve communication between family and nursing staff
• D. To ensure a more relaxed atmosphere for the client

Correct answer: B

Rationale: It is crucial for the nurse to inform the family about the client's situation to help them better adapt to necessary role changes. By providing early notification, the family can start preparing for potential adjustments. While reducing the client's anxiety and improving communication with the nursing staff are important, the primary purpose is to assist the family in undertaking the required role changes. Creating a relaxed atmosphere for the client, although beneficial, is not the main objective in this situation.

5. Which intervention would the nurse use to provide emotional support for a resident in a nursing home who recently immigrated from another country?

• A. Offer choices consistent with the resident's heritage.
• B. Assist the resident in adjusting to the nursing home culture.
• C. Ensure that the resident is treated respectfully like the other residents.
• D. Correct any misconceptions the resident may have about appropriate health practices.

Correct answer: A

Rationale: When providing emotional support to a resident in a nursing home who recently immigrated from another country, it is essential for the nurse to offer choices that align with the resident's heritage. This approach respects the resident's cultural beliefs and practices, promoting a sense of familiarity and comfort. Assisting the resident in adjusting to the nursing home culture is important but may not address the specific emotional support needed. While ensuring that the resident is treated respectfully is crucial, offering choices consistent with the resident's heritage goes a step further by acknowledging and valuing the resident's cultural background. Correcting any misconceptions about health practices is essential, but in this context, emotional support through cultural sensitivity takes precedence.

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