Nursing Elites

1. Which behavior would the nurse recognize as developmentally atypical in preschoolers?

• A. Thumb sucking during stress
• B. Feeling guilty for behaving inappropriately
• C. Feeling happy if there is a newborn in the family
• D. Curiosity about their surroundings

Correct answer: C

Rationale: The correct answer is feeling happy if there is a newborn in the family. Preschoolers are more likely to exhibit feelings of stress and jealousy rather than happiness with the arrival of a new baby in the family. Thumb sucking and bed-wetting are common behaviors displayed by preschoolers during times of stress. Guilt typically arises in children when they perceive that they have not behaved appropriately. Preschoolers are known to be naturally curious about their surroundings, showing an interest in exploring and learning about the environment around them. Therefore, feeling happy with the birth of a new baby is developmentally atypical for preschoolers.

2. On the first postpartum day, a client whose infant is rooming in asks the nurse to return her baby to the nursery and bring the baby to her only at feeding times. Which response would the nurse provide?

• A. It seems that you've changed your mind about rooming in.
• B. I think you're having difficulty caring for the baby.
• C. All right. I'll inform the other nurses of your decision.
• D. You must be tired. I'll bring the baby back at feeding time.

Correct answer: A

Rationale: Stating that it seems that the client has changed her mind opens communication and allows the client to verbalize her thoughts and feelings. This response acknowledges the client's request without being judgmental. Stating that the client is having difficulty caring for the baby is presumptuous and could make the client defensive. Informing other nurses of the client's decision without exploring the reasons behind it may not address the client's concerns. Although the client may be tired, assuming this without further discussion may overlook the client's true feelings and needs, hindering effective communication and support.

3. A client who exhibits blurred and double vision and muscular weakness is informed of the diagnosis of multiple sclerosis (MS). The client becomes visibly upset. Which response would the nurse make?

• A. That must have shocked you. Tell me what the health care provider told you about it.
• B. You should see a psychiatrist who will help you cope with this overwhelming news.
• C. Don't worry; early treatment often alleviates the symptoms of the disease.
• D. You should be glad that we caught it early so you can be cured.

Correct answer: A

Rationale: The response 'That must have shocked you. Tell me what the health care provider told you about it' acknowledges the effect of the diagnosis on the client and explores what is known. This response shows empathy and encourages the client to share their understanding. There is no evidence of ineffective coping, so a referral to a psychiatrist is not necessary at this initial stage. The statement 'Don't worry; early treatment often alleviates symptoms of the disease' provides false reassurance as the course of MS varies for each individual and may not always respond well to treatment. The statement 'You should be glad we caught it early so it can be cured' does not address the client's current emotional state and is inaccurate; MS is a chronic autoimmune disease that currently has no cure.

4. A client who is in a late stage of pancreatic cancer intellectually understands the terminal nature of the illness. Which behaviors indicate the client is emotionally accepting the impending death?

• A. Revising the client's will and planning a visit to a friend
• B. Alternating between crying and talking openly about death
• C. Seeking second, third, and fourth medical opinions
• D. Refusing to follow treatments and stating they won't help anyway

Correct answer: A

Rationale: Revising the will and planning a visit to a friend are indicative of emotional acceptance of impending death as they demonstrate realistic, productive, and constructive ways of using the remaining time. Alternating between crying and talking openly about death may suggest depression rather than acceptance. Seeking multiple medical opinions shows disbelief, denial, or desperation rather than acceptance. Refusing treatments and stating they won't help reflects anger and hopelessness, not acceptance.

5. What factor is likely the reason a woman with bipolar disorder, manic episode, rarely eats?

• A. Feelings of guilt
• B. Need to control others
• C. Desire for punishment
• D. Excessive physical activity

Correct answer: D

Rationale: During a manic episode of bipolar disorder, individuals often experience hyperactivity and an inability to stay still. This hyperactivity can manifest as excessive physical activity, which can prevent them from eating regularly. The correct answer is 'Excessive physical activity' because it directly relates to the woman's lack of appetite during the manic episode. Feelings of guilt, the need to control others, and the desire for punishment are not typically associated with eating difficulties in individuals with bipolar disorder during a manic episode. Clients in a manic episode usually have heightened energy levels and may engage in activities that exhaust them, leading to a decreased focus on eating.

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