Nursing Elites

1. Which feeling would be difficult for a client with major depression to express?

• A. Need for comforting
• B. Anger toward others
• C. Remorse for past behaviors
• D. Feelings of low self-esteem

Correct answer: B

Rationale: Clients with major depression often have difficulty expressing anger toward others as their anger is typically directed inwards. Expressing the need for comforting is common among clients with major depression. They can also articulate remorse for past behaviors to an excessive degree. Furthermore, feelings of low self-esteem can be openly expressed by clients with major depression. Therefore, the difficulty in expressing anger toward others is the most appropriate choice as clients with major depression tend to internalize their anger.

2. Nursing behaviors associated with the implementation phase of the nursing process are concerned with:

• A. participating in the mutual identification of patient outcomes.
• B. gathering accurate and sufficient patient-centered data.
• C. comparing patient responses and expected outcomes.
• D. carrying out interventions and coordinating care.

Correct answer: D

Rationale: During the implementation phase of the nursing process, nurses focus on executing interventions and coordinating care. This involves utilizing available resources, performing necessary interventions, exploring alternatives when needed, and collaborating with other healthcare team members to ensure comprehensive care delivery. Choice A is incorrect as it pertains more to the planning phase where patient outcomes are identified. Choice B is incorrect as it relates to data collection, which is primarily a part of the assessment phase. Choice C is incorrect as it involves evaluating patient responses against expected outcomes, which is part of the evaluation phase.

3. A client's blood pressure reading is 156/94 mm Hg. Which action should the nurse take first?

• A. Inform the client that the blood pressure is high and compare the reading with the client's previously documented blood pressure readings for accuracy.
• B. Contact the health care provider to report the reading and obtain a prescription for an antihypertensive medication.
• C. Replace the cuff with a larger one to ensure a proper fit for the client and increase arm comfort during blood pressure measurement.
• D. Compare the current reading with the client's previously documented blood pressure readings.

Correct answer: D

Rationale: The correct action for the nurse to take first when a client's blood pressure reading is 156/94 mm Hg is to compare the current reading with the client's previously documented readings. This comparison helps determine whether the current reading is abnormal for the client. Option A, which involves informing the client that the blood pressure is high and comparing it with the previous readings, is appropriate as it educates the client and aids in accurate assessment. Option B, contacting the health care provider for medication, is premature without further assessment. Option C, replacing the cuff with a larger one, is incorrect as it may affect the accuracy of the blood pressure measurement and is not a standard practice for managing high blood pressure readings.

4. The client is in the maintenance stage based on the transtheoretical model of health behavior change. Which stage is the client in?

• A. Action
• B. Preparation
• C. Maintenance
• D. Contemplation

Correct answer: C

Rationale: The client is in the maintenance stage of human behavior change. During this stage, the client has successfully incorporated the changes into their lifestyle. The maintenance stage typically begins 6 months after the action stage and continues indefinitely. The action stage lasts for 6 months from when the client initially incorporates the changes. In the preparation stage, the client starts realizing that the benefits of change outweigh the disadvantages and starts making small changes to prepare for major changes in the following month. The contemplation stage involves the client considering whether to make changes in the next 6 months. Therefore, in this scenario, the client's consistent adherence to the diet and exercise program for 8 months places them in the maintenance stage of behavior change.

5. What is the similarity between the stage-crisis theory proposed by Havighurst and the psychosocial development theory formulated by Erikson?

• A. Based on developmental tasks
• B. Incorporate eight stages of development
• C. Based on changes in a person's thoughts and emotions
• D. Emphasize that a child's growth is directed by individual gene activity

Correct answer: A

Rationale: Both Havighurst's stage-crisis theory and Erikson's psychosocial development theory are grounded in the concept of developmental tasks. They both emphasize that successful completion of specific tasks at various life stages is crucial for healthy development. While Erikson's theory consists of eight stages of psychosocial development, Havighurst's theory comprises six stages. The idea that a child's growth is guided by individual gene activity is attributed to Gesell's theory, not Havighurst or Erikson. The emphasis on changes in a person's thoughts, emotions, and behaviors shaping beliefs about morality aligns with moral development theory, not specifically with Havighurst's or Erikson's theories.

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