Nursing Elites

1. Which of these is a one-on-one communication between the nurse and another person?

• A. Small-group communication
• B. Intrapersonal communication
• C. Interpersonal communication
• D. Transpersonal communication

Correct answer: C

Rationale: Interpersonal communication is a one-on-one interaction between a nurse and another person that often occurs face-to-face. It involves direct communication between two individuals. Small-group communication involves interaction among a small number of people, not just one-on-one. Intrapersonal communication is internal communication that occurs within an individual's mind. Transpersonal communication involves interactions within a person's spiritual domain, which is beyond individual one-on-one communication.

2. Which statement best describes the pathophysiology of dementia of the Alzheimer type?

• A. There is a genetic predisposition and dysregulation of neurotransmitters.
• B. The dementia is transient and secondary to a physical imbalance or disorder.
• C. Hypoxia and decreased perfusion of select areas of the brain cause tissue damage.
• D. The presence of amyloid plaques is associated with brain tissue destruction.

Correct answer: D

Rationale: In Alzheimer's disease, the accumulation of amyloid plaques in the brain is a hallmark feature. These plaques are associated with the destruction of brain tissue, contributing to the cognitive decline seen in dementia. Genetic predisposition and dysregulation of neurotransmitters are factors linked to the development of Alzheimer's disease, but the primary pathology lies in the amyloid plaques. Transient dementia is not characteristic of Alzheimer's disease, which is a progressive neurodegenerative disorder. Hypoxia and decreased perfusion are more typical of vascular dementia, where blood flow to the brain is compromised.

3. While obtaining a lie-sit-stand blood pressure reading on a client, what action is most important for the nurse to implement?

• A. Stay with the client while the client is standing.
• B. Record the findings on the graphic sheet in the chart.
• C. Keep the blood pressure cuff on the same arm.
• D. Record changes in the client's pulse rate.

Correct answer: A

Rationale: The most crucial action for the nurse to implement when obtaining a lie-sit-stand blood pressure reading is to stay with the client while the client is standing. This is essential to monitor the client's immediate response to position changes and ensure their safety. Recording the findings on the graphic sheet is important for documentation but is not as critical as staying with the client. Keeping the blood pressure cuff on the same arm helps maintain consistency in readings but is not as vital as ensuring client safety. Recording changes in the client's pulse rate is important for a comprehensive assessment but does not take precedence over monitoring the client during position changes.

4. Which nurse statement defines boundaries in the orientation phase of the nurse-client relationship when talking to a depressed client who has just been admitted to the psychiatric unit?

• A. ''Tell me about the relationship that you have with your mother and father.''
• B. ''Hello! I'm Nurse Andrea. I'll introduce you around and help you settle in.''
• C. ''What is the main thing that you would like to work on during therapy?'
• D. ''I understand that you have been depressed. What can you tell me about that?'

Correct answer: B

Rationale: In the orientation phase of the nurse-client relationship, setting boundaries involves establishing the nurse's role and responsibilities while maintaining a professional distance. Option B demonstrates a clear boundary by introducing the nurse and offering assistance with settling in, which is appropriate for the initial phase of building rapport with the client. Choices A, C, and D delve into personal or therapeutic topics that are more suitable for the working phase of the relationship when the client's goals and problems are being addressed. Asking about the client's family relationships (Choice A), therapy focus (Choice C), or delving into the client's depression (Choice D) would be more relevant in later stages of the therapeutic process, once trust and rapport have been established during the orientation phase.

5. The nurse is teaching an obese client, newly diagnosed with arteriosclerosis, about reducing the risk of a heart attack or stroke. Which health promotion brochure is most important for the nurse to provide to this client?

• A. Monitoring Your Blood Pressure at Home
• B. Smoking Cessation as a Lifelong Commitment
• C. Decreasing Cholesterol Levels Through Diet
• D. Stress Management for a Healthier You

Correct answer: C

Rationale: The most important health promotion brochure to provide to an obese client newly diagnosed with arteriosclerosis is one focused on decreasing cholesterol levels through diet. Arteriosclerosis is significantly influenced by excess dietary fat, especially saturated fat and cholesterol. Monitoring blood pressure at home, while important, does not directly address the underlying cause of arteriosclerosis. Smoking cessation and stress management are crucial for overall cardiovascular health, but lowering cholesterol through diet takes precedence in this scenario.

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