Nursing Elites

1. Which parameter would be assessed to determine the degree of anxiety being experienced by the client?

• A. Memory state
• B. Creativity level
• C. Perceptual field
• D. Delusional system

Correct answer: C

Rationale: The correct parameter to assess the degree of anxiety experienced by a client is the perceptual field. As anxiety increases, perceptual fields tend to narrow. Memory state, creativity level, and delusional system are not directly related to the level of anxiety and are not appropriate parameters for determining the degree of anxiety. Memory state refers to the ability to remember, creativity level to the ability to generate new ideas or solutions, and delusional system to a set of false beliefs.

2. An increase in the neurotransmitter dopamine is associated with which of the following illnesses?

• A. Schizophrenia
• B. Depression
• C. Alzheimer's disease
• D. Anxiety

Correct answer: A

Rationale: An increase in the neurotransmitter dopamine is associated with schizophrenia. Dopamine dysregulation is linked to some symptoms of schizophrenia, such as hallucinations and delusions. Depression (choice B) is more commonly associated with abnormalities in serotonin and norepinephrine. Alzheimer's disease (choice C) is primarily characterized by deficits in acetylcholine and other neurotransmitters. Anxiety disorders (choice D) are often linked to imbalances in neurotransmitters like serotonin, norepinephrine, and GABA, rather than dopamine.

3. Which is the most appropriate nursing intervention when providing care for parents who have experienced a stillbirth?

• A. Giving a detailed explanation of possible causes of the stillbirth
• B. Providing the parents the opportunity to say goodbye to their newborn
• C. Explaining that an autopsy is not recommended in the setting of a stillbirth
• D. Arranging follow-up care and providing information to the parents before they leave the hospital

Correct answer: B

Rationale: The most appropriate nursing intervention when caring for parents who have experienced a stillbirth is to provide them with the opportunity to say goodbye to their newborn. This helps in the grieving process and allows the parents closure. Giving a detailed explanation of possible causes of the stillbirth may overwhelm the parents and is not the immediate priority. While an autopsy can be performed in the case of a stillbirth, the decision should be discussed with the parents and their wishes respected. Arranging follow-up care and providing information before the parents leave the hospital is crucial in ensuring they have the necessary support and resources to cope with the loss effectively.

4. A client dies while several family members are in the room. Which intervention will the hospice nurse initially use during the shock phase of a grief reaction?

• A. Stay at the bedside with the family and the deceased.
• B. Direct activities related to funeral arrangements.
• C. Mobilize the support systems for the family.
• D. Present the full reality of the loss to the family.

Correct answer: A

Rationale: During the shock phase of a grief reaction, the hospice nurse's initial intervention should be to stay at the bedside with the family and the deceased. This action provides immediate support to the family until coping mechanisms and personal support systems can be mobilized. Directing activities related to funeral arrangements is not within the nurse's role and responsibility. Mobilizing the support systems for the family is important, but staying with the family and the deceased helps in providing immediate comfort and support. Presenting the full reality of the loss to the family is not appropriate during the shock phase as acceptance of the loss takes time and is not the immediate priority.

5. Which benefit accompanies mild apprehension?

• A. Physiological functions are slowed.
• B. There is an increased alertness.
• C. Behavioral responses become automatic.
• D. Ego defense mechanisms are mobilized.

Correct answer: B

Rationale: A mild level of anxiety can be beneficial because it increases alertness and focuses attention. Physiological functions are actually amplified initially, not slowed, due to mild apprehension; however, prolonged anxiety can lead to decreased function due to exhaustion. Automatic behavioral responses and ego defense mechanisms may hinder an individual's awareness rather than enhancing it, making them less beneficial compared to increased alertness.

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