Nursing Elites

1. Which psychosocial attribute plays an important role in the development of a healthy personality from birth to 1 year of age?

• A. Initiative versus guilt
• B. Trust versus mistrust
• C. Autonomy versus shame
• D. Industry versus inferiority

Correct answer: B

Rationale: According to Erikson's theory of psychosocial development, the first attribute that helps develop a healthy personality after birth is trust. Mistrust develops if the care provided to the infant is inconsistent. Initiative versus guilt is observed at 3 to 6 years of age, when children explore their surroundings and may experience guilt if their actions conflict with parental expectations. Autonomy versus shame occurs between 1 and 3 years of age, as children develop motor skills and new activities, with shame emerging if they feel self-conscious. Industry versus inferiority is evident in children aged 6 to 12 years, where successful task completion fosters a sense of industry, while excessive expectations can lead to feelings of inferiority. Therefore, the correct attribute for a healthy personality development from birth to 1 year of age is trust versus mistrust.

2. A client decides to have hospice care rather than undergo an extensive surgical procedure. Which ethical principle does the client's behavior illustrate?

• A. Justice
• B. Veracity
• C. Autonomy
• D. Beneficence

Correct answer: C

Rationale: The correct answer is 'Autonomy.' Autonomy refers to an individual's right to make decisions about their own care. In this scenario, the client is choosing hospice care over surgery, demonstrating their autonomy in making healthcare choices. Justice involves fairness and equality in the distribution of resources and services, which is not the primary ethical principle illustrated in this case. Veracity pertains to truthfulness and honesty, which is not directly related to the client's decision-making process. Beneficence refers to the duty to do good and act in the best interest of the patient, which is not the central ethical principle demonstrated by the client's decision for hospice care.

3. Which of the following is an example of neurofeedback used with a child diagnosed with reactive attachment disorder (RAD)?

• A. A child's brain waves are monitored through electrodes placed on the scalp
• B. Parents give their child a sticker when he behaves appropriately
• C. A child uses a sand tray to draw shapes and release stress while talking with a nurse
• D. Parents or a nurse hold a child close during play until he becomes angry enough to unleash his rage

Correct answer: A

Rationale: Neurofeedback is a form of treatment that may be used for children diagnosed with reactive attachment disorder (RAD). Neurofeedback involves attaching electrodes to the scalp in a method similar to an EEG. The child's brainwaves are then monitored while being exposed to positive images or games to produce positive brain patterns. Choice A is the correct answer as it describes the process of neurofeedback, which is a common therapeutic approach for managing RAD. Choices B, C, and D are incorrect because they do not directly involve monitoring brain waves through electrodes to provide feedback for brain pattern adjustments, which is the core concept of neurofeedback therapy.

4. What is the nurse's initial plan for providing pain relief measures during labor for a pregnant client with a history of opioid abuse?

• A. Scheduling pain medication at regular intervals
• B. Administering the medication only when the pain is severe
• C. Avoiding the administration of medication unless it is requested
• D. Recognizing that less pain medication will be needed by this client compared with other women in labor

Correct answer: A

Rationale: In a pregnant client with a history of opioid abuse, scheduling pain medication at regular intervals is the initial plan for providing pain relief during labor. This client may have a lower tolerance for pain and a greater need for pain relief. If medication is only administered when the pain is severe, larger doses may be needed, leading to increased anxiety and discomfort. Avoiding medication unless requested is not ideal, as proactive pain management is crucial during labor. Recognizing that less pain medication will be needed by this client compared with others is incorrect, as individuals with a history of opioid abuse often require more medication due to tolerance to addictive drugs.

5. A client says, 'I hear a man speaking from the corner of the room. Do you hear him, too?' Which response is best?

• A. What is he saying to you? Does it make any sense?
• B. Yes, I hear him. What do you think he is saying?
• C. No one is in the corner of the room. Can't you see that?
• D. No, I don't hear him, but that must be upsetting for you.

Correct answer: D

Rationale: The best response is D: 'No, I don't hear him, but that must be upsetting for you.' This response acknowledges the client's experience without validating the hallucination. The nurse expresses empathy by acknowledging the client's feelings ('that must be upsetting for you'), showing understanding and support. Choice A focuses on the content of the hallucination, which may inadvertently reinforce the delusion. Choice B validates the hallucination by agreeing that the nurse also hears the man. Choice C denies the client's experience and can lead to further distress by invalidating their perception.

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