Nursing Elites

1. Which risk factor for suicide is considered the most lethal?

• A. History of alcohol and drug abuse
• B. Previous high-lethality suicide attempts
• C. Recent withdrawal from friends
• D. Disturbance of family dynamics

Correct answer: B

Rationale: The correct answer is 'Previous high-lethality suicide attempts.' This is the most lethal risk factor as it indicates that the individual has previously attempted suicide in a manner that could lead to death. This history increases the likelihood of future attempts. While substance abuse, like alcohol and drug use, is a significant risk factor for suicide, it is not considered the most lethal. Withdrawal from friends or social isolation can contribute to suicide risk but is not as directly deadly as high-lethality attempts. Disturbance of family dynamics can also be a stressor but does not represent the immediate lethality associated with a history of high-lethality suicide attempts.

2. A client who is to undergo dilation and curettage and conization of the cervix for cancer appears tense and anxious. Which approach would the nurse use to support the client emotionally?

• A. Explaining that these procedures are considered minor surgery
• B. Asking whether something is troubling the client and whether she'd like to talk about it
• C. Stating that the procedures are routine and asking what the client is really worried about
• D. Explaining that everyone is fearful before the surgery even though there is little reason to worry

Correct answer: B

Rationale: The correct approach for the nurse to support the client emotionally is to ask whether something is troubling the client and if she would like to talk about it. This approach acknowledges the client's anxiety and encourages communication without dismissing her feelings. Option A, explaining that the procedures are minor surgery, may invalidate the client's emotions. Option C assumes the client is worried about something specific, which may not be the case, leading to miscommunication. Option D provides false reassurance and may hinder open communication by dismissing the client's feelings as unwarranted.

3. Which of the following actions is most appropriate when working with a client who is extremely angry?

• A. Place a light hand on the client's shoulder to convey understanding
• B. Maintain close proximity to build trust
• C. Temporarily change the subject if the client's behavior is escalating
• D. Close the door to the room to ensure privacy

Correct answer: C

Rationale: When dealing with an angry client, it is crucial to employ techniques that can help de-escalate the situation or ensure safety while providing care. If the client's behavior is escalating or they are fixating on a particular topic that is fueling their anger, it is advisable to temporarily change the subject. This technique can serve as a distraction from the initial trigger, allowing the client to refocus their thoughts and emotions. Placing a hand on the client's shoulder may not be well-received as physical touch can escalate the situation. Maintaining close proximity might be perceived as confrontational rather than building trust. Closing the door for privacy is important but may not directly address the client's anger or help in de-escalation.

4. Which of the following outcomes is most appropriate during the crisis stage of caring for a victim of domestic violence?

• A. The client will verbalize community resources from which to seek shelter after discharge.
• B. The client will write a plan to keep herself and her children safe.
• C. The client will contact an attorney for help with pressing charges.
• D. The client will be safe and receive treatment for injuries.

Correct answer: D

Rationale: During the crisis stage of caring for a victim of domestic violence, the immediate priority is ensuring the client's safety and providing treatment for any injuries sustained. This focuses on addressing the urgent physical and emotional needs of the victim. While options like verbalizing community resources or creating safety plans are important for long-term support, they are not the primary concerns during the crisis phase. Contacting an attorney for legal assistance, though vital in the future, is not the immediate priority during the crisis stage when the client's safety and health are at the forefront.

5. After giving birth to her third child, a client tearfully says to the nurse, 'How much more can I give of myself?' Which principle would the nurse consider in the care of any new mother?

• A. It is easier to adjust to the first child than to later ones.
• B. Feeling anger and resentment toward a child is pathological.
• C. Some parents experience feelings of being overwhelmed by multiple children.
• D. Parents usually have inborn feelings of love and acceptance of their children.

Correct answer: C

Rationale: A parent's feeling of being overwhelmed by multiple children is a normal response. It is vital to help parents realize this as a means of easing feelings of guilt and shame. The first child causes the greatest amount of adjustment in one's life. It is common for parents to feel anger and resentment toward their children at times due to the challenges of parenting. Stating that parents usually have inborn feelings of love and acceptance of their children is a false generalization and may not hold true for everyone. Therefore, the most appropriate principle for the nurse to consider in this situation is that some parents may experience feelings of being overwhelmed by multiple children.

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