Nursing Elites

1. Which source of stress would the nurse anticipate in a 5-year-old client?

• A. Jealousy
• B. Stubbornness
• C. Procrastination
• D. Companionship

Correct answer: C

Rationale: Procrastination, which refers to delaying completing chores or activities, is a common source of stress for 5-year-old clients. At this age, children may start experiencing stress related to the pressure of tasks or expectations. Jealousy and stubbornness are more typical sources of stress for 3- and 4-year-old clients who are still developing social and emotional skills. Companionship, on the other hand, is generally seen as a positive aspect in a child's life and is not typically a source of stress but rather a source of support and comfort.

2. Which action should the nurse implement when providing wound care instructions to a client who does not speak English?

• A. Ask an interpreter to provide wound care instructions.
• B. Speak directly to the client, with an interpreter translating.
• C. Request the accompanying family member to translate.
• D. Instruct a bilingual employee to read the instructions.

Correct answer: B

Rationale: When providing wound care instructions to a client who does not speak English, the nurse should speak directly to the client with the assistance of an interpreter for accurate translation. The interpreter is trained to provide objective translations in the client's primary language, ensuring the client understands the instructions and can ask questions. Using family members for translation is discouraged as they may alter instructions or feel uncomfortable discussing certain topics. Instructing a bilingual employee to read the instructions is not ideal as they may lack the necessary training in accurate interpretation, which could lead to misunderstandings in crucial wound care instructions.

3. According to Erikson's theory, which behavior would the nurse expect a preschooler to exhibit?

• A. The child develops the superego.
• B. The child plays beside other children.
• C. The child concentrates on work and play.
• D. The child becomes casual about body appearance.

Correct answer: A

Rationale: According to Erikson's theory, a preschooler develops the superego or conscience during the initiative versus guilt stage. This stage occurs around ages 3 to 6 years old. The development of the superego is crucial for the child to start understanding and internalizing societal and parental values. Choice B is incorrect because playing beside other children typically occurs during the autonomy versus shame and doubt stage, which is seen in toddlers. Choice C is incorrect as concentrating on work and play is more characteristic of the industry versus inferiority stage, typically seen in school-aged children. Choice D is incorrect because becoming casual about body appearance is more aligned with the identity versus role confusion stage, which is seen in adolescents who have a marked preoccupation with appearance and body image.

4. Which characteristic is associated with anorexia nervosa?

• A. Manic
• B. Rebellious
• C. Hypoactive
• D. Perfectionistic

Correct answer: D

Rationale: Individuals with anorexia nervosa often exhibit perfectionistic traits, characterized by rigid standards and extreme self-discipline as a way to maintain control and fulfill personal and societal expectations. The focus on achieving an ideal body image through strict dietary habits and excessive exercise is a common manifestation of this perfectionism. The incorrect choices are: A) 'Manic' is not typically associated with anorexia nervosa; individuals with this disorder are more likely to experience anxiety and depression. B) 'Rebellious' does not align with the usual behavior seen in individuals with anorexia nervosa, who tend to comply with societal expectations rather than rebel against them. C) 'Hypoactive' does not describe the characteristic behavior of individuals with anorexia nervosa, who often engage in excessive physical activity as a means of weight loss.

5. 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.

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