Nursing Elites

1. Which statement regarding an interpreter is correct?

• A. Relatives or friends of the client cannot serve as interpreters.
• B. The interpreter should aim to convey meaning rather than provide literal translations.
• C. Interpreting not only the language but also the culture is important.
• D. The interpreter should be available only during client-provider communication.

Correct answer: C

Rationale: The correct answer is that interpreting not only the language but also the culture is important. Health care facilities should provide professional interpreters to ensure accurate communication with clients who do not speak English proficiently. It is crucial for interpreters to understand and convey cultural nuances to prevent misunderstandings. Relatives or friends of the client should not serve as interpreters as they may not be impartial or adequately skilled. Providing literal word-for-word translations is not always effective as it may not capture the intended meaning. Interpreters should be available throughout the client's care process, not just during direct communication, to ensure effective and culturally sensitive care.

2. A nurse is assigned to care for a close friend in the hospital setting. Which action should the nurse take first when given the assignment?

• A. Notify the friend that all medical information will be kept confidential.
• B. Explain the relationship to the charge nurse and ask for reassignment.
• C. Approach the client and ask if the assignment is uncomfortable.
• D. Accept the assignment but protect the client's confidentiality.

Correct answer: B

Rationale: When a nurse is assigned to care for a close friend, it is essential to maintain professional boundaries to ensure the best care for the client and the nurse. The most appropriate action for the nurse to take first is to explain the relationship to the charge nurse and ask for reassignment (B). This is important to avoid potential conflicts of interest and maintain objectivity in the care provided. Option A, notifying the friend about confidentiality, may not address the underlying issue of the conflict of interest. Option C, asking the client if the assignment is uncomfortable, may not be appropriate as it puts the client in a difficult position. Option D, accepting the assignment but protecting the client's confidentiality, does not address the conflict of interest and potential ethical issues that may arise from caring for a close friend.

3. When bathing an uncircumcised boy older than 3 years, which action should the nurse take?

• A. Remind the child to clean his genital area.
• B. Defer perineal care because of the child's age.
• C. Retract the foreskin gently to cleanse the penis
• D. Ask the parents why the child is not circumcised

Correct answer: C

Rationale: When bathing an uncircumcised boy older than 3 years, it is essential to gently retract the foreskin to cleanse the penis. This helps in preventing the buildup of bacteria and maintaining good hygiene. Reminding the child to clean his genital area (Option A) may not be effective due to the child's cognitive development level. Perineal care should not be deferred (Option B) as it is necessary for maintaining hygiene at any age. Asking the parents why the child is not circumcised (Option D) is not relevant to the immediate care required during bathing.

4. After a client has a spontaneous abortion at 12 weeks' gestation, the nurse notes that both she and her partner are visibly upset and crying. Which statement would be a therapeutic response?

• A. 'I'll be here if you want to talk.''
• B. 'Try to relax"?it'll speed up the healing process.''
• C. 'With any luck, you'll get pregnant again soon.''
• D. 'It's best that this happened early rather than having the baby die after it was born.''

Correct answer: A

Rationale: A therapeutic response in this situation is to offer support and empathy. Saying, 'I'll be here if you want to talk' gives the client and her partner the opportunity to express their emotions and seek comfort. It acknowledges their distress and assures them of the nurse's availability. Choice B, advising to relax to speed up the healing process, dismisses their current emotions and may hinder open communication. Choice C, suggesting getting pregnant again soon, minimizes their grief over the loss and may not be what the couple needs to hear at that moment. Choice D, stating it's best that the miscarriage happened early, is insensitive as it invalidates the couple's feelings of loss and grief. Grieving is a natural process, and the timing of the loss does not diminish its significance.

5. A client who just had a bilateral mastectomy is preparing to talk about body changes. Which of the following actions of the nurse is most appropriate during this discussion?

• A. Provide a room that offers minimal distractions
• B. Ask closed-ended questions to allow the client to think about her situation
• C. Write detailed notes during the conversation to track important information
• D. Ask personal questions about the client's background to determine how the procedure has affected her self-concept

Correct answer: A

Rationale: When preparing to discuss sensitive topics such as body changes post-bilateral mastectomy, it is crucial to create a conducive environment. Providing a room with minimal distractions allows the client to feel comfortable, safe, and more likely to open up about personal feelings without interruptions. This setting fosters open communication between the nurse and client, facilitating a more empathetic and supportive interaction. Closed-ended questions (Choice B) may limit the client's ability to express emotions fully. Writing detailed notes (Choice C) during the conversation may distract the nurse from actively listening and being present for the client. Asking personal questions about the client's background (Choice D) may not be appropriate during such a vulnerable discussion and could potentially create discomfort for the client.

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