Professionalism
A nurse has recently transitioned from a student nurse to a newly licensed nurse. Which of the following behaviors best describes the nurse during the novice stage of development?
a) The nurse is able to independently assess and implement a complex care plan for clients with various conditions.
b) The nurse recognizes the importance of asking questions, accepts their limitations, and follows a clear, step-by-step approach in patient care.
c) The nurse anticipates patient needs and adapts care plans based on the patient's condition.
d) The nurse can manage multiple tasks simultaneously and confidently handles difficult patient situations.
b) The nurse recognizes the importance of asking questions, accepts their limitations, and follows a clear, step-by-step approach in patient care.
A nurse is caring for a 3-year-old child who is learning to dress themselves. The parents provide encouragement and praise when the child attempts to dress independently. According to Erikson’s stages of development, which of the following is the child developing?
A. Trust
B. Initiative
C. Identity
D. Generativity
B. Initiative
Rationale: According to Erikson, preschoolers (ages 3-5) are in the "Initiative vs. Guilt" stage. They begin to explore and try new things, and encouragement helps develop initiative.
A nurse is educating a client who recently lost a close friend. The nurse explains that the emotional response the client is experiencing is a normal reaction to a significant loss. Which type of grief is the client most likely experiencing?
a) Anticipatory grief
b) Disenfranchised grief
c) Normal grief
d) Prolonged grief disorder (PGD)
c) Normal grief
Rationale: Normal grief, also known as uncomplicated grief, occurs after the death of a loved one or the end of a significant relationship. It involves emotional responses to loss and is considered a typical reaction to these events.
A nurse is educating parents on cognitive development in infants. Which of the following milestones is most indicative of a 9-month-old infant’s cognitive development?
A) The infant can search for and find a hidden object.
B) The infant begins to use symbols and language.
C) The infant starts to walk and explore the environment.
D) The infant can understand the concept of object permanence.
A) The infant can search for and find a hidden object.
Rationale: At around 8-12 months, infants begin to demonstrate goal-directed behavior, such as searching for hidden objects, which reflects the development of object permanence.
According to Provision 1 of the Nursing Code of Ethics, which of the following is the nurse’s responsibility in caring for clients?
a) Provide care without regard for the client’s cultural or spiritual beliefs.
b) Ensure that all clients receive care based solely on the nurse’s professional opinion, without considering the client’s values.
c) Deliver care in a manner that respects the client's dignity, beliefs, and values, and provides information in an understandable way.
d) Impose treatments on clients who refuse care because it is deemed necessary for their health.
c) Deliver care in a manner that respects the client's dignity, beliefs, and values, and provides information in an understandable way.
At the advanced beginner stage of nursing, a nurse is most likely to experience which of the following?
a) Ability to manage complex, unpredictable clinical situations independently without assistance.
b) Difficulty recognizing the full scope of a patient’s condition and may focus on isolated tasks, such as medication administration, rather than the whole care process.
c) Confidence in making independent clinical decisions and adjustments based on the patient’s condition.
d) Demonstrating mastery in providing individualized care without prompting.
b) Difficulty recognizing the full scope of a patient’s condition and may focus on isolated tasks, such as medication administration, rather than the whole care process.
A nurse is caring for a 10-year-old child who is struggling to master reading. The child expresses feeling discouraged and inferior compared to peers who read more easily. Which of the following is most likely occurring based on Erikson's theory of psychosocial development?
A. The child is in the "Autonomy vs. Shame and Doubt" stage.
B. The child is in the "Industry vs. Inferiority" stage.
C. The child is experiencing "Role Confusion."
D. The child is in the "Intimacy vs. Isolation" stage.
B. The child is in the "Industry vs. Inferiority" stage.
Rationale: According to Erikson, children between the ages of 6-12 are in the "Industry vs. Inferiority" stage, where they develop competence and confidence in skills like reading. Failure or criticism can lead to feelings of inferiority.
A nurse is caring for a client who is showing signs of grief but is not able to move forward with accepting the loss of a loved one, continuing to experience intense sorrow for an extended period. Which condition should the nurse suspect?
a) Disenfranchised grief
b) Anticipatory grief
c) Prolonged grief disorder (PGD)
d) Normal grief
c) Prolonged grief disorder (PGD)
Rationale: Prolonged grief disorder (PGD), previously known as complicated grief, involves intense sorrow and inability to accept a loss, extending beyond the typical grieving period. It can significantly impair the individual’s ability to function.
A 5-year-old child is playing pretend games, such as pretending a block is a car. This behavior is best described as:
A) Egocentrism
B) Animism
C) Abstract reasoning
D) Concrete operations
B) Animism
Rationale: Animism is the belief that inanimate objects have feelings and intentions, which is common in the preoperational stage (ages 2-7).
In the competent stage of nursing, a nurse is most likely to demonstrate which of the following?
a) The nurse is still in the process of learning basic skills and requires direct supervision.
b) The nurse can plan, make decisions, and perform tasks efficiently with minimal errors but still seeks guidance from others.
c) The nurse can handle complex clinical situations independently with no need for support.
d) The nurse functions as a mentor to less experienced colleagues.
b) The nurse can plan, make decisions, and perform tasks efficiently with minimal errors but still seeks guidance from others.
A nurse is working with a client who is hesitant to proceed with a recommended treatment. According to the Code of Ethics, the nurse’s role in this situation is to:
a) Tell the client that the treatment is necessary for their well-being and cannot be refused.
b) Encourage the client to follow the treatment plan as prescribed by the physician without questioning.
c) Inform the client of their right to make decisions about their care, provide clear information, and support their decision, whether they accept or refuse treatment.
d) Report the client’s refusal to treatment to the healthcare team without discussing it further with the client.
c) Inform the client of their right to make decisions about their care, provide clear information, and support their decision, whether they accept or refuse treatment.
A nurse is caring for an adolescent who is experimenting with different hobbies, hairstyles, and friend groups. According to Erikson, this behavior is most consistent with which developmental stage?
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt
C. Identity vs. Role Confusion
D. Generativity vs. Stagnation
C. Identity vs. Role Confusion
Rationale: During the "Identity vs. Role Confusion" stage (adolescence), individuals experiment with different behaviors, roles, and identities as they seek to form a clear sense of self.
A nurse is discussing grief with a client who is grieving the death of a partner but feels unable to openly express their emotions due to societal stigma surrounding their relationship. Which type of grief does the nurse suspect the client is experiencing?
a) Normal grief
b) Anticipatory grief
c) Prolonged grief disorder (PGD)
d) Disenfranchised grief
d) Disenfranchised grief
Rationale: Disenfranchised grief occurs when an individual experiences grief over a relationship or loss that is not publicly acknowledged or socially recognized as valid, leading to difficulty expressing or processing the grief.
Which of the following abilities is most characteristic of a child in the concrete operational stage of cognitive development?
A) Ability to think abstractly
B) Understanding of conservation
C) Imagining multiple solutions to a problem
D) Using logic to solve hypothetical problems
B) Understanding of conservation
Rationale: In the concrete operational stage (ages 7-12), children develop the understanding that quantity remains the same despite changes in shape or appearance, known as conservation.
A nurse is teaching a client about the importance of a low-sodium diet. The client verbalizes understanding of how high sodium intake can lead to increased blood pressure and other health problems. This is an example of learning in which domain?
A) Psychomotor domain
B) Affective domain
C) Cognitive domain
D) Social domain
C) Cognitive domain
Rationale: The cognitive domain involves understanding and knowledge. The client demonstrates comprehension of the information regarding sodium intake and its effects on health, which aligns with the cognitive domain.
Which of the following best defines the role of the nurse as an advocate for a client?
a) To assume control of the client’s care plan and make all decisions on their behalf.
b) To help the client make decisions by providing information, ensuring their rights are respected, and supporting them through the healthcare process.
c) To persuade the client to accept all prescribed treatments, regardless of their personal beliefs or preferences.
d) To limit communication with the client and only share necessary information with the healthcare team.
b) To help the client make decisions by providing information, ensuring their rights are respected, and supporting them through the healthcare process.
An adult expresses feelings of unfulfillment and dissatisfaction with their life, stating they feel “stuck” and are not contributing to society. According to Erikson’s theory, this adult is experiencing which of the following?
A. Trust vs. Mistrust
B. Intimacy vs. Isolation
C. Generativity vs. Stagnation
D. Integrity vs. Despair
C. Generativity vs. Stagnation
Rationale: Adults in the "Generativity vs. Stagnation" stage are focused on contributing to society through work, family, and community. Failure to do so can lead to stagnation and a sense of dissatisfaction.
A nurse is providing anticipatory grief education to a client whose spouse has been diagnosed with a terminal illness. Which of the following statements by the client indicates a correct understanding of anticipatory grief?
a) "I will not experience any grief until after my spouse passes away."
b) "I am grieving the loss of my spouse even though he is still alive."
c) "Anticipatory grief occurs only when the death is unexpected."
d) "Grieving before the loss can make it easier for me to move on after the death."
b) "I am grieving the loss of my spouse even though he is still alive."
Rationale: Anticipatory grief refers to the grief experienced before a loss occurs, often in the context of terminal illness, as individuals may begin to process the expected loss prior to the actual death.
An adolescent believes that their thoughts and feelings are unique and that others cannot understand them. This is an example of:
A) Egocentrism
B) Imaginary audience
C) Personal fable
D) Postconventional moral reasoning
C) Personal fable
Rationale: The personal fable is a belief that one’s own thoughts and experiences are unique and different from others, often leading to a sense of invulnerability or specialness during adolescence.
Psychomotor Domain
Question:
A nurse is teaching a client how to properly perform a dressing change. After explaining the procedure, the nurse asks the client to demonstrate the steps. The client successfully completes the dressing change. Which domain does this skill primarily fall under?
A) Cognitive domain
B) Affective domain
C) Psychomotor domain
C) Psychomotor domain
Rationale: The psychomotor domain involves physical skills and coordination, including the hands-on aspect of performing tasks like a dressing change. The client’s ability to demonstrate the procedure reflects the psychomotor domain.
A nurse observes a colleague making an error in patient care. According to the Code of Ethics, the nurse should:
a) Ignore the error to avoid conflict.
b) Report the error to the supervisor or appropriate authority and ensure that corrective actions are taken to prevent harm to the patient.
c) Immediately correct the colleague’s mistake in front of the patient to maintain professionalism.
d) Wait for the colleague to recognize the error and report it themselves.
b) Report the error to the supervisor or appropriate authority and ensure that corrective actions are taken to prevent harm to the patient.
A 75-year-old patient is reflecting on their life and expresses satisfaction with their accomplishments and the legacy they have created. According to Erikson, which of the following is the patient experiencing?
A. Role Confusion
B. Integrity
C. Shame and Doubt
D. Generativity
B. Integrity
Rationale: In late adulthood (Integrity vs. Despair), individuals look back on their lives. Those who feel satisfaction and acceptance of their life choices experience integrity, while those with regrets may experience despair.
A nurse is assessing a client who has been grieving the death of their parent for several months. The client reports ongoing difficulty accepting the death and expresses frustration at not feeling "better." Which of the following statements by the nurse is most appropriate?
a) "You should have moved on by now."
b) "It’s normal to grieve, but it might be time to seek help if your grief is not improving."
c) "You must stop thinking about your parent if you want to heal."
d) "It’s okay to cry, but you need to avoid thinking about your loss to get better."
b) "It’s normal to grieve, but it might be time to seek help if your grief is not improving."
Rationale: While grief is a normal response to loss, prolonged or complicated grief that interferes with daily functioning may require professional intervention. The nurse should offer support while suggesting appropriate action if needed.
Which of the following criticisms of Piaget’s cognitive development theory is supported by recent research?
A) Cognitive growth always occurs in distinct stages with no variability.
B) Piaget underestimated the influence of culture and environment on cognitive development.
C) Adolescents develop cognitive abilities earlier than Piaget suggested.
D) Piaget’s stages are universally applicable without individual differences.
B) Piaget underestimated the influence of culture and environment on cognitive development.
Rationale: Critics argue that Piaget’s theory does not account for the cultural and environmental factors that can influence cognitive development, suggesting that cognitive growth is more variable than Piaget proposed.
A nurse is discussing end-of-life care with a terminally ill client who expresses fear and sadness about dying. The nurse provides a compassionate and empathetic response to the client’s emotions. Which domain is the nurse primarily addressing?
A) Cognitive domain
B) Affective domain
C) Psychomotor domain
D) Educational domain
B) Affective domain
Rationale: The affective domain addresses emotions, feelings, attitudes, and values. The nurse's response to the client's fear and sadness addresses the emotional aspect of the client's learning process, which falls under the affective domain.