Mastery Guide: Realistic Situational Questions,
Verified Solutions, Detailed Explanations, and
Proven Methods for Guaranteed Success”
1.=The=nurse=is=working=in=the=emergency=department=(ED)=of=a=ch
ildren's=medical=center.=Which=client=should=the=nurse=assess=first?
1.=The=1-month-old=infant=who=has=developed=colic=and=is=crying.
2.=The=2-year-
old=toddler=who=was=bitten=by=another=child=at=the=day-
care=center.=3.=The=6-year-old=school-
age=child=who=was=hit=by=a=car=while=riding=a=bicycle.
4.=The=14-year-
old=adolescent=whose=mother=suspects=her=child=is=sexually=active.=-
=CORRECT=ANSWER-Rationale=
Correct=-=3-
The=child=hit=by=a=car=should=be=assessed=first=because=he=or=she=m
ay=have=life-
=threatening=injuries=that=must=be=assessed=and=treated=promptly.
1.=In=an=interview,=the=nurse=may=find=it=necessary=to=take=notes=to=a
id=his=or=her=memory=later.=Which=statement=is=true=regarding=note
-taking?=
1
,A)=Note-
taking=may=impede=the=nurse's=observation=of=the=patient's=nonverb
al=behaviors.
B)=Note-
taking=allows=the=patient=to=continue=at=his=or=her=own=pace=as=the=n
urse=records=what=is=said.
C)=Note-
taking=allows=the=nurse=to=shift=attention=away=from=the=patient,=res
ulting=in=an=increased=comfort=level.
D)=Note-
taking=allows=the=nurse=to=break=eye=contact=with=the=patient,=which
=may=increase=his=or=her=level=of=comfort.=-
=CORRECT=ANSWER-A)=Note-
taking=may=impede=the=nurse's=observation=of=the=patient's=nonverb
al=behaviors.
Page:=31=Some=use=of=history=forms=and=note-
taking=may=be=unavoidable.=But=be=aware=that=note-
taking=during=the=interview=has=disadvantages.=It=breaks=eye=contact
=too=often,=and=it=shifts=attention=away=from=the=patient,=which=dimi
nishes=his=or=her=sense=of=importance.=It=also=may=interrupt=the=pat
ient's=narrative=flow,=and=it=impedes=the=observation=of=the=patient's
=nonverbal=behavior.
2.=The=8-year-old=client=diagnosed=with=a=vaso-
occlusive=sickle=cell=crisis=is=complaining=of=a=severe=headache.=Wh
ich=intervention=should=the=nurse=implement=first?
1.=Administer=6=L=of=oxygen=via=nasal=cannula.
2.=Assess=the=client's=neurological=status.
2
,3.=Administer=a=narcotic=analgesic=by=intravenous=push=(IVP).=4.=In
crease=the=client's=intravenous=(IV)=rate.=-=CORRECT=ANSWER-
Rationale=
Correct=-=2-
Because=the=client=is=complaining=of=a=headache,=the=nurse=should=
first=rule=out=cerebrovascular=accident=(CVA)=by=assess-
=ing=the=client's=neurological=status=and=then=determine=whether=it=is
=a=headache=that=can=be=treated=with=medication.
2.=During=an=interview,=the=nurse=states,="You=mentioned=shortness
=of=breath.=Tell=me=more=about=that."=Which=verbal=skill=is=used=wit
h=this=statement?
A)=Reflection
B)=Facilitation
C)=Direct=question
D)=Open-ended=question=-=CORRECT=ANSWER-D)=Open-
ended=question
Page:=32=The=open-
ended=question=asks=for=narrative=information.=It=states=the=topic=to
=be=discussed=but=only=in=general=terms.=The=nurse=should=use=it=to=
begin=the=interview,=to=introduce=a=new=section=of=questions,=and=w
henever=the=person=introduces=a=new=topic.
3.=The=6-year-
old=client=who=has=undergone=abdominal=surgery=is=attempting=to=
make=a=pinwheel=spin=by=blowing=on=it=with=the=nurse's=assistance.=
The=child=starts=crying=because=the=pinwheel=won't=spin.=Which=act
ion=should=the=nurse=implement=first?
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, 1.=Praise=the=child=for=the=attempt=to=make=the=pinwheel=spin.
2.=Notify=the=respiratory=therapist=to=implement=incentive=spiromet
ry.=3.=Encourage=the=child=to=turn=from=side=to=side=and=cough.
4.=Demonstrate=how=to=make=the=pinwheel=spin=by=blowing=on=it.=-
=CORRECT=ANSWER-Rationale=
Correct=-
1.=The=nurse=should=always=praise=the=child=for=attempts=at=cooper
ation=even=if=the=child=did=not=accomplish=what=the=nurse=asked.
3.=A=nurse=is=taking=complete=health=histories=on=all=of=the=patients=
attending=a=wellness=workshop.=On=the=history=form,=one=of=the=wri
tten=questions=asks,="You=don't=smoke,=drink,=or=take=drugs,=do=you
?"=This=question=is=an=example=of:
A)=talking=too=much.
B)=using=confrontation.
C)=using=biased=or=leading=questions.
D)=using=blunt=language=to=deal=with=distasteful=topics.=-
=CORRECT=ANSWER-C)=using=biased=or=leading=questions.
Page:=36=This=is=an=example=of=using=leading=or=biased=questions.=
Asking,="You=don't=smoke,=do=you?"=implies=that=one=answer=is="bet
ter"=than=another.=If=the=person=wants=to=please=someone,=he=or=she
=is=either=forced=to=answer=in=a=way=corresponding=to=their=implied=
values=or=is=made=to=feel=guilty=when=admitting=the=other=answer.
4.=The=nurse=is=caring=for=clients=on=the=pediatric=medical=unit.=Wh
ich=client=should=the=nurse=assess=first?
4