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A 5-year-old presents with a history of urgency of micturition, occasional enuresis, and a slight, non-offensive vaginal discharge for 3 months. She has had no vaginal bleeding. Examination reveals some reddening of the labia majora. Which one of the following is the most likely diagnosis?
- A. Trichomonal infection.
- B. Gonorrhoea.
- C. Cystitis.
- D. Non-specific vulvo-vaginitis.
Correct Answer: D
Rationale: Non-specific vulvo-vaginitis (E) is common in young girls due to hygiene or irritation, causing these symptoms. Trichomonas (A) and gonorrhoea (B) are rare without sexual history, cystitis (C) lacks vaginal signs, and foreign body (D) typically causes bleeding or foul discharge.
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A 32-year-old client with an admitting diagnosis of catatonic schizophrenia has been mute and motionless for 2 days. The priority nursing diagnosis is:
- A. Risk for deficient fluid volume
- B. Impaired physical mobility
- C. Impaired social interaction
- D. Ineffective coping
Correct Answer: A
Rationale: The correct answer is A: Risk for deficient fluid volume. The priority nursing diagnosis in this case is to address the client's physical needs to ensure their safety and well-being. The client's mutism and immobility put them at risk for dehydration and malnutrition. By prioritizing the risk for deficient fluid volume, the nurse can address the immediate physiological needs of the client.
Choice B: Impaired physical mobility is incorrect because while the client is motionless, the immediate concern is addressing the risk of dehydration.
Choice C: Impaired social interaction is incorrect as addressing social interaction is not the priority when the client's physical needs are not being met.
Choice D: Ineffective coping is incorrect because the client's presentation is indicative of a more urgent physical need for hydration and nutrition.
Irrational and very specific fears that persist even when there is no real danger to a person are called
- A. anxieties
- B. dissociation's
- C. phobias
- D. obsessions
Correct Answer: C
Rationale: Phobias are specific, irrational fears persisting despite no real threat, distinct from general anxiety.
A nurse assesses that which of the following individuals is most likely to engage in eating behaviors characteristic of bulimia?
- A. A person who weighs 225 pounds and is 5 feet 4 inches tall.
- B. A person who is 5 pounds overweight and cannot stick to a diet.
- C. A person who lost up to 40 pounds but gained it back within 1 year.
- D. None of the above.
Correct Answer: A
Rationale: Step 1: Individuals with bulimia often engage in episodes of binge eating followed by purging behaviors.
Step 2: Choice A, a person who is significantly overweight, is more likely to engage in binge eating behavior.
Step 3: Being overweight can be a risk factor for bulimia due to body image concerns.
Step 4: Choices B and C do not provide as strong indicators for bulimia as choice A.
Summary: Choice A is correct as being significantly overweight is a common characteristic of individuals with bulimia. Choices B and C lack the same level of risk factors for engaging in eating behaviors characteristic of bulimia.
A client with anorexia nervosa has refused meal trays and supplemental feedings for 3 days following admission to the general hospital. The nurse can anticipate that intervention will include:
- A. IV infusions beginning immediately and continuing for 48 hours after client begins eating.
- B. Tube feedings until the client eats 90% of all meals for 1 day.
- C. Placing the client on suicide precautions and one-to-one observation.
- D. Limiting peer group visitors for 2 weeks.
Correct Answer: B
Rationale: The correct answer is B. Tube feedings until the client eats 90% of all meals for 1 day. This intervention is appropriate for a client with anorexia nervosa who is refusing to eat. Tube feedings ensure adequate nutrition while also encouraging the client to resume eating orally. It is a gradual approach that aims to transition the client back to regular eating habits.
Explanation for why other choices are incorrect:
A: IV infusions are not the first-line intervention for a client with anorexia nervosa refusing to eat. This choice does not address the underlying issue of the client's refusal to eat.
C: Placing the client on suicide precautions and one-to-one observation is not indicated solely based on refusal to eat. This choice does not address the nutritional needs of the client.
D: Limiting peer group visitors for 2 weeks does not address the client's refusal to eat and is not a relevant intervention in this situation.
An adult diagnosed with a serious mental illness says, I do not need help with money management. I have excellent ideas about investments. This patient usually does not have money to buy groceries by the middle of the month. The nurse assesses the patient as demonstrating:
- A. rationalization.
- B. identification.
- C. anosognosia.
- D. projection.
Correct Answer: C
Rationale: The patient shows anosognosia (C), an inability to recognize deficits due to illness, believing in their financial acumen despite evidence. This isn't rationalization (A), identification (B), or projection (D).