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A mother has just given birth to a baby who died soon after. The mother has been crying and states, 'I can't believe this has happened to me. I did everything right during this pregnancy.' How should the nurse respond to this mother?
- A. Tell her she did nothing wrong; it was God's will.
- B. Tell her she can have another baby.
- C. Tell her that her behavior is not going to solve anything.
- D. Tell her nothing and let her mourn this loss in the manner she chooses.
Correct Answer: D
Rationale: Perinatal loss is a great tragedy for the parents. A bereaved mother must resolve the crisis of perinatal loss in addition to the crisis of pregnancy. Such a loss is described as losing part of one's self-loss of self-worth. The perinatal grief response must involve attachment and detachment as a part of the mourning process.
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The nurse is teaching a teenage female about preventing the transmission of genital herpes. Which of the following statements should the nurse include?
- A. Do not sit on toilet seats without protection.'
- B. Oral sex does not transmit the virus.'
- C. This infection can be transmitted via intercourse even when you do not feel ill.'
- D. Try to drink lots of fluids after sex to flush the reproductive tract.'
Correct Answer: C
Rationale: Genital herpes can be transmitted by oral, genital, and anal sex. The other statements are myths.
A client with a diagnosis of Schizophrenia has been released from an acute care setting. The client had a prolonged recovery from relapse. One of the parents says to the discharge nurse, 'I do not understand what is going on. The hospital said she was better, but all she does is sit around all day and smoke. We cannot get her to go to the vocational training you arranged.' The nurse recognizes that more teaching is needed about
- A. the pathophysiology and behavioral manifestations of schizophrenia.
- B. support groups that can help the parents cope with their frustration.
- C. the prolonged recovery time and side effects of medications to prevent relapse.
- D. motivational techniques that are effective in engaging clients with schizophrenia.
Correct Answer: C
Rationale: The nurse conducting discharge teaching must emphasize the extended recovery process and the potential side effects of medications used to prevent relapse in individuals with schizophrenia. In this scenario, it is crucial for the parents to understand that the client's behavior may be influenced by the medication's sedative qualities and the time required for full recovery. While support groups can assist caregivers in coping with their emotions and providing better care, the priority here is educating on the recovery process and medication effects. Motivational techniques are beneficial but may not be the immediate focus in this situation.
What are the three major sequential maturational crises for females?
- A. puberty, pregnancy, and menopause.
- B. death of a spouse, menopause, and childbirth.
- C. rape, divorce, and menarche.
- D. dating, engagement, and separation.
Correct Answer: A
Rationale: The three major sequential maturational crises affecting females are puberty, pregnancy, and menopause. Puberty signifies the beginning of menarche, the first menstrual period. Pregnancy is a transformative experience with long-lasting effects on a woman's life. Menopause marks the end of menstrual cycles. These milestones are well-documented in research and are significant events in a woman's life. Nurses play a vital role in supporting females through these stages. Choices B, C, and D are incorrect as they do not accurately represent the recognized sequential maturational crises in a female's life.
A primary belief of psychiatric mental health nursing is:
- A. Most people have the potential to change and grow.
- B. Every person is worthy of dignity and respect.
- C. Human needs are individual to each person.
- D. Some behaviors have no meaning and cannot be understood.
Correct Answer: B
Rationale: The correct answer is that every person is worthy of dignity and respect. This is a fundamental principle in psychiatric mental health nursing, emphasizing the importance of treating individuals with dignity and respect regardless of their condition. This belief forms the basis of establishing a therapeutic nurse-client relationship. Choice A is a positive belief, but the primary focus in psychiatric mental health nursing is on respecting the worth and dignity of each individual. Choice C is related to understanding individual human needs but does not encompass the core value of dignity and respect. Choice D is incorrect as psychiatric nursing emphasizes the importance of interpreting and understanding all behaviors as meaningful expressions of the client's experience.
The nurse is caring for a client who is dying. While assessing the client for signs of impending death, the nurse observes the client for:
- A. elevated blood pressure.
- B. Cheyne-Stokes respiration.
- C. elevated pulse rate.
- D. decreased temperature.
Correct Answer: B
Rationale: Cheyne-Stokes respirations are a pattern of breathing characterized by rhythmic waxing and waning of respirations from very deep to very shallow breathing with periods of temporary apnea. This pattern is often associated with conditions like cardiac failure and can be a sign of impending death. Elevated blood pressure and pulse rate are not typically associated with the dying process. Decreased temperature is also not a common sign of impending death. Therefore, option B, Cheyne-Stokes respiration, is the correct choice when assessing a client for signs of impending death.