A patient's medical record documents sexual masochism. This patient derives sexual pleasure
- A. from inanimate objects.
- B. by inflicting pain on a partner.
- C. when sexually humiliated by a partner.
- D. from touching a nonconsenting person.
Correct Answer: C
Rationale: The correct answer is C because sexual masochism involves deriving sexual pleasure from being humiliated or degraded by a partner. This behavior is characterized by finding arousal in receiving physical or emotional pain or humiliation during sexual activities. Choices A, B, and D are incorrect because they do not align with the specific behavior associated with sexual masochism. Choice A refers to objectophilia, choice B describes sadism, and choice D pertains to non-consensual sexual behavior, none of which are indicative of sexual masochism.
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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.
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.
A new nurse asks, 'My elderly patient has Lewy body disease. What should I do about assessing for pain?' Select the best response from the nurse manager.
- A. Ask the patients family if they think the patient is experiencing pain.'
- B. Use a visual analog scale to help the patient determine the presence and severity of pain.'
- C. There are special scales for assessing patients with dementia. Lets review how to use them.'
- D. The perception of pain is diminished by this type of dementia. Focus your assessment on the patients mental status.'
Correct Answer: C
Rationale: Lewy body disease is a form of dementia. There are special scales to assess the presence and severity of pain in patients with dementia. The Pain Assessment in Advanced Dementia Scale evaluates breathing, negative vocalizations, body language, and consolability. A patient with dementia would be unable to use a visual analog scale. The family may be able to help the nurse gain perspective about the pain, but this strategy alone is inadequate. The other distracters are myths.
Care planning requires that a nurse recognize that the dynamic focus directing a patient with anorexia nervosa is:
- A. managing weight gain.
- B. controlling personal stressors.
- C. maintaining a sense of control.
- D. avoiding social interactions.
Correct Answer: C
Rationale: Step 1: Anorexia nervosa is characterized by an intense fear of gaining weight and a distorted body image.
Step 2: Patients often use strict control over food intake as a way to cope with underlying emotional issues.
Step 3: Maintaining a sense of control is crucial in managing anorexia nervosa as it addresses the core psychological aspects driving the disorder.
Step 4: Managing weight gain (A) is not the primary focus as patients may resist gaining weight due to their fear.
Step 5: Controlling personal stressors (B) may be important but does not address the underlying issue of control related to food and body.
Step 6: Avoiding social interactions (D) does not address the core psychological need for control and can further isolate the patient.
A patient tells the nurse that he is planning to hire a private detective to follow his wife, who he believes is having an extramarital affair. The patient looks behind the door to be sure no one is eavesdropping and asks the nurse what she did with his medical record after he left. The patient's behaviors are most consistent with a diagnosis of:
- A. antisocial personality disorder.
- B. schizoid personality disorder.
- C. paranoid personality disorder.
- D. obsessive-compulsive personality disorder.
Correct Answer: C
Rationale: Rationale: The correct diagnosis is paranoid personality disorder (C). This is supported by the patient's suspiciousness and mistrust, as shown by planning to hire a detective and checking for eavesdroppers. These behaviors align with the core features of paranoid personality disorder, such as pervasive distrust and suspicion of others.
Incorrect choices:
A: Antisocial personality disorder is characterized by disregard for others' rights and lack of empathy, not by suspicion or mistrust.
B: Schizoid personality disorder entails social withdrawal and emotional coldness, not suspiciousness.
D: Obsessive-compulsive personality disorder involves perfectionism and control, not paranoia or mistrust.
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