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A women who is 16 weeks pregnant presents with symptoms suggestive of a urinary tract infection. Which one of the following is correct?
- A. She should be assured that urinary tract infections are common in pregnancy and require no treatment.
- B. A midstream urine should be collected and the bacteriology report awaited.
- C. A midstream urine should be collected and a wide spectrum antibiotic prescribed.
- D. A self-retaining catheter should be introduced to promote free drainage of urine.
Correct Answer: C
Rationale: In pregnancy, UTIs require prompt treatment due to risks like pyelonephritis. Collecting a midstream urine and starting a broad-spectrum antibiotic (C) is standard, pending culture results. Ignoring treatment (A), waiting without antibiotics (B), or invasive measures (D, E) are inappropriate.
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The home care nurse assessed a client with a history of dementia who had a herniorrhaphy at an ambulatory surgical center the previous day. The client lives in a senior living facility. The client thinks he is in the army and that it is 1945. The nurse should:
- A. Reorient the client to the current time and place.
- B. Notify the client's family of the confusion.
- C. Document the client's confusion and disorientation.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Reorient the client to the current time and place. The nurse should reorient the client to prevent distress and promote safety. This approach helps the client feel more secure and may reduce confusion. Choice B is incorrect because the nurse should address the client's needs first. Choice C is not enough on its own as the nurse needs to actively assist the client. Choice D is incorrect as action is needed in this situation to support the client.
When a person's sexual identity does not match his or her physical gender, the diagnosis is
- A. paraphilia
- B. sexual dysfunction
- C. gender identity disorder
- D. androgyny
Correct Answer: C
Rationale: Gender identity disorder (now gender dysphoria) describes a mismatch between identity and physical sex.
A nurse is providing education to a patient with anorexia nervosa. Which of the following statements indicates a need for further education?
- A. I understand that my body needs food to function properly.
- B. I am willing to work on gaining weight with the help of my care team.
- C. I believe that eating food will make me fat and out of control.
- D. I am ready to learn how to improve my relationship with food.
Correct Answer: C
Rationale: The correct answer is C because the statement reflects a common misconception associated with anorexia nervosa, indicating a need for further education. Here's the rationale:
1. Anorexia nervosa involves a distorted body image and fear of gaining weight.
2. Believing that eating food will make one fat and out of control aligns with these distorted beliefs.
3. This statement demonstrates a lack of understanding and acceptance of the importance of proper nutrition for health.
4. Choices A, B, and D show positive attitudes towards recovery and willingness to address the disorder, highlighting a better understanding of the condition.
In summary, choice C shows a need for further education due to the presence of distorted beliefs, while the other options reflect a more positive and informed mindset towards recovery.
A nurse observes a patient who is sitting alone in a room put hands over both ears and vigorously shake her head as though saying, 'No.' Later the patient cries and mutters, 'You don't know what you're talking about! Leave me alone.' What assessment should the nurse attempt to validate?
- A. The patient is seeking the attention of staff.
- B. The patient is inappropriately expressing emotion.
- C. The patient is experiencing auditory hallucinations.
- D. The patient is displaying negative symptoms of schizophrenia.
Correct Answer: C
Rationale: The correct answer is C: The patient is experiencing auditory hallucinations. The patient's behavior of covering both ears and shaking her head as if responding to voices, along with muttering and crying, suggests a sensory perception that is not based on external stimuli. This aligns with the characteristic symptoms of auditory hallucinations, which are common in conditions like schizophrenia.
Choice A is incorrect because the patient's behavior is not necessarily seeking attention but rather responding to internal stimuli. Choice B is incorrect as the patient's emotional expression seems to be a result of the auditory hallucinations rather than being inappropriate. Choice D is incorrect as negative symptoms of schizophrenia typically involve a decrease or absence of normal functions, which is not clearly demonstrated in this scenario.
A major difference in assessment findings between a patient with anorexia nervosa and a patient with bulimia nervosa is the patient with bulimia:
- A. is well nourished while the patient with anorexia nervosa is malnourished.
- B. denies hunger while the patient with anorexia nervosa admits experiencing hunger.
- C. is often of near-normal weight while the patient with anorexia nervosa is underweight.
- D. has a distorted body image while the patient with anorexia nervosa has a realistic body image.
Correct Answer: C
Rationale: The correct answer is C because a major difference between anorexia nervosa and bulimia nervosa is that patients with bulimia are often of near-normal weight, while patients with anorexia are typically underweight. This is due to the different patterns of eating behaviors in the two disorders. In bulimia, individuals often engage in binge-eating episodes followed by compensatory behaviors such as purging, which may help maintain their weight. On the other hand, individuals with anorexia restrict their food intake significantly, leading to malnourishment and significant weight loss.
Choice A is incorrect because individuals with bulimia can still experience malnourishment due to the purging behaviors. Choice B is incorrect because both patients with anorexia and bulimia may deny hunger due to their disordered eating behaviors. Choice D is incorrect because both disorders involve a distorted body image, although the specific nature of the distortion may differ.