Nokea
A young adult client diagnosed with a spinal cord injury tells the nurse, 'It's so depressing that I'll never get to have sex again.' Which is the realistic reply for the nurse to make to the client?
- A. It must feel horrible to know you can never have sex again.'
- B. It's still possible to have a sexual relationship, but it will be different.'
- C. You're young, so you'll adapt to this more easily than if you were older.'
- D. Because of body reflexes, sexual functioning will be no different than before.'
Correct Answer: B
Rationale: It is possible to have a sexual relationship after a spinal cord injury, but it is different from what the client will have experienced before the injury. Males may experience reflex erections, although they may not ejaculate. Females can have adductor spasm. Sexual counseling may help the client adapt to changes in sexuality after a spinal cord injury.
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A parent of a young child says, 'I'm so upset! The doctor prescribed an antidepressant!' Which response is best?
- A. Tell me more about what's bothering you.'
- B. Weren't you told about the need for the medication?'
- C. I'll notify the healthcare provider about your concerns.'
- D. Maybe the medication is for attention deficit disorder.'
Correct Answer: A
Rationale: The best response in this situation is to express empathy and encourage the parent to share more about their concerns. Option A ('Tell me more about what's bothering you.') allows the nurse to show understanding and gather more information to address the parent's distress effectively. Option B ('Weren't you told about the need for the medication?') is confrontational and may make the parent defensive, hindering effective communication. Option C ('I'll notify the healthcare provider about your concerns.') is premature; the nurse should first assess the parent's feelings before deciding on further actions. Option D ('Maybe the medication is for attention deficit disorder.') assumes without clarification, which is not appropriate; the nurse should validate the prescription before suggesting alternative reasons.
A mother complains to the nurse that her 3-year-old child refuses to go to preschool. The child rarely interacts and avoids playing with other children. Which statement would the nurse provide?
- A. Do not be concerned because all toddlers behave this way.
- B. Ask the teacher to push the child to speak up and open up to the other kids.
- C. Set boundaries and supervise the child closely.
- D. Give your child time to get acquainted and warm up to the new environment.
Correct Answer: D
Rationale: According to the mother's description, the child is a slow-to-warm-up child. These children are uneasy in new situations or with unfamiliar people. The nurse would educate the mother to give the child time to be more familiar with the new environment. All toddlers do not behave in the same manner. A slow-to-warm-up child should not be pressured to do anything against his or her wishes. Setting boundaries and closely supervising the child is not the best approach for a child who needs time to adapt. Asking the teacher to push the child to open up can create more anxiety and stress for the child, which is not recommended.
A nurse is caring for a client with agoraphobia. Which signs and symptoms would the nurse anticipate? Select all that apply.
- A. panic attacks
- B. impaired short-term memory
- C. auditory hallucinations
- D. inability to leave home
Correct Answer: A,D
Rationale: Agoraphobia involves panic attacks and fear of leaving safe environments, leading to inability to leave home. Memory issues and hallucinations are not typical.
During a survey, the community nurse meets a client who has not visited a gynecologist after the birth of her second child. The client says that her mother or sister never had annual gynecologic examinations. Which factor is influencing the client's health practices?
- A. Spiritual beliefs
- B. Family practices
- C. Emotional factors
- D. Cultural background
Correct Answer: B
Rationale: The correct answer is 'Family practices.' In this scenario, the client's health practices are influenced by the fact that her family members never had annual gynecologic examinations, leading her to believe that such preventive care measures are unnecessary. This highlights the impact of familial behavior on an individual's perception of healthcare. Spiritual beliefs are not the primary factor at play here; they may affect the choice of medical treatment but not the decision to seek preventive care. Emotional factors like stress or fear could influence health practices, but there is no indication of this in the client's case. Cultural background would come into play if the client followed specific health beliefs or customary practices related to illness and health restoration.
The nurse observes the parent of an adult client crying in the waiting area. The parent says to the nurse, 'My father died of meningitis decades ago. Now my child may die of the same thing.' Which is the best initial response by the nurse?
- A. The outlook for meningitis is better now than it was then.
- B. I can have the chaplain come speak with you if you like.
- C. This must be bringing back a lot of memories.
- D. Not necessarily. You can't make that assumption.
Correct Answer: C
Rationale: Acknowledging that the situation may evoke memories validates the parent’s emotional distress and opens communication. Offering facts, a chaplain, or dismissal does not address the immediate emotional need.