Nokea
The home health nurse is caring for the middle-aged client who is disabled due to a recent accident. The client has few interests, spends most days watching TV, and has become estranged from the family. Which of Erikson’s developmental stages should the nurse conclude that the client is not meeting?
- A. Industry versus inferiority
- B. Initiative versus guilt
- C. Generativity versus stagnation
- D. Intimacy versus isolation
Correct Answer: C
Rationale: The client’s isolation and lack of interests indicate stagnation, failing to meet generativity versus stagnation, the central task of middle adulthood. Other stages apply to younger age groups.
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The 32-year-old has been trying to get pregnant for the past 10 years- The client consults a family planning clinic after being unsuccessful with the calendar and basal body temperature methods in determining the time of ovulation. Which statement by the nurse would be most appropriate?
- A. Let me review the methods with you; maybe you have not been using them correctly.'
- B. Have you considered that you might not be ovulating and that adoption is an option?'
- C. Test kits are available that will detect an enzyme in cervical mucus that signals ovulation.'
- D. If your spouse wears restrictive underwear, this can reduce your chance of conception.'
Correct Answer: C
Rationale: Suggesting an ovulation test kit, which detects guaiacol peroxidase in cervical mucus to signal ovulation, is most appropriate after 10 years of unsuccessful methods. Reviewing methods is less helpful, adoption is premature, and male underwear addresses sperm count, not ovulation timing.
The nurse assesses that a hospitalized 20-year-old college student is anxious and not able to concentrate when given self-care instructions. Which intervention should the nurse implement to assist the client to deal with the stress of hospitalization?
- A. Have one parent stay in the room when the client is anxious
- B. Encourage using a cell phone or Internet to talk with friends
- C. Contact psychiatry to discuss treatments for depression
- D. Reinforce multiple times how best to perform self-care
Correct Answer: B
Rationale: To enhance coping, the nurse should focus on the developmental needs of a young adult, which include interaction with peers. Using a cell phone or Internet to communicate with friends assists in dealing with hospitalization stress. Parental presence may be intrusive, the client shows no depression, and reinforcing self-care doesn’t address emotional needs.
The 50-year-old asks the nurse how to calculate BM]. The client weighs 134 1b and is 5’3” tall. Together, the client and nurse calculate the client’s BMI rounded to the nearest tenth. What is the client’s BMI?
Correct Answer: 23.8
Rationale: BMI = [weight (lb) / height (in)²] × 703 = [134 / (63)²] × 703 = [134 / 3969] × 703 ≈ 23.75, rounded to 23.8.
The nurse is caring for the 87-year-old hospitalized client. The nurse should assess for which age-related changes to best protect the client from friction injury?
- A. Increased tissue vascularity
- B. Increase in subcutaneous tissue
- C. Increased rate of cellular replacement
- D. Loss of skin thickness and elasticity
Correct Answer: D
Rationale: Loss of skin thickness and elasticity increases friction injury risk due to a thinner epidermis and reduced strength. Vascularity, subcutaneous tissue, and cellular replacement decrease with aging.
The 18 year-old tells the clinic nurse, 'Thinking about college is stressing me out. I am used to getting A’s and B’s.' Which statement should the nurse reserve until a follow-up visit with the client?
- A. Expressing your feelings of anxiety to a friend or nurse helps you cope emotionally.'
- B. I will check with the provider about prescribing paroxetine hydrochloride.'
- C. Exercise increases the release of endorphins and can enhance your sense of well-being.'
- D. If you like drawing or painting, register for an art class during your first semester in college.'
Correct Answer: B
Rationale: The nurse should reserve suggesting an antidepressant until other interventions have been tried. Paroxetine influences neurotransmitters related to anxiety, but non-pharmacological coping strategies like expressing feelings, exercise, and art therapy should be prioritized initially.