Nokea
Which dysfunction of the reproductive system is associated with anorexia nervosa in females?
- A. Galactorrhea
- B. Gynecomastia
- C. Amenorrhea
- D. Premenstrual dysphoric disorder
Correct Answer: C
Rationale: Amenorrhea (cessation of menses) is associated with anorexia nervosa in females due to endocrine imbalances resulting from depleted fat stores. Galactorrhea is a milky discharge from the nipples unrelated to normal breast milk production. Gynecomastia is swelling of breast tissue in males. Premenstrual dysphoric disorder occurs about 1 week before menses and includes mood swings, depression, fatigue, bloating, overeating, and difficulty focusing, resolving when menstruation starts. In the context of anorexia nervosa, the primary concern is the disruption of the menstrual cycle due to low body weight, leading to amenorrhea.
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A charge nurse is supervising a new nurse who is providing care to a client diagnosed with end-stage heart failure. The client is withdrawn and reluctant to talk, and shows little interest in participating in hygienic care or activities. Which statement, if made by the new nurse to the client, indicates that the new nurse has a need for further teaching regarding the use of therapeutic communication techniques?
- A. What are your feelings right now?'
- B. Why don't you feel like getting up for your bath?'
- C. These dreams you mentioned, what are they like?'
- D. Many clients with end-stage heart failure fear death.'
Correct Answer: B
Rationale: When the nurse asks a 'why' question of the client, the nurse is requesting an explanation for feelings and behaviors when the client may not know the reason. Requesting an explanation is a nontherapeutic communication technique. In option 1, the nurse is encouraging the verbalization of emotions or feelings, which is a therapeutic communication technique. In option 3, the nurse is using the therapeutic communication technique of exploring, which involves asking the client to describe something in more detail or to discuss it more fully. In option 4, the nurse is using the therapeutic communication technique of giving information. Identifying the common fear of death among clients with end-stage heart failure may encourage the client to voice concerns.
A client who is to undergo dilation and curettage and conization of the cervix for cancer appears tense and anxious. Which approach would the nurse use to support the client emotionally?
- A. Explaining that these procedures are considered minor surgery
- B. Asking whether something is troubling the client and whether she'd like to talk about it
- C. Stating that the procedures are routine and asking what the client is really worried about
- D. Explaining that everyone is fearful before the surgery even though there is little reason to worry
Correct Answer: B
Rationale: The correct approach for the nurse to support the client emotionally is to ask whether something is troubling the client and if she would like to talk about it. This approach acknowledges the client's anxiety and encourages communication without dismissing her feelings. Option A, explaining that the procedures are minor surgery, may invalidate the client's emotions. Option C assumes the client is worried about something specific, which may not be the case, leading to miscommunication. Option D provides false reassurance and may hinder open communication by dismissing the client's feelings as unwarranted.
The home health nurse visits a client with a history of type 1 diabetes mellitus. The client has recently experienced permanent loss of vision and is having difficulty adjusting. Which action by the nurse is most appropriate?
- A. Ask the health care provider for a psychiatric referral.
- B. Recommend that the client join a support group.
- C. Warn the client that failure to adapt can increase risk for injury.
- D. Reassure client that a change in visual abilities does not change personal identity.
Correct Answer: D
Rationale: Reassuring the client that vision loss does not alter their personal identity addresses emotional adjustment, fostering hope and self-worth. Support groups are helpful but less immediate, and psychiatric referrals or warnings may not address the client’s current emotional needs.
For a client with obsessive-compulsive disorder, which reaction is most likely to occur when the performance of a ritual is interrupted?
- A. Anxiety
- B. Hostility
- C. Aggression
- D. Withdrawal
Correct Answer: A
Rationale: When a client with obsessive-compulsive disorder is interrupted while performing a ritual, the most likely reaction is anxiety. The compulsive ritual serves as a coping mechanism to control anxiety, so any disruption to this ritual can heighten the individual's anxiety levels. Hostility is typically part of the disorder itself and not a direct reaction to the interruption of the ritual. Aggression may occur only if anxiety escalates to a panic level, leading to overt anger expression. Withdrawal is not a common behavioral pattern associated with obsessive-compulsive disorder and is not a typical reaction to ritual interruption.
A female client who is undergoing infertility testing is taught how to examine her cervical mucus. After listening to the instructions, the client says, 'That sounds gross. I don't think I can do it.' Which conclusion would the nurse make from this statement?
- A. The client is unduly fastidious.
- B. The client feels that having a baby is not that important.
- C. The client may be uncomfortable with performing manual examination of the genitals.
- D. The client is afraid that she is the cause of the infertility.
Correct Answer: C
Rationale: The client's statement expressing discomfort with the procedure indicates a potential unease with performing a manual examination of her genitals. It is not uncommon for individuals to feel uncomfortable or anxious about such intimate procedures. The nurse should explore this further with the client to address any concerns or fears. The option stating that the client is unduly fastidious lacks evidence and is not supported by the client's statement. The assumption that the client does not value having a baby is not warranted based on the given statement. While self-blame is a common emotional response in cases of infertility, the client's statement does not directly suggest this as the primary concern in this scenario.