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Which of the following is a typical assessment finding of a 24-year-old female with anorexia nervosa?
- A. Weight loss of more than 2% body fat
- B. Frequent binge-eating episodes followed by induced vomiting
- C. A history of poor academic performance and mediocre achievements
- D. Lack of menstruation
Correct Answer: D
Rationale: The correct answer is D: Lack of menstruation. Amenorrhea, or lack of menstruation, is a common occurrence in individuals with anorexia nervosa. The induced starvation from anorexia can disrupt hormone levels, leading to menstrual irregularities. This hormonal imbalance can result in amenorrhea, which can have long-term consequences such as osteoporosis and infertility. Choices A, B, and C are incorrect. Weight loss of more than 2% body fat may be a consequence of anorexia but is not a specific assessment finding. Frequent binge-eating episodes followed by induced vomiting are more characteristic of bulimia nervosa, not anorexia nervosa. A history of poor academic performance and mediocre achievements is not a typical assessment finding related to anorexia nervosa symptoms.
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Which feeling would be difficult for a client with major depression to express?
- A. Need for comforting
- B. Anger toward others
- C. Remorse for past behaviors
- D. Feelings of low self-esteem
Correct Answer: B
Rationale: Clients with major depression often have difficulty expressing anger toward others as their anger is typically directed inwards. Expressing the need for comforting is common among clients with major depression. They can also articulate remorse for past behaviors to an excessive degree. Furthermore, feelings of low self-esteem can be openly expressed by clients with major depression. Therefore, the difficulty in expressing anger toward others is the most appropriate choice as clients with major depression tend to internalize their anger.
On her first visit to the neonatal intensive care unit to see her preterm newborn, the mother's only comment to the nurse is, 'My baby looks so fragile. Do you think my child will make it?' Which is the most appropriate response by the nurse?
- A. "Many infants born as small as yours have done just fine."
- B. "The staff is confident in your child's prognosis because preterm babies do look like this at first."
- C. "It's understandable that your baby looks fragile to you. What have you learned about the condition?"
- D. "Your baby is not as fragile as it appears. Do you find it so frightening that you can't touch your child?"
Correct Answer: C
Rationale: The nurse's response should aim to convey acceptance and encourage the mother to express her concerns. By saying, "It's understandable that your baby looks fragile to you. What have you learned about the condition?", the nurse acknowledges the mother's feelings and prompts her to share her understanding, fostering further communication and addressing any misconceptions. Choices A and B dismiss the mother's concerns by making general statements and do not encourage dialogue. Choice D implies judgment and may deter the mother from opening up about her fears.
After 5 years of unprotected intercourse, a childless couple comes to the fertility clinic. The husband tells the nurse that his parents have promised to make a down payment on a house for them if his wife gets pregnant this year. Which response would the nurse provide?
- A. This must be very difficult for you with this added pressure.''
- B. Having a child is a decision you should make without your parents' input.''
- C. You're lucky. It's nice that your parents are making such a generous offer.''
- D. Five years without a pregnancy is a long time. You were right to come to the fertility clinic.''
Correct Answer: A
Rationale: The correct response acknowledges the emotional challenge the couple is facing due to the added pressure of the incentive from the husband's parents. By expressing empathy and understanding, the nurse encourages the couple to open up about their feelings and concerns. Choice B is not the best response as it dismisses the husband's situation and fails to address the emotional impact of the added pressure. Choice C focuses on the parents' offer rather than the couple's emotional state, which is not the primary concern in this situation. Choice D, mentioning the duration of infertility, may come across as insensitive and may hinder open communication by potentially making the couple feel judged or discouraged.
The client is a 35-year-old multiparous individual scheduled for a tubal ligation. The nurse assesses the client's emotional response to the planned procedure. Which factor in the client's history will contribute to the healthy resolution of any emotional problem associated with sterilization?
- A. Belief that the surgery will relieve her monthly dysmenorrhea
- B. Knowledge that her partner does not want to have any more children
- C. Feeling that her family is complete and she now has the children she planned for
- D. Recovery from her previous complicated birth and a desire to avoid another birth
Correct Answer: C
Rationale: The correct answer is feeling that her family is complete and she now has the children she planned for. Many couples in their 30s who feel that their families are complete choose sterilization as their method of contraception. Sterilization by means of tubal ligation should not be expected to have an effect on dysmenorrhea. The decision to undergo sterilization should be the individual's own choice and should not be influenced by others, including partners. Decisions regarding sterilization should ideally be made when the individual is not under stress, such as after recovery from a previous complicated birth. Therefore, the key factor contributing to a healthy resolution of emotional issues related to sterilization is the feeling of family completeness and achieving the planned number of children.
When a man with dementia is admitted to a long-term care facility, his wife, who appears tired and angry, says in a sarcastic tone, 'Let's see what you can do with him.' Which response is therapeutic?
- A. It sounds like it's been difficult for you.'
- B. I don't understand what you mean.'
- C. I have experience with all types of clients.'
- D. It's too bad you didn't admit him sooner.'
Correct Answer: A
Rationale: The correct response is to acknowledge the caregiver's feelings and challenges without blaming them. Option A, 'It sounds like it's been difficult for you,' shows empathy and opens the channel of communication. Options B and C, 'I don't understand what you mean' and 'I have experience with all types of clients,' are nurse-focused responses that block effective communication. Option D, 'It's too bad you didn't admit him sooner,' is a hostile response that shifts the blame to the caregiver, which is not therapeutic in this situation.