A nurse is caring for an adolescent who recently found out that they are unexpectedly pregnant. Which of the following statements indicates that the client is emotionally prepared for pregnancy?
"I've been talking to the baby a lot and haven't told anyone except my mom yet."
"I don't want to tell my partner in case they don't believe me."
"I've decided to take a break from school and focus on the baby."
"I don't need to worry about how much I eat now that I'm pregnant."
The Correct Answer is A
A. "I've been talking to the baby a lot and haven't told anyone except my mom yet." Talking to the baby suggests emotional attachment and early bonding, which indicates the adolescent is beginning to process and accept the pregnancy. Sharing the news with a trusted individual, like their mother, also suggests they are seeking support.
B. "I don't want to tell my partner in case they don't believe me." Avoiding disclosure due to fear of disbelief suggests uncertainty or anxiety about the pregnancy, which may indicate emotional unpreparedness. Open communication is important for coping and planning.
C. "I've decided to take a break from school and focus on the baby." While prioritizing the baby is important, making major life decisions without exploring available resources may reflect a reactive rather than a well-thought-out approach. Support systems can help balance education and parenting responsibilities.
D. "I don't need to worry about how much I eat now that I'm pregnant." This statement indicates a misunderstanding of nutritional needs during pregnancy. Proper nutrition is crucial for both maternal and fetal health, and disregarding dietary needs may suggest a lack of readiness for the responsibility of pregnancy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Weight loss: Fluid overload is characterized by excessive fluid retention rather than loss. Weight gain is a more common finding due to fluid accumulation in tissues. Weight loss would be associated with dehydration, malnutrition, or inadequate caloric intake rather than fluid overload.
B. Decreased blood pressure: Fluid overload typically leads to increased blood pressure due to excess circulating volume. Decreased blood pressure is more commonly seen in dehydration or conditions that result in significant fluid loss, such as hemorrhage or severe diarrhea.
C. Decreased skin turgor: Poor skin turgor is a sign of dehydration rather than fluid overload. In fluid overload, clients may exhibit edema, moist skin, and increased vascular volume instead of signs of dehydration.
D. Crackles heard in the lungs: Crackles in the lungs indicate pulmonary congestion due to excess fluid accumulation, which can occur with fluid overload. Increased intravascular volume leads to leakage of fluid into the alveoli, causing difficulty breathing, shortness of breath, and pulmonary edema in severe cases.
Correct Answer is B
Explanation
A. "I think you should find other family members who could help your mother." While involving other family members can be helpful, this response may come across as dismissive rather than supportive. The nurse should offer specific resources or interventions to assist with caregiver burden.
B. "Let me give you some information about respite care for your mother." Respite care provides temporary relief for caregivers by allowing trained professionals to care for the client. This helps reduce caregiver stress, prevents burnout, and allows the son to rest while ensuring his mother receives appropriate care.
C. "You should think about placing your mother in a long-term care facility." Suggesting placement in a facility without first assessing the son’s willingness or ability to continue caregiving may be inappropriate. The nurse should offer less drastic options, such as respite care, before discussing long-term placement.
D. "You owe it to your mother to take care of her now that she needs you." This statement could induce guilt and increase stress for the caregiver. The nurse should provide emotional support and resources rather than making the son feel obligated to provide care without assistance.
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