A nurse is collecting data from a client who reports feeling stress. Which of the following should the nurse identify as an external stressor?

A recent move to a new city

Lack of nutritional knowledge

Report of feeling depressed

Recurring urinary tract infections

Answer and Explanation

The Correct Answer is A

A) A recent move to a new city: A move to a new city is an example of an external stressor. External stressors are environmental or situational factors that create stress, such as life changes, events, or challenges in the outside world. Relocating can involve significant adjustments, such as adapting to a new community, finding housing, and establishing new social connections, all of which can cause stress.

B) Lack of nutritional knowledge: Lack of nutritional knowledge is an internal stressor, as it involves an individual's beliefs, attitudes, and understanding. While it can cause stress, it is a personal factor rather than an external, environmental one.

C) Report of feeling depressed: Feelings of depression are an internal stressor because they are related to an individual’s emotional state or mental health. This reflects the client's internal experience rather than an external environmental factor.

D) Recurring urinary tract infections: Recurring urinary tract infections (UTIs) are a health-related concern and can be seen as a physiological stressor. However, they are not strictly external; they are related to the individual’s health and body rather than external environmental circumstances.

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Correct Answer is D

Explanation

A) Rubella titer nonimmune: A nonimmune rubella titer indicates that the client is not immune to rubella, which is a common finding in many pregnant women. However, rubella vaccination is not given during pregnancy because the vaccine is a live virus. The client will typically be vaccinated postpartum. Follow-up would be required, but it is not an urgent concern during the pregnancy itself.

B) Negative varicella titer: A negative varicella titer means the client is not immune to chickenpox, which is a concern because varicella can cause serious complications during pregnancy. However, similar to rubella, the varicella vaccine is contraindicated during pregnancy, and vaccination would be given postpartum. This requires follow-up after delivery but does not require urgent intervention during the pregnancy.

C) Positive Rh factor: The Rh factor is a blood type characteristic, but what is typically more concerning is the Rh incompatibility, which occurs when a Rh-negative mother carries a Rh-positive baby. A positive Rh factor is not a problem for the client themselves but could be important if the father is Rh-positive. If there is concern for Rh incompatibility, the nurse would monitor for the development of Rh sensitization and administer Rh immunoglobulin (RhoGAM) if needed. This does not require urgent intervention unless Rh incompatibility is confirmed.

D) Positive serologic test for syphilis: A positive test for syphilis requires immediate follow-up intervention. Syphilis is a sexually transmitted infection that can cause serious complications during pregnancy, including miscarriage, stillbirth, preterm birth, and congenital syphilis. Treatment with penicillin is recommended to prevent transmission to the baby and to treat the infection in the mother. A positive serologic test for syphilis warrants prompt intervention.

A. I do not need to sign a consent form before this procedure B. I will feel a warming sensation after the injection of the dye C. I should limit my fluid intake for 2 days after the procedure D. I can have a meal up to 2 hours before the procedure

Correct Answer is B

Explanation

A) "I do not need to sign a consent form before this procedure": This statement is incorrect. Most procedures involving intravenous (IV) dye or contrast require the client to sign a consent form. This is because the procedure involves the use of a contrast agent that could have potential risks or side effects, and the client needs to be informed and give consent for its use.

B) "I will feel a warming sensation after the injection of the dye": This statement is correct. It is common for patients to experience a warming or flushing sensation after the injection of IV contrast dye. This feeling is typically temporary and a normal response to the dye being introduced into the bloodstream. The nurse should reassure the client about this sensation.

C) "I should limit my fluid intake for 2 days after the procedure": This statement is incorrect. In most cases, clients are encouraged to increase their fluid intake after procedures involving IV contrast to help flush the dye from their system and prevent any potential kidney complications. Limiting fluid intake is generally not recommended unless otherwise instructed by the healthcare provider.

D) "I can have a meal up to 2 hours before the procedure": This statement is incorrect in many cases, especially if the procedure involves sedation or anesthesia. Typically, clients are instructed to fast for a period (usually 4–6 hours) before procedures involving contrast dye, particularly if anesthesia or sedation is used. Eating too soon before the procedure can increase the risk of aspiration or other complications. It’s important to follow specific instructions from the healthcare provider.

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A nurse is collecting data from a client who reports feeling stress. Which of the following should the nurse identify as an external stressor?

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