A woman with polycystic ovary syndrome tells the nurse, "I hate this disease. Just look at me! I have no hair on the front of my head, but I've got hair on my chin and upper lip. I don't feel like a woman anymore." Further assessment reveals breast atrophy and increased muscle mass. Which nursing diagnosis would the nurse identify as the priority?

social isolation related to feelings about appearance

ineffective peripheral tissue perfusion related to effects of disease on vasculature

risk for suicide related to effects of condition and fluctuating hormone levels

situational low self-esteem related to masculinization effects of the disease

Answer and Explanation

The Correct Answer is D

A. Social isolation related to feelings about appearance:

Social isolation refers to a state in which an individual lacks social interaction or feels disconnected from others. This can occur when individuals feel self-conscious or ashamed about their appearance and may withdraw from social situations as a result. In this scenario, the woman's feelings about her appearance may indeed lead to social isolation. However, while social isolation is a significant concern, it may not be the most immediate priority compared to addressing the woman's feelings of low self-esteem.

B. Ineffective peripheral tissue perfusion related to effects of disease on vasculature:

Ineffective peripheral tissue perfusion refers to inadequate blood flow to the peripheral tissues, which can lead to impaired tissue oxygenation and nutritional deficits. While PCOS can have metabolic and cardiovascular implications, such as insulin resistance and dyslipidemia, leading to potential vascular issues, there is no indication in the scenario provided that the woman is experiencing acute vascular compromise. Therefore, this nursing diagnosis is less relevant in this context.

C. Risk for suicide related to effects of condition and fluctuating hormone levels:

PCOS is associated with an increased risk of mental health issues, including depression and anxiety, which can contribute to an elevated risk of suicidal ideation or behavior. The woman's distress over the physical manifestations of PCOS and feelings of diminished femininity could certainly exacerbate such psychological issues. However, while suicide risk is a serious concern, there is no explicit indication in the scenario that the woman is actively expressing suicidal thoughts or behaviors. Therefore, while it's important to monitor for signs of depression and suicidal ideation, this nursing diagnosis may not be the most immediate priority at this stage.

D. Situational low self-esteem related to masculinization effects of the disease:

This nursing diagnosis addresses the woman's feelings of low self-esteem specifically related to the physical manifestations of PCOS, such as hirsutism, alopecia, breast atrophy, and increased muscle mass, which are affecting her sense of femininity and self-identity. Given her distress and negative perception of her appearance, addressing her low self-esteem and providing support and interventions to help improve her self-image would likely be the most immediate priority in her care.

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Correct Answer is A

Explanation

A. Candidiasis:

Candidiasis is caused by an overgrowth of the fungus Candida albicans in the vagina. It typically presents with symptoms such as thick, white vaginal discharge (resembling cottage cheese), itching, and discomfort during sexual intercourse (dyspareunia). This option is the most likely diagnosis based on the client's symptoms.

B. Genital herpes simplex:

Genital herpes simplex is caused by the herpes simplex virus (HSV). It presents with symptoms such as painful, fluid-filled blisters or sores in the genital area. While genital herpes can cause vaginal discharge, the discharge is typically clear or cloudy, not thick and white as described in the scenario.

C. Trichomoniasis:

Trichomoniasis is a sexually transmitted infection caused by the parasite Trichomonas vaginalis. It commonly presents with symptoms such as a frothy, yellow-green vaginal discharge, itching, and discomfort during urination or sexual intercourse. The discharge is typically not described as thick and white.

D. Bacterial vaginosis:

Bacterial vaginosis results from an imbalance of bacteria in the vagina, with a decrease in beneficial bacteria and an overgrowth of harmful bacteria. It presents with symptoms such as a thin, grayish-white vaginal discharge with a fishy odor. While bacterial vaginosis can cause vaginal discomfort, the discharge is not typically described as thick and white.

A. "I should avoid drinking orange juice." B. "I should take my iron with milk." C. "I need to eat foods high in fiber." D. "I'll call the primary care provider if my stool is black and tarry."

Correct Answer is D

Explanation

A. "I should avoid drinking orange juice."

- This statement is incorrect. Vitamin C, found in orange juice and other citrus fruits, can actually enhance the absorption of iron from iron supplements. Therefore, it is recommended to take iron supplements with vitamin C-rich foods or beverages to improve iron absorption. Advising the pregnant woman to avoid orange juice would be counterproductive to optimizing iron absorption.

B. "I should take my iron with milk."

- This statement is incorrect. Calcium, found in milk and dairy products, can inhibit the absorption of iron from iron supplements. Therefore, it is generally advised to avoid taking iron supplements with milk or other calcium-rich foods or beverages. Instead, iron supplements should be taken with water or vitamin C-rich foods or beverages to enhance iron absorption.

C. "I need to eat foods high in fiber."

- While it's important to maintain a balanced diet with adequate fiber intake for overall health, this statement does not directly relate to the appropriate use of iron supplements. While dietary fiber can affect digestion and bowel movements, it does not significantly impact the absorption of iron from iron supplements. Therefore, while it's beneficial to consume a diet high in fiber for various health reasons, it is not specifically necessary in relation to iron supplementation.

D. "I'll call the primary care provider if my stool is black and tarry."

- This statement is correct and indicates successful teaching. Black, tarry stools can indicate the presence of gastrointestinal bleeding, which can occur as a side effect of iron supplementation. By instructing the pregnant woman to contact her primary care provider if she experiences black, tarry stools, she demonstrates understanding of a potential adverse effect of iron supplementation and knows to seek appropriate medical attention if necessary.

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Naxlex Comprehensive Predictor Exams

Assessment of a female client reveals a thick, white vaginal discharge. The client also reports intense itching and dyspareunia. Based on these findings, the nurse would suspect that the client has:

Correct Answer is A

Explanation

A pregnant woman is diagnosed with iron-deficiency anemia and is prescribed an iron supplement. After teaching her about her prescribed iron supplement, which statement indicates successful teaching?

Correct Answer is D

Explanation

A nurse is reviewing a client's history and physical examination findings. Which information would the nurse identify as contributing to the client's risk for an ectopic pregnancy?

A nurse is obtaining a medication history from a pregnant client with a history of systemic lupus erythematosus (SLE). Which medication(s) would the nurse expect the woman to report to be currently using? Select all that apply.

It is determined that a client's blood Rh is negative and her partner's is Rh positive. To help prevent Rh isoimmunization, the nurse would expect to administer Rho(D) immune globulin at which time?

A client is scheduled for cryosurgery to remove some abnormal tissue on the cervix. The nurse teaches the client about this treatment, explaining that the tissue will be removed by which method?

Upon entering the room of a client who has had a spontaneous abortion, the nurse observes the client crying. Which response by the nurse would be most appropriate?

A pregnant woman is diagnosed with chlamydia and asks the nurse, "How will this infection affect my baby and pregnancy?" Which responses by the nurse are accurate? (Select All that Apply.)