A 15-year-old high school student named Emily has been consistently bullied by her peers for the past year.
She has become withdrawn, avoids social interactions, and her academic performance has declined. What psychological effect is Emily most likely experiencing as a result of the bullying?
Depression.
Increased self-esteem.
Enhanced social skills.
Improved academic performance.
The Correct Answer is A
Choice A rationale
Bullying, especially when prolonged, can lead to chronic stress and emotional distress, often manifesting as symptoms of depression. The consistent negative social interactions, feelings of helplessness, social isolation, and decline in academic performance are all classic indicators of major depressive disorder, characterized by persistent sadness, anhedonia, and functional impairment.
Choice B rationale
Bullying systematically erodes an individual's self-worth and confidence. The constant criticism, exclusion, and targeting by peers lead to feelings of inadequacy and shame, directly contradicting any notion of increased self-esteem. Over time, victims often internalize negative messages, resulting in a significant decrease in their overall self-perception and personal value.
Choice C rationale
Bullying typically leads to social withdrawal, not enhanced social skills. Victims often develop anxiety around social interactions due to fear of further judgment or aggression. This avoidance behavior prevents them from practicing and refining social skills, leading to a decline in their ability to engage effectively with peers and form healthy relationships.
Choice D rationale
Bullying causes significant psychological distress, including anxiety, depression, and difficulty concentrating. These factors directly interfere with cognitive functions necessary for learning, such as attention and memory. Consequently, academic performance often declines as the student struggles to focus in class and complete assignments, leading to lower grades. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
The passageway refers to the birth canal, including the pelvis and soft tissues. While an adequate passageway is essential for labor progression, the client's current cervical dilation (7 cm) and effacement (80%) indicate that the passageway is accommodating fetal descent, and there is no direct evidence from the scenario suggesting an issue with this factor.
Choice B rationale
The passenger refers to the fetus, including its size, presentation, lie, and attitude. There is no information in the scenario to suggest any concerns with the fetus itself, such as malpresentation or distress. The focus of the client's statement is on their emotional state rather than a physical aspect of the baby.
Choice C rationale
Psyche refers to the client's psychological and emotional state during labor. The client's statement "I am really afraid of giving birth" and subsequent crying directly indicate significant fear and anxiety. This emotional distress can negatively impact labor progression by increasing catecholamine release, potentially hindering uterine contractions and increasing pain perception, thus requiring immediate attention.
Choice D rationale
Powers refer to the uterine contractions (primary power) and the mother's pushing efforts (secondary power). While effective powers are crucial for labor progression, the scenario does not provide information to suggest that the client's contractions are inadequate or that there's an issue with her ability to push. The immediate concern presented is her emotional state.
Correct Answer is A
Explanation
Choice A rationale
A fundus that is deviated to the right, boggy, and 2 cm above the umbilicus suggests a distended bladder is displacing the uterus, preventing it from contracting effectively. A full bladder inhibits uterine involution by impeding the muscle fibers from compressing blood vessels, leading to uterine atony and increasing the risk of postpartum hemorrhage. Normal bladder capacity is 300-500 mL.
Choice B rationale
Obtaining a stat hemoglobin level is not the immediate priority. While a boggy uterus can indicate blood loss, the primary issue here is likely bladder distension causing uterine atony. Addressing the cause of the uterine displacement (bladder distension) takes precedence over assessing the degree of blood loss, which would be a secondary consequence. A normal hemoglobin for a woman is typically 12.0 to 15.5 grams per deciliter.
Choice C rationale
Administering methylergometrine is not the first action. Methylergometrine is a uterotonic agent used to promote uterine contractions and prevent postpartum hemorrhage. However, if the uterus is displaced by a full bladder, the medication's effectiveness will be significantly reduced until the bladder is emptied. Treating the underlying cause is crucial before administering uterotonics.
Choice D rationale
Inserting an indwelling urinary catheter is a more invasive intervention than assisting the client to void. While a catheter might be necessary if the client cannot void independently, the initial and least invasive action should always be to encourage spontaneous urination. Catheterization carries risks of urinary tract infection and discomfort, so it's not the first-line intervention.
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