A client states to the nurse, “I understand that I need a mastectomy, but I am worried about the pain and appearance afterwards.” When responding to the client, the nurse will need to address which domain?

Cognitive

Psychomotor

Affective

Behavioral

Answer and Explanation

The Correct Answer is C

Choice A reason: The cognitive domain involves knowledge and understanding, such as explaining the procedure or its rationale. The client’s statement indicates understanding (“I understand”), so their concern is not about knowledge but emotional worries about pain and appearance, which are better addressed in the affective domain to provide emotional support.

Choice B reason: The psychomotor domain focuses on physical skills, like performing a task or procedure. The client’s concerns about pain and appearance are emotional, not skill-based. Addressing psychomotor skills, such as teaching self-care techniques, is irrelevant to the client’s expressed emotional worries, requiring a focus on feelings instead.

Choice C reason: The affective domain involves emotions, attitudes, and feelings. The client’s worries about pain and appearance post-mastectomy reflect emotional concerns. Addressing this domain through empathetic listening and emotional support helps alleviate anxiety, validates feelings, and fosters coping, making it the most appropriate focus for the nurse’s response.

Choice D reason: The behavioral domain is not a standard learning domain in nursing education (cognitive, psychomotor, affective are typical). If interpreted as behavior modification, it is irrelevant here, as the client’s concerns are emotional, not behavioral. The nurse should focus on addressing the client’s feelings rather than attempting to change behaviors.

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Correct Answer is A

Explanation

Choice A reason: Homeostasis is the body’s ability to maintain stable internal conditions, including fluid and electrolyte balance. Imbalances, like hypokalemia or hypernatremia, disrupt cellular function, potentially causing arrhythmias or neurological issues. Restoring homeostasis is the priority, as it addresses the root cause, ensuring proper organ function and preventing complications.

Choice B reason: Preventing infection is important but not the priority in fluid and electrolyte imbalances. Infections may occur secondary to other conditions, but the primary concern is correcting imbalances that affect cellular and organ function. Homeostasis must be achieved first to stabilize the client’s physiological state before addressing infection risks.

Choice C reason: Promoting mobility is relevant for overall health but not the priority in fluid and electrolyte imbalances. Imbalances can cause muscle weakness or arrhythmias, but restoring electrolyte levels takes precedence to ensure safe mobility. Without homeostasis, mobility efforts may be unsafe or ineffective due to physiological instability.

Choice D reason: Enhancing nutrition supports overall recovery but is secondary to correcting fluid and electrolyte imbalances. Nutritional deficiencies may contribute to imbalances, but the immediate goal is restoring homeostasis to prevent acute complications like cardiac or neurological dysfunction. Nutrition can be addressed once the client is stabilized.

A. Rebound tenderness at McBurney’s point B. Left lower quadrant pain C. High-pitched bowel sounds D. Soft, non-tender abdomen

Correct Answer is A

Explanation

Choice A reason: Rebound tenderness at McBurney’s point (right lower quadrant) indicates peritoneal irritation, a hallmark of appendicitis. The inflamed appendix causes localized pain, exacerbated by pressure release due to peritoneal inflammation. This specific finding is highly suggestive of appendicitis, distinguishing it from other abdominal conditions.

Choice B reason: Left lower quadrant pain is not typical for appendicitis, which usually presents in the right lower quadrant due to the appendix’s anatomical location. Left-sided pain may suggest conditions like diverticulitis or colitis, but it does not align with the localized inflammation characteristic of appendicitis.

Choice C reason: High-pitched bowel sounds suggest increased peristalsis, as in early obstruction, but are not specific to appendicitis. Appendicitis may reduce bowel sounds due to peritoneal irritation. Rebound tenderness is a more direct indicator, as it reflects the localized inflammation and irritation of appendicitis.

Choice D reason: A soft, non-tender abdomen is inconsistent with appendicitis, which causes localized pain and tenderness due to inflammation. A non-tender abdomen suggests a normal or alternative condition, not appendicitis, where peritoneal irritation typically produces tenderness, especially at McBurney’s point, upon palpation or rebound.

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A client states to the nurse, “I understand that I need a mastectomy, but I am worried about the pain and appearance afterwards.” When responding to the client, the nurse will need to address which domain?

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