A nurse is caring for a client with a new colostomy. Which of the following statements indicates an issue with self-concept?

Choice A reason: This is not an observation that the nurse will note when considering the self-concept of a client. The surgical history of family members is not directly related to the client's self-concept, but rather to their genetic or environmental factors. The nurse may ask the client about their family history, but it is not a visual cue that reflects the client's self-perception.

Choice B reason: This is an observation that the nurse will note when considering the self-concept of a client. The posture of the client is a nonverbal communication that indicates the client's attitude, mood, and confidence. The nurse can observe if the client has a straight or slouched posture, and if they lean forward or backward. A straight and forward-leaning posture may suggest a positive and assertive self-concept, while a slouched and backward-leaning posture may suggest a negative and passive self-concept.

Choice C reason: This is an observation that the nurse will note when considering the self-concept of a client. The client's demeanor is the way that the client behaves and expresses themselves. The nurse can observe if the client is calm or agitated, cheerful or gloomy, friendly or hostile, and cooperative or resistant. A calm, cheerful, friendly, and cooperative demeanor may indicate a healthy and stable self-concept, while an agitated, gloomy, hostile, and resistant demeanor may indicate a poor and unstable self-concept.

Choice D reason: This is an observation that the nurse will note when considering the self-concept of a client. The grooming of the client is the way that the client takes care of their personal hygiene and appearance. The nurse can observe if the client is clean or dirty, neat or messy, and appropriately or inappropriately dressed. A clean, neat, and appropriate grooming may reflect a high and positive self-concept, while a dirty, messy, and inappropriate grooming may reflect a low and negative self-concept.

Choice E reason: This is an observation that the nurse will note when considering the self-concept of a client. The maintaining of eye contact is a nonverbal communication that shows the client's level of interest, attention, and respect. The nurse can observe if the client maintains, avoids, or shifts eye contact, and if they do so consistently or inconsistently. A consistent and moderate eye contact may indicate a strong and secure self-concept, while an inconsistent or extreme eye contact may indicate a weak and insecure self-concept.

Choice A reason: This is a correct answer. Second-hand smoke is the smoke that is exhaled by a smoker or emitted by a burning cigarette, cigar, or pipe. It contains many harmful chemicals that can cross the placenta and affect the developing fetus. Second-hand smoke can increase the risk of low birth weight, preterm birth, congenital anomalies, and sudden infant death syndrome (SIDS) .

Choice B reason: This is a correct answer. Drugs including alcohol are substances that can alter the mood, perception, or behavior of the user. They can also cross the placenta and affect the developing fetus. Drugs including alcohol can cause fetal alcohol spectrum disorders (FASDs), neonatal abstinence syndrome (NAS), growth restriction, brain damage, and birth defects .

Choice C reason: This is a correct answer. Infections are diseases that are caused by microorganisms, such as bacteria, viruses, fungi, or parasites. They can also cross the placenta and affect the developing fetus. Infections can cause miscarriage, stillbirth, preterm labor, congenital infections, and congenital anomalies .

Choice D reason: This is a correct answer. Metabolic conditions are disorders that affect the body's ability to produce or use energy, such as diabetes, thyroid disease, or phenylketonuria (PKU). They can also cross the placenta and affect the developing fetus. Metabolic conditions can cause macrosomia, hypoglycemia, congenital hypothyroidism, or intellectual disability .

Choice E reason: This is not a correct answer. Processed foods are foods that have been altered from their natural state, such as canned, frozen, or packaged foods. They may contain additives, preservatives, or artificial flavors or colors. They do not cross the placenta and affect the developing fetus directly, but they may affect the mother's nutrition and health. Processed foods may increase the risk of obesity, hypertension, or gestational diabetes, which can indirectly affect the fetal development .