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 B

Explanation

A. Hepatitis:

- Hepatitis viruses (such as hepatitis B and hepatitis C) primarily affect the liver and are not directly associated with an increased risk of cervical cancer. Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections can lead to liver inflammation, cirrhosis, and liver cancer (hepatocellular carcinoma), but they do not specifically increase the risk of cervical cancer.

B. Human papillomavirus (HPV):

- Human papillomavirus (HPV) infection is strongly associated with an increased risk of cervical cancer. HPV is a sexually transmitted virus that can infect the cells of the cervix, leading to cellular changes that may progress to cervical dysplasia and cervical cancer over time. Persistent infection with high-risk strains of HPV, particularly HPV types 16 and 18, is a major risk factor for the development of cervical cancer.

C. Cytomegalovirus (CMV):

- Cytomegalovirus (CMV) is a common virus in the herpesvirus family. While CMV infection can cause complications in certain populations, such as congenital CMV infection in infants born to mothers with primary CMV infection during pregnancy, it is not known to be directly associated with an increased risk of cervical cancer.

D. Epstein-Barr virus (EBV):

- Epstein-Barr virus (EBV) is a herpesvirus that is best known for causing infectious mononucleosis (mono). EBV infection has been associated with certain types of cancers, such as Burkitt's lymphoma, Hodgkin's lymphoma, and nasopharyngeal carcinoma. However, EBV infection is not directly linked to an increased risk of cervical cancer.

A. "I won't use my birth control pills for at least a year or two." B. "I will be sure to avoid getting pregnant for at least 1 year." C. "My blood pressure will continue to be increased for about 6 more months." D. "My intake of iron will have to be closely monitored for 6 months."

Correct Answer is B

Explanation

A. "I won't use my birth control pills for at least a year or two." - This statement does not accurately reflect the teaching provided. After treatment for gestational trophoblastic disease, it is important for the woman to avoid pregnancy for a specified period of time to allow for monitoring and to reduce the risk of complications. However, the use of birth control pills is typically recommended to prevent pregnancy during this period.

B. "I will be sure to avoid getting pregnant for at least 1 year." - This statement demonstrates understanding of the teaching. After treatment for gestational trophoblastic disease, healthcare providers typically recommend avoiding pregnancy for at least one year. This allows for monitoring of hCG levels to ensure they return to normal and to reduce the risk of recurrence.

C. "My blood pressure will continue to be increased for about 6 more months." - This statement is not related to the teaching about gestational trophoblastic disease. Blood pressure may be affected during pregnancy, but it is not a specific concern related to treatment for gestational trophoblastic disease.

D. "My intake of iron will have to be closely monitored for 6 months." - This statement is not directly related to the teaching about gestational trophoblastic disease. While monitoring of iron levels may be important for overall health, it is not a specific recommendation related to treatment for this condition.

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Naxlex Comprehensive Predictor Exams

A woman comes to the clinic for a routine checkup. After obtaining the client's history, the nurse identifies that the client is at increased risk for cervical cancer based on her history of exposure to which virus?

Correct Answer is B

Explanation

After teaching a woman who has had an evacuation for gestational trophoblastic disease (hydatidiform mole or molar pregnancy) about her condition, which statement indicates that the nurse's teaching was successful?

Correct Answer is B

Explanation

A client comes to the clinic for an evaluation. The client is at 22 weeks' gestation. After reviewing a client's history, which factor would the nurse identify as placing her at risk for preeclampsia?

Assessment of a pregnant woman and her fetus reveals tachycardia and hypertension. There is also evidence suggesting vasoconstriction. The nurse would question the woman about use of which substance?

A nurse has been invited to speak at a local high school about adolescent pregnancy. When developing the presentation, the nurse would incorporate information related to which aspects? (Select All that Apply.)

A nurse is reading a journal article about care of the woman with pelvic organ prolapse. The nurse would expect to find information related to which disorder? (Select All that Apply.)

To assist the woman in regaining control of the urinary sphincter after bladder surgery, the nurse should teach the client to perform which action?

The nurse is developing a plan of care for a client who is receiving aggressive drug therapy for treatment of HIV. The goal of this therapy is to:

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.