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. Recurrent pelvic infections:

Pelvic infections, particularly those affecting the fallopian tubes (such as pelvic inflammatory disease), can lead to scarring and damage to the fallopian tubes. Scar tissue can obstruct the normal passage of the fertilized egg, increasing the risk of ectopic pregnancy.

B. Heavy, irregular menses:

While irregular menstrual cycles can sometimes be associated with conditions like polycystic ovary syndrome (PCOS), heavy and irregular menses are not typically considered direct risk factors for ectopic pregnancy. However, underlying conditions contributing to irregular menstrual cycles, such as hormonal imbalances or conditions affecting the reproductive organs, could potentially increase the risk.

C. Use of oral contraceptives for 5 years:

Oral contraceptives (birth control pills) are known to significantly reduce the risk of ectopic pregnancy. They work by preventing ovulation and altering the uterine lining, making it less likely for a fertilized egg to implant outside the uterus. Therefore, long-term use of oral contraceptives would generally decrease the risk of ectopic pregnancy rather than increase it.

D. Ovarian cyst 2 years ago:

While ovarian cysts are common and usually benign, they typically do not directly contribute to the risk of ectopic pregnancy. However, certain types of ovarian cysts, such as those associated with conditions like polycystic ovary syndrome (PCOS) or endometriosis, may indirectly affect fertility and increase the risk of complications during pregnancy, including ectopic pregnancy.

A. "Change your behavior so as not to trigger the violence." B. "Remember-children do best in two-parent families." C. "Give your partner more time to come around." D. "You are a good person, and you deserve better than this."

Correct Answer is D

Explanation

A. "Change your behavior so as not to trigger the violence."

This statement is victim-blaming and places the responsibility for the violence on the victim. It suggests that the victim's actions or behavior are the cause of the violence they are experiencing, which is not true. This type of response can further disempower the victim and perpetuate a cycle of abuse by implying that they have control over the perpetrator's actions.

B. "Remember-children do best in two-parent families."

This statement is not only irrelevant but also potentially harmful. It implies that the victim should prioritize maintaining the family structure over their own safety and well-being. Additionally, it disregards the fact that exposure to domestic violence can have serious negative impacts on children's emotional and psychological development. Encouraging the victim to stay in an abusive relationship for the sake of the children is not empowering and fails to address the root issue of the violence.

C. "Give your partner more time to come around."

This statement minimizes the severity of the situation and suggests that the victim should be patient and wait for the perpetrator to change their behavior. It fails to recognize that domestic violence is a pattern of coercive control and manipulation, and waiting for the perpetrator to "come around" may put the victim at further risk of harm. Encouraging the victim to wait for change also implies that they do not have the right to safety and autonomy until the perpetrator decides to change, which is not empowering.

D. "You are a good person, and you deserve better than this."

This statement acknowledges the victim's inherent worth and validates their experience of abuse. It empowers the victim to recognize that they deserve to be treated with respect and dignity, and it encourages them to take action to protect themselves and seek help. By affirming the victim's worth and agency, this statement can help build their confidence and resilience, making it more likely that they will take steps to address the violence and seek support.

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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is A

Explanation

A nurse is working with a victim of violence. Which statement would be most appropriate to empower the victim to take action?

Correct Answer is D

Explanation

A woman who has undergone a right-sided modified-radical mastectomy returns from surgery. Which nursing intervention would be most appropriate for the nurse to include in the client's plan of care at this time?

When performing a clinical breast examination, which would the nurse do first?

A woman pregnant with twins comes to the clinic for an evaluation. While assessing the client, the nurse would be especially alert for signs and symptoms for which potential problem?

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?

When developing the plan of care for a woman who has had an abdominal hysterectomy, the nurse would identify which action as contraindicated?

When describing an episode of intimate partner violence, the victim reports attempting to calm the partner down to keep things from escalating. The nurse interprets this behavior as reflecting which phase of the cycle of violence?

Which approach would be most appropriate when counseling a client who is a suspected victim of intimate partner violence?

A woman comes to the clinic and asks the nurse about when she should have her first mammogram. The woman is at low risk and has no family history of breast cancer. Using the recommendations of the American Cancer Society, the nurse would suggest the woman have her first mammogram at which age?