An adolescent is at the pediatrician's office because he has been experiencing intense itching, particularly in the axilla and between the fingers.

The itching is worse during the night and he has not been sleeping well.

 With what is this symptom associated? 

Choice A rationale

Assessing the client's support system is a valuable step, but it is not the best initial action. Overwhelmed clients need to feel a sense of control over their situation before they can effectively utilize external support. Focusing on one manageable change empowers the client, which is a more immediate and effective intervention for dealing with feelings of being overwhelmed.

Choice B rationale

Overwhelmed clients often feel a lack of control and competence. By assisting the client to identify and focus on a single, achievable lifestyle change, the nurse can help the client experience a sense of mastery and success. This positive experience can build confidence and motivation, making it more likely for the client to attempt and sustain further lifestyle changes.

Choice C rationale

While understanding a client's stressors is important for holistic care, this information may further overwhelm a client who is already feeling burdened. The immediate priority is to help the client feel capable of making a change. By first focusing on one small, manageable step, the nurse can begin to empower the client and then address broader stressors later.

Choice D rationale

Inquiring about delegating obligations may not be practical or appropriate for many clients and does not directly address the core issue of feeling overwhelmed by lifestyle changes. This suggestion externalizes the problem and does not empower the client to take control of their health. The focus should be on internal motivation and self-efficacy, not simply shifting responsibilities.

Choice A rationale

This statement describes secondary hypertension, where an underlying medical condition, such as kidney disease or an endocrine disorder, is the identifiable cause. Secondary hypertension accounts for a minority of cases, and treating the underlying disease is the primary focus.

Choice B rationale

This response uses a colloquial interpretation of the word "essential" rather than the medical definition. While treatment is indeed essential for all hypertension, this explanation does not accurately describe the etiology or classification of the condition from a scientific perspective.

Choice C rationale

Essential hypertension, also known as primary hypertension, is the medical term for high blood pressure that has no identifiable, specific cause. It accounts for the vast majority of hypertension cases and is believed to result from a combination of genetic and environmental factors.

Choice D rationale

This statement is incorrect. While some cases of essential hypertension can be severe, the term "essential" refers to the absence of a known cause, not the severity of the condition. Hypertension severity is categorized separately, regardless of its underlying etiology.