The nurse asks a client to roll up his sleeves so she can take his blood pressure. The client replies “If you want I can go naked for you.” The most therapeutic response by the nurse is:
-
Solution
“I only need access to your arm. Putting up your sleeve is fine.”
The nurse needs to deal with the client with sexually connotative behavior in a casual, matter of fact way.
Options A and B: These responses are not therapeutic because they are challenging and rejecting.
Option C: Threatening the client is not therapeutic.
The inability to maintain the physiologic requirements in sexual intercourse is:
-
Solution
Sexual Arousal Disorder
This describes sexual arousal disorder.
Option A: Sexual Desire Disorder refers to the persistent and recurrent lack of desire or willingness for sexual intercourse.
Option C: Orgasm Disorder is the inability to complete the sexual response cycle because of the inability to achieve an orgasm.
Option D: Sexual Pain Disorder is characterized by genital pain before, during or after sexual intercourse.
The sexual response cycle in which the sexual interest continues to build:
-
Solution
Sexual arousal
Sexual arousal or excitement refers to attaining and maintaining the physiologic requirements for sexual intercourse.
Option A: Sexual Desire refers to the ability, interest or willingness for sexual stimulation.
Option C: Orgasm refers to the peak of the sexual response where the female has vaginal contractions for the female and ejaculatory contractions for the male.
Option D: Resolution is the final phase of the sexual response in which the organs and the body systems gradually return to the unaroused state.
Which of the following statements is true for gender identity disorder?
-
Solution
It is the desire to live or involve in reactions of the opposite sex
Gender identity disorder is a strong and persistent desire to be the other sex.
Option A: This is fetishism.
Option B: This refers to masochism.
Option C: This describes exhibitionism.
Situation: The nurse may encounter clients with concerns on sexuality. The most basic factor in the intervention with clients in the area of sexuality is:
-
Solution
Comfort with one’s sexuality
The nurse must be accepting, empathetic and non-judgmental to patients who disclose concerns regarding sexuality. This can happen only when the nurse has reconciled and accepted her feelings and beliefs related to sexuality.
Options A, B, and D are important considerations, but these are not the priority.
The client is concerned about his coming discharge, manifested by being unusually sad. Which is the most therapeutic approach by the nurse?
-
Solution
“You seem to have concerns about going home.”
This statement reflects how the client feels. Showing empathy can encourage the client to talk which is important as an alternative more adaptive way of coping with stressors.
Option A: Giving false reassurance is not therapeutic.
Option B: While this technique explores plans after discharge, it does not focus on the expression of feelings.
Option D: This close-ended question does not encourage verbalization of feelings.
Included as a priority of care for the client will be:
-
Solution
Place in semi-fowlers position and render O2 inhalation as ordered
Since psychophysiological disorder has an organic basis, priority intervention is directed towards disease-specific management. Failure to address the medical condition of the client may be a life threat.
Options A and B. The client has a physical symptom that is adversely affected by psychological factors. Verbalization of feelings in a non-threatening environment and involvement in relaxing activities are an adaptive way of dealing with stressors. However, these are not the priority.
Option D: Helping the client connect the physical symptoms with the emotional problems can be done when the client is ready.
The nurse ensures a therapeutic environment for the client. Which of the following best describes a therapeutic milieu?
-
Solution
A living, learning or working environment.
A therapeutic milieu refers to a broad conceptual approach in which all aspects of the environment are channeled to provide a therapeutic environment for the client. The six environmental elements include structure, safety, norms, limit setting, balance and unit modification.
Option A: Behavioral approach in psychiatric care is based on the premise that behavior can be learned or unlearned through the use of reward and punishment.
Option B: Cognitive approach to change behavior is done by correcting distorted perceptions and irrational beliefs to correct maladaptive behaviors.
Option D: This is not congruent with the therapeutic milieu.
The personality type of Ryan is:
-
Solution
Dependent
A client with dependent personality is predisposed to develop asthma.
Option A: The conforming non-assertive client is predisposed to develop hypertension because of the tendency to repress rage.
Option C: The perfectionist and compulsive tend to develop a migraine.
Option D: The masochistic, self-sacrificing type are prone to develop rheumatoid arthritis.
Situation: A 14-year-old male was admitted to a medical ward due to bronchial asthma after learning that his mother was leaving soon for U.K. to work as a nurse. The client has which of the following developmental focus:
-
Solution
Establishing relationship with the opposite sex and career planning.
The client belongs to the adolescent stage. The adolescent establishes his sense of identity by making decisions regarding familial, occupational and social roles. The adolescent emancipates himself from the family and decides what career to pursue, what set of friends to have and what value system to uphold.
Option B: This refers to the middle adulthood stage concerned with transmitting his values to the next generation to ensure his immortality through the perpetuation of his culture.
Option C: This reflects school age which is concerned with the pursuit of knowledge and skills to deal with the environment both in the present and in the future.
Option D: The stage of young adulthood is concerned with the development of an intimate relationship with the opposite sex, the establishment of a safe and congenial family environment and building of one’s lifework.