The clinic nurse sees the client today and asks about his chief complaint. The client describes to the nurse his inability to attain an erection. Which of the following would be a priority for the nurse to assess? Choose all that apply
A) Medication history
B) Specifics about sexual problem
C) Sleep history
D) Physical activity history
E) History of diabetes
Ans: A, B, E
Assessment priorities for erectile dysfunction should include history of hypertension, current medications, diabetes, and specifics about the erectile problem. Physical activity should not adversely affect ability to attain an erection. Unless the client is severely sleep deprived, this also should not affect erectile ability.
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The nurse is assessing a child for an anxiety disorder. What manifestations noted by the nurse are common to all anxiety disorders? (Select all that apply.)
A. Distress or avoidance of feared situations B. Does not go away or gets worse over time C. Impaired functioning or development D. Leads to avoiding social situations E. Physical symptoms such as palpitations and sweating
The nurse is assisting a victim of spousal abuse to create a plan for escape if it becomes necessary. What components should the plan include? Select all that apply
a. A code word to signal children that it is time to leave b. Phone numbers for the nearest shelter and crisis hotline c. Telling the spouse that she has a plan and will leave d. Collecting birth certificates and other essential documents e. Bringing a cell phone or change to make phone calls f. Obtaining a weapon to use as needed for self-defense
The nurse who is preparing a Muslim female for a physical examination is told by the patient, "I cannot undress completely." The nurse will appropriately choose interventions based on the knowledge that Muslim women
a. observe standards of modesty requiring coverage from head to ankle. b. speak openly to women but are silent in the presence of men. c. wear writings from the Koran on the neck, arm, or waist. d. are given alcoholic beverages with each meal.
A woman with borderline personality disorder has been admitted to the inpatient unit because she has been engaging in wrist cutting
The client's sister is visiting, and the sister asks the nurse to explain why her sister sometimes does this to herself. Which response by the nurse would be most appropriate? A) "Sometimes the self-injurious behavior is undertaken to relieve stress." B) "Self-injurious behavior often calms and sedates people with this diagnosis." C) "Sometimes they do it to avoid the onslaught of delusional thinking." D) "The self-mutilation often slows the mood swings your sister experiences."