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Free NCLEX-PN Exam Braindumps (page: 19)

Page 19 of 254
PDF with 1015 Questions

Which of the following home-care strategies is most likely to negatively impact the body image of a client with Cushing’s syndrome?

  1. providing safety measures to prevent falls
  2. taking medications as prescribed
  3. wearing a medical ID indicating Cushing’s syndrome
  4. having regular health assessments

Answer(s): C

Explanation:

All of the strategies listed are included in home care for the client with Cushing’s syndrome. Choice “wearing a medical ID indicating Cushing’s syndrome” is the best answer because wearing a medical ID is a visible sign that something is wrong and a constant reminder to the client that he or she has a loss of body function.
Choice “providing safety measures to prevent falls” might enhance body image because it prevents falls that could cause further injury and debilitation.
Taking medications as prescribed should enhance body image because it decreases the symptoms present. Having regular health assessments indicates an enhanced body image because it signals the desire to take care of the body and keep it at its best.



When a client who is 25 years of age asks the nurse when she should seek fertility counseling, the best response by the nurse is ______________.

  1. “Fertility counseling should be sought when you have been unable to conceive after 1 year of unprotected intercourse.”
  2. “Fertility couseling should be sought when you have not been able to conceive after 6-9 months of unprotected intercourse.”
  3. “The average time it takes someone your age to conceive is 51⁄2 months, so if you haven’t conceived by then, we can refer you.”
  4. “We can give you some guidance now on how to increase your chances of conceiving and then refer you if it doesn’t happen within a year.”

Answer(s): D

Explanation:

The guidelines for a fertility workup are to refer after the couple has not conceived after one year of unprotected intercourse. So, Choice “Fertility counseling should be sought when you have been unable to conceive after 1 year of unprotected intercourse.” is technically correct, but it doesn’t consider the immediate need for the couple to have some counseling.
Choice “We can give you some guidance now on how to increase your chances of conceiving and then refer you if it doesn’t happen within a year.” is the best answer because it gives the couple guidance now and the referral at the appropriate time.
If the woman is over the age of 35, an earlier referral, at six to nine months of unprotected intercourse, is appropriate.

It is true that the average time it takes a 25-year-old woman to conceive is 5.3 months, but that does not address the concern the client is expressing. Choice “We can give you some guidance now on how to increase your chances of conceiving and then refer you if it doesn’t happen within a year.” is still the most caring and correct answer.
Couples conceive within the first month of unprotected intercourse 20% of the time.



When a couple experiencing infertility presents for a fertility workup, which of the following procedures should the nurse prepare the couple to have first?

  1. hysterosalpingography
  2. semen analysis
  3. endometrial biopsy
  4. transvaginal ultrasound

Answer(s): B

Explanation:

Because semen analysis is the least invasive of the tests listed and because in 35% of the cases the infertility is related to a male factor, semen analysis should be one of the first diagnostic tests performed.
Hysterosalpingography fills the uterus and fallopian tubes with a radiopaque substance that can be seen with an X ray. It demonstrates tubal patency or any distortion of the uterine cavity.
Endometrial biopsy provides information about the effects of progesterone after ovulation and the endometrial receptivity.
Transvaginal ultrasound is mostly used in the treatment of infertility. For diagnosis it allows the endocrinologist to evaluate the developing follicle, assess oocyte maturity, and diagnose luteal phase defects.
Hysterosalpingography, endometrial biopsy and transvaginal ultrasound are more invasive, require greater expertise to evaluate and treat, and are more costly.
If the semen analysis is normal, the couple can expect to progress through these tests as well.



If a client has chronic renal failure, which of the following sexual complications is the client at risk of developing?

  1. retrograde ejaculation
  2. decreased plasma testosterone
  3. hypertrophy of testicles
  4. state of euphoria

Answer(s): B

Explanation:

Untreated chronic renal failure causes decreased testosterone levels, atrophy of testicles, and decreased spermatogenesis.
Retrograde ejaculation is not a complication of chronic renal failure. It is a complication of transurethral resection of the prostate.
In chronic renal failure, the testicles atrophy; they do not hypertrophy. Chronic renal failure produces a state of depression, not euphoria.






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