Comprehensive Nursing of Dire Dawa University

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频道帖子

A 22-year-old woman who was raped by one of her family members was admitted to a hospital ward. On nursing assessment, the nurse found that the client has the feeling of being abandonment by others, impaired cognition fostering a negative view of self, and low self-esteem. What is the most likely initial nursing intervention in this case? A. Accept the client and spend time with her B. Allow client to participate in goal setting regarding own care C. Reassure the client that she is not alone when feeling inadequate D. Help client identify areas of life situation that are under own control

2	A 16-year-old woman who was raped by an unknown person came to a psychiatric clinic with her mother. She has a significant distressing feeling about the situation. As she explained to a nurse, she has a flashback related to the event and fear of discussing it with others. What is the most likely prior intervention in this case? A. Assess for self-destructive ideas and behavior of a patient B. Encourage the client to talk about the trauma at her own pace C. Assess the impact of the trauma on the client's ability to resume regular activities D. Respect client's wishes regarding interaction with individuals of opposite sex	673
3	A 30-year-old female patient came to a psychiatry clinic with complaints of flashbacks, intrusive recollections, and nightmares for the last one month. The patient also has psychological numbness which is related to an event and de-realization. A physician diagnosed her with Acute Stress Disorder. What is the most likely nursing diagnosis in this case? A. Stress overload B. Ineffective Coping C. Dysfunctional Grieving D. Post-trauma Syndrome	610
4	After a month experiencing a Bajaj accident, a 20-year-old single female who was born into socio-economically deprived family patient came to a psychiatric clinic with symptoms of recurrent, involuntary, and intrusive distressing memories of the accident, and blaming herself for the accident. She has an inability to express her feeling, especially in conditions that make everyone happy. What is the most appropriate stage of the traumatic event that predisposes to poor prognosis in this case? A. Pretraumatic factors B. Peritraumatic factors C. Posttraumatic factors D. Psychosocial factors	569
5	An 18-year-old male patient arrived at a psychiatry emergency unit with his relatives. The patient has an overt and aggressive behavior towards his relative as well as the health workers. He also tries to break objects and has self-destructive behavior. The nurse made a nursing diagnosis of "Risk for violence of self-directed and other-directed behavior related to catatonic excitement". What is the most likely nursing intervention in this case? A. Observe the client's behavior after sometimes B. Provide frequent assistance with self-care needs C. Provide information for the family about the illness D. Maintain a low level of stimuli in the client's environment	558
6	A 30-year-old woman came to a psychiatric clinic with complaints of feeling depressed and inability to do daily activities. The woman has significant impairment on interpersonal interaction, is unable to sleep, and thought of self-killing for the last one month. A physician diagnosed her with Major Depression Disorder. What is the most likely priority nursing care in this case? A. Working on sleep problem B. Working on Suicidal behaviors C. Working to alleviate a depressed mood D. working on interpersonal impairment	544
7	A 65-year-old known diabetic with pain in and around eyes, blurred vision, decreased visual acuity and field, nausea, vomiting, tonometer reading 28 mmHg. What is the most likely priority nursing diagnosis? A. Acute pain B. Impaired vision C. Fluid volume deficit D. Disturbed sensory perception	594
8	A 30-year-old single woman came to a psychiatric clinic with her older brother. The woman has urged to go out from home, talk alone, and assault people verbally and physically. During the interview, she is highly agitated, and non-cooperative for the past two months. She was saying that there is a person who is whispering in her ear to hurt the people around. What is the most likely diagnosis in this case? A. Schizophrenia Disorder B. Schizoaffective Disorder C. Brief Psychotic Disorder D. Schizophreniform Disorder	620
9	A known schizophreniform male patient came to a psychiatric clinic with an improved symptom of excessive fear of being harmed by his family. As a result, he isn't willing to take any foods that were prepared by his family. Because of this behavior, his social interaction has been significantly impaired. What is the most likely type of delusional symptoms presented in this case? A. Delusion of Erertomania B. Delusion of Grandiosity C. Delusion of Persecutory D. Delusion of Jealousy	547
10	An 11-year-old male child is brought to a psychiatric clinic with his mother. During the assessment, a health professional identified that the child faced difficulty of complying with parent's directions, problems with concentration, difficulties of following instructions in school, and the child has emotionally labile, explosive, lacks focus and is irritable. What is the most likely diagnosis of this child? A. Attention Deficit/Hyperactive disorder B. Autistic Spectrum disorder C. Intellectual disability D. Learning Disorder	520
11	A 19-year-old unmarried girl came to a hospital with a complaint of abdominal bloating for three days. The girl is irritable and feels mood swings during her period. She feels restlessness and sleeplessness during few days before her menstruation. She said that she is in a state of inability to manage her condition. What is the most likely nursing diagnosis in this case? A. Post-Trauma Syndrome B. Compromised Family Coping C. Ineffective Individual Coping D. Readiness for Enhanced Family Coping	493
12	A 21-year-old lady came to a health center with a complaint of excessive vaginal bleeding during the past three menstrual cycles. The woman is unable to identify her menstrual period in most of her cycle. She bleeds for an average of 10 days and the cycle is irregular. What is the most likely pattern of menstruation in this case? A. Metrorrhagia B. Menorrhagia C. Olymenorrhea D. Menometrorrhagia	470
13	A 22-year-old primipara with gestational age of nine week came to gynecology OPD with complaints of vaginal bleeding followed by uterine contraction. A nurse suspected of inevitable abortion. What is the most likely typical clinical manifestation that suggested the diagnosis in this case? A. Dilatation of cervix B. Passage of blood and some tissue C. Passes all of the contents of the uterus D. Retention of a failed intrauterine pregnancy	480
14	A 23-year-old student came to a hospital with excessive vaginal bleeding for six days. She also has frequent period even twice per month. The girl is irritable and feels moody during her period. Her vital signs show a blood pressure of 100/65mmHg, pulse rate of 90 beats/minute, and normal body temperature. What is the most likely intervention for this woman? A. Uterine curettage B. Routine perineal care C. Counsel on safe sex practice D. Hormonal therapy with COC	536
15	A 20-year-old new COC user came to a health center with complaints of nausea and vomiting. A nurse reassures the client by saying "Many women use COC experience as a side effect and also it is not harmful since it is normal after the first few months of use." What would be the most likely additional side effect the client experienced? A. Migraine Headache B. Suspected pregnancy C. Irregular vaginal bleeding D. Severe lower abdominal pain	507
16	A 22-year-old girl and her partner came to a health center with a complaint of sexual discomfort due to the IUCD string. The girl had inserted IUCD three months ago, and the nurse checked that IUCD was in place. What is the most likely nursing intervention in this case? A. Remove and replace with a new method B. Cut the string to a level of the cervix then counsel C. Counsel that this is the natural course of the method D. Reassure that it's a sign of feeling appropriate insertion	545
17	A couple visited a health center for family planning services. Both of them are known HIV positive and have been taking a recommended ART regimen containing protease inhibitors for the last one year. Following counseling on family planning options, both of them agreed to use Progestin-only pills (POPs). What is the most likely additional contraceptive the couple needs to use in this case? A. Jadelle B. Female Condom C. Injectable contraceptives D. Intrauterine Contraceptive Device	527
18	A nurse is providing essential newborn care for a baby who cried strongly at birth. After drying the baby with a dry towel, the nurse assessed the breathing and colors of the baby. Since breathing was normal, the nurse performed cord care. What is the most appropriate next logical newborn care in this case? A. Apply chlorohexidine on the cord B. Apply tetracycline eye ointment C. Initiate breastfeeding D. Give vitamin K	507
19	A 34-year-old known HIV-positive pregnant woman gave spontaneous vaginal delivery in the labor ward of a health center. A nurse had completed fetal evaluation, and the APGAR score was 7/10 and 10/10 at the 1 st & 5th minute respectively. What is the most appropriate next priority nursing intervention needed for HIV exposed infant? A. Provide HIV testing B. Provide cotrimoxazole C. Provide ART prophylaxis D. Provide vaccination as protocol	569
20	A 28-year-old multipara woman comes to a hospital with excessive vaginal bleeding after she gave birth at home three hours ago. The placenta is not delivered and the cord is visible outside the vagina. The vital signs show BP of 90/60mmHg, PR of 110 beats/minute, and RR of 22 Breaths/minute. A nurse makes a diagnosis of Postpartum Hemorrhage. What is the most appropriate outcome criterion for the prioritized nursing diagnosis? A. Pain will be relived B. Placenta will be removed C. Vital signs will be stabled D. Bleeding will be controlled	586

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