A nurse is formulating a diagnosis for a client who is reliving a brutal mugging that took place several months ago. The client is crying uncontrollably and states that he 'can’t live with this fear.' Which of the following diagnoses for this client is correctly written?

Correct Answer: A

Rationale: The correct answer is A: Post-trauma syndrome related to being attacked. This diagnosis accurately reflects the client's symptoms of reliving the traumatic event, crying uncontrollably, and expressing fear. Post-trauma syndrome encompasses a range of symptoms following a traumatic event, such as flashbacks, anxiety, and emotional distress. The other choices are incorrect because they are either too vague (B: Psychological overreaction) or do not capture the specific nature of the client's symptoms (C: Needs assistance coping; D: Mental distress). Therefore, option A is the most appropriate diagnosis based on the client's presentation.

Correct Answer: A

Rationale: Step 1: Reassessing the wound and client's condition allows the nurse to identify any factors contributing to the lack of improvement. Step 2: It helps determine if the current care plan needs modifications or if there are underlying issues affecting healing. Step 3: This step ensures a comprehensive evaluation before making any changes to the care plan, promoting evidence-based practice. Step 4: Choosing this option aligns with the nursing process of assessment, which is crucial for making informed decisions in client care. Summary: Option A is correct as it emphasizes the importance of reassessment to gather more information and make informed decisions. Discontinuing the care plan (Option B) without assessment can be harmful. Increasing dressing changes (Option C) may not address the underlying issue. Referring immediately (Option D) may be premature without reassessment.

Correct Answer: C

Rationale: Step 1: The nurse should explain that bladder irrigation is necessary to prevent blood clots from occluding the catheter after a TURP procedure. Step 2: Without irrigation, blood clots could block the catheter, leading to urinary retention and potential complications. Step 3: This explanation addresses the patient's concern about increased pain and highlights the importance of the irrigation in maintaining proper urine flow. Step 4: Choice A is incorrect because the primary purpose of irrigation is not to stop bleeding but to prevent clot formation. Choice B is incorrect because the irrigation is not for administering antibiotics. Choice D is incorrect as it does not address the issue of clot formation.

Correct Answer: C

Rationale: The correct answer is C: Painful and frequent urination. Cloudy penile discharge is a common symptom of urethritis, which is inflammation of the urethra. Painful and frequent urination are classic symptoms of urethritis due to irritation and inflammation of the urinary tract. Throat or rectal infection (choice A) are not typically associated with urethritis. Chancres or vesicles on the genitals (choice B) are more indicative of sexually transmitted infections like syphilis or herpes. Oliguria and flank pain (choice D) are more suggestive of kidney or urinary tract issues rather than urethritis.

Correct Answer: A

Rationale: The correct answer is A: 11mEq/L. In renal failure, the kidneys are unable to excrete excess magnesium, leading to hypermagnesemia. The patient's symptoms of stomach distress and ingesting antacids suggest magnesium intake. A Mg level of 11mEq/L aligns with symptoms like flushed face and weakness. Choices B, C, and D are too low for hypermagnesemia symptoms and would not explain the patient's presentation.