Which of the following teenagers is at increased risk for acquiring a sexually transmitted disease and should be provided with anticipatory guidance?

Correct Answer: B

Rationale: In this scenario, option B is the correct answer as the teenager who feels that her friends and family do not care about her is at increased risk for acquiring a sexually transmitted disease (STD). This feeling of isolation and lack of support may lead her to seek validation and connection through risky behaviors, including engaging in unprotected sexual activities. By providing anticipatory guidance to this teenager, healthcare professionals can address underlying emotional issues and educate her on the importance of safe sex practices to reduce the risk of acquiring an STD. Option A, a teenager asking for information about condoms, may actually demonstrate a proactive approach to practicing safe sex, which is a positive behavior that can help reduce the risk of STD transmission. Options C and D do not directly indicate increased risk for acquiring an STD based on the information provided. In an educational context, it is important for healthcare professionals to understand the social and emotional factors that can influence adolescents' behaviors related to sexual health. By recognizing indicators of emotional distress and providing appropriate support and guidance, healthcare providers can effectively promote healthy behaviors and reduce the risk of STD transmission among teenagers.

Correct Answer: A

Rationale: In discussing interventions for weight reduction with a 30-year-old woman with a BMI of 36, it is crucial to prioritize the most effective and evidence-based approaches. Option A (4, 3, 2, 1) is the correct order of interventions to be discussed. 1. **Step 4 (Physical Activity)**: Starting with physical activity is essential as it plays a significant role in weight reduction by increasing energy expenditure and promoting overall health. 2. **Step 3 (Behavioral Changes)**: Next, addressing behavioral changes like improving eating habits and portion control is crucial for sustainable weight loss. 3. **Step 2 (Nutritional Counseling)**: Providing guidance on healthy eating habits and balanced nutrition supports weight management and overall well-being. 4. **Step 1 (Setting Realistic Goals)**: Beginning with setting realistic and achievable goals is fundamental in building motivation and ensuring success in weight reduction efforts. **Why Other Options Are Incorrect**: - Option B (4, 2, 3, 1) prioritizes nutritional counseling before addressing physical activity, which is less effective for weight reduction. - Option C (3, 4, 2, 1) focuses on behavioral changes before physical activity and nutritional counseling, missing the importance of exercise in weight management. - Option D (3, 2, 1, 4) delays setting realistic goals until the end, which could hinder the patient's motivation and commitment to the weight reduction plan. **Educational Context**: Understanding the sequential order of interventions in weight reduction discussions is crucial for healthcare providers to effectively guide patients in achieving their goals. By following a systematic approach, providers can empower individuals to make sustainable lifestyle changes and improve their overall health outcomes.

Correct Answer: C

Rationale: The correct question for a nurse to ask a 26-year-old individual being screened for depression or suicide ideation is option C: “Have you thought of harming yourself?” This question is crucial as it directly addresses the issue of suicidal ideation, which is essential to assess for in individuals who may be experiencing depression or distress. Option A, asking about pets, is not as pertinent to screening for depression or suicide ideation. Option B, inquiring about work, although important, does not directly assess for suicidal thoughts. Option D, asking about seeing friends, is also not as directly related to screening for suicidal ideation. In an educational context, it is important for nurses to understand the significance of directly addressing the issue of suicidal ideation in their assessments. Suicide is a serious concern, especially in individuals with depression, and early detection through appropriate questioning can lead to timely interventions and potentially life-saving support for the individual. Nurses need to be trained to ask direct and sensitive questions related to mental health to provide holistic care to their patients.

Correct Answer: D

Rationale: The most appropriate statement when discussing a woman concerned about osteoporosis and menopause is option D, “Tell me about your diet, walking, and medications.” This response is the correct choice because it demonstrates patient-centered care by actively engaging the woman in discussing relevant factors that can impact her bone health. Option A, “The American diet is much better now,” is incorrect because it does not address the individual woman's specific risk factors or provide actionable advice for managing her osteoporosis risk. Option B, “You have a strong genetic risk factor,” while important to consider, does not encourage the woman to take an active role in her health or provide her with guidance on preventive measures she can take. Option C, “You need about 1000 mg of calcium a day,” is oversimplified and does not take into account the multifactorial nature of osteoporosis risk, which includes factors beyond just calcium intake. In an educational context, it is crucial for healthcare providers to engage patients in discussions about their health, empower them to take an active role in disease prevention, and tailor recommendations to individual risk factors and lifestyle choices. By encouraging open dialogue and considering the holistic healthcare needs of the patient, providers can better support women in managing their bone health during menopause.

Correct Answer: B

Rationale: In this scenario, the likely disorder the 62-year-old person is experiencing is glaucoma (Option B). Glaucoma is a condition characterized by increased intraocular pressure leading to damage of the optic nerve and peripheral vision loss. This is a common condition in older adults and can lead to irreversible vision loss if not detected and managed promptly. Presbyopia (Option A) is a normal age-related change where the lens loses its flexibility, leading to difficulty focusing on close objects, but it does not cause peripheral vision loss. Cataracts (Option C) involve clouding of the lens in the eye, which can cause blurred vision, but typically does not present as peripheral vision loss unless in advanced stages. Diabetic retinopathy (Option D) is a complication of diabetes affecting the blood vessels in the retina, leading to vision problems such as blurred vision, but it is not typically associated with peripheral vision loss as the primary symptom. Understanding the distinctions between these eye disorders is crucial for healthcare professionals, especially in the context of health promotion and maintenance. Regular eye exams, especially for older adults, can aid in early detection and appropriate management of these conditions to prevent irreversible vision impairment. Encouraging individuals to seek routine eye care as part of their overall health maintenance can help in the early identification and management of eye disorders like glaucoma.