A client is seen at the ambulatory care clinic for a routine ...

[littleanan]

A client is seen at the ambulatory care clinic for a routine physical examination.
 
  During the examination, the client discusses having gained more than 25 pounds in the past year despite not changing the level of activity or dietary intake. What response by the nurse is the most appropriate?
  1. You must be eating more than you realize.
  2. Do you think increasing exercise might help you with your excessive weight gain?
  3. Tell me about any changes in your stress levels.
  4. This weight gain is likely the result of aging.

Question 2

A client, whose mother has a history of schizophrenia, voices concerns about becoming pregnant and is fearful of having a child with the same disorder. Which response by the nurse is the most appropriate?
 
  1. Schizophrenia is a genetic disorder so you are right to be very concerned.
  2. Your family history does increase the risk factors but there are other variables to be considered.
  3. Schizophrenia should not be a significant concern for you.
  4. You should consider being tested before becoming pregnant.

[onowka]

Answer to Question 1

Correct Answer: 3

Periods of stress may result in obesity. In addition, some individuals will use comfort foods during periods of stress. Telling the client that he is indeed eating more than realized is confrontational. Encouraging the client to increase exercise may be beneficial but the nurse must first assess for potential causes. Many people do gain weight as they age but there is no indication that this is correct for this individual.

Answer to Question 2

Correct Answer: 2

Schizophrenia does have genetic links. Individuals having a family history have a greater incidence of also displaying the disorder. There are, however, other variables such as environment that should be considered. Telling the patient to be very concerned does not present the maximum amount of information. Advising the client that it should not be a significant concern both downplays the actual risk and minimizes the client's concerns. There are no tests that can be run for this disease.