Practice Quiz

NCLEX-PN

Category - Psychosocial Integrity

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The nurse walks into the room of a client who had a left radical mastectomy. The client, who is newly married, says, “How can I fully satisfy my husband if I look abnormal? Surely, he’ll find another woman who can please him.” Based on this statement, which nursing diagnosis is the most appropriate for the client?
  1. Skin integrity, impaired
  2. Risk for situational low self-esteem
  3. Risk for delayed surgical recovery
  4. Risk for loneliness
Explanation
Answer: B - Based on the statement, the client is demonstrating early signs of low self-esteem. Situational low self-esteem is manifested by a negative perception of self-worth in response to a current situation. Post-mastectomy clients are at risk for impaired social interaction and loneliness, but there is no indication in the client’s statement that these are present. The other options are not appropriate.
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