NCLEX-RN LATEST UPDATE EXIT EXAM QUESTION WITH RATIONALES

A 21-year-old male with Hodgkin’s lymphoma is a senior at the local
university. He is engaged to be married and is to begin a new job upon
graduation. Which of the following diagnoses would be a priority for
this client?
• A. Sexual dysfunction related to radiation therapy
• B. Anticipatory grieving related to terminal illness
• C. Tissue integrity related to prolonged bed rest
• D. Fatigue related to chemotherapy
Correct Answer: A. Sexual dysfunction related to radiation
therapy
Radiation therapy often causes sterility in male clients and would be
of primary importance to this client. The psychosocial needs of the
client are important to address in light of the age and life choices.
Hodgkin’s disease, however, has a good prognosis when diagnosed
early. Know the importance of sex to individual, partner, and patient’s
motivation for change. Because lymphomas often affect the relatively
young who are in their productive years, these people may be
affected more by these problems and may be less knowledgeable
about the possibilities of change.
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• Option B: Grieving may not be an appropriate diagnosis since
the client would be experiencing new milestones in his life
despite his condition. Let the patient describe the problem in
their own words. Provides a more accurate picture of patient
experience with which to develop a plan of care.
• Option C: Option B is not applicable since the client is not on
bed rest. Encourage the patient to share thoughts and concerns
with his partner and to clarify values and impact of condition on
relationship. Helps the couple begin to deal with issues that can
strengthen or weaken the relationship.
Option D: Fatigue may occur during chemotherapy, but it is not
the priority diagnosis. Identify pre-existing and current stress
factors that may be affecting the relationship. The patient may
be concerned about other issues, such as job, financial, and
illness-related problems.