10. Priority Decision: A bedridden patient tells the nurse she has low back pain and asks if the area could be massaged. What is the best action by the nurse?

Correct Answer: C

Rationale: In this scenario, the correct action for the nurse is option C: Comfortably position the patient to expose the area and massage the back with effleurage and petrissage strokes. The rationale behind this choice is that gentle massage techniques like effleurage and petrissage can help alleviate mild back pain and promote relaxation, which can be beneficial for a bedridden patient. Additionally, providing hands-on care can also enhance the nurse-patient relationship and improve overall patient comfort. Option A is incorrect as suggesting acupuncture does not directly address the patient's request for a massage. Option B is incorrect because while it is true that massage should typically be done by a licensed therapist, in this case, the nurse can provide a gentle massage within their scope of practice. Option D is also incorrect as it delays addressing the patient's immediate need for comfort and relief by involving physical therapy. Educationally, this question highlights the importance of understanding basic nursing interventions for pain management and comfort measures. Nurses should be aware of simple techniques like effleurage and petrissage that can be safely used to address patient discomfort. It also emphasizes the significance of therapeutic communication and meeting patient needs promptly and effectively.

Correct Answer: D

Rationale: In the context of pharmacology and sleep disorders, understanding parasomnias is crucial. A parasomnia is a type of sleep disorder characterized by abnormal behaviors or experiences during sleep. In this case, the correct answer is D) Sleep terrors. Sleep terrors, also known as night terrors, are a type of parasomnia where the individual experiences intense fear or terror during sleep, often accompanied by screaming or thrashing. This is different from nightmares, which occur during REM sleep. Option A) Cataplexy is not a parasomnia but a symptom of narcolepsy, involving sudden muscle weakness triggered by emotions. Option B) Hypopnea refers to shallow breathing during sleep and is a sign of sleep-disordered breathing, not a parasomnia. Option C) Sleep apnea is a common sleep disorder characterized by pauses in breathing during sleep, also not classified as a parasomnia. Educationally, recognizing different sleep disorders, including parasomnias, is essential for healthcare professionals, especially in pharmacology when considering treatment options that may impact sleep patterns. Understanding the distinction between parasomnias and other sleep disorders helps in accurate diagnosis and appropriate management strategies for patients experiencing these conditions.

Correct Answer: B

Rationale: In this scenario, option B, "It’s okay to have my usual two glasses of wine in the evening before bed," indicates a misunderstanding of sleep hygiene practices. Alcohol consumption close to bedtime can disrupt sleep patterns, leading to poor-quality sleep. Therefore, this statement is incorrect and requires further clarification. Option A is correct as it aligns with proper sleep hygiene by suggesting that if unable to fall asleep within 20 minutes, the individual should get up and engage in a quiet activity before trying to sleep again. This helps prevent associating the bed with wakefulness. Option C suggests a light snack before bed, which can promote relaxation and improve sleep quality. This aligns with sleep hygiene practices, making it a suitable choice. Option D recommends exercising earlier in the day, at least 6 hours before bedtime. This is in line with sleep hygiene recommendations as exercising too close to bedtime can stimulate the body and make it harder to fall asleep. Educationally, understanding and implementing sleep hygiene practices are crucial for promoting good sleep habits and overall health. Incorrect practices, such as consuming alcohol before bed, can have detrimental effects on sleep quality. By addressing misconceptions like the one in option B, individuals can improve their sleep hygiene and well-being.

Correct Answer: C

Rationale: In a patient with obstructive sleep apnea (OSA), the correct order of events is as follows: 1) Narrowing of air passages with muscle relaxation during sleep (Option B) 2) Apnea lasting 10 to 90 seconds (Option C) 3) Brief arousal and airway opened (Option D) 4) Sleep just before going to work (Option A) The correct answer, Option C, is the first event because in OSA, the air passages become narrowed due to relaxation of the muscles during sleep. This narrowing leads to apnea, where breathing stops for a period of time, typically 10 to 90 seconds. Following this, the body briefly arouses itself to reopen the airway and resume breathing. Option B is incorrect as it occurs before the apnea in the sequence of events. Option D is also incorrect as it follows the apnea and arousal. Option A is the last event in the sequence as it indicates the patient's sleep just before going to work, which would occur after the cycle of apnea and arousal. Understanding the sequence of events in OSA is crucial for healthcare providers to recognize and manage this condition effectively. Educating students on these events helps them comprehend the pathophysiology of OSA and how it impacts patient health and well-being.

Correct Answer: A

Rationale: In pharmacology, understanding how drugs can impact nerve transmission is crucial. The correct answer is A) The transmission may be interrupted by drugs such as local anesthetics. Local anesthetics work by blocking sodium channels, which are essential for the propagation of action potentials along nerve fibers. By inhibiting these channels, local anesthetics prevent the transmission of pain signals along peripheral nerves to the spinal cord, effectively blocking pain sensation. Option B) Nothing can stop the action potential along an intact nerve until it reaches the spinal cord is incorrect because we know that drugs like local anesthetics can indeed interfere with nerve transmission. Option C) The action potential must cross several synapses, points at which the impulse may be blocked by drugs is incorrect because local anesthetics primarily act at the level of the nerve fiber itself, not at synapses. Option D) The nerve fiber produces neurotransmitters that may activate nearby nerve fibers to transmit pain impulses is incorrect because local anesthetics do not target neurotransmitters but rather the conduction of action potentials along the nerve fiber. In an educational context, this question highlights the importance of understanding how specific pharmacological agents, such as local anesthetics, can selectively target and interrupt the transmission of nerve impulses, providing effective pain management in clinical practice.