A college student observes a roommate going out wearing uncharacteristically seductive clothing, returning 12 to 24 hours later, and then sleeping for 8 to 12 hours. At other times, the roommate sits on the floor speaking like a young child. Which health problem should be considered?

Correct Answer: B

Rationale: The correct answer is B: Dissociative identity disorder. The roommate displaying different behaviors indicates potential dissociation, where different identities or states of consciousness take control. Seductive clothing and extended absence may indicate a different identity, while childlike speech may suggest another identity. This pattern aligns with the criteria for dissociative identity disorder. Functional neurological disorder (Choice A) involves physical symptoms without a clear organic cause. Dissociative amnesia (Choice C) pertains to memory loss due to psychological trauma. Body dysmorphic disorder (Choice D) involves obsession with perceived flaws in physical appearance. These options do not align with the diverse behaviors and identity shifts observed in the roommate.

Correct Answer: D

Rationale: In the context of admitting a patient with a seizure disorder, delegating tasks appropriately is crucial for effective patient care. In this scenario, the correct answer is D) Pad the side rails before the patient arrives. This task can be safely delegated to the LPN/LVN because it is within their scope of practice and does not require advanced assessment skills. Padding the side rails helps prevent injury during a seizure by providing a soft surface in case the patient hits or thrashes against the rails. It is a proactive safety measure that can be done in advance of the patient's arrival without the need for immediate assessment or intervention. The other options are not suitable for delegation to the LPN/LVN in this situation. Completing the admission assessment (option A) requires thorough assessment skills and critical thinking abilities typically performed by the RN. Setting up oxygen and suction equipment (option B) involves ensuring proper functioning and appropriate settings, which are tasks best handled by a more experienced nurse. Placing a padded tongue blade at the bedside (option C) is not recommended as tongue blades are generally contraindicated during a seizure due to the risk of injury. This task also involves a level of judgment and decision-making that falls within the RN's scope of practice. By understanding the rationale behind delegating tasks based on scope of practice and patient safety, nursing students can develop the necessary skills to prioritize and assign responsibilities effectively in various clinical scenarios involving patients with neurological conditions like seizure disorders.

Correct Answer: C

Rationale: The correct answer is C) Alteplase dissolves clots and may cause more bleeding into your wife's brain. In the context of an acute hemorrhagic stroke, where bleeding in the brain has already occurred, administering a clot-busting medication like alteplase can exacerbate the bleeding, leading to further damage and complications. It is crucial to differentiate between ischemic strokes (where a clot blocks blood flow) and hemorrhagic strokes (where a blood vessel ruptures), as the management approaches are different. Option A is incorrect because it does not address the specific risk of using alteplase in a hemorrhagic stroke. Option B is incorrect as alteplase is not primarily used for acute heart attacks but for ischemic strokes. Option D is incorrect as a history of gallbladder surgery is not a contraindication for alteplase use in stroke management. Educationally, understanding the rationale behind the use or avoidance of specific treatments in different types of strokes is vital for nursing practice, especially in emergency situations like acute strokes. It highlights the importance of accurate assessment, diagnosis, and treatment selection based on the underlying pathology to optimize patient outcomes and prevent harm.

Correct Answer: A

Rationale: The correct answer is A) lie down in a safe place. When a person experiences an aura before a seizure, it serves as a warning sign that a seizure is imminent. Instructing the person to lie down in a safe place helps prevent injury during the seizure. Option B) take additional anticonvulsant medication is incorrect because taking medication during a seizure is not safe or effective. Anticonvulsant medications are prescribed to prevent seizures, not to be taken as needed during a seizure. Option C) call an ambulance is not necessary for every seizure, especially if the person is aware of their seizure pattern and can manage it safely. Option D) exercise vigorously is unsafe during a seizure and can increase the risk of injury. It is important to promote a safe environment and positioning during a seizure to prevent harm. In an educational context, it is crucial for nurses to understand seizure management to provide safe and effective care to patients. Teaching individuals with epilepsy about seizure precautions and appropriate responses helps empower them to manage their condition effectively. Nurses play a key role in educating patients and caregivers on seizure first aid, including the importance of lying down in a safe place during an aura to prevent injury.

Correct Answer: A

Rationale: The correct answer is A) Atropine sulfate. In the context of an edrophonium (Tensilon) test, which is used to diagnose myasthenia gravis, atropine sulfate must be available as an antidote. Edrophonium is a cholinesterase inhibitor that temporarily increases acetylcholine levels at the neuromuscular junction, potentially causing cholinergic crisis characterized by excessive muscarinic stimulation. Atropine sulfate, an anticholinergic agent, is used to counteract the muscarinic effects by blocking the action of acetylcholine at muscarinic receptors, effectively reversing the cholinergic crisis symptoms. The other options are incorrect because: - B) Diazepam (Valium) is a benzodiazepine used for its anxiolytic and anticonvulsant properties, not for reversing cholinergic crisis. - C) Ephedrine is a sympathomimetic amine that acts on adrenergic receptors, not muscarinic receptors like atropine sulfate. - D) Corticosteroids are anti-inflammatory agents that are not indicated for acute cholinergic crisis management. Understanding the appropriate antidotes and interventions for potential complications during diagnostic tests is crucial for nursing practice. Knowing the specific antidote needed for cholinergic crisis in the context of an edrophonium test is essential to ensure prompt and effective management of adverse reactions, thereby improving patient safety and outcomes.