A patient has blindness related to a functional neurological (conversion) disorder but is unconcerned about this problem. Which understanding should guide the nurse's planning for this patient? The patient is:

Correct Answer: B

Rationale: The correct answer is B because the patient is unconcerned about the blindness, indicating that the symptom is relieving anxiety. This is characteristic of conversion disorder where physical symptoms alleviate psychological distress. Other choices are incorrect because the patient is not necessarily suppressing feelings (A), not meeting needs through hospitalization (C), and not refusing to disclose fears (D).

Correct Answer: B

Rationale: In this scenario, the correct action to take first is option B) Check the Foley tubing for kinks or obstruction. The patient's presentation with a sudden severe headache, along with increased blood pressure, decreased heart rate, diaphoresis, and flushing, indicates autonomic dysreflexia, a medical emergency commonly seen in individuals with spinal cord injuries. Autonomic dysreflexia is characterized by a sudden onset of excessively high blood pressure triggered by a noxious stimulus below the level of injury, such as a blocked urinary catheter (Foley tubing). Checking the Foley tubing for kinks or obstruction is crucial because addressing this issue can help alleviate the noxious stimulus triggering autonomic dysreflexia and prevent further complications such as seizures, stroke, or even death. The other options are not the most appropriate actions to take in this situation: A) Administering acetaminophen may help with the headache but does not address the underlying cause of autonomic dysreflexia. C) Adjusting the room temperature is not a priority when dealing with a medical emergency like autonomic dysreflexia. D) Notifying the physician is important but should come after addressing the immediate issue of the blocked Foley tubing to stabilize the patient's condition. This case underscores the importance of prompt recognition and intervention in managing autonomic dysreflexia in patients with spinal cord injuries, highlighting the critical role of nursing assessment and quick decision-making in ensuring patient safety and well-being.

Correct Answer: A

Rationale: The correct answer is A) The student enters the room without putting on a mask and gown. This action requires immediate intervention because patients with meningococcal meningitis are highly contagious, and strict infection control measures must be followed to prevent the spread of the disease. Failure to use personal protective equipment (PPE) like masks and gowns puts the patient, staff, and visitors at risk of contracting the infection. Option B is incorrect because instructing the family about visitation restrictions is within the scope of caring for a patient with an infectious disease to prevent further spread. Option C is incorrect as providing a warm blanket to a patient feeling cold is a comfort measure that does not pose a risk to the patient or others. Option D is incorrect as checking the patient's pupil response is a standard neurological assessment and does not pose an immediate risk in this scenario. In an educational context, it is crucial to emphasize the importance of following infection control protocols, especially in high-risk settings like the ICU. Students must understand the rationale behind these measures to prioritize patient safety and prevent healthcare-associated infections. Reinforcing the use of PPE and proper isolation techniques is essential for student nurses to provide safe and effective care in such environments.

Correct Answer: A

Rationale: In this case, the correct answer is option A) decreasing level of consciousness. This is an early indication of increasing intracranial pressure (ICP) because as pressure within the skull rises, it can impede blood flow to the brain, leading to altered mental status. This change in consciousness is a crucial sign that requires immediate attention as it indicates potential brain dysfunction. Option B) increasing systolic blood pressure is not typically an early sign of increasing ICP. While the body may try to compensate for the rising pressure by increasing blood pressure, this is not an early indicator and may occur later in the process. Option C) slowing of respirations is more commonly associated with brain stem dysfunction due to severe increases in ICP, rather than being an early sign. It is a late and serious sign of impending herniation. Option D) decreasing pulse rate is not typically an early indicator of increasing ICP. In fact, the pulse rate may be variable or initially increase in response to stress before decreasing in later stages of increased ICP. Educationally, understanding these early signs of increasing ICP is crucial for healthcare professionals, especially those working in neurology, critical care, or emergency settings. Recognizing these signs promptly can lead to timely interventions that can prevent further neurological damage and improve patient outcomes. This knowledge is essential for providing safe and effective care to patients at risk for intracranial hypertension.

Correct Answer: B

Rationale: The correct answer is B) Explaining the need for regular daily activity, rest, and relaxation would be most helpful in assisting Mrs. Brown to live with her multiple sclerosis. This is because maintaining a balance between activity and rest is crucial in managing symptoms and preventing exacerbations in multiple sclerosis. Regular physical activity can help improve strength, coordination, and overall well-being, while adequate rest and relaxation can help manage fatigue and stress, which are common in multiple sclerosis. Option A) Teaching her about specific diet restrictions may be important for overall health but is not the most crucial aspect in managing multiple sclerosis. Diet can play a role in managing symptoms, but it is not the primary focus. Option C) Encouraging regular appointments with a psychotherapist may be beneficial for emotional support and coping strategies, but it is not the most essential aspect in managing the physical symptoms of multiple sclerosis. Option D) Explaining that complete recovery can be expected is incorrect because multiple sclerosis is a chronic condition with unpredictable courses. Managing expectations and focusing on symptom management and quality of life are more realistic approaches in dealing with the disease. In an educational context, it is important to emphasize to students that a holistic approach to managing chronic conditions like multiple sclerosis is crucial. Understanding the importance of physical activity, rest, and stress management can help patients lead a better quality of life despite their diagnosis. Educating patients on self-care strategies empowers them to take an active role in managing their health and well-being.