A patient who fears serious heart disease was referred to the mental health center by a cardiologist after diagnostic evaluation showed no physical illness. The patient says, My heart misses beats. I'm frequently absent from work. I don't go out much because I need to rest. Which health problem is most likely?

Correct Answer: C

Rationale: Rationale: The correct answer is C: Illness anxiety disorder (hypochondriasis). This is because the patient's persistent fear of having a serious illness despite medical reassurance aligns with the key feature of excessive health-related anxiety. The patient's focus on physical symptoms and avoidance behaviors also indicate a somatic symptom-related disorder. Incorrect choices: A: Body dysmorphic disorder - This disorder involves preoccupation with perceived defects in physical appearance, not fear of having a serious illness. B: Antisocial personality disorder - This disorder is characterized by a disregard for others' rights and feelings, not health-related anxiety. D: Persistent depressive disorder (dysthymia) - While depression can present with physical symptoms, the patient's primary concern is health-related anxiety rather than low mood.

Correct Answer: B

Rationale: In this scenario, the correct answer is option B: Assess the patient's neurologic status for changes. This task requires a higher level of assessment skill and critical thinking, which is typically within the scope of practice of a registered nurse rather than an LPN/LVN. The LPN/LVN can assist with tasks that are more routine and do not require advanced assessment skills. Option A, checking the patient's skin for pressure from the device, is a task that can be safely delegated to the LPN/LVN as it involves basic assessment and monitoring of skin integrity. Option C, observing the halo insertion sites for signs of infection, requires a higher level of assessment to differentiate between normal healing and signs of infection. This task is more appropriate for a registered nurse. Option D, cleaning the halo insertion sites with hydrogen peroxide, involves a specific procedure that may require specialized training or knowledge. It is best performed by a healthcare provider with the appropriate skill set, such as a registered nurse. In an educational context, it is important to understand the principles of delegation in nursing practice. Delegation is a critical skill that ensures safe and efficient patient care delivery. Understanding the scope of practice for different healthcare team members helps in assigning tasks appropriately to optimize patient outcomes and utilize the skills of each team member effectively.

Correct Answer: C

Rationale: In this scenario, option C, "Remind the patient to allow adequate time for meals," is the appropriate task to delegate to a nursing assistant (NA). Delegating this task to the NA is suitable as it involves providing reminders and assistance with activities of daily living, which falls within the NA's scope of practice and does not require specialized nursing knowledge or skills. Options A, B, and D involve more complex nursing assessments and interventions that require a higher level of nursing knowledge and skill. Checking for orthostatic changes in pulse and blood pressure, monitoring tremor improvement after medication, and observing for abnormal involuntary movements are tasks that require critical thinking, clinical judgment, and the ability to make appropriate decisions based on the assessment findings. These tasks are best performed by a registered nurse who has the necessary training and expertise to interpret and respond to the assessment data effectively. From an educational perspective, understanding the principles of delegation is crucial for nursing students and practicing nurses. It is essential to recognize the scope of practice for different members of the healthcare team and delegate tasks appropriately based on individual competencies and responsibilities. By delegating tasks effectively, nurses can optimize patient care outcomes, promote teamwork, and ensure safe and efficient delivery of care.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) large output of low specific gravity urine. The pituitary gland plays a crucial role in regulating the body's water balance through the secretion of antidiuretic hormone (ADH). When the pituitary gland is injured, it may affect the production or release of ADH, leading to decreased reabsorption of water in the kidneys and subsequently causing a large output of diluted urine with low specific gravity. Option B) watery nasal discharge positive for glucose is incorrect because this symptom is more indicative of conditions affecting the nasal passages or sinuses, such as a nasal infection or diabetes insipidus. Option C) pupils failing to react to light is incorrect because it is more suggestive of a neurological issue involving the optic nerve or brain, rather than a pituitary gland injury. Option D) positive Babinski reflex is incorrect as it is a response seen in neurological conditions affecting the corticospinal tract, not related to pituitary gland function. Educationally, understanding the signs and symptoms of pituitary gland dysfunction is essential for nurses and healthcare professionals, especially when assessing patients with suspected endocrine disorders. This knowledge helps in early identification, appropriate referral, and management of pituitary gland-related conditions, contributing to better patient outcomes and care.

Correct Answer: D

Rationale: In the context of Mr. Jay receiving levodopa (L-dopa) for Parkinson's disease, the correct answer is D) Rapid reduction of rigidity. Levodopa is a medication commonly used to manage the symptoms of Parkinson's disease, including rigidity, tremors, and bradykinesia. When the medication is taken properly, it should lead to a rapid reduction in rigidity, indicating that it is effectively addressing the symptoms of the disease. Option A) Anorexia, nausea, and vomiting are common side effects of levodopa and do not indicate proper medication administration. Option B) Transient hypertension is not a typical response to levodopa and would not be expected as an indication of proper medication use. Option C) Constipation is not a direct effect of levodopa and does not reflect the expected outcome of taking the medication properly in the context of treating Parkinson's disease. Educationally, understanding the expected outcomes and side effects of medications used in neurological conditions like Parkinson's disease is crucial for healthcare providers to ensure safe and effective patient care. Recognizing the appropriate responses to medications helps in monitoring patient progress and adjusting treatment plans as needed to optimize outcomes.