A patient with a lack of oxygen to his heart will have pain in his chest and possibly in the shoulder, arms, or jaw. The nurse knows that the best explanation why this occurs is which one of these statements?

Correct Answer: C

Rationale: The correct answer is C because the sensory cortex does not have the ability to localize pain in the heart, leading to referred pain in other areas like the shoulder, arms, or jaw. This phenomenon is known as referred pain, where the brain misinterprets the source of pain. Choices A, B, and D are incorrect because the issue lies with the brain's interpretation of the pain location, not with sensory cortex discrimination, decreased oxygen supply to the affected areas, or lesions in the dorsal root. Therefore, C is the best explanation for why the patient experiences pain in the chest, shoulder, arms, or jaw when there is a lack of oxygen to the heart.

Correct Answer: B

Rationale: The correct answer is B: Risk for suicide. This is the priority nursing diagnosis as patients with body dysmorphic disorder have an increased risk of suicidal ideation and behaviors. Addressing this risk is crucial for patient safety. A: Anxiety is a common symptom of body dysmorphic disorder but may not be the priority if the patient is at risk for suicide. C: Disturbed body image is a characteristic of body dysmorphic disorder, but addressing the risk of suicide takes precedence. D: Ineffective role performance may be a concern, but it is not as urgent as addressing the risk for suicide in this case.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) The NA performs the patient's complete bath and oral care. This is the action that requires intervention because it involves providing personal hygiene care, which is outside the scope of practice for a nursing assistant. Option A is correct as the NA assisting the patient to ambulate aligns with promoting physical mobility. Option B is incorrect as reminding the patient not to look at his feet is a helpful cue for individuals with Parkinson's disease to improve their gait. Option D is also acceptable as it encourages the patient's independence in feeding, which is important for maintaining physical function. Educationally, it is crucial to emphasize the scope of practice for nursing assistants and the importance of adhering to professional boundaries. Providing clear guidelines on what tasks they can and cannot perform ensures patient safety and quality care delivery. Additionally, understanding the specific needs of patients with Parkinson's disease is essential for tailoring care interventions to promote their functional independence and well-being.

Correct Answer: A

Rationale: In this scenario, option A, which instructs the nursing assistant to position the patient sitting up in bed before feeding her, is the correct answer. This is because positioning the patient in an upright position helps prevent aspiration, a common risk for stroke patients with swallowing difficulties. By sitting the patient up, gravity assists in the safe passage of food down the esophagus. Option B, checking the patient's gag and swallowing reflexes, is important but should have been done by the healthcare provider or nurse before the feeding task. Nursing assistants should not independently assess these reflexes. Option C is incorrect as it promotes rushing through the feeding process, which can increase the risk of aspiration and compromise the patient's safety and dignity. Option D is also incorrect because suctioning between bites of food is not a standard practice and should only be done if there is a specific medical indication for it. Educationally, this question highlights the importance of proper positioning during feeding for stroke patients to prevent complications like aspiration pneumonia. It emphasizes the role of nursing assistants in following established protocols for patient safety and the importance of understanding the rationale behind each task in patient care.

Correct Answer: A

Rationale: In the management of epilepsy, the primary factor in determining the choice of anticonvulsant medication is seizure classification (Option A). Seizure classification is crucial as different types of seizures respond better to specific anticonvulsants. For example, absence seizures are typically treated with different medications than focal seizures. The other options are not the primary factor in choosing an anticonvulsant medication. The size of the dosage (Option B) is important for determining the therapeutic range and ensuring efficacy but is not the primary factor in initial selection. The age of the patient (Option C) is a consideration due to potential side effects and dosing adjustments, but it is not the primary factor in choosing the medication. Side effects produced (Option D) are important to monitor and manage, but they are not the primary factor in the initial selection of the anticonvulsant. In an educational context, understanding the rationale behind choosing anticonvulsant medications based on seizure classification is essential for healthcare professionals involved in the care of patients with epilepsy. It ensures that the most appropriate treatment is selected, leading to better seizure control and improved quality of life for patients. Educating healthcare providers on this principle enhances their clinical decision-making skills and ultimately improves patient outcomes.