A patient with Guillain-Barré syndrome asks whether he is going to die as the paralysis spreads toward his chest. In responding to the patient, what should the nurse know to be able to answer this question?

Correct Answer: C

Rationale: The correct answer is C) Most patients with Guillain-Barré syndrome make a complete recovery. This response is accurate because Guillain-Barré syndrome is a disorder where the body's immune system attacks the nervous system, leading to muscle weakness and paralysis. However, with proper treatment and care, most individuals with this syndrome do recover fully over time. Option A is incorrect because patients who require ventilatory support do not almost always die from Guillain-Barré syndrome. Ventilatory support is often needed during the acute phase of the illness to assist with breathing but does not necessarily indicate a poor prognosis. Option B is incorrect as death in Guillain-Barré syndrome is not primarily due to nerve damage affecting the brain and meninges; it is more related to complications from severe muscle weakness and respiratory failure. Option D is incorrect because death prevention is not solely related to the permanence of residual paralysis and sensory impairment. Recovery outcomes vary among individuals with Guillain-Barré syndrome and are not solely determined by the presence of residual symptoms. Educationally, understanding the potential outcomes and prognosis of Guillain-Barré syndrome is crucial for healthcare providers to provide accurate and supportive information to patients and their families. It is essential to emphasize that while the condition can be serious, many individuals do recover fully with appropriate medical management and support. It is important to offer reassurance and hope to patients facing this challenging diagnosis.

Correct Answer: D

Rationale: The correct answer is D) Fibrous connective tissue covering bone. The periosteum is a thin, dense membrane that covers the outer surface of bones. It is rich in blood vessels and nerve endings, playing a crucial role in bone growth, repair, and nutrition. Option A) Lining of a joint capsule is incorrect because the periosteum is not associated with joint capsules. Option B) A characteristic of skeletal muscle is incorrect as the periosteum is specific to bones, not muscle tissue. Option C) Most common type of cartilage tissue is incorrect as the periosteum is not cartilage tissue at all. Educationally, understanding the structure and function of the periosteum is essential in the study of the skeletal system. Knowing its role in bone health, repair, and sensitivity to injury helps students grasp the importance of this structure in maintaining overall skeletal integrity. This knowledge is foundational for healthcare professionals in fields such as anatomy, physical therapy, and orthopedics.

Correct Answer: C

Rationale: The most common diagnostic test used to assess musculoskeletal disorders is a standard x-ray (Option C). This is the correct answer because x-rays are readily available, cost-effective, and provide detailed images of bones and some soft tissues, making them ideal for initial evaluation of musculoskeletal conditions like fractures, arthritis, or dislocations. X-rays can reveal abnormalities in bone structure and density, joint alignment, and can help identify potential issues. Option A, Myelogram, is primarily used to evaluate spinal cord or nerve root compression, not musculoskeletal disorders. Option B, Arthroscopy, is a minimally invasive procedure where a camera is inserted into a joint to visualize and treat issues like torn cartilage or inflammation, not a diagnostic test. Option D, Magnetic Resonance Imaging (MRI), is useful for soft tissue evaluation and can provide more detailed images, but it is not as commonly used as standard x-rays due to higher cost and limited availability. In an educational context, understanding the appropriate use of diagnostic tests is crucial for healthcare providers to make accurate diagnoses and treatment decisions. Teaching students the indications, limitations, and benefits of various diagnostic tests helps develop their clinical reasoning skills and enhances their ability to provide quality patient care.

Correct Answer: A

Rationale: The correct answer is A) The use of a footboard to prevent plantar flexion. This intervention is indicated for a patient with hemiplegia to prevent foot drop, a common issue due to weakness of dorsiflexion muscles. Using a footboard helps maintain the foot in a neutral position, preventing contractures and promoting proper alignment of the ankle joint. Option B) Immobilization of the affected arm against the chest with a sling is incorrect because it does not address the specific issue of hemiplegia, which involves paralysis of one side of the body, usually the arm and leg. Immobilization could lead to further complications like joint stiffness and muscle atrophy. Option C) Positioning the patient in bed with each joint lower than the joint proximal to it is incorrect for a patient with hemiplegia. This position could potentially increase the risk of contractures and pressure injuries due to poor circulation and prolonged pressure on bony prominences. Option D) Having the patient perform passive ROM of the affected limb with the unaffected limb is incorrect because passive ROM exercises do not actively engage the weakened muscles on the affected side, which are essential for preventing muscle atrophy and maintaining function. Educationally, understanding the rationale behind each option helps to reinforce the importance of evidence-based nursing interventions tailored to specific patient conditions like hemiplegia. Implementing the correct interventions can improve patient outcomes and prevent complications associated with immobility.

Correct Answer: C

Rationale: The correct answer is C) Typical absence. In the context of pediatric neurology, typical absence seizures, also known as petit mal seizures, are characterized by brief episodes of staring or unresponsiveness lasting a few seconds. These seizures are common in children and often go unnoticed or are mistaken for daydreaming due to their subtle nature. A) Atonic seizures involve a sudden loss of muscle tone and are not characterized by the staring spell seen in absence seizures. B) Simple focal seizures typically involve abnormal electrical activity in one specific area of the brain, resulting in localized symptoms such as twitching or sensory changes. They do not present with the hallmark staring spell of absence seizures. D) Atypical absence seizures are similar to typical absence seizures but last longer and may be associated with other features like eye blinking or slight jerking movements. They are not the same as the brief staring spells seen in typical absence seizures. Understanding the different types of seizures is crucial for healthcare professionals working with children, as accurate identification and management of seizures can significantly impact a child's quality of life. Recognizing the specific features of absence seizures, like the staring spell described in this question, helps in making an accurate diagnosis and providing appropriate care and support to affected children and their families.