A patient with paraplegia has developed an irritable bladder with reflex emptying. What will be most helpful for the nurse to teach the patient?

Correct Answer: C

Rationale: In this scenario, the most helpful teaching for a patient with paraplegia and an irritable bladder with reflex emptying is option C: To empty the bladder with manual pelvic pressure in coordination with reflex voiding patterns. This technique, known as Crede maneuver, involves applying manual pressure on the lower abdomen to assist in bladder emptying by utilizing the existing reflex voiding mechanism. Option A (Hygiene care for an indwelling urinary catheter) is incorrect because using a catheter is not the ideal long-term solution for a patient with reflex emptying bladder due to the risk of infections and complications associated with catheterization. Option B (How to perform intermittent self-catheterization) is also not the best choice as in this case, the patient is experiencing reflex emptying, and self-catheterization may not address the specific issue of irritable bladder with reflex emptying effectively. Option D (That a urinary diversion, such as an ileal conduit, is the easiest way to handle urinary elimination) is not appropriate for this patient because urinary diversions are usually considered when other interventions have failed, and they are more invasive procedures that are not typically the first line of management for reflex emptying bladder. From an educational perspective, teaching the patient how to coordinate manual pelvic pressure with reflex voiding patterns empowers the patient to actively participate in managing their bladder function effectively, promoting independence, and potentially reducing the need for invasive interventions. This approach aligns with patient-centered care and encourages patient engagement in self-care management.

Correct Answer: C

Rationale: In this scenario, option C is correct because bursitis is the inflammation of the synovial membrane sac at friction sites, which are small, fluid-filled sacs that reduce friction between bones, tendons, and muscles near joints. When these sacs become inflamed, it causes pain, swelling, and tenderness in the affected area. This is a common condition among athletes due to repetitive movements or overuse of a joint. Option A, tearing of a ligament, is incorrect because bursitis does not involve damage to ligaments. Option B, stretching of muscle and fascia sheath, is incorrect as bursitis primarily affects the synovial membrane sac, not muscles or fascia. Option D, incomplete separation of articular surfaces of joint caused by ligament injury, is also incorrect as it describes a different condition involving joint surfaces, not bursitis. Understanding the pathophysiology of bursitis is crucial for nurses to accurately assess, diagnose, and provide appropriate care for patients presenting with this condition. By knowing the specific tissue involved and the typical symptoms associated with bursitis, nurses can effectively educate patients on self-care strategies, management of symptoms, and prevention of further injuries.

Correct Answer: C

Rationale: The correct answer is C) Encouraging the patient and family members to seek assistance from family therapy or stroke support groups. This option is the most appropriate because coping with the long-term effects of a stroke involves not only the physical aspects but also the emotional and psychological impact on both the patient and the family. Support groups and therapy can provide a safe space for sharing experiences, learning coping strategies, and receiving emotional support from others facing similar challenges. Option A is incorrect because simply informing family members about the patient's need for assistance with ADLs does not address the emotional and psychological aspects of coping. Option B is incorrect because improvement after a stroke varies for each individual, and it is not guaranteed that the patient's prestroke behavior will fully return. Option D is also incorrect as understanding the significance of residual stroke damage is important, but it may not address the emotional support and coping strategies that support groups and therapy can provide. In an educational context, it is crucial for nurses to understand the holistic approach to caring for stroke patients and their families. Providing emotional support, facilitating access to resources like support groups, and promoting coping mechanisms are essential components of nursing care in the context of stroke rehabilitation. Educating nurses on the importance of addressing the emotional and psychological aspects of stroke recovery can lead to better outcomes for patients and their families.

Correct Answer: C

Rationale: The correct answer is C) Promote the use of assistive devices so the patient can participate in self-care activities. This option is the most appropriate because it focuses on promoting the patient's independence and autonomy, which are crucial for their physical and psychological well-being. By using assistive devices, the patient can engage in self-care tasks, maintain a sense of control, and preserve their dignity. Option A is incorrect because while educating family members is important, the priority should be on empowering the patient themselves. Option B is incorrect as while social interactions are important, the patient's ability to engage in self-care activities takes precedence in this scenario. Option D is incorrect as it promotes dependency rather than independence, which can lead to a decline in the patient's overall functioning and quality of life. In an educational context, it is vital for nurses to prioritize patient-centered care that promotes independence and self-care abilities. By encouraging the use of assistive devices, nurses can support patients in maintaining their functional abilities and enhancing their quality of life. Empowering patients to engage in self-care tasks also fosters a sense of dignity and self-worth, contributing to their overall well-being.

Correct Answer: C

Rationale: The correct answer is C) Recently developed symptoms of hypothyroidism. In a patient with dementia, if the condition is potentially reversible, it suggests that an underlying and treatable cause may be contributing to the cognitive impairment. Hypothyroidism can present with symptoms that mimic dementia, such as memory problems, confusion, and difficulty concentrating. Once hypothyroidism is identified and treated with thyroid hormone replacement therapy, cognitive function can improve significantly, leading to a reversal of dementia-like symptoms. Option A) Has long-standing abuse of alcohol is incorrect because while chronic alcohol abuse can lead to cognitive impairment and conditions like Wernicke-Korsakoff syndrome, it is not typically reversible to the extent that the dementia-like symptoms would completely resolve. Option B) Has a history of Parkinson's disease is incorrect because Parkinson's disease is a progressive neurodegenerative disorder that can lead to cognitive decline over time. While some symptoms of Parkinson's disease can be managed with treatment, the dementia associated with it is not considered reversible. Option D) Was infected with human immunodeficiency virus (HIV) 10 years ago is incorrect because although HIV can lead to neurocognitive disorders, once the virus has caused damage to the brain, the resulting cognitive impairment is usually not reversible even with antiretroviral therapy. Educationally, this question highlights the importance of thorough assessment in patients presenting with dementia-like symptoms. It emphasizes the need to consider and investigate potentially reversible causes of cognitive impairment to provide appropriate and timely treatment to improve patient outcomes. It also reinforces the significance of understanding the pathophysiology of different conditions that can manifest with similar clinical presentations in order to make accurate diagnostic and treatment decisions.