Benzodiazepine medication is being used to help manage this patient's behavior?

Correct Answer: C

Rationale: In this case, the correct answer is C) Lorazepam (Ativan). Benzodiazepines like lorazepam are commonly used to manage acute symptoms of anxiety, agitation, or aggression in patients. They work by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain, leading to a calming effect. Benzodiazepines are not typically used to manage behavior in the context of neurological symptoms or disorders, but rather for acute symptom management. Option A) Sertraline (Zoloft) is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat depression, anxiety disorders, and other mental health conditions. It does not have the same immediate calming effects as benzodiazepines. Option B) Donepezil (Aricept) is a medication used to treat symptoms of Alzheimer's disease by improving cognitive function. It is not indicated for managing behavior. Option D) Risperidone (Risperdal) is an antipsychotic medication often used to treat schizophrenia, bipolar disorder, and irritability associated with autism. While it can help manage behavior in certain conditions, it is not a benzodiazepine and does not work in the same way. In an educational context, it is important for healthcare providers to understand the appropriate use of medications based on their mechanisms of action and indications. Understanding the differences between medications like benzodiazepines, SSRIs, acetylcholinesterase inhibitors, and antipsychotics is crucial for making informed treatment decisions and providing optimal care for patients with neurological conditions.

Correct Answer: D

Rationale: In providing discharge instructions for a patient following a hip prosthesis with a posterior approach, option D, "Have a family member put on the patient's shoes and socks," is the correct choice. This is important because after hip surgery, especially with a posterior approach, there are restrictions on bending at the hip to prevent dislocation of the prosthesis. The action of putting on shoes and socks requires bending at the hip, which the patient should avoid. Option A, "Restrict walking for 2 to 3 months," is incorrect as early mobilization is essential for post-operative recovery and to prevent complications like blood clots and muscle weakness. Option B, "Take a bath rather than a shower to prevent falling," is incorrect as both baths and showers are acceptable as long as proper precautions are taken to prevent falling. Option C, "Keep the leg internally rotated while sitting and standing," is incorrect as maintaining the leg in an internally rotated position is not a standard post-operative instruction for a hip prosthesis with a posterior approach. Educationally, understanding the rationale behind post-operative instructions is crucial for nurses to provide safe and effective care to patients. By knowing the reasons behind each instruction, nurses can confidently educate patients and their families, ensuring better outcomes and preventing complications.

Correct Answer: D

Rationale: The correct answer is D) Antibiotics are not effective against microorganisms that cause chronic osteomyelitis. In chronic osteomyelitis, the infection persists due to the formation of biofilms that protect bacteria from antibiotics and the immune system. Surgical debridement is necessary to remove the infected tissue and biofilm, as antibiotics alone cannot penetrate these barriers effectively. Option A is incorrect because while removal of the infection is crucial, it does not necessarily prevent the need for bone and skin grafting, which may be required to repair tissue damage caused by the infection. Option B is incorrect because the formation of scar tissue does not necessarily lead to a protected area of bacterial growth in chronic osteomyelitis. The primary issue lies in the bacterial biofilm that resists antibiotic treatment. Option C is incorrect because the process of depositing new bone does not directly block the vascular supply to the bone in chronic osteomyelitis. The vascular compromise in osteomyelitis is mainly due to inflammation and infection rather than the process of new bone formation. In an educational context, understanding the rationale behind surgical treatment for chronic osteomyelitis is crucial for healthcare professionals to provide effective care to patients. Knowing why antibiotics alone are insufficient and why surgical intervention is necessary helps in making informed clinical decisions and providing thorough patient education.

Correct Answer: C

Rationale: In promoting healthy feet, it is crucial for the nurse to recognize that improperly fitting shoes are associated with most foot problems. The correct answer (C) is based on the fact that wearing shoes that do not fit properly can lead to a wide range of foot issues such as corns, calluses, bunions, blisters, and even more serious conditions like plantar fasciitis or metatarsalgia. Ill-fitting shoes can cause pressure points, alter gait mechanics, and lead to long-term structural problems in the feet. Option A, poor foot hygiene, is not the primary factor associated with most foot problems. While proper hygiene is important to prevent infections, it is not the leading cause of foot issues. Congenital deformities (Option B) are pre-existing conditions that individuals are born with and are not necessarily the most common cause of foot problems in the general population. Peripheral vascular disease (Option D) is a serious condition that affects blood flow to the extremities, including the feet. While it can certainly contribute to foot problems, it is not as prevalent or as directly linked to most foot issues as improperly fitting shoes. Educationally, understanding the impact of shoe fit on foot health is essential for nurses and healthcare professionals when providing patient education on preventive foot care. It highlights the importance of wearing properly fitting shoes, choosing appropriate footwear for different activities, and conducting regular foot assessments to identify potential problems early on. Proper footwear can significantly reduce the risk of foot discomfort, pain, and complications, promoting overall foot health and mobility.

Correct Answer: C

Rationale: The correct answer is C) Drug interactions and toxicity are more likely to occur with multidrug therapy. In older adults with rheumatoid arthritis (RA), they often have multiple comorbidities requiring various medications. As a result, the risk of drug interactions and toxicity increases with the use of multiple drugs for RA management. This is a major concern in the older adult population due to age-related changes in drug metabolism and increased susceptibility to adverse effects. Option A, "RA is usually more severe in older adults," is incorrect because disease severity is not necessarily age-dependent. RA can affect individuals of any age group and the severity varies based on individual factors. Option B, "Older patients are not as likely to comply with treatment regimens," is incorrect as compliance with treatment regimens is influenced by various factors such as patient education, support systems, and understanding of the treatment plan, rather than just age. Option D, "Laboratory and other diagnostic tests are not effective in identifying RA in older adults," is incorrect because although diagnosing RA in older adults can be challenging due to atypical presentations, laboratory and diagnostic tests are still valuable in confirming the diagnosis. In an educational context, understanding the unique challenges and considerations in managing RA in older adults is crucial for healthcare providers. It highlights the importance of medication management, monitoring for drug interactions, and individualizing treatment plans to optimize outcomes while minimizing risks in this vulnerable population.