During the patient's process of grieving for the losses resulting from spinal cord injury, what should the nurse do?

Correct Answer: A

Rationale: In the context of a patient grieving losses due to a spinal cord injury, option A is the correct choice because it acknowledges the complex nature of grief and emphasizes the importance of ongoing support. Grieving over such a significant loss is indeed a lifelong process, and the nurse should help the patient understand this reality. This approach encourages the patient to accept their emotions and seek support when needed, fostering resilience and adaptive coping strategies. Option B is incorrect because the stages of grief are not linear; individuals may move back and forth between stages, and acceptance may not always be the final outcome. Limiting the grieving process to specific stages oversimplifies the complexity of emotions experienced by the patient. Option C is incorrect as it dismisses the patient's valid emotions and can be perceived as invalidating. Anger is a common and natural response to loss and should be acknowledged and supported rather than dismissed. Option D is also incorrect because setting a timeline for the grieving process is unrealistic and can add pressure to the patient, potentially hindering their emotional healing. Educationally, this question highlights the importance of understanding the nuances of grief in healthcare settings. It emphasizes the need for nurses to provide continuous, compassionate support to patients experiencing loss, especially in the context of life-altering injuries like spinal cord injury. By choosing option A, nurses can foster a therapeutic relationship with the patient based on empathy, understanding, and long-term support.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) computed tomography (CT) scan with contrast. A CT scan with contrast is the most appropriate diagnostic test to determine the size and location of a stroke and to differentiate between ischemic and hemorrhagic strokes. A lumbar puncture (option A) is not typically used in the evaluation of strokes but rather in diagnosing conditions such as meningitis. A cerebral arteriogram (option B) is an invasive procedure used to visualize blood vessels in the brain and is not typically the initial diagnostic test for determining stroke type. Magnetic resonance imaging (MRI) (option C) is useful in stroke evaluation but is not typically the first-line imaging modality due to its time-consuming nature and limited availability in emergency settings. In an educational context, understanding the rationale behind choosing the appropriate diagnostic test for stroke evaluation is crucial for healthcare providers. Knowing when to order a CT scan with contrast can lead to timely and accurate diagnosis, which is essential for initiating appropriate treatment and improving patient outcomes in cases of acute stroke.

Correct Answer: D

Rationale: The correct answer to the question, "What is the most important method of diagnosing functional headaches?" is option D) Thorough history of the headache. This is the correct choice because functional headaches are primarily diagnosed through a comprehensive assessment of the patient's symptoms, triggers, patterns, and associated factors. Choosing option A) CT scan is incorrect because functional headaches are not typically associated with structural abnormalities that would be detected by a CT scan. Option B) Electromyography (EMG) is also not the most important method for diagnosing functional headaches as EMG is primarily used to assess muscle activity, which is not directly related to functional headaches. Option C) Cerebral blood flow studies are not the most essential diagnostic method for functional headaches as these headaches are not primarily due to vascular issues. In an educational context, understanding the importance of taking a thorough history when diagnosing functional headaches is crucial for healthcare providers. It allows for a comprehensive evaluation of the patient's symptoms, triggers, and overall health status, which can lead to a more accurate diagnosis and appropriate treatment plan. Teaching students the significance of patient history in diagnosing various conditions helps them develop strong clinical reasoning skills and enhances their ability to provide quality patient care.

Correct Answer: A

Rationale: Rigidity is a characteristic feature of Parkinson's disease, a neurological disorder that affects movement. The correct answer, option A) shuffling gait, is a consequence related to rigidity. Rigidity in Parkinson's disease causes stiffness in the muscles, leading to a shuffling gait where the steps become shorter and the feet may drag on the ground due to difficulty in initiating movement. Option B) impaired handwriting is more commonly associated with bradykinesia, which is another hallmark symptom of Parkinson's disease characterized by slowness of movement rather than rigidity. Option C) lack of postural stability is more closely related to problems with balance and coordination, which are more commonly associated with conditions like cerebellar disorders rather than rigidity. Option D) muscle soreness and pain may occur as a result of prolonged muscle stiffness due to rigidity, but it is not a direct consequence of rigidity itself. In an educational context, understanding the specific manifestations of rigidity in neurological disorders like Parkinson's disease is crucial for healthcare professionals in diagnosing and managing patients effectively. Differentiating between symptoms like rigidity, bradykinesia, and postural instability is essential for providing targeted interventions and improving quality of life for individuals with neurological conditions.

Correct Answer: B

Rationale: The correct answer to the question, "A diagnosis of AD is usually made when what happens?" is B) All other possible causes of dementia have been eliminated. This is because Alzheimer's disease (AD) is a diagnosis of exclusion, meaning that it can only be definitively diagnosed after other potential causes of dementia, such as vascular dementia or frontotemporal dementia, have been ruled out through a comprehensive evaluation that may include medical history, physical examination, cognitive testing, blood tests, and imaging studies. Option A) A urine test indicating elevated levels of isoprostanes is incorrect because there is no definitive urine test for diagnosing AD. Option C) Blood analysis revealing increased amounts of β-amyloid protein is a potential biomarker for AD, but it is not the sole criteria for diagnosis as these proteins can also be elevated in other conditions. Option D) A CT scan showing brain atrophy is a common finding in AD, but it is not specific to AD and can be seen in other types of dementia as well. In an educational context, understanding the diagnostic process for AD is crucial for healthcare professionals working with older adults or individuals with cognitive impairments. Knowing that AD is a diagnosis of exclusion emphasizes the importance of a thorough assessment to ensure an accurate diagnosis and appropriate management of the condition. Educating healthcare providers about the complexities of diagnosing AD can lead to better patient outcomes and quality of care.