For a patient with a stroke and right-sided hemiplegia, what should the nurse teach the family?

Correct Answer: B

Rationale: The correct answer is B) Provide directions to the patient verbally in small steps. In the context of a patient with a stroke and right-sided hemiplegia, it is crucial for the nurse to teach the family to provide directions verbally in small steps for the patient. Patients with hemiplegia often experience difficulty with cognitive processing, attention, and memory. Breaking down instructions into manageable steps can help the patient better comprehend and follow through with tasks. This approach promotes independence and encourages the patient to engage in activities to aid in their recovery. Option A) Ignore undesirable behaviors is incorrect as it does not address the patient's needs and may lead to frustration and feelings of neglect. Option C) Distract the patient from inappropriate emotional responses does not address the need for structured guidance in activities of daily living and rehabilitation. Option D) Supervise all activities before allowing the patient to pursue them independently is overly restrictive and does not promote the patient's autonomy and self-efficacy in relearning skills post-stroke. In an educational context, teaching families how to effectively communicate and support patients with neurological deficits is essential for optimizing their rehabilitation outcomes and quality of life. Encouraging families to use clear, concise instructions can enhance the patient's understanding and participation in their care, fostering a supportive environment for the patient's recovery.

Correct Answer: B

Rationale: Mitoxantrone (Novantrone) is a chemotherapeutic agent used in the treatment of multiple sclerosis (MS). The correct answer, B, states that a disadvantage of Mitoxantrone compared to other MS drugs is its lifetime dose limit due to cardiac toxicity. This is a crucial factor to consider as cardiac toxicity can lead to serious complications, limiting the long-term use of the medication. Option A, administering subcutaneously every day, is incorrect as Mitoxantrone is typically given intravenously every 3 months, not subcutaneously daily. Option C, being an anticholinergic causing urinary incontinence, is incorrect as Mitoxantrone is not an anticholinergic agent. Option D, being an immunosuppressant agent increasing infection risk, is incorrect as Mitoxantrone's mechanism of action is not primarily immunosuppressive. Educationally, understanding the unique characteristics of each medication used in MS treatment is crucial for safe and effective patient care. Knowledge of the specific advantages and disadvantages of Mitoxantrone compared to other MS drugs helps healthcare providers make informed decisions and provide comprehensive patient education regarding treatment options.

Correct Answer: D

Rationale: The correct answer to the question "Which statement accurately describes dementia?" is option D) Vascular dementia can be diagnosed by brain lesions identified with neuroimaging. The rationale for why option D is correct is that vascular dementia is a type of dementia caused by reduced blood flow to the brain, leading to brain damage that can be visualized on neuroimaging studies such as MRI or CT scans. This imaging evidence plays a crucial role in diagnosing vascular dementia, distinguishing it from other types of dementia, and guiding treatment decisions. Option A is incorrect because while the accumulation of β-amyloid protein is a characteristic feature of Alzheimer's disease, it is not the cause of all dementias. Dementia can result from various underlying conditions, each with its own unique pathophysiology. Option B is incorrect because dementia resulting from neurodegenerative causes, such as Alzheimer's disease, Parkinson's disease, or Huntington's disease, cannot be prevented as these conditions are currently incurable and progressive in nature. Option C is incorrect because dementia caused by hepatic or renal encephalopathy can potentially be reversed or improved with appropriate treatment of the underlying liver or kidney dysfunction. Unlike neurodegenerative dementias, these types of dementia may be reversible if the root cause is addressed in a timely manner. In an educational context, understanding the different types of dementia and their diagnostic criteria is crucial for healthcare professionals, caregivers, and individuals affected by dementia. Recognizing the role of neuroimaging in diagnosing vascular dementia highlights the importance of interdisciplinary collaboration and evidence-based practice in managing cognitive impairments.

Correct Answer: C

Rationale: The correct answer is C) It can help to document the degree of cognitive impairment in delirium and dementia. Rationale: The Mini-Mental State Examination (MMSE) is a widely used tool to assess cognitive function in patients with cognitive impairment. It specifically evaluates various domains such as orientation, memory, attention, and language skills. In the context of delirium and dementia, the MMSE is valuable in documenting the baseline cognitive function and tracking changes over time. It provides a quantitative measure of cognitive impairment, aiding in the diagnosis and monitoring of conditions affecting cognition. Option A) It is a good tool to determine the etiology of dementia: This is incorrect because while the MMSE can assess cognitive function, it is not designed to pinpoint the specific cause or etiology of dementia. A comprehensive diagnostic workup is needed for determining the underlying causes of cognitive decline. Option B) It is a good tool to evaluate mood and thought processes: This is incorrect as the MMSE primarily focuses on cognitive function assessment and may not comprehensively evaluate mood or thought processes. Other tools or assessments would be more appropriate for evaluating mood disorders or thought processes. Option D) It is useful for the initial evaluation of mental status, but additional tools are needed to evaluate changes in cognition over time: While the MMSE is useful for initial screening and assessing cognitive status, it is also suitable for tracking changes in cognition over time. Therefore, this option is not the best choice. Educational Context: Understanding the appropriate use of assessment tools like the MMSE is crucial for healthcare professionals working with patients experiencing cognitive impairment. By utilizing the MMSE effectively, nurses and other healthcare providers can accurately document cognitive function, monitor changes, and contribute to the overall management and care planning for patients with delirium and dementia.

Correct Answer: D

Rationale: In the management of an acute soft tissue injury of the ankle within the first 48 hours, it is crucial to follow evidence-based practices to promote optimal healing and recovery. The correct answer, D) Alternating the use of heat and cold, is incorrect because applying heat in the initial phase of injury can exacerbate inflammation and increase bleeding, delaying the healing process. Cold therapy, on the other hand, helps to reduce swelling and pain by constricting blood vessels. A) Using an elastic wrap provides compression and support to the injured area, helping to reduce swelling and stabilize the ankle joint. B) Initial immobilization and rest are key components of the RICE (Rest, Ice, Compression, Elevation) protocol, which is widely recommended for managing acute soft tissue injuries. C) Elevating the ankle above the heart level helps to reduce swelling by promoting venous return and preventing fluid accumulation in the injured area. Educationally, understanding the appropriate management of acute soft tissue injuries is essential for healthcare professionals, athletic trainers, and individuals involved in sports and physical activities. Knowing the correct interventions can prevent further damage, promote faster healing, and improve outcomes for patients. It is vital to stay updated on evidence-based practices to provide the best care for individuals with acute injuries.