Priority Decision: When planning care for the patient with trigeminal neuralgia, which patient outcome should the nurse set as the highest priority?

Correct Answer: A

Rationale: In caring for a patient with trigeminal neuralgia, the highest priority outcome the nurse should set is option A) Relief of pain. Trigeminal neuralgia is characterized by severe facial pain, often described as sharp, shooting, or electric shock-like, which can be debilitating for the patient. Providing relief from this intense pain is crucial to improving the patient's quality of life and promoting their overall well-being. Option B) Protection of the cornea is important as trigeminal neuralgia can cause intense facial pain that may lead to eye complications due to decreased blinking reflex. However, this outcome is secondary to pain relief as the primary focus should be on addressing the underlying cause of the pain first. Option C) Maintenance of nutrition is essential for overall health but may not be the highest priority in this case. While pain can impact a patient's ability to eat, addressing the pain to improve their comfort level and ability to function is more critical in the immediate term. Option D) Maintenance of positive body image is important for the patient's emotional well-being but is not as urgent as addressing the severe pain associated with trigeminal neuralgia. Educationally, this question highlights the importance of prioritizing patient care based on immediate needs and potential complications. Understanding the hierarchy of patient outcomes allows nurses to provide effective and efficient care, ensuring the best possible outcomes for their patients.

Correct Answer: B

Rationale: In this scenario, option B is the correct answer. Metastatic tumors of the spinal cord are commonly extradural lesions, meaning they are located outside the spinal cord and are typically treated palliatively. This is because complete removal of these tumors may not be possible due to their location and the potential risks involved in trying to remove them entirely. Option A is incorrect because most cord tumors do not cause autodestruction of the cord as in traumatic injuries. Option C is incorrect because radiation therapy is not routinely administered following surgery for all malignant spinal cord tumors; the decision to use radiation therapy would depend on the specific case and treatment plan. Option D is incorrect because while surgery for intramedullary tumors may be considered palliative in some cases, it is not always the case for all spinal cord tumors. Educationally, understanding the nature of spinal cord tumors and their treatment options is crucial for nurses caring for patients undergoing surgeries like laminectomies. It is important for nurses to recognize the differences in treatment approaches for various types of spinal cord tumors to provide optimal postoperative care and support for their patients.

Correct Answer: C

Rationale: In this question, the correct answer is C) Shortening of a muscle or ligament. A contracture refers to a condition where there is a permanent shortening of a muscle or joint, leading to limited movement in that area. This is commonly seen in patients with neurological conditions or prolonged immobility. Option A) A fluid-filled cyst is incorrect because a contracture does not involve a cyst but rather a structural change in the muscle or ligament. Option B) Generalized muscle pain is incorrect as it does not accurately describe a contracture, which is specifically related to the shortening of a muscle or ligament. Option D) Grating sensation between bones with movement is incorrect as it describes a symptom commonly associated with conditions like osteoarthritis, not a contracture. In an educational context, understanding the term "contracture" is crucial for nurses assessing patients with neurological conditions, musculoskeletal issues, or those at risk for immobility-related complications. Recognizing a contracture allows nurses to implement appropriate interventions to prevent further limitations in movement and promote optimal patient outcomes.

Correct Answer: C

Rationale: In the context of neurological system assessment and stroke prevention, the correct answer to the question is option C) Daily low-dose aspirin. This is because aspirin, specifically in low doses, is a well-established medication for reducing the risk of ischemic stroke in patients with TIAs (transient ischemic attacks) and other risk factors. Aspirin works by inhibiting platelet aggregation, thereby reducing the formation of blood clots that can lead to blockages in the blood vessels supplying the brain, causing an ischemic stroke. Option A) Furosemide (Lasix) is a diuretic often used to manage fluid retention but does not play a role in stroke prevention. Option B) Lovastatin (Mevacor) is a statin medication used to lower cholesterol levels and prevent cardiovascular events but is not specifically indicated for stroke prevention. Option D) Nimodipine (Nimotop) is a calcium channel blocker that is used in certain situations related to subarachnoid hemorrhage but is not the recommended medication for reducing the risk of ischemic stroke in patients with TIAs. In an educational context, understanding the appropriate medications for stroke prevention is crucial for healthcare professionals involved in assessing and managing patients at risk for cerebrovascular events. By knowing the rationale behind the use of daily low-dose aspirin in this population, healthcare providers can make informed decisions to optimize patient care and reduce the incidence of ischemic strokes. It is essential to reinforce the importance of evidence-based practice and staying updated on current guidelines to deliver high-quality care to patients at risk for stroke.

Correct Answer: D

Rationale: The correct answer is D) Specific serotonin receptor agonists such as sumatriptan (Imitrex) for acute migraine and cluster headaches. Sumatriptan works by binding to serotonin receptors in the brain, causing vasoconstriction of the dilated blood vessels that contribute to headache pain. This helps to interrupt the migraine or cluster headache process at the neurochemical level, providing relief. Option A) β-Adrenergic blockers like propranolol are typically used for migraine prevention, not for acute treatment. Option B) Serotonin antagonists like methysergide are not commonly used anymore due to side effects and availability of more effective treatments. Option C) Tricyclic antidepressants such as amitriptyline can be used for migraine prevention, but they do not directly target the pathophysiologic process of acute migraine or cluster headaches. Educationally, understanding the rationale behind specific drug therapies for different types of headaches is crucial for healthcare providers to effectively manage and treat patients with these conditions. This knowledge helps in making informed decisions regarding appropriate medications based on the underlying pathophysiology of the headache disorder.