Select the correct etiology to complete this nursing diagnosis for a patient diagnosed with dissociative identity disorder: Disturbed personal identity, related to:

Correct Answer: D

Rationale: The correct answer is D because dissociative identity disorder (DID) is often linked to unresolved childhood abuse issues, leading to fragmentation of identity as a coping mechanism. This is supported by research showing a high prevalence of childhood trauma among individuals with DID. Option A is incorrect because it relates more to anxiety disorders. Option B is incorrect as it describes traits more associated with personality disorders. Option C is incorrect as it pertains to mood disorders like depression, which are not the primary etiology of DID.

Correct Answer: B

Rationale: In this scenario, the most crucial intervention is option B) Infuse ceftriaxone (Rocephin) 2000 mg IV to treat the infection. Bacterial meningitis is a life-threatening infection that requires urgent treatment with appropriate antibiotics to prevent serious complications and reduce mortality. Prompt initiation of antibiotics is essential to target the causative organism and halt the progression of the infection within the central nervous system. Option A) Administer codeine 15 mg orally for the patient's headache is incorrect because although pain management is important, addressing the underlying infection takes precedence in this situation. Option C) Give acetaminophen (Tylenol) 650 mg orally to reduce the fever is also incorrect as reducing fever alone does not treat the underlying cause of bacterial meningitis, which is the infection. Option D) Give furosemide (Lasix) 40 mg IV to decrease intracranial pressure is not the priority intervention as reducing intracranial pressure may be necessary in some cases of meningitis, but addressing the infection with antibiotics is the primary focus in bacterial meningitis management. Educationally, this question emphasizes the importance of understanding the urgent nature of treating bacterial meningitis with appropriate antibiotics to prevent serious neurological complications and improve patient outcomes. It highlights the necessity of prioritizing interventions based on the urgency of the patient's condition and the underlying pathophysiology.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) problems in reading. Nystagmus and diplopia are visual disturbances that can occur as side effects of anticonvulsants. Nystagmus is an involuntary eye movement that can cause difficulty in focusing on objects, leading to problems in reading. Diplopia, or double vision, can also make reading challenging as the individual sees two images instead of one. Option A) drowsiness is a common side effect of anticonvulsants, but it is not directly related to nystagmus and diplopia. Drooping eyelids (Option B) could indicate ptosis, which is not typically associated with nystagmus and diplopia caused by anticonvulsants. Excessive tearing (Option D) is more commonly associated with conditions like allergies or eye irritation, rather than nystagmus and diplopia. In an educational context, understanding the side effects of medications is crucial for nurses to provide safe and effective care to their patients. Recognizing symptoms like nystagmus and diplopia can help nurses intervene early, prevent complications, and improve the quality of care provided to patients taking anticonvulsants.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) avoid respiratory infection. Educating Susan on avoiding respiratory infections is crucial because individuals with neurological conditions, such as those requiring discharge instructions, are more susceptible to respiratory complications. Neurological conditions can compromise respiratory function, making individuals prone to infections like pneumonia. Teaching Susan preventive measures, such as practicing good hand hygiene, avoiding crowds during flu season, and getting vaccinated, will help in reducing her risk of respiratory infections. Option A) take anticholinergic drugs as ordered with meals is incorrect because it is not relevant to Susan's discharge teaching unless specifically prescribed for her condition. Option C) increase activities could be harmful as it may not be suitable for Susan depending on her specific neurological condition and could lead to complications. Option D) take sedatives to ensure sound sleep is inappropriate as a general instruction and may not address Susan's individual needs or promote her overall well-being. In an educational context, understanding the rationale behind each option helps students grasp the importance of individualized patient education based on specific health conditions. By comprehending why certain actions are necessary or contraindicated, students can develop critical thinking skills essential for providing safe and effective patient care in various clinical scenarios.

Correct Answer: B

Rationale: In the context of a paraplegic patient accepting his disability, the correct answer is B) practices push-up exercises. Engaging in physical activities like push-up exercises indicates a level of acceptance as the patient is actively participating in rehabilitation and adapting to their new physical limitations. This demonstrates a proactive approach towards their disability and a willingness to work towards physical improvement. Option A) sitting and looking out the window does not necessarily indicate acceptance but could be a coping mechanism or a passive activity. Option C) discussing the preinjury state may show reminiscence or longing for the past, indicating a lack of acceptance. Option D) drinking plenty of milk is unrelated to the acceptance of a disability and is a distractor in this context. Educationally, understanding the behaviors and signs of acceptance in patients with disabilities is crucial for healthcare professionals, especially nurses. It helps them provide appropriate support, encouragement, and care tailored to the patient's emotional and physical needs. Encouraging and recognizing positive behaviors, like engaging in rehabilitation exercises, can contribute to the patient's overall well-being and quality of life.