The family of a child diagnosed with an impulse control disorder needs help to function more adaptively. Which aspect of the child's plan of care will be provided by an advanced practice nurse rather than a staff nurse?

Correct Answer: D

Rationale: The correct answer is D because providing dialectical behavioral therapy (DBT) requires specialized training and expertise typically possessed by advanced practice nurses. DBT is a specific therapeutic approach designed for individuals with impulse control disorders, and it involves intensive training and ongoing supervision. Leading an activity group (A) and providing positive feedback (B) are within the scope of practice of both staff nurses and advanced practice nurses. Formulating nursing diagnoses (C) is also a skill that staff nurses can perform as part of the nursing process. In summary, the advanced practice nurse would be better equipped to provide DBT due to their advanced training and expertise in this specific therapeutic approach.

Correct Answer: C

Rationale: The correct answer is C because reduced gray matter in the cortex and dysfunction of the amygdala can lead to decreased feelings of empathy. 1. The cortex is responsible for higher-order cognitive functions, including empathy. 2. The amygdala plays a crucial role in processing emotions, such as empathy and remorse. 3. Reduced gray matter in the cortex and dysfunction of the amygdala can result in deficits in recognizing and processing emotions like empathy and remorse. Therefore, the adolescent's lack of remorse could be attributed to these neurological abnormalities. Other choices are incorrect because: A: Serotonin dysregulation and increased testosterone activity primarily affect mood regulation and aggression, not necessarily remorse. B: Neuron destruction in the hippocampus affects memory and learning, not empathy or remorse. D: Disturbances in the occipital lobe primarily impact vision and visual processing, not empathy or remorse.

Correct Answer: D

Rationale: Step-by-step rationale for why answer D is correct: 1. Identifying a clinically relevant question is crucial for guiding the integration of evidence into practice. 2. This step ensures that the evidence sought aligns with the specific needs and concerns of the patient. 3. By focusing on the patient's individual situation, the therapist can tailor the evidence-based interventions effectively. 4. It sets the foundation for a patient-centered approach to care, enhancing clinical decision-making. 5. Overall, starting with a clinically relevant question is the essential first step in evidence-based practice. Summary: A: Identifying current best evidence is premature without understanding the patient's specific needs. B: Critically appraising evidence comes after identifying the question to ensure relevance. C: Discussing evidence with the patient is important but should follow after identifying the relevant question.

Correct Answer: C

Rationale: The correct answer is C: The aorta and carotid arteries. Baroreceptors are sensors that detect changes in blood pressure. The highest concentration of baroreceptors is found in the aorta and carotid arteries because these are major arteries close to the heart and brain, which are crucial for maintaining blood pressure regulation. The aorta and carotid arteries constantly monitor blood pressure and send signals to the brain to help regulate it. Choices A, B, and D are incorrect because the carotid veins, supraclavicular arteries, and femoral arteries do not contain as high a concentration of baroreceptors as the aorta and carotid arteries, which play a significant role in blood pressure regulation.

Correct Answer: A

Rationale: The correct answer is A: Refer the patient for assessment by a physician. Given the patient's age, smoking history, family history, and elevated blood pressure, there is a high likelihood of cardiovascular issues. As a physical therapist, it is crucial to prioritize patient safety and rule out any serious medical conditions before proceeding with any interventions. Referring the patient for immediate medical assessment allows for proper diagnosis and management of potential cardiovascular emergencies. This is the first and most important step to ensure the patient's well-being. Other choices are incorrect because: B: Assuming it is a 'white coat' effect overlooks the serious symptoms and risks associated with the patient's presentation. C: Continuing the examination with modifications may delay necessary medical intervention and put the patient at risk. D: Modifying the examination and avoiding manual therapy may not address the underlying cause of the symptoms and delay appropriate medical care.