The nurse practitioner is evaluating a patient with cluster headaches who has been prescribed sumatriptan (Imitrex). Which finding indicates that the medication is working?

Correct Answer: A

Rationale: The correct answer is A: Decreased symptoms. Sumatriptan works by constricting blood vessels in the brain, reducing inflammation and pain associated with cluster headaches. Therefore, a decrease in symptoms such as intensity of pain, duration of headache, and associated symptoms indicates that the medication is working effectively. Choices B, C, and D are incorrect as the absence of headaches may not be realistic, improved neurological function may not be directly related to the medication, and decreased frequency of headaches does not necessarily imply effectiveness in managing the current headache episode.

Correct Answer: D

Rationale: Step 1: Define somatic system disorders (SSD) as physical symptoms caused by psychological distress. Step 2: Define dissociative disorders as disruptions in memory, consciousness, or identity due to stress. Step 3: Identify that the primary difference is how stress manifests: SSD through physical symptoms and dissociative disorders through disruptions in memory, consciousness, or identity. Step 4: Choose D as the correct answer as it accurately distinguishes between the two types of disorders. Summary: A: Incorrect, as it inaccurately describes the nature of somatic system and dissociative disorders. B: Incorrect, as it oversimplifies the triggers for each type of disorder. C: Incorrect, as it generalizes the causes of dissociative disorders and somatic system disorders.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) Fatigue related to disease state. This is the priority nursing diagnosis because fatigue is a common and debilitating symptom of multiple sclerosis (MS). It directly impacts the patient's ability to engage in activities of daily living, such as taking a bath. Addressing fatigue is crucial to improving the patient's quality of life and promoting independence. Option B) Activity Intolerance due to generalized weakness is not the most appropriate choice in this case because it focuses on the patient's inability to tolerate physical activity, rather than addressing the underlying issue of fatigue specifically related to the disease state of MS. Option C) Impaired Physical Mobility related to neuromuscular impairment is not the priority nursing diagnosis in this situation because the patient's main concern is fatigue affecting her ability to perform self-care activities, not solely physical mobility issues. Option D) Self-care Deficit related to fatigue and neuromuscular weakness is not the priority as it combines two aspects (fatigue and neuromuscular weakness) without specifically addressing the primary issue of fatigue and its impact on the patient's ability to engage in self-care activities. Educationally, this question highlights the importance of understanding the unique symptoms and challenges faced by patients with neurological conditions like MS. By prioritizing the nursing diagnosis of fatigue related to the disease state, healthcare providers can tailor interventions to address this specific symptom and support the patient in managing their condition effectively.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A - "The patient does not recognize family members." This is the most concerning assessment information as it could indicate a decline in neurological function and potential signs of increased intracranial pressure or neurological deterioration. Option B - "The blood glucose level is 234 mg/dL" is not the most concerning in this context as elevated blood glucose levels can be managed medically and are not directly indicative of immediate neurological deterioration. Option C - "The patient complains of a continued headache" is not as concerning as the patient's presenting symptoms of right arm weakness and headache are the reasons for the current treatment. However, persistent headache should be monitored and managed. Option D - "The daily weight has increased 1 kg" is also not as concerning as the other options in the context of a patient with a recurrent glioblastoma. Weight gain can be attributed to various factors including fluid retention, nutritional status, or medication effects. In an educational context, understanding the rationale behind the correct answer helps healthcare providers prioritize assessments and interventions for patients with neurological conditions. Recognizing changes in cognition and mental status is crucial in the care of patients with brain tumors to prevent potential complications and provide timely interventions. This case highlights the importance of thorough neurological assessments and vigilance in monitoring subtle changes in a patient's condition, especially in the context of a known brain tumor.

Correct Answer: A

Rationale: The most comfortable position for Mr. Tucker would be option A) Supine with head elevated 20-30° and knees flexed. This position helps to reduce pressure on the lower back, promotes proper spinal alignment, and facilitates optimal blood circulation. Elevating the head slightly can also help with breathing and reduce the risk of aspiration in patients with neurological issues. Option B) Prone with head turned to the side and feet extending over the mattress edge is incorrect as it can cause strain on the neck and back, leading to discomfort and potential breathing difficulties. Option C) Flat on the back with the bed gatched in the middle is incorrect as it does not provide adequate support for the spine or promote proper alignment, potentially leading to discomfort and pressure sores. Option D) Supine with a hard thick pillow under the lumbar region is incorrect as it can cause hyperextension of the lumbar spine, leading to discomfort and potential exacerbation of any existing neurological issues. Educationally, understanding the importance of proper positioning for patients with neurological conditions is crucial in preventing complications, promoting comfort, and supporting overall well-being. Teaching healthcare providers about the rationale behind optimal positioning can improve patient care outcomes and enhance their quality of life.