Which of the following is a sign of urinary retention in older adults with neurologic deficit?

Correct Answer: D

Rationale: Urinary retention is a common issue in older adults with neurologic deficits due to impaired bladder function. The correct answer, "D) A behavior change," is indicative of urinary retention because individuals may exhibit behaviors such as restlessness, agitation, or increased confusion due to the discomfort caused by the inability to empty their bladder. Option A, "Amnesia," is not a sign of urinary retention but rather a memory-related issue. Option B, "Hypotension," and Option C, "Hypertension," are related to blood pressure regulation and are not directly associated with urinary retention in this context. Educationally, understanding the signs of urinary retention in older adults with neurologic deficits is crucial for healthcare providers to provide timely interventions and prevent complications such as urinary tract infections and bladder distention. Recognizing behavioral changes can prompt further assessment and appropriate management to improve the patient's comfort and prevent potential complications.

Correct Answer: C

Rationale: The correct answer is C) Most patients with Guillain-Barré syndrome make a complete recovery. This response is accurate because Guillain-Barré syndrome is a disorder where the body's immune system attacks the nervous system, leading to muscle weakness and paralysis. However, with proper treatment and care, most individuals with this syndrome do recover fully over time. Option A is incorrect because patients who require ventilatory support do not almost always die from Guillain-Barré syndrome. Ventilatory support is often needed during the acute phase of the illness to assist with breathing but does not necessarily indicate a poor prognosis. Option B is incorrect as death in Guillain-Barré syndrome is not primarily due to nerve damage affecting the brain and meninges; it is more related to complications from severe muscle weakness and respiratory failure. Option D is incorrect because death prevention is not solely related to the permanence of residual paralysis and sensory impairment. Recovery outcomes vary among individuals with Guillain-Barré syndrome and are not solely determined by the presence of residual symptoms. Educationally, understanding the potential outcomes and prognosis of Guillain-Barré syndrome is crucial for healthcare providers to provide accurate and supportive information to patients and their families. It is essential to emphasize that while the condition can be serious, many individuals do recover fully with appropriate medical management and support. It is important to offer reassurance and hope to patients facing this challenging diagnosis.

Correct Answer: B

Rationale: In the scenario of a patient admitted with a possible cervical spinal cord injury after an automobile crash, the highest priority for the nurse is maintaining immobilization of the cervical spine (Option B). This is crucial to prevent further damage to the spinal cord, which could result in irreversible neurological deficits or even paralysis. By stabilizing the cervical spine, the nurse helps to minimize the risk of exacerbating the initial injury. Maintaining a patent airway (Option A) is important but comes after securing the cervical spine, as airway management can be accomplished once the spine is immobilized. Assessing the patient for head and other injuries (Option C) is important but not the highest priority when the primary concern is preventing further harm to the spinal cord. Assessing the patient's motor and sensory function (Option D) is essential but should come after immobilization to prevent movement that could worsen the injury. Educationally, this scenario highlights the critical nature of prioritizing care in emergency situations, especially when dealing with potential spinal cord injuries. Nurses need to be able to quickly assess and address the most urgent needs of the patient to provide effective and timely care that can impact outcomes significantly. Understanding the rationale behind prioritizing interventions can help nurses make informed decisions in high-stress environments where quick thinking and action are paramount.

Correct Answer: D

Rationale: The correct answer is D) Fibrous connective tissue covering bone. The periosteum is a thin, dense membrane that covers the outer surface of bones. It is rich in blood vessels and nerve endings, playing a crucial role in bone growth, repair, and nutrition. Option A) Lining of a joint capsule is incorrect because the periosteum is not associated with joint capsules. Option B) A characteristic of skeletal muscle is incorrect as the periosteum is specific to bones, not muscle tissue. Option C) Most common type of cartilage tissue is incorrect as the periosteum is not cartilage tissue at all. Educationally, understanding the structure and function of the periosteum is essential in the study of the skeletal system. Knowing its role in bone health, repair, and sensitivity to injury helps students grasp the importance of this structure in maintaining overall skeletal integrity. This knowledge is foundational for healthcare professionals in fields such as anatomy, physical therapy, and orthopedics.

Correct Answer: C

Rationale: The most common diagnostic test used to assess musculoskeletal disorders is a standard x-ray (Option C). This is the correct answer because x-rays are readily available, cost-effective, and provide detailed images of bones and some soft tissues, making them ideal for initial evaluation of musculoskeletal conditions like fractures, arthritis, or dislocations. X-rays can reveal abnormalities in bone structure and density, joint alignment, and can help identify potential issues. Option A, Myelogram, is primarily used to evaluate spinal cord or nerve root compression, not musculoskeletal disorders. Option B, Arthroscopy, is a minimally invasive procedure where a camera is inserted into a joint to visualize and treat issues like torn cartilage or inflammation, not a diagnostic test. Option D, Magnetic Resonance Imaging (MRI), is useful for soft tissue evaluation and can provide more detailed images, but it is not as commonly used as standard x-rays due to higher cost and limited availability. In an educational context, understanding the appropriate use of diagnostic tests is crucial for healthcare providers to make accurate diagnoses and treatment decisions. Teaching students the indications, limitations, and benefits of various diagnostic tests helps develop their clinical reasoning skills and enhances their ability to provide quality patient care.