Which treatment modality should a nurse recommend to help a patient diagnosed with somatic symptom disorder cope more effectively?

Correct Answer: B

Rationale: The correct answer is B: Relaxation. For a patient with somatic symptom disorder, relaxation techniques can help reduce anxiety and physical symptoms associated with the disorder. Relaxation promotes a sense of calm, reduces stress, and can improve coping skills. Flooding (A) involves exposing a patient to a feared stimulus in a sudden and intense manner, which can exacerbate symptoms in somatic symptom disorder. Response prevention (C) is used in treating obsessive-compulsive disorder, not somatic symptom disorder. Systematic desensitization (D) is a technique used for phobias, not somatic symptom disorder.

Correct Answer: B

Rationale: The best first action in this scenario is to select option B: Notify the physician immediately. This choice is correct because the patient with myasthenia gravis (MG) is displaying signs of a myasthenic crisis, a life-threatening condition that requires urgent medical attention. The combination of an elevated temperature, increased heart rate, elevated blood pressure, and incontinence suggests a crisis situation in a patient with MG. Notifying the physician promptly is crucial to initiate appropriate interventions and prevent further deterioration. Option A, administering an acetaminophen suppository, is incorrect as it does not address the underlying cause of the symptoms and delays necessary medical intervention. Option C, rechecking vital signs in 1 hour, is also incorrect because the patient's condition requires immediate attention due to the severity of symptoms. Option D, rescheduling the patient's physical therapy, is inappropriate and does not address the urgent medical needs of the patient in crisis. Educationally, this scenario highlights the importance of recognizing acute changes in a patient's condition and the critical role of prompt communication with healthcare providers in ensuring patient safety and optimal outcomes. Nurses must be vigilant in monitoring patients with MG for signs of myasthenic crisis and act swiftly to prevent serious complications.

Correct Answer: C

Rationale: The correct answer to the question is option C, the 46-year-old patient admitted 48 hours ago with bacterial meningitis and has an antibiotic dose due. This patient is the best choice for the RN from the medical unit because bacterial meningitis requires close monitoring, timely administration of antibiotics, and ongoing assessment for any changes in neurological status. The RN from the medical unit would likely have more experience and comfort managing infectious conditions and administering antibiotics compared to the other neurologically complex cases presented in the question. Option A, the 26-year-old patient with a basilar skull fracture and clear drainage coming out of the nose, requires specialized neurologic care due to the risk of cerebrospinal fluid leak and potential complications. Option B, the 42-year-old patient with a ruptured berry aneurysm, also needs specialized care in a neuro ICU setting for monitoring and potential interventions related to the aneurysm. Option D, the 65-year-old patient with an astrocytoma who just had a craniotomy, requires specialized neurosurgical care and monitoring postoperatively. Providing this educational context helps students understand the importance of matching the complexity and acuity of patients with the appropriate level of nursing expertise to ensure safe and effective care delivery, especially in critical care settings like the neurologic ICU.

Correct Answer: D

Rationale: In this scenario, option D is deemed inappropriate because it suggests turning the patient on his side by moving the shoulders and upper trunk first, which can strain the back muscles. This method puts excessive pressure on the back and can lead to injury. Option A is correct as it recommends using a turning sheet to logroll the patient onto a bedpan, minimizing strain on the back muscles. Option B is also appropriate as it supports proper alignment by placing a pillow between the knees when lying on the side. Option C is suitable as it helps maintain proper alignment by placing pillows under the knees when lying on the back. Educationally, it is crucial for nurses to understand and implement proper body mechanics to prevent injury to both patients and themselves. Teaching correct techniques for repositioning patients is essential in maintaining their comfort and preventing musculoskeletal issues. Nurses must always prioritize patient safety and well-being by utilizing appropriate methods for patient care.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) lack of muscle activity results in poor circulation. Turning a patient every 2 hours is a crucial preventive measure to avoid developing decubitus ulcers or pressure sores. When a patient is immobile or paralyzed, the lack of movement can lead to pressure on certain areas of the body, reducing circulation to those areas. This restricted blood flow can cause tissue damage, leading to the formation of ulcers. Option A is incorrect because while nutritional requirements may be increased in paralyzed patients, it is not the primary reason for developing decubitus ulcers. Option B is incorrect as muscle spasms causing flexion contractures may contribute to the risk of pressure sores, but it is not the primary reason for their development. Option C is also incorrect as retention of waste products causing metabolic acidosis is not directly linked to the formation of decubitus ulcers. Educationally, understanding the rationale behind turning immobile patients helps students grasp the importance of preventive nursing care. It reinforces the significance of maintaining proper circulation to prevent complications such as pressure ulcers, highlighting the holistic care approach needed for patients with limited mobility. This knowledge is vital for nurses to provide effective care and prevent potential complications in their patients.