You are mentoring a student nurse in the intensive care unit (ICU) while caring for a patient with meningococcal meningitis. Which action by the student requires that you intervene immediately?

Correct Answer: A

Rationale: The correct answer is A) The student enters the room without putting on a mask and gown. This action requires immediate intervention because patients with meningococcal meningitis are highly contagious, and strict infection control measures must be followed to prevent the spread of the disease. Failure to use personal protective equipment (PPE) like masks and gowns puts the patient, staff, and visitors at risk of contracting the infection. Option B is incorrect because instructing the family about visitation restrictions is within the scope of caring for a patient with an infectious disease to prevent further spread. Option C is incorrect as providing a warm blanket to a patient feeling cold is a comfort measure that does not pose a risk to the patient or others. Option D is incorrect as checking the patient's pupil response is a standard neurological assessment and does not pose an immediate risk in this scenario. In an educational context, it is crucial to emphasize the importance of following infection control protocols, especially in high-risk settings like the ICU. Students must understand the rationale behind these measures to prioritize patient safety and prevent healthcare-associated infections. Reinforcing the use of PPE and proper isolation techniques is essential for student nurses to provide safe and effective care in such environments.

Correct Answer: B

Rationale: The correct answer is B) Explaining the need for regular daily activity, rest, and relaxation would be most helpful in assisting Mrs. Brown to live with her multiple sclerosis. This is because maintaining a balance between activity and rest is crucial in managing symptoms and preventing exacerbations in multiple sclerosis. Regular physical activity can help improve strength, coordination, and overall well-being, while adequate rest and relaxation can help manage fatigue and stress, which are common in multiple sclerosis. Option A) Teaching her about specific diet restrictions may be important for overall health but is not the most crucial aspect in managing multiple sclerosis. Diet can play a role in managing symptoms, but it is not the primary focus. Option C) Encouraging regular appointments with a psychotherapist may be beneficial for emotional support and coping strategies, but it is not the most essential aspect in managing the physical symptoms of multiple sclerosis. Option D) Explaining that complete recovery can be expected is incorrect because multiple sclerosis is a chronic condition with unpredictable courses. Managing expectations and focusing on symptom management and quality of life are more realistic approaches in dealing with the disease. In an educational context, it is important to emphasize to students that a holistic approach to managing chronic conditions like multiple sclerosis is crucial. Understanding the importance of physical activity, rest, and stress management can help patients lead a better quality of life despite their diagnosis. Educating patients on self-care strategies empowers them to take an active role in managing their health and well-being.

Correct Answer: D

Rationale: The correct answer is D) will decrease the tendency for constipation. Encouraging a paraplegic patient to drink plenty of fluids is essential to prevent constipation, a common issue in individuals with limited mobility. Adequate fluid intake helps soften stool, making it easier to pass and reducing the risk of constipation, which can be exacerbated by factors such as reduced activity and certain medications. Option A) replaces fluid lost during periods of increased perspiration is incorrect in this context because paraplegic patients may not experience increased perspiration due to their limited mobility and lack of sensation below the level of injury. Option B) decreases renal calculi formation is incorrect because while adequate fluid intake can help prevent kidney stones, the primary reason for encouraging fluid intake in a paraplegic patient is to address constipation. Option C) tends to decrease the possibility of spinal shock is incorrect because fluid intake does not directly impact the occurrence of spinal shock. Spinal shock is a physiological response to spinal cord injury characterized by a temporary loss of function, and fluid intake does not specifically prevent or treat this condition. In an educational context, it is crucial for healthcare providers to understand the importance of individualized care for patients with neurological conditions like paraplegia. Ensuring proper hydration and addressing issues like constipation can significantly improve the patient's quality of life and prevent complications. Educating nurses and other healthcare professionals about the specific needs of patients with spinal cord injuries is essential for providing optimal care and promoting patient well-being.

Correct Answer: B

Rationale: In assessing Bob for radial nerve injury, the correct indication would be "B) Inability to extend the wrist." This is because the radial nerve innervates the muscles responsible for wrist extension, such as the extensor carpi radialis longus and brevis. Therefore, damage to the radial nerve would result in the inability to perform this action. Option A, "Pain at the fracture site," is not indicative of radial nerve injury specifically. Pain at the fracture site may be present in any type of injury involving a fracture. Option C, "Inability to flex the elbow," is more commonly associated with musculocutaneous nerve injury, as this nerve innervates the muscles responsible for elbow flexion. Option D, "Paralysis of the hand and forearm," is more characteristic of a more extensive nerve injury, such as a brachial plexus injury, rather than isolated radial nerve damage. Understanding the specific signs and symptoms associated with different nerve injuries is crucial in clinical assessment. This knowledge helps healthcare providers accurately diagnose and manage patients with neurological deficits, leading to appropriate treatment interventions and better patient outcomes.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Scatter rugs. This poses the greatest danger to Mr. Hall while he is still on crutches because scatter rugs are a common tripping hazard, especially for individuals with limited mobility or using crutches. Scatter rugs can easily slide or bunch up, increasing the risk of a fall, which could lead to further injury for someone already on crutches. Option A) Stairs could also be a hazard, but it is a more obvious danger that can be mitigated by taking precautions like using handrails or assistance while navigating them. Option B) Doors and Option D) Easy chairs are less likely to pose an immediate danger compared to scatter rugs. In an educational context, this question highlights the importance of assessing home environments for potential hazards, especially for individuals with mobility issues. It emphasizes the need for healthcare providers to consider all aspects of a patient's living situation to ensure a safe and smooth recovery process. By understanding these risks, healthcare professionals can provide appropriate guidance and support to promote the well-being of their patients.