Nokea
After teaching a male client with a spinal cord injury at the T4 level, the nurse assesses the client's understanding. Which statements indicate a correct understanding of the teaching related to sexual effects of this injury? (Select all that apply.)
- A. I will explore other ways besides intercourse to please my partner.
- B. I will not be able to have an erection because of my injury.
- C. Ejaculation may not be as predictable as before.
- D. I may urinate with ejaculation but this will not cause infection.
- E. I should be able to have an erection with stimulation.
Correct Answer: C,D,E
Rationale: Men with injuries above T6 can often have reflex erections with stimulation. Ejaculation may be less predictable and mixed with urine, which is sterile and does not cause infection. Exploring alternative intimacy methods is also appropriate.
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An emergency room nurse initiates care for a client with a cervical spinal cord injury who arrives via emergency medical services. Which action should the nurse take first?
- A. Assess level of consciousness.
- B. Obtain vital signs.
- C. Administer oxygen therapy.
- D. Evaluate respiratory status.
Correct Answer: D
Rationale: The first priority for a client with a cervical spinal cord injury is to assess respiratory status and airway patency, as these injuries can compromise breathing. Other assessments follow after ensuring airway and breathing are stable.
A nurse plans care for a client with lower back pain from a work-related injury. Which intervention should the nurse include in this work plan care?
- A. Encourage the client to stretch the back by reaching toward the toes.
- B. Massage the affected area with ice twice a day.
- C. Apply a heating pad for 20 minutes at least four times daily.
- D. Advise the client to avoid warm baths or showers.
Correct Answer: C
Rationale: Heat increases blood flow to the affected area and promotes healing of injured nerves. Stretching and ice will not promote healing, and there is no need to avoid warm baths or showers.
A nurse promotes the prevention of lower back pain by teaching clients at a community center. Which instruction should the nurse include in this education?
- A. Participate in an exercise program to strengthen muscles.
- B. Purchase a mattress that allows you to adjust the firmness.
- C. Wear flat instead of high-heeled shoes to work each day.
- D. Keep your weight within 20% of your ideal body weight.
Correct Answer: A
Rationale: Exercise can strengthen back muscles, reducing the incidence of low back pain. The other options will not prevent low back pain.
A nurse assesses a client with multiple sclerosis after administering prescribed fingolimod (Gilenya). For which adverse effect should the nurse monitor?
- A. Peripheral edema
- B. Black and tarry stools
- C. Bradycardia
- D. Nausea and vomiting
Correct Answer: C
Rationale: Fingolimod (Gilenya) can cause bradycardia, especially within the first 6 hours after administration. Peripheral edema, black and tarry stools, and nausea and vomiting are not typical adverse effects of this medication.
A nurse assesses a client who is recovering from a diskectomy 6 hours ago. Which assessment finding should the nurse address first?
- A. Pain at the surgical site.
- B. Numbness in the lower extremities.
- C. Difficulty breathing.
- D. Weak pedal pulses.
Correct Answer: C
Rationale: Difficulty breathing could indicate a compromised airway, possibly due to swelling, which is a critical postoperative complication requiring immediate attention. Pain, numbness, and weak pulses are important but not as urgent as airway issues.