Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition - Caring for Clients With Neurologic Deficits

Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition - Caring for Clients With Neurologic Deficits Related

Review Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition - Caring for Clients With Neurologic Deficits related questions and content

An emergency department nurse is admitting a client brought in by the paramedics after falling from a tree stand. The client has fractured vertebrae at T3 and T4. The nurse knows the client is in the acute phase of neurologic deficit. What should the nurse know about the medical management of this client?

  • A. Goal is to keep the client stable and prevent or treat complications, such as pneumonia, and further neurologic impairment.
  • B. Goal is to plan a rehabilitation program in several domains according to the client's abilities and limitations.
  • C. Goal is to admit the client to a hospital for treatment of complications.
  • D. Goal is to stabilize the client and prevent further neurologic damage.
Correct Answer: D

Rationale: The focus of management during the acute phase is to stabilize the client and prevent further neurologic damage. The client with a CVA may require management of hypertension or hypotension through drug therapy. The client with a head or spinal cord injury may require respiratory support through mechanical ventilation or surgical intervention to stabilize the injured area or remove bone fragments, blood clots, or foreign objects. Sometimes, surgery is postponed until the client is stabilized and the acute phase has passed. In other instances, surgery is performed during the acute phase as a lifesaving measure. Keeping the client stable and preventing or treating complications is the aim of medical management of the recovery phase. Planning a rehabilitation program according to the client abilities and limitations and admit the client for treatment of complications are nursing goals, not medical goals for different phases of neurologic deficit.

You may also like to solve these questions

A nursing instructor is teaching the senior nursing class about clients with neurologic disorders. The instructor tells the students that these clients are at risk of disuse syndrome due to musculoskeletal inactivity and neuromuscular impairment. What nursing intervention helps prevent plantar flexion?

  • A. Use of parallel bars or a walker
  • B. Application of an abdominal binder
  • C. Use of a footboard
  • D. Use of a flotation mattress
Correct Answer: C

Rationale: A footboard positions the foot and ankle in such a way as to prevent plantar flexion. Parallel bars help the client with impaired mobility to support body weight and move forward before ambulating independently. An abdominal binder prevents dizziness and faintness. A flotation mattress helps relieve pressure when the client is lying down and sitting.

The nurse is instructing the client on how to perform Cred?© maneuver. In which situation is this maneuver helpful?

  • A. When a client is experiencing a vagal response during a bowel movement
  • B. When a client is experiencing orthostatic hypotension upon arising
  • C. When a client is attempting to empty the bladder
  • D. When a client is experiencing numbness of the lower extremities
Correct Answer: C

Rationale: Cred?©'s maneuver is intended to increase abdominal pressure and facilitate the emptying of the bladder. The nurse instructs the client to bend at the waist or press inward and downward over the bladder. The other options are not correct.

A nurse is caring for a client with a neurologic deficit whose condition has stabilized. What phase of the neurologic deficit begins now?

  • A. Recovery
  • B. Chronic
  • C. Terminal
  • D. Acute
Correct Answer: A

Rationale: The recovery phase begins when the client's condition is stabilized. It starts several days or weeks after the initial event and lasts weeks or months. This makes the other options incorrect.

The nurse is evaluating the progression of a client in the home setting. Which activity of the hemiplegic client indicates that the client is assuming independence?

  • A. The client grasps the affected arm at the wrist and raises it.
  • B. The client arranges a community service to deliver meals.
  • C. The clientmu client ambulates with the assistance of one.
  • D. The client uses a mechanical lift to climb steps.
Correct Answer: A

Rationale: The best evidence that the client is assuming independence is providing range of motions exercises to the affected arm by grasping the arm at the wrist and raising it. The other options require assistance.

A nurse is caring for a client diagnosed with neurologic deficit who has recently become responsive when interacted with. What therapy should the nurse suggest to help strengthen muscles that are under voluntary control?

  • A. Occupational therapy
  • B. Range-of-motion (ROM) exercises
  • C. Recreational therapy
  • D. Music Therapy
Correct Answer: A

Rationale: Occupational therapy is designed to help strengthen muscles that are under voluntary control. ROM exercises maintain joint flexibility and prevent permanent contractures. Participation in recreational and music therapies increases socialization time.

Copyright © 2025 Nokea. All rights reserved.