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An interdisciplinary team has been working collaboratively to improve the health outcomes of a young adult who suffered a spinal cord injury in a workplace accident. Which member of the rehabilitation team is the one who determines the final outcome of the process?
- A. Most-responsible nurse
- B. Patient
- C. Patients family
- D. Primary care physician
Correct Answer: B
Rationale: The patient is the key member of the rehabilitation team. He or she is the focus of the team effort and the one who determines the final outcomes of the process. The nurse, family, and doctor are part of the rehabilitation team but do not determine the final outcome.
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A patient is being transferred from a rehabilitation setting to a long-term care facility. During this process, the nurse has utilized the referral system? Using this system achieves what goal of the patients care?
- A. Minimizing costs of the patients care
- B. Maintaining continuity of the patients care
- C. Maintain the nursing care plan between diverse sites
- D. Keeping the primary care provider informed
Correct Answer: B
Rationale: A referral system maintains continuity of care when the patient is transferred to the home or to a long-term care facility. The interests of cost and of keeping the primary care provider informed are not primary. The nursing plan is likely to differ between sites.
You are the nurse creating the care plan for a patient newly admitted to your rehabilitation unit. The patient is an 82-year-old patient who has had a stroke but who lived independently until this event. What is a goal that you should include in this patients nursing care plan?
- A. Maintain joint mobility.
- B. Refer to social services.
- C. Ambulate three times every day.
- D. Perform passive range of motion twice daily.
Correct Answer: A
Rationale: The major goals may include absence of contracture and deformity, maintenance of muscle strength and joint mobility, independent mobility, increased activity tolerance, and prevention of further disability. The other listed actions are interventions, not goals.
You are the nurse caring for a female patient who developed a pressure ulcer as a result of decreased mobility. The nurse on the shift before you has provided patient teaching about pressure ulcers and healing promotion. You assess that the patient has understood the teaching by observing what?
- A. Patient performs range-of-motion exercises.
- B. Patient avoids placing her body weight on the healing site.
- C. Patient elevates her body parts that are susceptible to edema.
- D. Patient demonstrates the technique for massaging the wound site.
Correct Answer: B
Rationale: The major goals of pressure ulcer treatment may include relief of pressure, improved mobility, improved sensory perception, improved tissue perfusion, improved nutritional status, minimized friction and shear forces, dry surfaces in contact with skin, and healing of pressure ulcer, if present. The other options do not demonstrate the achievement of the goal of the patient teaching.
A patient has been transferred to a rehabilitative setting from an acute care unit. What is the most important reason for the nurse to begin a program for activities of daily living (ADLs) as soon as the patient is admitted to a rehabilitation facility?
- A. The ability to perform ADLs may be the key to dependence.
- B. The ability to perform ADLs is essential to living in a group home.
- C. The ability to perform ADLs may be the key to reentry into the community.
- D. The ability to perform ADLs is necessary to function in an assisted-living situation.
Correct Answer: C
Rationale: An ADL program is started as soon as the rehabilitation process begins because the ability to perform ADLs is frequently the key to independence, return to the home, and reentry into the community. ADLs are frequently the key to independence, not dependence. The ability to perform ADLs is not always a criterion for admission to a group home or assisted-living facility.
You are the nurse caring for a patient who has paraplegia following a hunting accident. You know to assess regularly for the development of pressure ulcers on this patient. What rationale would you cite for this nursing action?
- A. You know that this patient will have a decreased level of consciousness.
- B. You know that this patient may not be motivated to prevent pressure ulcers.
- C. You know that the risk for pressure ulcers is directly related to the duration of immobility.
- D. You know that the risk for pressure ulcers is related to what caused the immobility.
Correct Answer: C
Rationale: The development of pressure ulcers is directly related to the duration of immobility: If pressure continues long enough, small vessel thrombosis and tissue necrosis occur, and a pressure ulcer results. The cause of the immobility is not what is important in the development of a pressure ulcer; the duration of the immobility is what matters. Paraplegia does not result in a decreased level of consciousness and there is no reason to believe that the patient does not want to prevent pressure ulcers.