Nokea
The rehabilitation nurse assesses localized edema around the knee of a patient with paraplegia. The nurse suspects that this is the first sign of ossification.
Correct Answer: heterotopic
Rationale: Heterotopic ossification is a bony growth in joints of spinal cord injury patients below the injury that ultimately limits range of motion.
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When changing the position of a patient with a spinal cord injury at T4, the nurse should recognize that what symptom is an indication of an episode of autonomic dysreflexia?
- A. Nausea
- B. Pallor
- C. Goose bumps
- D. Dizziness
Correct Answer: C
Rationale: Patients with spinal cord lesions above T5 may experience sudden and extreme elevations in blood pressure caused by a reflex action of the autonomic nervous system. It is produced by stimulation of the body below the level of the injury, usually by a distended bladder from a blocked catheter. Any stimulation can produce the syndrome, including constipation, diarrhea, sexual activity, pressure injuries, position changes (from lying to sitting), and even wrinkles in clothing or bed sheets. Other symptoms may include diaphoresis, shivering, goose bumps, flushing of the skin, and a severe pounding headache.
What is the best way to define a handicap?
- A. Any loss of function
- B. A disability that interferes with one's normal functioning
- C. Any loss of ability to perform activities of daily living
- D. An irreversible lifelong impairment
Correct Answer: B
Rationale: A handicap is a disadvantage for a given individual from an impairment that limits his or her role performance. A particular handicap for one person might not pose any handicap for another with the same disability. An impairment is a loss of function. A functional limitation is a disability that interferes with one's normal functioning. A chronic illness is an irreversible lifelong impairment.
What should the nurse do to reduce the incidence of postural hypotension in a patient with a spinal cord injury?
- A. Monitor diastolic blood pressure closely.
- B. Encourage the patient to remain in the bed.
- C. Raise the head of the bed for 15 to 20 minutes before transfer to a wheelchair.
- D. Encourage adequate intake of fluids to expand fluid volume.
Correct Answer: C
Rationale: Raising the head of the bed before transfer allows for gradual vessel accommodation from the supine position to the upright position. It is important to check the patient's blood pressure, but it will not reduce the incidence of postural hypotension. It is important to encourage the patient to get out of bed. Postural hypotension is related to a pooling of blood in the lower extremities and is not related to a fluid volume deficit.
When planning care for children, the nurse uses a concept that recognizes the pivotal role of the family in the lives of children with disabilities or other chronic conditions. What is this philosophy called?
- A. Child-centered care
- B. Systems-centered care
- C. Family-centered care
- D. Individual-centered care
Correct Answer: C
Rationale: Family-centered care is an evolving concept that uses the family as equal partners in the rehabilitation process.
The acquisition of adaptive skills and behaviors by an individual who has been disabled since birth refers to:
- A. training.
- B. education.
- C. development.
- D. habilitation.
Correct Answer: D
Rationale: Habilitation refers to developing skills and behaviors in people who did not have the skills originally. Children who are disabled from birth have no skills to relearn and are habilitated rather than rehabilitated.