Nokea
The rehabilitation nurse can use basic rehabilitation skills regardless of the origin of the disability. What intervention would be effective for a person with arthritis, a person with a brain injury, or a person with a spinal cord injury?
- A. Encouraging large fluid intake
- B. Seeking spiritual support from a higher being
- C. Using the spouse as a support system
- D. Positioning to maintain alignment
Correct Answer: D
Rationale: Alignment preservation is an implementation that is appropriate for a variety of rehabilitation patients, regardless of the origin of their disability.
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When caring for a patient with a disability, the rehabilitation nurse provides individual treatment to help the patient stay focused on which goals?
- A. Returning to normal
- B. Independence
- C. Employment
- D. Promotion of health
Correct Answer: B
Rationale: The focus on rehabilitation is on enabling the individual to move from a totally dependent state to a level of independence.
Which is a characteristic of the interdisciplinary approach to the rehabilitation team?
- A. Each discipline makes its own goals for the patient.
- B. There are clear boundaries between the disciplines.
- C. There is a combination of expanded problem solving beyond the boundaries of the individual disciplines.
- D. Cross-trained people are used who have functional ability in two or more disciplines.
Correct Answer: C
Rationale: In the interdisciplinary approach, the team collaborates on the goals for the patient. In the multidisciplinary rehabilitation team approach, each discipline makes its own goals for the patient and there are clear boundaries between the disciplines. The transdisciplinary rehabilitation team is characterized by the blurring of boundaries between disciplines and the cross-training and flexibility to reduce a duplication of efforts.
The spinal cord injury patient has paralysis of all extremities and bowel and bladder disturbance. The nurse recognizes the injury as most likely occurring at what vertebral level?
- A. C1 to C2
- B. C3 to C4
- C. C2 to C7
- D. C4 to C7
Correct Answer: C
Rationale: The vertebral level of injury for a cervical cord is C2 to C7 if the patient has paralysis of all extremities and trunk, and has lost control of bowel and bladder function.
The nurse instructs the mother of a 5-year-old who sustained a mild brain injury that although all neurologic evaluations are normal, her child may exhibit postconcussive syndrome. What are common characteristics of this syndrome?
- A. Convulsions and high fever
- B. Irritability and memory deficits
- C. Muscular twitching and muscle pain
- D. Paresis of limbs and fatigue
Correct Answer: B
Rationale: Mild brain injury is characterized by brief or no loss of consciousness. This type constitutes the majority of head injuries. Neurologic examinations are often normal. Postconcussive syndrome can persist for months, years, or indefinitely. Signs and symptoms include fatigue, headache, vertigo, lethargy, irritability, personality changes, cognitive deficits, decreased information processing speed and memory, understanding, learning, and perceptual difficulties.
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.