Nokea
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.
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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.
A patient with quadriplegia resulting from a spinal cord injury says to the rehabilitation nurse, 'I'm sick of this therapy! What is an occupational therapist going to do for me? Can she give me an 'occupation'?' What response by the nurse would be the most helpful?
- A. No, but the occupational therapist can show you how to enjoy some recreational activities.
- B. Yes, in a way. The occupational therapist provides training that strengthens muscles you can still control.
- C. Maybe. The occupational therapist recommends adaptive equipment that will make you more independent.
- D. No, the voc-rehab counselor helps with employment. The occupational therapist helps train you for improved communication skills.
Correct Answer: C
Rationale: The occupational therapist recommends adaptive equipment or helps in modifying skills to enhance independence.
The nurse explains that the Americans with Disabilities Act of 1990 defines a person as disabled if which criteria are met?
- A. The person has a physical or mental impairment.
- B. The person is limited in at least one major life activity.
- C. The person has a medical record of the impairment.
- D. The person is unemployed.
- E. The person needs assistance in completion of ADLs.
Correct Answer: A,B,C
Rationale: The definition is that a disabled person may have a physical or mental impairment that limits the person in one or more major life activities and has a medical record of that disability.
The nurse who helps a patient with a disability rejoice in the acquisition of the smallest new skill is embracing which rehabilitation philosophy?
- A. Resolving impairments
- B. Removing disabilities
- C. Increasing quality of life
- D. Eliminating complications
Correct Answer: C
Rationale: A philosophy of rehabilitation is to increase the quality of life. Impairments may not be able to be resolved, disabilities may not be able to be completely removed, and complications may not be totally eliminated. However, with rehabilitation, the individual can learn to adjust to the new lifestyle.
The nurse should tell a paraplegic that the rehabilitation experience will consist of:
- A. relearning former skills.
- B. learning to walk.
- C. learning new skills to adapt to a different lifestyle.
- D. developing muscle strength.
Correct Answer: C
Rationale: The type and the focus of rehabilitation are individualized to the patient, the injury, and abilities. Skills will be taught to enhance the patient's adaptation to a new lifestyle.