Deck 40: Caring for Clients With Neurologic Deficits

Question 1

You are caring for an 82-year-old client who needs bladder training. You know that bladder training is difficult for older adult clients with neurologic deficit because of what?

A) Urinary incontinence
B) Urinary retention
C) Decreased energy expenditure
D) Relaxation of the internal bladder sphincter

Answer 1

Relaxation of the internal bladder sphincter

Question 2

You have admitted a new client to the neuro ICU. You have performed a general neurologic assessment and are preparing to use a standardized assessment tool to assess the extent of neurologic deficits related to which of the following?

A) Knowledge
B) Math
C) Thought processes
D) Speech

Answer 2

Speech

Question 3

A student nurse is working with a preceptor on a rehabilitation unit. One of their clients has a neurologic deficit. What nursing intervention may help the client maintain independence as long as possible?

A) Provide encouragement and praise.
B) Encourage the client to set attainable goals.
C) Suggest available support groups.
D) Show personal interest and pleasure in each accomplishment.

Answer 3

Encourage the client to set attainable goals.

Question 4

A paraplegic client is distressed and wants to know about fathering a child. What should the nurse tell the client?

A) The buoyancy of a water bed promotes potential for fertility.
B) Penile implants provide potential for fertility.
C) Motor paralysis does not affect potential for fertility.
D) Ejaculation is rare.

Question 5

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.

Question 6

A client is brought to the Emergency Department (ED) by family members who tell the triage nurse that the client doesn't recognize them. The client is diagnosed with a neurologic deficit. What other conditions are considered neurologic deficits? Select all that apply.

A) Impaired speech
B) Abnormal bladder elimination
C) Muscle strength
D) Normal gait
E) Paralysis

Question 7

A student nurse is giving a report on clients with bladder problems. What instructions related to bladder care should the student nurse include in her report on clients with bladder problems?

A) The client should start a bladder training program when all else fails to work.
B) The client should use continence pads.
C) The client should take in adequate fluids.
D) The client should eat a high-fiber diet.

Question 8

A client has a neurologic deficit that was just diagnosed. In what phase of the neurologic deficit is this client?

A) Onset
B) Chronic
C) Recovery
D) Acute

Question 9

A client with a neurologic deficit has been admitted to your unit. The nurse caring for the client is assessing the client and observes significant changes in the client's status. Which of the following action should the nurse perform immediately?

A) Use the Glasgow Coma Scale.
B) Use the Mini-Mental Status Examination.
C) Report the change to the physician.
D) Monitor the blood pressure.

Question 10

A nursing instructor is teaching the senior nursing class about clients with neurologic disorder. 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.

Question 11

A nurse has just implemented a bladder training program with a client who has a neurologic deficit. The nurse instructs the client to bend at the waist or press inward and downward over the bladder. What statement justifies this action?

A) It stimulates the relaxation of the urinary sphincter.
B) It increases abdominal pressure.
C) It helps the client to identify voiding.
D) It reduces the calculus formation in the urinary tract.

Question 12

A client is in the recovery phase of neurologic deficit. What does medical management in this phase aim at?

A) Stabilizes the client and prevents further neurologic damage
B) Curing the client
C) Keeping the client stable and preventing or treating complications
D) Uses a wide range of therapies and treatments

Question 13

What phase of a neurologic deficit begins when the client's condition is stabilized?

A) Recovery
B) Chronic
C) Terminal
D) Acute

Question 14

When a nurse is caring for a client diagnosed with neurologic deficit who has begun responding to those around him, what therapies 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) Physiotherapy

Question 15

Some clients go into the chronic phase of neurologic deficit. What does the client do in this phase?

A) The client improves slowly over time.
B) The client shows little or no improvement, remains stationary, or progressively worsens.
C) The client does some rehabilitation work but progresses slowly.
D) The client is in a state of flux having exacerbations and getting better.

Question 16

During the recovery phase of neurologic deficit, what healthcare professionals are part of the team approach to planning and overseeing the care of these clients? Select all that apply.

A) Prosthetist
B) Pharmacy tech
C) Physical therapy aide
D) Dietitian
E) Nursing assistant

Question 17

The nurse is writing a plan of care for a client who is in spinal shock. What is one nursing diagnosis the nurse would be sure to include?

A) Enhanced physical mobility
B) Potential sexual function
C) Risk for Disuse Syndrome
D) Risk for urinary continence

Question 18

A nurse is assisting a client with a neurologic deficit to have a bowel movement. Which of the following nursing actions increases peristalsis and encourages defecation?

A) Help the client to the bathroom at a particular time each day.
B) Administer a low-volume enema each day at the same time.
C) Encourage liquids throughout the day.
D) Encourage a high-fiber diet.

Question 19

Which of the following assessment tools should the nurse use to perform a neurologic assessment?

A) Cutaneous triggering
B) Mini-Mental Status Examination
C) Credé's maneuver
D) Mechanical lift

Question 20

A client is being discharged home with a neurologic deficit. The nurse has finished discharge teaching. What should the nurse have taught the client and their family about the medications prescribed for the client and members of the healthcare team?

A) Open capsules and put in ice cream to facilitate swallowing.
B) Advise family members to check with their physician or pharmacist before crushing or breaking tablets or opening capsules.
C) Crush pills that are difficult for the client to swallow.
D) All the medicine will be provided in liquid form.

Question 21

A client has been discharged home with a neurologic deficit that includes paraplegia. While in the hospital, the client was being cared for by a psychotherapist who is going to follow this client on an outpatient basis. What would the psychotherapist treat this client for?

A) Family relationships
B) Grief work
C) Obesity
D) Physical integrity

Question 22

You are caring for a client diagnosed with a neurologic deficit. The client's family asks you what this means. What is your best answer?

A) A condition in which one or more functions of the central and peripheral nervous systems are decreased, impaired, or absent.
B) A condition where the client has had a stroke.
C) A condition where one or more functions of the autonomic nervous system is decreased, impaired, or absent.
D) A condition where the parasympathetic nervous system misfires causing severe tremors.

Question 23

The nurse caring for a client in the chronic phase of a neurologic deficit knows that nursing management focus on what?

A) Working with team members to plan a rehabilitation program.
B) Retraining the client's bowel and bladder.
C) Supporting the client during recovery.
D) Preventing physical and psychological complications.

Question 24

Medical management in the chronic phase does what?

A) Stabilizes the client and prevents further neurologic damage
B) Focuses on independent living
C) Uses a wide range of therapies and treatments
D) Aims at keeping the client stable and preventing or treating complications

Question 25

One of the major concerns for a client with a neurologic deficit is the potential for impaired skin integrity. What can the physical therapist recommend to prevent pressure sores in these clients?

A) Flotation devices
B) Large, fluffy pillows
C) Folded quilts
D) Foam filled devices