Question 1

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?

Accepted Answer

The occupational therapist recommends adaptive equipment or helps in modifying skills to enhance independence.

Question 2

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?

Accepted Answer

Family-centered care is an evolving concept that uses the family as equal partners in the rehabilitation process.

Question 3

What is the primary difference between the rehabilitation of children and the rehabilitation of adults?

Accepted Answer

The primary difference between rehabilitation of children and rehabilitation of adults is the developmental potential of the child.

Question 4

The nurse should tell a paraplegic that the rehabilitation experience will consist of:

Accepted Answer

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.

Question 5

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?

Accepted Answer

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.

Question 6

The nurse explains that the main roles of the gerontological rehabilitation nurse are to provide rehabilitative care and what other role?

Accepted Answer

Teaching prevention is the dual role of the geriatric rehabilitation nurse. Restoration, adaptive skills, and positive reinforcements are all part of providing rehabilitative care.

Question 7

The nurse who is part of a team focused on restoring an individual to the fullest physical, mental, social, vocational, and economic capacity is practicing what type of nursing?

Accepted Answer

Rehabilitation is the process of restoring an individual to the fullest physical, mental, social, vocational, and economic capacity of which he or she is capable.

Question 8

The nurse takes special care to be gentle in caring for patients with spinal cord injuries to avoid stimulating the autonomic nervous system and triggering which condition?

Accepted Answer

Autonomic dysreflexia is a sudden and extreme elevation in blood pressure caused by a reflex action of the autonomic nervous system. It is the result of stimulation of the body below the level of the spinal cord injury.

Question 9

The acquisition of adaptive skills and behaviors by an individual who has been disabled since birth refers to:

Accepted Answer

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.

Question 10

When caring for a patient with a disability, the rehabilitation nurse provides individual treatment to help the patient stay focused on which goals?

Accepted Answer

The focus on rehabilitation is on enabling the individual to move from a totally dependent state to a level of independence.

Question 11

The nurse recognizes that the rehabilitation process involves the efforts of various disciplines. The focus of rehabilitation is to build on which area?

Accepted Answer

The underlying philosophy of rehabilitation is to focus on the abilities of the patient.

Question 12

The nurse who helps a patient with a disability rejoice in the acquisition of the smallest new skill is embracing which rehabilitation philosophy?

Accepted Answer

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.

Question 13

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?

Accepted Answer

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 ulcers, 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.

Question 14

What should the nurse do to reduce the incidence of postural hypotension in a patient with a spinal cord injury?

Accepted Answer

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.

Question 15

What is the best way to define a handicap?

Accepted Answer

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.

Question 16

When assessing a patient with a traumatic brain injury, the nurse notes that his memory is improving. The nurse should explain to the family that what other symptom may occur with memory improvement?

Accepted Answer

Generally, the more memory improves in a patient with a brain injury, the more the patient becomes depressed.

Question 17

Which is a characteristic of the interdisciplinary approach to the rehabilitation team?

Accepted Answer

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.

Question 18

Following admission, how soon must a comprehension rehabilitation plan of care be implemented on a rehabilitation patient?

Accepted Answer

A comprehensive rehabilitation plan must be initiated within 24 hours of admission to the rehabilitation service. The results of the interdisciplinary assessment provide the basis for development of the plan of care. The team has 3 days from admission to review and revise the plan of care.

Question 19

The nurse who is engaged in gerontological rehabilitation nursing has a dual challenge. The gerontological rehabilitation nurse must assess not only the debilitating factors of disease but also which other factor?

Accepted Answer

Gerontological rehabilitation nursing focuses on the unique requirements of older adult rehabilitation. The elderly, with their potential physical limitations, require specialized care.

Question 20

When caring for a 32-year-old Hispanic male who has become disabled, on what should the rehabilitation team base the priority of treatment goals?

Accepted Answer

Culture defines the significance of disease and disability. Although all of the options must be addressed, the significance of the disability has highest priority.

Quiz 38: Rehabilitation Nursing