Chapter 09: Chronic Illness and Rehabilitation deWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition

MULTIPLE CHOICE 1. The rehabilitation nurse describes a patient who is blind, works full time as a Spanish interpreter, and lives with his wife in a downtown apartment. How should the nurse classify this person? a. Impaired b. Disabled c. Handicapped d. Dependent ANS: A The blindness is an impairment of vision that does not inhibit the patient from performing his job or enjoying a normal life. PTS:1 DIF: Cognitive Level: Comprehension REF: 178 OBJ:1 (theory) TOP: Concepts of Rehabilitation KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. A resident with advanced Parkinson disease stays in his wheelchair all day. He reports that he is too tired to walk and is fearful of falling. Which intervention to increase the patient’s mobility should the nurse add to the patient’s care plan? a. Instruct the resident in crutch walking. b. Assist the resident with ambulating in the hallway with a gait belt. c. Encourage the resident to rock back and forth in his wheelchair to off-load weight. d. Arrange for a walking cane. ANS: B Walking is the best exercise to prevent problems associated with immobility. The gait belt will make the resident more secure. Canes and crutches do not diminish the weakness or the fear of falling. PTS:1 DIF: Cognitive Level: Application REF:185, Box 9-5 OBJ:2 (theory) TOP: Preventing Problems of Immobility KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance 3. The nurse is caring for an obese resident with a pressure ulcer on her coccyx. The patient frequently lies on her backbecause it is difficult to turn due to her weight. Which intervention most effectively encourages independence? a. Instruct the staff turn the resident every 2 hours. b. Turn the patient on her side and use pillows to stabilize her. c. Arrange for short side rails to be used for positioning. d. Arrange for a trapeze so the patient can assist with positioning. ANS: D The trapeze allows for self-positioning and is less confining than are bed rails. Turning the patient on her side or using short rails for positioning do not foster independence. PTS:1 DIF: Cognitive Level: Application REF:187 OBJ:2 (theory) TOP: Preventing Problems of Immobility KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance 4. After assessing reddened heels on a bed-bound patient with a history of a stroke, which intervention should the nurse add to the care plan? a. Massage heels briskly. b. Apply socks to feet. c. Swab heels with alcohol. d. Elevate feet on pillows.