Chapter 09 Chronic Illness and Rehabilitation

Chapter 09  Chronic Illness and Rehabilitation

Complete Chapter Questions And Answers
 

Sample Questions

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. The nurse classifies this person as:
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.

DIF: Cognitive Level: Application REF: 177 OBJ: 1 (theory)
TOP: Concepts of Rehabilitation KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

2. A resident with advanced Parkinson’s disease stays in his wheelchair all day because it is too tiring to walk and he is fearful of falling. In order to increase mobility, the best intervention would be to:
a.
instruct the resident in crutch walking.
b.
assist the resident to walk 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.

DIF: Cognitive Level: Application REF: 184 | Box 9-5
OBJ: 2 (theory) TOP: Preventing Problems of Immobility
KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance

3. The obese resident who lies on her back because it is difficult to turn due to her weight has a pressure ulcer on her coccyx that is covered with a dressing. The most effective intervention to encourage independence is:
a.
have 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. The other options do not foster independence.

DIF: Cognitive Level: Application REF: 186-187 OBJ: 2 (theory)
TOP: Preventing Problems of Immobility
KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance

4. When the nurse assesses reddened heels on the bed-bound stroke patient, the nurse modifies the care plan to include which intervention?
a.
Massage heels briskly.
b.
Apply socks to feet.
c.
Swab heels with alcohol.
d.
Elevate feet on pillows.

ANS: D
Elevation of the feet gets the weight off the heels and will allow them to heal. All other options are not helpful to damaged skin. Brisk massage may promote damage to the skin. Alcohol can be irritating and may further damage heel skin.

DIF: Cognitive Level: Application REF: 180 | Nursing Care Plan 9-1
OBJ: 2 (theory) TOP: Preventing Problems of Immobility
KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance

5. The nurse cautions the 70-year-old patient who just had the cast removed from a broken arm that the immobility during the time he was in a cast can cause:
a.
arthritis.
b.
phlebitis.
c.
frozen shoulder.
d.
painful swelling.

ANS: C
Immobility can cause loss of strength and flexibility in the older adult.

DIF: Cognitive Level: Knowledge REF: 178 | 180 | Table 9-1
OBJ: 3 (theory) TOP: Effects of Immobility: Joint Stiffness
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance

6. The nurse assessing an 85-year-old patient who has been on bed rest for a fractured hip finds the patient flushed with a temperature of 100° F, pulse of 100, and respiration rate of 24. The next intervention should be to assess:
a.
BP.
b.
breath sounds.
c.
abdominal distention.
d.
amount of urinary output.

ANS: B
The initial assessments are the cardinal signs of pneumonia. The breath sounds should be assessed next to determine the presence of any adventitious breath sounds. BP will also need to be assessed, but the breath sounds are more important with the signs and symptoms present. Abdominal distention is indicative of a gastrointestinal problem. Amount of urinary output is important to an ongoing assessment but not a priority in the present circumstances.

DIF: Cognitive Level: Analysis REF: 179 | Table 9-1
OBJ: 3 (theory) TOP: Effects of Immobility: Hypostatic Pneumonia
KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance