Question 1

As a member of the rehabilitation team, the nurse is conscious of the need to perform the nursing role in collaboration with the other members of the team. Which of the following variables has the greatest bearing on the nurses choice of actions and interventions during rehabilitative care?

Accepted Answer

A)  The skills of the other members of the team 
B)  The circumstances of the patient 
C)  The desires of the patients family 
D)  The nurses education and experience level

Question 2

An elderly female patient who is bedridden is admitted to the unit because of a pressure ulcer that can no longer be treated in a community setting. During your assessment of the patient, you find that the ulcer extends into the muscle and bone. At what stage would document this ulcer?

Accepted Answer

A)  I 
B)  II 
C)  III 
D)  IV

Question 3

A female patient, 47 years old, visits the clinic because she has been experiencing stress incontinence when she sneezes or exercises vigorously. What is the best instruction the nurse can give the patient?

Accepted Answer

A)  Keep a record of when the incontinence occurs. 
B)  Perform clean intermittent self-catheterization. 
C)  Perform Kegel exercises four to six times per day. 
D)  Wear a protective undergarment to address this age-related change.

Question 4

A patient who is receiving rehabilitation following a spinal cord injury has been diagnosed with reflex incontinence. The nurse caring for the patient should include which intervention in this patients plan of care?

Accepted Answer

A)  Regular perineal care to prevent skin breakdown 
B)  Kegel exercises to strengthen the pelvic floor 
C)  Administration of hypotonic IV fluid 
D)  Limited fluid intake to prevent incontinence

Question 5

You are the nurse caring for a female patient who developed a pressure ulcer as a result of decreased mobility. The nurse on the shift before you has provided patient teaching about pressure ulcers and healing promotion. You assess that the patient has understood the teaching by observing what?

Accepted Answer

A)  Patient performs range-of-motion exercises. 
B)  Patient avoids placing her body weight on the healing site. 
C)  Patient elevates her body parts that are susceptible to edema. 
D)  Patient demonstrates the technique for massaging the wound site.

Question 6

You are planning rehabilitation activities for a patient who is working toward discharge back into the community. During a care conference, the team has identified a need to focus on the patients instrumental activities of daily living (IADLs). When planning the patients subsequent care, you should focus particularly on which of the following?

Accepted Answer

A)  Dressing 
B)  Bathing 
C)  Feeding 
D)  Meal preparation

Question 7

A school nurse is providing health promotion teaching to a group of high school seniors. The nurse should highlight what salient risk factor for traumatic brain injury?

Accepted Answer

A)  Substance abuse 
B)  Sports participation 
C)  Anger mismanagement 
D)  Lack of community resources

Question 8

You are creating a nursing care plan for a patient who is hospitalized following right total hip replacement. What nursing action should you specify to prevent inward rotation of the patients hip when the patient is in a partial lateral position?

Accepted Answer

A)  Use of an abduction pillow between the patients legs 
B)  Alignment of the head with the spine using a pillow 
C)  Support of the lower back with a small pillow 
D)  Placement of trochanter rolls under the greater trochanter

Question 9

An adult patients current goals of rehabilitation focus primarily on self-care. What is a priority when teaching a patient who has self-care deficits in ADLs?

Accepted Answer

A)  To provide an optimal learning environment with minimal distractions 
B)  To describe the evidence base for any chosen interventions 
C)  To help the patient become aware of the requirements of assisted-living centers 
D)  To ensure that the patient is able to perform self-care without any aid from caregivers

Question 10

The nurse is providing care for a 90 -year-old patient whose severe cognitive and mobility deficits result in the nursing diagnosis of risk for impaired skin integrity due to lack of mobility. When planning relevant assessments, the nurse should prioritize inspection of what area?

Accepted Answer

A)  The patients elbows 
B)  The soles of the patients feet 
C)  The patients heels 
D)  The patients knees

Question 11

You are the nurse caring for a patient who has paraplegia following a hunting accident. You know to assess regularly for the development of pressure ulcers on this patient. What rationale would you cite for this nursing action?

Accepted Answer

A)  You know that this patient will have a decreased level of consciousness. 
B)  You know that this patient may not be motivated to prevent pressure ulcers. 
C)  You know that the risk for pressure ulcers is directly related to the duration of immobility. 
D)  You know that the risk for pressure ulcers is related to what caused the immobility.

Question 12

An elderly woman diagnosed with osteoarthritis has been referred for care. The patient has difficulty ambulating because of chronic pain. When creating a nursing care plan, what intervention may the nurse use to best promote the patients mobility?

Accepted Answer

A)  Motivate the patient to walk in the afternoon rather than the morning. 
B)  Encourage the patient to push through the pain in order to gain further mobility. 
C)  Administer an analgesic as ordered to facilitate the patients mobility. 
D)  Have another person with osteoarthritis visit the patient.

Question 13

An interdisciplinary team has been working collaboratively to improve the health outcomes of a young
Adult who suffered a spinal cord injury in a workplace accident. Which member of the rehabilitation team is the one who determines the final outcome of the process?

Accepted Answer

A)  Most-responsible nurse 
B)  Patient 
C)  Patients family 
D)  Primary care physician

Question 14

A patient has been transferred to a rehabilitative setting from an acute care unit. What is the most
Important reason for the nurse to begin a program for activities of daily living (ADLs) as soon as the patient is admitted to a rehabilitation facility?

Accepted Answer

A)  The ability to perform ADLs may be the key to dependence. 
B)  The ability to perform ADLs is essential to living in a group home. 
C)  The ability to perform ADLs may be the key to reentry into the community. 
D)  The ability to perform ADLs is necessary to function in an assisted-living situation.

Question 15

You are the rehabilitation nurse caring for a 25 -year-old patient who suffered extensive injuries in a motorcycle accident. During each patient contact, what action should you perform most frequently?

Accepted Answer

A)  Complete a physical assessment. 
B)  Evaluate the patients positioning. 
C)  Plan nursing interventions. 
D)  Assist the patient to ambulate.

Question 16

A patient is undergoing rehabilitation following a stroke that left him with severe motor and sensory deficits. The patient has been unable to ambulate since his accident, but has recently achieved the goals of sitting and standing balance. What is the patient now able to use?

Accepted Answer

A)  A cane 
B)  Crutches 
C)  A two-wheeled walker 
D)  Parallel bars

Question 17

A patient is being transferred from a rehabilitation setting to a long-term care facility. During this process, the nurse has utilized the referral system? Using this system achieves what goal of the patients care?

Accepted Answer

A)  Minimizing costs of the patients care 
B)  Maintaining continuity of the patients care 
C)  Maintain the nursing care plan between diverse sites 
D)  Keeping the primary care provider informed

Question 18

The nurse is providing care for an older adult man whose diagnosis of dementia has recently led to urinary incontinence. When planning this patients care, what intervention should the nurse avoid?

Accepted Answer

The answer of The nurse is providing care for an...

Question 19

You are caring for a 35-year-old man whose severe workplace injuries necessitate bilateral below-theknee amputations. How can you anticipate that the patient will respond to this news?

Accepted Answer

A)  The patient will go through the stages of grief over the next week to 10 days. 
B)  The patient will progress sequentially through five stages of the grief process. 
C)  The patient will require psychotherapy to process his grief. 
D)  The patient will experience grief in an individualized manner.

Question 20

You have been referred to the care of an extended care resident who has been diagnosed with a stage III pressure ulcer. You are teaching staff at the facility about the role of nutrition in wound healing. What would be the best meal choice for this patient?

Accepted Answer

A)  Whole wheat macaroni with cheese 
B)  Skim milk, oatmeal, and whole wheat toast 
C)  Steak, baked potato, spinach and strawberry salad 
D)  Eggs, hash browns, coffee, and an apple

Exam 10: Principles and Practices of Rehabilitation