A nurse is assessing a client who has myasthenia gravis. Which of the following client statements should indicate to the nurse that the client needs a referral for occupational therapy?

"I've been having problems with bladder control."

"I have difficulty swallowing food."

"I have a hard time with brushing my hair."

"I would rather be in a wheelchair than use a walker to get around."

Answer and Explanation

The Correct Answer is C

Choice A reason: While bladder control issues can significantly affect a client's quality of life, they are typically managed by a urologist or a specialist in continence, rather than an occupational therapist. Occupational therapy focuses on improving the ability to perform activities of daily living (ADLs), which generally does not include bladder control.

Choice B reason: Difficulty swallowing, known as dysphagia, can be a symptom of myasthenia gravis due to muscle weakness. Although it is a serious concern, it is usually managed with the help of a speech therapist who specializes in swallowing difficulties, rather than an occupational therapist.

Choice C reason: Having a hard time with brushing hair is directly related to the performance of ADLs, which is the primary focus of occupational therapy. An occupational therapist can assist the client by teaching energy conservation techniques, providing adaptive equipment, and modifying the task to make it easier for the client to maintain personal grooming independently.

Choice D reason: Preferring a wheelchair over a walker is a matter of mobility and personal preference. While occupational therapy can help with mobility issues, this statement alone does not indicate a need for occupational therapy unless the client has difficulty performing ADLs due to the choice of mobility aid.

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Correct Answer is A

Explanation

Choice A reason: Glycosylated hemoglobin, also known as hemoglobin A1C, reflects the average blood glucose levels over the past two to three months. It is a crucial indicator of long-term glycemic control in individuals with diabetes. The American Diabetes Association recommends that the A1C level be checked at least two times a year in patients who are meeting treatment goals and have stable glycemic control. An A1C level below 7% is generally considered good control, and achieving this target can reduce microvascular complications of diabetes.

Choice B reason: Postprandial blood glucose levels indicate the amount of glucose in the blood after a meal. While it's an important measure, it reflects only the immediate response to food intake and does not provide information about long-term glycemic control.

Choice C reason: Fasting blood glucose levels measure the amount of glucose in the blood after an overnight fast. This test is used to detect diabetes or prediabetes but is less effective than the A1C test for monitoring long-term glycemic control.

Choice D reason: The oral glucose tolerance test (OGTT) measures blood glucose levels before and two hours after consuming a glucose-rich drink. This test is primarily used for diagnosing diabetes and gestational diabetes, not for long-term monitoring.

A. Severe, throbbing headache B. Hypotension C. Fever D. Cyanosis of the head and neck

Correct Answer is A

Explanation

Choice A reason : A severe, throbbing headache is a common and significant manifestation of autonomic dysreflexia. This condition is a potentially life-threatening medical emergency that can occur in individuals with spinal cord injuries, typically above the T6 level. The headache results from a sudden and severe increase in blood pressure due to an exaggerated response of the autonomic nervous system to a stimulus below the level of the injury.

Choice B reason: Hypotension, or low blood pressure, is not a manifestation of autonomic dysreflexia. In fact, the condition is characterized by hypertension, or high blood pressure, which is a critical sign that requires immediate attention to prevent complications such as stroke or seizure.

Choice C reason: Fever is not a direct manifestation of autonomic dysreflexia. While a fever may indicate an infection or other systemic issue, autonomic dysreflexia itself is specifically associated with a rapid onset of high blood pressure and other autonomic disturbances.

Choice D reason: Cyanosis of the head and neck, which refers to a bluish discoloration of the skin due to poor circulation or inadequate oxygenation of the blood, is not a typical manifestation of autonomic dysreflexia. The condition primarily causes hypertension and its associated symptoms, rather than issues with oxygenation.

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A nurse is assessing a client who has myasthenia gravis. Which of the following client statements should indicate to the nurse that the client needs a referral for occupational therapy?

Nursing Test Bank

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Correct Answer is A

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Correct Answer is A

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