A nurse is caring for a client who has a spinal cord injury at the fourth cervical level. Which of the following mobility options should the nurse anticipate for this client?
Manual wheelchair
Sip-and-puff device
Drive-adapted wheelchair
Ultra-light wheelchairs
The Correct Answer is B
Choice A Reason:
Manual wheelchair is inappropriate. A manual wheelchair requires the use of the client's upper extremities to propel the wheelchair forward by pushing on the wheels. With a spinal cord injury at the fourth cervical level, the client may have limited or no function in their upper extremities, making it difficult to self-propel a manual wheelchair.
Choice B Reason:
Sip-and-puff device is appropriate. A sip-and-puff device allows individuals with limited or no hand function to control a powered wheelchair using their breath. This device enables the client to navigate the wheelchair by inhaling or exhaling into a straw-like device, which activates controls to move the wheelchair forward, backward, and turn.
Choice C Reason:
Drive-adapted wheelchair is inappropriate. A drive-adapted wheelchair is a powered wheelchair that can be modified with adaptive controls to accommodate individuals with limited hand function or mobility. These wheelchairs may include joystick controls, head arrays, chin controls, or other adaptive devices that allow the client to operate the wheelchair independently despite limited hand function.
Choice D Reason:
Ultra-light wheelchairs is inappropriate. Ultra-light wheelchairs are manual wheelchairs that are lightweight and often customized to fit the client's specific needs and preferences. While ultra-light wheelchairs may offer advantages in terms of maneuverability and ease of transportation, they still require sufficient upper extremity function to self-propel the wheelchair.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Keeping lights turned to medium level in the evening is incorrect. This intervention is aimed at reducing environmental stimuli, which may be appropriate for some patients with neurological conditions to minimize sensory overload and promote rest. However, it is not a specific intervention for preventing cerebral aneurysm rupture.
Choice B Reason:
Maintaining the head of the bed between 30 and 45° is correct. Keeping the head of the bed elevated can help reduce intracranial pressure and decrease the risk of cerebral aneurysm rupture or rebleeding in patients with aneurysmal subarachnoid hemorrhage. This position promotes venous drainage from the brain and helps prevent increases in intracranial pressure.
Choice C Reason:
Administering hypotonic intravenous solutions is incorrect. Hypotonic intravenous solutions have a lower osmolarity than blood plasma and can lead to cerebral edema, which may exacerbate intracranial pressure and increase the risk of cerebral aneurysm rupture. Isotonic solutions, such as normal saline (0.9% NaCl) or lactated Ringer's solution, are typically preferred for fluid resuscitation and maintenance in patients at risk of cerebral aneurysm rupture.
Choice D Reason:
Reposition the client every shift is incorrect. Repositioning the client every shift helps prevent complications associated with immobility, such as pressure ulcers, pneumonia, and venous thromboembolism. While important for overall patient care, repositioning alone does not directly address the risk of cerebral aneurysm rupture.
Correct Answer is D
Explanation
Choice A Reason:
Repeating the same question over and over is incorrect. Repeating the same question over and over is not a desired outcome of client education. It may indicate confusion or cognitive impairment rather than effective learning and understanding of COPD management.
Choice B Reason:
Awareness of COPD manifestations is incorrect. This is a desirable outcome of client education. Increasing the client's awareness of COPD manifestations, such as dyspnea, coughing, and sputum production, can help them recognize exacerbations early and take appropriate action to manage their condition.
Choice C Reason:
Anxiety and restlessness is incorrect. Anxiety and restlessness are not desired outcomes of client education. While anxiety is common in individuals with COPD due to the chronic nature of the condition and its impact on daily activities, education should aim to reduce anxiety by providing information and strategies for coping with COPD-related symptoms and challenges.
Choice D Reason:
Motivation and engagement of the client is correct. This is a desirable outcome of client education. Motivating and engaging the client in their own care empowers them to take an active role in managing their COPD and improving their quality of life. Education should provide information, support, and encouragement to help the client feel motivated and engaged in self-management strategies.
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