A rehabilitation nurse is caring for a client who has had a spinal cord injury that resulted in paraplegia. After a week on the unit, the nurse notes that the client is withdrawn and increasingly resistant to rehabilitative efforts by the staff. Which of the following actions should the nurse take?

Establish a plan of care with the client that sets attainable goals.

Inform the client that privileges are related to participation in therapy.

Limit visiting hours until the client begins to participate in therapy.

Allow the client to control the timing and frequency of the therapy.

Answer and Explanation

The Correct Answer is A

A.   This option focuses on involving the client in their own care and goal-setting. By establishing attainable goals together, the nurse can help the client regain a sense of control and motivation, which may encourage participation in therapy.
B.   This option uses a form of coercion, implying that the client must comply with therapy to earn privileges. While consequences for non-participation can be a component of care, this approach may increase resistance and feelings of resentment.
C.   This approach is punitive and likely to worsen the client's emotional state. Limiting support from family and friends can increase feelings of isolation and abandonment, potentially leading to greater resistance to therapy.
D.   While offering the client some control can be beneficial, this option may lead to inconsistencies in therapy participation. If the client chooses to minimize their participation or avoid therapy altogether, it could hinder their rehabilitation progress. However, a balanced approach that includes some client choice alongside structured therapy may be beneficial.

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Correct Answer is D

Explanation

A. While sporting accidents can lead to spinal cord injuries, they are more prevalent in younger populations who are more physically active. In older adults, the likelihood of sustaining a spinal cord injury from sports is relatively low compared to other causes.
B. Gunshot wounds are a significant cause of spinal cord injuries, but they are not common in older adults. This type of injury is more frequently seen in younger individuals, particularly in areas with higher rates of violence or firearms.
C. Motor vehicle accidents can cause spinal cord injuries, but their prevalence in older adults has decreased in recent years due to improved safety features in vehicles and the tendency for older adults to drive less frequently. While still a risk, they are not the leading cause.
D. Falls are the most common cause of spinal cord injuries in individuals aged 65 and older. As people age, they experience changes in balance, strength, and mobility, increasing their risk of falls. Falls can lead to serious injuries, including fractures and spinal cord injuries, making this the primary concern in this age group.

A. Neutropenic B. Bleeding C. Droplet D. Contact

Correct Answer is B

Explanation

A. Neutropenic precautions are necessary for patients with low white blood cell counts (neutrophils), which increases the risk of infections. However, in this scenario, the child has a critically low platelet count, not necessarily low white blood cells.
B. This option refers to implementing bleeding precautions, which are critical for a child with low platelet counts (thrombocytopenia). This includes measures to prevent injury and bleeding, such as avoiding invasive procedures, using soft toothbrushes, and ensuring a safe environment.
C. Droplet precautions are used to prevent the spread of infections transmitted through respiratory droplets, such as influenza or COVID-19. While important for specific infections, this does not apply directly to the child's condition regarding leukemia and low platelets unless there is a concern for a respiratory illness.
D. Contact precautions are used to prevent the spread of infections through direct contact with the patient or their environment. This is important for infections that can be spread by touch. However, it is not the primary concern for a child with low platelet counts unless there is a known infectious risk.

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A rehabilitation nurse is caring for a client who has had a spinal cord injury that resulted in paraplegia. After a week on the unit, the nurse notes that the client is withdrawn and increasingly resistant to rehabilitative efforts by the staff. Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

A nurse is teaching a group of nursing students about spinal cord injuries in clients who are aged 65 years and older. Which of the following should the nurse tify as the most common cause of spinal cord injuries for this age group?

Correct Answer is D

Explanation

A nurse is admitting a child who has leukemia and a critically low platelet count. Which of the following precautions should the nurse initiate?

Correct Answer is B

Explanation

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