Chapter 6: Rehabilitation Concepts for Chronic and Disabling Health Problems

Chapter 6: Rehabilitation Concepts for Chronic and Disabling Health Problems

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A nurse assesses a client recovering from coronary artery bypass graft surgery. Which assessment should the nurse complete to evaluate the client’s activity tolerance?
   1. Vital signs before, during, and after activity
   2. Body image and self-care abilities
   3. Ability to use assistive or adaptive devices
   4. Client’s electrocardiography readings

ANS:   A

To see whether a client is tolerating activity, vital signs are measured before, during, and after the activity. If the client is not tolerating activity, heart rate may increase more than 20 beats/min, blood pressure may increase over 20 mm Hg, and vital signs will not return to baseline within 5 minutes after the activity. A body image assessment is not necessary before basic activities are performed. Self-care abilities and ability to use assistive or adaptive devices is an important assessment when planning rehabilitation activities, but will not provide essential information about the client’s activity tolerance. Electrocardiography is not used to monitor clients in a rehabilitation setting.

DIF:     Applying/Application                         REF: 77                       KEY: Rehabilitation care| functional ability                                                         MSC:             Integrated Process: Nursing Process: Evaluation                                         NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation

2. A nurse teaches a client with a past history of angina who has had a total knee replacement. Which statement should the nurse include in this client’s teaching prior to beginning rehabilitation activities?
   1. “Use analgesics before and after activity, even if you are not experiencing pain.”
   2. “Let me know if you start to experience shortness of breath, chest pain, or fatigue.”
   3. “Do not take your prescribed beta blocker until after you exercise with physical therapy.”
   4. “If you experience knee pain, ask the physical therapist to reschedule your

therapy.”

ANS:   B

Participation in exercise may increase myocardial oxygen demand beyond the ability of the coronary circulation to deliver enough oxygen to meet the increased need. The nurse must determine the client’s ability to tolerate different activity levels. Asking the client to notify the nurse if symptoms of shortness of breath, chest pain, or fatigue occur will assist the nurse in developing an appropriate cardiac rehabilitation plan.

DIF:     Applying/Application                         REF: 78                       KEY: Rehabilitation care| nitroglycerin/nitrates| pain                              MSC: Integrated Process: Teaching/Learning                       NOT:                                                 Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

3. A rehabilitation nurse prepares to move a client who has new bilateral leg amputations. Which is the best approach?
   1. Use the bear-hug method to transfer the client safely.
   2. Ask several members of the health care team to carry the client.
   3. Utilize the facility’s mechanical lift to move the client.
   4. Consult physical therapy before performing all transfers.

ANS:           C

Use mechanical lifts to minimize staff work-related musculoskeletal injuries. The bear-hug method and the use of several members of the team to carry the client do not eliminate staff injuries. Physical therapy should be consulted but cannot be depended upon for all transfers. Nursing staff must be capable of transferring a client safely.

DIF:            Applying/Application                         REF: 81                       KEY: Rehabilitation care| patient safety| staff safety                                                   MSC:                         Integrated Process: Nursing Process: Implementation                                        NOT:                          Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control

4. A nurse performs passive range-of-motion exercises on a semiconscious client and meets resistance while attempting to extend the right elbow more than 45 degrees. Which action should the nurse take next?
   1. Splint the joint and continue passive range of motion to the shoulder only.
   2. Progressively increase joint motion 5 degrees beyond resistance each day.
   3. Apply weights to the right distal extremity before initiating any joint exercise.
   4. Continue to move the joint only to the point at which resistance is met.

ANS:           D

Moving a joint beyond the point at which the client feels pain or resistance can damage the joint. The nurse should move the joint only to the point of resistance. Splinting the joint will not assist the client’s range of motion. The client’s joint should not be forced. Applying weights to the extremity will not increase range of motion of the joint but most likely will cause damage.

DIF:            Applying/Application                         REF: 84

KEY:          Rehabilitation care| exercise

MSC:          Integrated Process: Nursing Process: Implementation           NOT: Client Needs Category: Physiological Integrity: Basic Care and Comfort