Chapter 10: Rehabilitation Nursing School Test Banks

Black & Hawks: Medical-Surgical Nursing, 8th Edition

Test Bank

Chapter 10: Rehabilitation

MULTIPLE CHOICE

1. The rehabilitation nurse stresses that the major focus in a rehabilitation setting is

a.

acquisition of services for the newly discharged client.

b.

elimination of clinical manifestations.

c.

prevention of disease progression.

d.

skills instruction for independence.

ANS: D

Rehabilitation nursing is a complex arrangement of services from a multifaceted team to support the client and family in learning to live with chronic disease and disability.

DIF: Comprehension/Understanding REF: p. 111 OBJ: Intervention

MSC: Health Promotion and Maintenance Prevention and/or Early Detection of Health Problems-Self Care

2. The nurse clarifies that the Medicare criteria to qualify for rehabilitation services include that a client will

a.

communicate adequately to be understood.

b.

participate in 3 hours of therapy daily.

c.

require three or more therapeutic modalities.

d.

walk independently with crutches, cane, or walker.

ANS: A

Medicare criteria require that the client seeking rehabilitation services is able to participate in 3 hours of therapy daily and requires two or more therapeutic modalities in addition to rehabilitation medicine and nursing. Goals, such as for locomotion, are established by a transdisciplinary team and are individualized for each client.

DIF: Application REF: pp. 112-113 OBJ: Intervention

MSC: Safe, Effective Care Environment Management of Care-Resource Management

3. The rehabilitation nurse reminds a client that according to the International Classification of Functioning, Disability and Health (ICF), the broad theoretical qualification criterion for rehabilitation services is that the client

a.

has impaired mobility in two limbs.

b.

has impairments that lead to reduced ability to engage in activities.

c.

is no longer capable of independent living.

d.

requires assistance in mobility, dressing, and toileting.

ANS: B

The ICF has the theoretical qualification of impairment severe enough to reduce the ability to engage in activities. ICF criteria do not consider the stricter criteria of third-party payers.

DIF: Comprehension/Understanding REF: p. 112 OBJ: Intervention

MSC: Health Promotion and Maintenance Prevention and/or Early Detection of Health Problems-Self Care

4. The rehabilitation nurse uses the Functional Independence Measures (FIM) tool to assess the clients

a.

attitude.

b.

physical strength.

c.

rehabilitation goals.

d.

self-care capabilities.

ANS: D

The FIM tool assesses the client on a 7-point scale over 18 areas of functioning to arrive at a score for the clients rehabilitation needs. The 18 areas are related to self-care, sphincter management, transfers, locomotion, communication, and social cognition.

DIF: Application/Applying REF: pp. 113-114 OBJ: Assessment

MSC: Physiological Integrity Physiological Adaptation-Alteration in Body Systems

5. The rehabilitation nurse explains that the transdisciplinary approach to rehabilitation provides the client with

a.

more efficient service at a greatly reduced cost.

b.

reduced number of personnel with whom to interact.

c.

reduced time spent on therapeutic modalities.

d.

shortened stay in the rehabilitation unit.

ANS: B

The transdisciplinary approach reduces the number of personnel interacting with the client. This is especially effective for clients who need longer-term rehabilitation and for those with significant cognitive sequelae following brain trauma.

DIF: Comprehension/Understanding REF: p. 114 OBJ: Application

MSC: Safe, Effective Care Environment Management of Care-Collaboration with Interdisciplinary Team

6. To set the stage for a successful rehabilitation experience, the rehabilitation nurse helps the client and the family conceptualize their definition of

a.

activity participation.

b.

independence.

c.

quality of life.

d.

wellness.

ANS: C

The conceptualization of the clients idea and familys idea of quality of life is the cornerstone of a successful rehabilitation experience.

DIF: Application/Applying REF: p. 114 OBJ: Intervention

MSC: Psychosocial Integrity Psychosocial Adaptation-Quality of Life

7. The nurse makes sure that the client and the family understand that in the transdisciplinary approach, the entire team

a.

estimates the time required for full functioning.

b.

identifies a primary therapist.

c.

limits what each discipline will offer.

d.

sets team goals during transdisciplinary meetings.

ANS: B

The team appoints a primary therapist based on the major needs of the rehabilitation client. Each member develops a plan for how their discipline will contribute to the realization of the clients goals. The client may never attain full functioning. Transdisciplinary team meetings do occur, but goals are set for the client, not the team.

DIF: Comprehension/Understanding REF: p. 114 OBJ: Intervention

MSC: Safe, Effective Care Environment Management of Care-Collaboration with Interdisciplinary Team

8. A rehabilitation nurse scores the client at 1 in a functional area on the FIM. This means the client has

a.

full independence in that area.

b.

independence in that area with use of an assistive device.

c.

partial dependence in need of significant assistance.

d.

total dependence.

ANS: D

The rating scale is 1 through 7, with 1 indicating total dependence and 7 signaling total independence.

DIF: Application/Applying REF: pp. 113-114 OBJ: Assessment

MSC: Physiological Integrity Physiological Adaptation-Alteration in Body Systems

9. A nurse incorporating a clients psychosocial reaction to a disabling illness into the plan of care would use a staging model because the model

a.

allows the nurse to group the client with peers for socializing.

b.

describes the process of adaptation as a standardized process.

c.

explains some common reactions to the disabling condition.

d.

predicts the experience of psychosocial adaptation.

ANS: C

There are several models that explain stages clients may go through as they adapt to the reality of their condition. The advantage to using a model is that it can explain some of the reactions clients commonly have and can offer interventions appropriate for each stage. But client responses are individual and are influenced by many factors including the meaning of the event, past coping experiences, and others response to the event. Common responses are denial, grieving, uncertainty, hopelessness, helpfulness, and eventual adaptation.

DIF: Application/Applying REF: p. 115 OBJ: Intervention

MSC: Psychosocial Adaptation Coping and Adaptation-Coping Mechanisms

MULTIPLE RESPONSE

1. The rehabilitation nurse ensures that teaching is (Select all that apply)

a.

designed, delivered, and reinforced in ways that are meaningful.

b.

designed to cover all aspects of the rehabilitation process.

c.

individualized to the client and family even when standardized material is used.

d.

presented in appropriate levels and formats.

e.

readily available so that learning can occur when the learner is ready.

ANS: A, C, D, E

Research shows that clients, families, and nurses perceived a discrepancy in the effectiveness of education. Families also often have limited recollection of the material they were taught. Good education is designed to accommodate personal factors of the learner. Some good strategies include the above options. Since education is individualized, a client may not need education on all aspects of rehabilitation.

DIF: Application/Applying REF: p. 115 OBJ: Intervention

MSC: Health Promotion and Maintenance Prevention and/or Early Detection of Health Problems-Principles of Teaching/Learning

Elsevier items and derived items 2009 by Saunders, an imprint of Elsevier Inc.

Some material was previously published.

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