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 D
Explanation
Correct answer: D
Choice A Reason:
Decreased pulmonary vascular resistance is incorrect. Inflammatory mediators released in response to a pulmonary embolism can lead to vasoconstriction and increased pulmonary vascular resistance. This is part of the body's response to redirect blood flow away from the affected area of the lung and maintain adequate perfusion to other areas.
Choice B Reason:
Hypercapnia is incorrect. Hypercapnia refers to elevated levels of carbon dioxide (CO2) in the blood.Hypocapnia usually is present with embolism; hypercapnia, on the other hand, is rare.
Choice C Reason:
Hypoventilation is incorrect. Hypoventilation occurs when there is inadequate ventilation of the lungs relative to metabolic demands. In the context of a pulmonary embolism, hypoventilation can occur due to factors such as pain, respiratory muscle fatigue, or impaired gas exchange, all of which can be influenced by the release of inflammatory mediators.
Choice D Reason:
Respiratory alkalosis is correct.In response to the blockage and the resulting inflammation, the body often increases the respiratory rate as a compensatory mechanism to maintain adequate oxygen levels and remove carbon dioxide.Due to the increased breathing rate, there is excessive exhalation of carbon dioxide, leading to a decrease in the partial pressure of CO2 in the blood. This results in an increase in blood pH, causing respiratory alkalosis.

Correct Answer is A
Explanation
Choice A Reason:
COPD is a chronic lung condition characterized by airflow limitation that is not fully reversible. Individuals with COPD often have underlying structural lung changes, such as emphysematous bullae or blebs. These areas of weakened lung tissue are prone to rupture, leading to the development of pneumothorax. Additionally, the chronic inflammation and damage to the airways and lung parenchyma in COPD contribute to the development of pneumothorax.
Choice B Reason:
Sarcoidosis is incorrect. Sarcoidosis is a granulomatous disease that primarily affects the lungs and lymph nodes. While it can cause lung damage and lead to pneumothorax, it is less common than COPD as a comorbidity associated with SSP.
Choice C Reason:
Lung cancer is incorrect. Lung cancer can lead to pneumothorax, especially if the tumor erodes into the pleural space. However, SSP is more commonly associated with underlying lung diseases like COPD rather than lung cancer.
Choice D Reason:
Cystic fibrosis is incorrect. Cystic fibrosis is a genetic disorder characterized by abnormal mucus production and impaired clearance in various organs, including the lungs. While individuals with cystic fibrosis are at increased risk of pneumothorax due to underlying lung disease, SSP is less commonly seen in this population compared to COPD.
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