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 After a week on the unit, the nurse notes that the client is withdrawn and increasingly resistant to rehabilitative efforts by the staff.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. The client has some movement and also some sensation below the level of the injury. B. The client has some movement but no sensation below the level of the injury. C. The client has some sensation but no movement below the level of the injury. D. The client has no sensation or movement below the level of the injury.

Correct Answer is D

Explanation

A. A complete spinal cord injury means that both sensory and motor functions are lost below the level of the injury. If the client had some movement and sensation, it would indicate an incomplete injury, which is not consistent with a complete transection.
B. This option describes a situation known as "motor incomplete," where there is preserved motor function but loss of sensory function below the level of injury. However, in a complete transection at C7, there would be no movement or sensation below that level, making this statement inaccurate.
C. This describes a condition where sensory pathways remain intact while motor pathways are disrupted, which is seen in incomplete spinal cord injuries. However, a complete transection at C7 would mean both movement and sensation are absent below the injury level, making this option incorrect.
D. In the case of a complete spinal cord transection at C7, the client would experience total loss of both sensation and movement below that level. This is consistent with the definition of a complete spinal cord injury.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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