Discharge plans are being made for a 25-year-old hospitalized client diagnosed with multiple sclerosis. The client has significant muscle weakness in the lower extremities bilaterally. Which of the following facilities should the nurse expect this client to be discharged to?
Skilled nursing facility
Home care services
Rehabilitation facility
Sub-acute care facility
The Correct Answer is C
Choice A reason: A skilled nursing facility is a type of long-term care facility that provides 24-hour nursing care and supervision for residents who need assistance with activities of daily living, such as bathing, dressing, eating, and toileting. A skilled nursing facility may not be suitable for a young client with multiple sclerosis who has the potential for improvement and recovery.
Choice B reason: Home care services are a type of community-based care that provides medical and personal care to clients in their own homes. Home care services may include nursing, physical therapy, occupational therapy, speech therapy, social work, or home health aide services. Home care services may be appropriate for a client with multiple sclerosis who has mild to moderate symptoms and a supportive family or caregiver.
Choice C reason: A rehabilitation facility is a type of short-term care facility that provides intensive physical and occupational therapy to clients who have functional impairments due to injury, illness, or surgery. A rehabilitation facility may also provide medical, nursing, and psychological care to clients who need them. A rehabilitation facility may be suitable for a client with multiple sclerosis who has significant muscle weakness and needs to regain strength, mobility, and independence.
Choice D reason: A sub-acute care facility is a type of transitional care facility that provides medical and nursing care to clients who are stable but need complex monitoring or treatment that cannot be provided at home or in a skilled nursing facility. A sub-acute care facility may also provide rehabilitation services to clients who need them. A sub-acute care facility may not be appropriate for a young client with multiple sclerosis who has the potential for improvement and recovery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: It is a tool that is used to determine your maximum level of self-sufficiency as the appropriate nursing response, as it accurately describes the purpose and function of the FIM. The FIM measures how much assistance you need to perform 18 activities of daily living, such as eating, dressing, toileting, walking, and communicating. The FIM helps to evaluate your functional status, monitor your progress, and plan your rehabilitation goals and interventions. ¹²³
Choice B reason: It is a test that determines which activities you feel most comfortable performing is not an appropriate nursing response, as it does not reflect the objective and standardized nature of the FIM. The FIM is not a subjective or self-reported measure of your preferences or comfort level, but rather an observational and rating scale that assesses your actual performance and independence in various tasks. The FIM uses a 7-point ordinal scale that ranges from 1 (total assistance) to 7 (complete independence) and requires trained and certified raters to administer and score it. ¹²³
Choice C reason: It is a tool used by insurance companies to determine qualifications for medical reimbursement is not an appropriate nursing response, as it does not capture the primary purpose and benefit of the FIM. The FIM is not a financial or administrative tool that determines your eligibility or coverage for medical services, but rather a clinical and research tool that measures your functional outcomes and quality of care. The FIM provides a uniform system of measurement for disability based on the International Classification of Impairment, Disabilities, and Handicaps and allows for comparison and evaluation of different rehabilitation programs and settings. ¹²³
Choice D reason: It is a tool that is used to assess what services you will need a home health aide to perform for you is not an appropriate nursing response, as it does not reflect the comprehensive and multidimensional scope of the FIM. The FIM is not a specific or limited tool that assesses only your home care needs or dependence on others, but rather a general and broad tool that assesses your functional abilities and disabilities in various domains and environments. The FIM covers both motor and cognitive aspects of functioning, such as comprehension, expression, social interaction, problem-solving, and memory. The FIM can be used with all diagnoses within rehabilitation and can be applied across different levels and settings of care.
Correct Answer is A
Explanation
Choice A reason: Hypertension is a manifestation of increased intracranial pressure, as it reflects the body's attempt to maintain adequate cerebral perfusion pressure (CPP) and blood flow to the brain. CPP is the difference between the mean arterial pressure (MAP) and the intracranial pressure (ICP). When ICP rises, MAP must also rise to keep CPP constant and prevent cerebral ischemia. Hypertension is part of the Cushing's triad, which is a classic sign of increased ICP that also includes bradycardia and irregular respirations.
Choice B reason: Tinnitus is not a manifestation of increased intracranial pressure, as it does not affect the auditory system. Tinnitus is a ringing, buzzing, or hissing sound in the ears that can be caused by various factors, such as ear infections, noise exposure, medications, or aging. Tinnitus may be associated with other neurological conditions, such as Meniere's disease, acoustic neuroma, or multiple sclerosis, but not with increased ICP.
Choice C reason: Hypotension is not a manifestation of increased intracranial pressure, as it indicates a decrease in MAP and CPP, which can lead to cerebral ischemia and infarction. Hypotension can be caused by various factors, such as blood loss, dehydration, shock, or medications. Hypotension may worsen the outcome of increased ICP by reducing the oxygen and nutrient delivery to the brain.
Choice D reason: Tachycardia is not a manifestation of increased intracranial pressure, as it contradicts Cushing's triad. Tachycardia is an increase in heart rate that can be caused by various factors, such as anxiety, pain, fever, dehydration, or medications. Tachycardia may increase the oxygen demand and metabolic rate of the brain, which can exacerbate the effects of increased ICP.
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