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A form of NEGLECT in which the pt. fails to recognize the severity of paralysis is: - ✔✔answer anosognosia A neurological exam of a pt. with a complete lower motor neuron lesion would demonstrate which reflex activity? - ✔✔answer bulbocavernosus absent A nurse notes hyperactive reflexes and an increased resistance to passive motion in the extremities. This is known as: - ✔✔answer spasticity A patient who is unwilling to discuss his disability or to touch or look at his involved body parts may have a nursing diagnosis of: - ✔✔answer body image disturbance A patient who presents with drooling or insufficiently chewed food has a problem in which phase of the swallowing process? - ✔✔answer oral A patient with a complete SCI at T5 uses digital rectal stimulation to: - ✔✔answer stimulate peristalsis and relax the anal spincter A patient with left hemiplegia would be MOST likely to present: - ✔✔answer perceptual deficits A person with verbal apraxia experiences difficulty with: - ✔✔answer voluntary speech A positive gag reflex indicates that: - ✔✔answer pharyngeal muscles are constricting A prudent cardiac rehabilitation exercise program for a pt. following myocardial infarction is based upon: - ✔✔answer gradually increasing exercise after cardiac testing A pt. who has sustained an injury to the conus medullaris will usually have which of the folowing bladder symptoms? - ✔✔answer hypotonicity, no voiding reflex, overflow dribbling

ALS affects: - ✔✔answer skeletal muscles An initial nursing intervention for a pt. with altered respiratory function includes: - ✔✔answer encouraging coughing and deep breathing techniques An intrinsic factor which affects tissue tolerance and is responsible for pressure ulcer development is: - ✔✔answer low arteriolar pressure Antihypertensives may cause urinary incontinence because they: - ✔✔answer relax the smooth muscle of the bladder neck Autonomous areflexic bladder dysfunction occurs when a lesion involves: - ✔✔answer both the motor and sensory components of the sacral segments of the spinal cord Besides joint pain, the MOST frequently cited causes of sexual impairment associated with rheumatoid arthritis include: - ✔✔answer fatigue Blindness of the nasal half of one eye and the temporal half of the other is known as: - ✔✔answer homonymous hemianopsia Brain injuries MOST often occur as a result of: - ✔✔answer auto accidents Capitation payment - ✔✔answer involves a fixed monthly payment Contractual allowance - ✔✔answer discounts from normal charges given to large payers for health care services Contribution margin - ✔✔answer the amount by which the price exceeds the varible cost Cost reimbursement - ✔✔answer the revenue based on the organization receiving payment for costs incurred

Cost-control efforts in the US are characterized by a combination of gov. regulation and market-based competition. Which of the following is an example of a regulation-based cost-containment strategy? - ✔✔answer restrictions on supply of physicians Cross- subsidization - ✔✔answer when some pts. are assigned more costs than they create and others less During periods of stress or trauma, which nutrients are used by the body as energy sources? - ✔✔answer proteins During the initial interview, the rehab nurse assesses a pt's cognition by: - ✔✔answer determining the pt's understanding of gestures and vocal inflections Dysarthria is characterized by: - ✔✔answer slurred or thick-tongued speech Each method of paying health care providers has incentives or imposes financial risks to affect choices and decisions. Which method places all the risk on the payer of health care? - ✔✔answer fee-for-service payment For a pt in the chronic stage of rheumatoid arthritis, which of the following interferes with functioning? - ✔✔answer pain, muscle weakness, and joint disordees For the pt. with decreased attention span, the nurse should: - ✔✔answer use repetition For who were intervention programs INITIALLY designed? - ✔✔answer children with developmental or physical disabilities How can the case manager positively INCREASE the value of an Independent Medical Examination? - ✔✔answer by using a physician whose expertise matches the issue

Metered dose inhalers deliver medicine to pts. with lung disease. Which of the following is an ADVANTAGE of this delivery method? - ✔✔answer less likelihood for systemic side effects Motor nerve fibers cross over in the brainstem at the level of the: - ✔✔answer medulla Mr. V has had damage to his right parietal lobe as a result of a brain injury. Mr. V will probably have difficulty with which of the following activities? - ✔✔answer finding his room Ms. H has recently had a right hemisphere stroke. It is likely that Ms. H's rctremities will tend to be positioned in which pattern? - ✔✔answer upper extremity flexion and adduction with lower extremity extension Nursing interventions for the patient with verbal apraxia include: - ✔✔answer having the pt. use writing as an alternative to speaking Nursing theorists draw from existing knowledge in nursing as well as from other disciplines. Which theorist used learning and motivational theories? - ✔✔answer Lydia Hall Parasomnias such as sleepwalking and enuresis occur during which phase of sleep? - ✔✔answer stage 4 Positive Homan's sigh is an indication of: - ✔✔answer thrombophlebitis Proprioceptors mediate deep somatic sensations related primarily to: - ✔✔answer position and movement Prospective payment - ✔✔answer health plans shift part of the financial risk to hospitals by paying a fixed amount based on admission diagnosis Pts. with disabilities are MOST likely to comply with a skin care program when they: - ✔✔answer perceive themselves at risk for a severe pressure ulcer

Pursed lip breathing improves oxygenation because it: - ✔✔answer keeps the alveoli open longer Reflexogenic erections are possible when which spinal segments are perserved? - ✔✔answer sacral Roger's Paradigm for Nursing outlines the interaction between: - ✔✔answer human beings and the environment School age children with disabilities need to develop social skills to overcome the fear and prejudices they may face. This can be accomplished by which of the following? - ✔✔answer providing health related activities at a time that does not interfere with critical academic subjects or peer relationships Sleep deprivation can result in: - ✔✔answer psychosis Spatial-perceptual deficits are MOST commonly associated with: - ✔✔answer right cerebral hemisphere lesion Subluxation of the shoulder in a pt. with hemiplegia can be prevented by: - ✔✔answer positioning Swan neck deformities in the fingers are caused by: - ✔✔answer rheumatoid arthritis Tardive dyskinesia, associated with the prolonged use of psychotropic drugs, may be assessed by instructing the patient to: - ✔✔answer grimace, smile, frown, pucker, and chew The 1990 Americans with Disabilities ACT expands legislation for equal access for people with disabilities to include which of the following groups? - ✔✔answer privately-owned and funded businesses, organizations and institutions The act of recognizing objects on the basic of touching and manipulating them is: - ✔✔answer stereognosis The average adult has a normal bladder capacity of approximately: - ✔✔answer 250 - 400 ml

The MOST advanced stage of pressure ulcer grading involves: - ✔✔answer muscle tissue and bone The MOST appropriate approach to manage fatique in a pt. with an exacerbation of MS is to schedule: - ✔✔answer moderate conditioning exercise and higher energy activities in the morning and following rest periods The most common barrier to community re-entry that a patient with disabilities encounters is: - ✔✔answer societal attitudes The MOST effective bowel retraining program based on normal physiology is one in which bowel movements are consistently scheduled: - ✔✔answer 15 - 30 minutes after a meal The MOST important treatment in promoting wound healing is: - ✔✔answer a high protein diet The MOST significant variable in determining a team's effectiveness is its: - ✔✔answer communication The motor strip is located in the: - ✔✔answer frontal lobe The pt. seems unaware of objects on his right side. What is MOST important in planning how to help him compensate for this loss? - ✔✔answer encourage the pt. to position and turn his head frequently to scan the environment on his affected side The pt. who is unable to roll over on command, but is able to do so spontaneously, MOST likely suffers from which typ of apraxia? - ✔✔answer ideomotor The reflex arc associated with micturition is located at which level of the spinal cord? - ✔✔answer sacral The sensory strip is located in the: - ✔✔answer parietal lobe The teaching plan for a pt. post MI who needs to travel extensively should include emphasis on the need to: - ✔✔answer use two small suitcases instead of one large suitcase

The terms perceived "susceptibility," "perceived threat," and "cues to action" are important concepts in which nursing theory? - ✔✔answer health belief model The three point gate consists of: - ✔✔answer moving both crutches forward along with the affected leg and followed by the unaffected leg The volume of air that can be exhaled by the deepest possible expiration after the deepest possible inspiration is known as: - ✔✔answer vital capcity To provide complete range of motion to the shoulder joint, which motions should be performed? - ✔✔answer flexion/extension, abduction/adduction, internal/external rotation Traction is used to control all of the following EXCEPT: immobility, contracture, muscle spasms, bone alignment - ✔✔answer immobility Upon discharge, what is the MOST important learning outcome for the patient with quadriplegia? - ✔✔answer demonstrating knowledge and skills of self care What advice about walking should be given to the pt. with Parkinson's disease? - ✔✔answer lift the toes with every step What area of the spinal cord controls bladder, bowel, and sexual functioning? - ✔✔answer S2-S What best defines a contracture? - ✔✔answer shortening of muscle fibers What bladder disorder will MOST likely be present in a patient with a CVA? - ✔✔answer uninhibited neurogenic bladder What bladder retraining program would MOST likely be implemented for a pt. with a left-hemisphere CVA? - ✔✔answer timed voiding schedule

What is an appropriate nursing intervention for a pt. experiencing physiological and/or psychosocial disturbances who has recently been transferred from one environment to another? - ✔✔answer encourage pt's verbalization of feelings What is an appropriate nursing intervention for the pt. who has trouble remembering the sequence of simple tasks? - ✔✔answer giving one command at a time What is an important travel tip for people with COPD? - ✔✔answer avoid elevation above 4000 feet unless in a pressurized cabin What is not included in a patient's occupational history? - ✔✔answer past learning difficulties What is ONE of the overall purposes of spirituality? - ✔✔answer to help people develop a cohesive view of the meaning of their livies What is the Barthel Index? - ✔✔answer consists of 10 items that measure a person's daily functioning specifically the activities of daily living and mobility What is the FIRST indicator of peripheral nerve impairment in a hip replacement patient? - ✔✔answer paresthesia What is the function of the detrusor muscle? - ✔✔answer contracts the urinary bladder What is the legal definition of blindness? - ✔✔answer visual field restriction of up to 20 degrees or central visual acuity in the better eye of no more than 20/ What is the lowest level of SCI that requires a pt. to be ventilator-dependent due to the neurological injury? - ✔✔answer C What is the major focus of Orem's Nursing Model? - ✔✔answer self-care

What is the MOST appropriate nursing intervention for fluid volume imbalance? - ✔✔answer monitor intake and output What is the MOST important part of a job analysis? - ✔✔answer visit the job site What is the most therapeutic position for distribution of body weight over bony prominences? - ✔✔answer prone What is the PLISSIT Model? - ✔✔answer an approach used for sexual counseling that involves four levels of intervention What is the premise of the Bobath neurodevelopmental technique? - ✔✔answer pt's learn the sensation of movement, not the movement itself What is the PRIMARY characteristic of Broca's (nonfluent) aphasia? - ✔✔answer ability to speak only a word or two with great effort What is the primary purpose of the bridging technique? - ✔✔answer avoid pressure on boney prominences What learning domain is MOST influenced by a lecture-style teaching approach? - ✔✔answer cognitive What MUST an internal case manager do when arranging for equipment in the home environment? - ✔✔answer identify if the payer source has contracts with any vendors What nursing diagnosis is BEST related to denial of physical disability six months after injury? - ✔✔answer ineffective individual coping What produces esophageal speech? - ✔✔answer burping to exert pressure and produce vibration

Which complication in the pt. with paraplegia is indicative of maladaptation? - ✔✔answer reccurent pressure ulcers over three years post discharge Which cranial nerves are MOST affected in persons with multiple sclerosis? - ✔✔answer II and III Which cranial nerves innervate the muscles necessary for eye movemnet? - ✔✔answer oculomotor, abducens, and trochlear Which ethical principle justifies an amptee's refusal to wear a prosthesis? - ✔✔answer autonomy Which intervention is useful for a person with hypercalcemia? - ✔✔answer force fluids Which of the following approaches are MOST effective in managing phantom pain? - ✔✔answer prosthesis usage and restoration of functional abilities Which of the following BEST defines cross-subsidization? - ✔✔answer the practice of assigning some pts. more costs than they incur and others less Which of the following can be achieved by a pt with C5 injury with biceps and most shoulder muscles functioning? - ✔✔answer dressing the upper extremity, writing, and typing with devices Which of the following does NOT typically characterize autonomic dysreflexia? hypotension; bradycardia; sweating; nasal obstruction - ✔✔answer hypotension Which of the following is an application of the Bobath principles? - ✔✔answer transfer of a patient to a chair from the affected side Which of the following is characteristic of a pt. with a CVA who has a proprioceptive deficit on the affected side? - ✔✔answer inability to know where the affected extremities are in relation to space

Which of the following MOST commonly occurs in conjunction with spina bifida? - ✔✔answer hydrocephalus Which of the following techniques would BEST help the pt. with a recent amputation deal with phantom sensations and prepare for prosthesis use? - ✔✔answer gently stimulating the stump Which organization has taken the lead in developing case managementt standards? - ✔✔answer The National Coalition of Associations for Advancement of Case Management Which part of the brain control temperature? - ✔✔answer hypothalamus Which stage of sleep is when the person is most difficult to awaken? - ✔✔answer stage 4 Which theorist developed a health care systems model in which the person is viewed as an open system in interaction with the environment? - ✔✔answer Betty Neuman Which theorist developed a model for data collection system comprised of 10 functional health patterns necessary for the assessment of a pts. health status? - ✔✔answer Marjory Gordon Which theorist identified four central concepts that provide the foundation for nursing theories: person; environment; health; and nursing - ✔✔answer Jacqueline Fawcett Which theorist model focused on the person's ability to perform self-care? - ✔✔answer Dorothea Orem Which theorist used adaptation theory? - ✔✔answer Sister Calista Roy Which theorist used general systems theory? - ✔✔answer Imogene King Which theorist used physics theory - ✔✔answer Martha Rogers