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181 terms

Test questions for CRRN

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The INITIAL purpose of stump wrapping is to:
aid in venous return and reduce swelling
What is an important travel tip for people with COPD?
avoid elevation above 4000 feet unless in a pressurized cabin
What produces esophageal speech?
burping to exert pressure and produce vibration
What is not included in a patient's occupational history?
past learning difficulties
Blindness of the nasal half of one eye and the temporal half of the other is known as:
homonymous hemianopsia
The terms perceived "susceptibility," "perceived threat," and "cues to action" are important concepts in which nursing theory?
health belief model
What bladder disorder will MOST likely be present in a patient with a CVA?
uninhibited neurogenic bladder
What is the legal definition of blindness?
visual field restriction of up to 20 degrees or central visual acuity in the better eye of no more than 20/200
Pursed lip breathing improves oxygenation because it:
keeps the alveoli open longer
What is a result of injury to the satiety center?
overeating
Tardive dyskinesia, associated with the prolonged use of psychotropic drugs, may be assessed by instructing the patient to:
grimace, smile, frown, pucker, and chew
With normal capillary perfusion, the color will return within:
3 seconds
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?
encourage pt's verbalization of feelings
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:
body image disturbance
What is a principle upon which learning depends?
providing for learner participation
Autonomous areflexic bladder dysfunction occurs when a lesion involves:
both the motor and sensory components of the sacral segments of the spinal cord
Reflexogenic erections are possible when which spinal segments are perserved?
sacral
What is the Barthel Index?
consists of 10 items that measure a person's daily functioning specifically the activities of daily living and mobility
What is a normal finding when assessing the skin of an elderly person?
decreased subcutaneous fat
What is the premise of the Bobath neurodevelopmental technique?
pt's learn the sensation of movement, not the movement itself
Sleep deprivation can result in:
psychosis
A patient who presents with drooling or insufficiently chewed food has a problem in which phase of the swallowing process?
oral
Upon discharge, what is the MOST important learning outcome for the patient with quadriplegia?
demonstrating knowledge and skills of self care
Which part of the brain control temperature?
hypothalamus
In order to qualify for SSI, an individual must:
demonstrate financial need by income level
In the absence of an audiologist, which professionals would formally evaluate a pt's hearing?
speech therapist
The three point gate consists of:
moving both crutches forward along with the affected leg and followed by the unaffected leg
What is the most therapeutic position for distribution of body weight over bony prominences?
prone
Proprioceptors mediate deep somatic sensations related primarily to:
position and movement
The most common barrier to community re-entry that a patient with disabilities encounters is:
societal attitudes
What is a characteristic of the autonomous neurogenic bowel?
flaccid anal sphincter
Which cranial nerves innervate the muscles necessary for eye movemnet?
oculomotor, abducens, and trochlear
The factor determining Social Security Disability Insurance eligibility is that the person:
can no longer engage in gainful activity
In a patient with hemiplegia, how should the affected shoulder be positioned to minimize the risk of shoulder problems?
abduction
In developing a discharge plan, it is MOST essential to consider the patient's:
previous lifestyle
The sensory strip is located in the:
parietal lobe
A neurological exam of a pt. with a complete lower motor neuron lesion would demonstrate which reflex activity?
bulbocavernosus absent
What intervention would help a pateint with figure ground deficit to dress independently?
choose distinct colors or patterns for different articles of clothing
When assisting a patient with spastic cerebral palsy to perform activities of daily living, what action is most important?
moving spastic body parts with slow, even movements
What is a common side effect of hyperosmotic tube feedings?
diarrhea
The General Aptitude Test Battery and the Differential Aptitude Test are frequently used to measure:
cognitive ability
A prudent cardiac rehabilitation exercise program for a pt. following myocardial infarction is based upon:
gradually increasing exercise after cardiac testing
A pt. with a right hemisphere CVA may be at risk for injury due to:
impulsivity and perceptual deficits
Which complication in the pt. with paraplegia is indicative of maladaptation?
reccurent pressure ulcers over three years post discharge
A patient with a complete SCI at T5 uses digital rectal stimulation to:
stimulate peristalsis and relax the anal spincter
ALS affects:
skeletal muscles
What is the lowest level of SCI that requires a pt. to be ventilator-dependent due to the neurological injury?
C2
A form of NEGLECT in which the pt. fails to recognize the severity of paralysis is:
anosognosia
Which intervention is useful for a person with hypercalcemia?
force fluids
What advice about walking should be given to the pt. with Parkinson's disease?
lift the toes with every step
The MOST important treatment in promoting wound healing is:
a high protein diet
A pt. with a right hemisphere CVA generally experience a DECREASE in:
processing of directional information
The INITIAL step in planned change is to:
identify a need for change
Subluxation of the shoulder in a pt. with hemiplegia can be prevented by:
positioning
For the pt. with decreased attention span, the nurse should:
use repetition
What type of depression is a pt. MOST likely to experience following the onset of disability?
psychotic
What is a true statement regarding a person with a laryngectomy?
breathing and coughing patterns change
What is the primary purpose of the bridging technique?
avoid pressure on boney prominences
A pt. whose SCI is above the sacral reflex arc generally has what type of neurogenic bladder?
reflex
What best defines a contracture?
shortening of muscle fibers
What is a MAJOR complication often occuring in pts. with a lower extremity amputation?
hip flexion contracture
According to the gate control theory by Melzack and Wall, the
cells in the dorsal horn block transmission of nerve impulses
In preparing a pt. for crutch walking, it is essential to:
begin exercises to strengthen the upper extremities
The pt. seems unaware of objects on his right side. What is MOST important in planning how to help him compensate for this loss?
encourage the pt. to position and turn his head frequently to scan the environment on his affected side
What is an appropriate nursing intervention for the pt. who has trouble remembering the sequence of simple tasks?
giving one command at a time
What strategy may BEST resolve the interprofessional issues that are a frequent cause of rehabilitation team dysfunction?
conflict management
What is the PRIMARY characteristic of Broca's (nonfluent) aphasia?
ability to speak only a word or two with great effort
The FIRST sign of respiratory muscle fatigue is usually:
an increase in respiratory rate
An intrinsic factor which affects tissue tolerance and is responsible for pressure ulcer development is:
low arteriolar pressure
The FIRST step in developing a pt. education program is to assess:
the educational need
What should discharge instructions to a pt. with COPD regarding use of an inhaler include?
coordinating the squeezing action upon inhalation
Antihypertensives may cause urinary incontinence because they:
relax the smooth muscle of the bladder neck
According to Lewin's theory, what are the stages of change?
unfreezing, moving, refreezing
The act of recognizing objects on the basic of touching and manipulating them is:
stereognosis
What is the MOST important part of a job analysis?
visit the job site
What is the PLISSIT Model?
an approach used for sexual counseling that involves four levels of intervention
How should a pt. with dysphagia and hemiplegia be positioned for meals
leaning at 90 degrees leaning slightly forward
A person with verbal apraxia experiences difficulty with:
voluntary speech
What area of the spinal cord controls bladder, bowel, and sexual functioning?
S2-S4
Intake of which foods should be increase during the healing phase of a drainging pressure ulcer?
meat and legumes
Positive Homan's sigh is an indication of:
thrombophlebitis
What is the major focus of Orem's Nursing Model?
self-care
When assessing the bowel function of a child with spinal bifida, the nurse is MOST likely to encounter:
ineffective defecation reflex and leakage of fecal matter
A positive gag reflex indicates that:
pharyngeal muscles are constricting
When teaching the pt. with left hemiplegia to put on a button front shirt, the first instruction should be to:
put the left arm into the sleeve
The motor strip is located in the:
frontal lobe
The teaching plan for a pt. post MI who needs to travel extensively should include emphasis on the need to:
use two small suitcases instead of one large suitcase
The MOST appropriate approach to manage fatique in a pt. with an exacerbation of MS is to schedule:
moderate conditioning exercise and higher energy activities in the morning and following rest periods
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?
ideomotor
A value-belief pattern assessment will include questions that identify the patients:
resources for hope and strength founded on reality
The function of the lateral corticospinal tract is to:
transmit impulses for voluntary motion
Traction is used to control all of the following EXCEPT: immobility, contracture, muscle spasms, bone alignment
immobility
What cranial nerves are involved in eating?
glossopharyngeal, hypoglossal, vagus
What learning domain is MOST influenced by a lecture-style teaching approach?
cognitive
What bladder retraining program would MOST likely be implemented for a pt. with a left-hemisphere CVA?
timed voiding schedule
To provide complete range of motion to the shoulder joint, which motions should be performed?
flexion/extension, abduction/adduction, internal/external rotation
Which areas are MOST at risk whan a pt. with a below the knee amputation begins ambulating with a prosthesis?
the patellar tendon and popliteal areas
Which of the following is characteristic of a pt. with a CVA who has a proprioceptive deficit on the affected side?
inability to know where the affected extremities are in relation to space
Learned helplessness is caused by:
previous exposure to events over which a pt. had no control
Which of the following techniques would BEST help the pt. with a recent amputation deal with phantom sensations and prepare for prosthesis use?
gently stimulating the stump
The average adult has a normal bladder capacity of approximately:
250-400 ml
What nursing diagnosis is BEST related to denial of physical disability six months after injury?
ineffective individual coping
Motor nerve fibers cross over in the brainstem at the level of the:
medulla
A pt. with a posterior lesion of the first temporal gyrus of the left hemisphere has:
Wernicke's aphasia
Besides joint pain, the MOST frequently cited causes of sexual impairment associated with rheumatoid arthritis include:
fatigue
The volume of air that can be exhaled by the deepest possible expiration after the deepest possible inspiration is known as:
vital capcity
The MOST significant variable in determining a team's effectiveness is its:
communication
Which of the following approaches are MOST effective in managing phantom pain?
prosthesis usage and restoration of functional abilities
Which act requires state and local sponsors to identify and recruit people with disabilities?
Comprehensive Employment and Training Act
In Bobath's third stage of recovery of movement patterns for a stroke pt., spasticity is:
decreased
A pt. who has sustained an injury to the conus medullaris will usually have which of the folowing bladder symptoms?
hypotonicity, no voiding reflex, overflow dribbling
Nursing interventions for the patient with verbal apraxia include:
having the pt. use writing as an alternative to speaking
What is the FIRST indicator of peripheral nerve impairment in a hip replacement patient?
paresthesia
A work sample evaluation is primarily performed to:
determine the types of tasks the person can perform
Roger's Paradigm for Nursing outlines the interaction between:
human beings and the environment
With spasticity, what complication is MOST likely if proper nursing measures are not implemented?
contractures
The 1990 Americans with Disabilities ACT expands legislation for equal access for people with disabilities to include which of the following groups?
privately-owned and funded businesses, organizations and institutions
Swan neck deformities in the fingers are caused by:
rheumatoid arthritis
Brain injuries MOST often occur as a result of:
auto accidents
In Bloom's cognitive domain of learning, the progression from basic to complex is from:
knowledge to comprehension to application
Which of the following is an application of the Bobath principles?
transfer of a patient to a chair from the affected side
Pts. with disabilities are MOST likely to comply with a skin care program when they:
perceive themselves at risk for a severe pressure ulcer
Spatial-perceptual deficits are MOST commonly associated with:
right cerebral hemisphere lesion
Which of the following MOST commonly occurs in conjunction with spina bifida?
hydrocephalus
Mechanical friction on a wound delays wound healing because it:
disrupts granulation tissue
Which ethical principle justifies an amptee's refusal to wear a prosthesis?
autonomy
What symptom is MOST frequent with peripheral thrombophlebitis?
sweling and redness in an extremity
During the initial interview, the rehab nurse assesses a pt's cognition by:
determining the pt's understanding of gestures and vocal inflections
For a pt in the chronic stage of rheumatoid arthritis, which of the following interferes with functioning?
pain, muscle weakness, and joint disordees
A nurse notes hyperactive reflexes and an increased resistance to passive motion in the extremities. This is known as:
spasticity
Which of the following can be achieved by a pt with C5 injury with biceps and most shoulder muscles functioning?
dressing the upper extremity, writing, and typing with devices
Which wheelchair modifications is necessary for a sliding board transfer?
removable arm rest
The inability of a person to comprehend spatial relationships involving his or her body is called:
impaired proprioception
What health and wellness theory is based on the belief that a person is capable of mobilizing his or her cognitive, socail, and behavioral skills?
self-efficacy
Which of the following does NOT typically characterize autonomic dysreflexia? hypotension; bradycardia; sweating; nasal obstruction
hypotension
A patient with left hemiplegia would be MOST likely to present:
perceptual deficits
The MOST effective bowel retraining program based on normal physiology is one in which bowel movements are consistently scheduled:
15-30 minutes after a meal
Dysarthria is characterized by:
slurred or thick-tongued speech
An initial nursing intervention for a pt. with altered respiratory function includes:
encouraging coughing and deep breathing techniques
What can cause REM suppression during sleep?
alcohol
What is the function of the detrusor muscle?
contracts the urinary bladder
What is the MOST appropriate nursing intervention for fluid volume imbalance?
monitor intake and output
The MOST advanced stage of pressure ulcer grading involves:
muscle tissue and bone
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?
finding his room
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?
providing health related activities at a time that does not interfere with critical academic subjects or peer relationships
Metered dose inhalers deliver medicine to pts. with lung disease. Which of the following is an ADVANTAGE of this delivery method?
less likelihood for systemic side effects
The cost of health care has been positively impacted by which of the following action?
payment for home care services with federal funds
What type of living environment provides supervised living for persons with similar disabilities and staff who are available at all times of the day and night?
group home
The bulbocavernosus reflex is a test that is used frequently in which pt. population to determine if there is the potential for training the bowel to empty in response to a suppository or digital stimulation?
spinal cord injury
Which of the following BEST defines cross-subsidization?
the practice of assigning some pts. more costs than they incur and others less
A young woman has had a stroke as a result of cocaine usage. She has poor eye contact with staff, often is impatient with her abilities, has been seen by staff to injure affected limbs, and frequently refers to herself as a cripple. This client may be experiencing which of the following alterations of self perception as a result of her stroke?
body-image
What is ONE of the overall purposes of spirituality?
to help people develop a cohesive view of the meaning of their livies
For who were intervention programs INITIALLY designed?
children with developmental or physical disabilities
Which theorist developed a model for data collection system comprised of 10 functional health patterns necessary for the assessment of a pts. health status?
Marjory Gordon
Which theorist developed a health care systems model in which the person is viewed as an open system in interaction with the environment?
Betty Neuman
Which theorist identified four central concepts that provide the foundation for nursing theories: person; environment; health; and nursing
Jacqueline Fawcett
Which theorist model focused on the person's ability to perform self-care?
Dorothea Orem
The reflex arc associated with micturition is located at which level of the spinal cord?
sacral
A pt. with diabetes has been admitted to a skilled care unit for recovery and wound healing after several revisions of an AKA that had begun as an ingrown toenail. The pt. says to the nurse, "I don't know what eles to do. Nothing I try seems to make a difference with respect to healing this wound." This statement might be an example of which alteration?
hopelessness
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?
restrictions on supply of physicians
Which organization has taken the lead in developing case managementt standards?
The National Coalition of Associations for Advancement of Case Management
What MUST an internal case manager do when arranging for equipment in the home environment?
identify if the payer source has contracts with any vendors
During periods of stress or trauma, which nutrients are used by the body as energy sources?
proteins
Contractual allowance
discounts from normal charges given to large payers for health care services
Contribution margin
the amount by which the price exceeds the varible cost
Cross- subsidization
when some pts. are assigned more costs than they create and others less
Cost reimbursement
the revenue based on the organization receiving payment for costs incurred
Which cranial nerves are MOST affected in persons with multiple sclerosis?
II and III
The case manager for the brain injured child start the process of re-entry into the school system?
prior to discharge from the rehabilitation facility
When should discharge planning begin?
prior to admission to the rehab facility
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?
fee-for-service payment
Prospective payment
health plans shift part of the financial risk to hospitals by paying a fixed amount based on admission diagnosis
Capitation payment
involves a fixed monthly payment
Parasomnias such as sleepwalking and enuresis occur during which phase of sleep?
stage 4
Which stage of sleep is when the person is most difficult to awaken?
stage 4
Nursing theorists draw from existing knowledge in nursing as well as from other disciplines. Which theorist used learning and motivational theories?
Lydia Hall
Which theorist used general systems theory?
Imogene King
Which theorist used adaptation theory?
Sister Calista Roy
Which theorist used physics theory
Martha Rogers
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?
upper extremity flexion and adduction with lower extremity extension
How can the case manager positively INCREASE the value of an Independent Medical Examination?
by using a physician whose expertise matches the issue