Managing Care, Quality, and Safety of Clients with Neurologic Health Problems

Question 1

An UAP is providing care to a client with left-sided paralysis. Which action by the UAP requires the nurse to provide further instruction?

1. providing passive ROM exercises to the left extremities during the bed bath
2. elevating the foot of the bed to reduce edema
3. pulling up the client under the left shoulder when getting the client out of bed to a chair
4. putting high top tennis shoes on the client after bathing

Answer 1

3. pulling up the client under the left shoulder when getting the client out of bed to a chair

Pulling a client up under the arm can cause shoulder displacement.

Question 2

The nurse notices that a client with Parkinson’s disease is coughing frequently when eating. Which intervention should the nurse consider?

1. Have the client hyperextend the neck when swallowing
2. Tell the client to place the chin firmly against the chest when eating
3. Thicken all liquids before offering to the client
4. Place the client on a clear liquid diet

Answer 2

3. Thicken all liquids before offering to the client

Question 3

After receiving a change of shift report at 0700, the nurse should assess which client first?

1. a 23 yr old with a migraine headache who has severe nausea associated with retching
2. a 45 yr old who is scheduled for a craniotomy in 30 mins and needs pre-op teaching
3. a 59 yr old with Parkinson’s disease who will need a swallowing assessment before breakfast
4. a 63 yr old with MS who has an oral temp of 101.8 F and flank pain

Answer 3

4. a 63 yr old with MS who has an oral temp of 101.8 F and flank pain

UTI is a frequent complication in clients with MS because of the effect on bladder function. This patient may have pyelonephritis. The client should be notified immediately so that antibiotic therapy can be started quickly.

Question 4

The nurse is caring for a client who is confused about time and place. The client has IV fluid infusing. The nurse attempts to reorient the client, but the client remains unable to demonstrate appropriate use of the call light. In order to maintain client safety, what should the nurse do first?

1. Ask the family to stay with the client
2. Contact the HCP and request a prescription for soft wrist restraints
3. Increase the frequency of client observation
4. Administer a sedative

Answer 4

3. Increase the frequency of client observation