Addies Adaptive Quiz 25 Questions

D: Penetrating Trauma

A client was admitted to the hospital with a direct injury to the vertebral column from a gunshot after a mass shooting. The nurse suspects a spinal cord injury. Which mechanism of injury might be the reason for the injury? A: Hyperflexion B: Hyperextension C: Excessive rotation D: Penetrating Trauma

B: Place the client in sitting position

A client who sustained a spinal cord injury experienced an episode of autonomic dysreflexia. Which intervention should the nurse perform first? A: Assess for the cause B: Place the client in the sitting position C: Check the client for fecal impaction D: Give an alpha blocker prophylactically

C: Administering prescribed antibiotics

A client with a recent history of sinusitis develops meningitis and demonstrates a positive Brudzinski Sign. What is the priority nursing care? A: Monitoring intracranial pressure B: Adding pads to the side of the bed C: Administering prescribed antibiotics D: Hydrating the client with hypotonic saline

C: Distended large intestine

The nurse is caring for a client with a spinal cord injury. The client exhibits signs of autonomic hyperreflexia. What does the nurse recall is the most common cause of this response?: A: Hemodynamic changes related to tilt table positioning B: Deteriorating myelin sheath C: Distended large intestine D: Crushed spinal cord

D: Paroxysmal hypertension and bradycardia

Which response should alert the nurse that a client with a spinal cord injury is developing Autonomic Dysreflexia? A: Flaccid paralysis and numbness B: Absence of sweating and pyrexia C: Escalating tachycardia and shock D: Paroxysmal hypertension and bradycardia