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1. The nurse is providing care for an older adult man whose diagnosis of dementia has
recently led to urinary incontinence. When planning this patient's care, what
intervention should the nurse avoid?
A) Scheduled toileting
B) Indwelling catheter
C) External condom catheter
D) Incontinence pads
Ans: B
Feedback:
Indwelling catheters are avoided if at all possible because of the high incidence of
urinary tract infections with their use. Intermittent self-catheterization is an appropriate
alternative for managing reflex incontinence, urinary retention, and overflow
incontinence related to an overdistended bladder. External catheters (condom catheters)
and leg bags to collect spontaneous voiding are useful for male patients with reflex or
total incontinence. Incontinence pads should be used as a last resort because they only
manage, rather than solve, the incontinence.

2. You are the nurse caring for a female patient who developed a pressure ulcer as a result
of decreased mobility. The nurse on the shift before you has provided patient teaching
about pressure ulcers and healing promotion. You assess that the patient has understood
the teaching by observing what?
A) Patient performs range-of-motion exercises.
B) Patient avoids placing her body weight on the healing site.
C) Patient elevates her body parts that are susceptible to edema.
D) Patient demonstrates the technique for massaging the wound site.
Ans: B
Feedback:
The major goals of pressure ulcer treatment may include relief of pressure, improved
mobility, improved sensory perception, improved tissue perfusion, improved nutritional
status, minimized friction and shear forces, dry surfaces in contact with skin, and
healing of pressure ulcer, if present. The other options do not demonstrate the
achievement of the goal of the patient teaching.

Page 1
3. An elderly female patient who is bedridden is admitted to the unit because of a pressure
ulcer that can no longer be treated in a community setting. During your assessment of
the patient, you find that the ulcer extends into the muscle and bone. At what stage
would document this ulcer?
A) I
B) II
C) III
D) IV
Ans: D
Feedback:
Stage III and IV pressure ulcers are characterized by extensive tissue damage. In
addition to the interventions listed for stage I, these advanced draining, necrotic
pressure ulcers must be cleaned (débrided) to create an area that will heal. Stage IV is
an ulcer that extends to underlying muscle and bone. Stage III is an ulcer that extends
into the subcutaneous tissue. With this type of ulcer, necrosis of tissue and infection
may develop. Stage I is an area of erythema that does not blanch with pressure. Stage II
involves a break in the skin that may drain.

4. A 74-year-old woman experienced a cerebrovascular accident 6 weeks ago and is

currently receiving inpatient rehabilitation. You are coaching the patient to contract and
relax her muscles while keeping her extremity in a fixed position. Which type of
exercise is the patient performing?
A) Passive
B) Isometric
C) Resistive
D) Abduction
Ans: B
Feedback:
Isometric exercises are those in which there is alternating contraction and relaxation of
a muscle while keeping the part in a fixed position. This exercise is performed by the
patient. Passive exercises are carried out by the therapist or the nurse without assistance
from the patient. Resistive exercises are carried out by the patient working against
resistance produced by either manual or mechanical means. Abduction is movement of
a part away from the midline of the body.

Page 2
5. An interdisciplinary team has been working collaboratively to improve the health
outcomes of a young adult who suffered a spinal cord injury in a workplace accident.
Which member of the rehabilitation team is the one who determines the final outcome
of the process?
A) Most-responsible nurse
B) Patient
C) Patient's family
D) Primary care physician
Ans: B
Feedback:
The patient is the key member of the rehabilitation team. He or she is the focus of the
team effort and the one who determines the final outcomes of the process. The nurse,
family, and doctor are part of the rehabilitation team but do not determine the final
outcome.

6. A school nurse is providing health promotion teaching to a group of high school

seniors. The nurse should highlight what salient risk factor for traumatic brain injury?
A) Substance abuse
B) Sports participation
C) Anger mismanagement
D) Lack of community resources
Ans: A
Feedback:
Of spinal cord injuries, 50% are related to substance abuse, and approximately 50% of
all patients with traumatic brain injury were intoxicated at the time of injury. This
association exceeds the significance of sports participation, anger mismanagement, or
lack of community resources.

7. A nurse is giving a talk to a local community group whose members advocate for
disabled members of the community. The group is interested in emerging trends that
are impacting the care of people who are disabled in the community. The nurse should
describe an increasing focus on what aspect of care?
A) Extended rehabilitation care
B) Independent living
C) Acute-care center treatment
D) State institutions that provide care for life
Ans: B
Feedback:
There is a growing trend toward independent living for patients who are severely
disabled, either alone or in groups. The goal is integration into the community. The
nurse would be sure to mention this fact when talking to a local community group. The
nurse would not describe extended rehabilitation care, acute-care center treatment, or
state institutions because these are not increasing in importance.

Page 3
8. The nurse is caring for an older adult patient who is receiving rehabilitation following
an ischemic stroke. A review of the patient's electronic health record reveals that the
patient usually defers her self-care to family members or members of the care team.
What should the nurse include as an initial goal when planning this patient's subsequent
care?
A) The patient will demonstrate independent self-care.
B) The patient's family will collaboratively manage the patient's care.
C) The nurse will delegate the patient's care to a nursing assistant.
D) The patient will participate in a life skills program.
Ans: A
Feedback:
An appropriate patient goal will focus on the patient demonstrating independent
self-care. The rehabilitation process helps patients achieve an acceptable quality of life
with dignity, self-respect, and independence. The other options are incorrect because an
appropriate goal would not be for the family to manage the patient's care, the patient's
care would not be delegated to a nursing assistant, and participating in a social program
is not an appropriate initial goal.

9. You are caring for a 35-year-old man whose severe workplace injuries necessitate
bilateral below-the-knee amputations. How can you anticipate that the patient will
respond to this news?
A) The patient will go through the stages of grief over the next week to 10 days.
B) The patient will progress sequentially through five stages of the grief process.
C) The patient will require psychotherapy to process his grief.
D) The patient will experience grief in an individualized manner.
Ans: D
Feedback:
Loss of limb is a profoundly emotional experience, which the patient will experience in
a subjective manner, and largely unpredictable, manner. Psychotherapy may or may not
be necessary. It is not possible to accurately predict the sequence or timing of the
patient's grief. The patient may or may not benefit from psychotherapy.

Page 4
10. An elderly woman diagnosed with osteoarthritis has been referred for care. The patient
has difficulty ambulating because of chronic pain. When creating a nursing care plan,
what intervention may the nurse use to best promote the patient's mobility?
A) Motivate the patient to walk in the afternoon rather than the morning.
B) Encourage the patient to push through the pain in order to gain further mobility.
C) Administer an analgesic as ordered to facilitate the patient's mobility.
D) Have another person with osteoarthritis visit the patient.
Ans: C
Feedback:
At times, mobility is restricted because of pain, paralysis, loss of muscle strength,
systemic disease, an immobilizing device (e.g., cast, brace), or prescribed limits to
promote healing. If mobility is restricted because of pain, providing pain management
through the administration of an analgesic will increase the patient's level of comfort
during ambulation and allow the patient to ambulate. Motivating the patent or having
another person with the same diagnosis visit is not an intervention that will help with
mobility. The patient should not be encouraged to “push through the pain.”

11. The nurse is providing care for a 90-year-old patient whose severe cognitive and
mobility deficits result in the nursing diagnosis of risk for impaired skin integrity due to
lack of mobility. When planning relevant assessments, the nurse should prioritize
inspection of what area?
A) The patient's elbows
B) The soles of the patient's feet
C) The patient's heels
D) The patient's knees
Ans: C
Feedback:
Full inspection of the patient's skin is necessary, but the coccyx and the heels are the
most susceptible areas for skin breakdown due to shear and friction.

12. An elderly patient is brought to the emergency department with a fractured tibia. The
patient appears malnourished, and the nurse is concerned about the patient's healing
process related to insufficient protein levels. What laboratory finding would the floor
nurse prioritize when assessing for protein deficiency?
A) Hemoglobin
B) Bilirubin
C) Albumin
D) Cortisol
Ans: C
Feedback:
Serum albumin is a sensitive indicator of protein deficiency. Albumin levels of less
than 3 g/mL are indicative of hypoalbuminemia. Altered hemoglobin levels, cortisol
levels, and bilirubin levels are not indicators of protein deficiency.

Page 5
13. A patient who is receiving rehabilitation following a spinal cord injury has been
diagnosed with reflex incontinence. The nurse caring for the patient should include
which intervention in this patient's plan of care?
A) Regular perineal care to prevent skin breakdown
B) Kegel exercises to strengthen the pelvic floor
C) Administration of hypotonic IV fluid
D) Limited fluid intake to prevent incontinence
Ans: A
Feedback:
Reflex incontinence is associated with a spinal cord lesion that interrupts cerebral
control, resulting in no sensory awareness of the need to void. Total incontinence
occurs in patients with a psychological impairment when they cannot control excreta. A
patient who is paralyzed cannot perform Kegel exercises. Intravenous fluids would
make no difference in reflex incontinence. Limited fluid intake would make no impact
on a patient's inability to sense the need to void.

14. A female patient, 47 years old, visits the clinic because she has been experiencing stress
incontinence when she sneezes or exercises vigorously. What is the best instruction the
nurse can give the patient?
A) Keep a record of when the incontinence occurs.
B) Perform clean intermittent self-catheterization.
C) Perform Kegel exercises four to six times per day.
D) Wear a protective undergarment to address this age-related change.
Ans: C
Feedback:
For cognitively intact women who experience stress incontinence, the nurse should
instruct the patient to perform Kegel exercises four to six times per day to strengthen
the pubococcygeus muscle. Keeping a record of when the incontinence occurs or
accepting incontinence as part of aging are incorrect answers because they are of no
value in treating stress incontinence. Women with stress incontinence do not need clean
intermittent catheterization. Protective undergarments hide the effects of urinary
incontinence but they do not resolve the problem.

Page 6
15. While assessing a newly admitted patient you note the following: impaired
coordination, decreased muscle strength, limited range of motion, and reluctance to
move. What nursing diagnosis do these signs and symptoms most clearly suggest?
A) Ineffective health maintenance
B) Impaired physical mobility
C) Disturbed sensory perception: Kinesthetic
D) Ineffective role performance
Ans: B
Feedback:
Impaired physical mobility is a limitation of physical movement that is identified by the
characteristics found in this patient. The other listed diagnoses are not directly
suggested by the noted assessment findings.

16. A patient has completed the acute treatment phase of care following a stroke and the
patient will now begin rehabilitation. What should the nurse identify as the major goal
of the rehabilitative process?
A) To provide 24-hour, collaborative care for the patient
B) To restore the patient's ability to function independently
C) To minimize the patient's time spent in acute care settings
D) To promote rapport between caregivers and the patient
Ans: B
Feedback:
The goal of rehabilitation is to restore the patient's ability to function independently or
at a preillness or preinjury level of functioning as quickly as possible. Twenty-four hour
care, rapport, and minimizing time in acute care are not central goals of rehabilitation.

17. A 52-year-old married man with two adolescent children is beginning rehabilitation
following a motor vehicle accident. You are the nurse planning the patient's care. Who
will the patient's condition affect?
A) Himself
B) His wife and any children that still live at home
C) Him and his entire family
D) No one, provided he has a complete recovery
Ans: C
Feedback:
Patients and families who suddenly experience a physically disabling event or the onset
of a chronic illness are the ones who face several psychosocial adjustments, even if the
patient recovers completely.

Page 7
18. You are planning rehabilitation activities for a patient who is working toward discharge
back into the community. During a care conference, the team has identified a need to
focus on the patient's instrumental activities of daily living (IADLs). When planning
the patient's subsequent care, you should focus particularly on which of the following?
A) Dressing
B) Bathing
C) Feeding
D) Meal preparation
Ans: D
Feedback:
Instrumental activities of daily living (IADLs) include grocery shopping, meal
preparation, housekeeping, transportation, and managing finances. Activities of daily
living (ADLs) include bathing dressing, feeding, and toileting.

19. A 93-year-old male patient with failure to thrive has begun exhibiting urinary
incontinence. When choosing appropriate interventions, you know that various
age-related factors can alter urinary elimination patterns in elderly patients. What is an
example of these factors?
A) Decreased residual volume
B) Urethral stenosis
C) Increased bladder capacity
D) Decreased muscle tone
Ans: D
Feedback:
Factors that alter elimination patterns in the older adult include decreased bladder
capacity, decreased muscle tone, increased residual volumes, and delayed perception of
elimination cues. The other noted phenomena are atypical.

20. You are the nurse caring for an elderly patient who has been on a bowel training
program due to the neurologic effects of a stroke. In the past several days, the patient
has begun exhibiting normal bowel patterns. Once a bowel routine has been well
established, you should avoid which of the following?
A) Use of a bedpan
B) Use of a padded or raised commode
C) Massage of the patient's abdomen
D) Use of a bedside toilet
Ans: A
Feedback:
Use of bedpans should be avoided once a bowel routine has been established. An
acceptable alternative to a private bathroom is a padded commode or bedside toilet.
Massaging the abdomen from right to left facilitates movement of feces in the lower
tract.

Page 8
21. As a member of the rehabilitation team, the nurse is conscious of the need to perform
the nursing role in collaboration with the other members of the team. Which of the
following variables has the greatest bearing on the nurse's choice of actions and
interventions during rehabilitative care?
A) The skills of the other members of the team
B) The circumstances of the patient
C) The desires of the patient's family
D) The nurse's education and experience level
Ans: B
Feedback:
Nurses assume an equal or, depending on the circumstances of the patient, a more
critical role than other members of the health care team in the rehabilitation process.
The nurse's role on the rehabilitation team does not depend primarily on other members
of the team, the family's desires, or the nurse's education level.

22. The rehabilitation team has reaffirmed the need to maximize the independence of a
patient in rehabilitation. When working toward this goal, what action should the nurse
prioritize?
A) Encourage families to become paraprofessionals in rehabilitation.
B) Delegate care planning to the patient and family.
C) Recognize the importance of informal caregivers.
D) Make patients and families to work together.
Ans: C
Feedback:
In working toward maximizing independence, nurses affirm the patient as an active
participant and recognize the importance of informal caregivers in the rehabilitation
process. Nurses do not encourage families to become paraprofessionals in
rehabilitation. The patient and family are central, but care planning is not their
responsibility. Nurses do not “make” patients and families work together.

23. You are the nurse creating the care plan for a patient newly admitted to your
rehabilitation unit. The patient is an 82-year-old patient who has had a stroke but who
lived independently until this event. What is a goal that you should include in this
patient's nursing care plan?
A) Maintain joint mobility.
B) Refer to social services.
C) Ambulate three times every day.
D) Perform passive range of motion twice daily.
Ans: A
Feedback:
The major goals may include absence of contracture and deformity, maintenance of
muscle strength and joint mobility, independent mobility, increased activity tolerance,
and prevention of further disability. The other listed actions are interventions, not goals.

Page 9
24. You are the rehabilitation nurse caring for a 25-year-old patient who suffered extensive
injuries in a motorcycle accident. During each patient contact, what action should you
perform most frequently?
A) Complete a physical assessment.
B) Evaluate the patient's positioning.
C) Plan nursing interventions.
D) Assist the patient to ambulate.
Ans: B
Feedback:
During each patient contact, the nurse evaluates the patient's position and assists the
patient to achieve and maintain proper positioning and alignment. The nurse does not
complete a physical assessment during each patient contact. Similarly, the nurse does
not plan nursing interventions or assist the patient to ambulate each time the nurse has
contact with the patient.

25. A patient has been transferred to a rehabilitative setting from an acute care unit. What is
the most important reason for the nurse to begin a program for activities of daily living
(ADLs) as soon as the patient is admitted to a rehabilitation facility?
A) The ability to perform ADLs may be the key to dependence.
B) The ability to perform ADLs is essential to living in a group home.
C) The ability to perform ADLs may be the key to reentry into the community.
D) The ability to perform ADLs is necessary to function in an assisted-living
situation.
Ans: C
Feedback:
An ADL program is started as soon as the rehabilitation process begins because the
ability to perform ADLs is frequently the key to independence, return to the home, and
reentry into the community. ADLs are frequently the key to independence, not
dependence. The ability to perform ADLs is not always a criterion for admission to a
group home or assisted-living facility.

Page 10
26. A female patient has been achieving significant improvements in her ADLs since
beginning rehabilitation from the effects of a brain hemorrhage. The nurse must
observe and assess the patient's ability to perform ADLs to determine the patient's level
of independence in self-care and her need for nursing intervention. Which of the
following additional considerations should the nurse prioritize?
A) Liaising with the patient's insurer to describe the patient's successes.
B) Teaching the patient about the pathophysiology of her functional deficits.
C) Eliciting ways to get the patient to express a positive attitude.
D) Appraising the family's involvement in the patient's ADLs.
Ans: D
Feedback:
The nurse should also be aware of the patient's medical conditions or other health
problems, the effect that they have on the ability to perform ADLs, and the family's
involvement in the patient's ADLs. It is not normally necessary to teach the patient
about the pathophysiology of her functional deficits. A positive attitude is beneficial,
but creating this is not normally within the purview of the nurse. The nurse does not
liaise with the insurance company.

27. An adult patient's current goals of rehabilitation focus primarily on self-care. What is a
priority when teaching a patient who has self-care deficits in ADLs?
A) To provide an optimal learning environment with minimal distractions
B) To describe the evidence base for any chosen interventions
C) To help the patient become aware of the requirements of assisted-living centers
D) To ensure that the patient is able to perform self-care without any aid from
caregivers
Ans: A
Feedback:
The nurse's role is to provide an optimal learning environment that minimizes
distractions. Describing the evidence base is not a priority, though nursing actions
should indeed be evidence-based. Assisted-living facilities are not relevant to most
patients. Absolute independence in ADLs is not an appropriate goal for every patient.

Page 11
28. You are admitting a patient into your rehabilitation unit after an industrial accident. The
patient's nursing diagnoses include disturbed sensory perception and you assess that he
has decreased strength and dexterity. You know that this patient may need what to
accomplish self-care?
A) Advice from his family
B) Appropriate assistive devices
C) A personal health care aide
D) An assisted-living environment
Ans: B
Feedback:
Patients with impaired mobility, sensation, strength, or dexterity may need to use
assistive devices to accomplish self-care. An assisted-living environment is less
common than the use of assistive devices. Family involvement is imperative, but this
may or may not take the form of advice. A healthcare aide is not needed by most
patients.

29. The nurse is working with a rehabilitation patient who has a deficit in mobility
following a skiing accident. The nurse knows that preparation for ambulation is
extremely important. What nursing action will best provide the foundation of
preparation for ambulation?
A) Stimulating the patient's desire to ambulate
B) Assessing the patient's understanding of ambulation
C) Helping the patient perform frequent exercise
D) Setting realistic expectations
Ans: C
Feedback:
Regaining the ability to walk is a prime morale builder. However, to be prepared for
ambulation—whether with brace, walker, cane, or crutches—the patient must
strengthen the muscles required. Therefore, exercise is the foundation of preparation.

30. A patient is undergoing rehabilitation following a stroke that left him with severe motor
and sensory deficits. The patient has been unable to ambulate since his accident, but has
recently achieved the goals of sitting and standing balance. What is the patient now able
to use?
A) A cane
B) Crutches
C) A two-wheeled walker
D) Parallel bars
Ans: D
Feedback:
After sitting and standing balance is achieved, the patient is able to use parallel bars.
The patient must be able to use the parallel bars before he can safely use devices like a
cane, crutches, or a walker.

Page 12
31. The rehabilitation nurse is working closely with a patient who has a new orthosis
following a knee injury. What are the nurse's responsibilities to this patient? Select all
that apply.
A) Help the patient learn to apply and remove the orthosis.
B) Teach the patient how to care for the skin that comes in contact with the orthosis.
C) Assist in the initial fitting of the orthosis.
D) Assist the patient in learning how to move the affected body part correctly.
E) Collaborate with the physical therapist to set goals for care.
Ans: A, B, D, E
Feedback:
In addition to learning how to apply and remove the orthosis and maneuver the affected
body part correctly, patients must learn how to properly care for the skin that comes in
contact with the appliance. Skin problems or pressure ulcers may develop if the device
is applied too tightly or too loosely or if it is adjusted improperly. Nurses do not
perform the initial fitting of orthoses.

32. A patient is being transferred from a rehabilitation setting to a long-term care facility.
During this process, the nurse has utilized the referral system? Using this system
achieves what goal of the patient's care?
A) Minimizing costs of the patient's care
B) Maintaining continuity of the patient's care
C) Maintain the nursing care plan between diverse sites
D) Keeping the primary care provider informed
Ans: B
Feedback:
A referral system maintains continuity of care when the patient is transferred to the
home or to a long-term care facility. The interests of cost and of keeping the primary
care provider informed are not primary. The nursing plan is likely to differ between
sites.

Page 13
33. A home care nurse performs the initial visit to a patient who is soon being discharged
from a rehabilitation facility. This initial visit is to assess what the patient can do and to
see what he will need when discharged home. What does this help ensure for the
patient?
A) Social relationships
B) Family assistance
C) Continuity of care
D) Realistic expectations
Ans: C
Feedback:
A home care nurse may visit the patient in the hospital, interview the patient and the
family, and review the ADL sheet to learn which activities the patient can perform.
This helps ensure that continuity of care is provided and that the patient does not
regress, but instead maintains the independence gained while in the hospital or
rehabilitation setting. This initial visit does not ensure social relationships, family
assistance, or realistic expectations.

34. A nurse has been asked to become involved in the care of an adult patient in his fifties
who has experienced a new onset of urinary incontinence. During what aspect of the
assessment should the nurse explore physiologic risk factors for elimination problems?
A) Physical assessment
B) Health history
C) Genetic history
D) Initial assessment
Ans: B
Feedback:
The health history is used to explore bladder and bowel function, symptoms associated
with dysfunction, physiologic risk factors for elimination problems, perception of
micturition (urination or voiding) and defecation cues, and functional toileting abilities.
Elimination problems are not explored in the other listed aspects of assessment.

Page 14
35. You are the nurse caring for a patient who has paraplegia following a hunting accident.
You know to assess regularly for the development of pressure ulcers on this patient.
What rationale would you cite for this nursing action?
A) You know that this patient will have a decreased level of consciousness.
B) You know that this patient may not be motivated to prevent pressure ulcers.
C) You know that the risk for pressure ulcers is directly related to the duration of
immobility.
D) You know that the risk for pressure ulcers is related to what caused the
immobility.
Ans: C
Feedback:
The development of pressure ulcers is directly related to the duration of immobility: If
pressure continues long enough, small vessel thrombosis and tissue necrosis occur, and
a pressure ulcer results. The cause of the immobility is not what is important in the
development of a pressure ulcer; the duration of the immobility is what matters.
Paraplegia does not result in a decreased level of consciousness and there is no reason
to believe that the patient does not want to prevent pressure ulcers.

36. A nurse is caring for a patient undergoing rehabilitation following a snowboarding

accident. Within the interdisciplinary team, the nurse has been given the responsibility
for coordinating the patient's total rehabilitative plan of care. What nursing role is this
nurse performing?
A) Patient educator
B) Caregiver
C) Case manager
D) Patient advocate
Ans: C
Feedback:
When the nurse coordinates the patient's total rehabilitative plan of care, the nurse is
functioning as a case manager. The nurse must coordinate services provided by all of
the team members. The other answers are incorrect.

Page 15
37. You are the nurse providing care for a patient who has limited mobility after a stroke.
What would you do to assess the patient for contractures?
A) Assess the patient's deep tendon reflexes (DTRs).
B) Assess the patient's muscle size.
C) Assess the patient for joint pain.
D) Assess the patient's range of motion.
Ans: D
Feedback:
Each joint of the body has a normal range of motion. To assess a patient for
contractures, the nurse should assess whether the patient can complete the full range of
motion. Assessing DTRs, muscle size, or joint pain do not reveal the presence or
absence of contractures.

38. You are creating a nursing care plan for a patient who is hospitalized following right
total hip replacement. What nursing action should you specify to prevent inward
rotation of the patient's hip when the patient is in a partial lateral position?
A) Use of an abduction pillow between the patient's legs
B) Alignment of the head with the spine using a pillow
C) Support of the lower back with a small pillow
D) Placement of trochanter rolls under the greater trochanter
Ans: A
Feedback:
Abduction pillows can be used to keep the hip in correct alignment if precautions are
warranted following hip replacement. Trochanter rolls and back pillows do not achieve
this goal.

39. You have been referred to the care of an extended care resident who has been
diagnosed with a stage III pressure ulcer. You are teaching staff at the facility about the
role of nutrition in wound healing. What would be the best meal choice for this patient?
A) Whole wheat macaroni with cheese
B) Skim milk, oatmeal, and whole wheat toast
C) Steak, baked potato, spinach and strawberry salad
D) Eggs, hash browns, coffee, and an apple
Ans: C
Feedback:
The patient should be encouraged to eat foods high in protein, carbohydrates and
vitamins A, B, and C. A meal of steak, baked potato, spinach and strawberry salad best
exemplifies this dietary balance.

Page 16
40. You are the nurse caring for an elderly adult who is bedridden. What intervention
would you include in the care plan that would most effectively prevent pressure ulcers?
A) Turn and reposition the patient a minimum of every 8 hours.
B) Vigorously massage lotion into bony prominences.
C) Post a turning schedule at the patient's bedside and ensure staff adherence.
D) Slide, rather than lift, the patient when turning.
Ans: C
Feedback:
A turning schedule with a signing sheet will help ensure that the patient gets turned
and, thus, help prevent pressure ulcers. Turning should occur every 1 to 2 hours, not
every 8 hours, for patients who are in bed for prolonged periods. The nurse should
apply lotion to keep the skin moist, but should avoid vigorous massage, which could
damage capillaries. When moving the patient, the nurse should lift, rather than slide, the
patient to avoid shearing.

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 XIV.
And deep the shame on man’s insensate heart
For later woman doomed to hideous part;
Poor lostling, bowed with worse than brutal woes,—
To her not even dealt the brute’s repose;
Her sweetness sullied, and her frame disgraced,
Soul scarce might light her temple fair defaced,—
Its chastest sanctities coerced to give
For painful bread to eat, for piteous chance to live.
 XV.
While such her fate in lands of cultured creed,
Judge woman’s griefs with man of barbarous breed;
Slave to his lust, and tiller of his soil,
Crippled and crushed by cruelty and toil;
Yet still her heart a gentle mien essayed,
By deeper passion, holier impulse, swayed;
Care for her wretched offspring rarely swerved,
And mother-love alone the infant oft preserved.
 XVI.
Thus woman’s life, in low or high estate,
Man fettered with a more than natural weight
Of sexual function,—disproportioned theme
And single basis in his female scheme;
He strove to quench her flash of quicker fire,
That crossed his lordship or his low desire;
Her one permitted end to serve his race,
Her individual soul forbidden breathing place.
 XVII.
Scarce other seemed that soul than sentient tomb
Of human energy debarred to bloom;
Her spirit, pining in its durance drear,
Leaves legacy of many a burning tear
For aspirations crushed, and aims denied,
And instincts thwarted by man’s purblind pride;
Her every wish made subject to the nod
Of him whose mad conceit proclaimed himself her God.
 XVIII.
So stood at halt, through years of sterile change,
His narrowed brain and her restricted range;
And man intelligent and woman free,
Was union which the world had yet to see;
For time to come reserved the golden sight
Of glorious harvest from the natural right,
To her as amply as to him assigned
To compass power unknown in body and in mind.
 XIX.
Happy the epoch destined to show
What force of good from that free fate shall flow;
The artificial limits to efface
Of laws and forms that womanhood debase;
Even our own imperfect hour may prove
The ecstasy of earnest souls that move
In dual union of unselfish strife
To reach by mutual love to true and equal life.
 XX.
Yet slow, so slowly, gleams the gathering light,
And lingers still the hovering shade of night;
Though part undone the wrong that we confess,
Repentance cannot instant bring redress;
Nor woman, tortured by her thraldom long,
At once stand forth emancipate and strong;
Her pain persistent, though she calm suppress
Her rancour for the past, with sweet forgivingness.
 XXI.
For carnal servitude left cruel stain,
And galls that fester from the fleshly chain;
Unhealed the scars of man’s distempered greed,
The wounds of blind injustice still they bleed;
Recurrent suffering lets her not forget
The aimless payments of a dismal debt,—
Survival from dim age of man’s abuse
Of functions immature, profaned by savage use.
 XXII.
Her girlhood’s helpless years through cycles long
Had been a martyrdom of sexual wrong,
For little strength or choice might child oppose
To shield herself from force of sensual foes;
Impending motherhood might win no rest
Or refuge sacred from the satyr quest;
Unripe maternity, untimely birth,
The woman’s constant dole in those dark days of earth.
 XXIII.
Action repeated tends to rhythmic course,
And thus the mischief, due at first to force,
Brought cumulative sequence to the race,
Till habit bred hereditary trace;
On woman falls that heritage of woe,
And e’en the virgin feels its dastard blow,—
For, long ere fit to wield maternal cares,
Abnormal fruits of birth her guiltless body bears.
 XXIV.
Misread by man, this sign of his misdeed
Was held as symptom of her nubile need,
And on through history’s length her tender age
Has still been victim to his adult rage;
He, by his text, with irony serene,
Banned her resultant “manner” as “unclean”;
The censure base upon himself recoils,
Yet leaves the woman wan and cumbered in his toils.
 XXV.
Vicarious punishment for manhood’s crime
Takes grievous toll of all her active prime;
The hap, in educated woman’s fate,
Is instinct with antipathy and hate;
Reason confirming tells, no honest claim
Could ever cause such gust of inward shame,
Nor act of normal wont might man blaspheme
To make of Nature’s need a vile opprobrious theme.
 XXVI.
Thoughts like to these are breathings of the truth
To whoso ponders deep the tale of ruth;
The futile mannish pleas that would explain
The purport of her periodic pain,
All bear unconscious witness to the wrong
In blindness born, in error fostered long,—
The spurious function growing with the years,
Till almost natural use the morbid mode appears.
 XXVII.
Grievous the hurt to woman, which to right
Is instant duty of our stronger sight;
From off her weary shoulders, bruised and worn,
To lift the cross in longtime misery borne;
Until, reintegrate in frame and mind,
A speedy restitution she shall find,
From every trammel of man’s mastery freed,
Nor held by his behest from fullest life and deed.
 XXVIII.
And soon may pass her suffering, for the ill
By man begot lies subject to our skill;
All human malady may be allayed
With human forethought, human action’s aid;
Ours then the fault, since, given in our hand
Is power the evil hazard to command;
For Nature, kindly wise our woes to shape,
In very pang of pain both prompts and points escape.
 XXIX.
So woman shall her own redemption gain,
Instructed by the sting of bootless pain;
With Nature ever helpful to retrieve
The injury we heedlessly achieve,
From seed of act, by recent woman sown,
Already guerdon rich in hope is shown;—
Such faculty her new-found presence decks,
The sage physician, she, and saviour of her sex.
 XXX.
With purer phase of life proves woman less
The burden of the wasting weariness;
And thus, in rank refined or rude have grown
Maidens in whom the weakness was not known;
Hale woman and true mother have they been,
Yet never have the noisome habit seen:
Not to neglectful man to greatly care
How such immunity all womanhood might share.
 XXXI.
Her intellect alert the harm shall heal,
And ways of wholesomeness and strength reveal;
The saving truth she wins with studious thought
More swiftly to her daughter shall be taught,—
How body still is supple unto mind,
By dint of soul is fleshly form inclined,
And woman’s will shall work of man atone,
The deed his darkness wrought be by her light undone.
 XXXII.
No longer drilled deformity to nurse,
And woo, when slow to appear, the absent curse,
Her counter-effort, helped by Nature’s grace,
Shall quell the “custom’s” last abhorrent trace;
Its morbid usurpation shall refute,—
Not more to woman natural than to brute;—
A needless noyance with a baseless claim,
The lingering mark of man’s unthinking guilt and shame.
 XXXIII.
Her body, saved from enervating drain,
Shall lend a newer vigour to the brain;
Wide shall she roam in realms of untold thought,
Which ages since her shackled instinct sought;
For oft her prison had the yearnings heard,
In murmurings scarce rendered into word;—
Promptings which man suspicious strove to choke,
Lest that her soul should rise and break his timeworn yoke.