A nurse is caring for a client with a C5 spinal cord injury. Which of the following activity limitations should the nurse anticipate for this client?

A spinal cord injury at the C5 level affects motor and sensory function below the fifth cervical vertebra. This level of injury typically results in tetraplegia with significant impairment of both upper and lower extremities, but some shoulder and elbow function may remain intact depending on the extent of the injury. Clients often retain partial ability to flex the elbows, allowing limited independence in activities such as feeding with adaptive devices or assisted transfers. Functional capacity is largely dependent on residual muscle innervation above the level of injury. Rationale: A. The client will be able to use their hands without assistance is incorrect because hand and fine motor function are controlled by lower cervical nerves (C6–T1). In a C5 spinal cord injury, hand grasp and finger dexterity are typically lost, requiring assistance or adaptive devices for most self-care activities involving hand use. B. The client will have some ability to flex their elbows and may transfer with assistance is correct because C5 innervation allows for shoulder abduction and elbow flexion through the biceps muscle. This residual function enables limited independence, such as bringing food to the mouth with assistive devices or participating in assisted transfers using special equipment or caregiver support. C. The client will have full lower extremity function is incorrect because a C5 spinal cord injury results in loss of motor and sensory function below the level of injury, including the lower extremities. This leads to paralysis of the legs and loss of voluntary movement due to disrupted descending motor pathways. D. The client will be completely independent in all daily self-care activities is incorrect because a C5 injury results in significant functional limitations requiring assistance for most activities of daily living. Clients typically need help with dressing, bathing, toileting, and mobility, although they may achieve partial independence with adaptive equipment and caregiver support.