Chapter 33: Activity and Exercise Practice Questions

A client works in a warehouse and has been having low back pain. Which statement would indicate the need for more education regarding safe lifting?

"I hold the boxes away from my body so I don't drop them on my feet."

The nurse has been teaching a client about health promotion and exercise. The nurse knows that the education has been successful when the client states:

"I will invite a friend to exercise with me."

A patient is preparing to mobilize for the first time following the surgical removal of a bunion on her left foot. How should the nurse instruct the patient to ambulate with her crutches?

"Try to avoid putting too much pressure on your armpits with the tops of the crutches." Explanation: When using crutches, a patient should avoid pressure on the axillae in order to prevent skin breakdown. Elbows should be kept close to the sides and the crutches should come no closer than 12 inches from the feet. When rising from a chair, the patient should extend her left foot in order to prevent weight bearing.

The nursing assistant is preparing to help the client make a lateral transfer from the bed to a stretcher. The client informs the nurse that the client is able to move onto the stretcher without the nurse's help. What is the nurse's best response?

"You are free to move onto the stretcher without assistance, but I will supervise for your safety." Feedback: If the client is fully able to assist in the transfer, the nurse should allow the client to complete the movement independently, with supervision for safety.

A client has been bedridden for a week. The daughter of the client asks the nurse why her mother needs to sit on the bedside before getting out of bed. The nurse's best response is:

"Your mother might get dizzy when she gets up so she needs to sit on the side of the bed first."

A nurse is assessing the activity level of a 5-month-old baby. What normal findings would be assessed? A) ability to sit and head control B) ability to pick up small objects C) progress toward running and jumping D) progress toward unassisted walking

A) ability to sit and head control

While performing range-of-motion exercises on a patient, a nurse bends a patient's foot so that the toes are brought up, as though to point them at the knee. What is the term for this type of movement? A) dorsiflexion B) inversion C) rotation D) eversion

A) dorsiflexion

A nurse performing range-of-motion exercises on a bedfast patient moves the patient's chin down onto the chest and then back to an upright position. The nurse then tilts the head as far as possible to each shoulder. What therapeutic movement is the nurse achieving with this exercise? Select all that apply. A) flexion B) adduction C) extension D) dorsiflexion E) pronation F) abduction

A) flexion C) extension

Immobility affects the body in many ways. What is one serious effect of immobility on the cardiovascular system? A) increased cardiac workload B) decreased cardiac workload C) increased venous return D) increased peripheral resistance

A) increased cardiac workload

A middle-aged man walks 2 miles each day. What type of exercise is he getting by this activity? A) isotonic B) isometric C) isokinetic D) isostretching

A) isotonic

A nurse is teaching an older woman how to move and lift her disabled husband. The woman has osteoarthritis of the hips and knees. What is the goal of the nurse's teaching plan? A) minimize stress on the wife's joints B) provide exercise for the husband C) increase socialization with neighbors D) maintain self-esteem of the wife

A) minimize stress on the wife's joints

A nurse is ambulating a patient who has had a stroke. The patient has paresis on the right side of the upper body. Where would the nurse stand to walk the patient? A) on the weak side B) on the strong side C) in front of the patient D) in back of the patient

A) on the weak side

An immobile person has decreased movement of respiratory secretions. What condition is a greater risk as a result? A) respiratory tract infection B) increased gas exchange C) greater thoracic expansion D) increased respiratory rate

A) respiratory tract infection

A nurse recommends a regular exercise program for a patient who has difficulty sleeping. The patient asks how this will help. How would the nurse respond? A) "The fresh air will stimulate your metabolism." B) "Improved sleep is one benefit of regular exercise." C) "Exercise can help you control your weight." D) "Take my word for it. It sure helped me."

B) "Improved sleep is one benefit of regular exercise."

A patient has chronic obstructive pulmonary disease and is unable to perform basic self-care activities or activities of daily living. Which of the following would be an appropriate nursing diagnosis? A) Risk for Injury: Pathologic Fractures B) Activity Intolerance C) Altered Tissue Perfusion D) Altered Thought Processes

B) Activity Intolerance

A nurse is following a plan of care for passive range-of-motion (ROM) exercises. What specifics will be included on the plan? A) Ask the patient to demonstrate ROM at 9 a.m. each day. B) Do ROM exercises two times a day, each exercise two to five times. C) Request family be available twice a day to perform ROM. D) Move each joint until the patient complains of pain.

B) Do ROM exercises two times a day, each exercise two to five times.

A nurse is providing home care for an older woman with severe osteoporosis. What complication of this disease process must the nurse consider in the plan of care? A) diarrhea B) fractures C) visual deficits D) skin disorders

B) fractures

A nurse is assessing the muscles of an older adult. What will be assessed? A) temperature, turgor, moisture B) mass, tone, strength C) degree of flexion, associated pain D) reflexes, range of motion

B) mass, tone, strength

What term is used to document impaired muscle strength or weakness? A) paralysis B) paresis C) spasticity D) flaccidity

B) paresis

Laboratory results for a patient on prolonged bedrest include a high level of urinary calcium. What risk does this pose for the patient? A) urinary calcium is not a concern B) renal calculi (kidney stones) C) increased urinary output D) imbalanced intake/output

B) renal calculi (kidney stones)

Why is it important for the nurse to teach and role model proper body mechanics? A) to ensure knowledgeable patient care B) to promote health and prevent illness C) to prevent unnecessary insurance claims D) to demonstrate knowledge and skills

B) to promote health and prevent illness

Of the following guidelines, which would not be recommended to a person who has sustained an orthopedic injury during exercise? A) ice B) warmth C) rest D) elevation

B) warmth

A nurse is placing a patient in Fowler's position. What should she teach the family about this position? A) "Use at least two big pillows to support the head." B) "Cross the arms over the patient's abdomen." C) "Do not raise the knees with the knee gatch." D) "Keep the hands lower than the rest of the body."

C) "Do not raise the knees with the knee gatch."

A college student fell and sprained his right ankle. The student health physician recommends the student use crutches to facilitate healing. Which of the following would the nurse teach the student? A) The crutches should be as long as the student is tall. B) The support of the body should be in the axilla. C) The support of the body should be the hands and arms. D) Walk fast and use long steps when using the crutches.

C) The support of the body should be the hands and arms.

A nurse is assessing the vital signs of a patient who has exercised regularly for several years. What vital sign findings would be expected? A) increased body temperature and respirations B) increased pulse and blood pressure C) decreased pulse and blood pressure D) exercise has no effect on vital signs

C) decreased pulse and blood pressure

Bedrest, with resultant immobility, affects the whole body. What is one effect on the musculoskeletal system? A) impaired gas exchange B) increased risk for venous thrombosis C) increased risk for contractures D) decreased sensory stimulation

C) increased risk for contractures

A nurse is teaching an older adult about activity. What information would be included in the teaching plan? A) the requirement of frequent inactivity B) the recognition that exercise is not important C) the importance of regular exercise D) the possibility of exercise-induced fractures

C) the importance of regular exercise

Which of the following activities are normally acquired in the toddler years? Select all that apply A) rolling over B) pulling to a standing position C) walking D) running E) jumping F) climbing stairs

C) walking D) running E) jumping

Which of the following ambulatory aids could a nurse suggest to assist a client who has weakness in one side of his body?

Cane Explanation: The nurse could suggest the use of a cane to a client who has weakness in one side of his body in order to aid ambulation. Canes are hand-held ambulatory devices made of wood or aluminum. A walker is used by clients who require considerable assistance with balance. Clients who need brief, temporary assistance with ambulation are likely to use axillary crutches. Forearm crutches generally are used by experienced clients who need permanent assistance with walking.

The nurse is preparing to move a client from bed into a wheelchair to eat lunch. What client data would the nurse check to see if the assistance of another nurse is needed?

Client restrictions

The nurse is assisting a newly delivered mother ambulate to the nursery to see the baby. The client complains of light-headedness and begins to faint. What is the nurse's most important action? 1. Ensure the client's modesty as she falls. 2. Be certain the client does not hit the head on anything. 3. Call for immediate assistance. 4. Check the vital signs and for excessive vaginal bleeding.

Correct Answer: 2 Rationale 1: This is not the priority for the nurse at this time. Rationale 2: All of these actions are important, but the priority is ensuring the client does not strike her head on anything when falling. The nurse should ease the client down while supporting her body against the nurse, protecting the head and laying it gently on the floor. Rationale 3: This is important however does not address that the client is falling. Rationale 4: This is important to do after the client has been assisted to the floor.

The postoperative client is ambulating for the first time since surgery. The client has been able to tolerate sitting up on the side of the bed and has stood at the bedside without difficulty on two occasions. Which staff member should ambulate this client? 1. The UAP 2. A licensed practical (vocational) nurse 3. A registered nurse 4. It makes no difference

Correct Answer: 3 Rationale: Since this is the first time this client has ambulated, the best choice is for the registered nurse to ambulate the client. The registered nurse must assess and evaluate the client's response to the ambulation. Once the client has successfully ambulated, any nursing staff member can assist. The registered nurse should make assistive personnel aware of potential untoward effects of ambulation and of what to report to the nurse.

The newly admitted client has contractures of both lower extremities. What nursing intervention should be included in this client's plan of care? 1. Frequent position changes to reverse the contractures 2. Exercises to strengthen flexor muscles 3. Range of motion exercises to prevent worsening of contractures 4. Weight-bearing activities to stimulate joint relaxation

Correct Answer: 3 Rationale 1: Frequent position changes will not reverse contractures. Rationale 2: The contracture occurs because the flexor muscles are stronger than the extensor muscles. This imbalance in strength pulls the inactive joint into a flexed position, and a permanent shortening of the muscle occurs. Rationale 3: Once contractures occur they are irreversible except by surgical intervention. The best nursing intervention is to keep the contractures from getting tighter (or worse) by providing range of motion exercises. Rationale 4: Weight bearing activities will not reverse contractures.

The nurse is providing range of motion exercising to the client's elbow when the client complains of pain. What action should the nurse take? 1. Stop immediately and report the pain to the client's physician. 2. Discontinue the treatment and document the results in the medical record. 3. Reduce the movement of the joint just until the point of slight resistance. 4. Continue to exercise the joint as before to loosen the stiffness.

Correct Answer: 3 Rationale 1: Stopping the treatment is not justified until an assessment occurs. Rationale 2: Stopping the exercises is not justified until an assessment occurs. Rationale 3: Range of motion exercising should never cause discomfort. In this case, the best action is to reduce the movement of the joint just until the point of slight resistance is felt and evaluate the pain response at that level. If there is no pain, the exercise can be continued. Rationale 4: Continuing at the same level of intensity may cause damage to the joint as well as cause the client pain.

When planning care, the nurse would identify which client as needing logrolling for position changes? 1. A client with documented pneumonia 2. The client who has had abdominal surgery 3. The client who fell from a house, sustaining a fractured tibia 4. A client who has a severe headache from hypertensive crisis

Correct Answer: 3 Rationale 1: There is no physiological reason why a client with pneumonia would need to be logrolled. Rationale 2: There is no physiological reason why a client recovering from abdominal surgery would need to be logrolled. Rationale 3: Logrolling technique is used in moving any client who may have sustained a spinal injury. Of these clients, the most concern is for the client who fell from a house. Rationale 4: There is no physiological reason why the client with a headache would need to be logrolled.

While assisting the client with a bath, the nurse encourages full range of motion in all the client's joints. Which activity would best support range of motion in the hand and arm? 1. Give the client a washcloth to wash the face. 2. Move the wash basin farther toward the foot of the bed so the client must reach. 3. Have the client brush hair and teeth. 4. Move each of the client's hand and arm joints through passive range of motion.

Correct Answer: 3 Rationale 1: This activity does not utilize all of the major joints in the hands and arms. Rationale 2: The wash basin should be close to the client to prevent overreaching and possible falls. Rationale 3: Brushing the hair and teeth includes more of the joints of the hands and the arms than does washing the face. Rationale 4: Passive range of motion is a second best choice after normal use of the joints.

What is the priority action of the nurse prior to transferring a client from bed to wheelchair? 1. Place the bed in its lowest position. 2. Place the wheelchair parallel to the bed. 3. Lock the brakes on the bed. 4. Place a transfer belt on the client

Correct Answer: 3 Rationale 1: This is not the most important action of the nurse. Rationale 2: This is not the most important action of the nurse. Rationale 3: While all of these activities are important safety issues, the most important is to lock the wheels on the bed. If the wheels are not locked and the bed moves out from under the client, none of the other safety actions will likely prevent a fall or near fall. Rationale 4: This is not the most important action.

The nurse is evaluating the proper fit of crutches for a client who is to be discharged home. What portion of this client's body should support the weight?

Correct Answer: Arms Rationale : The weight of the body should rest on the arms, not the axilla. Weight on the axilla can cause radial nerve damage. Crutches that are too long will divert weight to the axilla. Crutches that are too short will cause the client to hunch over to walk and will alter the center of gravity, perhaps causing a fall.

The nurse is teaching a client how to use a cane while rehabilitating from a left leg injury. The nurse should advise this client to place the cane on which side of the body?

Correct Answer: Right Rationale : The cane should be placed on the stronger side of the body, in this case the right side. This provides maximum support and the best body alignment.

A patient at a community health center is discussing a planned exercise program. The patient is being treated for cardiovascular disease. What would the nurse recommend? A) "Begin the exercise program immediately." B) "It would be best if you did not exercise." C) "Be sure to take your pulse before you begin." D) "See your doctor and have a checkup first."

D) "See your doctor and have a checkup first."

What body system benefits the most from aerobic exercises? A) musculoskeletal B) neurologic C) respiratory D) cardiovascular

D) cardiovascular

What term is used to describe the correction or prevention of disorders of body structures used in locomotion? A) pediatrics B) obstetrics C) geriatrics D) orthopedics

D) orthopedics

A nurse is caring for a comatose patient. What can happen to the feet if they are unsupported in the dorsiflexed position? A) heel extension and pain B) toe contractures and numbness C) plantar extension and arch loss D) plantar flexion and footdrop

D) plantar flexion and footdrop

Which of the following postural deformities might be assessed in a teenager? A) kyphosis B) rickets C) osteoporosis D) scoliosis

D) scoliosis

At what time would a nurse assess the gait of an ambulatory patient? A) after the neurologic assessment B) at the end of the physical examination C) while the patient is lying supine on the examining table D) when the patient walks into the room

D) when the patient walks into the room

A nurse is promoting exercise and activities for an elderly patient. Which teaching point would be appropriate for this patient?

Encourage the patient to warm up before beginning exercises and to cool down after exercising. Feedback: The client should be encouraged to develop an exercise program that specifies warm-up and cool-down activities (walking, stretching). The client should not be encouraged to quickly increase the repetitions for arm and leg exercises. The client should not continue to exercise when feeling weak, this could lead to injury. The client should not be taught to force joints to meet their natural limit and beyond prior to modifying exercises. This could lead to injury. (less)

A nurse is logrolling a client who has a spinal injury. Which nursing action follows the recommended guidelines for this procedure?

Enlist the assistance of two or three other nurses to perform the procedure.

A nurse is repositioning a client who has physical limitations due to recent back surgery. How often would the nurse turn the client in bed?

Every two hours

A client 80 years of age experienced dysphagia (impaired swallowing) in the weeks following a recent stroke, but his care team wishes to now begin introducing minced and pureed food. How should the nurse best position the client?

Fowler's

The nurse is caring for a client who has been on bed rest. The primary care provider has just written a new order for the client to sit in the chair three times a day. Which of the following actions will be most effective to transfer the client safely into the chair?

Have the client sit on the side of the bed for several minutes before moving to the chair.

A client will be ambulating for the first time since his cardiac surgery. What should the nurse consider when assisting this client?

If an ambulating client whom a nurse is assisting begins to fall, the nurse should slide the client down his own body to the floor, carefully protecting the client's head. Feedback: The nurse would use the gait belt to ease the client backward against his own body and gently ease the client to the floor while protecting the client's head. The client should not look at his feet, but rather out at eye level at his surroundings. The nurse should consult the plan of care for the client, but the nurse regularly ambulates a client without a physical therapist present. The evaluation of a client's muscle power to permit walking cannot be measured by the ability to lift the legs off the bed.

The cardiac response to exercise is well-researched and documented. Which of the following is a cardiovascular response to regular exercise?

Increased efficiency of the heart

As a part of his workout regimen, a 21-year-old college football player often engages in squats and lateral arm holds. These are examples of what type of exercise?

Isometric

The nurse recognizes that which organization requires that employers comply with ergonomic recommendations?

National Institute for Occupational Safety and Health (NIOSH)

The nurse manager is assessing the unit for proper work ergonomics. Which finding will require immediate intervention by the nurse manager?

Nurses and unit assistants use telephones with handsets.

The nurse is assisting a client to ambulate following knee surgery. What is a key concern when assisting clients with activity?

Safety

A staff development nurse is discussing techniques to prevent back injury with a group of nursing assistants. The nurse informs the group that back stress and injury can be prevented by doing which of the following?

Spreading feet shoulder-width apart to broaden the base of support

A nurse is providing care for a client who has been newly admitted to the long-term care facility. What is the primary criterion for the nurse's decision whether to use a mechanized assistive device for transferring the client?

The client's ability to assist

A nurse is caring for a client who is on complete bed rest while recovering from hip surgery 12 hours ago. When the client is able to start walking, which ambulation aid will most likely be recommended for use?

Walker Explanation: The nurse could suggest the use of a walker for the client who is recovering from hip surgery and has been recommended complete bed rest. Clients who require considerable support and assistance with balance use a walker, the most stable form of ambulatory aid. A cane is used by clients who have weakness on one side of the body. Clients who need brief, temporary assistance with ambulation are likely to use axillary crutches. Forearm crutches generally are used by experienced clients who need permanent assistance with walking.

The nurse has completed proper body mechanic education for a group of unlicensed assistive personnel (UAP). Which UAP statement requires the nurse to intervene? a) "I don't like to wait for help; I would rather just lift alone." b) "When moving a client, we need to plan ahead for the distance we will be going." c) "We should report to our manager if the items we need are located on shelves that are too high to reach." d) "I always use the lift when I anticipate lifting more than 35 pounds."

a) "I don't like to wait for help; I would rather just lift alone."

The occupational nurse is teaching other nurses how to protect the back by using proper body mechanics. Which teaching will the nurse include? Select all that apply. a) Push, pull, or roll objects whenever possible. b) Position a heavy load over the center of the feet when lifting. c) Hold heavy objects away from the body. d) Bend the knee and keep the back straight when lifting. e) Keep the feet together when lifting.

a) Push, pull, or roll objects whenever possible. b) Position a heavy load over the center of the feet when lifting. d) Bend the knee and keep the back straight when lifting.

The nurse is assisting a client from the bed into a wheelchair. What is a recommended guideline for this procedure? a) Raise the head of the bed to a sitting position. b) Put the chair at the foot of the bed. c) Make sure the bed brakes are unlocked. d) Place the bed in the highest position.

a) Raise the head of the bed to a sitting position. Feedback: When assisting a client from the bed into a wheelchair, the nurse would place the bed in the lowest position and raise the head of the bed to a sitting position. The nurse would make sure the bed brakes are locked and put the wheelchair next to the bed, locking the brakes of the chair.

When a client is lifted or held by a nurse, the additional weight becomes a part of the nurse's weight and should be: a) balanced over the center of gravity. b) supported with a narrow base. c) controlled with the upper arm muscles. d) counterbalanced by a horizontal adjustment.

a) balanced over the center of gravity. Feedback: Maintaining balance involves keeping the spine in vertical alignment, the feet positioned for a broad base of balance, and the body weight close to the center of gravity.

The nurse is caring for a client who has a lower body injury and who is able to partially assist with transfers. The nurse should: a) provide the client with an overhead trapeze. b) use a pull sheet whenever moving the client. c) teach the client to pull up with the headboard. d) manually roll the client to the side of the bed.

a) provide the client with an overhead trapeze.

The occupational nurse is teaching an administrative assistant about proper posture when sitting. Which teaching will the nurse include? a) "Keep your knees bent, with the back of the knees against your chair." b) "Both of your feet should rest on the floor." c) "Cross your legs alternately throughout the day." d) "Upper and lower thighs are your base of support."

b) "Both of your feet should rest on the floor."

An older client is transferring from a supine position to a sitting position in a chair. The client reports dizziness when transferring. Which teaching by the nurse is most appropriate? a) "If you are dizzy, then you are not ready to get up from the supine position." b) "Move slowly and sit on the edge of the bed before transferring to the chair." c) "Move quickly from lying to sitting to avoid dizziness." d) "Dizziness will improve if you lie back down."

b) "Move slowly and sit on the edge of the bed before transferring to the chair."

The 55-year-old client who is newly diagnosed with osteoarthritis of the hips asks the nurse why it hurts when walking. What is the nurse's best response? a) "Osteoarthritis is painful and very common as you age." b) "You have lost the padding in your joints and the friction causes pain." c) "If you recently fell, you might have a fractured hip." d) "Because you lose muscle tone with age, it hurts to walk."

b) "You have lost the padding in your joints and the friction causes pain."

The nursing student learns in Fundamentals that the primary purpose for using proper body mechanics is for which reason? a) Primarily protects the client from injury b) Acts to prevent injury to the client and/or nurse c) Acts as a safeguard against legal action by the client d) Primarily protects the nurse from injury

b) Acts to prevent injury to the client and/or nurse

A nurse is teaching a client about the beneficial effects of exercise on his body. Which education point would the nurse include in the plan? Select all that apply. a) Exercise increases resting heart rate and blood pressure. b) Exercise increases intestinal tone. c) Exercise decreases rate of carbon dioxide excretion. d) Exercise increases efficiency of the metabolic system. e) Exercise increases blood flow to kidneys. Exercise decreases appetite.

b) Exercise increases intestinal tone. d) Exercise increases efficiency of the metabolic system. e) Exercise increases blood flow to kidneys. Exercise decreases appetite.

A client with a hip fracture is returning to the orthopedic unit, and the orders indicate that the client should be turned by logrolling. Which statement is correct regarding logrolling? a) It is acceptable to twist the client's head, but not the hips, while logrolling. b) Use a drawsheet or a friction-reducing sheet to facilitate smooth movement. c) Logrolling can be performed by one experienced nurse. d)Logrolling will maintain straight alignment when the client is sitting in a chair.

b) Use a drawsheet or a friction-reducing sheet to facilitate smooth movement. Explanation: Logrolling requires the assistance of two or three nurses. Logrolling will maintain straight alignment when the patient is being turned. The nurse should avoid twisting the patient's head, spine, shoulders, knees, or hips while logrolling. The nurse should use a drawsheet or a friction-reducing sheet to facilitate smooth movement.

The nurse is performing a physical assessment on an adolescent. What assessment priorities are needed for this age group? a) increased need for calcium and vitamin D b) scoliosis c) kyphosis d) shifted center of gravity

b) scoliosis Feedback: Numerous factors, including growth and development, influence a person's posture, movement, and daily activity level. The adolescent should be assessed for scoliosis (curvature of the spine). Kyphosis is increased convexity in the thoracic spine from disk shrinkage and decreased height, common in older adults. A shifted center of gravity occurs during pregnancy (in the adult) because of the developing fetus. Older adults have an increased need for calcium and vitamin D related to the risk for osteoporosis.

The UAP asks the nurse what hand rolls are used for when providing client care. What is the appropriate nursing response? a) "To prevent foot drop." b) "To avoid contractures." c) "To preserve the client's functional ability to grasp and pick up objects." d) "To prevent the legs from rotating outward."

c) "To preserve the client's functional ability to grasp and pick up objects.

The nurse would like to promote ventilation in a client with chronic obstructive pulmonary disease by elevating the client's arms. What intervention should the nurse implement? a) Place a trochanter roll under the arms. b) Instruct the client to place arms on the side rails. c) Place a small pillow under each arm. d) Elevate the head of the bed.

c) Place a small pillow under each arm.

Which type of mobility aid would be most appropriate for a client who has poor balance? a) axillary crutches b) a single-ended cane with a straight handle c) a cane with four prongs on the end (quad cane) d) a single-ended cane with a half-circle handle

c) a cane with four prongs on the end (quad cane) Feedback: Canes with three (tripod) or four prongs (quad cane) or legs to provide a wide base of support are recommended for clients with poor balance. Single-ended canes with half-circle handles are recommended for clients requiring minimal support and those who will be using stairs frequently. Single-ended canes with straight handles are recommended for clients with hand weakness because the handgrip is easier to hold, but are not recommended for clients with poor balance. Axillary crutches are used to provide support for clients who have temporary restrictions on ambulation.

A client is discharged to his daughter's home. He weighs 250 lb (113.4 kg) and is immobile. The nurse should instruct the daughter on the use of a: a) transfer with a gait belt. b) stand-up assist lift. c) hydraulic lift. d) three-person lift.

c) hydraulic lift

The nurse is caring for a 76-year-old client who has an unsteady gait. Which method is most appropriate to assist in transferring? a) mechanical lift b) transfer boards c) transfer belt d) roller sheet

c) transfer belt

A student nurse asks the nurse what trochanter rolls are used for when providing client care. What is the appropriate nursing response? a) "To avoid contractures." b) "To preserve the client's functional ability to grasp and pick up objects." c) "To prevent foot drop." d) "To prevent the legs from rotating outward."

d) "To prevent the legs from rotating outward." Feedback: Trochanter rolls prevent the legs from rotating outward. The other statements do not describe trochanter rolls. Hand rolls preserve the client's functional ability to grasp and pick up objects, and help the client avoid contractures. Foot boards prevent foot drop.

The nurse manager is assessing the unit for proper work ergonomics. Which finding will require immediate intervention by the nurse manager? a) Chairs have firm back support and allow the feet to touch the floor. b) A small dolly is used to transport heavy items. c) Work is being carried out under sources of non-glare lighting. d) Equipment is positioned to the side, 50 degrees away.

d) Equipment is positioned to the side, 50 degrees away.

A nurse is recommending aerobic exercise for a client who is overweight. Which exercise might the nurse suggest? a) Lifting weights b) Yoga c) Stretching exercises d) Swimming

d) Swimming Explanation: Swimming is an aerobic exercise, also known as a cardio exercise. The other options listed are anaerobic exercises

The nurse is caring for a client who is postoperative from a hip fracture repair. The nurse must be careful to avoid: a) flexion of the knee on the affected leg. b) hip abduction. c) extension of the knee on the affected leg. d) adduction of the affected leg

d) adduction of the affected leg

During range-of-motion exercises, the nurse turns the sole of a client's foot toward the midline and then turns the sole of the foot outward. Which type of movement is this nurse promoting by these actions? a) internal and external rotation of the ankle b) flexion and extension of the ankle c) dorsiflexion and plantar flexion of the ankle d) inversion and eversion of the ankle

d) inversion and eversion of the ankle

When an older adult client walks with her knees slightly flexed and body leaning, the nurse determines that the client: a) requires a better walking shoe. b) requires crutches for mobility. c) should have an orthopedic consultation. d) is demonstrating a common gait for the older adult.

d) is demonstrating a common gait for the older adult. Feedback: Many older people have more difficulty overcoming inertia and using gravity efficiently. One contributing factor is the shift in the center of gravity. To compensate for this shift, the knees flex slightly for support.

When logrolling a client, the nurse should use supportive devices in turning the client in order to: a) allow the client's leg to rest on the bed. b) prevent the blood stasis that can lead to skin breakdown. c) maximize the client's participation. d) maintain the natural alignment of the client's body.

d) maintain the natural alignment of the client's body. Feedback: Logrolling is a technique used for turning clients who have had surgery or an injury involving the back or spine. It maintains spinal alignment, thus preventing injury. It is not performed for the purpose of maximizing the client's participation or preventing blood stasis.

The nurse is planning care for a client with a nursing diagnosis of Activity Intolerance. What assessment finding would cause the nurse the most concern? a) joint stiffness after sitting for an hour b) a change in pulse from 80 to 84 after walking up 20 stairs c) walking with a slow and uncoordinated movement d) shortness of breath after walking up five stairs

d) shortness of breath after walking up five stairs Feedback: Activity Intolerance may result from any condition that interferes with the transport of oxygenated blood to tissue. The altered response to activity includes exertional dyspnea, shortness of breath. Shortness of breath after walking up five stairs would be included in this nursing diagnosis.

The nurse is performing an assessment of an older adult client. What finding does the nurse document as a normal age-related change?

decrease in flexibility

A male client is admitted to the unit following an amputation of his left leg below the knee. The nurse responsible for him is developing his nursing plan of care. This plan of care should not include:

elevating the stump to prevent pressure ulcers.

A 74-year-old client has kyphosis and is reporting discomfort of the cervical vertebrate. Which nursing intervention is most appropriate?

placing a small towel under the neck Feedback: Kyphotic changes can cause pressure on cervical vertebrae when someone is in a supine position. Effects of this can be minimized by placing a small towel or cervical pillow under the neck. Placing the client on the stomach is incorrect, and a muscle relaxer will not help reduce the pressure caused by the kyphosis. Contacting the physician is unnecessary.

An 85-year-old Caucasian woman walks 1 mile (1.6 km) every morning and every evening. She continues to smoke, but has cut back to half a pack per day. She had a total oophorectomy at age 45 secondary to stage I ovarian cancer. This client is currently not on any medications. Which is not a primary risk factor for osteoporosis for this client?

sedentary lifestyle

When assessing the physical activity of clients, the nurse would be most concerned about which client?

the middle-age computer programmer Explanation: Although further assessments should be done to avoid assumptions and stereotypes, there are many variables that may contribute to a sedentary lifestyle, such as occupations. A computer programmer has a job that is inactive. The nurse would be concerned about this client and would need to do further assessments to determine activity, frequency, and intensity that occur outside of work. The mother of small children would be involved in house cleaning and chasing after the children. Walking is a commonly prescribed exercise and going to the mall provides a safe environment where walking would be available. A Native American who hunts is engaging in culturally related physical activity.

A home care nurse visits a client with Parkinson's disease. The nurse observes that the client has rhythmic, repetitive movements of the hands. The home care nurse documents this as:

tremor Feedback: Tremors are rhythmic, repetitive movements that can occur at rest or when movement is initiated. A tremor usually interferes with fine motor control, but in Parkinson's disease it also can interfere with coordinated ambulation. Athetosis is movement characterized by slow, irregular, twisting motions. Dystonia is similar to athetosis but usually involves larger areas of the body. Ataxia is a general term used to describe impaired muscle coordination

A client with limited mobility has outward rotation of the bony protrusions at the head of the femur. Which assistive device would the nurse include in the plan of care?

trochanter rolls Feedback: Trochanter rolls prevent the legs from turning outward. The trochanters are the bony protrusions at the head of the femur near the hip. Placing a positioning device at the trochanters helps to prevent the leg from rotating outward. Other devices are inappropriate for this client.

Which exercises would the nurse recommend when planning isometric exercise for a client? Select all that apply.

• Contracting the quadriceps • Contracting and releasing the gluteal muscles • Kegel exercises

How should an injured muscle associated with exercise be treated? (Select all that apply.)

• Keep the injured elevated. • Apply an elastic bandage to the injured area.

The nurse observes an unlicensed assistive personnel (UAP) placing a client in the Fowler's position. To prevent complications to the client, in which situation should the nurse intervene? Select all that apply.

• There is a large pillow under the client's head. • The knee gatch on the bed is engaged. • The client's foot is in the plantar flexion position.

A recent paraplegic following a motor vehicle accident is a client on the nurse's rehabilitation unit. She has several daily appointments with physical therapy and occupational therapy. Which action would be most appropriate for the nurse to do to ensure safe transfers? Select all that apply.

• Use a transfer belt when moving the client to a wheelchair. • Teach the client to use the trapeze for transfer and upper body exercise.

The nurse would like the client to perform some exercises that use muscle shortening and active movement. The nurse tells the client it will help build bone and improve cardiac and respiratory functioning. Which exercises should the nurse encourage the client to do? Select all that apply

• Walking • Bicycling • Swimming

A 90-year-old widower lives alone in her home. The nurse knows that older clients are at increased risk for falls. What other factors contribute to increased risk for falls in clients? Select all that apply.

• ataxic gait • history of a fall 5 years ago • diuretics

Which body system effects would the nurse state as occurring due to immobility? Select all that apply.

• increased risk for renal calculi • Increased risk for electrolyte imbalance • increased cardiac workload

A nurse is assessing a client's mobility status. What data would the nurse document as normal findings? Select all that apply.

• independent maintenance of correct alignment • head, shoulders, and hips aligned in bed • full range of motion

Which clients will develop mobility issues in the future? Select all that apply.

• the 35-year-old computer programming technician • the 55-year-old clinical secretary who is to retire after 30 years working the same job