Chapter 48: Moving and Positioning Clients PNE 142 extra ?'s

The LPN/LVN in the postsurgical unit cares for the client immediately after an L4-L5 spinal fusion. The primary health care provider's order calls for the client to be turned every hour. Arrange the following steps in the order that the nurse should perform them. All options must be used. (1)Place the pillow between the client's legs. (2)Remove the pillow from under the client's head. (3)Perform hand hygiene. (4)Document the client's repositioning. (5)Firmly grasp the client's draw sheet with both hands. (6)Move the client's body as a unit.

(3)Perform hand hygiene. (2)Remove the pillow from under the client's head. (1)Place the pillow between the client's legs. (5)Firmly grasp the client's draw sheet with both hands. (6)Move the client's body as a unit. (4)Document the client's repositioning.

A client is being prepared for a thoracentesis. The nurse reinforces instructions with the client given by the registered nurse. Which points should be included in the instructions? Select all that apply. 1. The client leans over a bedside table. 2. The client should sit on the edge of the bed. 3. The procedure involves obtaining a biopsy. 4. A time-out is performed before the procedure. 5. The procedure is performed during a bronchoscopy. 6. A local anesthetic is administered before the procedure.

1. The client leans over a bedside table. 2. The client should sit on the edge of the bed. 4. A time-out is performed before the procedure. 6. A local anesthetic is administered before the procedure.

The nurse is preparing to reposition a dependent client who weighs more than 250 lbs. Which interventions should the nurse use to move this client? Select all that apply. 1. Use a friction-reducing slide sheet. 2. Use a mechanical lift to move the client. 3. Place the client in Trendelenburg position. 4. Keep elbows close and work close to the body. 5. Administer oral pain medication 5 minutes before moving the client. 6. Obtain assistance of a second caregiver to assist with mechanical aids.

1. Use a friction-reducing slide sheet. 2. Use a mechanical lift to move the client. 4. Keep elbows close and work close to the body. 6. Obtain the assistance of a second caregiver to assist with mechanical aids.

The nurse is reinforcing home-care instructions to a client and family regarding care after left cataract surgery with lens implant. Which statements made by the client indicate an understanding of the instructions? Select all that apply. 1. "I will bend over to tie my shoes." 2. "I will not sleep lying on my left side." 3. "I will sit at the table to eat breakfast." 4. "I will sit in my recliner with my feet elevated." 5. "I will not lift anything heavier than 10 pounds." 6. "I will resume my exercise routine including pushups."

2. "I will not sleep lying on my left side." 3. "I will sit at the table to eat breakfast." 4. "I will sit in my recliner with my feet elevated." 5. "I will not lift anything heavier than 10 pounds."

The nurse is assisting with the insertion of a nasogastric tube into a client. The nurse should place the client in which position for insertion? 1. Right side 2. Low Fowler's position 3. High Fowler's position 4. Supine, with the head flat

3. High Fowler's position

The nurse is assisting with caring for a client after a craniotomy. Which are the positions that can be used for the client? Select all that apply. 1. Prone position 2. Supine position 3. Semi-Fowler's position 4. Dorsal recumbent position 5. With the foot of the bed flat 6. With the foot of the bed elevated 30 degrees

3. Semi-Fowler's position 5. With the foot of the bed flat

The nurse is administering a cleansing enema to a client with a fecal impaction. Before administering the enema, the nurse asks the client to assume a left Sims' position. The nurse explains that this positioning is preferred because of which reason? 1. The nurse is right-handed. 2. The rectal sphincter will relax. 3. The enema will flow into the bowel easily. 4. The client is more likely to retain the enema solution.

3. The enema will flow into the bowel easily.

After a client undergoes a liver biopsy, the nurse places the client in the prescribed right-side lying position. The nurse understands that the purpose of this intervention is to accomplish which? 1. Promote bile flow 2. Limit client discomfort 3. Promote hepatic glucose storage 4. Limit bleeding from the biopsy site

4. Limit bleeding from the biopsy site

The nurse is assigned to assist with caring for a client after cardiac catheterization performed through the left femoral artery. The nurse should plan to maintain bed rest for this client in which position? 1. High Fowler's position 2. Supine with no head elevation 3. Left lateral (side-lying) position 4. Supine with head elevation no greater than 30 degrees

4. Supine with head elevation no greater than 30 degrees

The home-care LPN/LVN is visiting the frail client with type 2 diabetes, osteoporosis, and nighttime drooling. The client sleeps in the prone position. The nurse recognizes which of the following as an advantage of this position for the client? Select all that apply. A) It allows full extension of the hip and knee joints. B) It produces lordosis in most people. C) It causes plantar flexion. D) It keeps saliva drainage flowing from the mouth. E) It promotes better breathing. F) It prevents hypoglycemia.

A) It allows full extension of the hip and knee joints. D) It keeps saliva drainage flowing from the mouth.

The LPN/LVN is assisting with the care of a client 48 hours after a right total hip arthroplasty. Which observation requires an intervention by the LPN/LVN? A) The client is positioned in a high Fowler's position during meal times. B) The right and left legs are slightly abducted when client is supine. C) The head of the bed is elevated 50 degrees during morning oral care. D) The unlicensed assistive personnel (UAP) places a pillow between client's legs before turning client."

A) The client is positioned in a high Fowler's position during meal times.

The LPN/LVN is caring for the obstetrical client who is in active labor. Suddenly the fetus's umbilical cord can be seen protruding from the vagina. The LPN/LVN will immediately place the client in which of the following positions? A) Trendelenburg. B) Sims'. C) Prone. D) Semi-Fowler's.

A) Trendelenburg.

The LPN/LVN is preparing the female client for a vaginal examination. The client is positioned to best increase the vaginal opening for examination. Which of the following features would this position include? Select all that apply. A) Soft pillow under head. B) Back flat on the exam table. C) Knees straight. D) Elbows flexed. E) Thighs abducted. F) Legs adducted

B) Back flat on the exam table. E) Thighs abducted.

The LPN/LVN in the long-term care facility is assisting the client with chronic obstructive pulmonary disease and varicose veins. Before breakfast is served, the LPN/LVN places the client in Fowler's position. Which of the following best describes why Fowler's position would be used in this client? A) It straightens the neck, which allows client to swallow more effectively. B) It pulls the diaphragm downward, which permits greater chest expansion. C) It puts the back in a natural position, which relieves muscle tension. D) It increases venous return, which improves the circulation to the legs.

B) It pulls the diaphragm downward, which permits greater chest expansion.

The LPN/LVN is preparing the client with hemorrhoids for a rectal examination. Depending on the physical limitations of the client, the nurse should put the client in which of the following positions? Select all that apply." A) Prone. B) Supine. C) Knee-chest. D) Trendelenburg. E) Sims'. F) Fowler's.

C) Knee-chest. E) Sims'

The LPN/LVN is assisting with the care of a client diagnosed with a 4th cervical (C4) complete spinal cord injury. Which observation most concerns the LPN/LVN? a) The unlicensed assistive personnel (UAP) positions the client in a 30-degree side-lying position. b) The client watches television with the head of the bed elevated at a 45-degree angle. c) The unlicensed assistive personnel (UAP) uses warm water and a gentle soap for bathing. d) The client lightly rubs the skin with a bath towel after bathing to ensure dryness.

b) The client watches television with the head of the bed elevated at a 45-degree angle.

The LPN/LVN is assisting with the care of a client diagnosed 2 weeks ago with a right-sided stroke. When assisting the client with meals, it is most important for the LPN/LVN to take which action? a) Encourage the client to swallow each bite of food 4 times. b) Assist the client to use a straw to drink fluids with the meal. c) Instruct the client to sit in a chair for 30 minutes after the meal. d) Provide 8 oz (240 mL) of milk with every meal and at bedtime.

c) Instruct the client to sit in a chair for 30 minutes after the meal.

The LPN/LVN is caring for a client diagnosed 6 months ago with a 6th thoracic (T6) spinal cord injury. The client reports a "throbbing headache," and the client's face, neck, and upper chest are flushed and diaphoretic. Which action should the LPN/LVN take first? a) Loosen the client's upper body clothing. b) Check the client for fecal impaction. c) Remove the indwelling urinary catheter. d) Sit the client in an upright position.

d) Sit the client in an upright position.