Chapter 24: Fitness and Therapeutic Exercise
The nurse is teaching a client about moving joints into positions of abduction and adduction. Which client action reflects that teaching has been effective?
moves the legs away from the midline and then toward the midline
The nurse is developing a plan of care for a client who has been in the (protective) prone position. What should the nurse be sure to monitor the client for, related to the positioning?
plantar flexion of the feet
A client has been prescribed exercise at the metabolic energy equivalent (MET) of 3. Which exercise type will the nurse recommend?
raking leaves
A client has been prescribed exercise at the metabolic energy equivalent (MET) of 5. Which exercise type will the nurse recommend?
slow swimming
A client is supposed to build up to exercise of moderate intensity. What activity would the nurse recommend to meet this criterion?
slow swimming
After teaching nursing students about isotonic and isometric exercises, the instructor determines a need for additional teaching when the students state:
"Isometric exercises help promote heart and lung function."
A nurse is assisting a female client during the walk-one-mile test. The client's score is 15 minutes 20 seconds. How would the nurse document the client's performance?
Average
The nurse assesses a 68-year-old client being treated for heart failure who reports dyspnea with mild activity, sitting at a desk most of the day while working, and preferring an orthopneic position. Recognizing that the client is at risk for disuse syndrome, which intervention(s) will the nurse initiate? Select all that apply.
-Instruct the client to sit upright to prevent dyspnea. -Offer activity options and their benefits that match the client's interests and address the client's needs. -Collaborate with physical, occupational, and recreational therapists to implement an individually tailored exercise program. -Encourage active range-of-motion exercises.
A nurse is caring for a client with hypertension. The nurse is aware that certain factors, including high blood pressure, affect the client's capacity to exercise. Which factors directly affect the client's capacity to exercise? Select all that apply
-obesity -advanced age -skeletal function
Two nurses are striving to increase their activity by wearing a self-monitoring motion-sensing device. How many steps will the nurses strive for on a daily basis?
10,000
What will the nurse calculate as the appropriate target heart rate for a 50-year-old client when using 60% of the maximum heart rate as the factor?
102 beats per minute
What will the nurse calculate as the appropriate target heart rate for a 30-year-old client when using 60% of the maximum heart rate as the factor?
114 beats per minute
A client tells the nurse that about wanting to improve physical fitness. The client asks the nurse advice about exercise. The nurse tells the client that, to strengthen the heart muscle and use fat stores, the client should exercise three or more times per week. How many minutes should the client exercise at the target heart rate?
15 minutes
A nurse is assessing the fitness level of a 30-year-old client. What is this client's target heart rate?
190
A male client is about to perform a step test. At what prescribed height should the nurse ensure that the platform is set?
20 in (51 cm)
A community health nurse is teaching a 22-year-old healthy client about activity monitoring with a self-monitoring motion-sensing device. The nurse will recommend that the client set a daily goal for how many steps?
5,000
A community health nurse is teaching a 42-year-old sedentary client about activity monitoring with a self-monitoring motion-sensing device. The nurse will recommend that the client set an initial daily goal for how many steps?
6,000
The nurse is assessing a 50-year-old client who wants to start a fitness program. The client has a sedentary lifestyle and has not exercised often in the past. The nurse determines the client should achieve which target heart rate when starting the fitness program?
85 beats/min
A nurse is assisting a client in determining the client's target heart rate. The client is 40 years old and just beginning an exercise program. What would be the client's target heart rate?
90 beats per minute
What will the nurse calculate as the appropriate target heart rate for a 60-year-old client when using 60% of the maximum heart rate as the factor?
96 beats per minute
The nurse is providing care for a client who is recovering in the hospital from a traumatic brain injury. How can the nurse best prevent the development of disuse syndrome and ankylosis?
Assist the client with passive range of motion of joints that the client is unable to move.
The nurse is assisting a client with performing daily range-of-motion exercises. To flex, extend, and hyperextend the hip joint, the nurse will instruct the client to perform which movement while standing?
Bring the straightened leg forward and backward from the body
The nurse is providing education to the family members of a client who has suffered right-sided weakness after having a cerebrovascular accident (CVA). The client has moderate cognitive impairment. To prevent falls, the nurse will instruct the family members to perform which range-of-motion exercise with the client?
Catch and throw a ball while seated.
The nurse is caring for a client after a cerebrovascular accident (CVA) who has complete movement of the left side and limited movement on the right side. Range-of-motion (ROM) exercises have been prescribed for the client. What movement or action by the client would alert the nurse that more instruction is required for performing ROM exercise?
Client allowing the nurse to perform all ROM exercises passively.
Which recommendation would the nurse include in the treatment plan for a client who has reported sleeping difficulties after being discharged from the hospital?
Engage in moderate aerobic exercise such as walking in the evening.
A client who has been wearing a pedometer reports 6,000 average daily steps. How will the nurse document this client's activity level?
Low active
A nurse is caring for an inactive client and assisting the client in performing range-of-motion (ROM) exercises. What care should the nurse take when performing range-of-motion exercises?
Move each joint until there is resistance but no pain
The nurse is performing range-of-motion exercises with a client who is immobile. Which action will the nurse take when performing these exercises?
Remove pillows and other positioning devices surrounding the client.
A client, currently being treated for cardiovascular disease, attends a nurse-led community-based exercise program. What would the nurse recommend to this client?
See the health care provider and have a checkup first."
A client reports taking 8,000 steps daily to the nurse. How will the nurse document this level of client activity?
Somewhat active
The nurse is caring for a client who is being discharged after having surgery for a total knee arthroplasty. The client will require a continuous passive motion (CPM) exercise machine at home. What will the nurse include in the discharge teaching about the home use of a CPM machine for this client?
The client should take prescribed pain medication before commencing use of the CPM machine.
A client has chronic obstructive pulmonary disease (COPD) and is unable to perform basic self-care activities or activities of daily living (ADLs). What would be an appropriate nursing diagnosis?
activity intolerance
When explaining the benefits of isotonic exercises to promote cardiorespiratory conditioning and increase lean muscle mass, which exercise should the nurse tell the client to perform?
aerobic exercise
The nurse is preparing an exercise plan for a client who has been getting more sedentary over the past few years due to health issues. Which action should the nurse prioritize after reviewing the results of the Holter monitor and diary notes?
delay exercise plan until further assessments completed
A client has been prescribed exercise at the metabolic energy equivalent (MET) of 1. Which exercise type will the nurse recommend?
dressing self
A nurse is performing range-of-motion exercises on a client's ankle and foot. Which movements would the nurse include? Select all that apply.
eversion, dorsiflexion, extension
A nurse is evaluating a client's body composition. The nurse would gather information about what as a determining factor? Select all that apply.
height skin-fold thickness mid-arm muscle circumference body-mass index
As a part of his workout regimen, a 21-year-old college football player often engages in both a 10-minute squat hold and 10-minute lateral arm hold. These are examples of what type of exercise?
isometric
A middle-aged man walks 2 miles each day. What type of exercise is he getting with this activity?
isotonic
During a physical examination, the nurse inquires about the client's level of physical activity. The client reports that he is a marathon runner. The nurse identifies running as which type of exercise?
isotonic exercise
The nurse is teaching a client about moving joints into positions of hyperextension and flexion. Which client action reflects that teaching has been effective?
tilts the chin down to touch the chest and then stretches the head back comfortably far
The nurse is teaching a client about moving joints into positions of pronation and supination. Which client action reflects that teaching has been effective?
turns the arms downward and then upward
The nurse is teaching a client about moving joints into positions of inversion and eversion. Which client action reflects that teaching has been effective?
turns the sole of the foot toward the midline and then away from the midline
A 77-year-old client has been admitted to the neurological unit after experiencing an ischemic stroke. In addition to difficulty swallowing and some cognitive deficits, the client has motor and sensory deficits to the left side. When planning care, the nurse should prioritize which potential nursing conern related to mobility?
unilateral neglect risk
An older adult client is beginning an exercise program and asks the nurse about the appropriate drink for fluid replacement. What would the nurse advise?
water