Practice questions for Mobility

Fascia

Connective tissue that surrounds muscles and bones can withstand limited stretching provides strength to the muscle tissue

Ligament

Connects bone to bone provides stability while allowing movement at the joint

Does loss of sensation suggest neurological dysfunction or is it an indication of a fat embolism?

It is a neurological dysfunction and is not an indication of a fat embolism

Is a positive Homans sign an indication of fat embolism?

No, it is a signs of thrombophlebitis

conversion disorder

a disorder in which a person experiences very specific genuine physical symptoms for which no physiological basis can be found

After a client with multiple fx of the left femur is admitted to the hospital for surgery, the client experiences a sudden onset of cyanosis, tachycardia, dyspnea, restlessness, and petechiae on the chest. Which is the priority nursing action? a. obtain vital signs b. administer O2 c. notify HCP d. auscultate the client's lung sounds

b. administer O2 (you should initiate help prior to notifying the HCP)

Which medications are useful to relieve pain associated with muscle spasms? select all that apply Cefazolin Carisoprodol Fondaparinux Methocarbamol Cyclobenzaprine

carisoprodol methocarbamol cyclobenzaprine (fondaparinux - heparin)

Is chest pain a common complaint of a patient with a fat embolism?

no and a fever may occur later but not in the beginning

bursae

small sacs of connective tissue lined w/synovial membrane and fluid located at bony prominences and joints to relieve pressure

A home care nurse is visiting a client who had a below the knee amputation. Which client statement indicates to the nurse that further teaching is needed? a. At night, I sleep with a pillow under my knees b. When I sit in a chair, I put my legs out straight on an ottoman c. I apply a firm even bandage around the end of my affected leg every day d. I press the end of my affected leg against a soft surface several times during the day

a. at night I sleep with a pillow under my knees

When would the nurse begin rehabilitation planning for the client who is scheduled for a below the knee amputation? a. before the surgery takes place b. during the convalescent phase c. on d/c from the hospital d. when it is time for a prosthesis

a. before the surgery takes place

A client who has severe back pain is found to have a vertebral compression fx. Which cause of fx would the nurse consider when planning interventions? a. collapse of the vertebral bodies b. demineralization of the spinal cord c. wear and tear o the spinous processess d. bulging of the spinal cord from the vertebra

a. collapse of the vertebral bodies (under the weight of the upper body or by improper or rapid turning, reaching, or lifting)

A school-aged child with a fx of the femur near the epiphyseal plate is admitted to the hospital. Which physiological characteristic of the femur would the nurse consider when teaching the family about the injury? a. growth of that leg may be affected b. risk for infection at this location is increased c. fracture repair will necessitate prolonged traction d. long bones contain marrow, which increases the risk for anemia

a. growth of that leg may be affected (epiphyseal is the growth plate)

Which postoperative nursing intervention is specifically related to spinal fusion performed in an adolescent with scoliosis? a. log-rolling every 2 hrs b. checking the dressing frequently c. supervising deep-breathing exercises d. maintaining the adolescent in the supine position for 3 days

a. log-rolling every 2hrs (necessary to prevent movement of the newly aligned and instrumented vertebrae and should be done frequently to prevent skin breakdown)

Which complication would the nurse monitor for in a client on strict bed rest for 3 days? select all that apply a. atelectasis b. hypotension c. constipation d. pressure injuries e. UTI

all of them (clients on bed rest are at risk for all of them because they are secondary to immobility)

Which reaction toward the physical symptom would the nurse observe in a client with conversion disorder? a. anger b. apathy c. anxiety d. agitation

b. apathy (in conversion disorder there is no agitation but rather an overly calmness/indifference about the physical symptom)

Which statement by the parent of a 6wk old infant would lead the nurse to assess the infant for the presence of a skeletal abnormality? a. they seem to want to sleep curled up b. it's hard to put the diaper between their legs c. their feet look flat when I put booties on them d. when I try to stand them up, their legs won't straighten

b. its hard to put the diaper between their legs (hip dysplasia)

Three days after a cast is applied to a clients fractured tibia, the client reports burning pain over the ankle that is not relieved by a change of position. The cast over the ankle feels warm to the touch. Which action would the nurse take? a. request a prescription for an abx b. report data to the pcp c. administer the rx pain meds d. reassure the client this is expected after a cast is applied

b. report the data to the primary health care provider (indicates tissue hypoxia or breakdown and should be reported immedidatly)

Which characteristic of a comminuted fx would the nurse consider when planning care for a client with an fx arm? a. bone protrudes through a break in the skin b. bone has broken into fragments, and the skin is intact c. bone is broken into two parts, and the skin may or may not be broken d. splintering has occurred on one side of the bone and bending on the other

b. the bone has broken into fragments, and the skin is intact

comminuted fracture

bone breaks into many fragments

Fat Embolism Syndrome (FES)

bone marrow fat globules are released and enter tissues and organs after a traumatic skeletal injury most likely to occur from fractures that are long bones or long and flat (long bones, ribs, tibia, pelvis) tissues most often affected are the lungs, brain, heart, kidneys, and skin -compromised O2 to the lungs causes SOB, pulmonary edema, and hemorrhage...surfactant production decreases resulting in alveolar collapse, hypoxia, and cerebral manifestations -change in consciousness in the brain bc fat travels to brain -look like heart attack with the heart petechia in 2-3 days in the skin (sclera, posterior pharynx, chest, and axilla) from fat blocking the O2 clinical manifestations: -interstitial pneumonitis -produce symptoms of ARDS (acute respiratory distress syndrome)...chest pain, tachypnea, cyanosis, decreased O2, apprehension, tachycardia -patient may become comatose in a short time

Which action would the nurse take for a client with a dx of conversion disorder manifesting as paralysis of the legs? a. encourage the client to try to walk b. explain to the client that there is nothing wrong c. avoid focusing on the client's physical symptoms d. help the client follow through with the physical therapy plan

c. avoid focusing on the client's physical symptoms (this is a psychological problem)

The HCP Rx raloxifene for a client with osteoporosis. Which manifestation would the nurse monitor in this client? a. check serum creatinine b. monitor urinary calcium c. monitor liver function tests d. observe for anxiety and drowsiness

c. monitor liver function tests (increased risk for hepatic disease)

Which distinguishing sign unique to a fat embolus will a nurse monitor for in a client with a distal femoral shaft fx who is at risk for developing a fat embolus? a. oliguria b. dyspnea c. petechiae d. confusion

c. petechiae

A client with a leg fracture is hospitalized. The RN instructs the nursing student to ask the client to determine the reason for the injury. Which question would help determine an extrinsic factor? a. do you have clear vision b. are you taking any sedatives or hypnotics c. what shoes were you wearing when you fell d. do you have a history of postural hypotension?

c. what shoes were you wearing when you fell

when the bone is broken into two parts and the skin may or may not be broken it is called a:

complete fracture

when the bone protrudes through a break in the skin it is called a:

compound fracture

After a below-the-knee amputation, a client is refusing to eat, talk, or perform any rehabilitative activities. Which approach would the nurse take when interacting with the client? a. explain why there is a need to increase activity b. emphasize that w/a prosthesis, there will be a return to previous lifestyle c. appear cheerful and noncritical regardless of the client's response to attempts at interventions d. acknowledge that the client's withdrawal is an expected and necessary part of initial grieving

d. acknowledge that the client's withdrawal is an expected and necessary part of initial grieving

The nurse is assisting a health care provider to perform a sigmoidoscopy. Which position would the nurse place the client for this procedure? a. left lateral recumbent b. prone c. lithotomy d. knee-chest

d. knee-chest (maximally exposes the rectal area and facilitates entry of the sigmoidoscope

A nurse is caring for a client with a below the knee amputation. Which action would the nurse teach the client to perform in order to prepare the residual limb for a prosthesis? a. abduct the residual limb when ambulating b. dangel the residual limb off the bed frequently c. soak the residual limb in warm water twice a day d. press the end of the residual limb against a pillow periodically

d. press the end of the residual limb against a pillow periodically (toughen the limb for weight bearing)

Which clinical manifestation would the nurse expect to find in a client who has had damage to major blood vessels caused by a fractured tibia? a. increased blood pressure b. extensive thigh edema c. increased skin temperature of the foot d. prolonged capillary refill of the toes

d. prolonged capillary refill of the toes (damage to blood vessels may decrease circulatory perfusion of the toes)

Which assessment finding after an open reduction and internal fixation (ORIF) of a fractured hip would cause the nurse to suspect and monitor for s/s of a fat embolism? a. fever and chest pain b. positive Homans sign c. loss of sensation in the operative leg d. tachycardia and petechiae over the chest

d. tachycardia and petechiae over the chest (tachycardia occurs because of impaired gas exchange; petechiae are caused by occlusion of small vessels w/in the skin)

tendon

dense fibrous connective tissue that attaches muscle to bone

extrinsic factors

environmental hazards outside and within the home

A client newly dx with type I diabetes asks why it is necessary to exercise on a regular basis.

exercise improves the cellular uptake of glucose (exercise increases the metabolic rate and glucose is needed for cellular metabolism; therefore excess glucose is consumed during exercise)

Lovett scale

grading muscle strength. zero, trace, poor, fair, good, normal.

When splintering has occurred on one side of the bone and bending on the other it is called:

greenstick fx

Pott disease

inflammation of the vertebrae, usually caused by tuberculosis

what is a positive Homans signs

pain while doing dorsal flexion; sign of clot in leg

When monitoring a client 24 - 48 hrs after abdominal surgery, the nurse would assess for which problem associated with anesthetic agents?

paralytic ileus (as a result of anesthetics, you should increase movement through turning and early ambulation)

A primary health care provider schedules a bone scan for a client with osteoporosis. Which nursing action is beneficial for the client? Select all that apply place client in supine position use a mild sedative verify presence of shellfish allergy instruct client to push fluids after the test ensuring client does not have metal on instruct client to empty bladder before scan inform client headache will resolve in 2 days apply jelly like substance to skin over site

place client in supine use a mild sedative instruct to push fluids after test empty bladder before scan