Chapter 39: Activity and Exercise

When assessing the activity tolerance of a patient, the nurse would evaluate which of the following? (Select all that apply.) a. Skeletal abnormalities b. Emotional factors c. Age d. Pregnancy status e. Race

A, B, C, D

Bones perform five functions in the body: support, protection, movement, mineral storage, and hematopoiesis. In the discussion of body mechanics, which are the most important? (Select all that apply.) a. Support b. Protection c. Movement d. Mineral storage e. Hematopoiesis

A, C

in developing a nursing care plan for increasing activity tolerance in a patient, the nurse should (Select all that apply.) a. Use generalized therapies because they work for everyone. b. Consult with members of the health care team. c. Avoid goals published by the American College of Sports Medicine. d. Involve the patient and the patient's family in designing an exercise plan. e. Consider the patient's ability to increase activity level.

B, D, E

The patient has been bedridden for several months owing to severe congestive heart disease. In determining a plan of care for this patient that will address his activity level, the nurse formulates which of the following nursing diagnoses? a. Fatigue related to poor physical condition b. Impaired gas exchange related to decreased cardiac output c. Decreased cardiac output related to decreased myocardial contractility d. Activity intolerance related to physical deconditioning

d. Activity intolerance related to physical deconditioning

The nurse is developing an exercise program for elderly patients living in a nursing home. To develop a beneficial health promotion program, the nurse needs to understand that when dealing with the elderly a. Exercise is of very little benefit because the patients are old. b. It is important to disregard their current interests in favor of exercise. c. No physical benefit can be gained without a formal exercise program. d. Adjustments to exercise programs may have to be made to prevent problems.

d. Adjustments to exercise programs may have to be made to prevent problems

The nurse is preparing to position an immobile patient. Before doing so, the nurse must understand that a. Manual lifting is the easier method and should be tried first. b. Following body mechanics principles alone will prevent back injury. c. Body mechanics can be ignored when patient handling equipment is used. d. Body mechanics alone are not sufficient to prevent injuries.

d. Body mechanics alone are not sufficient to prevent injuries

Which of the following exercise activities would most likely provide the opportunity for mind-body awareness? a. Warm-up activity b. Resistance training c. Aerobic exercise d. Cool-down activity

d. Cool-down activity

The patient has been in bed for several days and needs to be ambulated. Before ambulation, the nurse a. Removes the gait belt to allow for unrestricted movement. b. Has the patient get up from bed before he has a chance to get dizzy. c. Has the patient look down to watch his feet to prevent tripping. d. Dangles the patient on the side of the bed.

d. Dangles the patient on the side of the bed

The nurse is working with the patient in developing an exercise plan. The patient tells the nurse that she just will not participate in a formal exercise program. The nurse then suggests that exercise activities can be incorporated into activities of daily living. The patient seems to be agreeable to that concept. Of the following activities, which would be considered a moderate-intensity activity? a. Doing laundry b. Making the bed c. Ironing d. Folding clothes

d. Folding clothes

An active lifestyle is important for maintaining and promoting health. In developing an exercise program, the nurse understands that a. Physical exercise is contraindicated for patients with chronic illnesses. b. Regular physical activity is beneficial only for the body part that is exercised. c. Physical exercise has no effect on psychological well-being. d. Physical activity enhances functioning of all body systems.

d. Physical activity enhances functioning of all body systems

In assisting the patient to exercise, the nurse should a. Expect that pain will occur with exercise of unused muscle groups. b. Set the pace for the exercise class. c. Force muscles or joints to go just beyond resistance. d. Stop the exercise if pain is experienced.

d. Stop the exercise if pain is experienced

The nurse encourages a patient with type 2 diabetes to engage in a regular exercise program primarily to improve the patient's: a. Gastric motility, thereby facilitating glucose digestion b. Respiratory effort, thereby decreasing activity intolerance c. Overall cardiac output, thereby resuming resting heart rate d. Use of glucose and fatty acids, thereby decreasing blood glucose level

d. Use of glucose and fatty acids, thereby decreasing blood glucose level

The patient weighs 450 lbs (204.5 kg) and complains of shortness of breath with any exertion. His health care provider has recommended that he begin an exercise program. He states that he can hardly get out of bed and just cannot do anything around the house. To focus on the cause of the patient's complaints, the nurse devices which of the following nursing diagnoses? a. Activity intolerance related to excessive weight b. Activity intolerance related to bed rest c. Impaired gas exchange related to shortness of breath d. Imbalanced nutrition: less than body requirements

a. Activity intolerance related to excessive weight

The body alignment of the patient in the tripod position includes the following: (Select all that apply) a. An erect head and neck b. Straight vertebrae c. Extended hips and knees d. Axillae resting on crutch pads e. Bent knees and hips

a, b, c

Before transferring a patient from the bed to a stretcher, which assessment data does the nurse need to gather? (Select all that apply.) a. Patient's weight b. Patient's level of cooperation c. Patient's ability to assist d. Presence of medical equipment e. 24-hour calorie intake

a, b, c, d

The nurse is attempting to start an exercise program in a local community as a health promotion project. In explaining the purpose of the project, the nurse explains to community leaders that a. A sedentary lifestyle contributes to the development of health-related problems. b. The recommended frequency of workouts should be twice a day. c. An exercise prescription should incorporate aerobic exercise only. d. The purpose of weight training is to bulk up muscles.

a. A sedentary lifestyle contributes to the development of health-related problems

The nurse is preparing to reposition a patient. Before doing so, the nurse must a. Assess the weight to be lifted and the assistance needed. b. Attempt to manually lift the patient alone before asking for assistance. c. Attempt a manual lift only when lifting most or all of the patient's weight. d. Not use the agency lift team if a mechanical lift is available.

a. Assess the weight to be lifted and the assistance needed.

The patient is being admitted for elective knee surgery. While the nurse is admitting the patient, she will a. Begin to develop a discharge plan. b. Plan to wait until after the surgery to plan for discharge. c. Place a generalized discharge plan in the record for later use. d. Address immediate needs of the patient only and address other needs later.

a. Begin to develop a discharge plan

Isotonic, isometric, and resistive isometric are three categories of exercise. They are classified according to the type of muscle contraction involved. Of the following exercises, which are considered isotonic? a. Bicycling, swimming, walking, jogging, dancing b. Tightening or tensing of muscles without moving body parts c. Push-ups, hip lifting, pushing feet against a footboard on the bed d. Quadriceps set exercises and contraction of the gluteal muscles

a. Bicycling, swimming, walking, jogging, dancing

A patient is experiencing some problems with joint stability. The doctor has prescribed crutches for the patient to use while still being allowed to bear weight on both legs. Which of the following gaits should the patient be taught to use? a. Four-point b. Three-point c. Two-point d. Swing-through

a. Four-point

The nurse recognizes that the older adult's progressive loss of total bone mass and tendency to take smaller steps with feet kept closer together will most likely: a. Increase the patient's risk for falls and injuries b. Result in less stress on the patient's joints c. Decrease the amount of work required for patient movement d. Allow for mobility in spite of the aging effects on the patient's joints

a. Increase the patient's risk for falls and injuries

The nurse is providing care to a patient who is bedridden. To prevent fatigue, the nurse raises the height of the bed. The nurse understands that balance is maintained by raising the bed to a. Prevent a shift in the nurse's base of support. b. Narrow the base of support. c. Allow the nurse to bring his or her feet close together. d. Shift the center of gravity further away from the base of support.

a. Prevent a shift in the nurse's base of support

A structural curvature of the spine associated with vertebral rotation is known as a. Scoliosis. b. Osteogenesis. c. Osteomalacia. d. Arthritis.

a. Scoliosis

Which of the following statements made by an older adult reflects the best understanding of the need to exercise regardless of age? a. "You are never too old to begin an exercise program." b. "My granddaughter and I walk together around the high school track 3 times a week." c. "I purchased a subscription to a runner's magazine for my grandson for Christmas." d. "When I was a child, I exercised more than I see kids doing today."

b. "My granddaughter and I walk together around the high school track 3 times a week."

Which is the correct gait when a patient is ascending stairs on crutches? a. A modified two-point gait. (The affected leg is advanced between the crutches to the stairs.) b. A modified three-point gait. (The unaffected leg is advanced between the crutches to the stairs.) c. A swing-through gait. d. A modified four-point gait. (Both legs advance between the crutches to the stairs.)

b. A modified three-point gait. (The unaffected leg is advanced between the crutches to the stairs.)

The nurse is ambulating a patient in the hall when she notices that he is beginning to fall. The nurse should a. Grab the patient and hold him tight to prevent the fall. b. Gently lower the patient to the floor. c. Jump back and let the patient fall naturally. d. Push the patient against the wall and guide him to the floor.

b. Gently lower the patient to the floor

Which of the following is a principle of proper body mechanics when lifting or carrying object? (Select all that apply) a. Keep the knees in a lock position b. Bend at the waist to maintain a center of gravity c. Maintain a wide base of support d. Hold objects away from the body for improved leverage e. Encourage patient to help as much as possible

c, e

A nursing assistive personnel asks for help to transfer a patient who is 125 lbs (56.8 kg) from the bed to a wheelchair. The patient is unable to help. What is the nurse's best response? a. "As long as we use proper body mechanics, no one will get hurt." b. "The patient only weighs 125 lbs. You don't need my assistance." c. "Call the lift team for additional assistance." d. "The two of us can lift the patient easily."

c. "Call the lift team for additional assistance."

Approximately what percentage of all back pain is associated with manual lifting tasks? a. 10% b. 25% c. 50% d. 75%

c. 50%

The nurse is developing a plan of care for a patient diagnosed with activity intolerance. Of the following strategies, which has the best chance of maintaining patient compliance? a. Performing 20 minutes of aerobic exercise daily with 10 minute warm-up and cool-down periods b. Instructing the patient to use an exercise log to record day, time, duration, and responses to exercise activity c. Instructing the patient on the evils of not exercising, and getting her to take responsibility for her current health status d. Arranging for the patient to join a gym that she will have to pay, for so that she does not need to depend on insurance

b. Instructing the patient to use an exercise log to record day, time, duration, and responses to exercise activity

The nurse is examining a patient who is admitted to the emergency department with severe elbow pain. Of the following situations, which would cause the nurse to suspect a ligament tear or joint fracture? a. Range of motion of the elbow is limited. b. Joint motion is greater than normal. c. The patient has arthritis. d. The elbow cannot be moved (frozen).

b. Joint motion is greater than normal

The patient is admitted with a stroke. The outcome of this disorder is uncertain, but the patient is unable to move his right arm and leg. The nurse understands that a. Active range of motion is the only thing that will prevent contractures from forming. b. Passive range of motion must be instituted to help prevent contracture formation. c. Range-of-motion exercises should be started 2 days after the patient is stable. d. Range-of-motion exercises should be done on major joints only.

b. Passive range of motion must be instituted to help prevent contracture formation

The nurse is developing an exercise plan for someone diagnosed with congestive heart failure and exercise intolerance. In doing so, the nurse should a. Plan for 20 minutes of continuous aerobic activity and increase as tolerated. b. Perform 6-minute walks at the patient's pace at least 2 times a day. c. Instruct the patient that he should not take his beta blocker medication on exercise days. d. Encourage a high-calorie diet to plan for extra calorie expenditure.

b. Perform 6-minute walks at the patient's pace at least 2 times a day

The patient is eager to begin his exercise program with a 2-mile jog. The nurse instructs the patient to warm up with stretching exercises. The patient states that he is ready and does not want to waste time with a "warm-up." The nurse explains that the warm-up a. Allows the body to readjust gradually to baseline functioning. b. Prepares the body and decreases the potential for injury. c. Should not involve stretching exercises because they can lead to injury. d. Should be performed with high intensity to prepare for the coming challenge.

b. Prepares the body and decreases the potential for injury

Which of the following most motivates a patient to participate in an exercise program? a. Providing a patient with a pamphlet on exercise b. Providing information to the patient when he or she is ready to change behavior c. Explaining the importance of exercise at the time of diagnosis of a chronic disease d. Providing the patient with a booklet with examples of exercises

b. Providing information to the patient when he or she is ready to change behavior

In planning a physical activity program for a patient, the nurse must understand that a. Isotonic exercises cause contraction without changing muscle length. b. The best program includes a combination of exercises. c. Isometric contraction involves the movement of body parts. d. Resistive isometric exercises can lead to bone wasting.

b. The best program includes a combination of exercises

The patient is brought to the emergency department with possible injury to his shoulder. To help determine the degree of injury, the nurse should evaluate a. The patient's gait. b. The patient's range of motion. c. Fine motor coordination. d. Activity tolerance.

b. The patient's range of motion

A patient with a right knee replacement is prescribed no weight bearing on the right leg. You reinforce crutch walking knowing that which of the following crutch gaits is most appropriate for this patient? a. Two-point gait b. Three-point gait c. Four-point gait d. Swing-through gait

b. Three-point gait

Many patients find it difficult to incorporate an exercise program into their daily lives because of time constraints. For these patients, it is beneficial to reinforce that many ADLs are used to accumulate the recommended 30 minutes or more per day of moderate-intensity physical activity. When instructing these patients, the nurse explains that a. Housework is not considered an aerobic exercise. b. To strengthen back muscles, the patient should bend using back muscles. c. Daily chores should begin with gentle stretches. d. The patient should stick to one chore until it is done before beginning a new one.

c. Daily chores should begin with gentle stretches

Unlike arthritis, joint degeneration a. Occurs only from noninflammatory disease. b. Occurs only from inflammatory disease. c. Involves overgrowth of bone at the articular ends. d. Affects mostly non-weight-bearing joints

c. Involves overgrowth of bone at the articular ends

Which of the following indicates that additional assistance is needed to transfer the patient from the bed to the stretcher? a. The patient is 5 feet 6 inches and weighs 120 lbs b. The patient speaks and understands English c. The patient is returning to unit from recovery room after a procedure requiring conscious sedation. d. The patient received analgesia for pain 30 minutes ago

c. The patient is returning to unit from recovery room after a procedure requiring conscious sedation

A nurse is instructing a patient who has decreased leg strength on the left side how to use a cane. Which action indicates proper cane use by the patient? a. The patient keeps the cane on the left side of the body b. The patient slightly leans to one side while walking c. The patient keeps two points of support on the floor at all times d. After the patient places the cane forward, he or she then moves the right leg forward to the cane

c. The patient keeps two points of support on the floor at all times

The coordinated efforts of the musculoskeletal and nervous system maintain balance, posture, and body alignment. Body alignment refers to a. A low center of gravity balanced over a wide base of support. b. The result of weight, center of gravity, and balance. c. The relationship of one body part to another. d. The force that occurs in a direction to oppose movement.

c. The relationship of one body part to another

A nurse plans to provide education to the parents of school-age children, which includes the increased prevalence of __________ as a result of children being less physically active outside of school.

childhood obesity