Ch. 36 Activity and exercise

16. The nurse is caring for a client diagnosed with bilateral middle ear infections. Which of the following statements made by the nurse best reflects an understanding of the effects of this condition on the client's ability to move appropriately? 1. "He hasn't reported any nausea or vomiting." 2. "His ability to hear doesn't seem to be affected." 3. "I'll identify the client as a high falls' risk by noting it on his Kardex." 4. "I believe he is capable of using his call bell when he needs assistance."

"I'll identify the client as a high falls' risk by noting it on his Kardex."

17. An obese quadriplegic client has requested being transferred to a chair so he can be fed lunch sitting upright. Which of the following statements made by the ancillary personnel assigned the task reflects the best understanding of the implementation of this transfer? 1. "I'll reserve the mechanical lift for right before lunch." 2. "I'll certainly need someone to help me with this transfer." 3. "Eating in an upright position will certainly make lunch more enjoyable for him." 4. "Maybe he would enjoy being transferred into the dayroom to eat with the others."

"I'll reserve the mechanical lift for right before lunch."

20. Which of the following statements made by a woman recently diagnosed with osteoporosis indicates the greatest degree of readiness to begin a daily walking routine? 1. "The tests showed that I have osteoporosis and need to walk." 2. "I've walked around the local park three times, and that measures 1.75 miles." 3. "My sister has this problem, and she walks one mile a day around her neighborhood." 4. "I can join the spa and use the treadmill when the weather gets too cold to walk outside."

"I've walked around the local park three times, and that measures 1.75 miles."

14. A postmenopausal client is experiencing mild osteopenia and has been encouraged to walk 1 mile daily. Which of the following statements made by the client shows the best understanding of the positive effects of exercise on her condition? 1. "It makes me stronger and healthier." 2. "It helps make all my bones stronger." 3. "Walking increases the muscle mass in my legs." 4. "Regular walking improves my stamina and endurance."

"It helps make all my bones stronger."

21. Which of the following statements made by an older adult reflects the best understanding of the need to exercise no matter one's age? 1. "You are never too old to start exercising." 2. "My grandson and I walk together around the park 3 times a week." 3. "I got my granddaughter a subscription to a runner's magazine for her birthday." 4. "Kids today just don't seem to get the exercise we did when I was growing up."

"My grandson and I walk together around the park 3 times a week."

27. The nurse has delegated the task of ambulating a client who is experiencing activity intolerance. Which of the following statements made by the nurse best reflects an understanding of the nurse's role to properly instruct the ancillary personnel regarding this task? 1. "Stop the walking if the client complains of pain or weakness." 2. "Please be sure she has proper footwear on before starting out." 3. "Be sure to document the time spent and the distance she walked." 4. "Take her blood pressure and pulse both before and after walking."

"Stop the walking if the client complains of pain or weakness."

30. The nurse is discussing the benefits of regular walking with a group of senior citizens. Which of the following statements shows the best understanding of the positive impact of exercise on the older adult? 1. "Remember to warm up and cool down with stretching exercises." 2. "Find a walking partner that will accompany you on a regular basis." 3. "Be sure to hydrate yourself well before, during, and after your walk." 4. "Talk with your health care provider before starting a regular walking program."

"Talk with your health care provider before starting a regular walking program."

22. Which of the following nursing assessment questions will best determine the nature of an exercise-related injury? 1. "Do you experience the pain during or after your workout?" 2. "Tell me what is included in your typical workout routine." 3. "How long does it hurt after you have stopped exercising?" 4. "On a scale of 1 to 10, please rate your postexercise pain for me."

"Tell me what is included in your typical workout routine."

1. When discussing the benefits of physical activity and exercise with a client, the nurse identifies which of the following as a positive outcome to the client? (Select all that apply.) 1. Stress management 2. Enhanced cardiac output 3. Improved bone integrity 4. Facilitation of weight control 5. Increased cognitive function 6. Increased musculoskeletal flexibility

1. Stress management 2. Enhanced cardiac output 3. Improved bone integrity 4. Facilitation of weight control 6. Increased musculoskeletal flexibility

32. A client who will be going home will need to use crutches for ambulation. Following teaching, the nurse notes that the client complains of pain under his arms. How much room should be between the crutch pad and client's axilla? 1. Axilla should lightly touch the crutch pad 2. 1 to 2 finger widths from the axilla 3. 3 to 4 finger widths from the axilla 4. 4 to 5 finger widths from the axilla

3 to 4 finger widths from the axilla

18. During a musculoskeletal assessment of a 20-month-old toddler, the nurse expects to observe: 1. A swayback and outwardly turned feet 2. A spine that is flexed and lacking anteroposterior curves 3. Widened hips and fat deposits on the thighs and buttocks 4. A stance with moderately spaced foot placement and a slightly rounded abdomen

A swayback and outwardly turned feet

33. When planning care for a client with newly diagnosed hypertension, the nurse knows that which form of exercise would be most beneficial in lowering both systolic and diastolic blood pressure? 1. Lifting weights 2. Running 3. Bicycling 4. Competitive swimming

Bicycling

34. In teaching a newly diagnosed 17-year-old client with type 1 diabetes, the nurse knows that the exercise is an important component in care. Which of the following activities would be most appropriate for the previously sedentary client? 1. Kick-boxing class 2. Football 3. Bicycling 4. Soccer

Bicycling

36. A client with coronary heart disease has been meeting with a cardiac rehabilitation nurse for the past 5 weeks. The nurse has provided the client with interventions to increase the client's activity level. The client states that they don't know if the exercise program is helping. The nurse can assess the effectiveness of the interventions by: 1. Comparing baseline vital signs with current vital signs 2. Weighing the client 3. Asking the client if he feels that he has met his goals 4. Telling the client that the exercise will only help if the client has a positive attitude

Comparing baseline vital signs with current vital signs

13. Which of the following nursing interventions is likely to have the most impact on reducing friction when positioning an immobile client? 1. Involving at least two personnel in the actual transfer 2. Lubricating all body parts that are in contact with the bed 3. Dressing the bed with a lift sheet to be use during the transfer 4. Thoroughly explaining the process to the client before the move

Dressing the bed with a lift sheet to be use during the transfer

25. The nurse has determined that a client reporting general fatigue is experiencing activity intolerance. Which of the following assessment findings, observed after the client ambulates to the bathroom, best confirms this nursing diagnosis? 1. Dyspnea 2. Diaphoresis 3. Hypotension 4. Mental confusion

Dyspnea

15. A client who is confined to a wheelchair is encouraged to engage in resistive isometric exercises to increase muscle strength and decrease the development of pressure ulcers. Which of the following is the most appropriate example of such an exercise for this client? 1. Hip lifting 2. Gluteal contraction 3. Foot pressure off-loading 4. Bicep-tricep compression

Hip lifting

19. The nurse recognizes that the older adult's tendency to take smaller steps with feet kept closer together will most likely: 1. Increase the client's risk of injury resulting from falls 2. Result in less stress on the client's knees, hips, and ankles 3. Decrease the amount of energy the client expends on movement 4. Allow for mobility in spite of the effects of aging on the client's joints

Increase the client's risk of injury resulting from falls

31. A client who is immobilized in bed due to skeletal traction tells the nurse that they miss their exercise regimen that they had started prior to the accident that resulted in their hospitalization. The nurse knows that which of the following is a good form of exercise that this client can still perform while immobilized? 1. Isotonic exercise 2. Isometric contraction 3. Resistive isometric exercise 4. Aerobic exercise

Isometric contraction

7. While ambulating in the hallway of a hospital, the client complains of extreme dizziness. The nurse, alert to a syncopal episode, should first: 1. Support the client and walk quickly back to the room 2. Lean the client against the wall until the episode passes 3. Lower the client gently to the floor 4. Go for help

Lower the client gently to the floor

10. The nurse is presenting a teaching session on exercise for a group of corporate executives. An appropriate recommendation is that 1. Continuous activity is required in order for the exercise to be worthwhile 2. 3000 to 4000 calories may be easily expended each week 3. Lower-intensity activities need to be done more often for value 4. Only formal exercise activities are counted in a regular plan

Lower-intensity activities need to be done more often for value

39. The nurse is working with a nursing assistive personnel to provide care for a group of clients. The nurse can delegate which of the following activities to the nursing assistive personnel? 1. Assess for medical limitations before beginning the exercise activity. 2. Teach the clients breathing skills to help reduce their anxiety. 3. Obtain preexercise and postexercise vital signs. 4. Document the client's progress.

Obtain preexercise and postexercise vital signs.

1. A client has been prescribed bed rest for a prolonged time. To specifically promote the use of resistive isometric exercise for the client, the nurse will initiate: 1. Quadriceps setting 2. Gluteal muscle contraction 3. Moving the arms and legs in circles 4. Pushing against a footboard

Pushing against a footboard

2. The nurse is assessing the body alignment of an alert and mobile client. The first action that the nurse should take is to: 1. Observe gait 2. Put the client at ease 3. Determine activity tolerance 4. Determine range of joint motion

Put the client at ease

6. The client needs to use crutches at home, and will have to manage going up and down a short flight of stairs. The nurse evaluates the use of an appropriate technique if the client: 1. Uses a banister or wall for support when descending 2. Uses one crutch for support while going up and down 3. Advances the crutches first to ascend the stairs 4. Advances the affected leg after moving the crutches to descend the stairs

Advances the affected leg after moving the crutches to descend the stairs

40. A client with cancer expresses interest in increasing his activity level. The nurse begins by assessing baseline data regarding the client's current activity patterns. The nurse uses professional standards to develop a plan of care for this client. Professional standards are important because they: 1. Are developed by government agencies 2. Establish scientifically proven guidelines 3. Shift responsibility for the plan of care from the nurse 4. Are required by all healthcare organizations

Establish scientifically proven guidelines

11. Following an assessment of the client, the nurse identifies the nursing diagnosis activity intolerance related to increased weight gain and inactivity. An outcome identified by the nurse should be: 1. Resting heart rate will be 90 to 100 beats/minute 2. Blood pressure will be maintained between 140/80 and 160/90 mm Hg 3. Exercise will be performed 3 to 4 times over the next 2 weeks 4. Achievement of a rating of 3 for activity endurance

Exercise will be performed 3 to 4 times over the next 2 weeks

8. A client is admitted to the medical unit following a CVA (stroke). There is evidence of left-sided hemiparesis and the nurse will be following up on range-of-motion and other exercises performed in physical therapy. The nurse correctly teaches the client and family members which one of the following principles of range-of-motion exercises? 1. Flex the joint to the point of discomfort. 2. Work from proximal to distal joints. 3. Move the joints quickly. 4. Provide support for distal joints.

Flex the joint to the point of discomfort.

9. Nurses need to implement appropriate body mechanics in order to prevent injury to themselves and their clients. Which principle of body mechanics should the nurse incorporate into client care? 1. Flex the knees and keep the feet wide apart. 2. Assume a position far enough away from the client. 3. Twist the body in the direction of movement. 4. Use the strong back muscles for lifting or moving.

Flex the knees and keep the feet wide apart.

26. A client with a nursing diagnosis of activity intolerance has developed reddened areas on both heels and his coccyx. Which of the following nursing interventions will most likely have the greatest impact on this diagnosis? 1. Ambulating him to the bathroom before returning to bed 2. Encouraging him to change position every 2 hours while in bed 3. Including active range-of-motion exercises in both AM and PM care 4. Planning a rest period after AM care but before walking to the dining room for lunch

Planning a rest period after AM care but before walking to the dining room for lunch

38. One of the most debilitating health hazards among nurses is musculoskeletal injuries. In order to eliminate these injuries, the American Nurses Association is advocating which of the following? 1. Mandate that physical therapists do all patient transfers. 2. Require minimum staffing levels in health care organizations. 3. Request the use of assistive equipment and devices. 4. Require a minimum number of staff to be involved in all patient transfers.

Request the use of assistive equipment and devices.

12. The primary purpose for placing an immobile client's arms across his or her chest when preparing to transfer the client up in the bed is to: 1. Increase the stability of the client's body 2. Protect the client's arms from being hurt during the transfer 3. Produce a more compact form that facilitates the transfer 4. Reduce the amount of body surface area that is in contact with the bed.

Reduce the amount of body surface area that is in contact with the bed.

3. An average-size male client has right-sided hemiparesis. The nurse helps this client to walk by: 1. Standing at his left side and holding his arm 2. Standing at his left side and holding one arm around his waist 3. Standing at his right side and holding his arm 4. Standing at his right side and holding one arm around his waist

Standing at his right side and holding one arm around his waist

28. A client is discussing an exercise program that includes running 1.5 miles 3 times a week. Which of the following suggestions made by the nurse is most likely to result in minimizing the client's risk for injury? 1. Stretching before and after running 2. Alternating running paths every week 3. Hydrating well with sports drinks during and after running 4. Wearing running shoes that have been professionally fitted

Stretching before and after running

35. A newly diagnosed client with type 2 diabetes expresses concern that he will not be able to maintain his active lifestyle, which includes bicycling. The nurse instructs the client about risks and precautions regarding exercise including which of the following? 1. To avoid leisurely bicycling day trips 2. To avoid strenuous bicycling for long periods of time 3. It is better for them to exercise for 1 to 2 hours once a week than for 20 minutes 3 days per week 4. As long as he is not participating in strenuous exercise, there is no need to include warm-up or cool-down exercises

To avoid strenuous bicycling for long periods of time

41. When moving a client who is unable to assist, what is the most important principle for the nurse to remember to avoid injury? 1. Face opposite of the direction of movement. 2. Keep your feet close together. 3. The higher the center of gravity, the greater the stability of the nurse. 4. Try to avoid lifting the patient if possible.

Try to avoid lifting the patient if possible.

4. The nurse is working with a client who has left-sided weakness. After instruction, the nurse observes the client ambulate in order to evaluate the use of the cane. Which action indicates that the client knows how to use the cane properly? 1. The client keeps the cane on the left side. 2. Two points of support are kept on the floor at all times. 3. There is a slight lean to the right when the client is walking. 4. After advancing the cane, the client moves the right leg forward.

Two points of support are kept on the floor at all times.

5. A client with a fractured left femur has been using crutches for the past 4 weeks. The physician tells the client to begin putting a little weight on the left foot when walking. Which of the following gaits should the client be taught to use? 1. Two-point 2. Three-point 3. Four-point 4. Swing-through

Two-point

37. Passive range-of-motion exercises are most important for which of the following clients? 1. Pediatric client with a broken femur 2. Diabetic client with a total knee replacement 3. Unconscious client in ICU 4. Elderly client with a bowel obstruction

Unconscious client in ICU

29. The first rule of safety when managing client transfers is: 1. Flex your knees and plant your feet far apart 2. Keep your back aligned with your neck, pelvis, and feet 3. Use lift teams or mechanical lifts when the transfer requires it 4. Always use the large muscles of the arms and legs, not the small muscles of the back

Use lift teams or mechanical lifts when the transfer requires it

23. The nurse encourages a non-insulin-dependent diabetic client to engage in a regular exercise program primarily because to do so will most likely improve the client's: 1. Gastric motility, thus affecting glucose digestion 2. Respiratory recovery time, thus decreasing breath load 3. Average cardiac output, thus decreasing resting heart rate 4. Use of glucose and fatty acids, thus decreasing blood glucose level

Use of glucose and fatty acids, thus decreasing blood glucose level