Ch. 38

A patient is fully dependent, and the nurse is trying to determine if an assistive device should be used. How much of the patient's weight is the nurse required to lift to validate using an assistive device? Record your answer in pounds using a whole number. ____________ pounds

During any patient-transferring task, if the nurse is required to lift more than 35 pounds of a patient's weight, the patient should be considered fully dependent, and assistive devices should be used.

Which event describes an impulse that is transmitted from the nervous system to the musculoskeletal system? 1 Isotonic contraction 2 Voluntary movement 3 Isometric contraction 4 Electrochemical activity

Electrochemical activity

Which structure connects muscle to bone? 1 Tendon 2 Cartilage 3 Ligament 4 Syndesmosis

Tendon Tendons are white, fibrous bands of tissue that connect muscle to bone at the origin or insertion of the muscle. Cartilage acts as a shock absorber between articulating bones, whereas ligaments are the structures that connect bones and cartilage. Syndesmosis is a fibrous joint between the tibia and fibula.

Which structure is white and glistening and defined as fibrous bands of tissue that connect muscle to bone? 1 Joints 2 Tendons 3 Cartilage 4 Ligaments

Tendons A joint is the connection between bones. Cartilage is nonvascular; it supports connective tissue that sustain weight and serve as a shock absorber between articulating bones. Ligaments are white, shiny, flexible bands of fibrous tissue that bind joints and connect bones with cartilage.

A toddler has awkward posture because of a slight swayback and protruding abdomen. The legs and feet are far apart, and the feet are slightly everted. By which age would the child become slimmer, taller, and better balanced? Record your answer using a whole number. ____ years

The posture changes by 3 years of age, and the child's gait becomes more balanced.

Which statement made by the student nurse indicates that he or she has understood the mechanism of balance in the human body? 1 "The cerebellum coordinates all voluntary movements." 2 "Our tympanic membranes help maintain balance." 3 "Highly skilled movements are coordinated by the cerebrum." 4 "The inner ear coordinates all voluntary movements."

"The cerebellum coordinates all voluntary movements."

A patient is discharged from acute care to pulmonary rehabilitation after an exacerbation of chronic obstructive pulmonary disease (COPD). The patient states, "I'm afraid to go to pulmonary rehabilitation." Which statement is the nurse's best response? 1 "Pulmonary rehabilitation provides a safe environment for monitoring your progress." 2 "You have to participate or you will be back in the hospital." 3 "Why are you concerned about pulmonary rehabilitation?" 4 "The staff at our pulmonary rehabilitation agency are professionals and will not cause you any harm."

"Pulmonary rehabilitation provides a safe environment for monitoring your progress."

Which statement made by a nurse is correct? 1 "Permanent cartilage is ossified." 2 "Ligaments connect bones to cartilage." 3 "Cartilage is a vascular supporting connective tissue." 4 "The Achilles tendon is the thinnest tendon in the body."

"Ligaments connect bones to cartilage."

Which developmental factor related to activity and exercise would the nurse explain to the parent of a toddler? Select all that apply. One, some, or all responses may be correct. 1 "Toddlers have slightly everted feet." 2 "They have a flexed thoracic spine." 3 "Toddlers have a sporadic and uneven growth." 4 "They lack anteroposterior curves of the adult." 5 "Toddlers have a slight swayback and a protruded abdomen."

"Toddlers have slightly everted feet." "Toddlers have a slight swayback and a protruded abdomen." Newborns have a flexed thoracic spine. Adolescents have sporadic and uneven growth. Infants lack the anteroposterior curves of the adult.

For which duration would a patient contract the biceps and triceps muscles while performing isometric exercises? Record your answer using a whole number. _________seconds

10 seconds

A patient is admitted with an injury to the knee joint. The nurse notices increased mobility of the joint while assessing the range of motion (ROM). Which factor would be the reason for the increased mobility of the knee joint? 1 Arthritis 2 Ligament tears 3 Contractures 4 Fluid collection

2

Which environmental issue is a hindrance to activity and exercise? 1 Hormonal changes and increased osteoclastic activity with increasing age 2 Work sites reluctant in motivating employees for physical fitness regimens 3 A patient's decisions to change his or her behavior to include a daily exercise routine 4 A patient's knowledge, values, and beliefs about exercise in relation to health

2

The nurse is measuring crutches for a patient and determining the height and placement of the handgrips. Which distance would be between the crutch pad and the patient's axilla? Record your answer using a whole number. _________ inches

2 inches

The nurse is transferring a patient from the hospital bed to a stretcher. The patient responds to reflexes and is physically sound enough to assist in the transfer. Which nursing action would be a part of the transfer activity? Select all that apply. One, some, or all responses may be correct. 1 Fastening a gait belt around the patient's waist. 2 Dividing balanced activity between the arms and legs. 3 Facing the opposite direction of the patient's movement. 4 Telling the patient to keep the body in proper alignment. 5 Standing with feet wide enough apart to improve the base of stability

2,4,5

Damage to any part of the central nervous system that regulates voluntary movements would cause which condition? Select all that apply. One, some, or all responses may be correct. 1 Fractures 2 Impaired body alignment 3 Joint degeneration 4 Articular disruption 5 Impaired mobility

2,5

The nurse measures the distance between the greater trochanter muscle of the patient and the floor and finds it to be 3 feet. Which length in feet would be the patient's cane? 1 2 feet 2 3 feet 3 4 feet 4 5 feet

3 feet it should be equal distance

If a patient with crutches is in a perfect tripod position, which distance in centimeters would be between the crutches? 1 15 cm 2 30 cm 3 45 cm 4 60 cm

30 cm A tripod position is formed when the crutches are placed 15 cm to the side of each foot. Therefore the distance between the crutches is 30 cm.

Which statement is true about the different forms of exercise? 1 Isotonic exercises promote osteoclastic activity. 2 Push-ups and hip lifting are examples of isotonic exercises. 3 A patient who is immobilized can perform isometric exercises. 4 Resistive isometric exercises involve tensing muscles without moving body parts

A patient who is immobilized can perform isometric exercises. A patient who is immobilized in bed can perform isometric exercises. Isotonic exercises promote osteoblastic activity rather than osteoclastic activity. Push-ups and hip lifting are examples of resistive isometric exercises. Isometric exercises involve tensing muscles without moving body parts.

Which nursing intervention would the nurse provide to a patient who has impaired gas exchange related to decreased cardiac output? 1 Teach the patient how to restrict fluid intake. 2 Administer oxygen at 2 L/min via the nasal cannula. 3 Record activity of the patient in an exercise log daily along with the response. 4 Ask the patient to perform a 2- to 3-mile brisk walk and isometric exercises 3 to 4 times a week

Administer oxygen at 2 L/min via the nasal cannula.

The nurse plans to provide education to the parents of school-age children. Which option would the nurse include to emphasize the results of children being less physically active outside of school? 1 An increase in obesity 2 An increase in heart disease 3 Higher computer literacy 4 Improved school attendance and grades

An increase in obesity It is increasingly clear that many children today are less active, resulting in an increase in childhood obesity. Strategies for physic

Where does the center of gravity of a pregnant woman shift? 1 Anterior 2 Posterior 3 Left lateral side 4 Right lateral side

Anterior

Which phrase best explains the term proprioception? 1 Orientation to time, place, and person 2 Awareness of the position of the body and its parts 3 Perception of pressure over the palmar and plantar surfaces 4 Perception of abnormal thermal sensation on the skin

Awareness of the position of the body and its parts

Which measure would a nurse least likely take to prevent self-injuries from lifting patients? 1 Take a position close to the patient. 2 Bend at the knees and keep the feet close together. 3 Encourage the patient to help as much as possible. 4 Slide the patient closer using a pull sheet or slide board

Bend at the knees and keep the feet close together.

Which action occurs during the process of flexion at the elbow joint?

Biceps brachii acts as a synergistic muscle and contracts.

A patient is in a tripod position. Which body part would be in alignment? 1 Bent head 2 Curved vertebrae 3 Weight-bearing axillae 4 Extended hips and kneesExtended hips and knees

Extended hips and knees The body alignment of a patient in the tripod position includes extended hips and knees. The head should be erect, and the vertebrae should be straight. The axillae should not bear any weight because it puts pressure on and damages the axillae.

Identify the type of joint that is circled in the image below.

Fibrous joints

Which measurement length is appropriate in determining the correct size of the cane? 1 Hip joint to the floor 2 Iliac crest to the ground 3 Greater trochanter to the floor 4 Great toe to the lesser trochanter

Greater trochanter to the floor

Which nursing intervention would the nurse provide to a patient who is diagnosed with activity intolerance related to physical deconditioning? 1 Teach the patient how to restrict fluids. 2 Administer oxygen at a rate of 2 L/min via the nasal cannula. 3 Schedule rest periods for the patient between nursing activities. 4 Guide the patient to take a 2- to 3-mile brisk walk and perform isometric exercises 3 to 4 times a week.

Guide the patient to take a 2- to 3-mile brisk walk and perform isometric exercises 3 to 4 times a week.

Which statement is true regarding exercise and activity? 1 There are four categories of exercise. 2 Isotonic exercises cause muscle relaxation. 3 Examples of resistive isometric exercise are walking and swimming. 4 Isometric exercises involve tensing muscles without moving body parts.

Isometric exercises involve tensing muscles without moving body parts.

The nurse is assessing the body alignment and posture of a patient. Which indicator would encompass an optimal standing posture? Select all that apply. One, some, or all responses may be correct. 1 Knees are in a straight line between the hips and ankles. 2 Head is flexed anteriorly and in midline. 3 Feet are flat on the floor and slightly apart. 4 Spine is straight with normal curvatures. 5 Abdominal muscles are relaxed.

Knees are in a straight line between the hips and ankles. Feet are flat on the floor and slightly apart. Spine is straight with normal curvatures. The head should be erect in both standing and sitting positions. The abdominal muscles must not be relaxed but should be well tucked. The abdominals form an important part of the core muscles that support the vertebral column.

The nurse is teaching a group of menopausal women about osteoporosis. Which factor would be a cause of osteoporosis? Select all that apply. One, some, or all responses may be correct. 1 Lack of exercise 2 Brittle bones 3 Decreased estrogen levels 4 Increase in bone mass 5 Increased resorption of bone tissue

Lack of exercise Decreased estrogen levels Increased resorption of bone tissue

Which group of patients is most at risk of severe injuries related to falls? 1 Adolescents 2 Older adults 3 Toddlers 4 Young children

Older adults

A patient on bed rest for several days attempts to walk with assistance. He becomes dizzy and nauseated. His pulse rate jumps from 85 beats per minute to 110 beats per minute. These signs and symptoms would most likely originate from which condition? 1 Rebound hypertension 2 Orthostatic hypotension 3 Dysfunctional proprioception 4 Central nervous system rebound hypotension

Orthostatic hypotension Rebound hypertension is caused by abruptly discontinuing certain drugs such as beta blockers. Dysfunctional proprioception is the patient's lack of awareness of the position of certain body parts. Central nervous system rebound hypotension can be caused by cerebrospinal fluid leakage or certain drugs.

Which physiological factor would influence a patient's activity tolerance? 1 Age 2 Pain 3 Depression 4 Motivation

Pain

Which sign or symptom is present with orthostatic hypotension? Select all that apply. One, some, or all responses may be correct. 1 Pallor 2 Fainting 3 Diarrhea 4 Dizziness 5 Bradycardia

Pallor, fainting, and dizziness are the signs and symptoms of orthostatic hypotension. Diarrhea and bradycardia may indicate other disorders.

Which option best motivates a patient to participate in an exercise program? 1 Giving a patient information on exercise 2 Providing information to the patient when the patient is ready to change behavior 3 Explaining the importance of exercise when a patient is diagnosed with a chronic disease such as diabetes 4 Following up with instructions after the health care provider tells a patient to begin an exercise program

Providing information to the patient when the patient is ready to change behavior

Which nursing intervention would be most appropriate for a patient who has fatigue related to poor physical condition? 1 Teach the patient how to restrict fluids. 2 Reduce the number of nighttime interruptions. 3 Instruct the patient to take his or her medications as prescribed. 4 Schedule rest for the patient after all nursing activities are complete

Reduce the number of nighttime interruptions.

Which factor would render older women more susceptible to fractures? 1 Firmness of the skeleton 2 Elasticity of the skeletal system 3 Flexibility of the skeletal system 4 Resorption and osteoporosis

Resorption and osteoporosis

Which defect would be considered congenital? 1 Arthritis 2 Scoliosis 3 Osteoporosis 4 Osteomalacia

Scoliosis

Which group of muscles contract to accomplish the same movement? 1 Skeletal muscles 2 Synergistic muscles 3 Antigravity muscles 4 Antagonistic muscles

Synergistic muscles

Which structure connects muscle to bone? 1 Tendon 2 Cartilage 3 Ligament 4 Syndesmosis

Tendon

Which gait requires the patient to bear all of the weight on one foot? 1 Four-point 2 Two-point 3 Three-point alternating 4 Three-point and two-point

Three-point alternating There are four standard gaits in crutch walking. The type of gait to be used is determined by the type of injury and the functional abilities. A three-point alternating or three-point gait requires a patient to bear all of the weight on one foot. In a four-point gait, the patient needs to bear the weight on both legs. In the two-point gait, the patient bears the weight partially on both legs. Weight bearing is on one limb in a three-point gait and is on both the limbs (partially) in a two-point gait.