Fundamentals of Nursing CH: 24: Fitness and Therapeutic Exercise

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 the client set an initial daily goal for how many steps?

6000

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

The nurse knows that the following is not an example of a fitness test:

Range-of-motion test

A nurse is supervising a client who is exercising. The client is performing isometric exercises. The nurse teaches the client that isometric exercise preserves:

muscle mass.

What motion is being provided for the shoulder when the nurse raises a client's arm at the side until the upper arm is in line with the shoulder, bends the elbow at a 90-degree angle, moves the forearm upward and downward, and returns the arm to the side?

rotation

A nurse is assessing the fitness level of a 30-year-old client. What is this client's target heart rate? Record your answer using a whole number.

190

A nurse is teaching a client about ROM exercises. How many times should the client exercise each joint during the exercise period?

2 to 5

A male client is about to perform a step test. The nurse is sure to check that the platform is set to the following prescribed height, in inches. Record your answer using a whole number.

20

What action is the nurse performing in the accompanying photo?

flexion

The nurse performs passive range of motion for a client by bending each knee and then straightening it again. How will the nurse document this motion?

flexion and extension

The nurse performs passive range of motion for a client by turning the sole of the foot toward midline, and then away from the midline. How will the nurse document this motion?

flexion and extension

The nurse is teaching a client how to perform range-of-motion exercises on the toes. What motions would be accomplished by curling the toes downward, spreading the toes apart, and then bringing them together?

flexion, extension, abduction, and adduction

When teaching a 49-year-old client about factors that can impair fitness, which factors will the nurse identify? Select all that apply.

high blood pressure age obesity smoking history

A nurse wearing a Fitbit averages taking 14,000 steps daily when working a 12-hour shift, 3 days weekly. During a physical assessment, how will this nurse describe this activity level to the employee health nurse?

highly active

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 client at a community health center is discussing a planned exercise program. The client is being treated for cardiovascular disease. What would the nurse recommend?

"See your doctor and have a checkup first."

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

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

advanced age obesity skeletal function

An older adult client reports, "Walking for exercise is useless for me because I get too tired." What is the appropriate nursing response?

"Alternate period of rest and activity so that you don't get overtired."

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

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

A nurse at a long-term care home has organized a program that is aimed at increasing residents' levels of physical activity. The nurse is aware of precautions that must be taken when promoting exercise among older adults. The nurse should teach participants to:

ensure that they drink water in order to stay hydrated.

A client is demonstrating active range-of-motion exercises to the nurse. The nurse asks the client to bend the sole of the foot toward the midline. The client is demonstrating:

inversion.

The nurse is teaching a 68-year-old client who has had a stroke how to strengthen weakened muscles. Which exercise type will the nurse teach?

isokinetic

The occupational nurse is assessing a worker's vital signs at rest. Which finding requires nursing intervention?

pulse rate 120 beats per minute

A client has been prescribed exercise at the metabolic energy equivalent (MET) of 3. Which exercise type will the nurse recommend?

raking leaves

The community nurse working at a community health fair is assessing a client's vital signs at rest. Which finding requires nursing intervention?

respirations 28 per minute

The nurse is teaching a client about moving joints into positions of hyperextension and flexion. Which client action reflects that teaching has been effective?

turns 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 arms downward, and then upward

The nurse is preparing a client for a stress electrocardiogram. Which teaching will the nurse include?

Heart rate and rhythm will be monitored throughout this test.

The community health nurse is teaching a neighborhood group about a safe exercise program. Which education will the nurse provide? Select all that apply.

Use supportive shoes when walking. Complex carbohydrates give energy. Use reflective clothing when walking after dark. Calculate the target heart rate for each individual.

A nurse is conducting a class for a local community about the benefits of physical exercise. What benefits would the nurse be likely to include in the presentation? Select all that apply.

iImproved cardiopulmonary function increased muscle tone increased bone density reduced blood pressure

The nurse is caring for a client who has undergone a left mastectomy. Which example of active exercise will the nurse teach? Select all that apply.

Provide comb for client to comb hair with left hand. Instruct client to squeeze stress ball with left hand.

The nurse is measuring the amount of body tissue that is lean versus the amount that is fat. How will the nurse document this assessment finding?

body composition

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

A client has been cleared by the health care provider to begin a fitness program. The nurse reviews with the client important aspects about engaging in a safe exercise program. Which statement by the client indicates that the teaching was successful?

"I should try to sustain my target heart rate for about 12 to 15 minutes."

A nurse uses a continuous passive motion (CPM) machine for a client who has undergone knee replacement surgery. What does the continuous passive motion machine do? Select all that apply.

Accelerates wound healing Controls the degree of joint movement Prevents pooling of venous blood

A client with asthma tries to jog a mile but cannot finish and reports fatigue. An appropriate nursing diagnosis would be:

Activity Intolerance related to fatigue

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 diagnoses related to mobility?

Risk for Unilateral Neglect

A nurse is assisting a female client during a Walk-a-Mile test. The client's score is 15 minutes and 20 seconds. How would the nurse document the client's performance?

average

The nurse is teaching a client about moving joints into a position of abduction and adduction. Which client action reflects that teaching has been effective?

moves legs away from the midline, then toward the midline

A nurse is educating an obese, middle-aged client regarding the benefits of exercise. What should the nurse tell the client are the significant benefits of regular physical exercise? Select all that apply.

regularity of bowel elimination increased cardiopulmonary function increased lean mass

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 arms downward, and then upward

An older adult is beginning an exercise program and asks the nurse about the appropriate drink for fluid replacement. What would the nurse advise?

water

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

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.

A client is scheduled for range-of-motion exercises. When the nurse arrives, the client reports that his knee is hurting. Which nursing action is correct?

Avoid doing range-of-motion exercises on the knee.

A nurse is caring for a client who has been recommended an ambulatory electrocardiogram for recording the heart rate and rhythm. What instructions should the nurse provide the client with regarding the use of the Holter monitor? Select all that apply.

Avoid using magnets during the test. Avoid using an electrical blanket while the device is in place. Avoid taking a shower while the device is in place.

The nurse is assisting with passive range-of-motion exericses. The nurse supports the client's head and neck and turns the head in a circular direction. The nurse is performing:

circumduction.

A nurse is assisting a client with ROM exercises that involve turning a client's body part from side to side as in an arc. What type of movement is this?

rotation

A client reports taking 8,000 steps daily to the nurse. How will the nurse document this level of client activity?

somewhat active

The home care nurse is assessing a client's vital signs at rest. Which finding requires nursing intervention?

temperature 100.0º F (37.78º C)

The nurse is teaching a client about an ambulatory electrocardiogram. Which client statement requires further nursing teaching?

"I can sleep with an electric blanket to stay warm."

An adult client has been scheduled for a stress electrocardiogram as part of a larger diagnostic workup. How should the nurse best describe this test to the client?

"The electrical activity of your heart will be measured while you perform exercise."

The nurse is calculating the maximum heart rate for a 70-year-old client. Which accurately reflects the client's maximum heart rate?

142 beats per minute

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 assessing a client's fitness to provide the client with a suitable exercise regimen. Which assessment technique will provide reliable results for fitness levels?

electrocardiogram

The nurse is helping a client with musculoskeletal alterations to perform range-of-motion exercises. In what order would the nurse perform the exercises for the client?

from the head and down one side of the body at a time

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 the client set a daily goal for how many steps?

10,000

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

A client tells the nurse that he wants 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 at the target heart level for how many minutes? Record your answer using a whole number.

15

The nurse is calculating the maximum heart rate for a 38-year-old client. Which accurately reflects the client's maximum heart rate?

182 beats per minute

A nurse is following a plan of care for passive range-of-motion (ROM) exercises. What specifics will be included on the plan?

Do ROM exercises twice a day, each exercise 2 to 5 times.

A nurse is performing range of motion to a client's ankle and foot. Which movements would the nurse include? Select all that apply.

Eversion Dorsiflexion Extension

The nurse is helping a client perform range-of-motion exercises on the hand and fingers. Which exercise would be performed first?

Flex the hand down and backward and relax.

The nurse teaches an unlicensed assistive personnel (UAP) to perform passive range of motion exercises for a client, using circumduction. How will the nurse teach the UAP to move the joint?

Form a circle.

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 instructing a client to perform range-of-motion exercises on the head. Which accurately describes a recommended movement?

Move the chin down to rest on the chest.

A nurse is performing passive range-of-motion exercises on a client. What would be most appropriate for the nurse to do?

Stop the movement if the client develops spasticity.

A community health nurse is teaching a workshop on exercise during a health fair that is being sponsored by a local community center. A participant has asked the nurse about a reasonable and healthy goal for the heart rate while a person exercises. The nurse has responded by explaining the relationship between maximum heart rate and target heart rate. How should an individual's maximum heart rate be calculated?

Subtract the individual's age from 220.

When the client restricts use of her dominant arm because of pain and the nurse notes that the measurement of the circumference of the client's nondominant arm is greater than her dominant arm, the nurse determines that the lack of use has resulted in the dominant arm's:

atrophy

The community nurse working at a community health fair is assessing a client's vital signs at rest. Which finding requires nursing intervention?

blood pressure 180/90 mm Hg

A nurse is preparing to teach a community group about fitness exercise and how the activities and exercises affect a person's energy and oxygen consumption. The nurse is planning to address the activities listed. Place the activities in the order that the nurse would describe them from the least to greatest consumption of energy and oxygen.

bowling raking leaves square dancing playing basketball cross-country skiing

The nurse is teaching a 65-year-old client who has had a stroke. Which type of exercise will the nurse recommend to strengthen weakened muscles?

isokinetic

The nurse is teaching a healthy 29-year-old client who wishes to increase muscle mass and strength while toning and defining muscle groups. Which type of exercise will the nurse recommend?

isometric

The nurse is teaching a healthy 40-year-old client whose goals are to increase muscle mass and strength while toning and defining muscle groups. Which type of exercise will the nurse recommend?

isometric