Question 1

An 82-year-old patient is unsteady on her feet when walking about the room.She reports feeling a little sore but has no complaints of weakness.What is the appropriate piece of equipment to use when helping her ambulate?

Accepted Answer

Crutches are commonly used when the patient has an injured lower extremity.A cane or walker is generally used for the patient with a lower extremity injury or weakness.The most appropriate equipment to use would be a transfer belt.A transfer belt allows the patient the greatest amount of independence while ensuring safety.

Question 2

Which of the following body systems must interact to produce mobility and locomotion? Select all that apply.

Accepted Answer

Activity and exercise require bodily movement (mobility)and locomotion (self-powered movement from one place to another).Mobility depends on the successful interaction among the skeleton,the muscles,and the nervous system.

Question 3

A patient has started a fitness program.What program features illustrate that he has started a well-rounded program? Select all that apply.

Accepted Answer

Flexibility training helps warm up the muscles and prevents injury during exercise.Resistance training increases muscular strength and endurance.Aerobic conditioning affects fitness and body composition.Exercises that maintain or improve balance and core strength are important for preventing falls,especially for older adults.

Question 4

A patient is on strict bedrest for 5 days.During this time,she has not had a bowel movement,although she normally passes stool daily.She describes feeling bloated and uncomfortable.A nursing diagnosis that would best address a patient who is on bed rest is Constipation related to:

Accepted Answer

Immobility slows peristalsis,which leads to constipation,gas,and difficulty evacuating stools from the rectum.Based on the scenario,this nursing diagnosis would specifically address the patient's condition.

Question 5

Which of the following patients would you expect to be at risk for decreased activity? Select all that apply.

Accepted Answer

The person who lives in a skilled nursing facility might be sedentary because of advancing age and other age-associated medical problems that lead to inactivity.With obesity,movement becomes more difficult and strain on joints increases.A sedentary lifestyle,whether adult or child,contributes to obesity; activities,such as computer work and video games,are sedentary and require little physical activity.Physical activity doesn't have to be a structured fitness class but can also be walking,even walking in a mall or neighborhood,as long as the intensity is moderately vigorous.

Question 6

The nurse is helping an 82-year-old patient to ambulate in the hallway.Suddenly she states,"I feel so light-headed and weak," as her knees begin to buckle.The nurse's best action at this time would be to:

Accepted Answer

If a patient becomes weak or begins to fall when walking,do not attempt to hold the patient up.Instead,protect the patient as you guide her to a seated or lying position.Create a wide base of support,and project forward the hip closest to the patient.Assist the patient to slide down your leg as you call for help.Protect the patient's head as her body descends.

Question 7

The nurse providing care to the patient with a fracture explains how bones heal.Which type of cells repair damaged bone and build new bone to keep the skeleton strong?

Accepted Answer

Osteoblasts repair damaged bone and build new bones,which would be needed for the patient with fractured bone.Osteoclasts are specialized cells that break down old or damaged bone,laying the groundwork for the osteoblasts to build a new,stronger foundation of bone.Amphiarthrosis is a type of joint that allows for limited movement.Articular cartilage is connective tissue found in the joints and skeleton.

Question 8

The nurse assessing the mobility of a patient with Parkinson's disease might expect to observe which type of gait?

Accepted Answer

A propulsive gait is characterized by a stooped,rigid posture with the head and neck bent forward.The patient takes small,shuffling steps in involuntary acceleration,which is typical of a parkinsonian gait.An antalgic gait is a limp to avoid pain when bearing weight on an injured lower extremity.In a scissors gait,the legs flex slightly at the hip and knees; the thighs cross in a scissor-like motion,common with cerebral palsy,stroke,head trauma,or brain tumor.A steppage gait is an exaggerated lifting of the leg that appears as though the foot is floppy and toes point downward.This occurs with Guillain-Barré syndrome.

Question 9

A woman with a high-risk pregnancy with triplets is in preterm labor; she is on strict bedrest for 5 days.During this time,she has not had a bowel movement,although she normally passes stool daily.She describes feeling bloated and uncomfortable.What information should the nurse give the patient when explaining constipation?

Accepted Answer

Immobility slows peristalsis,which leads to constipation,gas,and difficulty evacuating stools from the rectum.Increasing fiber in the diet often prevents constipation.A stool softener may be ordered if other measures are unsuccessful.Some people do find use of a bedpan difficult.

Question 10

The nurse is instructing a patient about the need to replace fluid before,during,and after exercise to avoid dehydration.On what basis should she teach the patient to determine the amount of fluid to consume? Select all that apply.

Accepted Answer

Lost fluids must be replaced to decrease the risk of dehydration,regardless of level of fitness.During intense exercise,the body can lose 2 liters of fluid for every hour of exercise.Elevated environmental temperatures also increase the amount of fluid lost through sweating.When athletes drink according to thirst,the risk of overdrinking and so developing exercise-associated hyponatremia is minimized (Noakes,2007).Conversely,exercise can suppress thirst,making it an unreliable signal to replace fluids lost with exercise.

Question 11

When encouraging a fitness program for healthy older adults,what must the nurse consider?

Accepted Answer

Older adults should do exercises that maintain or improve balance if they are at risk of falling.Older adults should follow the adult guidelines,which are for 150 minutes per week of moderate-intensity or 75 minutes per week of vigorous-intensity aerobic physical activity,or an equivalent combination of moderate- and vigorous-intensity aerobic physical activity.Aerobic activity should be performed in periods of at least 10 minutes,preferably spread throughout the week.If this is not possible because of limiting chronic conditions,older adults should be as physically active as their abilities allow.They should avoid inactivity.Structured calisthenics programs are no more beneficial for achieving health benefits than other forms of moderate- and vigorous-intensity physical activity.Structured fitness programs can become boring for some individuals.A varied routine often improves compliance and consistency of exercise.

Question 12

The nurse attempts to transfer a totally dependent patient from a stretcher to a bed.What is the best step to reduce the musculoskeletal risk factors?

Accepted Answer

The nurse uses a friction-reducing device,such as a transfer roller sheet,when transferring an immobile patient who is unable to assist in the transfer.A mechanical lift is a hydraulic device,such as a sling-style or ceiling-mount mechanical lift,used to safely transfer immobile patients who can sit or stand during the transfer.The American Nurses Association's national campaign Handle With Care emphasizes the use of assistive devices to decrease the risk of injury and recommends virtually no manual lifting.Do not rely on body mechanics alone to prevent injury.Overexertion is the primary reason for work-related injury in the healthcare setting.

Question 13

Which of the following actions represent proper body mechanics for nurses providing care as well as teaching patients about safe body movements? Select all that apply.

Accepted Answer

Proper body mechanics involves good body alignment,erect posture,and a wide base of support.To prevent back injury resulting from reaching and straining muscles,carry objects close to the trunk.Bending at the waist to lift objects uses the back muscles and increases the risk of injury.Instead,squat to lower your center of gravity,and use your leg muscles for lifting.

Question 14

The nurse teaching a patient about ways to regain strength after a period of prolonged immobility advises the patient to seek assistance from a physical therapist.Which type of exercise is performed using specialized apparatuses that use resistance at a constant,preset speed?

Accepted Answer

Isokinetic exercise provides variable resistance to controlled movement.Physical therapists often use specialized apparatuses that combine the best features of isometrics and weight training.Isotonic involves movement of the joint during the muscle contraction (e.g.,weight lifting).Isometric exercise involves muscle contraction without motion.The patient would apply pressure against an immoveable surface,such as pushing against a wall."Isomorphic" is not a type of exercise; it describes a body type.

Question 15

The nurse planning care for a patient after severe head trauma and long-term unresponsiveness considers which effect of immobility affecting the lungs? Select all that apply.

Accepted Answer

Immobility decreases the strength of muscles involved in chest wall expansion,which also affects ventilation.The depth of respirations decreases (hypoventilation),and secretions pool in the airways.The ability to effectively cough and expectorate secretions diminishes as muscle tone of the abdomen and chest decrease.As a result,pooled secretions block air passages and alveoli,decrease oxygen and carbon dioxide exchange (hypoxema and hypercarbia),and often lead to atelectasis (collapse of air sacs),or pneumonia.The smooth muscle in the mainstem airway is not reactive as it would be for the patient with asthma,for example.

Question 16

According to the U.S.Department of Health and Human Services 2008 Physical Activity Guidelines for Americans,which of the following statements about the benefits of physical activity is correct?

Accepted Answer

The combination of aerobic and bone- and muscle-strengthening physical activities leads to health benefits for people of all ethnic groups and ages.Physical activity is safe for almost everyone,and the health benefits of physical activity far outweigh the risks.Additional health benefits are provided by increasing to 300 minutes a week of moderate-intensity aerobic physical activity,or 150 minutes a week of vigorous-intensity physical activity,or an equivalent combination of both.For all individuals,some activity is better than none.

Question 17

A 32-year-old with a high spinal cord injury has been admitted to the hospital for antibiotic therapy to treat pneumonia.He lives independently and has developed strong upper-body strength to maximize his independence.Which transfer device should be used when transferring him from the bed to his wheelchair?

Accepted Answer

A transfer board is used by patients with longstanding mobility problems; it offers them the greatest amount of independence while ensuring safety.Patients using a transfer board should have sufficient upper-body strength to perform the transfer safely.A mechanical lift could be used,but it does not promote independence.A transfer belt is used for clients who are able to stand.A draw sheet is useful for moving a patient in bed rather than from bed to wheelchair.

Quiz 32: Physical Activity Mobility