Deck 25: Mobility

Question 1

A home care nurse is assessing a client in the home. The client had a cerebrovascular accident and has right side paralysis. After 6 weeks of rehabilitation, the client has increasing mobility when:

A) she can lift the right arm ¹/₂ inch.
B) she can move the right arm with the left.
C) she can chew and swallow food.
D) she can smile and open her right eye.

Answer 1

she can lift the right arm ¹/₂ inch.

Question 2

When the muscle contracts, which element is released into the sarcoplasmic reticulum?

A) Potassium
B) Calcium
C) Sodium
D) Chloride

Answer 2

Calcium

Question 3

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

A) atrophy.
B) hypertrophy.
C) dystrophy.
D) malrotation.

Answer 3

atrophy.

Question 4

When the client has been diagnosed as having an infection in the semicircular canals in the vestibular apparatus of the ear, the nurse should assess the client for:

A) instability when walking, because the semicircular canals maintain equilibrium.
B) anxiety, because the semicircular canals maintain psychological understanding.
C) ability to lift, because the semicircular canals control gravitational pull.
D) confusion, because the semicircular canals control understanding.

Question 5

The proper use of the principles of body mechanics:

A) acts as a safeguard against legal action by the client.
B) acts to prevent injury to the client and/or nurse.
C) primarily protects the client from injury.
D) primarily protects the nurse from injury.

Question 6

When a client is lifted or held by a nurse, the additional weight becomes a part of the nurse's weight and should be:

A) supported with a narrow base.
B) counterbalanced by a horizontal adjustment.
C) controlled with the upper arm muscles.
D) balanced over the center of gravity.

Question 7

The nurse is caring for a client who has a lower body injury and who is able to partially assist with transfers. The nurse should:

A) use a pull sheet whenever moving the client.
B) manually roll the client to the side of the bed.
C) provide the client with an overhead trapeze.
D) teach the client to pull up with the headboard.

Question 8

An orthopedic client is instructed to tighten the gluteus muscles and relax. This is an example of an:

A) isometric exercise.
B) isotonic exercise.
C) anaerobic exercise.
D) aerobic exercise.

Question 9

An infant develops one extremity that is shorter than the other. This occurs with:

A) bone tumors.
B) hip fractures.
C) loss of calcium.
D) hip dislocation.

Question 10

To compensate for the shift in the center of gravity, an older adult tends to:

A) shift weight to the right side.
B) try to stand more erect.
C) sway from side to side when walking quickly.
D) flex the knees for support.

Question 11

A client with cancer has developed a metastatic bone tumor in the right hip. What complication is the client at risk for?

A) Fracture
B) Decreased circulation to the joint
C) Bleeding
D) Loss of sensation

Question 12

When an older adult client walks with the knees slightly flexed and body leaning, the nurse determines that the client:

A) should have an orthopedic consultation.
B) is demonstrating a common gait for the older adult.
C) requires a better walking shoe.
D) requires crutches for mobility.

Question 13

An 82-year-old client is taking medication for blood pressure and is suffering from syncope. The client is at risk for:

A) edema.
B) stroke.
C) fractures.
D) paralysis.

Question 14

A client suffered a spinal cord injury resulting in the loss of function to the arms and legs. This client would be diagnosed as having:

A) paraplegia.
B) hemiplegia.
C) monoplegia.
D) tetraplegia.

Question 15

When a home care nurse notes that a widow of 3 months is not sleeping well, has no appetite, and does not attend activities outside the home, the nurse suspects the client is experiencing:

A) depression.
B) dementia.
C) sensory overload.
D) sensory deprivation.

Question 16

The nurse is caring for a client who is on strict bed rest. The medical history includes partial paralysis from a stroke suffered several years ago. There is also evidence of early dementia. The nurse correctly recognizes the client is at an increased risk for which complication?

A) Altered gait
B) Fractures
C) Edema
D) Muscle atrophy

Question 17

Which gait is characterized by one leg being dragged and swung forward by hip motion?

A) Festinating
B) Spastic
C) Hemiplegic
D) Waddling

Question 18

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

A) activity intolerance related to fatigue.
B) activity intolerance related to poor conditioning.
C) activity intolerance related to limited range of motion.
D) activity intolerance related to heat.

Question 19

A flexion contracture usually occurs because of inactivity and:

A) extensor muscles being stronger that flexors.
B) flexor muscles being stronger than extensors.
C) cartilage and bone changes occurring inside the joints.
D) synovial fluid decreases related to age.

Question 20

A nurse applies padded boots to maintain the foot in dorsiflexion on a client who is comatose. The nurse is protecting the client from:

A) pressure injuries.
B) pooling of blood.
C) blood pressure changes.
D) foot drop.

Question 21

An older adult client who suffered a hip fracture and 1 day postoperative is to receive heparin 5,000 units subcutaneous daily. This is administered to:

A) increase circulation.
B) decreasing blood pooling.
C) enhance mobility.
D) prevent deep vein thrombosis.

Question 22

A client who is immobile reports severe pain in the right flank. The physician diagnoses the client with renal calculi. This condition often results from:

A) increased serum calcium.
B) decreased serum calcium.
C) increased serum phosphorous.
D) decreased serum phosphorous.

Question 23

When logrolling a client, the nurse should use supportive devices in turning the client in order to:

A) maintain the natural alignment of the client's body.
B) allow the client's leg to rest on the bed.
C) maximize the client's participation.
D) prevent the blood stasis that can lead to skin breakdown.

Question 24

The nurse is caring for a client who is postoperative from a hip fracture repair. The nurse must be careful to avoid:

A) adduction of the affected leg.
B) hip abduction.
C) flexion of the knee on the affected leg.
D) extension of the knee on the affected leg.

Question 25

Which nursing strategy will prevent the dislocation of the hip prosthesis?

A) Turning on the affected side
B) Crossing the legs when sitting
C) Elevating the head of the bed to 90 degree
D) Maintaining abduction

Question 26

A client is discharged to the daughter's home. The client weighs 250 lbs and is immobile. The nurse should instruct the daughter on the use of a:

A) three-person lift.
B) transfer with a gait belt.
C) hydraulic lift.
D) stand-up assist lift.

Question 27

The nurse is caring for a client who had surgery 2 days ago. The nurse correctly recognizes which of the following as having the greatest ability to reduce the incidence of deep vein thrombosis (DVT)?

A) Early ambulation
B) Bed rest
C) Preoperative exercise
D) Frequent turning in bed

Question 28

The nurse is assessing a client who has presented at the ambulatory care unit. The nurse notes that the client has impaired muscle coordination. The nurse correctly documents the presence of:

A) ataxia.
B) tremors.
C) chorea.
D) athetosis.

Question 29

To assess a potential injury to a client's wrist, the nurse asks the client to turn the hand and forearm upward. This movement is referred to as:

A) pronation.
B) supination.
C) inversion.
D) eversion.