Deck 10: Exercise and Ambulation

Question 1

When assessing for DVT,the most reliable finding for the nurse to consider is:

A) A positive Homans' sign
B) Pallor to the distal area
C) Edema noted in the extremity
D) Tenderness and warmth on palpation

Answer 1

Tenderness and warmth on palpation

Question 2

The patient has been using crutches for the past 2 weeks.When she comes for her follow-up examination,she complains of tingling and numbness in her hands and upper torso.Possible causes of these symptoms are:

A) The patient's elbows are flexed 15 to 30 degrees when using the crutches
B) Crutch pad is approximately 2 inches below the patient's axilla
C) Patient holds the cane 4 to 6 inches to the side of her foot
D) Hand grip does not allow for elbow flexion

Answer 2

Hand grip does not allow for elbow flexion

Question 3

The patient has had a leg injury and is being fitted for a cane.The patient should be taught to:

A) Hold cane on uninvolved side
B) Hold cane on weaker side
C) Extend the cane 15 inches from the foot when used
D) Maintain approximately 60 degrees of elbow flexion

Answer 3

Hold cane on uninvolved side

Question 4

When using a SCD,the nurse should:

A) Apply powder to the patient's skin if redness and itching are present
B) Leave a two-finger space between the patient's leg and the compression stocking
C) Keep the patient connected to the compression device when transferring into and out of bed
D) Remove the elastic stockings before putting on the sequential pneumatic compression stockings

Question 5

An appropriate technique for the nurse to use when performing range of motion (ROM)exercises is to:

A) Repeat each action five times during the exercise
B) Perform the exercises quickly and firmly
C) Support the proximal portion of the extremity being exercised
D) Continue the exercise slightly beyond the point of resistance

Question 6

The patient has been admitted for hypertension.His blood pressure is normally in the 160/90 range.He has been on bed rest for the past few days,and the doctor has started him on a new blood pressure medication.The nurse is assisting the patient to move from the bed to the chair for breakfast,but when the patient tries to sit up on the side of the bed,he complains of being dizzy and nauseous.The nurse lays the patient down and takes his vital signs.His pulse is 124.His blood pressure is 130/80.The nurse realizes that this blood pressure is indicative of:

A) A normal blood pressure for this patient
B) Orthostatic hypotension
C) Orthostatic hypertension
D) Effective baroreceptor function

Question 7

An appropriate procedure for the nurse to use when applying an elastic stocking is to:

A) Remove the stockings every 24 hours
B) Keep the top of the stockings rolled down slightly
C) Turn the stocking inside out to apply from the toes up
D) Wash stockings daily and dry in a dryer

Question 8

While ambulating,the patient becomes light-headed and starts to fall.The nurse should first:

A) Call for help
B) Try to reach for a chair
C) Ease the patient down to the floor
D) Push the patient back toward the bed

Question 9

The patient is a paraplegic who possesses good arm and hand strength.When the following devices are compared,which would be most appropriate for this patient?

A) Axillary crutch
B) Platform crutch
C) Lofstrand crutch
D) Standard crook cane

Question 10

A nurse encourages a patient to prevent venous stasis by:

A) Crossing the legs when sitting in a chair
B) Wearing thigh-length nylon stockings or garters
C) Elevating the legs on pillows while in bed
D) Increasing early ambulation

Question 11

An appropriate way for the nurse to measure a patient for crutches is to:

A) Have a flexion of 45 degrees at both of the patient's elbows
B) Have a space of two to three fingers between the top of the crutch and the axilla
C) Place the crutch tips 1 foot to each side of the patient's feet, and observe the positioning of the crutches
D) Place the crutch tips 1 foot to the front of the patient's feet, and observe the positioning of the crutches

Question 12

The patient was admitted yesterday with a possible DVT.The patient is wearing antiembolic stockings.During the night,the patient calls for the nurse,complaining of chest pain and shortness of breath.The nurse finds that the patient's heart rate is 132 beats per minute,and his respirations are 32 breaths per minute.The patient also states that the calf pain that brought the patient into the hospital is worse than ever.The nurse should:

A) Massage the patient's calf to promote circulation
B) Call the physician immediately
C) Dorsiflex the patient's foot to check for Homans' sign
D) Check the calf for edema

Question 13

The patient is going home after being treated for DVT.He is instructed to wear antiembolic stockings until seen by the physician in 2 weeks.The nurse realizes that the patient needs reinforcement of instruction when she states:

A) "I will have two pair of stockings so that I will have a clean set available at all times."
B) "I need to wash my stockings every day and dry them in the dryer."
C) "My footwear has nonskid soles. I don't want to walk around in just stockings."
D) "I need to lay my stockings flat on a towel to dry them."

Question 14

Antiembolic stockings (TEDs)are ordered for the patient on bed rest after surgery.The nurse explains to the patient that the primary purpose for the elastic stockings is to:

A) Keep the skin warm and dry
B) Prevent abnormal joint flexion
C) Apply external pressure
D) Prevent bleeding

Question 15

A patient is admitted to the medical unit following a cerebrovascular accident (CVA).Evidence of left-sided hemiparesis is noted,and the nurse will be following up on ROM and other exercises performed in physical therapy.The nurse correctly teaches the patient and family members which of the following principles of ROM exercises?

A) Flex the joint to the point of discomfort.
B) Medicate the patient after ROM exercise session.
C) Move the joints quickly.
D) Provide support for distal joints.

Question 16

The nurse is caring for a patient who has just been treated for a broken leg.She needs to teach the patient how to use crutches.The crutch gait that is most appropriate for this patient is the:

A) Four-point gait
B) Three-point gait
C) Two-point gait
D) Swing-to gait

Question 17

The patient is an elderly gentleman who has been on bed rest for the past several days.When getting the patient up,the nurse should:

A) Tell the patient not to move his legs when dangling
B) Tell the patient to hold his breath while dangling
C) Raise the head of the bed and allow a few minutes before dangling
D) Have the patient stand without dangling

Question 18

A nurse should be concerned when observing a patient performing isometric exercises if the patient is:

A) Holding his or her breath while exerting
B) Performing the exercises four times per day
C) Tightening each muscle group for 8 seconds, then relaxing
D) Repeating each exercise 8 to 10 times for each muscle group

Question 19

The patient is a strict Orthodox Jew who has had a knee replacement and is using a continuous passive motion machine (CPM).The patient is concerned because the Sabbath is coming up,and he does not believe that he can use the machine on the Sabbath.The nurse should:

A) Respect the patient's wishes and not use the machine on the Sabbath
B) Consult the rabbi to obtain permission for the patient
C) Tell the patient that all he needs to do is turn his machine on and off
D) Double the number of treatments the day before and after the Sabbath

Question 20

When the four gaits listed below are compared,which is the most stable of the crutch gaits?

A) Four-point gait
B) Three-point gait
C) Two-point gait
D) Swing-to gait

Question 21

Static exercises that involve tightening or tensing of muscles without moving a body part are known as ______________.

Question 22

A drop in blood pressure that occurs when the patient changes position from a horizontal to a vertical position is known as _________________.

Question 23

The nurse is concerned that the patient may fall while he is ambulating.To help her maintain control while the patient walks the nurse may apply a ______________ around the patient's waist.

Question 24

Factors that contribute to the development of DVT are: (Select all that apply.)

A) Elevated sodium (Na+) levels
B) Hypercoagulability of the blood
C) Venous wall damage
D) Stasis of blood flow

Question 25

A patient with left hemiparesis is using a quad cane for ambulation.The following is the correct technique for the nurse to use in teaching the patient:

A) Use the cane on the right side, with the cane moving forward first.
B) Use the cane on the left side, with the left leg moving forward with the cane.
C) Use the cane in either hand, with the right leg moving forward first.
D) Use the cane in either hand, with the left leg moving beyond the forward placement of the cane.

Question 26

When teaching the use of a three-point crutch gait,a nurse instructs the patient to:

A) Move both crutches and the affected leg first, then the stronger leg
B) Move the right crutch, left foot, left crutch, and right foot in sequence
C) Move the left crutch and right foot, then move the right crutch and left foot
D) Move both crutches, then lift and swing the legs forward as far as the crutches

Question 27

_________________ increase muscle tension but do not change the length of muscle fibers.

Question 28

____________ refers to an ability to move about freely.

Question 29

The nurse is applying a CPM machine to the patient's leg.To do so,she must: (Select all that apply.)

A) Provide analgesia 1 hour before starting the CPM
B) Stop the CPM when in extension and place a sheepskin on the machine
C) Align patient's joint with the CPM's mechanical joint
D) Secure the patient's extremity tightly with Velcro straps

Question 30

A person's inability to move about freely is known as _______________.

Question 31

The patient had a stroke and is currently immobile.The nurse realizes that increasing mobility is critical because immobility can result in alterations in which of the following? (Select all that apply.)

A) Cardiovascular function
B) Pulmonary function
C) Skin integrity
D) Elimination
E) None of above

Question 32

Virchow's triad (hypercoagulability of blood,venous wall damage,and stasis of blood flow)has been found to contribute to ________________.

Question 33

The nurse is caring for an immobile patient.Which of the following may help reduce the hazards associated with immobility? (Select all that apply.)

A) A high-fiber diet
B) Frequent repositioning
C) Muscle and joint exercises
D) Increased fluid intake
E) None of above

Question 34

The patient is performing ROM exercises independently.These are known as ________________ exercises.