Question 1

Which of the following is true of synarthroses? Joints are:
A) Freely movable
B) Capable of only limited movement
C) Immovable
D) Painful with movement

Accepted Answer

Synarthroses joints are immovable joints.The sutures between the cranial bones are considered synarthroses joints.Although these joints have some flexibility in youth to allow for growth,they gradually become rigid and immovable with age.There is no pain associated with synarthroses.

Question 2

The nurse is helping the patient to perform leg exercises after surgery to prevent thrombophlebitis.Which type of muscle is the patient using for these exercises?
A) Skeletal
B) Smooth
C) Cardiac
D) Slow-twitch fibers

Accepted Answer

Skeletal muscle moves the bones with ligaments.Smooth muscle is found in the digestive tract and other hollow structures,such as the blood vessels and bladder.Cardiac muscle contracts spontaneously and as blood is ejected out of the heart.Slow-twitch fibers are a subtype of skeletal muscle cell.Slow-twitch fibers (type I),or "red" muscle,have a rich blood supply and are rich in mitochondria (the powerhouse of the cell)to give the muscle more oxygen and energy to sustain aerobic activity.The fast-twitch fibers (type II skeletal muscle type)are known as "white" muscle.These fibers increase the speed of muscle contraction.

Question 3

The nurse planning the care of a frail,malnourished,immobile patient recognizes which of the following as the best treatment to protect the patient's integument?
A) Offering the patient six small meals a day
B) Assisting the patient to sit in a chair three times a day
C) Turning the patient at least every 2 hours
D) Administering fluid boluses as directed by the healthcare provider

Accepted Answer

External pressure from lying or sitting in one position compresses capillaries and obstructs blood flow to the skin.Immobile patients confined to a bed should be turned at least every 2 hours to protect their skin and relieve pressure.

Question 4

A healthy 32-year-old man wants to start a fitness program to increase his muscle tone and muscle strength.What advice should the nurse offer him? "The U.S.Department of Health and Human Services recommends:
A) That exercising even once a week is sufficient"
B) 30 minutes or more of moderate-intensity physical activity three times a week"
C) 1 hour, three times a week of moderate-intensity physical activity"
D) 150 to 300 minutes or more of moderate-intensity physical activity per week"

Accepted Answer

Exercise involves physical activity and increases muscle tone and strength.The U.S.Department of Health and Human Services recommends 150 to 300 minutes or more of moderate- or vigorous-intensity physical activity per week.

Question 5

A frail,elderly man is admitted to the hospital after a fall at home resulted in a left hip fracture.After surgery,he is to begin ambulating with a walker but must avoid weight bearing on his left lower leg.What is the best intervention to help him use his walker?
A) Aerobic exercise with deep breathing
B) Quadriceps and gluteal repetitions
C) Isometric toning of lower legs
D) Arm resistance training

Accepted Answer

Arm strength is necessary for ambulating with a walker and other assistive devices.Upper body resistance training increases muscle strength and tone,which will aid him in using the walker more easily.Toning the lower body through exercise of the quadriceps and gluteal muscles,although important for regaining strength in general after surgery,does not specifically aid in using a walker.Aerobic exercise with deep breathing produces the greatest benefit to the cardiovascular health and does little to improve the upper body strength needed for ambulating with an assistive device.

Question 6

A nurse has been asked to design an exercise program with the goal of increasing a client's muscular strength and endurance.Which exercise program would specifically focus on meeting that goal?
A) Flexibility training
B) Resistance training
C) Aerobic conditioning
D) Anaerobic conditioning

Accepted Answer

Resistance training involves movement against resistance,which increases muscular strength and endurance.Most commonly,resistance training refers to weight lifting and isotonic movement.When exercising for strength,the amount of resistance is increased with each exercise.When exercising for endurance,the number of repetitions is increased with each exercise.Flexibility training will not increase muscular strength.Aerobic and anaerobic conditioning may have some benefit on strength and endurance,but their primary focus is cardiovascular conditioning.

Question 7

What action is most important in limiting the nurse's risk of back injuries?
A) Use good body mechanics at all times.
B) Work with another nurse or an aide when lifting and turning patients.
C) Avoid manual lifting by using assistive devices as often as possible.
D) Develop a lift team at the clinical site.

Accepted Answer

Back injuries are the leading cause of injury among nurses.Good body mechanics and teamwork limit the risk of injury.However,the ANA Handle With Care program advocates the regular use of assistive devices as well as avoiding manual lifting.

Question 8

A patient fractured her right ulna 8 weeks ago and has just had her cast removed.The orthopedic surgeon prescribes isometric exercises for the right arm.Which of the following exercises complies with the surgeon's orders?
A) Place a 5-pound dumbbell in the right hand and squeeze; hold the squeeze position for 6 to 8 seconds, and repeat 5 to 10 times.
B) Grasping the right wrist with the left hand, move the right arm up, down, and side to side; hold each position for 6 to 8 seconds, and repeat 5 to 10 times.
C) Grasping the right wrist with the left hand, pull the right arm across the body; hold this position for 6 to 8 seconds, and repeat 5 to 10 times.
D) Press the right hand against a wall; hold this position for 6 to 8 seconds, and repeat 5 to 10 times.

Accepted Answer

Isometric exercise involves muscle contraction without motion.Isometric exercises are useful for developing strength.This type of exercise is appropriate for the patient who has had an extremity confined to a cast because muscle atrophy occurs when the muscle is not used.Performing repetitions with a light weight increases strength but this would stress the healing fracture at this point in the rehabilitation.Pulling an arm across the body improves flexibility but does not benefit the ulna while healing.

Question 9

A man has been admitted to the hospital unit with a medical diagnosis of Chronic Obstructive Pulmonary Disease (COPD).He is receiving supplemental oxygen at 2 L/min via nasal cannula.Which positioning technique will best assist him with his breathing?
A) Fowler's position
B) Sims' position
C) Lateral recumbent position
D) Lateral position

Accepted Answer

Fowler's position is a semisitting position in which the head of the bed is elevated 45 to 60 degrees.This position promotes respiratory function by lowering the diaphragm and allowing the greatest chest expansion.Sims' position is a side-lying position in which the patient is on his left side with left leg extended and right leg flexed.This position is commonly used for rectal examination.Lateral recumbent position is another term describing Sims' position.Lateral position simply means side lying.

Question 10

To achieve balance,body mass must be distributed around which point?
A) Center of body alignment
B) Center of balance
C) Center of gravity
D) Base of support

Accepted Answer

Balance is achieved when the body is in alignment.To be balanced,a person's line of gravity must pass through his center of gravity,and the center of gravity must be close to his base of support.The center of gravity is the point around which mass is distributed.

Question 11

What would be the most appropriate goal for a frail,elderly patient with a nursing diagnosis of Risk for Injury after hip surgery?
A) Remain free from injury or falls throughout hospital stay.
B) Increase activity tolerance by discharge from hospital.
C) Demonstrate effective breathing when ambulating.
D) Increase mobility by discharge from hospital.

Accepted Answer

Remaining free from injury or falls is a measurable goal,and it is directly related to the patient's nursing diagnosis,Risk for Injury.Increasing activity tolerance and mobility by the time of discharge is not specific and measurable.Additionally,these outcomes do not relate to Risk for Injury.A goal of effective breathing for a frail,elderly patient after hip surgery does not relate to Risk for Injury.

Question 12

Which course of action taken by her patient with osteoporosis would allow the nurse to know that her teaching was effective?
A) Taking a calcium supplement every day and increasing her phosphorous intake
B) Participating in an aerobic barbell strength class at the gym three times a week
C) Using a wheelchair to reduce the risk of spontaneous fractures to her legs and feet
D) Seeking healthcare by scheduling a follow-up examination with bone density testing

Accepted Answer

Active participation in a weight-bearing and weight-lifting program demonstrates not only understanding of the treatment of osteoporosis but also commitment to an action plan to reduce bone loss that accompanies osteoporosis.Calcium supplementation is also part of the treatment for osteoporosis.However,high phosphorous intake lowers calcium levels and would not be appropriate for a client with osteoporosis.Restricting weight-bearing activity to a wheelchair will actually lower bone density.Although follow-up care is appropriate for a client with osteoporosis,it does not indicate commitment to a daily treatment plan.

Question 13

A teenage boy was hospitalized 3 weeks ago.He has been confined to bed throughout his hospital stay because of a crushed pelvis.His parents tell the nurse,"Our son is just staring off into space; he won't talk to us.We are worried because he has not even listened to his iPod,watched television,or played his video games for 2 days.That is so unlike him." What is the best response the nurse can make?
A) "I will inform his doctor and see whether we can get your son started on an antidepressant medication."
B) "He is at a critical time in his life; teens are often moody, and being in the hospital with an injury will only make that worse."
C) "Your son had a major injury, and his immobility might be causing him to feel isolated and depressed."
D) "He is bored because he has been in the hospital for 3 weeks; I'll try to find something new for him to do."

Accepted Answer

Being immobile,whether in the hospital or home,leads to isolation and mood changes.Patients who are in bed for long periods can suffer from psychological changes such as depression,anxiety,hostility,sleep disturbances,and changes in their ability to perform self-care activities.

Question 14

A nurse is caring for a 25-year-old male quadriplegic patient.Which of the following treatments would the nurse perform to decrease the risk of joint contracture and promote joint mobility?
A) Active ROM
B) Turning the patient every 2 hours
C) Passive ROM
D) Administering glucosamine supplements

Accepted Answer

Passive ROM involves moving the joints through their ROM when the patient is unable to do so for himself.Passive ROM promotes joint mobility.Active ROM would not be possible for a quadriplegic patient.Turning the patient every 2 hours prevents skin breakdown but does not promote mobility or prevent contracture.Glucosamine is a building block for the formation and repair of cartilage.However,there is inconclusive scientific evidence regarding the benefit of this substance to improve joint function.

Question 15

When caring for a patient with osteoporosis,which of the following is the most important action to take to minimize progression of the disease?
A) Take a calcium supplement twice a day.
B) Start a weight-bearing exercise program.
C) Avoid strenuous activity that puts stress on the bones.
D) Schedule regular healthcare checkups.

Accepted Answer

Osteoporosis causes bones to become porous and weak.Starting a weight-bearing exercise program is the most important aid in promoting bone strength and decreasing the rate of bone loss.Calcium supplementation does help maintain bone density.

Question 16

What is the correct method for turning an adult patient who recently sustained a spinal cord injury?
A) Ask the patient to assist with the turn by holding the siderails of the bed.
B) Place a draw sheet under the patient to assist with turning.
C) Request help from another nurse to perform the logrolling technique.
D) Use a mechanical lift for safe turning and protecting the nurse's back.

Accepted Answer

The patient's spine should be maintained in straight alignment.Logrolling moves the patient's body as a unit and maintains the patient's spine in straight alignment.Holding on to the siderail or using a draw sheet or mechanical lift will not keep the spine in alignment.

Question 17

Identify the most appropriate nursing diagnosis for promoting the safety of a frail,elderly patient after hip replacement surgery who also has a history of emphysema.
A) Impaired Mobility related to weakness
B) Ineffective Breathing Pattern related to disease process
C) Activity Intolerance related to injury
D) Risk for Injury related to medical condition

Accepted Answer

The patient's medical condition places him at an increased Risk for Injury: He is at risk for falls and for further injury to his hip.The patient does have Impaired Mobility; however,his Impaired Mobility puts him at Risk for Injury.A diagnosis of Impaired Mobility would focus the outcomes on improving his mobility rather than protecting him from further injury.We have no data other than a diagnosis of Emphysema to indicate that he is experiencing Ineffective Breathing Pattern.He is experiencing Activity Intolerance,but this is not his primary safety risk.A diagnosis of Activity Intolerance would focus the goals on increasing his endurance and conserving his energy.

Question 18

An older patient with newly diagnosed osteoporosis asks the nurse to explain her health problem.Which of the following is the correct description of osteoporosis?
A) Loss of bone density that increases the risk of fracture
B) Degenerative joint disease that produces pain and decreased function
C) Chronic inflammatory joint disease that must be treated with steroids
D) Acute infection in the bone that must be treated with antibiotics

Accepted Answer

Osteoporosis is a decrease in total bone density.The internal structure of the bone diminishes,and the bone collapses in on itself.Women experience a rapid decline in bone mass after menopause.Osteoarthritis is a degenerative joint disease.Osteomyelitis is a serious infection in the bone.

Question 19

A 15-year-old patient complains of left ankle pain after being tackled while playing football.He asks the nurse what tests he needs to have to determine whether he has a strain or a fracture.How should the nurse reply?
A) "You don't need an x-ray; I can tell by the way your ankle looks and feels whether you have a strain or fracture."
B) "Sprains, strains, and fractures have similar symptoms at first; you will need an x-ray of the joint to be certain."
C) "We will need to get a venous Doppler study to make sure that there is not a fracture."
D) "First, we need to get an MRI to diagnose your injury as a fracture instead of strain or sprain."

Accepted Answer

Signs and symptoms associated with a sprain,strain,or fracture are the same.An x-ray allows the medical provider to visually observe for any breaks in a bone.An x-ray is more practical than an MRI to diagnose a fracture.A venous or arterial Doppler is used to detect blood flow.

Question 20

A nurse is assessing a healthy,older adult patient for an exercise program to be offered at the local hospital.During the evaluation,the nurse notes the following vital signs: P = 72,RR = 16,BP = 132/70.After 3 minutes of moderate-intensity running on the treadmill,the patient becomes short of breath and states,"I have to stop.I can't do this anymore." The nurse measures his vital signs again: P = 152,RR = 40,BP = 172/98.She instructs him to rest.Vital signs return to baseline after 15 minutes.The nurse should recognize his symptoms as associated with which of the following?
A) Anxiety
B) Orthostatic hypotension
C) Limited activity tolerance
D) Respiratory distress

Accepted Answer

To assess for activity tolerance,assess and record vital signs before and after exercise.A rapid change from baseline vital signs or a slow return to baseline indicates limited activity tolerance.Anxiety might primarily be exhibited via signs of difficulty getting enough air,elevated heart rate,and systolic blood pressure.Vital signs would resolve when anxiety is reduced and not after exercise.Orthostatic hypotension is a temporary lowering of blood pressure when suddenly standing up.It is not a finding related to exercise.

Quiz 32: Physical Activity Mobility

Which of the following is true of synarthroses? Joints are:

The nurse is helping the patient to perform leg exercises after surgery to prevent thrombophlebitis.Which type of muscle is the patient using for these exercises?

The nurse planning the care of a frail,malnourished,immobile patient recognizes which of the following as the best treatment to protect the patient's integument?

A healthy 32-year-old man wants to start a fitness program to increase his muscle tone and muscle strength.What advice should the nurse offer him? "The U.S.Department of Health and Human Services recommends:

A frail,elderly man is admitted to the hospital after a fall at home resulted in a left hip fracture.After surgery,he is to begin ambulating with a walker but must avoid weight bearing on his left lower leg.What is the best intervention to help him use his walker?

A nurse has been asked to design an exercise program with the goal of increasing a client's muscular strength and endurance.Which exercise program would specifically focus on meeting that goal?

What action is most important in limiting the nurse's risk of back injuries?

A patient fractured her right ulna 8 weeks ago and has just had her cast removed.The orthopedic surgeon prescribes isometric exercises for the right arm.Which of the following exercises complies with the surgeon's orders?

A man has been admitted to the hospital unit with a medical diagnosis of Chronic Obstructive Pulmonary Disease (COPD) .He is receiving supplemental oxygen at 2 L/min via nasal cannula.Which positioning technique will best assist him with his breathing?

To achieve balance,body mass must be distributed around which point?

What would be the most appropriate goal for a frail,elderly patient with a nursing diagnosis of Risk for Injury after hip surgery?

Which course of action taken by her patient with osteoporosis would allow the nurse to know that her teaching was effective?

A nurse is caring for a 25-year-old male quadriplegic patient.Which of the following treatments would the nurse perform to decrease the risk of joint contracture and promote joint mobility?

When caring for a patient with osteoporosis,which of the following is the most important action to take to minimize progression of the disease?

What is the correct method for turning an adult patient who recently sustained a spinal cord injury?

Identify the most appropriate nursing diagnosis for promoting the safety of a frail,elderly patient after hip replacement surgery who also has a history of emphysema.

An older patient with newly diagnosed osteoporosis asks the nurse to explain her health problem.Which of the following is the correct description of osteoporosis?

A 15-year-old patient complains of left ankle pain after being tackled while playing football.He asks the nurse what tests he needs to have to determine whether he has a strain or a fracture.How should the nurse reply?