Chapter 12: Exercise Nursing School Test Banks

Chapter 12: Exercise
Edelman: Health Promotion Throughout the Life Span, 8th Edition

MULTIPLE CHOICE

1. Activity that uses large muscle groups in a repetitive, rhythmic fashion over an extended period to improve the efficiency of the oxidative energy producing system and improve cardiorespiratory endurance is known as:
a. aerobic activity.
b. anaerobic activity.
c. flexibility.
d. muscular fitness.
ANS: A
Aerobic activity is defined as activity that uses large muscle groups in a repetitive, rhythmic fashion over an extended period to improve the efficiency of the oxidative energy producing system and improve cardiorespiratory endurance.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 265

2. A nurse is working with a group of individuals to start an exercise program. Which of the following would require the most attention and assistance?
a. White man who works 50 to 60 hours a week as a business executive
b. Unemployed, obese Hispanic woman
c. Employed White woman with hypertension
d. White man with a high school diploma
ANS: B
The number of adults with no leisure-time physical activity varies by race, ethnicity, gender, education level, geographic location, disability status, and age. Women are less active than men. Lower income and less educated people are not as physically active as those with higher socioeconomic and educational levels. In addition, African Americans and Hispanics are less active. The unemployed, obese Hispanic woman has three risk factors for inactivity: (1) she is unemployed and therefore likely has no or a low income level; (2) she is a woman, and (3) she is Hispanic. All of these factors place her at risk for inactivity.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 265 | p. 286

3. According to the physical activity and fitness section of the Healthy People 2020 report, what percentage of adults 18 years of age or older report no leisure-time physical activity?
a. 16%
b. 26%
c. 36%
d. 46%
ANS: D
According to the physical activity and fitness section of the Healthy People 2020 report, 36% of adults 18 years of age or older report no leisure-time physical activity.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 265

4. A nurse is developing a primary prevention strategy to address the problem of obesity. Which of the following interventions is being created?
a. Encouraging an active lifestyle during childhood years
b. Prescribing orlistat (Alli)
c. Recommending the Jenny Craig program
d. Recommending gastric banding surgery
ANS: A
Exercise is an important component of primary prevention. Less active children increase their risk of sedentary lifestyles as adults. Sedentary lifestyles lead to obesity. Therefore, a primary prevention method for obesity is to encourage an active lifestyle during the childhood years.

DIF: Cognitive Level: Apply (Application) REF: p. 266

5. A nurse is providing care for a 10-year-old child with a BMI at the 80th percentile. Which of the following best describes this child?
a. Normal weight
b. Overweight
c. Obese
d. Morbidly obese
ANS: A
A child or adolescent is categorized as being overweight if his or her BMI is greater than or equal to the 95th percentile of age- and gender-specific BMI growth charts. Thus, the 10-year-old child with a BMI at the 80th percentile is considered to be normal weight.

DIF: Cognitive Level: Apply (Application) REF: p. 266

6. According to the 2009-2010 National Health and Nutrition Examination Survey, what percentage of 6- to 11-year-old children are overweight?
a. 14%
b. 18%
c. 24%
d. 28%
ANS: B
According to the 2009-2010 National Health and Nutrition Examination Survey conducted by the CDCs National Center for Health Statistics, 18% of 6- to 11-year-old children are overweight.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 266

7. A nurse is providing care for a 40-year-old adult with a BMI of 32. Which of the following best describes this person?
a. Normal weight
b. Overweight
c. Obese
d. Morbidly obese
ANS: C
An adult 20 years of age or older is considered overweight if his or her BMI is 25 to 29.9, obese if his or her BMI is 30 or higher, and morbidly obese if his or her BMI is 40 or higher. Thus, the 40-year-old adult with a BMI of 32 is considered obese.

DIF: Cognitive Level: Apply (Application) REF: p. 266

8. During an office visit, a nurse meets with a woman who states she does not have time to exercise. Which of the following actions should the nurse take next?
a. Do nothing because she has already made the decision to not exercise.
b. Provide her with information on the benefits of exercising.
c. Develop an exercise prescription with her.
d. Schedule a follow-up in 2 months to see if she still feels the same way.
ANS: B
The woman is in the precontemplation state and thus should not be forced into a plan at this time. However, exercise has many benefits and it implementation should be encouraged. The nurse should continue to ask at each visit because when individuals are counseled by clinicians they are more likely to increase physical activity. As a result, providing the woman with information regarding the benefits of exercising and bringing up the topic of exercise is the best approach at this stage.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 267 | p. 288

9. During an office visit, a nurse provides counseling to a 70-year-old woman with osteoporosis who is otherwise very healthy. Which of the following information should the nurse provide to the woman?
a. Avoid all forms of exercise because of the risk of fractures.
b. Walk with a partner at least 30 minutes a day 5 days a week.
c. Use a wheelchair to get around so that she can prevent falls.
d. Take a step aerobics class 5 days a week.
ANS: B
Regular physical activity helps maintain functional independence and improve quality of life throughout the aging process. The benefits of exercise have been documented for both healthy and chronically ill older adults. Exercise improves bone mineral density, especially weight-bearing activities such as walking, aerobic, and dance. Women 30 to 40 years past menopause also need to consider decreasing the risk of fractures by preventing falls. Advanced age and osteoporosis should not exclude anyone from exercise. Therefore, walking with a partner provides the exercise that is needed as well as a companion to help prevent falls or notify someone if a fall occurs.

DIF: Cognitive Level: Apply (Application) REF: p. 267 | pp. 273-274

10. A nurse is providing health education for a group of older adults about the risks of developing coronary heart disease. Which of the following group members is at highest risk?
a. Takes a beta-blocker for hypertension
b. Has a total cholesterol level of 201
c. Doesnt participate in any form of regular physical activity
d. Has a family history of Type 2 diabetes mellitus
ANS: C
Physical inactivity affects more people in the development of coronary heart disease than any other risk factor. At any level or combination of risk factors, sedentary individuals are at greater risk of developing coronary heart diseases. Exercise provides both primary and secondary prevention. Thus, the person who does not participate in any form of regular physical activity is at most risk of developing coronary heart disease.

DIF: Cognitive Level: Apply (Application) REF: p. 268

11. During a home visit, a nurse notes that a person with hypertension lives on the third floor of a subsidized housing project on a busy road with no sidewalks and few street lights. Which of the following would be the best recommendation for exercise for the nurse to make to the person?
a. Do not exercise because you have high blood pressure.
b. Use the stairs whenever you are entering or leaving the building.
c. Go for short walks around the block during the daytime only.
d. Purchase an exercise bike.
ANS: B
Exercise decreases blood pressure and thus should be encouraged in those with hypertension, especially aerobic activity. Participation in physical activity depends on the availability of facilities and a safe environment. Walking in the road is not safe, and it is also unlikely that this person, who lives in a subsidized housing project, has the funds to purchase an exercise bike. Therefore, using the stairs as much as possible would be a safe, inexpensive form of exercise for this person.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 269 | p. 290

12. A 51-year-old woman has begun menopause. The nurse emphasizes the importance of a diet high in calcium and vitamin D as well as exercise for this woman.
This recommendation is important because by the time the client is 56, she will have experienced another _____ bone loss.
a. 3%
b. 7%
c. 10%
d. 15%
ANS: D
The rate of bone loss accelerates rapidly during the first 5 postmenopausal years, with annual losses of 3% to 5% being common. Thus, if at least 3 % is lost over 5 years, 3% 5 years (56 51) = 15%.

DIF: Cognitive Level: Apply (Application) REF: p. 273

13. A nurse is educating a 35-year-old woman about the best exercises to engage in to prevent bone loss. Which of the following exercises would the nurse recommend?
a. Walking
b. Swimming
c. Weight training
d. Bike riding
ANS: A
Weight-bearing activities have a positive effect on bone density, and walking is a weight-bearing activity. In young women, the goal is to increase bone mineral density; thus, walking is the best exercise to prevent osteoporosis in this woman.

DIF: Cognitive Level: Apply (Application) REF: pp. 273-274

14. A nurse is developing an exercise program for a person with moderate osteoarthritis of the knees. Which of the following forms of exercise would the nurse include in this program?
a. Step aerobics
b. Running
c. Water aerobics
d. Bike riding
ANS: C
Water activities are good exercise alternatives for people with musculoskeletal limitations who need some weight relief with exercise. The water provides buoyancy while also providing resistance to the limbs as they move. Studies have also demonstrated that people who participate in aquatic exercise experienced greater pain reduction than those who participated in land activities. Thus, water aerobics would be the most appropriate form of exercise for this individual.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 275 | p. 282

15. A nurse is providing care to a person who has lower back pain. Which of the following exercises would the nurse recommend to assist with pain reduction?
a. Walking
b. Pilates
c. Swimming
d. Bike riding
ANS: B
Maintaining proper curves of lordosis and kyphosis in the vertebrae is important for sustaining the spring and shock absorption quality of the spine. Poor posture can increase stress on the back and lead to pain. Exercises that train the paraspinal muscles to improve posture (like Pilates) are effective for people with lower back pain. Aerobic activity is recommended to maintain endurance and prevent debilitation from inactivity.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 276

16. Which of the following statements about exercise is true?
a. People who engage in high-intensity exercise are at lowest risk for illness.
b. Aerobic exercise should be part of daily exercise routines.
c. Regular exercise may cause people to experience fatigue and increased susceptibility to mental health disorders.
d. Low-level physical activity may have a protective effect on gastric and pancreatic cancer.
ANS: D
Low-level physical activity may have a protective effect on gastric and pancreatic cancer. People who engage in moderate-intensity activity are at lowest risk for illness, whereas those who engage in high-intensity activity are at higher risk for illness. Aerobic exercise is recommended at a frequency of three to five times per week. Every other day is a good frame of reference as it allows for recovery between training sessions. Cross-training is recommended as part of daily exercise routines. Regular exercise promotes positive well-being and decreased susceptibility to mental health disorders.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 278

17. A nurse is monitoring the exercise of a 42-year-old woman. Which of the following would be the estimated maximum heart rate (MHR) for this woman?
a. 126
b. 142
c. 178
d. 184
ANS: C
A generic formula for determining MHR is 220 minus age: 220 42 = 178.

DIF: Cognitive Level: Apply (Application) REF: p. 279

18. A nurse is counseling a 40-year-old person who is going to start an exercise program. Which of the following heart rate ranges would the nurse encourage the person to maintain while exercising?
a. 70 to 140 beats/min
b. 80 to 143 beats/min
c. 90 to 153 beats/min
d. 100 to 180 beats/min
ANS: C
The maximum heart rate for a 40-year-old is 180. Exercise should produce a heart rate that is 50% to 85% of maximum heart rate. This percentage corresponds to a rate of perceived exertion of 11 to 14: 50% of 180 = 90, 85% of 180 = 153. Thus, the range should be 90 to 153.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 279 | p. 281

19. A nurse is discussing exercise intensity with a client. Which of the following medications that the client is taking may limit the usefulness of heart rate as an indicator of exercise intensity?
a. Ciprofloxacin (Cipro)
b. Metoprolol (Toprol)
c. Atorvastatin (Lipitor)
d. Lansoprazole (Prevacid)
ANS: B
Beta-blockers may alter the relationship between heart rate and the rate of perceived exertion. Metoprolol is a beta-blocker and thus may limit the usefulness of heart rate as an indicator of exercise intensity.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 281

20. The nurse is discussing an exercise prescription with a person. To help him determine the appropriate intensity, the nurse tells him that he should monitor his rate of perceived exertion. Which of the following should the nurse tell the man he should experience while exercising?
a. Talking and singing without difficulty
b. Feeling extremely fatigued
c. Having mild musculoskeletal discomfort
d. Being out of breath
ANS: C
The rate of perceived exertion helps people determine a comfortable, beneficial level of exercise intensity. Being slightly short of breath, able to talk with difficulty, being pleasantly fatigued, and having mild musculoskeletal pain reflect a rate of perceived exertion that corresponds well with 50% to 85% of maximum heart rate, an appropriate target range for most individuals.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 281

21. A nurse is discussing resistance training with a 24-year-old woman. The woman is resistant to weight lifting because she does not want to get too muscular. She prefers a program that is strictly aerobic. Which of the following would be the most appropriate response from the nurse?
a. Ok, just make sure you perform one hour of aerobics every day.
b. Lifting weights is a necessary part of exercise.
c. Weight lifting has many purposes and benefits; can we talk about them?
d. Looking muscular at your age is attractive.
ANS: C
Weight training helps develop healthy muscles that provide strength to perform activities of daily living (ADLs) without injury and it stimulates bone health. Additionally, the risk of injury outweighs the benefits of aerobic exercise more than 5 days a week. Not all weight lifting leads to a bodybuilder physique. Offering the patient the opportunity to discuss weight training will allow the patient the opportunity to open up and discuss fears and concerns. It also provides the nurse with the opportunity to discuss the risks and benefits.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 279 | p. 282

22. An inborn set of physiological changes that offset those of the fight or flight response is known as:
a. Self-efficacy
b. Catecholamine surge
c. Relaxation response
d. Metabolism
ANS: C
Relaxation response is an inborn set of physiological changes that offset those of the fight or flight response.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 283

23. A nurse is caring for a man who states he is ready to start exercising. Which of the following actions should the nurse take next?
a. Do nothing because he has already made the decision to implement a change.
b. Provide him with information on the benefits of exercising.
c. Develop an exercise prescription with him.
d. Schedule a follow-up in 2 months to see if he still feels the same way.
ANS: C
Working with a person to choose an activity that he likes will improve adherence. The person is displaying that he is in the action phase of change, and he should be given a prescription that promotes exercise and places him in the maintenance phase.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 288

24. A nurse is counseling a 19-year-old person who has recently been diagnosed with Type 1 diabetes mellitus. The person asks if there is anything specific that should be done before going to play tennis with a friend. Which of the following instructions should the nurse give the person to avoid hypoglycemia?
a. Inject the insulin into the abdomen.
b. Inject the insulin into the arm.
c. Inject the insulin into the thigh.
d. Skip taking any insulin before exercising.
ANS: A
When insulin is injected in a muscle that will be active, it will speed up the absorption of insulin and quickly decrease blood glucose. Because tennis involves a lot of leg and arm movement, insulin should be given in the abdomen. Additionally, not all insulins have the same onset or duration of action. Changes in insulin dosage schedules should not be made without knowing the onset or duration of action.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 287 (Box 12-10)

25. A woman is going for a 2-hour hike in the Grand Canyon and she asks the nurse how much fluid she should take along with her. Which of the following recommendations should be given by the nurse?
a. Bring at least 24 ounces of water.
b. Bring at least 72 ounces of water.
c. Bring at least 24 ounces of sports drink.
d. Bring at least 72 ounces of sports drink.
ANS: D
If the weather is hot, 5 to 12 oz of fluid should be taken every 15 to 20 minutes during exercise. Additionally, if exercise lasts more than 1 hour, a drink that provides carbohydrates and electrolytes helps delay fatigue and improve performance.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 284

26. An occupational health nurse is trying to promote regular activity at her institution. Which of the following interventions would most likely be the most successful?
a. Educate all employees regarding the benefits of exercise.
b. Initiate a lunchtime walking group that employees can join.
c. Provide all employees with an exercise prescription.
d. Recommend that employees who do not exercise be terminated from their positions.
ANS: B
Individuals are more likely to initiate and maintain physical activity if they feel competent doing the activity, feel safe doing it, perceive no negative financial or social cost, can access the activity easily on a regular basis, and can fit the activity into their regular schedule. Knowledge is not enough to sustain activity. Role models are helpful. Initiating a lunchtime walking group demonstrates enthusiasm on the part of the nurse, provides an activity that is easy and mastered by most and provides a social activity that can promote reinforcement by others who participate.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 281 | p. 288

MULTIPLE RESPONSE

1. A nurse is providing an educational program addressing the importance of being physically active. The nurse states that individuals should engage in exercise for a minimum of 30 minutes of activity on most days of the week. For which of the following individuals is that recommendation appropriate? (select all that apply)
a. A 54-year-old with hypercholesterolemia
b. A 66-year-old with hypertension
c. A 48-year-old with obesity
d. A 58-year-old with Type 2 diabetes mellitus
ANS: A, B, D
The risk of CHD decreases with an increase in physical activity. Exercise positively affects lipoprotein metabolism and is a common part of the treatment for hypertriglyceridemia. Regular exercise also decreases blood pressure in adults. Exercise improves glycemic control by increasing insulin sensitivity in people with Type 2 diabetes mellitus. The Physical Activity Guidelines for Americans advise adults to perform at least 150 minutes of moderate intensity or 75 minutes of vigorous activity per week. Exercise also has a positive effect on obesity. However, the American College of Sports Medicine recommends a minimum of 40 to 60 minutes of exercise 5 to 7 days a week for those with obesity.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 266 | pp. 268-269 | p. 272

2. A nurse is reviewing an exercise prescription for a person. Which of the following aspects should be included? (select all that apply)
a. Frequency of exercise
b. Intensity level of exercise
c. Time and duration of exercise
d. Type of exercise
ANS: A, B, C, D
An exercise prescription should include frequency of exercise, intensity level of exercise, time and duration of exercise, and type of exercise.

DIF: Cognitive Level: Apply (Application) REF: p. 279

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