Chapter 24- Mobility Nursing School Test Banks

 

1.

To assess a potential injury to a patients wrist, the examiner asks the patient to turn the hand and forearm upward. This movement is referred to as which of the following?

A)

Pronation

B)

Supination

C)

Inversion

D)

Exversion

Ans:

B

Feedback:

Pronation refers to turning a body or a body part to face downward. Turning the body or a body part to face upward is known as supination. Inversion refers to the turning of the feet inward so toes point toward the midline. Exversion refers to turning the feet outward so toes point away from the midline.

2.

The nurse is assessing a patient who has presented at the ambulatory care unit. The nurse notes the patient has impaired muscle coordination. The nurse correctly documents the presence of which of the following?

A)

Ataxia

B)

Tremors

C)

Chorea

D)

Athetosis

Ans:

A

Feedback:

Ataxia refers to a lack of muscle coordination. Tremors are rhythmic repetitive movements. Chorea is spontaneous, brief, involuntary muscle twitching of the limbs or facial muscles. Athetosis refers to movement characterized by slow, irregular, twisting motions.

3.

The nurse is caring for a patient 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)

Bedrest

C)

Preoperative exercise

D)

Frequent turning in bed in the postoperative period

Ans:

A

Feedback:

Immobility promotes venous stasis, which contributes to the development of DVT. When leg muscles are inactive, venous return to the heart decreases. Ambulation will reduce the incidence of DVT. Bedrest increases the incidence of DVT. Exercising prior to surgery does reduce complications but not as much as early ambulation in the postoperative period. Frequent turning is helpful to reduce respiratory complications and the onset of pressure ulcers.

4.

A patient is discharged to his daughters home. He weighs 250 pounds 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

Ans:

C

Feedback:

A hydraulic lift is a mechanical device that permits a patient to be transferred from the bed to a chair.

5.

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

A)

Turning on the affected side

B)

Crossing the legs when sitting

C)

Sitting at a 90-degree angle

D)

Maintaining abduction

Ans:

D

Feedback:

The nurse should take special care to prevent adduction of the affected leg and hip. To avoid this, some orthopedic surgeons order abductor pillows.

6.

A patient who is postoperative from a hip fracture repair should be turned on the

A)

Unaffected side

B)

Affected side

C)

Stomach

D)

Back

Ans:

A

Feedback:

Turn patients who have had hip replacement surgery on the nonoperative side only.

7.

Log rolling requires the nurse to use supportive devices in turning the patient to

A)

Maintain the natural alignment of the body

B)

Allow the patients leg to rest on the bed

C)

Decrease the chance for skin breakdown

D)

Prevent the stasis of urine in the bladder

Ans:

A

Feedback:

Logrolling is a technique used for turning patients who have had surgery or an injury involving the back or spine.

8.

A patient who is immobile complains of severe pain in the right flank. The physician diagnoses the patient with renal calculi. This condition often results from

A)

Increased serum calcium

B)

Decreased serum calcium

C)

Increased serum phosphorous

D)

Decreased serum phosphorous

Ans:

A

Feedback:

Urinary stasis and an increased serum calcium level promote the formation of renal calculi.

9.

An elderly man who suffered a hip fracture and is 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 DVT

Ans:

D

Feedback:

Use of heparin prophylactically has been shown to decrease the incidence of DVTs in the immobile patient.

10.

A young adult woman has had orthopedic surgery on her right knee. The first time she gets out of bed, she describes weakness, dizziness, and feeling faint. The nurse correctly recognizes which of the following conditions is likely affecting the patient?

A)

Thrombophlebitis

B)

Anemia

C)

Orthostatic hypotension

D)

Bradycardia

Ans:

C

Feedback:

Orthostatic hypotension refers to a reduction in blood pressure with position changes from lying to sitting or standing. Blood pooling in the legs increases, thus increasing the postural hypotension. Thrombophlebiits refers to an inflammation of the veins. It manifests with redness and swelling. Anemia refers to a reduction in hemoglobin. This may present with feelings of weakness. Bradycardia refers to a reduced heart rate.

11.

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

A)

Decubitus ulcers

B)

Pooling of blood

C)

Blood pressure changes

D)

Foot drop

Ans:

D

Feedback:

A footboard or boots should be applied to maintain dorsiflexion and tendon flexibility. Foot drop is a contracture in which the foot is fixed in plantar flexion.

12.

A flexion contracture 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

Ans:

A

Feedback:

Flexion contractures are most common in immobilized patients. Flexor muscles are usually stronger than their extensor counterparts. Common flexor contractures occur at the joints of the elbow, hip, knee, shoulder, wrist, and ankles.

13.

A patient with asthma tries to jog a mile but cannot finish and complains of 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

Ans:

A

Feedback:

Commonly, disorders that affect oxygenation, such as respiratory or cardiac problems, decrease a patients ability to tolerate increases in activity.

14.

Which of the following gaits is characterized by one leg being dragged and swung forward by hip motion?

A)

Festinating

B)

Spastic

C)

Hemiplegic

D)

Waddling

Ans:

C

Feedback:

A hemiplegic gait occurs when one leg is paralyzed or neurologically damaged, so that the leg is dragged or swung around to propel it forward.

15.

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

A)

Altered gait

B)

Prone to fractures

C)

Suffer from edema

D)

Muscle atrophy

Ans:

D

Feedback:

Disuse may be accompanied by muscle atrophy, which is a decrease in muscle size.

16.

When the 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 patient is experiencing

A)

Depression

B)

Dementia

C)

Sensory overload

D)

Sensory deprivation

Ans:

A

Feedback:

Severe affective disorders can hinder mobility. Depression and catatonic states result in limited mobility not because of physical impairments, but because the person lacks the desire to move.

17.

A 20-year-old man driving a motorcycle loses control and hits a tree. He states I cannot feel my arms or legs. He will likely receive the diagnosis of

A)

Paraplegic

B)

Hemiplegic

C)

Monoplegic

D)

Tetraplegic

Ans:

D

Feedback:

Tetraplegia describes paralysis of the arms and legs.

18.

An 82-year-old woman is taking medication for her blood pressure and is suffering from syncope. She is at risk for

A)

Edema

B)

Stroke

C)

Fractures

D)

Paralysis

Ans:

C

Feedback:

Motor ability depends on the integrity of the multisynaptic pathways of the afferent and efferent nerves and the central integration provided by the cerebral cortex. Balance and stability are the products of equilibrium, which can be affected by some medications.

19.

When an elderly patient walks with her knees slightly flexed and body leaning, the nurse determines that the patient

A)

Should have an orthopedic consultation

B)

Is demonstrating a common gait for the elderly

C)

Requires a better walking shoe

D)

Requires crutches for mobility

Ans:

B

Feedback:

Many older people have more difficulty overcoming inertia and using gravity efficiently. One contributing factor is the shift in the center of gravity. To compensate for this shift, the knees flex slightly for support.

20.

A patient has been smoking for more than 40 years. He developed a bone tumor in the right hip. What is the greatest risk the patient may experience?

A)

Fracture

B)

Pain

C)

Immobility

D)

Numbness

Ans:

A

Feedback:

The bone tumor may cause pain, but the demineralization of the bone will cause hip fracture.

21.

To compensate for the shift in the center of gravity, an older adult will

A)

Shift weight to the right side

B)

Shift weight to the left side

C)

Use a wider base of support

D)

Flex the knees for support

Ans:

D

Feedback:

Many older people have more difficulty overcoming inertia and using gravity efficiently. One contributing factor is the shift in the center of gravity. To compensate for this shift, the knees flex slightly for support.

22.

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

Ans:

D

Feedback:

Hip dislocation/subluxation can occur any time during the first year of life. Assessing all infants for hip abnormalities during well-baby examinations is crucial.

23.

An orthopedic patient 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

Ans:

A

Feedback:

Isometric exercise is static exercise by which the patient tenses a muscle, holding it stationary while maintaining tension.

24.

Patients with fractures, back surgeries, or joint replacements should be instructed to

A)

Use a pull sheet with movement

B)

Log roll to the side of the bed

C)

Use the overhead trapeze

D)

Pull up with the headboard

Ans:

C

Feedback:

Overhead trapezes may provide handholds for orthopedic patients.

25.

When a patient is lifted or held by a nurse, the additional weight becomes a part of the nurses 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

Ans:

D

Feedback:

Maintaining balance involves keeping the spine in vertical alignment, the feet positioned for a broad base of balance, and the body weight close to the center of gravity.

26.

The proper use of the principles of body mechanics

A)

Acts as a safeguard against legal action by the patient

B)

Acts to prevent injury to the patient and/or nurse

C)

Primarily protects the patient from injury

D)

Primarily protects the nurse from injury

Ans:

B

Feedback:

When nurses use their bodies to perform therapies, to assist patients with movement, or to move equipment, they benefit from the effective use of body mechanics to prevent injury to themselves and others.

27.

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

Ans:

A

Feedback:

Equilibrium is provided mainly by the vestibular apparatus consisting of the cochlear duct, the three semicircular canals, and two large chambers known as the utricle and saccule.

28.

When the patient restricts use of her dominant arm because of pain and the nurse notes that the measurement of the circumference of the patients nondominant arm is greater than her dominant arm, the nurse determines that the lack of use has resulted in the dominant arms

A)

Atrophy

B)

Hypertrophy

C)

Dystrophy

D)

Malrotation

Ans:

A

Feedback:

Atrophy causes the muscle to decrease in strength and size because of disuse.

29.

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

A)

Potassium

B)

Calcium

C)

Sodium

D)

Chloride

Ans:

B

Feedback:

The transmitting activity occurs when calcium is released into the sarcoplasmic reticulum (site of storage and release for calcium in the muscle), which initiates a complex series of biochemical events that result in muscle contraction.

30.

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

A)

She can lift the right arm 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

Ans:

A

Feedback:

Permanent changes in mobility occur when physiologic dysfunction that interferes with normal body movement cannot be reversed (e.g., spinal cord injuries that result in paralysis or cerebrovascular accidents that cause weakness or paralysis on one side of the body). Rehabilitation is the key to restoring a person with certain disabilities to optimal health.

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