Chapter 36: Activity and Exercise Nursing School Test Banks

Potter & Perry: Fundamentals of Nursing, 6th Edition

MULTIPLE CHOICE

1. A client has been on bed rest for a prolonged period specifically to promote the use of resistive isometric exercise for the client, the nurse will initiate:

a.

Quadriceps setting

b.

Gluteal muscle contraction

c.

Moving the arms and legs in circles

d.

Pushing against a footboard

ANS: d

d. Resistive isometric exercises are those in which the individual contracts the muscle while pushing against a stationary object or resisting the movement of an object. An example of a resistive isometric exercise is pushing against a footboard.

a. Quadriceps setting is an example of an isometric exercise.

b. Gluteal muscle contraction is an example of an isometric exercise.

c. Moving the arms and legs in a circle is an example of isotonic exercise.

REF: Text Reference: p. 932

2. The nurse is assessing the body alignment of an alert and mobile client. The first action that the nurse should take is to:

a.

Observe gait

b.

Put the client at ease

c.

Determine activity tolerance

d.

Determine range of joint motion

ANS: b

b. The first step in assessing body alignment is to put the client at ease so that unnatural or rigid positions are not assumed.

a. When assessing body alignment, the nurses first action is to put the client at ease. Later the nurse may assess the clients gait to observe the clients balance, posture, and ability to walk without assistance.

c. Activity tolerance is the kind and amount of exercise or activity a person is able to perform. It is not the first step in assessing a clients body alignment.

d. Assessing ROM is one of the first assessment techniques used to determine the degree of damage or injury to a joint. It is not the first step in assessing a clients body alignment.

REF: Text Reference: p. 937

3. An average size male client has right-sided hemiparesis. The nurse helps this client to walk by:

a.

Standing at his left side and holding his arm

b.

Standing at his left side and holding one arm around his waist

c.

Standing at his right side and holding his arm

d.

Standing at his right side and holding one arm around his waist

ANS: d

d. The nurse provides support at the waist so that the clients center of gravity remains at the midline. The nurse should be on the clients weaker side to assist him with ambulation.

a. The nurse should hold onto the clients waist, not his arm, and should be on his weaker side, not his strong side.

b. The nurse should be on the clients weaker side.

c. The nurse should hold onto the clients waist to help steady him in maintaining his center of gravity midline so that he does not lose his balance and fall.

REF: Text Reference: p. 948

4. The nurse is working with a client who has left-sided weakness. After instruction, the nurse observes the client ambulate to evaluate the use of the cane. Which action indicates that the client knows how to use the cane properly?

a.

The client keeps the cane on the left side.

b.

Two points of support are kept on the floor at all times.

c.

A slight lean to the right occurs when the client is walking.

d.

After advancing the cane, the client moves the right leg forward.

ANS: b

b. Two points of support, such as both feet or one foot and the cane, should be on the floor at all times.

a. The cane should be kept on the stronger side, the clients right side.

c. The client should keep his or her body upright and midline. Leaning can cause the client to lose his or her balance and fall.

d. After advancing the cane, the client should move the weaker leg, the clients left leg, forward to the cane.

REF: Text Reference: p. 948

5. A client with a fractured left femur has been using crutches for the past 4 weeks. The physician tells the client to begin putting a little weight on the left foot when walking. Which of the following gaits should the client be taught to use?

a.

Two-point

b.

Three-point

c.

Four-point

d.

Swing-through

ANS: a

a. The two-point gait requires at least partial weight bearing on each foot. The client moves a crutch at the same time as the opposing leg, so that the crutch movements are similar to arm motion during normal walking.

b. In a three-point gait, weight is borne on both crutches and then on the uninvolved leg.

c. The four-point gait gives stability to the client but requires weight bearing on both legs. Each leg is moved alternately with each opposing crutch so that three points of support are on the floor at all times. This client is supposed to use only partial weight bearing, so this gait would not be appropriate.

d. Paraplegics who wear weight-supporting braces on their legs use the swing-through gait. It would not be appropriate for this client.

REF: Text Reference: p. 951

6. The client needs to use crutches at home and will have to manage going up and down a short flight of stairs. The nurse evaluates the use of an appropriate technique if the client:

a.

Uses a banister or wall for support when descending

b.

Uses one crutch for support while going up and down

c.

Advances the crutches first to ascend the stairs

d.

Advances the affected leg after moving the crutches to descend the stairs

ANS: d

d. To descend stairs, the client places the crutches on the stairs, and the client moves the affected leg and then the unaffected leg to the stairs with the crutches.

a. The client should continue to use the crutches for support, not the banister or wall.

b. The client should continue to use both crutches for support when going up or down stairs.

c. When ascending stairs, the client moves the unaffected leg up the stair and then the crutches and affected leg.

REF: Text Reference: p. 951

7. While ambulating in the hallway of a hospital, the client complains of extreme dizziness. The nurse, alert to a syncopal episode, should first:

a.

Support the client and walk quickly back to the room

b.

Lean the client against the wall until the episode passes

c.

Lower the client gently to the floor

d.

Go for help

ANS: c

c. If the client has a syncopal episode or begins to fall, the nurse should assume a wide base of support with one foot in front of the other, supporting the clients weight, and then extend the leg allowing the client to slide against the leg gently lowering the client to the floor and protecting the clients head.

a. The nurse should not attempt to walk the client quickly back to the room.

b. The nurse should not lean the client against a wall as he or she might fall.

d. The nurse should not leave the client alone and go for help.

REF: Text Reference: p. 948

8. Nurses must implement appropriate body mechanics to prevent injury to themselves and clients. Which principle of body mechanics should the nurse incorporate into client care?

a.

Flex the knees, and keep the feet wide apart

b.

Assume a position far enough away from the client

c.

Twist the body in the direction of movement

d.

Use the strong back muscles for lifting or moving

ANS: a

a. Flexing the knees and keeping the feet wide apart provides a broad base of support and increases stability.

b. The nurse should position himself or herself close to the client or object being lifted to minimize the force (10 pounds held at waist height close to the body is equal to 100 pounds held at arms length). Having the client or object close to the center of gravity also helps maintain balance.

c. Twisting should be avoided, as it increases the risk of back injury.

d. The leg muscles should be used for lifting or moving. They are stronger, larger muscles capable of greater work without injury.

REF: Text Reference: p. 946

9. The nurse is presenting a teaching session on exercise for a group of corporate executives. An appropriate recommendation is that:

a.

Continuous activity is required for the exercise to be worthwhile.

b.

3000 to 4000 calories may be easily expended each week.

c.

Lower-intensity activities need to be done more often for value.

d.

Only formal exercise activities are counted in a regular plan.

ANS: c

c. Lower-intensity activities should be done more often, for longer periods, or both.

a. The activity does not have to be continuous; benefits can be realized with short bouts of activity over the course of the day.

b. This is inaccurate because 1000 to 1400 calories may be easily expended each week.

d. All types of activity can be applied in an exercise plan; it does not have to be formal exercises.

REF: Text Reference: p. 945

10. After an assessment of the client, the nurse identifies the nursing diagnosis: Activity intolerance related to increased weight gain and inactivity. An outcome identified by the nurse should be:

a.

Resting heart rate will be 90 to 100 beats per minute

b.

Blood pressure will be maintained between 140/80 and 160/90

c.

Exercise will be performed 3 to 4 times over the next 2-week period

d.

Achievement of a rating of 3 for activity endurance

ANS: c

c. An appropriate outcome for Activity intolerance related to increased weight gain and inactivity is that the client will perform exercise 3 to 4 times over the next 2-week period. This outcome is realistic, measurable, and addresses the problem.

a. A resting heart rate of 90 to 100 beats per minute is too high, and it does not address the need to increase activity.

b. This outcome does not state whether this blood pressure is at rest or after exercising. It also does not address the need to increase activity.

d. A more appropriate outcome is that the client will increase his or her activity (over the next 2-week period).

REF: Text Reference: p. 940

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