Question 1

A nurse is caring for a patient with a neuromuscular condition.The nurse needs to assess the patient's muscle movement and strength.In doing so,the nurse recalls that chemicals that transfer electrical impulses from the nerve across the myoneural junction are called which of the following?
A) Isometrics
B) Synergistics
C) Proprioceptors
D) Neurotransmitters

Accepted Answer

Transmission of the impulse from the nervous system to the musculoskeletal system is an electrochemical event that requires a neurotransmitter,a chemical that transfers the electric impulse from the nerve to the muscle.Isometrics is a type of exercise using muscles.Synergistics are opposite effects.Proprioceptors are located in nerve endings.

Question 2

A nurse is caring for a patient with a broken tibia and fibula.The patient is in a half cast to his knee and is unable to bear weight.The nurse has instructed the patient on how to walk and climb stairs with his injuries.What is the best way to assess the patient's knowledge of how to ascend and descend stairs?
A) Incorrectly re-demonstrate the procedure and have the patient point out any errors.
B) Have the family member explain the procedure.
C) Have the patient explain the procedure.
D) Have the patient demonstrate the procedure.

Accepted Answer

Ensuring patient safety is an essential role of the professional nurse.To ensure patient safety,communicate clearly with members of the health care team,assess and incorporate the patient's priorities of care and preferences,and use the best evidence when making decisions about your patient's care.Explain the procedure,and describe what you expect of the patient.Demonstration is the most accurate way for the nurse to assess understanding of the skill.

Question 3

A patient presents to the emergency department with a fractured leg that requires a full leg cast.The nurse needs to teach the patient to ambulate with crutches using which of the following?
A) Two-point gait
B) Three-point gait
C) Four-point gait
D) Tripod alternating position

Accepted Answer

Three-point gait requires the patient to bear all of the weight on one foot.In a three-point gait,the patient puts weight on both crutches and then on the uninvolved leg.A two-point gait requires at least partial weight bearing on each foot.A four-point gait gives stability to the patient but requires weight bearing on both legs.The tripod position is the basic crutch stance.

Question 4

The nurse manager is concerned with the safety of the staff as they transfer patients.Facility policy reinforces the principles of appropriate body mechanics,which include which of the following? (Select all that apply.)
A) A wide base of support increases stability
B) A higher center of gravity increases stability
C) Facing the direction of movement prevents abnormal twisting of the spine
D) Pivoting requires less work than lifting
E) Manually lift the patient in sections
F) Dividing balanced activity between arms and the legs

Accepted Answer

Principles of body mechanics include the following: A wide base of support increases stability; a lower center of gravity increases stability; the equilibrium of an object is maintained when the line of gravity passes through its base of support; facing the direction of movement prevents abnormal twisting of the spine; dividing balanced activity between arms and legs reduces the risk for back injury; and leverage,rolling,turning,or pivoting requires less work than lifting.Manual lifting is the last resort,and it is only used when it does not involve lifting most or all of the patient's weight.

Question 5

A nurse is assisting a patient with right-sided hemiplegia to transfer from the bed to a chair.The most appropriate action for the nurse is to do which of the following?
A) Use a transfer belt.
B) Grab the patient under the arms while assisting with the transfer.
C) Stand on the unaffected side of the patient to ensure less strain on the nurse's back.
D) Encourage the patient not to use the hand rests because of their restrictions on movement.

Accepted Answer

A patient with neurological deficits sometimes has paresis (muscle weakness)or paralysis unilaterally or bilaterally,which complicates safe transfer.A flaccid arm sustains injury during transfer if unsupported.As a general rule,use a transfer belt and obtain assistance for mobilization of such patients.Use patient-handling equipment and devices,such as height-adjustable beds,ceiling-mounted lifts,friction-reducing slide sheets,air-assisted devices,and encourage the patient to help as much as possible.Grasping the patient under his or her arms could cause damage to this delicate area and does not allow for a firm hold,as the arms could lift up.A transfer belt is more secure.Always be aware of the patient's motor deficits,ability to aid in transfer,and body weight.As a rule of thumb,GET HELP to transfer a patient.

Question 6

Which of the following actions are effective in reducing friction when repositioning a patient in bed? (Select all that apply.)
A) Lifting rather than pushing
B) Pushing the patient up in bed
C) Asking the patient to bend his or her knees and lift the hips when moving up in bed
D) Asking the patient to lie still as you reposition him or her; even when the patient offers to help
E) The use of a draw sheet
F) The use of a transfer board

Accepted Answer

You reduce friction by lifting rather than pushing a patient.Lifting has an upward component and decreases the pressure between the patient and the bed or chair.The use of a draw sheet reduces friction because you are able to move the patient more easily along the bed's surface.However,there are several commercially available products to assist in the task of positioning and moving patients in bed such as transfer boards and Maxi Slides.Pushing the patient up in bed is incorrect because pushing increases the friction between the patient and the bed.Asking the patient to lie still is incorrect because a passive or immobilized patient produces greater friction to movement.

Question 7

The nurse delegates the task of ambulating a patient to the assistive personnel.The nurse ascertains that the assistive personnel understands how to intervene when the patient complains of dizziness when the assistive personnel verbalizes which of the following?
A) "I call for help."
B) "I gently lower the patient to the floor."
C) "I support the patient and walk quickly back to the room."
D) "I lean the patient against the wall and wait until the episode passes."

Accepted Answer

When a patient begins to fall,the nurse should assume a wide base of support with one foot in front of the other to support the patient's weight,gently lower the patient to the floor,and protect the patient's head.Assess the patient for injuries at this time and notify the patient's health care provider.Even if the patient is stable,get the assistance of a lift team to help you get the patient off the floor and back in bed or a chair.

Question 8

A patient with arthritis is complaining of sensitivity and warmth in the elbow and wrist joints.To determine the degree of limitation or injury,the nurse can assess which of the following?
A) Posture
B) Activity tolerance
C) Body mechanics
D) Range of motion

Accepted Answer

The easiest intervention to maintain or improve joint mobility for patients and one that you are able to coordinate with other activities is the use of range-of-motion exercises.Joints that are not moved periodically develop contractures,a permanent shortening of a muscle followed by the eventual shortening of associated ligaments and tendons.Over time the joint becomes fixed in one position,and the patient loses normal use of the joint.The term posture means maintaining optimal body position.Activity tolerance assesses the patient's ability to become fatigued,lightheaded,dizzy,or short of breath related to activity.Body mechanics require knowledge of proper walking,turning,and lifting and carrying objects in a way to prevent injury.

Question 9

A nurse is caring for a patient with osteogenesis imperfecta.The nurse needs to assess the patient's muscle movement and strength.In doing so,the nurse recalls that osteogenesis imperfecta is characterized by fractures and bone deformities.This condition is known as which of the following?
A) A form of osteoporosis
B) A form of arthritis
C) A congenital defect
D) A neurological defect

Accepted Answer

Osteogenesis imperfecta is a congenital defect that affects the bone.Osteoporosis is a well-known and well-publicized disorder of aging in which the density or mass of bone is reduced.Inflammatory and noninflammatory joint diseases and articular disruption all alter joint mobility.Some characteristics of inflammatory joint disease (e.g.,arthritis)are inflammation or destruction of the synovial membrane and articular cartilage and systemic signs of inflammation.Damage to any component of the central nervous system that regulates voluntary movement results in impaired body alignment and mobility.

Question 10

Which of the following trouble points are common in the side-lying position? (Select all that apply.)
A) Lack of support for the feet
B) Lack of protection for pressure points for the ears, shoulders, anterior iliac spine, trochanter, and ankles
C) Adduction of the shoulder and hip joints
D) Hyperextension of the neck
E) Spinal curves out of normal alignment

Accepted Answer

The following are trouble points that are common in the side-lying position:
•Lateral flexion of the neck
•Spinal curves out of normal alignment
•Shoulder and hip joints internally rotated,adducted,or unsupported
•Lack of support for the feet
•Lack of protection for pressure points at the ear,shoulder,anterior iliac spine,trochanter,and ankles
•Excessive lateral flexion of the spine if the patient has large hips and a pillow is not placed superior to the hips at the waist

Quiz 27: Exercise and Activity

A nurse is caring for a patient with a neuromuscular condition.The nurse needs to assess the patient's muscle movement and strength.In doing so,the nurse recalls that chemicals that transfer electrical impulses from the nerve across the myoneural junction are called which of the following?

A patient presents to the emergency department with a fractured leg that requires a full leg cast.The nurse needs to teach the patient to ambulate with crutches using which of the following?

The nurse manager is concerned with the safety of the staff as they transfer patients.Facility policy reinforces the principles of appropriate body mechanics,which include which of the following? (Select all that apply.)

A nurse is assisting a patient with right-sided hemiplegia to transfer from the bed to a chair.The most appropriate action for the nurse is to do which of the following?

Which of the following actions are effective in reducing friction when repositioning a patient in bed? (Select all that apply.)

The nurse delegates the task of ambulating a patient to the assistive personnel.The nurse ascertains that the assistive personnel understands how to intervene when the patient complains of dizziness when the assistive personnel verbalizes which of the following?

A patient with arthritis is complaining of sensitivity and warmth in the elbow and wrist joints.To determine the degree of limitation or injury,the nurse can assess which of the following?

A nurse is caring for a patient with osteogenesis imperfecta.The nurse needs to assess the patient's muscle movement and strength.In doing so,the nurse recalls that osteogenesis imperfecta is characterized by fractures and bone deformities.This condition is known as which of the following?

Which of the following trouble points are common in the side-lying position? (Select all that apply.)