Question 1

The nurse is assessing a client and notes resistance of the elbow joints to passive movement. In which way should the nurse describe this finding?&#10;A) Spastic&#10;B) Rigid&#10;C) Frozen&#10;D) Immobile

Accepted Answer

1. Spasticity is a sudden, prolonged involuntary muscle contraction.
2. A joint that is resistant to passive movement is considered rigid.
3. Frozen implies that the joint will not move.
4. Immobile is not a term used to describe joint mobility.

Question 2

The nurse is performing range of motion on a client. On which joint should the nurse use circumduction?&#10;A) Neck&#10;B) Shoulder&#10;C) Foot&#10;D) Knee

Accepted Answer

1. Circumduction is movement in a circle while the proximal end remains fixed. The two joints that are circumducted are the shoulder and the hip. The foot and neck cannot make a complete circle, whereas the knee does not rotate in that manner.
2. Circumduction is movement in a circle while the proximal end remains fixed. The two joints that are circumducted are the shoulder and the hip. The foot and neck cannot make a complete circle, whereas the knee does not rotate in that manner.
3. Circumduction is movement in a circle while the proximal end remains fixed. The two joints that are circumducted are the shoulder and the hip. The foot and neck cannot make a complete circle, whereas the knee does not rotate in that manner.
4. Circumduction is movement in a circle while the proximal end remains fixed. The two joints that are circumducted are the shoulder and the hip. The foot and neck cannot make a complete circle, whereas the knee does not rotate in that manner.

Question 3

The nurse caring for several clients could safely assign which task to the assistive personnel (AP)?&#10;A) Initial application of the continuous positive motion (CPM) device to the postoperative client&#10;B) Assessment of client's tolerance for passive range of motion&#10;C) Documentation of joint improvement resulting from active range of motion&#10;D) Performance of passive range of motion to client experiencing a CVA 2 weeks ago

Accepted Answer

1. The AP can safely perform passive range of motion on a stable client if educated in the skill. Initial application of the CPM, and assessing a client's tolerance or progress, must be performed by the nurse.
2. The AP can safely perform passive range of motion on a stable client if educated in the skill. Initial application of the CPM, and assessing a client's tolerance or progress, must be performed by the nurse.
3. The AP can safely perform passive range of motion on a stable client if educated in the skill. Initial application of the CPM, and assessing a client's tolerance or progress, must be performed by the nurse.
4. The AP can safely perform passive range of motion on a stable client if educated in the skill. Initial application of the CPM, and assessing a client's tolerance or progress, must be performed by the nurse.

Question 4

The nurse is assigning the performance of passive range of motion to the assistive personnel (AP). For which client should the nurse complete this task?&#10;A) Client who has been a quadriplegic for 3 years&#10;B) Unconscious client following excision of a brain tumor 2 days ago&#10;C) Client in rehabilitation center recovering from a CVA&#10;D) Client in a chronic vegetative state following a motor vehicle crash

Accepted Answer

1. The client who is unconscious following recent brain surgery is at risk for increased intercranial pressure, so passive range of motion should be performed only while constantly assessed for signs of increased pressure. This client could not be safely assigned to an AP. The remaining clients could be safely assigned to the AP.
2. The client who is unconscious following recent brain surgery is at risk for increased intercranial pressure, so passive range of motion should be performed only while constantly assessed for signs of increased pressure. This client could not be safely assigned to an AP. The remaining clients could be safely assigned to the AP.
3. The client who is unconscious following recent brain surgery is at risk for increased intercranial pressure, so passive range of motion should be performed only while constantly assessed for signs of increased pressure. This client could not be safely assigned to an AP. The remaining clients could be safely assigned to the AP.
4. The client who is unconscious following recent brain surgery is at risk for increased intercranial pressure, so passive range of motion should be performed only while constantly assessed for signs of increased pressure. This client could not be safely assigned to an AP. The remaining clients could be safely assigned to the AP.

Question 5

The nurse is applying the continuous passive motion (CPM) device to a postoperative client for the first time. Which action should the nurse take when setting up the device?&#10;A) Consult with a physical therapist to ensure proper set up&#10;B) Set the degree of joint flexion according to the client's comfort level&#10;C) Set the degree of joint extension according to the joint's ability&#10;D) Set the speed of movement to be &#34;moderate&#34;

Accepted Answer

1. Physical therapists should be consulted to ensure proper initial setup of a CPM device.
2. The degree of joint flexion should be set as prescribed by the primary care provider.
3. The degree of joint extension should be set as prescribed by the primary care provider.
4. The speed of movement should be set as prescribed by the primary care provider.

Question 6

The nurse completes range-of-motion exercises with a client recovering from a stroke. Which information should the nurse include when documenting this activity? Select all that apply.&#10;A) Joints exercised&#10;B) Type of exercise&#10;C) Client's tolerance&#10;D) Joints hyperextended&#10;E) Degree of joint motion

Accepted Answer

1. Documentation after completing range-of-motion exercises is to include the joints exercised.
2. Documentation after completing range-of-motion exercises is to include the type of exercise.
3. Documentation after completing range-of-motion exercises is to include the client's tolerance.
4. Joints are not hyperextended when performing range-of-motion exercises.
5. Documentation after completing range-of-motion exercises is to include the degree of joint motion.

Deck 13: Maintaining Joint Mobility