Fundamentals of Nursing

Nursing

Quiz 44 :

Activity and Exercise

Quiz 44 :

Activity and Exercise

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To increase stability during client transfer, the nurse increases the base of support by performing which action? 1) Leaning slightly backward 2) Spacing the feet farther apart 3) Tensing the abdominal muscles 4) Bending the knees
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The base of the body is represented by the feet, which carry the body weight and maintain balance. Translocation of a certain patient with mobilization issues, the base of the body should be well supported to avoid accidental falling and physical injuries.
Instructing the patient to lean backward would actually reduce the balance of the body. As a result weight stabilization decreases thereby increasing the risk for injuries. Stimulating abdominal muscle tension alone is not enough to increase the balanced weight distribution on the base of the body.
The nurse should not ask the patient to bend the knees as this is not enough to cause balanced weight distribution on the base.
Hence, the options 1, 3 and 4 are incorrect.
Positioning the legs farther apart provides more support and a well distribution of the body weight on the base of the body. Therefore, this should be ideally done while translocation of the patient.
Hence, the correct answer is option
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What assessment findings alert you that Mr. Chan is developing problems associated with his current state of decreased mobility?
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Prolonged immobility results in the absence of regular functioning of the associated muscles and limbs thereby leading to their gradual dysfunction. The patient is diagnosed with an enlarged heart that is unable to meet the oxygen requirement of the body due to decreased cardiac output (CO).
The assessment data that confirm that the patient is developing disuse syndrome due to his occupational immobility is as follows:
1. Prolonged sitting- Prolonged sitting as required by the patient's occupation, results in absence of positional changes of the body parts and regular movement of the limbs. This would lead to loss of functionality of the body parts subjected to chronic immobility.
2. Obesity- Obesity results in lack of interest to promote movement or locomotion. This would lead to immobility associated disuse syndrome.
3. Edema- The patient has developed edema of potential size in both ankles. This indicates the severity of the immobility and the increased risk for disuse syndrome in the patient.
4. Decreased respiration rate- The patient's decreased respiration rate indicates less than body requirement oxygen circulation. This in turn would lead to muscle fatigue and the corresponding immobility. This would result in disuse syndrome.
5. Enlarged heart- The patient is diagnosed with an enlarged heart that is unable to meet the oxygen requirement of the body due to decreased cardiac output (CO). This results in imbalance issues, which disable the patient to continue spontaneous movement leading to immobility and disuse syndrome.

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The care plan does not address one of Mr. Chan's risk factors-obesity. Would you add this to the plan?
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Physical immobility refers to the limitations in spontaneous and purposeful movement of one or more parts of the body as a result of neurological and cardiac disorders, prolonged bed rest due to chronic illness or deformities.
Immobility may lead to disuse syndrome of the limb or body part subjected to prolonged immobilization. The nursing care plan for the patient includes interventions for the patient's appropriate positioning and maintenance of muscular functions and flexibility.
This plan does not include obesity, which should have been included because of the following reasons:
1. The patient is already overweight indicated by his 102 Kg (kilograms) weight, which results in extra pressure on his lower limbs.
2. The extra weight of the body has already led to the formation of edema of a clinically significant size of 5 mm (millimeters) on both of his ankles and feet.
3. The obesity would further complicate the patient's condition by disrupting the patient's ability to mobilize spontaneously and maintain balance.

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When assessing a client's gait, which does the nurse look for and encourage? 1) The spine rotates, initiating locomotion. 2) Gaze is slightly downward. 3) Toes strike the ground before the heel. 4) Arm on the same side as the swing-through foot moves forward at the same time.
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What assumptions has the nurse made in assigning the desired outcome of "Immobility Consequences: Psycho-Cognitive"?
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A client weighs 250 pounds and needs to be transferred from the bed to a chair. Which instruction by the nurse to the unlicensed assistive personnel (UAP) is most appropriate? 1) "Using proper body mechanics will prevent you from injuring yourself." 2) "You are physically fit and at lesser risk for injury when transferring the client." 3) "Use the mechanical lift and another person to transfer the client from the bed to the chair." 4) "Use the back belt to avoid hurting your back."
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A nurse is teaching a client about active range-of-motion (ROM) exercises. The nurse then watches the client demonstrate these principles. The nurse would evaluate that teaching was successful when the client does which of the following? 1) Exercises past the point of resistance. 2) Performs each exercise one time. 3) Performs each series of exercises once a day. 4) Uses the same sequence during each exercise session.
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Five minutes after the client's first postoperative exercise, the client's vital signs have not yet returned to baseline. Which is an appropriate nursing diagnosis? 1) Activity Intolerance 2) Risk for Activity Intolerance 3) Impaired Physical Mobility 4) Risk for Disuse Syndrome
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Performance of activities of daily living (ADLs) and active range-of-motion (ROM) exercises can be accomplished simultaneously as illustrated by which of the following? Select all that apply. 1) Elbow flexion with eating and bathing 2) Elbow extension with shaving and eating 3) Wrist hyperextension with writing 4) Thumb ROM with eating and writing 5) Hip flexion with walking
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Which statement from a client with one weak leg regarding use of crutches when using stairs indicates a need for increased teaching? 1) "Going up, the strong leg goes first, then the weaker leg with both crutches." 2) "Going down, the weaker leg goes first with both crutches, then the strong leg." 3) "The weaker leg always goes first with both crutches." 4) "A cane or single crutch may be used instead of both crutches if held on the weaker side."
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How are the choices of outcomes influenced by the cause of his nursing diagnosis (a chronic illness)?
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The nurse is performing an assessment of an immobilized client. Which assessment causes the nurse to take action? 1) Heart rate 86 beats/min 2) Reddened area on sacrum 3) Nonproductive cough 4) Urine output of 50 ml/h
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Isotonic exercises such as walking are intended to achieve which of the following? Select all that apply. 1) Increase muscle tone and improve circulation. 2) Increase blood pressure. 3) Increase muscle mass and strength. 4) Decrease heart rate and cardiac output. 5) Maintain joint range of motion.
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Chan may benefit from using a walker to assist with ambulation at home. What teaching should be done in regard to use of a walker?
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The client is ambulating for the first time after surgery. The client tells the nurse, "I feel faint." Which is the best action by the nurse? 1) Find another nurse for help. 2) Return the client to her room as quickly as possible. 3) Tell the client to take rapid, shallow breaths. 4) Assist the client to a nearby chair.
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