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Chapter 037

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Potter & Perry: Fundamentals of Nursing, 7th Edition Test Bank Chapter 37: Activity and Exercise MULTIPLE CHOICE 1. A client has been prescribed bed rest for a prolonged time. To specifically promote the use of resistive isometric exercise for the client, the nurse will initiate: 1. Quadriceps setting 2. Gluteal muscle contraction 3. Moving the arms and legs in circles 4. Pushing against a footboard ANS: 4 Resistive isometric exercises are those in which the individual contracts the muscle while
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  Potter & Perry: Fundamentals of Nursing, 7 th  Edition Test Bank Chapter 37: !ti ity and E#er!ise$%T'PE C()'CE 1.A client has been prescribed bed rest for a prolonged time. To specifically promote the use of resistive isometric exercise for the client, the nurse will initiate:1.Quadriceps setting2.luteal muscle contraction!. oving the arms and legs in circles#.$ushing against a footboardA%&:#'esistive isometric exercises are those in which the individual contracts the muscle while pushing against a stationary ob(ect or resisting the movement of an ob(ect. An example of a resistive isometric exercise is pushing against a footboard. Quadriceps setting is an example of an isometric exercise. luteal muscle contraction is an example of an isometric exercise. oving the arms and legs in a circle is an example of isotonic exercise.)*+:A'+:-/0:AnalysisT/$:%ursing $rocess: Assessment &:%345 test plan designation: 6ealth $romotion and aintenance2.The nurse is assessing the body alignment of an alert and mobile client. The first action that the nurse should ta7e is to:1./bserve gait2.$ut the client at ease!.)etermine activity tolerance#.)etermine range of (oint motionA%&:2The first step in assessing body alignment is to put the client at ease so unnatural or rigid  positions are not assumed. 8hen assessing body alignment, the first action of the nurse isto put the client at ease. 3ater, the nurse may assess the client9s gait to observe the client9s balance, posture, and ability to wal7 without assistance. Activity tolerance is the 7ind andamount of exercise or activity a person is able to perform. *t is not the first step in assessing a client9s body alignment. Assessing '/ is one of the first assessment techniues used to determine the degree of damage or in(ury to a (oint. *t is not the first step in assessing a client9s body alignment.)*+:A'+:--/0:AnalysisT/$:%ursing $rocess: Assessment &:%345 test plan designation: 6ealth $romotion and aintenance osby items and derived items ; 2<<=, 2<<> by osby, *nc., an affiliate of lsevier *nc.  Test 0an7 !.An average?si@e male client has right?sided hemiparesis. The nurse helps this client to wal7 by:1.&tanding at his left side and holding his arm2.&tanding at his left side and holding one arm around his waist!.&tanding at his right side and holding his arm#.&tanding at his right side and holding one arm around his waistA%&:#The nurse provides support at the waist so the client9s center of gravity remains midline. The nurse should be on the client9s wea7er side to assist him with ambulation. The nurse should hold onto the client9s waist, not his arm, and should be on his wea7er side, not his strong side. The nurse should be on the client9s wea7er side. The nurse should hold onto the client9s waist to help steady him in maintaining his center of gravity midline so that he does not lose his balance and fall.)*+:A'+:-=#/0:AnalysisT/$:%ursing $rocess: Assessment &:%345 test plan designation: 6ealth $romotion and aintenance#.The nurse is wor7ing with a client who has left?sided wea7ness. After instruction, the nurse observes the client ambulate in order to evaluate the use of the cane. 8hich action indicates that the client 7nows how to use the cane properly1.The client 7eeps the cane on the left side.2.Two points of support are 7ept on the floor at all times.!.There is a slight lean to the right when the client is wal7ing.#.After advancing the cane, the client moves the right leg forward.A%&:2Two points of support, such as both feet or one foot and the cane, should be on the floor at all times. The cane should be 7ept on the stronger side, the client9s right side. The client should 7eep his or her body upright and midline. 3eaning can cause the client to lose his or her balance and fall. After advancing the cane, the client should move the wea7er leg, the client9s left leg, forward to the cane.)*+:A'+:<!/0:AnalysisT/$:%ursing $rocess: Assessment &:%345 test plan designation: 6ealth $romotion and aintenance>.A client with a fractured left femur has been using crutches for the past # wee7s. The  physician tells the client to begin putting a little weight on the left foot when wal7ing. 8hich of the following gaits should the client be taught to use1.Two?point2.Three?point!.+our?point#.&wing?through A%&:1 osby items and derived items ; 2<<=, 2<<> by osby, *nc., an affiliate of lsevier *nc. !-?2  Test 0an7 The two?point gait reuires 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 wal7ing. *n a three?point gait, weight is borne on both crutchesand then on the uninvolved leg. The four?point gait gives stability to the client but reuires weight bearing on both legs. ach leg is moved alternately with each opposing crutch so that three points of support are on the floor at all times. This client is only supposed to use partial weight bearing, so this gait would not be appropriate. $araplegics who wear weight?supporting braces on their legs use the swing?through gait. *t would not be appropriate for this client.)*+:A'+:<>/0:AnalysisT/$:%ursing $rocess: Assessment &:%345 test plan designation: 6ealth $romotion and aintenanceB.The client needs to use crutches at home, and will have to manage going up and down a short flight of stairs. The nurse evaluates the use of an appropriate techniue if the client:1.Cses a banister or wall for support when descending2.Cses one crutch for support while going up and down!.Advances the crutches first to ascend the stairs#.Advances the affected leg after moving the crutches to descend the stairsA%&:#To descend stairs, the crutches are placed on the stairs and the client moves the affected leg, then the unaffected leg to the stairs with the crutches. The client should continue to use the crutches for support, not the banister or wall. The client should continue to use  both crutches for support when going up or down stairs. 8hen ascending stairs, the clientmoves the unaffected leg up the stair, then the crutches and affected leg.)*+:A'+:<>/0:AnalysisT/$:%ursing $rocess: Assessment &:%345 test plan designation: 6ealth $romotion and aintenance-.8hile ambulating in the hallway of a hospital, the client complains of extreme di@@iness. The nurse, alert to a syncopal episode, should first:1.&upport the client and wal7 uic7ly bac7 to the room2.3ean the client against the wall until the episode passes!.3ower the client gently to the floor #.o for helpA%&:!*f the client has a syncopal episode or begins to fall, the nurse should assume a wide base of support with one foot in front of the other, supporting the client9s weight, and then extend the leg, allowing the client to slide against the leg while gently lowering the client to the floor and protecting the client9s head. The nurse should not attempt to wal7 the client uic7ly bac7 to the room. The nurse should not lean the client against a wall as the client may fall. The nurse should not leave the client alone and go for help. osby items and derived items ; 2<<=, 2<<> by osby, *nc., an affiliate of lsevier *nc. !-?!  Test 0an7 )*+:A'+:<2/0:AnalysisT/$:%ursing $rocess: Assessment &:%345 test plan designation: 6ealth $romotion and aintenance.A client is admitted to the medical unit following a DA Estro7eF. There is evidence of left?sided hemiparesis and the nurse will be following up on range?of?motion and other exercises performed in physical therapy. The nurse correctly teaches the client and familymembers which one of the following principles of range?of?motion exercises 1.+lex the (oint to the point of discomfort.2.8or7 from proximal to distal (oints.!. ove the (oints uic7ly.#.$rovide support for distal (oints.A%&:1+lexing the 7nees and 7eeping the feet wide apart provide a broad base of support and increase stability. The nurse should position himself or herself close to the client or ob(ect being lifted to minimi@e the force E1< pounds held at waist height close to the body is eual to 1<< pounds held at arms9 lengthF. 6aving the client or ob(ect close to the center of gravity also helps maintain balance. Twisting should be avoided because it increases the ris7 of bac7 in(ury. The leg muscles should be used for lifting or moving. They are stronger, larger muscles capable of greater wor7 without in(ury.)*+:A'+:-=#/0:AnalysisT/$:%ursing $rocess: Assessment &:%345 test plan designation: 6ealth $romotion and aintenance=.%urses need to implement appropriate body mechanics in order to prevent in(ury to themselves and their clients. 8hich principle of body mechanics should the nurse incorporate into client care1.+lex the 7nees and 7eep the feet wide apart.2.Assume a position far enough away from the client.!.Twist the body in the direction of movement.#.Cse the strong bac7 muscles for lifting or moving.A%&:1The correct answer is to flex the 7nees and 7eep the feet wide apart. This will create a wide base of support, providing greater stability for the nurse and reducing the ris7 of  bac7 in(ury. The nurse should be positioned close to the client and use the arms and legs. )ividing balanced activity between arms and legs reduces the ris7 of bac7 in(ury. +acing the direction of movement prevents abnormal twisting of the spine, also reducing the ris7 of bac7 in(ury.)*+:'+:<1/0:AnalysisT/$:%ursing $rocess: *mplementation &:%345 test plan designation: &afe and ffective are nvironment osby items and derived items ; 2<<=, 2<<> by osby, *nc., an affiliate of lsevier *nc. !-?#

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