Chapter 35 Immobility

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Chapter 35  Immobility

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

MULTIPLE CHOICE

1. Mr. Elliott is a 76-year-old patient who was admitted to the hospital after falling in the nursing home. He had broken his right femur and is awaiting surgery. His health care provider told him that his activity would be limited to bed rest. He asks the nurse what this means. What is the best explanation?
A.
“You are to be immobile.”
B.
“You cannot move.”
C.
“Your activity is restricted.”
D.
“You have to remain in bed.”

ANS: D
Immobility occurs when a patient is unable to move independently or is restricted for therapeutic reasons, such as bed rest.

PTS: 1 DIF: Cognitive Level: Application REF: 1033
OBJ: Describe mobility and immobility TOP: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment

2. Mr. Gregory was involved in a motor vehicle accident. He has a fractured right hip and is on bed rest in Buck’s traction. Which of the following systems is least likely to be impaired as a result of his immobility?
A.
Musculoskeletal
B.
Lymphatic
C.
Respiratory
D.
Cardiovascular

ANS: B
Despite a patient’s age, impairment as a result of immobility affects the respiratory system, metabolism, fluid and electrolyte balance, gastrointestinal tract, cardiovascular system, musculoskeletal system, integument, and urinary elimination.

PTS: 1 DIF: Cognitive Level: Analysis REF: 1033
OBJ: Describe physical and physiological changes associated with immobility
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity

3. Morgan is a student nurse who is caring for a 24-year-old patient who is immobile with a back injury. On auscultation, Morgan heard rhonchi in his lower lobes. Morgan is most concerned that the patient may have developed which of the following?
A.
A collapsed lung
B.
Hypostatic pneumonia
C.
Aspiration pneumonia
D.
Tension pneumothorax

ANS: B
Decreased lung expansion, generalized respiratory muscle weakness, and stasis of secretions occur with immobility. These conditions often contribute to the development of atelectasis (collapse of alveoli) and hypostatic pneumonia (inflammation of the lung from stasis or pooling of secretions).

PTS: 1 DIF: Cognitive Level: Analysis REF: 1033
OBJ: Discuss the benefits and hazards of bed rest
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity

4. Michael is a 23-year-old patient who was involved in a motorcycle accident. He was in the intensive care unit of the hospital for 2 months and was just discharged to a rehabilitation hospital. He tells his nurse that he doesn’t understand why he is so weak. What is the best response from the nurse?
A.
“When you are in bed for a long time, your body begins to break down its own protein.”
B.
“When you don’t use it, you lose it.”
C.
“You haven’t eaten much for the past couple of months.”
D.
“Your body has spent energy trying to heal itself.”

ANS: A
Prolonged bed rest decreases the body’s ability to produce insulin and metabolize glucose. When the body is unable to metabolize glucose, it begins to break down its protein stores for energy.

PTS: 1 DIF: Cognitive Level: Analysis REF: 1033
OBJ: Identify changes in metabolic rate associated with immobility
TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance

5. Patients on prolonged bed rest are at risk for a deep vein thrombosis. Which of the following factors is not included in Virchow’s triad?
A.
Loss of integrity of the vessel wall
B.
Abnormalities of blood flow
C.
Alterations in blood constituents
D.
Increased muscle atrophy

ANS: D
Three factors contribute to venous thrombus formation: (1) loss of integrity of the vessel wall (e.g., injury), (2) abnormalities of blood flow (e.g., slow blood flow in calf veins associated with bed rest), and (3) alterations in blood constituents (e.g., a change in clotting factors or increased platelet activity). These three factors are referred to as Virchow’s triad.

PTS: 1 DIF: Cognitive Level: Application REF: 1034
OBJ: Describe physical and physiological changes associated with immobility
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity

 

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