Activity and Exercise

Chapter 38 application and Exercise Test Bank MULTIPLE CHOICE 1. The coordinated efforts of the musculoskeletal and nervous system keep back balance, posture, and torso alignment. Body alignment refers to a. A low center of gravity equilibrate over a wide source of support. b. The result of weight, center of gravity, and balance. c. The relationship of iodin corpse pull up stakes to a nonher. d. The force that occurs in a direction to oppose vogue. ANS C Body alignment refers to the relationship of i frame part to a nonher tree trunk part along a horizontal or vertical line.Body balance occurs when a relatively low center of gravity is balanced over a wide, stable base of support. Coordinated body movement is a result of weight, center of gravity, and balance. Friction is a force that occurs in a direction to oppose movement. DIF Remember reviewer 746-747 OBJ set forth the role of the musculoskeletal and nervous systems in the regulation of movement. big top app raisal manuscript Teaching/ accomplishment 2. A structural curvature of the spine associated with vertebral rotation is known as a. Scoliosis. b. Osteogenesis. c. Osteomalacia. . Arthritis. ANS A Scoliosis is a structural curvature of the spine associated with vertebral rotation. Osteogenesis imperfecta is an inherited unhealthiness that makes bones porous, short, bowed, and deformed. Osteomalacia is an uncommon metabolic ailment characterized by inadequate and delayed mineralization, resulting in compact and spongy bone. Arthritis is an inflammatory vocalise disease characterized by inflammation or destruction of the synovial membrane and articular cartilage, and by systemic signs of inflammation. DIF Remember REF 749 OBJDiscuss physiological and pathologic influences on body alignment and joint mobility. TOP judging multiple sclerosis Teaching/Learning a. 3. Unlike arthritis, joint degeneration Occurs only from noninflammatory disease. b. Occurs only from inflamma tory disease. c. Involves overgrowth of bone at the articular ends. d. Affects just aboutly nonweight-bearing joints ANS C Joint degeneration, which can occur with inflammatory and noninflammatory disease, is marked by changes in articular cartilage combined with overgrowth of bone at the articular ends. Degenerative changes commonly affect weight-bearing joints. DIF gain REF 749 OBJ Discuss physiological and pathological influences on body alignment and joint mobility. TOP quantifyment atomic number 62 Teaching/Learning The admit is providing cargon to a uncomplaining who is bedridden. To check fatigue, the shelter raises the height of the bed. The concur understands that balance is maintained by raising the bed to 4. a. Prevent a shift in the confines base of support. b. delimitate the base of support. c. Allow the nurse to bring his or her feet close together. d. Shift the center of gravity further away from the base of support. ANSA summit the height of the bed when performing a procedure counteracts bending too far at the waist and causing a shift in the base of support. Balance is maintained by maintaining proper body alignment and posture through two simple techniques. First, widen the base of support by separating the feet to a comfortable distance. Second, increase balance by bringing the center of gravity closer to the base of support. DIF Understand REF 747 OBJ Discuss physiological and pathological influences on body alignment and joint mobility. TOP Assessment MSC Teaching/Learning 5.Approximately what percentage of all back pain is associated with manual lifting tasks? a. 10% b. 25% c. 50% d. 75% ANS C Half of all back pain is associated with manual lifting tasks. DIF Remember REF 758 OBJ let on how to maintain and habit proper body mechanics. TOP Assessment MSC Teaching/Learning The nurse is preparing to position an immobile forbearing. Before doing so, the nurse must understand that 6. a. manual(a) liftin g is the easier method and should be tried first. b. Followe body mechanics principles alone will prevent back injury. c.Body mechanics can be snub when enduring handling equipment is used. d. Body mechanics alone be not sufficient to prevent injuries. ANS D Body mechanics alone atomic number 18 not sufficient to prevent musculoskeletal injuries when view or transferring longanimouss. The use of uncomplaining-handling equipment in junto with proper body mechanics is much feelingive than each one in isolation. Body mechanics cannot be ignored even when tolerant handling equipment is being used. Manual lifting is the last resort, and it is only used when it does not involve lifting most or all of the longanimouss weight. DIF UnderstandREF 758 OBJ Describe how to maintain and use proper body mechanics. TOP Assessment MSC Teaching/Learning 7. The nurse is preparing to reposition a patient. Before doing so, the nurse must a. Assess the weight to be lifted and the a ssistance needed. b. flak to manually lift the patient alone in advance asking for assistance. c. Attempt a manual lift only when lifting most or all of the patients weight. d. Not use the agency lift team if a mechanical lift is available. ANS A Before lifting, assess the weight to be lifted and determine the assistance needed and the resources available.Manual lifting is the last resort, and it is used when the task at hand does not involve lifting most or all of the patients weight. Use safe patient handling equipment in conjunction with agency lift teams to reduce the risk of injury to the patient and members of the health headache team. DIF Apply REF 758 OBJ Describe how to maintain and use proper body mechanics. TOP executing MSC Teaching/Learning Isotonic, isometric, and repellent isometric are three categories of deterrent example. They are classified according to the type of muscle concretion involved.Of the following runs, which are driveed isotonic? 8. a . Bicycling, swimming, walking, jogging, dancing b. Tightening or tensing of muscles without moving body parts c. Push-ups, hip lifting, pushing feet against a footboard on the bed d. Quadriceps set puzzle outs and contraction of the gluteal muscles ANS A Examples of isotonic applys are walking, swimming, dancing aerophilouss, jogging, bicycling, and moving arms and legs with light resistance. Isometric exercises involve cruddyening or tensing of muscles without moving body parts. Examples include quadriceps set exercises and contraction of the gluteal muscles.Examples of resistive isometric exercises are push-ups and hip lifting, as well as placing a footboard on the foot of the bed for patients to push against with their feet. DIF Remember REF 747 OBJ Describe how exercise and use benefit physiological and psychological mathematical process. TOP Assessment MSC Teaching/Learning 9. In political programning a physical performance curriculumme for a patient, the nurse must understand that a. Isotonic exercises cause contraction without changing muscle length. b. The best program includes a combination of exercises. c.Isometric contraction involves the movement of body parts. d. Resistive isometric exercises can travel to bone wasting. ANS B The best program of physical exercise includes a combination of exercises that produce different physiological and psychological benefits. Isotonic exercises cause muscle contractions and changes in muscle length. Isometric exercises involve tightening or tensing of muscles without moving body parts. Resistive isometric exercises help promote muscle strength and provide sufficient stress against bone to promote osteoblastic employment. DIF UnderstandREF 747 OBJ Describe how exercise and activity benefit physiological and psychological functioning. TOP Assessment MSC Teaching/Learning An active lifestyle is important for maintaining and promoting health. In developing an exercise program, the nurse u nderstands that 10. a. Physical exercise is contraindicated for patients with chronic illnesses. b. Regular physical activity is beneficial only for the body part that is exercised. c. Physical exercise has no effect on psychological well-being. d. Physical activity enhances functioning of all body systems. ANS D Regular physical activity and exercise enhance the functioning of all body systems, including cardiopulmonary functioning, musculoskeletal fitness, weight control and maintenance, and psychological well-being. It is also essential in treatment for chronic illness. DIF Understand REF 747 OBJ Describe the benefits of implementing an exercise program for the purpose of health promotion. TOP Assessment MSC Teaching/Learning 11. The nurse is developing an exercise program for elderly patients backing in a breast feeding home.To develop a beneficial health promotion program, the nurse necessarily to understand that when dealing with the elderly a. Exercise is of genuin ely little benefit because the patients are old. b. It is important to disregard their current interests in favor of exercise. c. No physical benefit can be gained without a nominal exercise program. d. Adjustments to exercise programs may have to be made to prevent problems. ANS D Exercise is extremely beneficial for older adults, but adjustments to an exercise program may have to be made for those of advanced age to prevent problems.When developing an exercise program for any older adult, consider not only the persons current activity level, range of motion, muscle strength and tone, and response to physical activity, but also the persons interests, capacities, and limitations. erstwhile(a) adults who are unable to participate in a formal exercise program are able to achieve the benefits of improved joint mobility and enhanced circulation by simply stint and exaggerating movements during performance of routine activities of daily living. DIF Understand REF 759 OBJ Describe the benefits of implementing an exercise program for the purpose of health promotion.TOP Assessment MSC Teaching/Learning The nurse is attempting to start an exercise program in a local community as a health promotion project. In explaining the purpose of the project, the nurse explains to community leaders that 12. a. A sedentary lifestyle contributes to the development of health- relate problems. b. The recommended frequency of workouts should be twice a day. c. An exercise prescription should coordinated aerobic exercise only. d. The purpose of weight training is to bulk up muscles. ANS A A sedentary lifestyle contributes to the development of health-related problems.A holistic approach is taken to develop overall fitness and includes unassailable-ups, aerobic exercise, resistance training, weight training, and so forth. The recommended frequency of aerobic exercise is 3 to 5 quantify per workweek or every other day for approximately 30 minutes. Crosstraining is recomm ended for the patient who prefers to exercise every day. Some patients use weight training to bulk up their muscles. However, the purposes of weight training from a health perspective are to develop tone and strength and to simulate and maintain healthy bone. DIF Understand REF 796-797 OBJDescribe the benefits of implementing exercise and activity. TOP Assessment MSC Teaching/Learning The patient is eager to receive his exercise program with a 2-mile jog. The nurse instructs the patient to warm up with stretching exercises. The patient states that he is ready and does not want to waste time with a warm-up. The nurse explains that the warm-up 13. a. Allows the body to readjust in stages to baseline functioning. b. Prepares the body and decreases the potential for injury. c. Should not involve stretching exercises because they can lead to injury. d.Should be performed with high intensity to prepare for the coming challenge. ANS B The warm-up activity prepares the body for a ctivity and decreases the potential for injury. It usually lasts about 5 to 10 minutes and may include stretching, calisthenics, and/or aerobic activity performed at a lower intensity. The cool-down period conquers the body to readjust gradually to baseline functioning and provides an opportunity to combine movement such as stretching with relaxation-enhancing mind-body awareness. DIF Understand REF 757 OBJ Describe the benefits of implementing exercise and activity.TOP Assessment MSC Teaching/Learning Many patients find it difficult to incorporate an exercise program into their daily lives because of time constraints. For these patients, it is beneficial to reinforce that many ADLs are used to accumulate the recommended 30 minutes or more per day of moderate-intensity physical activity. When instructing these patients, the nurse explains that 14. a. Housework is not considered an aerobic exercise. b. To strengthen back muscles, the patient should bend using back muscles. c. Daily chores should begin with gentle stretches. d.The patient should stick to one chore until it is done before beginning a new one. ANS C Daily chores should begin with gentle stretches. Housework is considered aerobic exercise. To make it more aerobic, work faster and scrub harder. Bend your legs rather than your back to prevent back injury. Alternate cleaning activities to prevent over work the same muscle groups. DIF Understand REF 757 OBJ Describe important factors to consider when cooking an exercise program for patients across the life span and for those with specific chronic illnesses. TOP Assessment MSC Teaching/Learning 15.The nurse is developing an exercise intend for someone diagnosed with congestive heart failure and exercise in gross profit margin. In doing so, the nurse should a. Plan for 20 minutes of continuous aerobic activity and increase as tolerated. b. Perform 6-minute walks at the patients pace at to the lowest degree 2 times a day. c. Instruct the patient that he should not take his beta blocker medication on exercise days. d. Encourage a high-calorie diet to end for extra calorie expenditure. ANS B For the diagnosis of exercise in adjustment, the patient should begin by performing 6minute walks at his own pace at least twice a day.The patient would not be able to tolerate 20 minutes of continuous aerobic activity. Patients should be instructed to take medications as ordered. Low-calorie, low-sodium, and high-protein diets are best for this type of patient. DIF Apply REF 755 OBJ Describe important factors to consider when planning an exercise program for patients across the life span and for those with specific chronic illnesses. TOP carrying out MSC Teaching/Learning Which of the following exercise activities would most likely provide the opportunity for mind-body awareness? 16. a. Warm-up activity b. shelter training c. Aerobic exercise d. Cool-down activity ANS D The cool-down period allows the body to readjust gradually to baseline functioning and provides an opportunity to combine movement such as stretching with relaxationenhancing mind-body awareness. The warm-up activity prepares the body and decreases the potential for injury. Aerobic exercise includes running, bicycling, jumping rope, and so forth, and is the main portion of exercise activity it precedes the cool-down period.Resistance training increases muscle strength and endurance and is associated with improved performance of daily activities but not with enhancing mind-body awareness. DIF Analyze REF 757 OBJ Describe important factors to consider when planning an exercise program for patients across the life span and for those with specific chronic illnesses. TOP Evaluation MSC Teaching/Learning The patient is brought to the hand brake incision with possible injury to his shoulder. To help determine the degree of injury, the nurse should evaluate 17. a.The patients stride. b. The patients range of motion. c. Fine motor coordination. d. Activity tolerance. ANS B Assessing range of motion is one assessment technique used to determine the degree of terms or injury to a joint. footstep is the manner or style of walking. It may have little bearing on the shoulder damage. Assessing fine motor coordination would be beneficial in circumstances to assess the patients ability to perform tasks but would not help in evaluating the shoulder. Activity tolerance refers to the type and amount of exercise or activity a person is able to perform.Damage to the shoulder would affect this, but this would not have a direct bearing on the amount of damage done to the shoulder. DIF Apply REF 752-753 OBJ Assess patients for afflicted mobility and activity intolerance. TOP Implementation MSC Teaching/Learning The nurse is examining a patient who is admitted to the emergency department with severe shove pain. Of the following situations, which would cause the nurse to suspect a ligament tear or joint fracture? 1 8. a. Range of motion of the elbow is limited. b. Joint motion is greater than normal. c.The patient has arthritis. d. The elbow cannot be moved (frozen). ANS B Increased mobility (beyond normal) of a joint may indicate alignment tissue disorders, ligament tears, or possible joint fractures. Limited range of motion often indicates inflammation such as arthritis, fluid in the joint, altered inwardness supply, or contractures (frozen joints). DIF Analyze REF 752-753 OBJ Assess patients for impaired mobility and activity intolerance. TOP Evaluation MSC Teaching/Learning The patient has been bedridden for several months owing to severe congestive heart disease.In determining a plan of tending for this patient that will address his activity level, the nurse formulates which of the following nursing diagnoses? 19. a. dash related to poor physical condition b. damage gas exchange related to decreased cardiac output c. Decreased cardiac output related to decreased myocardial co ntractility d. Activity intolerance related to physical deconditioning ANS D When activity and exercise are problems for a patient, nursing diagnoses often stress on the individuals ability to move. The diagnostic label directs nursing interventions.In this case, physical deconditioning must be addressed relative to activity level, perhaps prima(p) to 6-minute walks twice a day. Physical deconditioning is the cause of fatigue as well, so it would take priority over that diagnosis. Decreased cardiac output and myocardial contractility are serious concerns that must be addressed before activity intolerance to keep the patient safe and to help determine the level of exercise that the patient can tolerate, but reconditioning of the patients body will help improve contractility and cardiac output. DIF Apply REF 753 755 OBJFormulate nursing diagnoses for patients experiencing problems with impaired mobility and activity intolerance. TOP Implementation MSC Teaching/Learning The pati ent weighs 450 lbs (204. 5 kg) and complains of shortness of breath with any exertion. His health concern provider has recommended that he begin an exercise program. He states that he can hardly get out of bed and just cannot do anything around the house. To focus on the cause of the patients complaints, the nurse devises which of the following nursing diagnoses? 20. a. Activity intolerance related to excessive weight . Activity intolerance related to bed rest c. Impaired gas exchange related to shortness of breath d. Imbalanced nutrition less than body requirements ANS A The diagnostic label directs nursing interventions. This requires the elucidate selection of related factors. For example, Activity intolerance related to excess weight gain requires very different interventions than if the related factor is prolonged bed rest. In this case, the intolerance is related to the patients excessive weight. He is not on bed rest, although he claims that it is difficult for him to ge t out of bed.Shortness of breath is a symptom, not a cause, of Impaired gas exchange, making this nursing diagnosis ineffective. The patient certainly has an imbalance of nutrition, but it is more than body requirements. DIF Apply REF 753 OBJ Formulate nursing diagnoses for patients experiencing problems with impaired mobility and activity intolerance. TOP Implementation MSC Teaching/Learning The patient is being admitted for elective knee surgery. While the nurse is admitting the patient, she will 21. a. Begin to develop a discharge plan. b.Plan to wait until after the surgery to plan for discharge. c. Place a generalized discharge plan in the degrade for later use. d. Address immediate needs of the patient only and address other needs later. ANS A The nurse needs to begin discharge planning when the patient enters the health care system. The nurse cannot wait until after surgery to begin to plan for discharge. In addition, the discharge plan is always individualized to the patient and directed at meeting the actual and/or potential needs of the patient. DIF Apply REF 754 OBJWrite a nursing care plan for a patient with impaired mobility and activity intolerance. TOP Implementation MSC Teaching/Learning The patient is admitted with a stroke. The outcome of this disorder is uncertain, but the patient is unable to move his right arm and leg. The nurse understands that 22. a. Active range of motion is the only thing that will prevent contractures from forming. b. peaceful range of motion must be instituted to help prevent contracture formation. c. Range-of-motion exercises should be started 2 days after the patient is stable. d.Range-of-motion exercises should be done on study joints only. ANS B When patients cannot participate in active range of motion, the nurse must institute peaceable range of motion to maintain joint mobility and prevent contractures. Passive range of motion can be substituted for active when needed. For the patient who does not have voluntary motor control, passive range-of-motion exercises are the exercises of choice. Unless contraindicated, the nursing care plan includes exercising each joint (not just major joints) through as nearly a full range of motion as possible.Initiate passive range-of-motion exercises as soon as the patient loses the ability to move the extremity or joint. DIF Understand REF 759 OBJ Describe interventions for maintaining activity tolerance and mobility. TOP Assessment MSC Teaching/Learning The patient has been in bed for several days and needs to be ambulated. Before ambulation, the nurse 23. a. Removes the gait belt to allow for unrestricted movement. b. Has the patient get up from bed before he has a chance to get dizzy. c. Has the patient look down to watch his feet to prevent tripping. d.Dangles the patient on the side of the bed. ANS D Some patients experience orthostatic hypotensiona drop in squanderer pressure that occurs when the patient changes from a horiz ontal to a vertical position. Assist the patient to a position of sitting at the side of the bed, and dangle for 1 to 2 minutes before standing. The nurse needs to provide support at the waist so that the patients center of gravity remains midline. This is achieved with the use of a gait belt. A gait belt encircles the patients waist and may have handles attached for the nurse to hold while the patient ambulates.The patient should maintain as normal a walking posture as possible with the head erect. DIF Apply REF 759 OBJ Describe interventions for maintaining activity tolerance and mobility. TOP Implementation MSC Teaching/Learning 24. The nurse is ambulating a patient in the hall when she notices that he is beginning to fall. The nurse should a. Grab the patient and hold him tight to prevent the fall. b. Gently lower the patient to the floor. c. Jump back and let the patient fall naturally. d. Push the patient against the wall and guide him to the floor. ANS B If the patient has a fainting episode or begins to fall, assume a wide base of support with one foot in front of the other, thus reenforcement the patients body weight. Then extend one leg and let the patient slide against the leg, and gently lower the patient to the floor, protecting the patients head. Grabbing the patient will shift the nurses center of gravity and may lead to a back injury. Allowing the patient to fall could lead to head injury for the patient. Pushing the patient against the wall could also cause the patient to hit his head and cause injury. DIFApply REF 759 OBJ Describe interventions for maintaining activity tolerance and mobility. TOP Implementation MSC Teaching/Learning a. 25. In assisting the patient to exercise, the nurse should Expect that pain will occur with exercise of clean muscle groups. b. Set the pace for the exercise class. c. Force muscles or joints to go just beyond resistance. d. Stop the exercise if pain is experienced. ANS D Assess for pain, shortne ss of breath, or a change in vital signs. If present, stop exercise. Let each patient exercise at his or her own pace.Assess for joint limitations, and do not force a muscle or a joint during exercise. DIF Apply REF 759 OBJ Describe interventions for maintaining activity tolerance and mobility. TOP Implementation MSC Teaching/Learning The nurse is developing a plan of care for a patient diagnosed with activity intolerance. Of the following strategies, which has the best chance of maintaining patient compliance? 26. a. Performing 20 minutes of aerobic exercise daily with 10 minute warm-up and cool-down periods b. Instructing the patient to use an exercise log to record day, time, duration, and responses to exercise activity . Instructing the patient on the evils of not exercising, and getting her to take responsibility for her current health status d. Arranging for the patient to join a gym that she will have to pay, for so that she does not need to depend on insurance ANS B K eeping a log may increase adherence to an exercise prescription. Cross-training (combination of exercise activities) provides variety to combat boredom and increases the potential for total body conditioning as opposed to daily aerobic exercise. Blaming a patient for his or her health status is usually counterproductive.Instead, the nurse should instruct the patient about the physiological benefits of a regular exercise program. maturation a plan of exercise that the patient may perform at home may improve compliance. DIF treasure REF 756 OBJ Evaluate the nursing care plan for maintaining activity and exercise for patients across the life span and with specific chronic illnesses. TOP Evaluation MSC Teaching/ Learning 27. The nurse is working with the patient in developing an exercise plan. The patient tells the nurse that she just will not participate in a formal exercise program.The nurse then suggests that exercise activities can be incorporated into activities of daily livin g. The patient seems to be agreeable to that concept. Of the following activities, which would be considered a moderate-intensity activity? a. Doing laundry b. do the bed c. Ironing d. Folding clothes ANS D Low-intensity ADLs include doing the laundry, making the bed, ironing, and washing dishes. Moderate-intensity ADLs include sweeping the kitchen or sidewalk, washing windows, folding clothes, and vacuuming. DIF Evaluate REF 757 OBJEvaluate the nursing care plan for maintaining activity and exercise for patients across the life span and with specific chronic illnesses. TOP Evaluation MSC Teaching/ Learning MULTIPLE RESPONSE Bones perform five functions in the body support, protection, movement, mineral storage, and hematopoiesis. In the discussion of body mechanics, which are the most important? (Select all that apply. ) 1. a. Support b. Protection c. Movement d. Mineral storage e. Hematopoiesis ANS A, C Bones perform five functions in the body support, protection, movem ent, mineral storage, and hematopoiesis.In the discussion of body mechanics, two of these functions support and movementare most important. In support, bones serve as the framework and contribute to the shape, alignment, and positioning of body parts. In movement, bones together with their joints constitute levers for muscle attachment. As muscles contract and shorten, they pull on bones, producing joint movement. Protection involves encasing the soft tissue organs in a protective cage. Mineral storage helps to strengthen bones but also helps regulate blood levels of certain nutrients. Hematopoiesis is the formation of blood cells. DIF RememberREF 747 OBJ Describe the role of the musculoskeletal and nervous systems in the regulation of movement. TOP Assessment MSC Teaching/Learning When assessing the activity tolerance of a patient, the nurse would evaluate which of the following? (Select all that apply. ) 2. a. Skeletal abnormalities b. Emotional factors c. Age d. Pregnancy st atus e. Race ANS A, B, C, D Factors influencing activity tolerance include physiological factors such as skeletal abnormalities, emotional factors such as anxiety/depression, developmental factors such as age and gender, and pregnancy status.Race is not a factor because people of all races are faced with similar factors that affect their activity tolerance. DIF Apply REF 754 OBJ Assess patients for impaired mobility and activity intolerance. TOP Implementation MSC Teaching/Learning In developing a nursing care plan for increasing activity tolerance in a patient, the nurse should (Select all that apply. ) 3. a. Use generalized therapies because they work for everyone. b. Consult with members of the health care team. c.Avoid goals published by the American College of Sports Medicine. d. Involve the patient and the patients family in designing an exercise plan. e. Consider the patients ability to increase activity level. ANS B, D, E When planning care, the nurse should confer with/collaborate with members of the health care team to increase activity, involve the patient and family in designing an activity and exercise plan (especially if family members are also providers of care), and consider the patients ability to increase activity level.Therapies should be individualized to the patients activity tolerance. Information from the American College of Sports Medicine serves as a standard that the nurse should use when applying activity and exercise goals. DIF Apply REF 754 OBJ Write a nursing care plan for a patient with impaired mobility and activity intolerance. TOP Implementation MSC Teaching/Learning