Homework Lance
1. The nurse explains that the slowed speed of nerve impulses will cause the older adult to:
a.
get a “scrambled” message in the brain.
b.
take longer to complete an activity.
c.
become confused.
d.
forget how to complete the activity.
ANS: B
Slowed transmission causes the older adult to take more time to complete an activity because the message must travel from the source to the brain and then from the brain to the parts of the body involved in completing the activity.
DIF: Cognitive Level: Application REF: 303 OBJ: 2
TOP: Slowed Transmission KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
2. The nurse takes into consideration that the arthritic patient may be less likely to exercise because:
a.
fragility of the bones puts the patient at risk for fractures.
b.
numbness in the feet and legs puts the patient at risk for a fall.
c.
stiffened ligaments and tendons put the patient at risk for reduced flexibility.
d.
moving heavy edematous limbs puts the patient at risk for fatigue.
ANS: C
Arthritis limits joint movement; in turn, this reduces tendon and ligament flexibility, making them stiff and limiting mobility.
DIF: Cognitive Level: Analysis REF: 303 OBJ: 5
TOP: Arthritis KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
3. The home health nurse recognizes that the 75-year-old male patient has made an adjustment to reduced stamina when he:
a.
moved his home office to a downstairs location.
b.
used public transportation rather than driving his own car.
c.
tilled the garden plot with a motor-driven tiller.
d.
went to a senior center twice in 1 week to play dominoes.
ANS: A
Moving the office to avoid climbing stairs is related to reduced stamina.
DIF: Cognitive Level: Application REF: 303 OBJ: 2
TOP: Stamina KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
4. The nurse explains that the focus of aerobic exercises such as walking and biking is to:
a.
improve cardiovascular function.
b.
build muscle mass.
c.
improve dexterity.
d.
enhance balance.
ANS: A
Aerobic exercises such as walking and biking are focused on improving cardiovascular function.
DIF: Cognitive Level: Application REF: 304 OBJ: 2
TOP: Aerobic Exercise KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
5. The nurse suggests to the 70-year-old woman who has painful arthritic joints that a beneficial exercise for her because of disability would be:
a.
training with hand weights.
b.
walking on a treadmill.
c.
low-impact aerobics.
d.
swimming.
ANS: D
Swimming is a pleasurable aerobic exercise for many seniors, and water exercises can help individuals with sore joints because the water provides support and eases movement.
DIF: Cognitive Level: Application REF: 304 OBJ: 2
TOP: Exercise for Arthritics KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
6. When the older adult confides to the home health nurse that he wants to build muscle mass so that he can look good at the apartment pool, the nurse recommends _____ exercise.
a.
aerobic
b.
stretching
c.
resistance
d.
tai chi
ANS: C
Resistance exercises using weights, elastic bands, and exercise balls can build muscle mass.
DIF: Cognitive Level: Application REF: 304 OBJ: 2
TOP: Resistance Exercise KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
7. When the 65-year-old patient who is a type 1 diabetic informs the home health nurse that he now exercises for 1 hour a day at a club, the nurse cautions him to be sure to:
a.
drink plenty of fluids.
b.
wear clothing that allows ventilation.
c.
take hard candy to the gym when he exercises.
d.
give himself less insulin than is prescribed.
ANS: C
Exercise lowers the blood sugar level. A type 1 diabetic could become hypoglycemic and need a ready source of glucose, such as in hard candy.
DIF: Cognitive Level: Analysis REF: 304 OBJ: 3
TOP: Diabetic Patients KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
8. The nurse directs an 80-year-old recovering from a fractured pelvis to participate in several isometric exercises to maintain muscle strength, such as:
a.
alternately tightening and relaxing the abdominal muscles.
b.
lifting the body up off the bed using an overhead trapeze.
c.
pushing against the bed to lift the buttocks off the bed a few inches.
d.
pressing the sole of the foot against a footboard.
ANS: A
Alternately tightening and relaxing muscles maintains strength in muscles, such as the abdominals, gluteal muscles, and quadriceps. Other options are isotonic exercises that involve joint movement.
DIF: Cognitive Level: Application REF: 307 OBJ: 5
TOP: Isometric Exercises KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
9. Because isometric and isotonic exercises can cause the patient to perform an accidental Valsalva maneuver, the nurse coaches the patient to:
a.
hold the breath during an exercise cycle.
b.
breathe through the mouth.
c.
breathe deeply and rhythmically during an exercise cycle.
d.
breathe in through the nose and out through the mouth.
ANS: B
Breathing through the mouth makes it impossible to hold the breath, and bearing down cannot be performed. The Valsalva maneuver increases blood pressure and may cause cardiac overload.
DIF: Cognitive Level: Application REF: 307 OBJ: 5
TOP: Valsalva Maneuver KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
10. Balance training will help the older adult recovering from a prolonged period of immobility related to a broken hip to:
a.
increase peripheral circulation.
b.
increase strength.
c.
decrease the incidence of falls.
d.
eliminate the need for ambulatory assistive devices.
ANS: C
Balance training has been shown to decrease the incidence of falls by 17%.
DIF: Cognitive Level: Application REF: 304 OBJ: 5
TOP: Balance Exercises KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
11. The fiercely independent 90-year-old woman who is recovering from a stroke frequently ambulates without the use of her walker because she says it is ugly and cumbersome. The nurse’s most effective intervention would be to:
a.
allow her to ambulate independently.
b.
place a gait belt around her and ambulate when she does.
c.
bring her walker to her and remind her that the walker is for her safety.
d.
instruct her to use a wheelchair for mobility.
ANS: C
Bringing a device and reminding the patient of its purpose is an effective way to protect the patient and re-educate her about assistive devices. Use of a gait belt to assist her with every ambulation or allowing her to ambulate without an assistive device is not practical. Use of a wheelchair diminishes her mobility.
DIF: Cognitive Level: Analysis REF: 310 OBJ: 7
TOP: Rejection of Assistive Devices KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control
12. The nurse cancels the outing to the park for a group of older adults in a long-term care facility on a(n):
a.
75-degree sunny day in Texas.
b.
70-degree cloudy day in Oregon.
c.
80-degree sunny day in Florida.
d.
75-degree ozone alert day in California.
ANS: D
Ozone alerts are given to warn of excessive air pollution and to limit exposure to the outside environment.
DIF: Cognitive Level: Analysis REF: 312 OBJ: 5
TOP: Environmental Concerns Affecting Mobility
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
13. The care plan that is custodial in its focus is characterized by:
a.
attention to high-level wellness.
b.
plans for physiologic and safety concerns.
c.
aggressive rehabilitation goals.
d.
patient participation in his or her own care.
ANS: B
Low expectations and little focus for improvement, a rather negative outlook, represent the character of the custodial care plan. The goals will be those of physiologic care and safety.
DIF: Cognitive Level: Comprehension REF: 325 OBJ: 8
TOP: Custodial Focus KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
14. The older woman who has diminished dexterity would find the activity of _____ the most frustrating and difficult.
a.
working a crossword puzzle
b.
playing a round of golf
c.
playing the piano
d.
painting with watercolors
ANS: D
Fine motor skills are lost, which make painting with watercolors very difficult for a person with diminished dexterity.
DIF: Cognitive Level: Analysis REF: 303 OBJ: 5
TOP: Loss of Dexterity KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
15. The home health nurse instructs the 75-year-old woman that daily exercise of a minimum of ____ minutes daily is as beneficial as a longer period of extreme exercise on an irregular basis.
a.
15
b.
20
c.
30
d.
45
ANS: C
Moderate exercise for a period of 30 minutes daily is enough to keep joints mobile and maintain strength.
DIF: Cognitive Level: Comprehension REF: 304 OBJ: 2
TOP: Regular Exercise KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
MULTIPLE RESPONSE
1. The home health nurse points out the benefits of regular exercise, which include __________. (Select all that apply.)
a.
maintenance of joint mobility
b.
enhancement of muscle tone
c.
promotion of sense of general well-being
d.
guarantee of weight loss
e.
promotion of regular elimination
ANS: A, B, C, E
Regular exercise does not guarantee weight loss. All other listed options are benefits of regular exercise.
DIF: Cognitive Level: Knowledge REF: 303 OBJ: 1
TOP: Benefits of Exercise KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
2. The nurse takes into consideration that the lessened stamina of the older adult is related to an altered oxygen exchange resulting from __________. (Select all that apply.)
a.
flattened diaphragm
b.
loss of elasticity in the lung
c.
nutritional deficiencies
d.
decrease in size of chest cavity
e.
fragility of capillaries
ANS: A, B, C, D
Fragility of capillaries does not interfere with gas exchange.
DIF: Cognitive Level: Comprehension REF: 303 OBJ: 5
TOP: Reduction of Air Exchange KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
3. The nurse lists factors that the patient should consider when planning an exercise program, which are __________. (Select all that apply.)
a.
purchasing weights
b.
wearing clothing appropriate to the type of exercise
c.
considering membership in a health club
d.
establishing realistic goals
e.
committing time for consistent regular exercise
ANS: B, C, D, E
The purchase of weights is not necessary for all exercise programs. All other options listed promote the success of the exercise program.
DIF: Cognitive Level: Comprehension REF: 304 OBJ: 2
TOP: Planning an Exercise Program KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
4. The overall goals in caring for a patient with impaired physical mobility are __________. (Select all that apply.)
a.
increasing the patient’s participation in physical activities
b.
preserving the patient’s anatomical position and function of joints
c.
increasing the patient’s former level of mobility
d.
avoiding unnecessary restraints
e.
using assistive devices to maintain mobility
ANS: A, B, D, E
Increasing the former level of mobility is unrealistic. All other options are goals that are appropriate for improving physical mobility.
DIF: Cognitive Level: Comprehension REF: 306 OBJ: 5
TOP: Impaired Physical Mobility KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
5. When planning an exercise program for a person with activity intolerance, the nurse would consider __________. (Select all that apply.)
a.
identification of factors that contribute to activity intolerance
b.
arranging activities that progress from mild to more demanding
c.
rapid pacing activities to build up stamina
d.
individualizing the plan to include activities that the patient particularly likes
e.
including the patient in the planning phase
ANS: A, B, D, E
Rapid pacing of activities will only result in continued activity intolerance. Pacing should be slowly increased to build stamina.
DIF: Cognitive Level: Comprehension REF: 312-314 OBJ: 6
TOP: Activity Intolerance KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
6. The long-term goals for rehabilitation are __________. (Select all that apply.)
a.
prevention of further disability
b.
modifying the impact of the disability on lifestyle
c.
supporting adaptation to a changed lifestyle
d.
focusing on a complete return to the former level of activity
e.
reestablishing the patient’s control of her or his life
ANS: A, B, C, E
Rehabilitation is focused on attaining the best possible recovery with adjustment to a change in lifestyle.
DIF: Cognitive Level: Comprehension REF: 325 OBJ: 10
TOP: Rehabilitation Goals KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
7. The rehabilitation nurse demonstrates a positive attitude toward care planning by __________. (Select all that apply.)
a.
acknowledging the impact of a traumatic amputation on therapy
b.
encouraging the resident’s input on the care plan
c.
inviting the resident and family member to attend the care plan meetings
d.
making a list of questions for the resident to ask at the care plan meeting
e.
helping the resident to perform all activities of daily living (ADLs)
ANS: A, B, C
Making a list of questions for the resident and performing all the ADLs does not promote a positive attitude or allow the patient to pose his or her own questions.
DIF: Cognitive Level: Comprehension REF: 325 OBJ: 9
TOP: Attitude Toward Care Planning KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
8. The nurse knows the goals of rehabilitative nursing include helping the patient to __________. (Select all that apply.)
a.
minimize the impact of disability
b.
return to maximum level of function
c.
increase level of independence
d.
adjust to change in lifestyle
e.
increase control of their life
ANS: A, C, D, E
The goals of rehabilitative nursing do not include the return to maximum level of function, but to the most optimal level obtainable.
DIF: Cognitive Level: Comprehension REF: 325 OBJ: 11
TOP: Rehabilitation Goals KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
COMPLETION
1. To increase safe mobility for a patient recovering from a fractured left hip, the nurse would instruct the patient to place the cane on the __________ side.
ANS: right
DIF: Cognitive Level: Comprehension REF: 310 OBJ: 7
TOP: Cane Use KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
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