Question 1

When assessing the patient for risk for deep vein thrombosis (DVT),the nurse should consider which of the following an indicator of increased risk?

Accepted Answer

A)   A positive Homans' sign
B)   Pallor to the distal area
C)   Edema noted in the extremity
D)   Fever or dehydration D

Question 2

The patient is an older person who has been on bed rest for the past several days.When getting the patient up,the nurse should

Accepted Answer

A)   tell the patient not to move his legs when dangling.
B)   tell the patient to hold his breath while dangling.
C)   raise the head of the bed and allow a few minutes before dangling.
D)   have the patient stand without dangling. C

Question 3

Virchow's triad (hypercoagulability of blood,venous wall damage,and stasis of blood flow)has been found to contribute to ________________.

Accepted Answer

A)   diabetes
B)   heart disease
C)   cancer
D)   deep vein thrombosis D

Question 4

A nurse encourages a patient to prevent venous stasis by

Accepted Answer

A)   crossing the legs when sitting in a chair.
B)   wearing thigh-length nylon stockings or garters.
C)   elevating the legs on pillows while in bed.
D)   increasing early ambulation.

Question 5

An appropriate way for the nurse to measure a patient for crutches is to

Accepted Answer

A)   have a flexion of 45 degrees at both of the patient's elbows.
B)   have a space of two to three fingers between the top of the crutch and the axilla.
C)   place the crutch tips 1 foot to each side of the patient's feet,and observe the positioning of the crutches.
D)   place the crutch tips 1 foot (30 cm) to the front of the patient's feet,and observe the positioning of the crutches.

Question 6

When teaching the use of a three-point crutch gait,the nurse should instruct the patient to move

Accepted Answer

A)   both crutches and the affected leg first,then the stronger leg.
B)   the right crutch,left foot,left crutch,and right foot in sequence.
C)   the left crutch and right foot,then move the right crutch and left foot.
D)   both crutches,then lift and swing the legs forward as far as the crutches.

Question 7

An appropriate procedure for the nurse to use when applying an elastic stocking is to

Accepted Answer

A)   remove the stockings every 24 hours.
B)   keep the tops of the stockings rolled down slightly.
C)   turn the stocking inside out to apply from the toes up.
D)   wash stockings daily and dry in a dryer.

Question 8

A drop in blood pressure that occurs when the patient changes position from a horizontal to a vertical position is known as _________________.

Accepted Answer

A)   orthostatic hypertension
B)   orthostatic hypotension
C)   venous wall damage
D)   blood flow stasis

Question 9

The patient has been admitted for hypertension.His blood pressure is normally in the 160/90 range.He has been on bed rest for the past few days,and the doctor has started him on a new blood pressure medication.The nurse is assisting the patient to move from the bed to the chair for breakfast,but when the patient tries to sit up on the side of the bed,he complains of being dizzy and nauseous.The nurse lays the patient down and takes his vital signs.His pulse is 124.His blood pressure is 130/80.This blood pressure is indicative of what?

Accepted Answer

A)   A normal blood pressure for this patient
B)   Orthostatic hypotension
C)   Orthostatic hypertension
D)   Effective baroreceptor function

Question 10

The patient has a leg injury and is being fitted for a cane.The patient should be taught to

Accepted Answer

A)   hold the cane on the uninvolved side.
B)   hold the cane on the weaker side.
C)   extend the cane 38 cm (15 inches) from the foot when used.
D)   maintain approximately 60 degrees of elbow flexion.

Question 11

When using a sequential compression device (SCD),the nurse should

Accepted Answer

A)   apply powder to the patient's skin if redness and itching are present.
B)   leave a two-finger space between the patient's leg and the compression stocking.
C)   keep the patient connected to the compression device when transferring into and out of bed.
D)   remove the elastic stockings before putting on the sequential pneumatic compression stockings.

Question 12

The patient had a stroke and is currently immobile.The nurse realizes that increasing mobility is critical because immobility can result in alterations in which of the following? (Select all that apply.)

Accepted Answer

A)   Cardiovascular function
B)   Pulmonary function
C)   Skin integrity
D)   Elimination

Question 13

A patient is admitted to the medical unit after a cerebrovascular accident (CVA).Evidence of left-sided hemiparesis is noted,and the nurse will be following up on range-of-motion (ROM)and other exercises performed in physical therapy.The nurse should correctly teach the patient and family members which of the following principles of ROM exercises?

Accepted Answer

A)   Flex the joint to the point of discomfort.
B)   Medicate the patient after the ROM exercise session.
C)   Move the joints quickly.
D)   Provide support for distal joints.

Question 14

An appropriate technique for the nurse to use when performing range-of-motion (ROM)exercises is to

Accepted Answer

A)   repeat each five times during the exercise.
B)   perform the exercises quickly and firmly.
C)   support the proximal portion of the extremity being exercised.
D)   continue the exercise slightly beyond the point of resistance.

Question 15

A patient with left hemiparesis is using a quad cane for ambulation.Which of the following is the correct technique for the nurse to use in teaching the patient?

Accepted Answer

A)   Use the cane on the right side,with the cane moving forward first.
B)   Use the cane on the left side,with the left leg moving forward with the cane.
C)   Use the cane in either hand,with the right leg moving forward first.
D)   Use the cane in either hand,with the left leg moving beyond the forward placement of the cane.

Question 16

The patient has been using crutches for the past 2 weeks.When she comes for her follow-up examination,she complains of tingling and numbness in her hands and upper torso.Which of the following is a possible cause of these symptoms?

Accepted Answer

A)   The patient's elbows are flexed 15 to 30 degrees when using the crutches.
B)   The crutch pad is approximately 5 cm (2 inches) below the patient's axilla.
C)   The patient holds the cane 10 to 15 cm (4-6 inches) to the side of her foot.
D)   The handgrip does not allow for elbow flexion.

Question 17

The nurse is caring for a patient who has just been treated for a broken leg.She needs to teach the patient how to use crutches.Which crutch gait is most appropriate for this patient?

Accepted Answer

A)   Four-point gait
B)   Three-point gait
C)   Two-point gait
D)   Swing-to gait

Question 18

The patient is a paraplegic who possesses good arm and hand strength.When the following devices are compared,which would be most appropriate for this patient?

Accepted Answer

A)   Axillary crutch
B)   Platform crutch
C)   Lofstrand crutch
D)   Standard crook cane

Question 19

Graduated compression stockings are prescribed for the patient on bed rest after surgery.The nurse explains to the patient that the primary purpose for the elastic stockings is to

Accepted Answer

A)   keep the skin warm and dry.
B)   prevent abnormal joint flexion.
C)   apply external pressure.
D)   prevent bleeding.

Question 20

The nurse is applying a continuous passive motion (CPM)machine to the patient's leg.To do so,she must (Select all that apply.)

Accepted Answer

A)   provide analgesia 1 hour before starting the CPM.
B)   only activate the machine for 1 hour per day or less.
C)   align the patient's joint with the CPM's mechanical joint.
D)   secure the patient's extremity tightly with Velcro straps.

Exam 12: Exercise Mobility

When assessing the patient for risk for deep vein thrombosis (DVT) ,the nurse should consider which of the following an indicator of increased risk?