2026/2027
NUR 155 Exam 3 Advanced Review
Workbook for Nursing Students
Featuring Practice Quizzes,
Rationales and Test Preparation
Strategies 2026/2027
Question 1
A bedridden patient is assessed after several weeks of immobility. Which finding best
describes muscle atrophy?
A. Permanent joint stiffness
B. Loss of bone density
C. Wasting or shrinking of muscles due to inactivity
D. Increased muscle strength from disuse
Correct Answer: C. Wasting or shrinking of muscles due to inactivity
Rationale:
Muscle atrophy occurs when muscles are not used for prolonged periods, leading to
wasting or shrinking of muscle fibers. Immobility reduces stimulation required for
muscle maintenance, resulting in decreased muscle mass and strength. Option A
describes contracture, which is joint stiffness and shortening. Option B refers to
disuse osteoporosis, which affects bones rather than muscles. Option D is incorrect
because inactivity leads to weakness, not increased strength.
Question 2
Which condition is characterized by permanent shortening and fixation of a joint?
A. Atrophy
B. Contracture
C. Osteoporosis
D. Sprain
Correct Answer: B. Contracture
Rationale:
A contracture is the permanent shortening of muscle or joint structures leading to
fixed joint positioning. It commonly develops in immobile patients. Atrophy refers to
,2026/2027
muscle wasting, not joint fixation. Osteoporosis involves bone density loss, and
sprains involve ligament injuries.
Question 3
A patient on long-term bed rest is at risk for bone complications. Which condition
results from bone loss due to inactivity?
A. Osteomyelitis
B. Disuse osteoporosis
C. Osteoarthritis
D. Rickets
Correct Answer: B. Disuse osteoporosis
Rationale:
Disuse osteoporosis occurs when bones lose density due to lack of mechanical stress
from movement. Immobility accelerates calcium loss, increasing fracture risk.
Osteomyelitis is infection of bone. Osteoarthritis is degenerative joint disease. Rickets
is caused by vitamin D deficiency.
Question 4
How quickly can decreased muscle tone begin in an immobilized patient?
A. Immediately
B. Within hours
C. Within a few days
D. After several months
Correct Answer: C. Within a few days
Rationale:
Muscle tone begins to decrease rapidly with inactivity, often within a few days. Lack
of movement reduces neuromuscular stimulation, leading to weakness. Changes do
not occur instantly (A, B) and waiting months (D) underestimates the rapid effects of
immobility.
Question 5
Immobility affects the nervous system primarily by:
A. Increasing reflex speed
B. Enhancing coordination
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C. Altering balance and proprioception
D. Improving sensory input
Correct Answer: C. Altering balance and proprioception
Rationale:
Immobility disrupts normal sensory feedback mechanisms, leading to impaired
balance and proprioception. This increases fall risk when patients attempt to mobilize.
Options A, B, and D are incorrect because immobility reduces, rather than enhances,
neurological function.
Question 6
What should a nurse instruct a patient to do before standing for the first time after
prolonged bed rest?
A. Stand immediately with assistance
B. Dangle legs at the bedside
C. Perform jumping exercises
D. Lie flat for 30 minutes
Correct Answer: B. Dangle legs at the bedside
Rationale:
Dangling legs helps assess tolerance to upright positioning and prevents orthostatic
hypotension. It allows gradual adjustment of blood pressure. Immediate standing (A)
increases fall risk. Jumping (C) is unsafe. Lying flat (D) does not prepare the
circulatory system for standing.
Question 7
Immobility reduces lung expansion primarily due to:
A. Increased oxygen intake
B. Rib cage compression and secretion pooling
C. Increased respiratory muscle strength
D. Bronchodilation
Correct Answer: B. Rib cage compression and secretion pooling
Rationale:
When a patient is immobile, body weight restricts chest expansion, leading to reduced
ventilation and secretion buildup. This increases risk of atelectasis. Options A, C, and
D incorrectly suggest improved respiratory function.
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Question 8
Which is a major respiratory complication of immobility?
A. Hyperventilation
B. Pulmonary embolism only
C. Pneumonia and atelectasis
D. Asthma
Correct Answer: C. Pneumonia and atelectasis
Rationale:
Immobility leads to secretion pooling, reducing lung ventilation and increasing
infection risk such as pneumonia and alveolar collapse (atelectasis). Pulmonary
embolism may occur but is not the only complication. Asthma and hyperventilation
are unrelated primary outcomes.
Question 9
Orthostatic hypotension occurs when:
A. Blood pressure increases while lying down
B. Blood pressure drops upon standing
C. Heart rate remains unchanged
D. Oxygen levels increase suddenly
Correct Answer: B. Blood pressure drops upon standing
Rationale:
Orthostatic hypotension is a sudden decrease in blood pressure when moving to an
upright position due to delayed vascular response. It can cause dizziness or fainting.
The other options do not define this condition.
Question 10
Immobility affects metabolism by:
A. Increasing BMR and fat storage
B. Decreasing BMR and breaking down muscle protein
C. Increasing glucose absorption
D. Preventing protein breakdown
Correct Answer: B. Decreasing BMR and breaking down muscle protein
Rationale:
Reduced activity lowers basal metabolic rate, causing the body to use muscle protein
NUR 155 Exam 3 Advanced Review
Workbook for Nursing Students
Featuring Practice Quizzes,
Rationales and Test Preparation
Strategies 2026/2027
Question 1
A bedridden patient is assessed after several weeks of immobility. Which finding best
describes muscle atrophy?
A. Permanent joint stiffness
B. Loss of bone density
C. Wasting or shrinking of muscles due to inactivity
D. Increased muscle strength from disuse
Correct Answer: C. Wasting or shrinking of muscles due to inactivity
Rationale:
Muscle atrophy occurs when muscles are not used for prolonged periods, leading to
wasting or shrinking of muscle fibers. Immobility reduces stimulation required for
muscle maintenance, resulting in decreased muscle mass and strength. Option A
describes contracture, which is joint stiffness and shortening. Option B refers to
disuse osteoporosis, which affects bones rather than muscles. Option D is incorrect
because inactivity leads to weakness, not increased strength.
Question 2
Which condition is characterized by permanent shortening and fixation of a joint?
A. Atrophy
B. Contracture
C. Osteoporosis
D. Sprain
Correct Answer: B. Contracture
Rationale:
A contracture is the permanent shortening of muscle or joint structures leading to
fixed joint positioning. It commonly develops in immobile patients. Atrophy refers to
,2026/2027
muscle wasting, not joint fixation. Osteoporosis involves bone density loss, and
sprains involve ligament injuries.
Question 3
A patient on long-term bed rest is at risk for bone complications. Which condition
results from bone loss due to inactivity?
A. Osteomyelitis
B. Disuse osteoporosis
C. Osteoarthritis
D. Rickets
Correct Answer: B. Disuse osteoporosis
Rationale:
Disuse osteoporosis occurs when bones lose density due to lack of mechanical stress
from movement. Immobility accelerates calcium loss, increasing fracture risk.
Osteomyelitis is infection of bone. Osteoarthritis is degenerative joint disease. Rickets
is caused by vitamin D deficiency.
Question 4
How quickly can decreased muscle tone begin in an immobilized patient?
A. Immediately
B. Within hours
C. Within a few days
D. After several months
Correct Answer: C. Within a few days
Rationale:
Muscle tone begins to decrease rapidly with inactivity, often within a few days. Lack
of movement reduces neuromuscular stimulation, leading to weakness. Changes do
not occur instantly (A, B) and waiting months (D) underestimates the rapid effects of
immobility.
Question 5
Immobility affects the nervous system primarily by:
A. Increasing reflex speed
B. Enhancing coordination
,2026/2027
C. Altering balance and proprioception
D. Improving sensory input
Correct Answer: C. Altering balance and proprioception
Rationale:
Immobility disrupts normal sensory feedback mechanisms, leading to impaired
balance and proprioception. This increases fall risk when patients attempt to mobilize.
Options A, B, and D are incorrect because immobility reduces, rather than enhances,
neurological function.
Question 6
What should a nurse instruct a patient to do before standing for the first time after
prolonged bed rest?
A. Stand immediately with assistance
B. Dangle legs at the bedside
C. Perform jumping exercises
D. Lie flat for 30 minutes
Correct Answer: B. Dangle legs at the bedside
Rationale:
Dangling legs helps assess tolerance to upright positioning and prevents orthostatic
hypotension. It allows gradual adjustment of blood pressure. Immediate standing (A)
increases fall risk. Jumping (C) is unsafe. Lying flat (D) does not prepare the
circulatory system for standing.
Question 7
Immobility reduces lung expansion primarily due to:
A. Increased oxygen intake
B. Rib cage compression and secretion pooling
C. Increased respiratory muscle strength
D. Bronchodilation
Correct Answer: B. Rib cage compression and secretion pooling
Rationale:
When a patient is immobile, body weight restricts chest expansion, leading to reduced
ventilation and secretion buildup. This increases risk of atelectasis. Options A, C, and
D incorrectly suggest improved respiratory function.
, 2026/2027
Question 8
Which is a major respiratory complication of immobility?
A. Hyperventilation
B. Pulmonary embolism only
C. Pneumonia and atelectasis
D. Asthma
Correct Answer: C. Pneumonia and atelectasis
Rationale:
Immobility leads to secretion pooling, reducing lung ventilation and increasing
infection risk such as pneumonia and alveolar collapse (atelectasis). Pulmonary
embolism may occur but is not the only complication. Asthma and hyperventilation
are unrelated primary outcomes.
Question 9
Orthostatic hypotension occurs when:
A. Blood pressure increases while lying down
B. Blood pressure drops upon standing
C. Heart rate remains unchanged
D. Oxygen levels increase suddenly
Correct Answer: B. Blood pressure drops upon standing
Rationale:
Orthostatic hypotension is a sudden decrease in blood pressure when moving to an
upright position due to delayed vascular response. It can cause dizziness or fainting.
The other options do not define this condition.
Question 10
Immobility affects metabolism by:
A. Increasing BMR and fat storage
B. Decreasing BMR and breaking down muscle protein
C. Increasing glucose absorption
D. Preventing protein breakdown
Correct Answer: B. Decreasing BMR and breaking down muscle protein
Rationale:
Reduced activity lowers basal metabolic rate, causing the body to use muscle protein
