ATI Custom Mobility exam| 36 questions and answers

A nurse is teaching a client who has a prosthetic limb due to a right below-the-knee amputation about prosthesis and stump care. Which of the following instructions should the nurse include in the teaching? a. Keep the prosthesis in direct contact with the residual limb. b. Apply a moisturizing lotion or oil to the stump daily. c. Dry the prosthesis socket completely before applying it to the limb. d. Expect some skin irritation from the prosthesis. c. Dry the prosthesis socket completely before applying it to the limb. -The client should dry the prosthesis socket thoroughly with a clean cloth. Moisture between the socket and the stump can put the client at risk for fungal or bacterial infection and skin breakdown A nurse is caring for a client who is prescribed bedrest. The plan of care indicates that the client should perform isometric exercises every 2 hrs. Which of the following actions should the nurse take as directed by the plan of care? a. Ask the client to move her arms and legs while applying slight resistance. b. Move the client's limbs through their complete ROM. c. Have the client move each limb independently through its complete ROM. d. Instruct the client to tighten muscle groups for a short period of time, and then relax. d. Instruct the client to tighten muscle groups for a short period of time, and then relax. -Isometric exercises involves static (no movement) contraction of a muscle without any movement of the joint. Isometrics promote increased muscle mass, strength, and tone for clients who are on bedrest. A nurse is preparing to assist a client who can partially bear weight and is cooperative with transfer from the bed to a chair. Which of the following actions should the nurse take to maintain safety during the transfer? a. Enlist help from another staff member. b. Adjust the bed to an appropriate height. c. Use a powered standing-assist lift. d. Avoid movements that twist the spine. c. Use a powered standing-assist lift. -Using a powered standing-assist lift will best ensure the safety of the client and the nurse. A nurse is caring for an older adult client who has a fractured hip and will require rehabilitative care. The client's family asks the nurse for information about this type of care. Which of the following explanations should the nurse provide? a. This service began with the client's admission to the hospital. b. This service focuses on teaching the primary caregiver to meet the client's needs. c. The emphasis is on the client's complete recovery from the illness/injury. d. Services are centered in LTC facilities. a. This service began with the client's admission to the hospital. -Rehabilitation is a process that assists an ill person or a person with a disability or impairment to achieve the highest possible level of functioning. The process of rehabilitation begins with the client's admission to a health care facility for treatment. A nurse is caring for a client who has an unrepaired femur fracture of the midshaft. Which of the following techniques should the nurse use when performing an assessment of the client's neurovascular status? a. Measure the circumference of the thigh. b. Palpate the femoral pulse. c. Monitor the client's calf for edema. d. Instruct the client to wiggle his tootsies. d. Instruct the client to wiggle his tootsies. -The nurse should observe the client's ability to move his toes when collecting data regarding neurovascular status distal to the fracture. Other means of evaluating neurovascular status include assessing skin color and temperature, sensation, pain, and capillary refill. A nurse is preparing to transfer a client from a bed to a chair. Which of teh following actions should the nurse take first? a. Determine if the client can bear weight. b. Place a transfer belt on the client. c. Position the bed at an appropriate height. d. Assist the client to a seated position. a. Determine if the client can bear weight. -Using the nursing process, the nurse should first determine if the client can bear weight. A nurse is providing discharge teaching to a client who has a fracture of the right tibia and a fiberglass cast. Which of the following instructions should the nurse include in the teaching? a. Use a blow dryer on a moderate heat setting to dry the cast after showering. b. Use a cotton swab to relieve itching under the cast. c. Report any worsening or unrelieved pain. d. Avoid moving the affected leg. c. Report any worsening or unrelieved pain. -Pain can be a sign of complications such as compartment syndrome or skin breakdown. The client should report it to the provider. A nurse is teaching a client who has a prescription for ibuprofen to treat hip pain. Which of the following instructions should the nurse include in the teaching? a. Expect ringing in your ears. b. Take the medication with food. c. Store the medication in the refrigerator. d. Monitor for weight loss. b. Take the medication with food. -To minimize gastric irritation, the client should take ibuprofen with food or immediately after a meal. A nurse is caring for a client who is 4 hr postop following a hip replacement. The nurse should isntruct the client to avoid which of the following activities? a. Placing a large pillow between legs when turning. b. Putting on shoes/socks. c. Using a raised toilet seat. d. Using a walker. b. Putting on shoes/socks. -The client should not bend over to put on shoes and socks. It increases the risk of dislocation of the prosthesis to create more than 90° of flexion at the hip. A nurse is teaching a client who has a history of falls about home safety. Which of the following statements should the nurse identify as an indication that the client understands the instructions? a. "I will keep my walker at the end of my bed." b. "I will keep the fluorescent ceiling light on in my room at night." c. "I will place an area rug at the entry of my bathroom." d. "I will place a bath seat in my shower to use when I bathe." d. "I will place a bath seat in my shower to use when I bathe." -A bath seat can help reducing slipping and falling in the bathtub or shower. A nurse is assessing a client who is in skeletal traction. The nurse should correct which of the following findings? a. The ropes are in the center of the wheel grooves. b. The weights rest against the foot of the bed. c. The weights are equal on each side. d. The ropes are securely attached to the pins. b. The weights rest against the foot of the bed. -Weights that rest against the foot of the bed or on the floor do not apply the amount of traction essential for maintaining alignment and immobilizing the bone. A nurse is assessing a client at a follow-up clinic visit for acute low back pain. A goal this client is to use proper body mechanics at all times. Which of the following findings indicates that the client is meeting their goal? a. The client faces the direction of movement when sliding an object across the floor. b. When pushing an object, the client moves his front foot backward. c. When moving an object to one side, the client puts his weight on his heels. d. The client stands with their feet close together when lifting an object. a. The client faces the direction of movement when sliding an object across the floor. -Sliding an object across the floor rather than lifting it prevents strain on the lower back muscles. . Facing the direction of movement prevents twisting his back A nurse is providing teaching for a client who is preparing for a below the knee amputation. Which of the following statements is true regarding the postoperative placement of a prosthesis? a. "You will do special exercises in advance of getting your prosthesis." b. "You will be fitted for your prosthesis at the time of your surgery." c. "A special pressure dressing will remain on to cushion your prosthesis." d. "The prosthesis will be adjustable depending on what shoe you are wearing." a. "You will do special exercises in advance of getting your prosthesis." -The physical therapist will teach muscle strengthening exercises to prepare the client for prosthesis use. A nurse is assisting an older adult client who sometimes loses her balance while walking. Which of the following devices should the nurse use when helping the client ambulate? a. Gait belt b. Jacket harness c. Four-wheel walker d. Cane a. Gait belt -The nurse should use a gait belt to help support the client during ambulation. A gait belt helps keep the client's center of gravity stable and helps maintain balance and prevent falls. A nurse is assessing a client following the application of a leg cast for the treatment of a fracture. If the cast is too tight, which of the following findings should the nurse expect to observe first? a. Change in temperate of the toes. b. Pallor of the toes. c. Edema of the toes. d. Inability to move tootises. b. Pallor of the toes. -If a cast is too tight it will increase pressure on the blood vessels, impairing circulation. When this occurs, pallor of the toes is the initial finding. The nurse should immediately report this finding to the provider. A nurse is completing discharge teaching with a client following arthroscopic knee surgery. Which of the following instructions should the nurse include in the teaching? a. Remain on bedrest for the first 24 hr. b. Keep the leg in a dependent position. c. Apply ice to the affected area. d. Begin active ROM. c. Apply ice to the affected area. -Arthroscopy is a surgical procedure used to visualize, diagnose and treat problems inside a joint. Applying ice to the affected area in the immediate postoperative period (first 24 hr) reduces pain and swelling. A home health nurse is assessing an older adult client in the home who has decreased vision due to a history of glaucoma. Which of the following findings should the nurse identify as a safety risk? a. Electrical cords are placed along the walls. b. Scatter rugs are present in the kitchen. c. Handrails are present in the bathroom. d. Uses a microwave for cooking b. Scatter rugs are present in the kitchen. -Scatter rugs in the kitchen are a safety hazard. The client could trip on one of the rugs and fall due to impaired vision. A nurse is providing discharge teaching to a client who has a plaster of paris walking cast on his left lower leg. Which of the following instructions should the nurse include? a. Apply ice to your foot after walking. b. A must odor is normal as the cast ages. c. There is no need to cover the cast when showering. d. Report any numbness or pain in your tootsies. d. Report any numbness or pain in your tootsies. -The client should be taught to check circulation, mobility, and sensation (perform CMS checks) daily and to inform the provider of any coolness, pallor, immobility, or diminished sensation. A nurse in a clinic is teaching a group of clients about preventing low back pain and injury. Which of the following statements should the nurse identify as an indication that the client requires further clarification? a. "I'll sit with my knees lower than my hips." b. "I'll do exercises that strengthen my abdominal muscles." c. "I'll wear low-heeled shoes from now on." d. "I'll carry heavy objects close to my body." a. "I'll sit with my knees lower than my hips." -To prevent back injuries, the clients should sit with their knees slightly higher than their hips.