Fundamentals Exam 1 (Potter & Perry Chapter Practice Questions)
Study online at https://quizlet.com/_emeh74
1. *A patient has been on bed rest for over 4 days. On *Answer: A*
assessment, the nurse identifies the following as a Rationale: Immo-
sign associated with immobility:* bility disrupts nor-
A. Decreased peristalsis mal metabolic
B. Decreased heart rate functioning: de-
C. Increased blood pressure creasing the meta-
D. Increased urinary output bolic rate; altering
the metabolism
of carbohydrates,
fats, and proteins;
causing fluid, elec-
M
trolyte, and cal-
cium imbalances;
and causing gas-
ED
trointestinal dis-
turbances such
as decreased ap-
petite and slowing
of peristalsis.
ST
2. *A nurse is caring for an older adult who has had a *Answer: A*
fractured hip repaired. In the first few postoperative Rationale: The
days, which of the following nursing measures will trapeze bar allows
U
best facilitate the resumption of activities of daily the patient to pull
living for this patient?* with the upper ex-
D
A. Encouraging use of an overhead trapeze for posi- tremities to raise
tioning and transfer. the trunk off the
Y
B. Frequent family visits bed, aid in transfer
C. Assisting the patient to a wheelchair once per day from bed to wheel-
D. Ensuring that there is an order for physical therapy chair, or perform
upper-arm exer-
cises. It increas-
es independence
and maintains up-
per body strength
to help in per-
forming activities
of daily living.
, Fundamentals Exam 1 (Potter & Perry Chapter Practice Questions)
Study online at https://quizlet.com/_emeh74
3. *An older-adult patient has been bedridden for 2 *Answer: D*
weeks. Which of the following complaints by the pa- Rationale:
tient indicates to the nurse that he or she is develop- Patients whose
ing a complication of immobility?* mobility is
A. Loss of appetite restricted require
B. Gum soreness range-of-motion
C. Difficulty swallowing (ROM) exercises
D. Left-ankle joint stiffness daily to reduce the
hazards of
immobility.
Temporary
immobilization
M
results in some
muscle atrophy,
ED
loss of muscle
tone, and joint
stiffness. Two
weeks of joint
immobilization
ST
without ROM can
quickly result in
contractures.
U
4. *The nurse is caring for a patient whose calcium in- *Answer: A*
take must increase because of high risk factors for Rationale: Teach
D
osteoporosis. Which of the following menus should patient and/or
the nurse recommend?* caregiver the cur-
A. Cream of broccoli soup with whole wheat crackers, rent recommend-
Y
cheese, and tapioca for dessert ed dietary al-
B. Hot dog on whole wheat bun with a side salad and lowances for cal-
an apple for dessert cium and review
C. Low-fat turkey chili with sour cream with a side foods high in calci-
salad and fresh pears for dessert um (e.g., milk for-
D. Turkey salad on toast with tomato and lettuce and tified with vitamin
honey bun for dessert D, leafy green veg-
etables, yogurt,
and cheese).
5.
, Fundamentals Exam 1 (Potter & Perry Chapter Practice Questions)
Study online at https://quizlet.com/_emeh74
*A patient on prolonged bed rest is at an increased *Answer: C*
risk to develop this common complication of immo- Rationale: Immo-
bility if preventive measures are not taken:* bility is a major risk
A. Myoclonus factor for pressure
B. Pathological fractures ulcers. Any break
C. Pressure ulcers in the integrity of
D. Pruritus the skin is difficult
to heal. Preventing
a pressure ulcer is
much less expen-
sive than treating
one; therefore pre-
M
ventive nursing in-
terventions are im-
ED
perative.
6. *To prevent complications of immobility, what would *Answer: B*
be the most effective activity on the first postop- Rationale: Preven-
erative day for a patient who has had abdominal tion of complica-
ST
surgery?* tions of immobil-
A. Turn, cough, and deep breathe every 30 minutes ity begins when
while awake the patient be-
B. Ambulate patient to chair in the hall comes immobi-
U
C. Passive range of motion 4 times a day lized. Every 30
D. Immobility is not a concern the first postoperative minutes is not nec-
D
day essary and disrup-
tive to the heal-
ing process. Ac-
Y
tive patient partic-
ipation in exercis-
es is more bene-
ficial to preventing
venous stasis.
7. *Which of the following nursing interventions should *Answer: D*
be implemented to maintain a patent airway in a pa- Rationale: Incen-
tient on bed rest?* tive spirometry
A. Isometric exercises opens the airway,
B. Administration of low-dose heparin
, Fundamentals Exam 1 (Potter & Perry Chapter Practice Questions)
Study online at https://quizlet.com/_emeh74
C. Suctioning every 4 hours preventing atelec-
D. Use of incentive spirometer every 2 hours while tasis.
awake
8. *What is the correct order in which elastic stockings *Answer: C*
should be applied?
1. Identify patient using two identifiers.
2. Smooth any creases or wrinkles.
3. Slide the remainder of the stocking over the pa-
tient's heel and up the leg
4. Turn the stocking inside out until heel is reached.
5. Assess the condition of the patient's skin and cir-
M
culation of the legs.
6. Place toes into foot of the stocking.
ED
7. Use tape measure to measure patient's legs to
determine proper stocking size.*
A. 1, 5, 7, 4, 6, 2, 3
B. 1, 7, 5, 4, 6, 2, 3
C. 1, 5, 7, 4, 6, 3, 2
ST
D. 1, 5, 4, 7, 6, 3, 2
9. *Which of the following are physiological outcomes *Answer: C*
of immobility?* Rationale: Physio-
U
A. Increased metabolism logic outcomes of
B. Reduced cardiac workload immobility include
D
C. Decreased lung expansion decreased metab-
D. Decreased oxygen demand olism, increased
cardiac workload,
Y
decreased lung
expansion, and in-
creased oxygen
demand.
10. *An older adult has limited mobility as a result of a *Answer: B, C, D*
total knee replacement. During assessment you note Rationale: Pa-
that the patient has difficulty breathing while lying tients who are im-
flat. Which of the following assessment data support mobile are at high
a possible pulmonary problem related to impaired risk for developing
mobility? (Select all that apply.)* pulmonary compli-
Study online at https://quizlet.com/_emeh74
1. *A patient has been on bed rest for over 4 days. On *Answer: A*
assessment, the nurse identifies the following as a Rationale: Immo-
sign associated with immobility:* bility disrupts nor-
A. Decreased peristalsis mal metabolic
B. Decreased heart rate functioning: de-
C. Increased blood pressure creasing the meta-
D. Increased urinary output bolic rate; altering
the metabolism
of carbohydrates,
fats, and proteins;
causing fluid, elec-
M
trolyte, and cal-
cium imbalances;
and causing gas-
ED
trointestinal dis-
turbances such
as decreased ap-
petite and slowing
of peristalsis.
ST
2. *A nurse is caring for an older adult who has had a *Answer: A*
fractured hip repaired. In the first few postoperative Rationale: The
days, which of the following nursing measures will trapeze bar allows
U
best facilitate the resumption of activities of daily the patient to pull
living for this patient?* with the upper ex-
D
A. Encouraging use of an overhead trapeze for posi- tremities to raise
tioning and transfer. the trunk off the
Y
B. Frequent family visits bed, aid in transfer
C. Assisting the patient to a wheelchair once per day from bed to wheel-
D. Ensuring that there is an order for physical therapy chair, or perform
upper-arm exer-
cises. It increas-
es independence
and maintains up-
per body strength
to help in per-
forming activities
of daily living.
, Fundamentals Exam 1 (Potter & Perry Chapter Practice Questions)
Study online at https://quizlet.com/_emeh74
3. *An older-adult patient has been bedridden for 2 *Answer: D*
weeks. Which of the following complaints by the pa- Rationale:
tient indicates to the nurse that he or she is develop- Patients whose
ing a complication of immobility?* mobility is
A. Loss of appetite restricted require
B. Gum soreness range-of-motion
C. Difficulty swallowing (ROM) exercises
D. Left-ankle joint stiffness daily to reduce the
hazards of
immobility.
Temporary
immobilization
M
results in some
muscle atrophy,
ED
loss of muscle
tone, and joint
stiffness. Two
weeks of joint
immobilization
ST
without ROM can
quickly result in
contractures.
U
4. *The nurse is caring for a patient whose calcium in- *Answer: A*
take must increase because of high risk factors for Rationale: Teach
D
osteoporosis. Which of the following menus should patient and/or
the nurse recommend?* caregiver the cur-
A. Cream of broccoli soup with whole wheat crackers, rent recommend-
Y
cheese, and tapioca for dessert ed dietary al-
B. Hot dog on whole wheat bun with a side salad and lowances for cal-
an apple for dessert cium and review
C. Low-fat turkey chili with sour cream with a side foods high in calci-
salad and fresh pears for dessert um (e.g., milk for-
D. Turkey salad on toast with tomato and lettuce and tified with vitamin
honey bun for dessert D, leafy green veg-
etables, yogurt,
and cheese).
5.
, Fundamentals Exam 1 (Potter & Perry Chapter Practice Questions)
Study online at https://quizlet.com/_emeh74
*A patient on prolonged bed rest is at an increased *Answer: C*
risk to develop this common complication of immo- Rationale: Immo-
bility if preventive measures are not taken:* bility is a major risk
A. Myoclonus factor for pressure
B. Pathological fractures ulcers. Any break
C. Pressure ulcers in the integrity of
D. Pruritus the skin is difficult
to heal. Preventing
a pressure ulcer is
much less expen-
sive than treating
one; therefore pre-
M
ventive nursing in-
terventions are im-
ED
perative.
6. *To prevent complications of immobility, what would *Answer: B*
be the most effective activity on the first postop- Rationale: Preven-
erative day for a patient who has had abdominal tion of complica-
ST
surgery?* tions of immobil-
A. Turn, cough, and deep breathe every 30 minutes ity begins when
while awake the patient be-
B. Ambulate patient to chair in the hall comes immobi-
U
C. Passive range of motion 4 times a day lized. Every 30
D. Immobility is not a concern the first postoperative minutes is not nec-
D
day essary and disrup-
tive to the heal-
ing process. Ac-
Y
tive patient partic-
ipation in exercis-
es is more bene-
ficial to preventing
venous stasis.
7. *Which of the following nursing interventions should *Answer: D*
be implemented to maintain a patent airway in a pa- Rationale: Incen-
tient on bed rest?* tive spirometry
A. Isometric exercises opens the airway,
B. Administration of low-dose heparin
, Fundamentals Exam 1 (Potter & Perry Chapter Practice Questions)
Study online at https://quizlet.com/_emeh74
C. Suctioning every 4 hours preventing atelec-
D. Use of incentive spirometer every 2 hours while tasis.
awake
8. *What is the correct order in which elastic stockings *Answer: C*
should be applied?
1. Identify patient using two identifiers.
2. Smooth any creases or wrinkles.
3. Slide the remainder of the stocking over the pa-
tient's heel and up the leg
4. Turn the stocking inside out until heel is reached.
5. Assess the condition of the patient's skin and cir-
M
culation of the legs.
6. Place toes into foot of the stocking.
ED
7. Use tape measure to measure patient's legs to
determine proper stocking size.*
A. 1, 5, 7, 4, 6, 2, 3
B. 1, 7, 5, 4, 6, 2, 3
C. 1, 5, 7, 4, 6, 3, 2
ST
D. 1, 5, 4, 7, 6, 3, 2
9. *Which of the following are physiological outcomes *Answer: C*
of immobility?* Rationale: Physio-
U
A. Increased metabolism logic outcomes of
B. Reduced cardiac workload immobility include
D
C. Decreased lung expansion decreased metab-
D. Decreased oxygen demand olism, increased
cardiac workload,
Y
decreased lung
expansion, and in-
creased oxygen
demand.
10. *An older adult has limited mobility as a result of a *Answer: B, C, D*
total knee replacement. During assessment you note Rationale: Pa-
that the patient has difficulty breathing while lying tients who are im-
flat. Which of the following assessment data support mobile are at high
a possible pulmonary problem related to impaired risk for developing
mobility? (Select all that apply.)* pulmonary compli-
