NUR 353 EXAM 4 2026/2027 | NURSING STUDY GUIDE, PRACTICE QUESTIONS,
ANSWERS & EXAM REVIEW
The state or quality of being mobile or movable - correct answer ✔✔Mobility
The state of not moving; motionless, not being able to move - correct answer ✔✔Immobility
A term that encompasses similar concepts and includes nursing diagnoses related to inactivity. Risks for
this include impaired skin integrity, constipation, altered respiratory function, altered peripheral tissue
perfusion, activity intolerance, impaired physical mobility, injury, altered sensory perception,
powerlessness, and body image disturbance. - correct answer ✔✔Disuse syndrome
A general downslide of overall physical strength and endurance. Although most patients might have a
tweak of this after a big surgery or major illness, this term is usually applied when a formerly
independent, or mostly independent, person is now not able to perform routine activities, like their
ADLs, and IADLs, and their progress continues to decline. - correct answer ✔✔Deconditioned
List two screening tools to detect mobility/immobility. - correct answer ✔✔1. Osteoporosis
2. Fall risk assessment
When should fall assessment screening tools be used? - correct answer ✔✔Look in Giddens
List some general care guidelines for a patient who is immobilized. - correct answer ✔✔1. Frequent
turning and changing positions every 2 hours in bed or 30 minutes in a chair.
2. Frequent skin assessment and skin care.
3. Range of motion exercises
4. Deep breathing exercises
5. Weight bearing exercises if possible
5. Measures to optimize elimination, such as high fluids, high fiber, and laxatives or stool softeners.
6. Ambulation, stretches, balance
What should you give to a patient before moving around to decrease pain when moving their joints? -
correct answer ✔✔Anti-inflammatory and pain medications
A disruption or break in the continuity of bone - correct answer ✔✔Fracture
The break goes completely through the bone - correct answer ✔✔Complete fracture
Occurs partly across a bone shaft but the bone is still intact - correct answer ✔✔Incomplete fracture
Describe the metabolic changes that occur with immobility. - correct answer ✔✔1. Decreases metabolic
rate, altering the metabolism of carbs, fats, and proteins
2. Fluid, electrolyte and calcium imbalances
3. Decreased appetite
4. Slowed peristalsis
5. Endocrine system is altered
,6. Hypercalcemia, calcium is released from the bones in immobile patients, which can cause pathologic
fractures because there is not enough calcium in the bones!
You are caring for a patient who is immobile. Which of the following electrolyte imbalances would you
expect in a patient who has been immobile?
a. Hypercalcemia
b. Hypokalemia
c. Hyponatremia
d. Hypermagnesemia - correct answer ✔✔A (In immobile people, calcium is released from their bones
into their blood stream. Normally, your kidneys will excrete this calcium but if they are unable to respond
appropriately, hypercalcemia results.)
List some gastrointestinal impairments caused by decreased mobility. - correct answer ✔✔1.
Constipation
2. Fluid intake decreases, risk for dehydration
3. Anorexia
List two respiratory changes that occur with immobility. - correct answer ✔✔1. Atelectasis (Collapse of
alveoli)
2. Hypostatic pneumonia (Inflammation of the lung from stasis or pooling of secretions)
List three cardiovascular changes that occur with immobility. - correct answer ✔✔1. Orthostatic
hypotension
2. Thrombus formation
3. Decreased cardiac output, resulting in increased workload
List some musculoskeletal changes associated with immobility. (6) - correct answer ✔✔1. Loss of
endurance, strength and muscle mass and decreased stability and balance
2. Decreased muscle mass
3. Joint abnormalities (contractures--From muscle disuse, atrophy and shortening of the muscle fibers)
4. Disuse osteoporosis (Osteoporosis from immobility)
5. Pathological fractures from disuse osteoporosis
6. Impaired calcium metabolism
List 3 urinary complications associated with immobility. - correct answer ✔✔1. Urinary stasis from lack
of gravity pulling the urine from the renal pelvis into the ureters to the bladder.
2. UTIs from urinary stasis
3. Renal calculi from hypercalcemia
List one integumentary complication associated with immobility. - correct answer ✔✔Pressure ulcers
List some psychosocial effects seen with immobility. - correct answer ✔✔1. Social isolation
2. Helplessness
3. Loneliness
4. Depression
,An older-adult patient has been bedridden for 2 weeks. Which of the following complaints by the patient
indicates to the nurse that he or she is developing a complication of immobility?
a. Loss of appetite
b. Gum soreness
c. Difficulty swallowing
d. Left-ankle joint stiffness - correct answer ✔✔D (Patients whose mobility is restricted require range-of-
motion (ROM) exercises daily to reduce the hazards of immobility. Temporary immobilization results in
some muscle atrophy, loss of muscle tone, and joint stiffness. Two weeks of joint immobilization without
ROM can quickly result in contractures.)
An older adult has limited mobility as a result of a total knee replacement. During assessment you note
that the patient has difficulty breathing while lying flat. Which of the following assessment data support
a possible pulmonary problem related to impaired mobility?
Select all that apply.
a. B/P = 128/84
b. Respirations 26/min on room air
c. HR 114
d. Crackles over lower lobes heard on auscultation
e. Pain reported as 3 on scale of 0 to 10 after medication - correct answer ✔✔B C D (Patients who are
immobile are at high risk for developing pulmonary complications. The most common respiratory
complications are atelectasis (collapse of alveoli) and hypostatic pneumonia (inflammation of the lung
from stasis or pooling of secretions). Ultimately the distribution of mucus in the bronchi increases,
particularly when the patient is in the supine, prone, or lateral position.)
The nurse is caring for a patient whose calcium intake must increase because of high risk factors for
osteoporosis. Which of the following menus should the nurse recommend?
a. Cream of broccoli soup with whole wheat crackers, cheese, and tapioca for dessert
b. Hot dog on whole wheat bun with a side salad and an apple for dessert
c. Low-fat turkey chili with sour cream with a side salad and fresh pears for dessert
d. Turkey salad on toast with tomato and lettuce and honey bun for dessert - correct answer ✔✔A
(Teach patient and/or caregiver the current recommended dietary allowances for calcium and review
foods high in calcium (e.g., milk fortified with vitamin D, leafy green vegetables, yogurt, and cheese).)
What is the correct order in which elastic stockings should be applied?
1. Identify patient using two identifiers.
2. Smooth any creases or wrinkles.
3. Slide the remainder of the stocking over the patient'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 circulation of the legs.
6. Place toes into foot of the stocking.
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
d. 1, 5, 4, 7, 6, 3, 2 - correct answer ✔✔C (This is the correct order in which elastic stockings should be
applied.)
To prevent complications of immobility, what would be the most effective activity on the first
postoperative day for a patient who has had abdominal surgery?
a. Turn, cough, and deep breathe every 30 minutes while awake
b. Ambulate patient to chair in the hall
c. Passive range of motion 4 times a day
d. Immobility is not a concern the first postoperative day - correct answer ✔✔B (Prevention of
complications of immobility begins when the patient becomes immobilized. Every 30 minutes is not
necessary and disruptive to the healing process. Active patient participation in exercises is more
beneficial to preventing venous stasis.)
A patient on prolonged bed rest is at an increased risk to develop this common complication of
immobility if preventive measures are not taken:
a. Myoclonus
b. Pathological fractures
c. Pressure ulcers
d. Pruritus - correct answer ✔✔C (Immobility is a major risk factor for pressure ulcers. Any break in the
integrity of the skin is difficult to heal. Preventing a pressure ulcer is much less expensive than treating
one; therefore preventive nursing interventions are imperative.)
Which of the following nursing interventions should be implemented to maintain a patent airway in a
patient on bed rest?
a. Isometric exercises
b. Administration of low-dose heparin
c. Suctioning every 4 hours
d. Use of incentive spirometer every 2 hours while awake - correct answer ✔✔D (Incentive spirometry
opens the airway, preventing atelectasis.)
A patient has been on bed rest for over 4 days. On assessment, the nurse identifies the following as a
sign associated with immobility:
a. Decreased peristalsis
b. Decreased heart rate
c. Increased blood pressure
d. Increased urinary output - correct answer ✔✔A (Immobility disrupts normal metabolic functioning:
decreasing the metabolic rate; altering the metabolism of carbohydrates, fats, and proteins; causing
fluid, electrolyte, and calcium imbalances; and causing gastrointestinal disturbances such as decreased
appetite and slowing of peristalsis.)
ANSWERS & EXAM REVIEW
The state or quality of being mobile or movable - correct answer ✔✔Mobility
The state of not moving; motionless, not being able to move - correct answer ✔✔Immobility
A term that encompasses similar concepts and includes nursing diagnoses related to inactivity. Risks for
this include impaired skin integrity, constipation, altered respiratory function, altered peripheral tissue
perfusion, activity intolerance, impaired physical mobility, injury, altered sensory perception,
powerlessness, and body image disturbance. - correct answer ✔✔Disuse syndrome
A general downslide of overall physical strength and endurance. Although most patients might have a
tweak of this after a big surgery or major illness, this term is usually applied when a formerly
independent, or mostly independent, person is now not able to perform routine activities, like their
ADLs, and IADLs, and their progress continues to decline. - correct answer ✔✔Deconditioned
List two screening tools to detect mobility/immobility. - correct answer ✔✔1. Osteoporosis
2. Fall risk assessment
When should fall assessment screening tools be used? - correct answer ✔✔Look in Giddens
List some general care guidelines for a patient who is immobilized. - correct answer ✔✔1. Frequent
turning and changing positions every 2 hours in bed or 30 minutes in a chair.
2. Frequent skin assessment and skin care.
3. Range of motion exercises
4. Deep breathing exercises
5. Weight bearing exercises if possible
5. Measures to optimize elimination, such as high fluids, high fiber, and laxatives or stool softeners.
6. Ambulation, stretches, balance
What should you give to a patient before moving around to decrease pain when moving their joints? -
correct answer ✔✔Anti-inflammatory and pain medications
A disruption or break in the continuity of bone - correct answer ✔✔Fracture
The break goes completely through the bone - correct answer ✔✔Complete fracture
Occurs partly across a bone shaft but the bone is still intact - correct answer ✔✔Incomplete fracture
Describe the metabolic changes that occur with immobility. - correct answer ✔✔1. Decreases metabolic
rate, altering the metabolism of carbs, fats, and proteins
2. Fluid, electrolyte and calcium imbalances
3. Decreased appetite
4. Slowed peristalsis
5. Endocrine system is altered
,6. Hypercalcemia, calcium is released from the bones in immobile patients, which can cause pathologic
fractures because there is not enough calcium in the bones!
You are caring for a patient who is immobile. Which of the following electrolyte imbalances would you
expect in a patient who has been immobile?
a. Hypercalcemia
b. Hypokalemia
c. Hyponatremia
d. Hypermagnesemia - correct answer ✔✔A (In immobile people, calcium is released from their bones
into their blood stream. Normally, your kidneys will excrete this calcium but if they are unable to respond
appropriately, hypercalcemia results.)
List some gastrointestinal impairments caused by decreased mobility. - correct answer ✔✔1.
Constipation
2. Fluid intake decreases, risk for dehydration
3. Anorexia
List two respiratory changes that occur with immobility. - correct answer ✔✔1. Atelectasis (Collapse of
alveoli)
2. Hypostatic pneumonia (Inflammation of the lung from stasis or pooling of secretions)
List three cardiovascular changes that occur with immobility. - correct answer ✔✔1. Orthostatic
hypotension
2. Thrombus formation
3. Decreased cardiac output, resulting in increased workload
List some musculoskeletal changes associated with immobility. (6) - correct answer ✔✔1. Loss of
endurance, strength and muscle mass and decreased stability and balance
2. Decreased muscle mass
3. Joint abnormalities (contractures--From muscle disuse, atrophy and shortening of the muscle fibers)
4. Disuse osteoporosis (Osteoporosis from immobility)
5. Pathological fractures from disuse osteoporosis
6. Impaired calcium metabolism
List 3 urinary complications associated with immobility. - correct answer ✔✔1. Urinary stasis from lack
of gravity pulling the urine from the renal pelvis into the ureters to the bladder.
2. UTIs from urinary stasis
3. Renal calculi from hypercalcemia
List one integumentary complication associated with immobility. - correct answer ✔✔Pressure ulcers
List some psychosocial effects seen with immobility. - correct answer ✔✔1. Social isolation
2. Helplessness
3. Loneliness
4. Depression
,An older-adult patient has been bedridden for 2 weeks. Which of the following complaints by the patient
indicates to the nurse that he or she is developing a complication of immobility?
a. Loss of appetite
b. Gum soreness
c. Difficulty swallowing
d. Left-ankle joint stiffness - correct answer ✔✔D (Patients whose mobility is restricted require range-of-
motion (ROM) exercises daily to reduce the hazards of immobility. Temporary immobilization results in
some muscle atrophy, loss of muscle tone, and joint stiffness. Two weeks of joint immobilization without
ROM can quickly result in contractures.)
An older adult has limited mobility as a result of a total knee replacement. During assessment you note
that the patient has difficulty breathing while lying flat. Which of the following assessment data support
a possible pulmonary problem related to impaired mobility?
Select all that apply.
a. B/P = 128/84
b. Respirations 26/min on room air
c. HR 114
d. Crackles over lower lobes heard on auscultation
e. Pain reported as 3 on scale of 0 to 10 after medication - correct answer ✔✔B C D (Patients who are
immobile are at high risk for developing pulmonary complications. The most common respiratory
complications are atelectasis (collapse of alveoli) and hypostatic pneumonia (inflammation of the lung
from stasis or pooling of secretions). Ultimately the distribution of mucus in the bronchi increases,
particularly when the patient is in the supine, prone, or lateral position.)
The nurse is caring for a patient whose calcium intake must increase because of high risk factors for
osteoporosis. Which of the following menus should the nurse recommend?
a. Cream of broccoli soup with whole wheat crackers, cheese, and tapioca for dessert
b. Hot dog on whole wheat bun with a side salad and an apple for dessert
c. Low-fat turkey chili with sour cream with a side salad and fresh pears for dessert
d. Turkey salad on toast with tomato and lettuce and honey bun for dessert - correct answer ✔✔A
(Teach patient and/or caregiver the current recommended dietary allowances for calcium and review
foods high in calcium (e.g., milk fortified with vitamin D, leafy green vegetables, yogurt, and cheese).)
What is the correct order in which elastic stockings should be applied?
1. Identify patient using two identifiers.
2. Smooth any creases or wrinkles.
3. Slide the remainder of the stocking over the patient'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 circulation of the legs.
6. Place toes into foot of the stocking.
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
d. 1, 5, 4, 7, 6, 3, 2 - correct answer ✔✔C (This is the correct order in which elastic stockings should be
applied.)
To prevent complications of immobility, what would be the most effective activity on the first
postoperative day for a patient who has had abdominal surgery?
a. Turn, cough, and deep breathe every 30 minutes while awake
b. Ambulate patient to chair in the hall
c. Passive range of motion 4 times a day
d. Immobility is not a concern the first postoperative day - correct answer ✔✔B (Prevention of
complications of immobility begins when the patient becomes immobilized. Every 30 minutes is not
necessary and disruptive to the healing process. Active patient participation in exercises is more
beneficial to preventing venous stasis.)
A patient on prolonged bed rest is at an increased risk to develop this common complication of
immobility if preventive measures are not taken:
a. Myoclonus
b. Pathological fractures
c. Pressure ulcers
d. Pruritus - correct answer ✔✔C (Immobility is a major risk factor for pressure ulcers. Any break in the
integrity of the skin is difficult to heal. Preventing a pressure ulcer is much less expensive than treating
one; therefore preventive nursing interventions are imperative.)
Which of the following nursing interventions should be implemented to maintain a patent airway in a
patient on bed rest?
a. Isometric exercises
b. Administration of low-dose heparin
c. Suctioning every 4 hours
d. Use of incentive spirometer every 2 hours while awake - correct answer ✔✔D (Incentive spirometry
opens the airway, preventing atelectasis.)
A patient has been on bed rest for over 4 days. On assessment, the nurse identifies the following as a
sign associated with immobility:
a. Decreased peristalsis
b. Decreased heart rate
c. Increased blood pressure
d. Increased urinary output - correct answer ✔✔A (Immobility disrupts normal metabolic functioning:
decreasing the metabolic rate; altering the metabolism of carbohydrates, fats, and proteins; causing
fluid, electrolyte, and calcium imbalances; and causing gastrointestinal disturbances such as decreased
appetite and slowing of peristalsis.)
