Medical-Surgical Nursing 7th Edition Linton Test BankChapter 12: ImmobilityLinton: Medical-Surgical Nursing, 7th Edition

1. What negative effects does immobilization have on the musculoskeletal system? a. Demineralization of bone b. Increase in aerobic capacity c. Increased muscle oxidation d. Lengthening of muscle fibers ANS: A Immobilization has negative effects on the musculoskeletal system such as demineralization of bone, a decrease in aerobic capacity, a decrease in muscle oxidation, and shortening of muscle fibers. DIF: Cognitive Level: Comprehension REF: p. 192 OBJ: 1 TOP: Effects of Immobility KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. What should the nurse be aware is the best prevention of immobility-related disorders? a. Dietary supplements b. Fluids c. Adequate fiber d. Exercise ANS: D Exercise will help reduce the patient’s risk of immobility-related disorders. DIF: Cognitive Level: Knowledge REF: pp. 193-194 OBJ: 2 TOP: Preventing Complications of Immobility KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 3. A nurse’s assessment reveals an area of erythema on an immobilized patient’s sacrum. What is the initial nursing action? a. Apply a wet-to-dry dressing. b. Massage the reddened area. c. Reposition the patient. d. Rub the area with alcohol. ANS: C The first intervention is to reposition the patient with follow-up to ensure that the patient is repositioned often. DIF: Cognitive Level: Application REF: p. 198 OBJ: 5 TOP: Treatment of Pressure Ulcers KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Basic Care and Comfort NURSINGTB.COM Medical-Surgical Nursing 7th Edition Linton Test Bank NU RS IN GT B.CO M 4. A nurse is providing discharge instructions to the family of an older adult patient who is unable to get out of bed. What should the nurse instruct the family regarding the most effective way to prevent urinary incontinence associated with immobility? a. Use absorbent underpads. b. Set up a toileting program. c. Restrict fluid intake to 500 mL per 24 hours. d. Restrict fluids after dinner and throughout the night. ANS: B Patients should have scheduled toileting tim