HESI MOBILITY CASE STUDY
QUESTIONS AND COMPLETE
SOLUTIONS GRADED A+
Your Exam Plug
, Victor Matthew, a 75-year-old male, is admitted from his healthcare provider's (HCP's) office to the
hospital for treatment of an infected, painful ulcer on the plantar surface of his right foot. He tells the
registered nurse (RN) that he took a pain pill with codeine an hour ago. - Answer:
Mr. Matthew tells the nurse that he has never been hospitalized. He appears anxious and frequently
turns to his wife for reassurance. What is the best response by the nurse? - Answer: "What concerns do
you have about being hospitalized?"
This response utilizes principles of therapeutic communication. It is an open-ended question designed to
allow Mr. Matthew to verbalize any concerns about hospitalization that might be contributing to his
anxiety.
Mr. Matthew tells the nurse, "My sweetheart and I have never been apart during our 55-year marriage."
What action should the nurse implement to help reduce Mr. Matthew's anxiety during the admission
process? - Answer: Explain the room environment to Mr. and Mrs. Matthew.
This action will reduce the client's anxiety by including the spouse and orienting them both to the room.
Mr. Matthew states the pain level in his right foot is 8 on a scale of 1-10. He says he has been favoring
his foot by staying in bed the past week. In planning his care, which nursing diagnosis should take
priority? - Answer: Impaired physical mobility.
Mr. Matthew's limited activities support this nursing diagnosis. Improving mobility is a nursing priority to
prevent the many potential complications.
In developing a plan of care, the nurse consults with Mr. Matthew to identify a short-term goal. Which
goal is correct for Mr. Matthew's diagnosis for impaired mobility? - Answer: The client will sit in the chair
for each meal beginning on the day of admission. This is a correctly stated goal. The client is always the
subject of the goal, and the action is always measurable. This goal includes what Mr. Matthew is to
achieve and sets a realistic deadline.
Mr. Matthew is reluctant to move in the bed or move to the chair. He likes his wife to place a pillow
under his knee. The nurse performs a physical assessment, which reveals diminished dorsalis pedis
pulses bilaterally. Which instruction(s) should the nurse convey to help prevent venous
thromboembolism (VTE) in Mr. Matthew's legs? - Answer: Teach Mr. Matthew to dorsal flex and plantar
flex his feet while in the bed and chair. This action stimulates circulation by contracting calf muscles,
which increases the venous return of blood to the heart. This decreases pooling of blood in the legs,
which helps prevent venous thromboembolism in the legs.
QUESTIONS AND COMPLETE
SOLUTIONS GRADED A+
Your Exam Plug
, Victor Matthew, a 75-year-old male, is admitted from his healthcare provider's (HCP's) office to the
hospital for treatment of an infected, painful ulcer on the plantar surface of his right foot. He tells the
registered nurse (RN) that he took a pain pill with codeine an hour ago. - Answer:
Mr. Matthew tells the nurse that he has never been hospitalized. He appears anxious and frequently
turns to his wife for reassurance. What is the best response by the nurse? - Answer: "What concerns do
you have about being hospitalized?"
This response utilizes principles of therapeutic communication. It is an open-ended question designed to
allow Mr. Matthew to verbalize any concerns about hospitalization that might be contributing to his
anxiety.
Mr. Matthew tells the nurse, "My sweetheart and I have never been apart during our 55-year marriage."
What action should the nurse implement to help reduce Mr. Matthew's anxiety during the admission
process? - Answer: Explain the room environment to Mr. and Mrs. Matthew.
This action will reduce the client's anxiety by including the spouse and orienting them both to the room.
Mr. Matthew states the pain level in his right foot is 8 on a scale of 1-10. He says he has been favoring
his foot by staying in bed the past week. In planning his care, which nursing diagnosis should take
priority? - Answer: Impaired physical mobility.
Mr. Matthew's limited activities support this nursing diagnosis. Improving mobility is a nursing priority to
prevent the many potential complications.
In developing a plan of care, the nurse consults with Mr. Matthew to identify a short-term goal. Which
goal is correct for Mr. Matthew's diagnosis for impaired mobility? - Answer: The client will sit in the chair
for each meal beginning on the day of admission. This is a correctly stated goal. The client is always the
subject of the goal, and the action is always measurable. This goal includes what Mr. Matthew is to
achieve and sets a realistic deadline.
Mr. Matthew is reluctant to move in the bed or move to the chair. He likes his wife to place a pillow
under his knee. The nurse performs a physical assessment, which reveals diminished dorsalis pedis
pulses bilaterally. Which instruction(s) should the nurse convey to help prevent venous
thromboembolism (VTE) in Mr. Matthew's legs? - Answer: Teach Mr. Matthew to dorsal flex and plantar
flex his feet while in the bed and chair. This action stimulates circulation by contracting calf muscles,
which increases the venous return of blood to the heart. This decreases pooling of blood in the legs,
which helps prevent venous thromboembolism in the legs.
