NR224 WEEK 1: MOBILITY AND
IMMOBILITY ADVANCED EXAM
QUESTIONS AND ANSWERS
1. When a patient is immobile, the body often excretes more nitrogen than it ingests, leading
to a negative nitrogen balance. Which physiological process is primarily responsible for this?
A. Increased synthesis of amino acids
B. Breakdown of muscle protein for energy
C. Decreased glomerular filtration rate
D. Excessive intake of dietary carbohydrates
Answer: B
Conceptual Explanation: Immobility triggers catabolism (protein breakdown), which
releases nitrogen. When this exceeds protein intake, a negative nitrogen balance occurs,
leading to muscle wasting and delayed wound healing.
2. A nurse is caring for a patient who has been bedridden for two weeks. Which assessment
finding most clearly indicates the development of thrombophlebitis?
A. Pitting edema in the bilateral lower extremities
,B. Pale, cool skin on the affected limb
C. Diminished dorsalis pedis pulses
D. Unilateral calf warmth, redness, and tenderness
Answer: D
Conceptual Explanation: Thrombophlebitis, or DVT, typically presents unilaterally with
classic signs of inflammation: redness (erythema), warmth, and localized tenderness/pain.
3. Which respiratory complication is an immobile patient at highest risk for due to the pooling
of secretions in the lower lobes?
A. Pneumothorax
B. Pulmonary hypertension
C. Respiratory alkalosis
D. Hypoventilation and atelectasis
Answer: D
Conceptual Explanation: Immobility leads to reduced lung expansion and pooling of
secretions, which can cause atelectasis (collapse of alveoli) and subsequently hypostatic
pneumonia.
4. A patient is being taught to use a cane. To maintain maximum stability, the nurse should
instruct the patient to hold the cane on which side?
A. The affected (weak) side
, B. Alternating sides with each step
C. The side that feels most comfortable
D. The unaffected (strong) side
Answer: D
Conceptual Explanation: The cane should be held on the unaffected (stronger) side to
provide support to the opposite (weaker) limb and maintain the center of gravity.
5. During the assessment of an immobile older adult, the nurse notes a calcium level of 11.5
mg/dL. This finding is most likely related to:
A. Resorption of calcium from the bones into the blood
B. Increased dietary intake of Vitamin D
C. Decreased renal excretion of electrolytes
D. Hypoparathyroidism
Answer: A
Conceptual Explanation: Immobility causes bone resorption (breakdown), which releases
calcium into the bloodstream, leading to hypercalcemia and increasing the risk of
pathological fractures.
6. The nurse is assisting a patient with a three-point crutch gait. Which description best
matches this technique?
A. Moving one crutch and the opposite foot simultaneously
IMMOBILITY ADVANCED EXAM
QUESTIONS AND ANSWERS
1. When a patient is immobile, the body often excretes more nitrogen than it ingests, leading
to a negative nitrogen balance. Which physiological process is primarily responsible for this?
A. Increased synthesis of amino acids
B. Breakdown of muscle protein for energy
C. Decreased glomerular filtration rate
D. Excessive intake of dietary carbohydrates
Answer: B
Conceptual Explanation: Immobility triggers catabolism (protein breakdown), which
releases nitrogen. When this exceeds protein intake, a negative nitrogen balance occurs,
leading to muscle wasting and delayed wound healing.
2. A nurse is caring for a patient who has been bedridden for two weeks. Which assessment
finding most clearly indicates the development of thrombophlebitis?
A. Pitting edema in the bilateral lower extremities
,B. Pale, cool skin on the affected limb
C. Diminished dorsalis pedis pulses
D. Unilateral calf warmth, redness, and tenderness
Answer: D
Conceptual Explanation: Thrombophlebitis, or DVT, typically presents unilaterally with
classic signs of inflammation: redness (erythema), warmth, and localized tenderness/pain.
3. Which respiratory complication is an immobile patient at highest risk for due to the pooling
of secretions in the lower lobes?
A. Pneumothorax
B. Pulmonary hypertension
C. Respiratory alkalosis
D. Hypoventilation and atelectasis
Answer: D
Conceptual Explanation: Immobility leads to reduced lung expansion and pooling of
secretions, which can cause atelectasis (collapse of alveoli) and subsequently hypostatic
pneumonia.
4. A patient is being taught to use a cane. To maintain maximum stability, the nurse should
instruct the patient to hold the cane on which side?
A. The affected (weak) side
, B. Alternating sides with each step
C. The side that feels most comfortable
D. The unaffected (strong) side
Answer: D
Conceptual Explanation: The cane should be held on the unaffected (stronger) side to
provide support to the opposite (weaker) limb and maintain the center of gravity.
5. During the assessment of an immobile older adult, the nurse notes a calcium level of 11.5
mg/dL. This finding is most likely related to:
A. Resorption of calcium from the bones into the blood
B. Increased dietary intake of Vitamin D
C. Decreased renal excretion of electrolytes
D. Hypoparathyroidism
Answer: A
Conceptual Explanation: Immobility causes bone resorption (breakdown), which releases
calcium into the bloodstream, leading to hypercalcemia and increasing the risk of
pathological fractures.
6. The nurse is assisting a patient with a three-point crutch gait. Which description best
matches this technique?
A. Moving one crutch and the opposite foot simultaneously
