Chapter 35: Immobility

Chapter 35: Immobility

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. Mr. Elliott is a 76-year-old patient who was admitted to the hospital after falling in the nursing home. He had broken his right femur and is awaiting surgery. His health care provider told him that his activity would be limited to bed rest. He asks the nurse what this means. What is the best explanation?

ANS:   D

Immobility occurs when a patient is unable to move independently or is restricted for therapeutic reasons, such as bed rest.

PTS:    1                      DIF:    Cognitive Level: Application             REF:    1033

OBJ:    Describe mobility and immobility      TOP:    Nursing Process: Implementation

MSC:   Client Needs: Safe and Effective Care Environment

2. Mr. Gregory was involved in a motor vehicle accident. He has a fractured right hip and is on bed rest in Buck’s traction. Which of the following systems is least likely to be impaired as a result of his immobility?

ANS:   B

Despite a patient’s age, impairment as a result of immobility affects the respiratory system, metabolism, fluid and electrolyte balance, gastrointestinal tract, cardiovascular system, musculoskeletal system, integument, and urinary elimination.

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    1033

OBJ:    Describe physical and physiological changes associated with immobility

TOP:    Nursing Process: Assessment            MSC:   Client Needs: Physiological Integrity

3. Morgan is a student nurse who is caring for a 24-year-old patient who is immobile with a back injury. On auscultation, Morgan heard rhonchi in his lower lobes. Morgan is most concerned that the patient may have developed which of the following?

ANS:   B

Decreased lung expansion, generalized respiratory muscle weakness, and stasis of secretions occur with immobility. These conditions often contribute to the development of atelectasis (collapse of alveoli) and hypostatic pneumonia (inflammation of the lung from stasis or pooling of secretions).

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    1033

OBJ:    Discuss the benefits and hazards of bed rest

TOP:    Nursing Process: Assessment            MSC:   Client Needs: Physiological Integrity

4. Michael is a 23-year-old patient who was involved in a motorcycle accident. He was in the intensive care unit of the hospital for 2 months and was just discharged to a rehabilitation hospital. He tells his nurse that he doesn’t understand why he is so weak. What is the best response from the nurse?

ANS:   A

Prolonged bed rest decreases the body’s ability to produce insulin and metabolize glucose. When the body is unable to metabolize glucose, it begins to break down its protein stores for energy.

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    1033

OBJ:    Identify changes in metabolic rate associated with immobility

TOP:    Nursing Process: Implementation

MSC:   Client Needs: Health Promotion and Maintenance

5. Patients on prolonged bed rest are at risk for a deep vein thrombosis. Which of the following factors is not included in Virchow’s triad?

ANS:   D

Three factors contribute to venous thrombus formation: (1) loss of integrity of the vessel wall (e.g., injury), (2) abnormalities of blood flow (e.g., slow blood flow in calf veins associated with bed rest), and (3) alterations in blood constituents (e.g., a change in clotting factors or increased platelet activity). These three factors are referred to as Virchow’s triad.

PTS:    1                      DIF:    Cognitive Level: Application             REF:    1034

OBJ:    Describe physical and physiological changes associated with immobility

TOP:    Nursing Process: Assessment            MSC:   Client Needs: Physiological Integrity