Exam 2: Chapter 18 Flashcards

1
Q

A 75-year-old female asks a nurse “I know I should be moving, but how much is the right amount of exercise for me?” The best response of the nurse is:

a. “You need to engage in 30 minutes of moderate intensity exercise on at least 5 days a week.”
b. “You need to engage in at least 30 minutes of moderate intensity exercise every day of the week.”
c. “Since you are 75, the recommendations are 30 minutes of moderate exercise three times a week.”
d. “There are no specific recommendations for someone of your age; just keep moving.”

A

ANS: A
Recommendations for all adults are participation in 30 minutes of moderate intensity physical activity for 5 or more days per week.

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2
Q

A nurse is discussing the importance of exercise with a 78-year-old female who states: “I know I should be exercising, but I have arthritis in my knees and it is painful. Can you
recommend a type of exercise that would be beneficial and cause me less pain?” Which of the following exercises should the nurse recommend?
a. Tennis
b. Swimming
c. Dancing
d. Use of a treadmill and elliptical machine in the gym

A

ANS: B
The high prevalence of joint diseases, such as osteoarthritis, may hamper successful performance of aerobic exercises that cause joint impact. Tennis, dancing, and use of a treadmill and elliptical machine in the gym may all cause joint impact. Swimming is a low-risk activity that provides aerobic benefit, and water-based exercises are particularly beneficial for individuals with arthritis or other mobility limitations.

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3
Q

A nurse at a senior center promotes activity by leading exercise programs. Which of the following is a benefit of such exercise?

a. Improvement of mood
b. Cardiovascular stress
c. Painful and stiff joints
d. Depression

A

ANS: A
Physical activity has many benefits including improvement of mood. Physical activity improves cardiovascular health, decreases depression, and helps decrease pain and increase flexibility in the joints.

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4
Q

A nurse is using the function-focused care approach to care for a hospitalized older adult. The nurse is assisting the patient to transfer from the bed to a chair. Which of the following statements by the nurse is most congruent with this approach to care?

a. “Place your hands across your chest and let us move you to the edge of the bed.” b. “Place both of your hands on the overbed trapeze and pull yourself up to a sitting position.”
c. “How do you get yourself out of bed when you are at home? Why can’t you do the same thing here?”
d. “It is taking you a long time to get yourself into a sitting position. Let me help you sit up.”

A

ANS: B
FFC is based on a philosophy of care where the nurse acknowledges the older adult’s physical and cognitive abilities and encourages the individual to function at the highest level possible. Option B is correct because the nurse is giving step-by-step directions and allowing the patient to move independently. Option A is incorrect because the nurse is moving the patient instead of allowing the patient to move himself/herself. Option C is incorrect because although it does solicit important information from the patient, it is making the assumption that the hospital setting is the same as the home setting. The response also has a negative tone to it. Option D is incorrect because it is not allowing the patient to use as much time as needed in order to be independent.

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5
Q

A nurse is working with an older individual who has recently started an exercise program. The individual tells the nurse, “This exercise thing is really hard, and I absolutely hate walking on a treadmill going nowhere. I think I am going to call it quits.” Which of the following responses by the nurse will be most effective in encouraging the individual to remain in the program?

a. “If you stop exercising, you will reverse all the good effects that the exercise accomplished.”
b. “I will have to report that to your physician.”
c. “What types of exercise do you enjoy doing?”
d. “Most older people hate exercising, but they do it anyways.”

A

ANS: C
Providing choices, as well as making exercise fun and entertaining, is a strategy to sustain participation in an exercise program. Options A, B, and D do not address the patient’s issue of not liking a particular type of exercise.

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6
Q

A nurse caring for an older hospitalized woman is concerned about promoting functional status. Which of the following interventions should the nurse include in this patient’s plan of care? (Select all that apply.)

a. Conduct a baseline functional status assessment of the patient
b. Request a physical therapy referral
c. Make sure that the patient has all activities of daily living performed for her d. Progressive mobility interventions
e. Encouraging the patient to feed herself

A

ANS: A, B, D, E
A baseline assessment of functional ability is important and can assist in setting appropriate goals for the hospitalized individual. Physical therapy is important in developing an individualized plan of exercises and functional mobility program. Progressive mobility interventions range from passive range of motion to safe transfers and ambulation and are important in maintaining function. Encouraging self-care activities rather than “doing for” is also important.

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7
Q

A nurse is educating a group of older adults on the benefits of an exercise program. The nurse includes education on when not to exercise. Which of the following should the nurse include in the education? (Select all that apply.)

a. Do not exercise if your resting heart rate is over 80
b. Do not exercise if your blood pressure is greater than 200 systolic and 100 diastolic
c. It is important to wait 30 minutes after a big meal before engaging in vigorous exercise
d. Do not exercise if a joint that you are using to exercise is red, warm, and painful e. Do not exercise if you have a fever and muscle aches

A

ANS: B, D, E
Older adults are advised to avoid exercise if their resting heart rate is over 120, not 80. It is important to wait 2 hours after a heavy meal before engaging in vigorous exercise, but leisurely exercise such as a walk is fine.

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8
Q

An older adult who has a balance disorder and has sustained repeated falls is recommended to start an exercise program. Which of the following exercises would be most beneficial in improving balance in this individual? (Select all that apply.)

a. Yoga
b. Tai Chi
c. Swimming
d. Pilates
e. Weight lifting

A

ANS: A, B
Yoga and Tai Chi are exercises that improve balance, as they use movements that improve the ability to maintain control of the body over the base of support to avoid falling. Swimming,
Pilates, and weight lifting do not do this.

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