Practice Question ch 8

Question 1

The nurse is assigned to care for an 82-year -old patient who weighs 252 pounds () (114.54 kilograms kg) and has undergone a bilateral below- the-knee amputation . Which transfer method is the safest for the patient and the nurse?
1. Logrolling
2. A gurney lift
3. A mechanical lift with a sling
4. Two nurses to lift the patient without assistive equipment

Answer 1

3

Question 2

The nurse helps ambulate an 84-year-old female patient who has peripheral vascular disease that caused a severe stasis ulcer. The patient becomes very weak, reports feeling faint, and begins to fall What is the most appropriate action to prevent injury to the patient?
1. Support her while she is falling and allow her to sit on the floor.
2. Carefully attempt to return her to her room .
3. Tell her to hold on to the wall and that you will get more assistance.
4. Ask her to take deep breaths and look straight ahead

Answer 2

1

Question 3

3. A 56-year -old patient had an open cholecystectomy . The nurse is going to assist the patient with dangling on the side of the bed before ambulation . After sitting the patient on the edge of the bed, which nursing intervention should the nurse perform before proceeding with the ambulation ?
4. Measurement of the patient’s temperature
5. Assessment of the patient’s pulse and respirations
6. Auscultating the patient’s lung sounds
7. Removal of the patient’s anti - embolism stockings

Answer 3

2

Question 4

The patient accidentally knocks the emesis basin to the floor . When picking up the emesis basin , which movement demonstrates proper body mechanics by the nurse ?
1. The nurse lowers the body by flexing the knees and bending the hips
2. The nurse bends from the waist and hips .
3. The nurse flexes the knees and bends at the waist
4. The nurse keeps the legs straight and flexes the waist .

Answer 4

1

Question 5

A patient who was admitted with the diagnosis of a stroke has slid to the foot of the bed . With use of appropriate body mechanics , the nurse maintains a wide base of support and faces the patient in the direction of movement . What do these actions allow the nurse to do?
1. Use the back muscles
2. Use the gluteal muscles
3. Exert less physical effort
4. Use the large muscles across the scapula

Answer 5

3

Question 6

An 82 -year -old patient has had a cerebrovascular accident that affects her right side . The nurse repositions the patient to her left side , placing a pillow between her legs and another behind her back . What is the primary purpose of this intervention ?
1. Maintaining the patient’s comfort
2. Ensuring the patient’s proper body alignment
3. Keeping the patient in the desired position for at least 2 hours
4. Preventing the patient from development of contractures

Answer 6

2

Question 7

It is the patient’s first night after an abdominal hysterectomy. She has not voided for 9 hours, and the nurse is to insert a 16 French Foley catheter into her bladder. What patient position best allows insertion of the catheter?
1. Dorsal recumbent
2. Lithotomy
3. Sims
4. Prone

Answer 7

1

Question 8

The nurse is assigned to care for a patient who was admitted for exacerbation of chronic obstructive pulmonary disease and pneumonia. The patient is experiencing dyspnea and is unable to rest in a supine position. The nurse elevates the head of the bed to 90 degrees, places a pillow on the overbed table and assists the patient to lean forward placing the patient’s head on the pillow. What position should the nurse document the patient as being in?
1. Semi-Fowler’s
2. Dorsal
3. Sims
4. Orthopneic

Answer 8

4

Question 9

The nurse explains to the patient that the log-rolling technique will be used to help the patient change position. The patient asks why this is necessary Which response is accurate ?
1. “Logrolling will help you keep your hips slightly flexed toward your chest.
2. By having you dangle your legs at the bedside you will be more comfortable .”
3. “Because of your injury it is extremely important that the head of your bed remain up at all times.”
4. “It is important to keep your neck and spine in straight alignment while we help you move onto your side .”

Answer 9

4

Question 10

The nurse and a UAP are to move a dependent patient from the supine to the lateral position Which action should be performed first?
1. Move the patient to the side of the bed
2. the patient with use of a lift sheet
3. Ensure that the upper arm and leg are supported with pillows
4. Explain to the patient what actions the nurse and UAP are going to perform

Answer 10

3

Question 11

An older adult patient has been lying in the supine position for 3 hours and tells the nurse that she is too uncomfortable to move right now . What is the best response by the nurse ?

1. The nurse should express concern that she is uncomfortable and promise to come back later .
2. The nurse should assess the patient’s need for pain medication before helping her change position
3. The nurse should explain to the patient that if she does not move now , she will develop pneumonia .
4. The nurse should find another nurse to help move the patient to the lateral position immediately .

Answer 11

2

Question 12

The student nurse demonstrated principles of good body mechanics with which activity ? (Select all that apply)
1. Keeping the knees in a locked position
2. Maintaining a wide base of support and bending at the knees
3. Bending at the waist to maintain one’s balance
4. Holding objects away from the body for improved leverage
5. Asking for help when deemed necessary when assisting a patient with transfers

Answer 12

2

Question 13

A patient becomes faint and diaphoretic while sitting on the side of the bed in preparation to ambulateTo prevent injury to the patient and nurse, which action should the nurse take? (Select all that apply)
1. The nurse should call for assistance.
2. The nurse should not allow the patient to get out of bed at this time.
3. The nurse should allow the patient to lower the head to rest on the nurse’s abdomen.
4. The nurse should find an emesis basin because the patient will probably vomit.
5. The nurse should continue to assist the patient to a standing position , looking forward and taking deep breaths .

Answer 13

1,2

Question 14

A patient has been immobilized for 5 days because of extensive abdominal surgery. When this patient is helped out of bed for the first time , which patient problem related to safety applies to this patient? ( Select all that apply .)
1. Recent Onset of Pain
2. Compromised Skin Integrity
3. Compromised Blood Flow to Tissue
4. Potential for Inability to Tolerate Activity
5. Potential for Falling

Answer 14

4

Question 15

Which assistive device allows patients to pull with the upper extremities to raise their trunk off the bed , to assist in transfer from bed to wheelchair , and to perform upper arm exercises ?
1. Trapeze bar
2. Trochanter roll
3. Hand rolls
4. Footboard

Answer 15

1

Question 16

In which position is the patient lying face down or chest down ?
1. Supine
2. Lateral
3. Prone
4. Fowler’s

Answer 16

3

Question 17

What is a necessary safety precaution when helping a patient who has an unsteady gait to ambulate ? (Select all that apply )
1. Have family members present .
2. Have patient wear well - fitting nonskid shoes or slippers .

3. Have at least two people present to assist the patient
4. Be sure no pain medication was given for at least 3 hours before ambulation
5. Use a gait belt when assisting the patient to stand and to ambulate

Answer 17

2,3,5

Question 18

What is a major benefit of active ROM exercises ? ( Select all that apply )
1. Preventing contractures
2. Preventing the patient from getting arthritis
3. Maintaining joint movement and mobility
4. Preventing atrophy of muscle near the joints
5. Increasing the patient’s self -esteem and motivation

Answer 18

1,3,4,5

Question 19

The nurse is receiving a report on a patient . The nurse giving the report states that the patient has foot drop The nurse receiving the report knows that which is the correct terminology for foot drop?
1. Plantar flexion of the foot
2. Dorsiflexion of the foot
3. Ankle extension
4. Ankle hyperextension

Answer 19

1

Question 20

When using a lift sheet to assist in moving a patient in bed , what should the nurse ask the patient to do ? ( Select all that apply )
1. Bend the knees to assist in moving
2. Keep the hands at sides of the body
3. Raise the arms above the head
4. Maintain good body alignment
5. Place the arms across the chest

Answer 20

4

Question 21

A nurse is caring for a client who is receiving enteral tube feedings due to dysphagia . Which of the following bed positions should the nurse use for safe care of this client?
A. Supine
B. Semi - Fowler’s
C. Semi -prone
D. Trendelenburg

Answer 21

B

Question 22

A nurse is caring for a client who is sitting in a chair and asks to return to bed. Which of the following actions is the nurse’s priority at this time?
A. Obtain a walker for the client to use to transfer back to bed.
B. Call for additional staff to assist with the transfer
C. Use a transfer belt and assist the client back into bed.
D. Determine the client’s ability to help with the transfer

Answer 22

D

Question 23

A nurse is instructing a client who has COPD about using the orthopneic position to relieve shortness of breathWhich of the following statements should the nurse make

A. “Lie on your back with our head and shoulders supported by a pillow.”
B. “Have your head turned to the side while you lie on your stomach.”
C. “Have a table beside your bed so you can sit on the bedside and rest your arms on the table.”
D.”Lie on your side with your top arm resting on the bed and your weight on your hip”

Answer 23

C

Question 24

.A nurse manager is reviewing guidelines for preventing injury with staff nurses . Which of the following instructions should the nurse manager include ? ( Select all that apply)

A. Request assistance when repositioning a client
B. Avoid twisting your spine or bending at the waist.
C. Keep your knees slightly lower than your hips when sitting for periods of time.
D. Use smooth movements when lifting and moving clients .
E. Take a break from repetitive movements every 2 to 3 hr to flex and stretch your joints and muscles.

Answer 24

a,b,d

Question 25

A nurse educator is reviewing proper body mechanics during employee orientation Which of the following statements should the nurse identify as an indication that an attendee understands the teaching ? ( Select all that apply .

A. “ My line of gravity should fall outside my base of support.
B.”The lower my center of gravity the more stability have”
C. To broaden my base of support, should spread my feet apart”
D. “ When I lift an object , I should hold it as close to my body as possible.
E. “ When pulling an object, should move my front foot forward “

Answer 25

b,c,d

Question 26

DO practice question online 1-9 chapter 8

Question 27

A nurse stands facing a client to demonstrate active range of motion exercises. Which of the following actions should the nurse take to demonstrate hyperextension of the hip?
-Move their legs behind their body.
-Move their leg forward and up
- Move their leg medially toward their other leg
-Turn their foot and leg away from their other leg

Answer 27

-Move their legs behind their body.

Question 28

A nurse is preparing to transfer a client who has left-sided weakness from the bed to a chair. Which of the following actions by the nurse demonstrates correct transfer technique?
-Positioning the chair slightly behind the nurse so that the seat faces the client’s bed
-Placing the client’s left leg in front of the right leg just prior to the transfer
-Aligning the nurse’s knees with the client’s knees just before the transfer
-Grasping the client under the axillae to assist them to their feet

Answer 28

-Aligning the nurse’s knees with the client’s knees just before the transfer

Question 29

A nurse is caring for a client who has a prescription for knee-length antiembolic stockings. Which of the following actions should the nurse take?
-Place the stockings on the client after the client ambulates to the restroom
-Ensure the client’s toes are visible after placing the stockings on the client.
-After applying the stockings, place two fingers between the client’s leg and stocking to check the fit
-Measure the client’s calf circumference and leg length from heel to knee.

Answer 29

-Measure the client’s calf circumference and leg length from heel to knee.

Question 30

A nurse is assisting with the ambulation of a client who becomes light- headed and begins to fallWhich of the following actions should the nurse take?
-Wrap both arms around the client’s arms and shoulders
-Move both feet together when the client begins to fall
-Protect the client’s extremities while lowering them to the floor
-Extend one leg and allow the client to slide down the leg to the floor

Answer 30

-Extend one leg and allow the client to slide down the leg to the floor

Question 31

A nurse is observing an assistive personnel (AP) who is using a mechanical lift with a hammock sling to transfer from the bed to a chair. For which of the following actions by the AP should the nurse intervene ?
-Places a removable cover over the sling
-Leaves the bed in the lowest position throughout the procedure
-Locks the hydraulic valve before attaching the sling to the lift
-Raises the head of the bed to a sitting position just before transfer

Answer 31

-Leaves the bed in the lowest position throughout the procedure

Question 32

A nurse is caring for a client who has been hospitalized and is performing active range-of-motion exercises. Which of the following body movements should indicate to the nurse that the client has full range of motion of the shoulder?

-Adducting the arm so that it lies next to the client’s side
-Flexing the shoulder by raising the arm from a side position to a 180angle
-Abducting the arm to a 90 angle from the side of the body
-Circumducting the shoulder in a 180half circle

Answer 32

-Flexing the shoulder by raising the arm from a side position to a 180angle

Question 33

A nurse in an emergency department is providing discharge teaching to a client who has a knee injury and will be using a pair of axillary crutches for the first time. Which of the following instructions should the nurse include?
-“Lean on the crutches to support your body weight when standing”
-“Fully extend your arms when holding onto the hand grips.”
-Hold the crutches on your unaffected side when preparing to sit in a chair
-Hold the crutches 9 inches in front of and to the side of each foot”

Answer 33

-Hold the crutches on your unaffected side when preparing to sit in a chair

Question 34

look 1-10

Answer 34

ch 8