B260 Adaptive Quiz Immobility, Immobility and the Nursing process, and
Nursing Skills- Moving and Positioning
A 60-year-old female patient sustained a femur fracture due to a fall in the bathroom. The patient complains of severe pain and expresses that she did not expect a fracture as the fall was not very severe.
The nurse tells the patient that fracture is common for people her age. Which condition should the nurse
cite as the most common cause of fracture in postmenopausal patients?
1. Osteosarcoma
2. Osteoblastoma
3. Osteomyelitis
4. Osteoporosis - correct answer ✔✔4. Osteoporosis
In a postmenopausal patient, osteoporotic changes in the bone increase the risk of fractures. Impaired calcium metabolism causes bone resorption, making it less dense. Bones affected by resorption are fragile and more susceptible to fractures. Osteosarcoma and osteoclastoma are bone tumors. Osteomyelitis is an infection of the bone.
Which is a common debilitating contracture?
1. Disuse
2. Atrophy
3. Footdrop
4. Shortening of the muscle - correct answer ✔✔3. Footdrop
Footdrop is a common and debilitating contracture in which the foot is permanently fixed in plantar flexion. Disuse, atrophy, and shortening of muscle fibers are the causes of joint contractures.
Which postural abnormality indicates an exaggeration of the anterior convex curve of the lumbar spine? 1. Lordosis
2. Kyphosis
3. Scoliosis
4. Torticollis - correct answer ✔✔1. Lordosis
Lordosis is a postural abnormality that involves an exaggeration of the anterior convex curve of the lumbar spine. Kyphosis is the increased convexity in the curvature of thoracic spine. Scoliosis is a lateral S- or C-shaped spinal column with vertebral rotation and unequal heights of hips and shoulders. Torticollis involves inclination of the head to the affected side and contraction of the sternocleidomastoid muscle.
What are the functions of the skeletal system? Select all that apply.
1. Provide support
2. Regulate calcium
3. Regulate posture
4. Contribute balance
5. Protect vital organs - correct answer ✔✔1. Provide support
2. Regulate calcium
5. Protect vital organs
The functions of the skeletal system include providing joint flexibility and support, regulating calcium, and protecting vital organs. The nervous system regulates movement and posture. Body alignment contributes to balance of the body.
The nurse is caring for a patient who is immobile. Which cardiovascular changes does the nurse expect to observe in the patient? Select all that apply.
1. Thrombus formation
2. Orthostatic hypotension 3. Increased cardiac output
4. Increased cardiac workload
5. Increased circulating fluid volume - correct answer ✔✔1. Thrombus formation
2. Orthostatic hypotension
4. Increased cardiac workload
Immobilization affects the cardiovascular system, frequently causing thrombus formation, increased cardiac workload, and orthostatic hypotension. As immobilization increases, cardiac output falls, further decreasing cardiac efficiency and increasing workload. In the immobilized patient, decreased circulating fluid volume and pooling of blood in the lower extremities occurs.
A patient complains of limited mobility. While assessing the past medical history of the patient, the nurse finds that the patient underwent surgery for a hip fracture. Which reason does the nurse suspect is
responsible for the patient's condition? Select all that apply.
1. The patient has contractures.
2. The patient has ligament tears.
3. The patient has a history of arthritis.
4. The patient has connective tissue disorders.
5. The patient has decreased synovial fluid in the joint. - correct answer ✔✔1. The patient has contractures.
5. The patient has decreased synovial fluid in the joint.
Range of motion is limited in patients with limited nerve supply. Range of motion may be limited in patients with arthritis due to severe pain. Decreased synovial fluid in the joints also leads to decreased range of motion. If the patient has a ligament tear, it may lead to increased range of motion beyond normal. If the patient has a connective tissue disorder, the patient may have increased range of motion.
The nurse assesses a patient's condition and suspects that the patient has footdrop. Which assessment finding supports the nurse's suspicion?
1. Internal rotation of entire foot 2. Both the legs bent outward at knee
3. The foot is permanently fixed in plantar flexion
4. Legs curved inward, so knees come together as person walks - correct answer ✔✔3. The foot is permanently fixed in plantar flexion
Footdrop is the leg contracture in which the foot is permanently fixed in plantar flexion, and the patient is unable to lift the toes off the ground. Internal rotation of the entire foot is a postural abnormality called pigeon toes. Bowleg is a condition in which the patient has both the legs bent outward at the knee. Knock-knee is the postural abnormality in which legs curve inward so the knees come together as the person walks.
The nurse is caring for a patient with paralysis. The nurse understands that footdrop is a common but preventable complication in these patients. Which statements are true about footdrop? Select all that apply.
1. Footdrop is a type of debilitating contracture.
2. The foot is permanently fixed in dorsiflexion position.
3. The patient is unable to lift the toes off the ground.
4. Patients with left- or right-side paralysis are at increased risk of developing footdrop.
5. Footdrop can be treated with regular physiotherapy. - correct answer ✔✔1. Footdrop is a type of debilitating contracture.
3. The patient is unable to lift the toes off the ground.
4. Patients with left- or right-side paralysis are at increased risk of developing footdrop.
Footdrop is the most common type of debilitating contracture. The patient is unable to lift the toes from the ground, making it difficult to ambulate. Patients who have suffered a right- or left-sided paralysis are at increased risk of developing footdrop due to immobility. The foot is permanently fixed in plantar flexion. Once footdrop occurs, it cannot be treated. However, it can be prevented through regular physiotherapy.
A patient is undergoing treatment in a long-term health care facility. Which type of immobility complication is likely to develop in the immobilized patient?
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