STUVIA 2024/2025
1. Science
2. Medicine
3. Surgery
Evolve Quiz 1: Immobility (5 reviews)
What are the risk factors for developing pathological fractures in patients with immobility?
Decreased metabolism
Decreased calcium regulation
Decreased metabolism and calcium regulation are the major risk factors for developing pathological
fractures in patients with immobility. Decreased urinary output is a urinary elimination change seen in
patients with immobility due to decreased intake of fluids. Decreased tissue catabolism is tissue
breakdown due to muscle weakness and decreased muscle mass in patients with immobility.
Decreased urinary concentration is a urinary elimination change seen in patients with immobility due
to decreased fluid intake and output.
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What are the functions of the skeletal system?
Provide support
Regulate calcium
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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.
What are ligaments?
White, shiny, flexible bands of fibrous tissue
Ligaments are white, shiny, flexible bands of fibrous tissue that bind joints together and connect
bones, and cartilages. Joints are the connections between bones. Tendons are white, glistening
fibrous bands of tissue that connect muscle to bone. Cartilage is a nonvascular, supporting
connective tissue located chiefly in the joints.
Which patient is at greatest risk for developing multiple adverse effects of immobility?
80-year-old woman who has suffered a hemorrhagic cerebrovascular accident (CVA)
The older the patient and the greater the period of immobility, which can be significant following a
hemorrhagic stroke, the greater is the number of systems that can be affected by the immobility.
A 3-year-old child has rickets. Which vitamin should be supplemented to the child's diet?
Vitamin D
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A deficiency of vitamin D causes rickets. Therefore, the child should receive vitamin D supplements.
Deficiency of vitamin A causes night blindness. Lack of vitamin B causes neural tube defects. Vitamin
C deficiency leads to scurvy.
STUDY TIP: Know the names of deficiencies for all the vitamins. If you are a visual learner, find
photographs of the deficiencies in textbooks or reliable websites to help you remember them.
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What is cartilage?
Nonvascular supporting connective tissue located chiefly in joints
Cartilage is nonvascular supporting connective tissue located chiefly in joints and the thorax, trachea,
nose, and ear. Joints are the connections between bones. Tendons are the white, glistening fibrous
bands of tissues that connect muscles to bones, and are strong, flexible, and inelastic. Ligaments are
shiny white flexible bands of fibrous tissues that bind joints together, connect bones and cartilage,
and aid joint flexibility and support.
Which postural abnormality indicates an exaggeration of the anterior convex curve of the lumbar
spine?
Lordosis
Lordosis is a postural abnormality that involves an exaggeration of the anterior convex curve of the
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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.
Which urinary elimination changes are often observed as the period of immobility continues for a
patient? Select all that apply.
Increased risk of renal calculi
Increased urinary concentration
Increased risk for urinary tract infections
The urinary elimination changes that are often observed as the period of immobility continues are
increased renal calculi, as immobilized patients may have hypercalcemia that causes calcium stones.
As the immobility continues, the fluid intake decreases and the concentration of urine increases. As
the concentration of urine increases, urinary tract infections also increase. As the period of immobility
continues, fluid intake often diminishes and, therefore, urinary output also decreases.
An elderly patient has undergone hip replacement surgery. On the second postoperative day, the
nurse finds that the pedal pulses are absent and the lower extremities are cold to the touch. What
should the nurse interpret from this finding?
The patient has venous thrombus formation.
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The absence of pedal pulses and abnormally cold extremities indicate that the patient has venous
thrombus formation. Venous thrombus formation occurs because of stagnation or alteration in the
blood flow as a result of immobility or injury to the vessel wall during surgery. The thrombus may
block the blood supply to the extremities. The clinical manifestations in the patient are not age-related
effects. Hip joint dislocation may not result in absence of pedal pulses. A cool room temperature may
cause the extremities to become cold but may not lead to an absence of pedal pulses.
The nurse assesses a patient's condition and suspects that the patient has footdrop. Which
assessment finding supports the nurse's suspicion?
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.
A patient who has hemiplegia is unable to dorsiflex and invert the feet. Which condition does the
patient likely have?
Footdrop
The inability to dorsiflex and invert the feet indicates that the patient has footdrop which is usually
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found in patients who are bedridden and immobile. The foot becomes permanently fixed in plantar
flexion, making ambulation difficult. The patient is unable to lift the toes off the ground. Exaggeration
of the anterior convex curve of the lumbar spine is called lordosis. One or both legs bent outward at
the knee indicates genu varum. Legs curved inward so that the knees come together while walking is
a sign of genu valgum.
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While assessing a patient with impaired mobility, the nurse prioritizes which type of related
complication?
Respiratory
Lack of movement and exercise places patients at risk for respiratory complications. The metabolic
changes seen in patients with impaired mobility are altered endocrine metabolism and calcium
resorption. An ulcer is characterized by inflammation and usually forms over a bony prominence. It is
seen due to integumentary changes in patients with impaired mobility. The musculoskeletal changes
seen in patients with impaired mobility are temporary impairment and permanent disability. According
to Maslow's hierarchy of needs, physiological complications take priority over social isolation.
Respiratory complications take top priority to ensure the ABCs: Airway, Breathing, Circulation.
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Which treatment is provided for patients with lordosis?
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Spine-stretching exercises
Spine stretching exercises is a treatment provided for patients with lordosis. Knee braces are
provided for patients with knock-knee. A Denis Browne splint is provided for patients with clubfoot.
Bracing with ankle-foot orthotic is provided for patients with footdrop.
A patient sustained a femur fracture due to a fall in the bathroom. The attending nurse understands
that the femur bone forms a hip joint with the pelvic bone. Which type of joint is the hip joint?
Ball-and-socket joint
The head of the femur acts as a ball and the pelvic bone as a socket, and together they form a
ball-and-socket type of joint , which is a freely movable synovial joint. The elbow and knee joints are
examples of hinge joints. The joints in the neck are pivot joints. Cartilaginous joints are found in the
sternum where cartilage unites with the bone.
A 60-year-old female patient sustained a femur fracture due to a fall in the bathroom. The patient
complains of severe pain. Which mineral supplement is likely to be added to the patient's prescription
to manage osteoporosis?
Calcium
In osteoporosis the bones lack calcium due to demineralization. Therefore, calcium supplements are
added to the prescription to improve bone strength. Zinc is useful in cellular metabolism but has no
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role in bone health. Sodium is important for cells to function but has no role in promoting bone health.
Iron is needed for hemoglobin production. It does not help in managing osteoporosis related to bone
changes.
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The nurse is teaching a nursing student about various deformities of the spine. Which statements are
true about spine deformities? Select all that apply.
- Kyphosis is the increased convexity in curvature of the thoracic spine.
- Lordosis is the exaggeration of the anterior convex curve of lumbar spine.
- Scoliosis is the lateral S- or C-shaped spinal column with vertebral rotation.
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?
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
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