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Chapter 28: Immobility
Chapter 28: Immobility
Potter et al.: Fundamentals of Nursing, 9th Edition
MULTIPLE CHOICE
1. A nurse is assessing body alignment. What is the nurse monitoring?
a. The relationship of one body part to another while in diӄerent positions
b. The coordinated eӄorts of the musculoskeletal and nervous systems
c. The force that occurs in a direction to oppose movement
d. The inability to move about freely
ANS: A
The terms body alignment and posture are similar and refer to the positioning of the joints, tendons, ligaments,
and muscles while standing, sitting, and lying. Body alignment means that the individual’s center of gravity is
stable. Body mechanics is a term used to describe the coordinated eӄorts of the musculoskeletal and nervous
systems. Friction is a force that occurs in a direction to oppose movement. Immobility is the inability to move
about freely.
DIF:Understand (comprehension)REF:407-408
OBJ iscuss physiological and pathological inӄuences on mobility.
TOP: Assessment MSC: Basic Care and Comfort
http://boostgrade.info/chapter28immobility/ 1/34
,10/15/2016 Chapter 28: Immobility | Nursing Test Banks
2. A nurse is providing range of motion to the shoulder and must perform external rotation. Which action will
the nurse take?
a. Moves patient’s arm in a full circle
b. Moves patient’s arm cross the body as far as possible
c. Moves patient’s arm behind body, keeping elbow straight
d. Moves patient’s arm until thumb is upward and lateral to head with elbow ӄexed
ANS: D
External rotation: With elbow ӄexed, move arm until thumb is upward and lateral to head. Circumduction: Move
arm in full circle (Circumduction is combination of all movements of ball-and-socket joint.) Adduction: Lower
arm sideways and across body as far as possible. Hyperextension: Move arm behind body, keeping elbow
straight.
DIF:Understand (comprehension)REF:415
OBJ: Compare and contrast active and passive range-of-motion exercises.
TOP: Implementation MSC: Basic Care and Comfort
3. A nurse is providing passive range of motion (ROM) for a patient with impaired mobility. Which technique will
the nurse use for each movement?
a. Each movement is repeated 5 times by the patient.
b. Each movement is performed until the patient experiences pain.
c. Each movement is completed quickly and smoothly by the nurse.
d. Each movement is moved just to the point of resistance by the nurse.
ANS: D
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,10/15/2016 Chapter 28: Immobility | Nursing Test Banks
Passive ROM exercises are performed by the nurse. Carry out movements slowly and smoothly, just to the
point of resistance; ROM should not cause pain. Never force a joint beyond its capacity. Each movement needs
to be repeated 5 times during the session. The patient moves all joints through ROM unassisted in active ROM.
DIF:Understand (comprehension)REF:427 | 430
OBJ: Compare and contrast active and passive range-of-motion exercises.
TOP: Implementation MSC: Basic Care and Comfort
4. A nurse is performing passive range of motion (ROM) and splinting on an at-risk patient. Which ӄnding will
indicate goal achievement for the nurse’s action?
a. Prevention of atelectasis
b. Prevention of renal calculi
c. Prevention of pressure ulcers
d. Prevention of joint contractures
ANS: D
Goal achievement for passive ROM is prevention of joint contractures. Contractures develop in joints not
moved periodically through their full ROM. ROM exercises reduce the risk of contractures. Researchers noted
that prompt use of splinting with prescribed ROM exercises reduced contractures and improved active range of
joint motion in aӄected lower extremities. Deep breathing and coughing and using an incentive spirometer will
help prevent atelectasis. Adequate hydration helps prevent renal calculi and urinary tract infections.
Interventions aimed at prevention of pressure ulcers include positioning, skin care, and the use of therapeutic
devices to relieve pressure.
DIF:Apply (application)REF:412 | 414
OBJ: Evaluate patient outcomes as a result of a nursing plan for improving or maintaining mobility.
TOP:EvaluationMSC:Management of Care
5. A nurse is preparing to reposition a patient. Which task can the nurse delegate to the nursing assistive
personnel?
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, 10/15/2016 Chapter 28: Immobility | Nursing Test Banks
a. Determining the level of comfort
b. Changing the patient’s position
c. Identifying immobility hazards
d. Assessing circulation
ANS: B
The skill of moving and positioning patients in bed can be delegated to nursing assistive personnel (NAP). The
nurse is responsible for assessing the patient’s level of comfort and for any hazards of immobility and
assessing circulation.
DIF:Understand (comprehension)REF:432
OBJ: Describe interventions for improving or maintaining patients’ mobility.
TOP lanningMSC:Management of Care
6. A nurse is preparing to assess a patient for orthostatic hypotension. Which piece of equipment will the nurse
obtain to assess for this condition?
a. Thermometer
b. Elastic stockings
c. Blood pressure cuӄ
d. Sequential compression devices
ANS: C
A blood pressure cuӄ is needed. Orthostatic hypotension is a drop of blood pressure greater than 20 mm Hg in
systolic pressure or 10 mm Hg in diastolic pressure and symptoms of dizziness, light-headedness, nausea,
http://boostgrade.info/chapter28immobility/ 4/34
Nursing Test Banks
One Account Get all Test Banks
Chapter 28: Immobility
Chapter 28: Immobility
Potter et al.: Fundamentals of Nursing, 9th Edition
MULTIPLE CHOICE
1. A nurse is assessing body alignment. What is the nurse monitoring?
a. The relationship of one body part to another while in diӄerent positions
b. The coordinated eӄorts of the musculoskeletal and nervous systems
c. The force that occurs in a direction to oppose movement
d. The inability to move about freely
ANS: A
The terms body alignment and posture are similar and refer to the positioning of the joints, tendons, ligaments,
and muscles while standing, sitting, and lying. Body alignment means that the individual’s center of gravity is
stable. Body mechanics is a term used to describe the coordinated eӄorts of the musculoskeletal and nervous
systems. Friction is a force that occurs in a direction to oppose movement. Immobility is the inability to move
about freely.
DIF:Understand (comprehension)REF:407-408
OBJ iscuss physiological and pathological inӄuences on mobility.
TOP: Assessment MSC: Basic Care and Comfort
http://boostgrade.info/chapter28immobility/ 1/34
,10/15/2016 Chapter 28: Immobility | Nursing Test Banks
2. A nurse is providing range of motion to the shoulder and must perform external rotation. Which action will
the nurse take?
a. Moves patient’s arm in a full circle
b. Moves patient’s arm cross the body as far as possible
c. Moves patient’s arm behind body, keeping elbow straight
d. Moves patient’s arm until thumb is upward and lateral to head with elbow ӄexed
ANS: D
External rotation: With elbow ӄexed, move arm until thumb is upward and lateral to head. Circumduction: Move
arm in full circle (Circumduction is combination of all movements of ball-and-socket joint.) Adduction: Lower
arm sideways and across body as far as possible. Hyperextension: Move arm behind body, keeping elbow
straight.
DIF:Understand (comprehension)REF:415
OBJ: Compare and contrast active and passive range-of-motion exercises.
TOP: Implementation MSC: Basic Care and Comfort
3. A nurse is providing passive range of motion (ROM) for a patient with impaired mobility. Which technique will
the nurse use for each movement?
a. Each movement is repeated 5 times by the patient.
b. Each movement is performed until the patient experiences pain.
c. Each movement is completed quickly and smoothly by the nurse.
d. Each movement is moved just to the point of resistance by the nurse.
ANS: D
http://boostgrade.info/chapter28immobility/ 2/34
,10/15/2016 Chapter 28: Immobility | Nursing Test Banks
Passive ROM exercises are performed by the nurse. Carry out movements slowly and smoothly, just to the
point of resistance; ROM should not cause pain. Never force a joint beyond its capacity. Each movement needs
to be repeated 5 times during the session. The patient moves all joints through ROM unassisted in active ROM.
DIF:Understand (comprehension)REF:427 | 430
OBJ: Compare and contrast active and passive range-of-motion exercises.
TOP: Implementation MSC: Basic Care and Comfort
4. A nurse is performing passive range of motion (ROM) and splinting on an at-risk patient. Which ӄnding will
indicate goal achievement for the nurse’s action?
a. Prevention of atelectasis
b. Prevention of renal calculi
c. Prevention of pressure ulcers
d. Prevention of joint contractures
ANS: D
Goal achievement for passive ROM is prevention of joint contractures. Contractures develop in joints not
moved periodically through their full ROM. ROM exercises reduce the risk of contractures. Researchers noted
that prompt use of splinting with prescribed ROM exercises reduced contractures and improved active range of
joint motion in aӄected lower extremities. Deep breathing and coughing and using an incentive spirometer will
help prevent atelectasis. Adequate hydration helps prevent renal calculi and urinary tract infections.
Interventions aimed at prevention of pressure ulcers include positioning, skin care, and the use of therapeutic
devices to relieve pressure.
DIF:Apply (application)REF:412 | 414
OBJ: Evaluate patient outcomes as a result of a nursing plan for improving or maintaining mobility.
TOP:EvaluationMSC:Management of Care
5. A nurse is preparing to reposition a patient. Which task can the nurse delegate to the nursing assistive
personnel?
http://boostgrade.info/chapter28immobility/ 3/34
, 10/15/2016 Chapter 28: Immobility | Nursing Test Banks
a. Determining the level of comfort
b. Changing the patient’s position
c. Identifying immobility hazards
d. Assessing circulation
ANS: B
The skill of moving and positioning patients in bed can be delegated to nursing assistive personnel (NAP). The
nurse is responsible for assessing the patient’s level of comfort and for any hazards of immobility and
assessing circulation.
DIF:Understand (comprehension)REF:432
OBJ: Describe interventions for improving or maintaining patients’ mobility.
TOP lanningMSC:Management of Care
6. A nurse is preparing to assess a patient for orthostatic hypotension. Which piece of equipment will the nurse
obtain to assess for this condition?
a. Thermometer
b. Elastic stockings
c. Blood pressure cuӄ
d. Sequential compression devices
ANS: C
A blood pressure cuӄ is needed. Orthostatic hypotension is a drop of blood pressure greater than 20 mm Hg in
systolic pressure or 10 mm Hg in diastolic pressure and symptoms of dizziness, light-headedness, nausea,
http://boostgrade.info/chapter28immobility/ 4/34
