Chapter 12: Immobility
Linton: Medical-Surgical Nursing, 7th Edition
MULTIPLE CHOICE
1. What should the nurse instruct a patient in a wheelchair to do to decrease risk for pressure
ulcers?
a. Use a ring pillow on the seat of the chair:
b. Lift the weight of the body using the arms of the wheelchair every 15 minutes:
c. Scoot forward and back in the seat to stimulate circulation:
d. Wear underwear that holds moisture close to skin:
ANS: B
Using the arms of the wheelchair to lift the weight off the buttocks and coccyx is
beneficial to reduce the risk of pressure ulcers in patients using wheelchairs:
DIF: Cognitive Level: Comprehension REF: p: 193 OBJ: 5
TOP: Pressure Ulcer in a Wheelchair KEY: Nursing Process Step:
Planning
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease
2. What negative effects does immobilization have on the musculoskeletal system?
a. Demineralization of bone
b. Increase in aerobic capacity
c. Increased muscle oxidation
d. Lengthening of muscle fibers
ANS: A
Immobilization has negative effects on the musculoskeletal system such as
demineralization of bone, a decrease in aerobic capacity, a decrease in muscle
oxidation, and shortening of muscle fibers:
DIF: Cognitive Level: Comprehension REF: p: 192 OBJ: 1
, TOP: Effects of Immobility KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
3. What should the nurse be aware is the best prevention of immobility-related disorders?
a. Dietary supplements
b. Fluids
c. Adequate fiber
d. Exercise
ANS: D
Exercise will help reduce the patient’s risk of immobility-related disorders:
DIF: Cognitive Level: Knowledge REF: pp: 193-194 OBJ: 2
TOP: Preventing Complications of Immobility
KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease
4. A nurse’s assessment reveals an area of erythema on an immobilized patient’s sacrum:
What is the initial nursing action?
a. Apply a wet-to-dry dressing:
b. Massage the reddened area:
c. Reposition the patient:
d. Rub the area with alcohol:
ANS: C
The first intervention is to reposition the patient with follow-up to ensure that the
patient is repositioned often:
DIF: Cognitive Level: Application REF: p: 198 OBJ: 5
TOP: Treatment of Pressure Ulcers KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
5. When preparing a plan care for an older adult patient, a nurse should consider the
common problems associated with immobility: What should these problems be classified
Linton: Medical-Surgical Nursing, 7th Edition
MULTIPLE CHOICE
1. What should the nurse instruct a patient in a wheelchair to do to decrease risk for pressure
ulcers?
a. Use a ring pillow on the seat of the chair:
b. Lift the weight of the body using the arms of the wheelchair every 15 minutes:
c. Scoot forward and back in the seat to stimulate circulation:
d. Wear underwear that holds moisture close to skin:
ANS: B
Using the arms of the wheelchair to lift the weight off the buttocks and coccyx is
beneficial to reduce the risk of pressure ulcers in patients using wheelchairs:
DIF: Cognitive Level: Comprehension REF: p: 193 OBJ: 5
TOP: Pressure Ulcer in a Wheelchair KEY: Nursing Process Step:
Planning
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease
2. What negative effects does immobilization have on the musculoskeletal system?
a. Demineralization of bone
b. Increase in aerobic capacity
c. Increased muscle oxidation
d. Lengthening of muscle fibers
ANS: A
Immobilization has negative effects on the musculoskeletal system such as
demineralization of bone, a decrease in aerobic capacity, a decrease in muscle
oxidation, and shortening of muscle fibers:
DIF: Cognitive Level: Comprehension REF: p: 192 OBJ: 1
, TOP: Effects of Immobility KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
3. What should the nurse be aware is the best prevention of immobility-related disorders?
a. Dietary supplements
b. Fluids
c. Adequate fiber
d. Exercise
ANS: D
Exercise will help reduce the patient’s risk of immobility-related disorders:
DIF: Cognitive Level: Knowledge REF: pp: 193-194 OBJ: 2
TOP: Preventing Complications of Immobility
KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease
4. A nurse’s assessment reveals an area of erythema on an immobilized patient’s sacrum:
What is the initial nursing action?
a. Apply a wet-to-dry dressing:
b. Massage the reddened area:
c. Reposition the patient:
d. Rub the area with alcohol:
ANS: C
The first intervention is to reposition the patient with follow-up to ensure that the
patient is repositioned often:
DIF: Cognitive Level: Application REF: p: 198 OBJ: 5
TOP: Treatment of Pressure Ulcers KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
5. When preparing a plan care for an older adult patient, a nurse should consider the
common problems associated with immobility: What should these problems be classified
