NUR 353 Exam 2 Review Questions and
Correct Answers
The state or quality of being mobile or movable ✅Mobility
The state of not moving; motionless, not being able to move ✅Immobility
A term that encompasses similar concepts and includes nursing diagnoses related to
inactivity. Risks for this include impaired skin integrity, constipation, altered respiratory
function, altered peripheral tissue perfusion, activity intolerance, impaired physical
mobility, injury, altered sensory perception, powerlessness, and body image
disturbance. ✅Disuse syndrome
A general downslide of overall physical strength and endurance. Although most patients
might have a tweak of this after a big surgery or major illness, this term is usually
applied when a formerly independent, or mostly independent, person is now not able to
perform routine activities, like their ADLs, and IADLs, and their progress continues to
decline. ✅Deconditioned
List two screening tools to detect mobility/immobility. ✅1. Osteoporosis
2. Fall risk assessment
When should fall assessment screening tools be used? ✅Look in Giddens
List some general care guidelines for a patient who is immobilized. ✅1. Frequent
turning and changing positions every 2 hours in bed or 30 minutes in a chair.
2. Frequent skin assessment and skin care.
3. Range of motion exercises
4. Deep breathing exercises
5. Weight bearing exercises if possible
5. Measures to optimize elimination, such as high fluids, high fiber, and laxatives or
stool softeners.
6. Ambulation, stretches, balance
What should you give to a patient before moving around to decrease pain when moving
their joints? ✅Anti-inflammatory and pain medications
A disruption or break in the continuity of bone ✅Fracture
The break goes completely through the bone ✅Complete fracture
Occurs partly across a bone shaft but the bone is still intact ✅Incomplete fracture
,Describe the metabolic changes that occur with immobility. ✅1. Decreases metabolic
rate, altering the metabolism of carbs, fats, and proteins
2. Fluid, electrolyte and calcium imbalances
3. Decreased appetite
4. Slowed peristalsis
5. Endocrine system is altered
6. Hypercalcemia, calcium is released from the bones in immobile patients, which can
cause pathologic fractures because there is not enough calcium in the bones!
You are caring for a patient who is immobile. Which of the following electrolyte
imbalances would you expect in a patient who has been immobile?
a. Hypercalcemia
b. Hypokalemia
c. Hyponatremia
d. Hypermagnesemia ✅A (In immobile people, calcium is released from their bones
into their blood stream. Normally, your kidneys will excrete this calcium but if they are
unable to respond appropriately, hypercalcemia results.)
List some gastrointestinal impairments caused by decreased mobility. ✅1.
Constipation
2. Fluid intake decreases, risk for dehydration
3. Anorexia
List two respiratory changes that occur with immobility. ✅1. Atelectasis (Collapse of
alveoli)
2. Hypostatic pneumonia (Inflammation of the lung from stasis or pooling of secretions)
List three cardiovascular changes that occur with immobility. ✅1. Orthostatic
hypotension
2. Thrombus formation
3. Decreased cardiac output, resulting in increased workload
List some musculoskeletal changes associated with immobility. (6) ✅1. Loss of
endurance, strength and muscle mass and decreased stability and balance
2. Decreased muscle mass
3. Joint abnormalities (contractures--From muscle disuse, atrophy and shortening of the
muscle fibers)
4. Disuse osteoporosis (Osteoporosis from immobility)
5. Pathological fractures from disuse osteoporosis
6. Impaired calcium metabolism
List 3 urinary complications associated with immobility. ✅1. Urinary stasis from lack of
gravity pulling the urine from the renal pelvis into the ureters to the bladder.
2. UTIs from urinary stasis
,3. Renal calculi from hypercalcemia
List one integumentary complication associated with immobility. ✅Pressure ulcers
List some psychosocial effects seen with immobility. ✅1. Social isolation
2. Helplessness
3. Loneliness
4. Depression
An older-adult patient has been bedridden for 2 weeks. Which of the following
complaints by the patient indicates to the nurse that he or she is developing a
complication of immobility?
a. Loss of appetite
b. Gum soreness
c. Difficulty swallowing
d. Left-ankle joint stiffness ✅D (Patients whose mobility is restricted require range-of-
motion (ROM) exercises daily to reduce the hazards of immobility. Temporary
immobilization results in some muscle atrophy, loss of muscle tone, and joint stiffness.
Two weeks of joint immobilization without ROM can quickly result in contractures.)
An older adult has limited mobility as a result of a total knee replacement. During
assessment you note that the patient has difficulty breathing while lying flat. Which of
the following assessment data support a possible pulmonary problem related to
impaired mobility?
Select all that apply.
a. B/P = 128/84
b. Respirations 26/min on room air
c. HR 114
d. Crackles over lower lobes heard on auscultation
e. Pain reported as 3 on scale of 0 to 10 after medication ✅B C D (Patients who are
immobile are at high risk for developing pulmonary complications. The most common
respiratory complications are atelectasis (collapse of alveoli) and hypostatic pneumonia
(inflammation of the lung from stasis or pooling of secretions). Ultimately the distribution
of mucus in the bronchi increases, particularly when the patient is in the supine, prone,
or lateral position.)
The nurse is caring for a patient whose calcium intake must increase because of high
risk factors for osteoporosis. Which of the following menus should the nurse
recommend?
a. Cream of broccoli soup with whole wheat crackers, cheese, and tapioca for dessert
b. Hot dog on whole wheat bun with a side salad and an apple for dessert
c. Low-fat turkey chili with sour cream with a side salad and fresh pears for dessert
, d. Turkey salad on toast with tomato and lettuce and honey bun for dessert ✅A (Teach
patient and/or caregiver the current recommended dietary allowances for calcium and
review foods high in calcium (e.g., milk fortified with vitamin D, leafy green vegetables,
yogurt, and cheese).)
What is the correct order in which elastic stockings should be applied?
1. Identify patient using two identifiers.
2. Smooth any creases or wrinkles.
3. Slide the remainder of the stocking over the patient's heel and up the leg
4. Turn the stocking inside out until heel is reached.
5. Assess the condition of the patient's skin and circulation of the legs.
6. Place toes into foot of the stocking.
7. Use tape measure to measure patient's legs to determine proper stocking size.
a. 1, 5, 7, 4, 6, 2, 3
b. 1, 7, 5, 4, 6, 2, 3
c. 1, 5, 7, 4, 6, 3, 2
d. 1, 5, 4, 7, 6, 3, 2 ✅C (This is the correct order in which elastic stockings should be
applied.)
To prevent complications of immobility, what would be the most effective activity on the
first postoperative day for a patient who has had abdominal surgery?
a. Turn, cough, and deep breathe every 30 minutes while awake
b. Ambulate patient to chair in the hall
c. Passive range of motion 4 times a day
d. Immobility is not a concern the first postoperative day ✅B (Prevention of
complications of immobility begins when the patient becomes immobilized. Every 30
minutes is not necessary and disruptive to the healing process. Active patient
participation in exercises is more beneficial to preventing venous stasis.)
A patient on prolonged bed rest is at an increased risk to develop this common
complication of immobility if preventive measures are not taken:
a. Myoclonus
b. Pathological fractures
c. Pressure ulcers
d. Pruritus ✅C (Immobility is a major risk factor for pressure ulcers. Any break in the
integrity of the skin is difficult to heal. Preventing a pressure ulcer is much less
expensive than treating one; therefore preventive nursing interventions are imperative.)
