A nurse is providing passive range of motion (ROM) for a patient with impaired mobility. Which technique will the nurse use for each movement?

Each movement is performed until the patient reports pain.

Each movement is moved just to the point of resistance by the nurse.

Each movement is repeated 5 times by the patient.

Each movement is completed quickly and smoothly by the nurse.

Answer and Explanation

The Correct Answer is B

A. Performing movements until the patient reports pain is inappropriate in passive range of motion, as the goal is to maintain joint function without causing discomfort.
B. Moving each joint to the point of resistance helps to maintain flexibility and prevent stiffness without causing harm, making this the appropriate technique.
C. Repeating movements five times by the patient is not applicable for passive range of motion, which is performed by the nurse on a patient who cannot do it themselves.
D. While smooth movements are essential, they should not be done quickly; the focus should be on the patient's comfort and safety, avoiding rapid or jerky motions.

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Correct Answer is A

Explanation

A. "Acute pain" is a NANDA-I approved nursing diagnosis that identifies a specific condition that nursing interventions can address.
B. "Sore throat" is a symptom rather than a nursing diagnosis and does not appear in NANDA-I.
C. "Sleep apnea" is classified as a medical diagnosis and not as a nursing diagnosis within NANDA-I.
D. "Heart failure" is also a medical diagnosis and not an approved nursing diagnosis, as it describes a condition rather than the patient's response or nursing concerns.

A. Moderate-carbohydrate B. Low-caffeine C. High-carbohydrate D. High-caffeine

Correct Answer is A

Explanation

A. A moderate-carbohydrate diet is recommended because carbohydrates increase CO₂ production during metabolism, and limiting excessive carbohydrate intake can help manage CO₂ retention in patients with respiratory issues.
B. Low-caffeine is not directly related to CO₂ retention and does not influence carbon dioxide levels in the body.
C. High-carbohydrate intake can exacerbate CO₂ production, worsening retention issues in patients with compromised lung function.
D. High-caffeine intake is not related to CO₂ retention management and would not impact CO₂ levels in the respiratory system.

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A nurse is providing passive range of motion (ROM) for a patient with impaired mobility. Which technique will the nurse use for each movement?

Nursing Test Bank

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