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

Each of movement is repeated 5 times by the patient

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

Each movement is completed quickly and smoothly by the nurse

Each movement is performed until the patient’s reports pain

Answer and Explanation

The Correct Answer is B

A) Each movement is repeated 5 times by the patient: While active range-of-motion (ROM) exercises often involve repetition, the key goal of passive ROM exercises (when the nurse is assisting the patient) is not to have the patient repeat movements. Instead, the nurse should ensure the patient’s joints are moved gently to their fullest range without causing discomfort or damage. Repeating movements a specific number of times isn't a required approach for passive ROM.

B) Each movement is moved just to the point of resistance by the nurse: This technique is the most appropriate when performing passive ROM exercises. The nurse should gently move the joint through its range of motion and stop at the point where resistance is felt, but without pushing into pain or forcing movement beyond the joint’s natural limits. This approach helps prevent injury while still providing the necessary mobility and flexibility.

C) Each movement is completed quickly and smoothly by the nurse: While the movement should be smooth, it should never be rushed or performed quickly, as that can cause strain or discomfort. ROM exercises should be done slowly and deliberately to avoid injury and to allow the joints to move through their full range of motion without abrupt movements. Quick motions could increase the risk of joint or muscle injury.

D) Each movement is performed until the patient reports pain: ROM exercises should be performed gently and within the range that does not cause pain. The goal is to maintain joint flexibility and prevent contractures, not to push the patient into pain. If the patient reports pain, the nurse should stop immediately to avoid injury and reassess the approach to ROM exercises. Pain should never be a target for achieving range of motion.

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Correct Answer is B

Explanation

A) Return any fresh linen not used for a client to the linen supply: Fresh linen that has been placed on a client’s bed but not used should not be returned to the linen supply. This is to prevent cross-contamination. Once linen is brought into a patient’s room, it should be considered contaminated, even if it was not used, and should be discarded properly.

B) Tie linen bags securely at the top: This is the correct action. When disposing of soiled linens, tying the linen bag securely helps to prevent the spread of pathogens and minimizes the risk of contamination. It also keeps the environment clean and safe for both staff and patients.

C) Fill linen bags with as much soiled linen as possible: Linen bags should not be overfilled. Overfilling bags can make them difficult to handle and can increase the risk of exposure to contaminants. Bags should be filled to a safe and manageable level to ensure proper handling and safety when transporting soiled linens.

D) Use double bagging to remove soiled linen from the client's room: Double bagging is typically not necessary unless there is a significant risk of contamination, such as with highly infectious material. Standard practice is to use a single, securely tied bag. Double bagging can create unnecessary waste and complicate disposal procedures unless specifically indicated by the situation or facility protocols.

A. Slide the patient into the new position B. Place the patient in a 30 degree supine position. C. utilize a transfer device to lift the patient. D. Elevate the head of the bed 45 degrees

Correct Answer is C

Explanation

A) Slide the patient into the new position: Sliding a patient when repositioning can create shear forces on the skin, which may contribute to skin damage. Shearing can occur when the skin sticks to the surface while the underlying tissues move, leading to increased risk of pressure ulcers. Therefore, sliding is not considered the most effective or safest way to reposition a patient at risk for skin impairment.

B) Place the patient in a 30-degree supine position: Placing the patient in a 30-degree supine position is a good method for reducing pressure on bony prominences and minimizing the risk of pressure injuries. However, while this position is helpful for preventing skin breakdown, it does not address the method of repositioning, which is what is being asked in this question.
C) Utilize a transfer device to lift the patient: Using a transfer device, such as a lift or slide sheet, to lift the patient is the best method for repositioning. This technique helps to reduce friction and shear forces on the skin, providing a safer and more effective way to move the patient without causing damage. Transfer devices also allow for a smoother repositioning, minimizing the risk of skin impairment.

D) Elevate the head of the bed 45 degrees: Elevating the head of the bed to 45 degrees can increase the risk of pressure injuries, especially if the patient is immobile and cannot relieve pressure themselves. This position can also contribute to shear forces as the patient slides downward. It may be appropriate in certain clinical situations, but it does not directly address the method of repositioning.

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