Deck 5: Positioning and Draping

Question 1

Who must be notified immediately of physical or drug-induced restraints used for a patient?

A) The patient's family and physical therapist
B) The patient's occupational and physical therapists
C) The patient's case manager and nurses
D) The patient's attending physician

Answer 1

D
The attending physician must be notified as soon as possible if he or she did not order the restraint or seclusion.These orders are good for no longer than 4 hours for adults,2 hours for those ages 9-17,and 1 hour for children under age 9.The total time limit of an order is 24 hours,after which time a new order may be prescribed.

Question 2

Which areas of the side-lying patient are at greatest risk for pressure sores?

A) Sternum, iliac crests, patellae, and lateral ears
B) Lateral ears, lateral ribs, greater trochanters, and humeral epicondyles
C) Occipital tuberosity, transverse processes of vertebrae, sacrum, and heels
D) Forehead, spines of the scapulae, lesser trochanters, and fibular heads

Answer 2

B
The areas of greatest pressure when the patient is in a side-lying position are the lowermost lateral ear,lateral ribs,lateral acromion process,lateral head of the humerus,medial or lateral epicondyles of the humerus,greater trochanter of the femur,lateral condyle of the femur,malleolus of the fibula,medial condyle of the femur,and malleolus of the tibia if the uppermost lower extremity is positioned directly over the lowermost.

Question 3

Which position is most detrimental to a patient with a transfemoral amputation?

A) Prolonged trunk extension
B) Prolonged hip adduction
C) Prolonged hip extension
D) Prolonged hip flexion

Answer 3

D
For the patient with a transfemoral amputation,prolonged hip flexion (e.g.,from placement of a pillow under the residual limb of a supine patient)should be avoided.This position promotes the development of a contracture of the patient's hip flexor muscles.If those muscles become contracted,the patient is likely to experience difficulty using a prosthetic for ambulation.

Question 4

What activity is especially important for a patient with rheumatoid arthritis unless the joints are in a state of acute inflammation?

A) Resistance training for all joints
B) Forceful and frequent passive stretching of the involved joints
C) Prolonged immobilization
D) Gentle and frequent active or passive movement of the involved joints

Question 5

Following a total hip replacement,what device is often used for proper positioning?

A) An adduction pillow to prevent excessive hip adduction
B) A continuous passive motion machine
C) Lateral towel rolls to maintain hip adduction
D) A full-length leg cast

Question 6

Which positions are most detrimental to a patient with a transtibial amputation?

A) Prolonged hip and knee extension
B) Prolonged hip and trunk extension
C) Prolonged hip and knee flexion
D) Prolonged hip adduction and knee extension

Question 7

What information should a caregiver provide a patient before draping techniques are performed?

A) The planned treatment
B) The specific position in which the person is to be treated
C) The specific application of the linen items, gown, robe, or other clothing desired
D) All of the above

Question 8

Which positions of the involved lower extremity are most detrimental to a patient with hemiplegia?

A) Prolonged hip extension and internal rotation, and ankle dorsiflexion
B) Prolonged hip flexion and internal rotation, and knee extension
C) Prolonged hip flexion and external rotation, and ankle plantarflexion
D) Prolonged hip extension and external rotation, and ankle dorsiflexion

Question 9

Which areas of a supine patient are at greatest risk for pressure sores?

A) Occipital tuberosity, spines of the scapula, sacrum, and heels
B) Acromions, lateral epicondyles, anterior iliac crests, and metatarsal heads
C) Posterior iliac crests, mandibular condyles, patellae, and medial malleoli
D) Inferior angles of the scapula, tibial tubercle, and transverse processes of the vertebrae

Question 10

Which positions of the involved upper extremity are most detrimental to a patient with hemiplegia?

A) Prolonged shoulder adduction and internal rotation, and elbow flexion
B) Prolonged shoulder abduction and internal rotation, and elbow extension
C) Prolonged shoulder adduction and external rotation, and elbow flexion
D) Prolonged shoulder abduction and external rotation, and elbow extension

Question 11

In general,how frequently should a dependent patient's positioned be changed?

A) At least every 2 hours
B) At least every 4 hours
C) Twice per day
D) Once per day

Question 12

Which area of pillow placement is most likely to contribute to a contracture of the hamstring muscles in the prone patient?

A) Anterior to the thighs
B) Anterior to the abdomen
C) Posterior to the knees
D) Anterior to the ankles

Question 13

Which areas are especially prone to pressure sores in a patient who is wheelchair dependent?

A) The mandible and knees
B) Acromions and dorsal surfaces of the feet
C) Ischial tuberosities and olecranon processes
D) Tibial tubercles and the occiput

Question 14

Concerning burned or grafted burn areas,what should be avoided?

A) Positions of comfort
B) Positions of mild stress or tension to the wound or graft
C) Frequent position changes
D) Active motion of the involved joints

Question 15

Why is patient draping important?

A) To provide for the modesty of the patient
B) To maintain appropriate body temperature
C) To provide access to areas to be treated while protecting other areas
D) All of the above

Question 16

What is a potential adverse effect of the placement of a small bolster behind the knees of a supine patient?

A) Quadriceps and hip extensor contractures
B) Erector spinae and ankle dorsiflexor contractures
C) Iliopsoas and hamstring contractures
D) Hip adductor and extensor contractures

Question 17

Following a total knee replacement,in what position is it important to keep the affected extremity at rest?

A) Knee flexion
B) Knee extension
C) Hip flexion
D) Hip extension

Question 18

Which exercises would help a patient bound to a wheelchair alleviate pressure on the ischial tuberosities?

A) Biceps curls and knee extensions
B) Wheelchair push-ups and weight shifts
C) Ankle pumps and neck curls
D) Trunk extension isometrics

Question 19

If a supine patient has a flaccid upper extremity,how should the hand be positioned?

A) Below the heart
B) Above the elbow
C) Near the side of the body
D) Palm up

Question 20

Which areas of a prone patient are at greatest risk for pressure sores?

A) Occipital tuberosity, sternum, sacrum, and heels
B) Dorsum of the feet, spines of the scapulae, patellae, and spinous processes of the vertebrae
C) Acromion processes, forehead, crests of the tibias, and dorsum of the feet
D) Ears, greater trochanters, ischial tuberosities, and heels