Question 1

What should the nurse instruct a 50-year-old male with a non-weight-bearing order on his right leg due to fractured femur regarding ambulation?

Accepted Answer

Answer reason: A three-point gait with crutches is the correct technique for a client with a non–weight-bearing order. This gait allows the patient to keep the affected leg completely off the ground while using both crutches and the unaffected leg to maintain balance and mobility.

Question 2

A client with a fractured hip is being taught the correct use of the walker. The nurse is aware that correct use of the walker is achieved if the?

Accepted Answer

Answer reason: Correct walker use includes hands resting on the grips with elbows flexed about 15–30° and the body staying within the walker, not walking ahead of it or carrying it. Thus, option A is the only correct statement among those listed.

Question 3

Which instruction should be given to the client who is fitted with a behind-the-ear hearing aid?

Accepted Answer

Answer reason: For BTE hearing aids, the ear mold is detachable and should be cleaned regularly (about weekly) with mild soap and water. Devices should not be stored in warm places; sharp objects like toothpicks should not be used to clean them, and battery changes depend on use rather than a fixed weekly schedule.

Question 4

Which nursing action is most appropriate to ensure patient safety when using assistive devices for mobility?

Accepted Answer

Answer reason: Assessing the patient's capability and technique before ambulation prevents falls and ensures the proper and safe use of the device. The other options increase risk or unnecessarily restrict mobility.

Question 5

When using crutches, which part of the body should absorb the patient's weight?

Accepted Answer

Answer reason: Proper crutch use places body weight through the hands on the handgrips, not in the axilla, to avoid nerve compression and ensure safe mobility.

Question 6

Why are support stockings used?

Accepted Answer

Answer reason: Support (compression) stockings provide graduated pressure that enhances venous return from the legs, reducing venous stasis and the risk of DVT.

Question 7

Which nursing intervention is most appropriate when training a patient with paraplegia to use a swing-through gait with crutches?

Accepted Answer

Answer reason: In a swing-through gait, both crutches are advanced first to create a stable base ahead of the body; the legs then swing through. Placing crutch tips ahead maximizes stability and safety. Pivoting on crutches and maintaining a wide leg stance are unsafe/irrelevant, and paraplegic patients typically cannot actively lift legs as suggested.

Question 8

Which intervention should the nurse implement to assist a client with a right leg fracture in learning the two-point gait with crutches?

Accepted Answer

Answer reason: Two-point gait involves moving the crutch and opposite foot together, then the other crutch with the other foot, mimicking normal walking. For a right leg fracture, move the right crutch with the left foot.

Question 9

Which of the following is essential for a nurse to include when teaching a patient with multiple sclerosis about the swing-through gait?

Accepted Answer

Answer reason: In a swing-through gait, both crutches advance together and the legs swing past the crutches; the knees should remain straight during the swing to maintain control and prevent buckling. Options A, B, and D are not essential or are incorrect (weight is borne primarily through the arms/crutches).

Question 10

Which statement indicates the patient's understanding of safe ambulation with a mastered three-point gait?

Accepted Answer

Answer reason: In a standard three-point gait the affected leg is non–weight bearing; weight is borne through the crutches and the unaffected leg. Options A and B reflect unsafe or incorrect use, and D is nonspecific; stair technique varies but does not define three-point gait understanding.

Question 11

When supervising a patient ambulating with crutches using a two-point gait, what should the nurse monitor most closely?

Accepted Answer

Answer reason: A two-point gait requires moving one crutch and the opposite leg together in an alternating pattern. Ensuring the client alternates legs and crutches correctly is key for safety and proper technique; vitals or endurance are secondary.

Question 12

If a 75-year-old patient with degenerative joint disease uses a cane correctly, which gait pattern should they utilize while ambulating?

Accepted Answer

Answer reason: When ambulating with a cane, the client holds the cane on the stronger side and advances the cane simultaneously with the weaker leg, then the stronger leg—this is the modified two-point gait.

Question 13

The nurse is caring for a client following a laryngectomy. The nurse can best help the client with communication by?

Accepted Answer

Answer reason: After laryngectomy the client cannot speak; providing writing materials offers an immediate, reliable way to communicate needs. Periodic checks or a call light do not enable full communication, and teaching sign language is impractical acutely.

Question 14

A client with a total hip replacement requires special equipment. Which equipment would assist the client with a total hip replacement with activities of daily living?

Accepted Answer

Answer reason: A raised or high-seat commode facilitates toileting while maintaining hip precautions (avoids hip flexion >90°), directly assisting with ADLs. A recliner may increase hip flexion; a TENS unit addresses pain, not ADLs; an abduction pillow is for positioning in bed, not daily activities.

Question 15

Which gait pattern is most suitable for a 72-year-old male with a recent left-side stroke to improve mobility while minimizing the risk of falls?

Accepted Answer

Answer reason: After a recent stroke the client has unilateral weakness; a three-point gait allows the device and weak leg to advance together while weight-bearing is maintained on the stronger leg, offering greater stability and reduced fall risk versus two-point or swing-to gaits.

Question 16

The doctor has ordered antithrombolic stockings to be applied to the legs of the client with peripheral vascular disease. The nurse knows antithrombolic stockings should be applied?

Accepted Answer

Answer reason: Antiembolic stockings are best applied before the client gets out of bed, when leg edema is minimal, typically with the client supine.

Question 17

An amputation bed is also known as which type of bed?

Accepted Answer

Answer reason: An amputation bed is specifically prepared to support the residual limb; it is called a stump bed.

Question 18

Which of the following positioning equipment is needed when preparing to do a posterior spinal fusion of the T3-L2 range?

Accepted Answer

Answer reason: Posterior thoracolumbar spinal fusion requires prone positioning with the abdomen free; a Wilson frame supports the chest and pelvis and flexes the spine. A Mayfield frame is for cranial/cervical fixation, a bean bag is for lateral positioning, and a fracture table is for lower-extremity fractures.

Question 19

________ assist a low vision patient?

Accepted Answer

Answer reason: A typoscope is a low-vision aid that helps patients read by masking surrounding text and reducing glare, allowing focus on a single line. An anomaloscope is used to test color vision deficiencies, not to assist with low vision tasks. A periscope is for viewing over obstacles, and an orthoscope is not a standard low-vision assistive device. Therefore, the best choice is a typoscope.

Question 20

A child was injured in an accident and has become a paraplegic. The child must use crutches on a permanent basis, most likely for the rest of his life. Which type of crutches would most commonly be used in this situation?

Accepted Answer

Answer reason: Forearm (Lofstrand) crutches are preferred for individuals who require long-term or permanent crutch use because they allow weight bearing through the forearms, are lighter, and enable greater mobility and independence. They also avoid the risk of brachial plexus/axillary nerve injury associated with prolonged use of axillary crutches. Platform crutches are for patients unable to bear weight through the hands or wrists, and leg-support devices are for unilateral lower-leg injuries. Therefore, forearm crutches are most appropriate for a paraplegic child needing lifelong assistance.

Question 21

A nurse is caring for an 80-year-old client who is in rehabilitation after having a stroke. The nurse is teaching the client about how to use a nosey cup. Which of the following best describes this device?

Accepted Answer

Answer reason: A nosey cup has a U-shaped cutout on the rim/front to accommodate the nose so the user can drink without extending the neck. This is helpful for clients with dysphagia or limited neck mobility, such as after a stroke, and reduces aspiration risk. It is not designed to channel liquid into the nose, nor does it primarily feature extra handles or increased volume.

Question 22

A client is learning to use a cane for the first time after a right-sided stroke that caused left-sided weakness. Which instruction should the nurse give?

Accepted Answer

Answer reason: Proper cane technique requires holding the cane on the strong side and moving it forward *with* the weak leg to provide stability during weight transfer. This reduces fall risk and maximizes support.

Question 23

A client using a standard walker asks how to safely climb the stairs at home. What instruction is most appropriate?

Accepted Answer

Answer reason: Standard walkers cannot be safely used on stairs due to instability. NCLEX requires directing the client to use handrails or alternative assistance rather than attempting to bring the walker on stairs.

Question 24

A nurse is assisting a client with a new left below-knee prosthesis. The client reports discomfort and redness at the stump site after standing for 15 minutes. What is the nurse’s best action?

Accepted Answer

Answer reason: Redness and discomfort may indicate improper fit, pressure injury risk, or the need for adjustment. The correct action is to remove the prosthesis and assess the skin integrity before continuing use.

Question 25

A client with bilateral weakness is learning to use axillary crutches. The nurse observes the client leaning heavily on the top of the crutches while standing. What is the nurse’s best instruction?

Accepted Answer

Answer reason: Weight should never be supported on the axilla because it can cause brachial plexus injury. Proper technique requires supporting weight through the hands, maintaining 2–3 finger widths of space at the axilla.

Question 26

A client with severe osteoarthritis is being fitted for a walker. Which finding indicates that the walker height is **correctly** adjusted?

Accepted Answer

Answer reason: Proper walker height allows slight elbow flexion (15–30 degrees) to promote balance, reduce strain, and improve gait stability. Too high or too low increases fall risk and joint discomfort.

Question 27

A client with weakness on the right side is learning to transfer from bed to wheelchair. Which action indicates correct technique taught by the nurse?

Accepted Answer

Answer reason: Safe transfers require placing the wheelchair on the client’s stronger side, locking the wheels, and using controlled movements rather than pulling on equipment. This maximizes stability and prevents falls.

Question 28

A client with non-weight-bearing status on the right leg is learning a new crutch gait. Which pattern should the nurse teach to maintain safety and comply with restrictions?

Accepted Answer

Answer reason: In non-weight-bearing situations, the three-point gait is required because the affected leg must avoid bearing weight while the crutches and unaffected leg alternate. Other gaits require partial or full weight-bearing.

Question 29

A client with limited shoulder mobility after rotator cuff repair asks about tools that can help with dressing independently. Which device is most appropriate?

Accepted Answer

Answer reason: After rotator cuff repair, shoulder flexion and abduction are limited. Long-handled shoehorns and sock aids allow the client to dress the lower extremities without excessive shoulder movement, promoting independence while protecting the healing shoulder.

Question 30

A client who uses a wheelchair is preparing to enter an elevator. Which instruction should the nurse give to ensure safety?

Accepted Answer

Answer reason: Entering straight improves stability, and locking the brakes prevents unintended rolling when the elevator shifts. Backward entry or sideways positioning increases fall risk and reduces control.

Question 31

A client with a new right above-knee prosthesis reports that the limb feels loose after walking short distances. The nurse notes that the prosthetic sock is wrinkled. What is the nurse’s best instruction?

Accepted Answer

Answer reason: Wrinkled or improperly applied socks create pressure points, friction, and unstable prosthetic fit. The correct action is to remove the prosthesis, smooth the sock, and reassess. Adding layers or tightening straps can worsen misalignment and cause skin injury.

Question 32

A client using a standard walker approaches a curb and asks how to step up safely. Which instruction is most appropriate?

Accepted Answer

Answer reason: When ascending a curb, safety guidelines require placing the walker up on the curb first, then stepping up with the strong leg. The weak leg follows. This preserves stability and prevents tipping.

Question 33

A postoperative spinal surgery client is learning to change position in bed. The nurse provides a trapeze bar. Which outcome indicates correct use of this assistive device?

Accepted Answer

Answer reason: Post-spinal surgery clients must avoid twisting. A trapeze assists with controlled, symmetrical movement and maintaining spinal alignment during repositioning. Twisting or rapid movements violate spinal precautions.

Question 34

A client with severe osteoarthritis in both knees reports difficulty rising from the toilet due to pain and limited flexion. Which assistive device would best promote independence and safety?

Accepted Answer

Answer reason: Low toilet seats require deep flexion and increase difficulty rising. A raised seat decreases flexion demands, and arm supports provide leverage, promoting safer and more independent transfers.

Question 35

A client with Parkinson’s disease experiences tremors and difficulty keeping food on utensils. The nurse wants to promote independence during meals. Which device is most appropriate?

Accepted Answer

Answer reason: Weighted utensils reduce tremor amplitude, and plate guards help keep food on the utensil. This combination maximizes functional independence while respecting the client’s autonomy.

Question 36

A client with a left leg fracture is learning to use crutches on stairs. Which instruction is correct when descending the stairs?

Accepted Answer

Answer reason: The rule is **up with the good, down with the bad**. Descending requires moving crutches + injured leg down first, allowing the strong leg to support and stabilize. Any other sequence increases fall risk.

Question 37

A client with limited trunk control is learning to use a slide board to transfer from the bed to a wheelchair. Which instruction should the nurse give first?

Accepted Answer

Answer reason: A safe slide-board transfer begins with securing one end of the board under the client’s hips and the other end on the destination surface. This creates a stable bridge and reduces fall risk.

Question 38

A client with severe hip pain uses a reacher at home. Which instruction will best reduce fall risk?

Accepted Answer

Answer reason: The goal of reacher use is to prevent bending, twisting, and overreaching. Keeping items at comfortable height reduces fall risk and eliminates unsafe repetitive movements.

Question 39

A client who self-propels a wheelchair reports arm fatigue when turning sharply. Which instruction by the nurse improves efficiency and reduces strain?

Accepted Answer

Answer reason: Efficient turning in a wheelchair requires differential propulsion—one wheel moves forward while the opposite wheel moves backward. This minimizes energy use and improves maneuverability.

Question 40

A client with right-sided hemiplegia is learning to button shirts independently. Which instruction by the nurse is most appropriate?

Accepted Answer

Answer reason: Hemiplegic dressing techniques require using the stronger hand for fine-motor tasks (button hook operation) and the weaker hand only for stabilization. This maximizes independence without overloading the affected side.

Question 41

During a home safety assessment, the nurse evaluates fall risk for a client with impaired balance. Which recommendation is most appropriate?

Accepted Answer

Answer reason: Poor lighting and loose throw rugs are major contributors to home falls. Increasing illumination and removing hazards directly improves mobility safety. High shelves or dim lighting increase risk further.

Question 42

A client with limited endurance asks how to safely bathe at home. Which adaptive device is most beneficial?

Accepted Answer

Answer reason: A shower chair ensures seated stability, a hand-held shower reduces energy expenditure, and non-slip flooring prevents falls. This setup maximizes safety and independence.

Question 43

A nurse is preparing to transfer a dependent client from the bed to a wheelchair using a mechanical (Hoyer) lift. Which action is essential for safety?

Accepted Answer

Answer reason: A widened lift base increases stability, and a locked wheelchair prevents movement during descent. These are foundational safety steps in mechanical lift transfers. Raising the lift unnecessarily increases fall risk.

Question 44

A client with reduced grip strength due to rheumatoid arthritis struggles to write legibly. Which adaptive tool should the nurse recommend?

Accepted Answer

Answer reason: Built-up and weighted pens reduce the fine motor precision needed for writing and compensate for weak grip strength. This promotes independence and improves handwriting quality.

Question 45

A client with foot drop receives an ankle-foot orthosis (AFO). Which teaching should the nurse include?

Accepted Answer

Answer reason: AFOs are worn inside the shoe, require proper sequence (brace first → shoe second), and need regular skin checks to prevent pressure injuries. They are not worn during sleep unless specifically prescribed.

Question 46

A client with multiple sclerosis is receiving a power wheelchair for community mobility. Which instruction should the nurse emphasize first during training?

Accepted Answer

Answer reason: Initial power wheelchair training should prioritize safety—low speed, open space, and supervised practice reduce collision and injury risk while the client develops control.

Question 47

A client with advanced macular degeneration is at risk for falls at home. Which recommendation by the nurse is most appropriate to enhance safe navigation?

Accepted Answer

Answer reason: High-contrast markings improve depth perception and stair visibility, while consistent furniture placement allows the client to memorize safe pathways. Frequent rearranging and dim lighting increase fall risk.

Question 48

A client with post-stroke dysphagia is at risk for aspiration but wants to maintain as much independence as possible during meals. Which adaptive approach is most appropriate?

Accepted Answer

Answer reason: Lidded cups with small openings help control sip volume and reduce aspiration risk. Combined with an upright position, this assists safe swallowing while preserving independence.

Question 49

A client with severe bilateral hand tremors wants to continue preparing simple meals independently. Which assistive device or adaptation should the nurse recommend first?

Accepted Answer

Answer reason: Weighted utensils reduce tremor amplitude, and stabilizing corner brackets keep food secure during cutting tasks. These combined adaptations maximize safety and independence. Lightweight utensils worsen tremor, and relying entirely on others reduces autonomy.

Question 50

A client with hemiparesis is learning to use a gait belt during supervised ambulation. Which action by the nurse ensures the safest technique?

Accepted Answer

Answer reason: The safest gait-belt technique is having the nurse walk slightly behind and to the weaker side, holding the belt securely from the back or side. This position prevents falls and allows proper support without restricting the client’s natural movement.

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