Assistive Devices: Use And Teaching - NCLEX Pn

1. What is the correct 3-point gait pattern with crutches for non-weight-bearing on one leg?

   Both crutches + affected leg, then unaffected leg steps through. This pattern maintains non-weight-bearing on the affected leg while ensuring stability through three points of support.

2. What is the safest way for a client to stand up when using a walker?

   Push up from chair armrests, then grasp walker once standing. Pushing from armrests allows controlled standing, followed by secure walker grasp to maintain balance.

3. What is the correct handgrip position on axillary crutches when properly fitted?

   Elbows flex about $20$ to $30$ degrees with hands on grips. Proper elbow flexion ensures ergonomic weight distribution through the hands, minimizing shoulder strain.

4. What is the safest way for a client to sit down when using a walker?

   Back to chair, reach for armrests, then sit; do not hold walker. Using chair armrests for support prevents instability, as the walker is not designed for weight-bearing during sitting.

5. What is the correct 4-point gait pattern with crutches (sequence)?

   Right crutch, left foot, left crutch, right foot. The 4-point gait offers maximum stability by alternating support, ideal for clients with poor balance or coordination.

6. Identify the error: Client bears weight on axillary pads while using crutches. What correction is needed?

   Shift weight-bearing to hands; keep pads $2$ to $3$ fingers below axilla. Axillary pads are for positioning only; weight on hands prevents nerve compression and ensures proper crutch function.

7. Which side should the nurse stand on when assisting ambulation with a cane?

   Stand on the weak (affected) side, slightly behind the client. Positioning on the affected side enables immediate support and assistance to prevent falls during cane-assisted walking.

8. Which cue should you teach for stair descent with crutches when going down?

   Down with the bad: crutches and affected leg first, then good leg. Descending with the affected leg first maintains balance and reduces stress on the weaker extremity during lowering.

9. What is the correct sequence for cane ambulation with a weak right leg?

   Cane + right leg forward together, then left leg steps through. Advancing the cane with the weak leg together transfers weight effectively, using the strong leg for propulsion.

10. What teaching prevents nerve damage when using axillary crutches?

    Support weight on hands, not on the axillae. Weight on the axillae can compress the brachial plexus, leading to nerve injury; hand support avoids this complication.

11. What should the nurse teach about footwear when using a cane, crutches, or a walker?

    Wear well-fitting, non-skid shoes; avoid socks-only ambulation. Appropriate footwear provides traction and support, essential for stability and fall prevention with assistive devices.

12. What is the correct swing-through gait pattern with crutches?

    Advance both crutches, then swing both legs past crutches. Swing-through gait enables faster ambulation for clients with good upper body strength and bilateral lower extremity involvement.

13. Which side should the nurse stand on when assisting ambulation with crutches?

    Stand on the weak side, slightly behind, using a gait belt. Standing on the weak side with a gait belt facilitates quick intervention and stability for crutch users at risk of falling.

14. Which instruction is correct for using a cane on stairs when a handrail is present?

    Use handrail with one hand and cane in the other; follow good/bad rule. Combining handrail and cane with the good/bad sequence optimizes support and safety on stairs with partial railing.

15. What is the correct axillary crutch fit for space between axilla and crutch pad?

    Approximately $2$ to $3$ finger widths below the axilla. Adequate spacing prevents pressure on the axillary nerves, reducing the risk of crutch palsy during use.

16. What is the correct cane length measurement for fitting a client standing upright?

    From greater trochanter to floor, or wrist crease to floor. This measurement ensures proper support and posture, preventing strain on the back and shoulders during ambulation.

17. What is the correct tripod position for standing with crutches?

    Crutch tips slightly ahead and to the side; weight on hands. The tripod stance distributes weight evenly, enhancing balance and preventing falls when stationary with crutches.

18. Which hand should hold a cane when one lower extremity is weak or painful?

    Hold the cane on the strong (unaffected) side. Placing the cane on the unaffected side provides optimal balance and support to the weakened extremity during weight transfer.

19. What is the correct cane height when the tip is on the floor beside the foot?

    Handle at wrist crease; elbow flexion about $20$ to $30$ degrees. This positioning allows for comfortable elbow flexion, promoting stability and reducing fatigue while using the cane.

20. Identify the error: Client advances walker, then steps outside the walker frame. What is the correction?

    Step into the walker, keeping body within the walker base. Stepping within the walker maintains a wide base of support, enhancing stability and reducing fall risk during ambulation.

21. What is the correct 2-point gait pattern with crutches (sequence of limbs and crutch tips)?

    Right crutch + left foot, then left crutch + right foot. The 2-point gait mimics natural walking, providing partial weight-bearing support for clients with bilateral weakness.

22. What is the correct placement of a walker when initiating gait?

    Advance walker first, then step into it; do not pull it forward. Advancing the walker creates a stable base of support before stepping, ensuring safety for clients with balance issues.

23. What is the priority home safety teaching for clients using assistive devices to prevent falls?

    Remove throw rugs/clutter; ensure adequate lighting and dry floors. Eliminating environmental hazards minimizes tripping risks, crucial for safe mobility with assistive devices at home.

24. What should the nurse teach about rubber tips and device condition before ambulation?

    Inspect for worn tips/loose parts; replace before use. Regular inspection ensures device integrity, preventing slips or failures that could lead to injury during use.

25. Which cue should you teach for stair climbing with crutches when going up?

    Up with the good: good leg first, then crutches and affected leg. Leading with the unaffected leg provides stability and leverages stronger muscles for safe upward progression on stairs.

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