Activities Of Daily Living Assistance
Help Questions
NCLEX-PN › Activities Of Daily Living Assistance
A 4-year-old child with cerebral palsy has poor trunk control and difficulty using utensils. The child needs assistance with eating and grooming and becomes tired easily. What is the nurse's PRIORITY when assisting with feeding?
Position the child upright with appropriate support and offer small bites, allowing time to swallow
Encourage the child to finish the entire meal to meet calorie needs
Ask the unlicensed assistive personnel to determine the safest food textures for the child
Offer fluids through a straw to speed up intake
Explanation
This question tests basic care and comfort related to assisting pediatric clients with activities of daily living, specifically feeding. Key considerations for assisting with ADLs include ensuring safe swallowing, preventing aspiration, and conserving the child's energy. Positioning upright with support and offering small bites with time to swallow (A) is the priority because it addresses the child's poor trunk control and reduces aspiration risk while accommodating fatigue. Encouraging the child to finish everything (B) may lead to fatigue and unsafe swallowing, offering fluids through a straw (C) may increase aspiration risk with poor trunk control, and delegating texture assessment to UAP (D) exceeds their scope of practice. The principle for feeding assistance in children with neuromuscular conditions is to prioritize safe positioning and pacing to prevent aspiration. When prioritizing ADL assistance for children with physical disabilities, always ensure proper positioning and allow adequate time for safe swallowing while monitoring for fatigue.
A 76-year-old client with Parkinson disease has a resting tremor and shuffling gait. The client requires assistance with bathing and dressing because of slowed movements and difficulty with fine motor tasks. What is the nurse's PRIORITY when assisting with bathing in the shower area?
Place non-skid footwear on the client and use a shower chair during bathing
Ask the client to wash the back and feet to encourage independence
Complete the bath quickly to reduce fatigue and limit time in the bathroom
Provide a warm blanket afterward to promote comfort and relaxation
Explanation
This question tests basic care and comfort related to assisting clients with activities of daily living during bathing. Key considerations for assisting with ADLs include ensuring safety, preventing falls, and adapting care to the client's specific mobility challenges. Placing non-skid footwear and using a shower chair (A) is the priority because it directly addresses the client's shuffling gait and movement difficulties, preventing slips and falls in the wet environment. Completing the bath quickly (B) may increase fall risk by rushing the client, providing a warm blanket (C) addresses comfort but not safety priorities, and asking the client to wash hard-to-reach areas (D) may be unsafe given their movement limitations. The principle for bathing assistance is to prioritize fall prevention through appropriate safety equipment and environmental modifications. When prioritizing ADL assistance in clients with movement disorders, always address safety hazards first before considering comfort or independence goals.
A 79-year-old client with dementia is admitted to a skilled nursing facility and needs assistance with dressing and toileting due to poor short-term memory and impaired judgment. The client attempts to get up without help. Which action should the nurse take to reduce fall risk while supporting toileting needs?
Implement a regular toileting schedule and keep the bed in the lowest position with the call light within reach
Limit the client's oral fluids to decrease urinary frequency
Use a full side-rail restraint to prevent the client from getting out of bed
Tell the client to wait until staff are available and return when the client calls again
Explanation
This question tests basic care and comfort related to assisting clients with activities of daily living while managing cognitive impairment. Key considerations for assisting with ADLs include preventing falls, maintaining continence, and adapting care to cognitive deficits. Implementing a toileting schedule and keeping the bed low with call light accessible (A) is the best approach because it proactively addresses toileting needs and reduces fall risk without using restraints. Using side-rail restraints (B) is inappropriate and increases injury risk, telling the client to wait (C) doesn't address the immediate need or cognitive limitations, and limiting fluids (D) can cause dehydration and doesn't solve the safety issue. The principle for ADL assistance with dementia is to use proactive, routine-based approaches that prevent unsafe behaviors. When prioritizing ADL assistance for clients with cognitive impairment, always implement structured routines and environmental modifications rather than restrictive measures.
A 59-year-old client is 2 days post-abdominal surgery and has weakness and dizziness when standing. The client needs assistance with feeding and ambulation to the bathroom. How should the nurse support the client during the first ambulation after surgery?
Delay ambulation until the client can walk to the bathroom without assistance
Increase the intravenous fluid rate to treat dizziness before assisting the client to stand
Assist the client to dangle at the bedside, then stand, and pause to assess for dizziness before walking
Encourage the client to walk independently to build confidence and endurance
Explanation
This question tests basic care and comfort related to assisting post-surgical clients with activities of daily living, specifically ambulation. Key considerations for assisting with ADLs include preventing orthostatic hypotension, ensuring safety during position changes, and gradually increasing activity tolerance. Having the client dangle, stand, and pause to assess for dizziness (B) is the correct approach because it allows for gradual position changes and assessment of orthostatic symptoms before walking. Encouraging independent walking (A) is unsafe with reported weakness and dizziness, delaying ambulation (C) contradicts post-operative mobility protocols, and increasing IV fluids (D) requires an order and doesn't address the immediate need for safe ambulation. The principle for post-surgical ADL assistance is to progress mobility gradually while monitoring for complications like orthostatic hypotension. When prioritizing ADL assistance after surgery, always use a systematic approach to position changes that allows for assessment and adaptation based on the client's response.
A 6-year-old child with autism spectrum disorder is hospitalized for dehydration and has sensory sensitivity to touch. The child needs assistance with eating and grooming due to limited cooperation and difficulty tolerating oral care. Which action should the nurse take to best support the child during toothbrushing?
Use a calm, step-by-step routine and allow the child to hold the toothbrush when possible
Skip oral care until discharge to avoid upsetting the child
Request a prescription for a sedative before each grooming session
Hold the child firmly and complete toothbrushing quickly to finish the task
Explanation
This question tests basic care and comfort related to assisting pediatric clients with activities of daily living. Key considerations for assisting with ADLs include accommodating sensory sensitivities, maintaining routines, and promoting participation within the child's comfort level. Using a calm, step-by-step routine and allowing the child to hold the toothbrush (A) is the best approach because it provides predictability, gives the child some control, and respects sensory sensitivities. Holding the child firmly and rushing (B) will increase distress and resistance, skipping oral care (C) neglects hygiene needs, and requesting sedatives (D) is inappropriate for routine care. The principle for ADL assistance with sensory-sensitive children is to use consistent, gentle approaches that allow for participation and control. When prioritizing ADL assistance for children with autism, always use predictable routines and offer choices to reduce anxiety and promote cooperation.