Sample NCLEX Questions
1. The nurse should have the client use appropriate safety measures with care by:
a. Placing the cane on the affected side.
b. Placing the cane on the opposite affected side.
c. Does not matter which side the cane is on.
d. Choice of cane placement should be the choice of the client.
Answer B.
Rationale: Safety demands that the cane be opposite the affected limb to provide support to the weakened extremity, thus preventing falls.
2. A cane assists the client to walk with greater balance and support. Canes have the following features for safety and support:
a. Feet (four, three, straight), adjustable to allow the elbow to bend slightly, a rubber cap.
b. Feet (straight or two), adjustable to what the client feels is best.
c. Four feet, a rubber tip at both ends.
d. Three feet, enables speed, using two canes.
Answer A.
Rationale: The cane can have four feet (quad), three feet (tripod), or be straight; the length should allow the elbow to bend slightly, and a rubber tip prevents slipping.
3. The standard walker is used when clients:
a. Have poor balance, cannot stand up, have weak arms, and have good hand strength.
b. Have poor balance, broken leg, or amputation.
c. Have poor balance, cardiac problems, and cannot use crutches or cane.
d. Have poor balance, autoimmune diseases, and weak arms.
Answer: C.
Rationale: The use of the walker is used for clients who have balance, cardiac problems, or who cannot use crutches or cane. The client needs to be partial weight bearing and have strength in wrists and arms. The client uses upper body to propel the walker forward.
4. Safety measures for crutches must be in place for a client when the nurse is the primary one for assistance. These safety measures are:
a. To be propel fitted for the client, have rubber tips at the end, and provide for a four-point gait.
b. Properly fitting crutches, education in the appropriate gait, and strength in the arms.
c. Crutches fitting to what the patient chooses, and gait chosen by patient.
d. Have both legs that touch the floor for all gaits.
Answer: B.
Rationale: In addition to the rubber tips on the end of the crutch, the patient needs to know the appropriate gait; arm strengthening exercises are necessary, and it is critical that the patient be fitted for the crutch.
5. The Hydraulic Lift (Hoyer Lift) is used for:
a. The Hydraulic Lift (Hoyer Lift) is used for:
b. All clients who are not able to stand and extremity obese clients.
c. All clients, both old and young in the hospital setting.
d. Not an assistive device for special needs.
Answer B.
Rationale: The Hydraulic Lift is used for safety purposes when a patient is not able to stand or is too heavy for the healthcare workers to lift safely.
NCLEX Questions for Basic Care and Comfort 1/4
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