NCLEX Daily Ten Question Practical Exercise 10

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6. A 75-year-old male patient with a history of right-sided hemiplegia due to a recent stroke is learning how to use a cane under the guidance of the nurse. The patient expresses a desire to be as independent as possible in mobility. During the teaching session, the nurse observes the patient’s ability to use the cane correctly. Which of the following behaviors, if demonstrated by the patient, indicates that the teaching was effective?

A. The client holds the cane with his right hand, moves the cane forward followed by the right leg, and then moves the left leg.

B. The client holds the cane with his right hand, moves the cane forward followed by his left leg, and then moves the right leg.

C. The client holds the cane with his left hand, moves the cane forward followed by the right leg, and then moves the left leg.

D. The client holds the cane with his left hand, moves the cane forward followed by his left leg, and then moves the right leg.

Correct Answer: C

Answer Explanation:

The cane acts as a support and aids in weight-bearing for the weaker right leg.

Option A: The client should hold the cane with his left hand because this side provides more stable support than the injured side.
Option B: The right side should act as the weight-bearing side because the left side is weaker.
Option D: Always move the affected leg first; in this case, the right leg.

7. An 82-year-old female patient with a history of mild cognitive impairment and Parkinson’s disease is admitted to a nursing home. The patient occasionally exhibits confusion and has an unsteady gait. The nurse is assessing the patient’s needs and environment to promote safety and comfort. Which of the following actions, if taken by the nurse, is most appropriate?

A. Ask the woman’s family to provide personal items such as photos or mementos.

B. Select a room with a bed by the door so the woman can look down the hall.

C. Suggest the woman eat her meals in the room with her roommate.

D. Encourage the woman to ambulate in the halls twice a day.

Correct Answer: A

Answer Explanation:

Photos and mementos provide visual stimulation to reduce sensory deprivation. Providing personal items can help in orienting the patient to the new environment and can be comforting, especially for someone with mild cognitive impairment.

Option B: The client is often confused and may wander outside her room and easily get lost.
Option C: The client may take her meals with a roommate or in the dining hall.
Option D: This may lead to incidence of falls or injury because the client’s gait is unsteady. Assistance during ambulation is most appropriate.

8. A 78-year-old male patient with a recent hip replacement surgery is learning to use a standard aluminum walker under the guidance of the nurse. The patient has mild arthritis in both hands and experiences occasional shortness of breath. Which of the following behaviors, if demonstrated by the patient, indicates that the nurse’s teaching was effective?

A. The client slowly pushes the walker forward 12 inches, then takes small steps forward while leaning on the walker.

B. The client lifts the walker, moves it forward 10 inches, and then takes several small steps forward.

C. The client supports his weight on the walker while advancing it forward, then takes small steps while balancing on the walker.

D. The client slides the walker 18 inches forward, then takes small steps while holding onto the walker for balance.

E. The patient places the walker ahead, leans on it with one hand while holding his hip with the other, and then steps forward.

F. The patient holds the sides of the walker, takes a step forward, and then moves the walker to align with his new position.

Correct Answer: B

Answer Explanation:

Lifting the walker slightly, moving it forward a short distance (10 inches), and then taking steps is the recommended method. This technique ensures stability and minimizes the risk of falls. A walker needs to be picked up, placed down on all legs.

Option A: Teach the client to lift, not push, the walker forward, and not to lean on it to avoid falls.
Option C: The client should not put his weight on the walker as it may lead to incidents of falls.
Option D: A walker should be lifted, not slide.
Option E: Leaning on the walker with one hand while holding the hip with the other does not provide adequate support and may lead to imbalance.
Option F: The patient should lift and move the walker slightly forward, not just hold its sides and step forward. This method might not provide sufficient stability.

9. A nurse is supervising a diverse group of elderly clients aged 75-90 years in a residential home setting. Many of these clients have varied health conditions, including vision and hearing impairments, limited mobility, and chronic illnesses that require medication. The nurse is assessing factors that could contribute to sensory deprivation in these clients. Which of the following reasons is most likely to increase the risk of sensory deprivation in this elderly group?

A. Increased sensitivity to the side effects of medications.

B. Decreased visual, auditory, and gustatory abilities.

C. Isolation from their families and familiar surroundings.

D. Decrease musculoskeletal function and mobility.

Correct Answer: B

Answer Explanation:

Gradual loss of sight, hearing, and taste interferes with normal functioning.

Option A: The side effects of medications do not usually affect the senses in the elderly.
Option C: Isolation is not the reason for developing sensory deprivation.
Option D: Decrease in mobility and functioning does not cause sensory deprivation.

10. A 68-year-old male patient with a history of chronic emphysema presents in the clinic with symptoms of increasing restlessness and confusion. He has a history of smoking and reports difficulty in breathing. The nurse is assessing the patient to determine the best immediate course of action. What step should the nurse take next?

A. Encourage the client to perform pursed-lip breathing.

B. Check the client’s temperature.

C. Assess the client’s potassium level.

D. Increase the client’s oxygen flow rate.

Correct Answer: A

Answer Explanation:

Pursed lip breathing prevents the collapse of the lung unit and helps client control the rate and depth of breathing.

Option B: Checking the temperature is unnecessary especially if the client is restless.
Option C: Emphysema does not significantly affect potassium levels.
Option D: Do not increase the oxygen levels in a client with emphysema.

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