A nurse is assessing a client's ability to ambulate with crutches using a three-point gait. Which of the following actions should the nurse identify as a risk to the client's safety?

The client stands in a tripod position prior to walking.

The client keeps the elbows in a flexed position.

The client pushes downward on the handgrips.

The client places partial weight on the affected leg.

Answer and Explanation

The Correct Answer is D

A. Standing in a tripod position prior to walking with crutches is a correct stance to maintain balance and stability.
B. Keeping the elbows flexed helps absorb shock during ambulation and is appropriate when using crutches.
C. Pushing downward on the handgrips is necessary to generate upward force and support while using crutches.
D. Placing partial weight on the affected leg while ambulating with crutches using a three-point gait is incorrect and can jeopardize safety by potentially causing injury or instability.

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Correct Answer is ["B","D","E"]

Explanation

A. Urine-specific gravity greater than 1.030 indicates concentrated urine, suggesting dehydration, not fluid volume excess.
B. A bounding pulse is a sign of fluid volume excess.
C. Swelling at the IV site indicates infiltration, not systemic fluid volume excess.
D. Crackles upon auscultation of the lungs indicate fluid accumulation in the lungs, a sign of fluid volume excess.
E. Pitting edema is a sign of fluid volume excess, indicating fluid retention in the tissues.

Correct Answer is ["0.5"]

Explanation

To administer the correct dose of lorazepam, which is 1 mg, when only 2 mg tablets are available, the nurse should administer half a tablet. This is because each tablet contains 2 mg of lorazepam, and the prescribed dose is 1 mg. Therefore, dividing the tablet into two equal parts will provide the necessary 1 mg dose. The answer, rounded to the nearest tenth as per the instruction, is 0.5.

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A nurse is assessing a client's ability to ambulate with crutches using a three-point gait. Which of the following actions should the nurse identify as a risk to the client's safety?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing an older adult client who is receiving IV therapy. The nurse should recognize that which of the following findings indicates fluid volume excess? (Select all that apply.)

Correct Answer is ["B","D","E"]

Explanation

A nurse is preparing to administer lorazepam 1 mg PO at bedtime. The amount available is lorazepam 2 mg tablets. How many tablets should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["0.5"]

Explanation

A nurse is preparing to administer 0.45% sodium chloride (NaCl) 1000 mL IV to infuse over 8 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero)

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