A nurse is performing a gait assessment on a client to evaluate the client's ability to perform ADLs. Which of the following findings indicates a standard gait?

The client's shoulders are rounded slightly forward.

The client's heels touch the ground before their toes.

The client's dominant foot bears more weight.

The client looks at the floor when walking.

Answer and Explanation

The Correct Answer is B

A. The client's shoulders are rounded slightly forward: Slightly rounded shoulders can indicate poor posture or musculoskeletal issues. While minor rounding is common, it is not a defining characteristic of a normal, standard gait and may reflect postural deviations.

B. The client's heels touch the ground before their toes: A standard gait involves initial contact with the heel, followed by a smooth rolling motion to the toes during the stance phase. This heel-to-toe pattern indicates normal foot mechanics and weight transfer, reflecting a healthy, functional gait for ADLs.

C. The client's dominant foot bears more weight: Unequal weight bearing between the dominant and non-dominant foot suggests an abnormal gait or musculoskeletal imbalance. In a normal gait, weight is distributed evenly between both lower extremities during walking.

D. The client looks at the floor when walking: Looking at the floor may indicate visual or balance issues, poor confidence, or gait instability. A standard gait typically involves a forward gaze with a stable, upright posture to maintain balance and coordination.

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Correct Answer is D

Explanation

A. Slurred speech: Slurred speech is typically associated with intoxication from central nervous system depressants, such as alcohol or opioids, rather than withdrawal. During withdrawal, the client is more likely to exhibit hyperactive or restless behavior.

B. Constricted pupils: Pupillary constriction (miosis) occurs with opioid intoxication. In contrast, opioid withdrawal usually causes dilated pupils (mydriasis) due to sympathetic nervous system overactivity.

C. Sedation: Sedation is a common effect of opioid use, not withdrawal. During withdrawal, clients are generally hyperalert, restless, and may experience insomnia rather than excessive sleepiness.

D. Yawning: Yawning is a classic sign of opioid withdrawal and reflects autonomic nervous system activation. It is often accompanied by lacrimation, rhinorrhea, sweating, and other early withdrawal symptoms.

A. "You should eat hot foods to reduce your sense of fullness during a meal. B. "While eating you should drink liquids frequently." C. "During meals, you should eat foods with a high-calorie content first." D. "Lunch should be your largest meal of the day."

Correct Answer is C

Explanation

A. "You should eat hot foods to reduce your sense of fullness during a meal.": Hot foods can actually increase the feeling of fullness and may lead to early satiety, which is not ideal for clients with COPD who need to maintain adequate nutrition and energy intake.

B. "While eating you should drink liquids frequently.": Drinking large amounts of liquids during meals can cause early satiety and reduce overall caloric intake. Clients with COPD are encouraged to drink fluids between meals rather than during meals to avoid feeling too full.

C. "During meals, you should eat foods with a high-calorie content first.": Prioritizing high-calorie, nutrient-dense foods ensures the client consumes adequate energy before fatigue or fullness sets in. This strategy helps prevent unintentional weight loss and supports overall respiratory function in COPD.

D. "Lunch should be your largest meal of the day.": For clients with COPD, smaller, more frequent meals are recommended to prevent dyspnea and fatigue during eating. Large meals can exacerbate breathing difficulties, so meal size should be balanced throughout the day.

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