A nurse is teaching a client who has left hemiparesis how to use a cane. Which of the following instructions should the nurse include?
Hold the cane on the right side to provide support for the weaker leg
Remove the rubber tip when using the cane.
Advance the right leg and the cane together to support the weaker leg
Place the cane approximately 61 cm (24 in) in front of her feet before advancing
The Correct Answer is A
A: The correct instruction is to hold the cane on the right side, which is the side opposite the weaker leg. This provides better support and balance for the weaker side.
B: Removing the rubber tip from the cane is not recommended. The rubber tip provides traction and stability, reducing the risk of slipping.
C: Advancing the right leg and the cane together is incorrect. The cane should move with the weaker leg (left leg in this case) to provide support during ambulation.
D: Placing the cane 61 cm (24 in) in front of the feet is too far. The cane should be placed about 15-25 cm (6-10 in) in front of the feet to provide optimal support and balance.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
A: Neostigmine is used to treat myasthenia gravis and to reverse the effects of muscle relaxants after surgery. It is not an antidote for morphine overdose.
B: Naloxone is the correct medication to have available. It is an opioid antagonist used to reverse the effects of opioid overdose, including respiratory depression caused by morphine.
C: Protamine is used to reverse the effects of heparin, an anticoagulant. It is not related to opioid overdose treatment.
D: Flumazenil is used to reverse the effects of benzodiazepines. It is not effective for reversing opioid overdose.
Correct Answer is B
Explanation
A: Auscultation, or listening for air injected into the tube, is not a reliable method for verifying feeding tube placement. It can lead to false positives and does not confirm the tube’s location accurately.
B: X-ray is the gold standard for verifying feeding tube placement. It provides a clear image of the tube’s position, ensuring it is correctly placed in the stomach or small intestine, reducing the risk of complications.
C: Aspiration of contents can help verify placement by checking the appearance and pH of the aspirate. However, it is not as definitive as an X-ray and can sometimes be inconclusive.
D: pH testing of aspirate can indicate whether the tube is in the stomach (acidic pH) or intestines (less acidic). While useful, it is not as reliable as an X-ray for confirming placement.
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