Which activity would the nurse teach a non weight bearing client in order to prepare for crutch walking?

This is a quiz that contains NCLEX review questions about assistive devices for mobility like crutches. As a nurse providing care to a patient who will be using crutches, it is important that the patient is fitted correctly for the crutches, is using the proper gait (two-point, three-point, four-point, swing-to-gait, or swing-through-gait), knows how to go up and down stairs, and how to sit down or get up from a chair or bed with crutches.

In the previous NCLEX review series, I explained about other assistive devices (canes and walkers), so be sure you check out those reviews too.

Don’t forget to watch the lecture on crutches before taking the quiz.

Crutches (Assistive Devices) NCLEX Questions

This quiz contains NCLEX review questions about how to use assistive devices, such as crutches.

• 1. Your patient will be using crutches for mobility. After educating the patient on how to adjust the crutches to fit correctly, you assess how well the patient understood the instructions. What findings demonstrate that the crutches were adjusted correctly by the patient? Select all that apply:*
  • A. The hand grips of the crutches are even with the mid-forearm.
  • B. When the patient grips the hand grips of the crutches the elbow bends at about 30 degrees.
  • C. The patient has a 2-3 finger width distance between the axillae and crutch rest pad.
  • D. The patient places weight on the axillae rather than the hands while ambulating.

• 2. Your patient is prescribed to use crutches for ambulation. The patient can bear partial weight and needs to be taught how to use the two-point gait while using crutches. Which description below best describes this type of gait with crutches?*
  • A. The patient moves both crutches forward and then moves both legs forward to the same point as the crutches.
  • B. The patient moves the right crutch (injured side), then moves the left foot (non-injured side), then moves the left crutch (non-injured side), and then moves the right foot (injured side).
  • C. The patient moves both the right crutch (injured side) and left foot (non-injured side) forward together, and then moves the left crutch (non-injured side) and right foot (injured side) forward together.
  • D. The patient moves both crutches and injured leg forward together, and then moves the non-injured leg forward.

• 3. While your patient is ambulating with crutches he moves both crutches forward along with the injured leg and then moves the non-injured forward. When you document you will note that the patient used what type of gait while ambulating with crutches?*
  • A. Two-point gait
  • B. Three-point gait
  • C. Four-point gait
  • D. Swing-to-gait

• 4. You’re demonstrating how to ambulate while using crutches to a group of pre-op patients, who will need to use crutches after surgery. You ask one of the group participants to demonstrate the four-point gait using the crutches. Which demonstration by the participant demonstrates they understood the demonstration you provided earlier?*
  • A. The participant moves both crutches forward and then moves both legs past the placement of the crutches.
  • B. The participant moves both crutches and injured leg forward together, and then moves the non-injured leg forward.
  • C. The participant moves both the right crutch and left foot forward together, and then moves the left crutch and right foot forward together.
  • D. The participant moves the right crutch, then moves the left foot, then moves the left crutch, and then moves the right foot.

• 5. While using crutches the patient moves both crutches forward and then moves both legs forward past the placement of the crutches. This is known as the:*
  • A. Two-point gait
  • B. Swing-to-gait
  • C. Swing-through-gait
  • D. Three-point gait

• 6. True or False: When using the swing-to gait with crutches, the patient will move both crutches forward, and then will move both legs forward to the same point as the crutches.*
  • True
  • False

• 7. You’re observing your patient using crutches. She is using the three-point gait. Which finding requires you to re-educate the patient on how to use the crutches?*
  • A. There is a 1.5 inch gap between the axillae and crutch rest pad during ambulation with the crutches.
  • B. The patient starts in the tripod position before ambulating with the crutches.
  • C. The patient leans on the crutch rest pads during ambulation.
  • D. The patient does not let the injured leg touch the ground while ambulating with the crutches.

• 8. A patient needs to go up the stairs while using crutches. What finding by the nurse demonstrates the patient understands how to ambulate upstairs with crutches?*
  • A. The patient moves the crutches forward up the step, then the injured and non-injured leg.
  • B. The patient moves the non-injured leg forward onto the step and then the moves the injured leg and crutches up.
  • C. The patient moves the injured leg forward onto the steps, then moves the crutches, and then moves the non-injured leg.
  • D. The patient moves the crutches and non-injured leg forward to the step together, and then the non-injured leg.

• 9. While going down the stairs with crutches the patient will move the crutches down onto the step followed by?*
  • A. moving the non-injured leg down onto the step.
  • B. moving the injured leg down onto the step.
  • C. moving both legs down onto the step.

• 10. Your patient attempts to sit down in the bedside chair after ambulating in the hallway with crutches. What finding requires you to re-educate the patient on how to sit down in the chair correctly while using crutches?*
  • A. The patient places both crutches on the non-injured side before sitting down in the chair.
  • B. The patient backs up to the chair’s seat until he feels it with his non-injured leg and stops.
  • C. The patient keeps the injured leg extended out in front of him while sitting down.
  • D. The patient holds both crutches on one side and reaches for the hand grips on the crutches and places weight on them while sitting down.

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1.      Your patient will be using crutches for mobility. After educating the patient on how to adjust the crutches to fit correctly, you assess how well the patient understood the instructions. What findings demonstrate that the crutches were adjusted correctly by the patient? Select all that apply:

A.     The hand grips of the crutches are even with the mid-forearm.

B.     When the patient grips the hand grips of the crutches the elbow bends at about 30 degrees.

C.     The patient has a 2-3 finger width distance between the axillae and crutch rest pad.

D.     The patient places weight on the axillae rather than the hands while ambulating.

The answers are B and C. Properly fitted crutches should be a 2-3 finger width (about 1-1.5 inches) distance between the axillae (armpit area) and the crutch rest pads during ambulation. This prevents damaging the nerves that are located in the axillae during ambulation. In addition, when the patient grips the hand grips of the crutches the elbow should slightly bend at about 30 degrees. Option A is wrong because the hand grips of the crutches should be even with the hip line (not the mid-forearm), and option D is wrong because the patient should place weight on the HANDS while ambulating NOT the axillae area (this can cause nerve damage).

2.      Your patient is prescribed to use crutches for ambulation. The patient can bear partial weight and needs to be taught how to use the two-point gait while using crutches. Which description below best describes this type of gait with crutches?

A.     The patient moves both crutches forward and then moves both legs forward to the same point as the crutches.

B.     The patient moves the right crutch (injured side), then moves the left foot (non-injured side), then moves the left crutch (non-injured side), and then moves the right foot (injured side).

C.     The patient moves both the right crutch (injured side) and left foot (non-injured side) forward together, and then moves the left crutch (non-injured side) and right foot (injured side) forward together.

D.     The patient moves both crutches and injured leg forward together, and then moves the non-injured leg forward.

The answer is C. The two-point gait is where the patient moves both the right crutch (injured side) and left foot (non-injured side) forward TOGETHER, and then moves the left crutch (non-injured side) and right foot (injured side) forward TOGETHER.

3.      While your patient is ambulating with crutches he moves both crutches forward along with the injured leg and then moves the non-injured forward. When you document you will note that the patient used what type of gait while ambulating with crutches?

A.     Two-point gait

B.     Three-point gait

C.     Four-point gait

D.     Swing-to-gait

The answer is B. This describes the three-point gait while using crutches.

4.      You’re demonstrating how to ambulate while using crutches to a group of pre-op patients, who will need to use crutches after surgery. You ask one of the group participants to demonstrate the four-point gait using the crutches. Which demonstration by the participant demonstrates they understood the demonstration you provided earlier?

A.     The participant moves both crutches forward and then moves both legs past the placement of the crutches.

B.     The participant moves both crutches and injured leg forward together, and then moves the non-injured leg forward.

C.     The participant moves both the right crutch and left foot forward together, and then moves the left crutch and right foot forward together.

D.     The participant moves the right crutch, then moves the left foot, then moves the left crutch, and then moves the right foot.

The answer is D. The four-point gait is where the person moves the right crutch, then moves the left foot, then moves the left crutch, and then moves the right foot.

5.      While using crutches the patient moves both crutches forward and then moves both legs forward past the placement of the crutches. This is known as the:

A.     Two-point gait

B.     Swing-to-gait

C.     Swing-through-gait

D.     Three-point gait

The answer is C. This description is known as the swing-through-gait. The key word to let you know it is the swing-through-gait is that the patient moves both legs PAST the placement of the crutches. It would have been the swing-to-gait if both legs moved forward to the same point as the crutch placement.

6.      True or False: When using the swing-to gait with crutches, the patient will move both crutches forward, and then will move both legs forward to the same point as the crutches.

The answer is true. This description describes the swing-to-gait.

7.      You’re observing your patient using crutches. She is using the three-point gait. Which finding requires you to re-educate the patient on how to use the crutches?

A.     There is a 1.5 inch gap between the axillae and crutch rest pad during ambulation with the crutches.

B.     The patient starts in the tripod position before ambulating with the crutches.

C.     The patient leans on the crutch rest pads during ambulation.

D.     The patient does not let the injured leg touch the ground while ambulating with the crutches.

The answer is C. The patient should NOT let the axillae (arm pits) rest or lean on the crutch rest pads during ambulation because this could cause nerve damage. The patient should exert weight on the hand grips while ambulating.

8.      A patient needs to go up the stairs while using crutches. What finding by the nurse demonstrates the patient understands how to ambulate upstairs with crutches?

A.     The patient moves the crutches forward up the step, then the injured and non-injured leg.

B.     The patient moves the non-injured leg forward onto the step and then the moves the injured leg and crutches up.

C.     The patient moves the injured leg forward onto the steps, then moves the crutches, and then moves the non-injured leg.

D.     The patient moves the crutches and non-injured leg forward to the step together, and then the non-injured leg.

The answer is B. The patient will move the non-injured leg forward onto the step and then will move the injured leg and crutches up.

9.      While going down the stairs with crutches the patient will move the crutches down onto the step followed by?

A.     moving the non-injured leg down onto the step.

B.     moving the injured leg down onto the step.

C.     moving both legs down onto the step.

The answer is B. When going down the stairs with crutches, the patient will move the crutches down first onto the step followed by moving the INJURED leg and then the patient will move the non-injured leg down.

10.   Your patient attempts to sit down in the bedside chair after ambulating in the hallway with crutches. What finding requires you to re-educate the patient on how to sit down in the chair correctly while using crutches?

A.     The patient places both crutches on the non-injured side before sitting down in the chair.

B.     The patient backs up to the chair’s seat until he feels it with his non-injured leg and stops.

C.     The patient keeps the injured leg extended out in front of him while sitting down.

D.     The patient holds both crutches on one side and reaches for the hand grips on the crutches and places weight on them while sitting down.

The answer is A. This requires re-education because the patient should place both crutches on the INJURED SIDE (NOT the non-injured side) before sitting down in the chair. The crutches will help provide weight support to the injured side while sitting down.

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