A nurse is caring for a client who has a spinal cord injury at the fourth cervical level. Which of the following mobility options should the nurse anticipate for this client?

Choice A reason: A spinal cord injury at the C4 level results in significant motor impairment, including loss of voluntary movement in the arms and legs. A sip-and-puff device allows the client to control a power wheelchair using breath control, which is appropriate for clients with high cervical injuries and limited upper extremity function. Choice B reason: Manual wheelchairs require upper body strength and coordination, which clients with C4 injuries typically lack. This option is not feasible for independent mobility. Choice C reason: Drive-adapted wheelchairs require hand control or joystick manipulation, which is not possible for clients with C4-level injuries due to limited or absent hand and arm function. Choice D reason: Ultralight wheelchairs are designed for users with good upper body strength and control, which is not present in clients with high cervical spinal cord injuries.