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    Hesi Rn compass exit B proctored exam

    The nurse is caring for a client with left-sided hemiparesis after a stroke. Which action should the nurse take to safely assist the client with ambulation?

    Explanation & Rationale

    Rationale: A. Provide support on the unaffected side: Supporting from the unaffected side gives less control if the weak side gives out. Assistance should be on the affected side to better prevent falls and provide stabilization. B. Hook an arm under the client's left arm: This is unsafe and risks injury to both the client and nurse. It provides poor leverage, may dislocate the shoulder, and does not allow controlled support during ambulation. C. Use a gait belt standing on affected side: This is the safest technique. Standing on the affected side offers direct support and balance while the gait belt allows secure, ergonomic assistance during movement. D. Hold the gait belt with palms facing down: Gait belts should be held with palms facing up, which provides a more secure grip and better control if the client loses balance during ambulation.

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