NCLEX Practice Question: Which Type of Crutches Is Best for Long-Term Use?

Choosing the right mobility aid is an important part of patient care, especially for individuals who require long-term assistance with walking. For nursing students preparing for the NCLEX, understanding the differences between axillary crutches and forearm crutches can help you answer questions about mobility, rehabilitation, and patient safety.

In this NCLEX Question of the Day review, we’ll walk through a practice question about a child with permanent paralysis and explore why forearm crutches are the best answer among the options provided.

NCLEX Practice Question: Choosing the Right Crutches

Nursing category: Musculoskeletal

NCLEX category: Basic Care and Comfort

A child is injured in an accident and becomes paraplegic. The child will need crutches on a permanent basis, most likely for the rest of their life.

Which type of crutches would most commonly be used in this situation?

A. Axillary crutches

B. Forearm crutches

C. Lofstrand crutches

D. Leg-support crutches

Correct answer: B. Forearm crutches

Note: Lofstrand crutches are another name for forearm crutches, so options B and C overlap. In a real NCLEX-style question, answer choices should be distinct. The intended answer is forearm crutches.

Why Are Forearm Crutches the Correct Answer?

Forearm crutches, also called Lofstrand crutches, have a handgrip and a cuff that fits around the forearm. They provide support for individuals who need assistance with mobility and can be appropriate for long-term use.

Compared with axillary crutches, which have supports positioned beneath the arms, forearm crutches allow the user to move without placing a support directly against the armpits.

For some children and adults with permanent mobility limitations, forearm crutches may be a practical option for ongoing use. Their suitability depends on the person’s strength, balance, coordination, functional abilities, and rehabilitation goals.

It is important to remember that paraplegia does not automatically mean a person can walk with crutches. The appropriate mobility aid depends on the level of injury, muscle function, stability, and the individual’s overall clinical assessment.

Understanding the Different Types of Crutches

Nursing students should recognize the basic features and common uses of different crutch types.

1. Axillary Crutches

Axillary crutches have padded supports that fit beneath the armpits. They are commonly used for temporary mobility assistance, such as when a patient must avoid bearing weight on an injured leg.

Nursing consideration: Teach patients to support their weight through their hands and arms rather than leaning their body weight on the underarm pads. Excessive pressure in the armpits can injure nerves and blood vessels.

2. Forearm Crutches (Lofstrand Crutches)

Forearm crutches have a cuff that wraps around the forearm, along with a handgrip. They are often used by individuals who need ongoing mobility support and have sufficient upper-body strength, balance, and coordination.

Nursing consideration: Proper fit and instruction are essential. Assess the patient’s ability to use the crutches safely and provide education on positioning, walking technique, and fall prevention.

3. Leg-Support Crutches

Leg-support crutches are designed to provide support for a leg in specific circumstances. They are not the usual answer when a question asks about conventional long-term crutch use without further details.

4. Choosing the Right Mobility Aid

The best mobility aid is not determined by the duration of use alone. Nurses and rehabilitation professionals consider the patient’s physical abilities, diagnosis, weight-bearing restrictions, safety, and independence.

Depending on the patient’s condition, options may include crutches, walkers, braces, or wheelchairs.

NCLEX Tip: Focus on Mobility and Patient Safety

When answering NCLEX questions about assistive devices, focus on the patient’s functional needs and the purpose of the device.

Remember these general associations:

• Axillary crutches: Often used for short-term mobility assistance.
• Forearm crutches: May be appropriate for longer-term use when the patient has the necessary strength and coordination.
• Safe crutch use: Requires proper fit, training, balance, and attention to fall prevention.
• Individualized care: The appropriate device depends on the patient’s abilities and rehabilitation assessment.

Also, watch for overlapping answer choices. Since Lofstrand crutches are forearm crutches, a question that lists both as separate options is ambiguous. Recognizing this distinction is useful when reviewing practice questions.

Test Your NCLEX Knowledge

Before moving on, see if you can answer this follow-up question:

A nurse is teaching a patient to use axillary crutches. Which instruction is most important for preventing injury?

A. Rest the patient’s body weight on the underarm pads.

B. Support body weight through the hands and keep pressure off the armpits.

C. Keep the crutches as far apart as possible while walking.

D. Avoid using the handgrips during transfers.

Correct answer: B. Support body weight through the hands and keep pressure off the armpits.

Pressure on the underarm pads can damage nerves and blood vessels. Proper positioning and instruction help promote safe mobility.

Prepare for the NCLEX with NURSING.com

Understanding mobility aids is one part of preparing for the NCLEX. Practicing questions regularly can help you strengthen your clinical judgment, recognize common testing patterns, and identify areas where you need additional review.

NURSING.com offers the free SimpleNursing-style NCLEX readiness experience referred to in this episode, called Simplex, to help nursing students assess their preparation.

Visit NURSING.com to explore the free Simplex assessment and get a better sense of your readiness for the exam.

Thanks for being part of the NURSING.com family. Keep practicing, keep learning, and keep building your confidence as you work toward becoming a nurse!