Quick answerUnsafe cane fit and gait sequence. Move the cane to the right hand and raise the handle to the wrist crease. Monitor the distance walked before fatigue and the cane-and-weak-leg sequence on return demonstration.
Why this is correctStrength of 4/5 is unchanged and speech and face are at baseline, which rules out an extending stroke. Standing blood pressure falls only 4 mm Hg, which rules out orthostatic hypotension, and there is no hip pain to suggest an arthritis flare. The problem is the device: a short cane on the weak side that moves with the strong leg gives no support to the left leg. Holding it in the right hand at wrist height lets the cane share the load with the weak leg. Walking distance and a correct sequence on return demonstration measure the result.
Easy analogy or mental pictureThe cane is a crutch for the weak leg that works from the other side, like a friend who walks on your good side and lends a shoulder when your bad leg steps.
Memory hookCane in the good hand, moves with the bad leg, handle at the wrist.
NCLEX decision ruleWhen a mobility problem appears, compare with the baseline neurologic and hemodynamic data; if they are unchanged, correct the device and technique before escalating.
Why the other choices are wrongA quad cane adds stability, but on the weak side it still fails to unload the left leg. An urgent neurologic assessment and NIH Stroke Scale tracking fit stroke extension, but strength and speech are unchanged. Dangling before walking and orthostatic blood pressure fit orthostatic hypotension, which the sitting and standing readings exclude. Hip range of motion fits an osteoarthritis flare, but the client has fatigue, not pain.
References
1MedlinePlus — Using a CaneCane fit at wrist level, use in the hand opposite the weak leg, and step sequence
22026 NCLEX-RN Test Plan (NCSBN)Mobility and assistive devices within Basic Care and Comfort