1. After moving a patient from the bed to a stretcher, the nurse raises the head of the stretcher. What will the nurse do next?

1. Lock the wheels on the stretcher.
2. Cover the patient with a blanket.
3. Raise the side rails on the stretcher.
4. Unlock the wheels of the bed.

2. To which position would the nurse assist the patient who is experiencing difficulty breathing?

1. Sims' position
2. 30-degree lateral position
3. Fowler's position
4. Prone position

3. Why does the nurse remove the patient’s elastic stockings at least once per shift?

1. To permit the skin to breathe.
2. To wash the legs with a disposable bath product.
3. To air out the stockings and allow sweat to evaporate.
4. To check the skin for irritation or breakdown.

4. Why might the nurse choose not to apply a pair of prescribed elastic stockings to a patient’s legs?

1. The patient will have a scheduled bath in a few hours.
2. The patient says they are too tight.
3. The patient’s skin is irritated.
4. The patient has become fully ambulatory.

5. When preparing to move a patient in bed, what will the nurse do first?

1. Assemble adequate help to move the patient.
2. Assess the patient’s ability to help with moving.
3. Determine the patient’s weight.
4. Decide on the most effective means of moving the patient.

6. The nurse is preparing to delegate the application of an SCD to nursing assistive personnel (NAP). Which statement by the NAP requires follow-up by the nurse?

1. "I will check for a green light on the mechanical unit.”
2. "I will remove the SCD before ambulating the patient."
3. "I will tell you if I see any signs of itching, redness, or irritation on the patient's legs."
4. "I will measure the patient's legs to determine what size SCD sleeve to use."

7. The nurse has applied a gait belt to a postoperative patient to facilitate ambulation. Within a few feet of the bed, the patient begins to complain of dizziness and leans heavily on the nurse. What would be the nurse’s initial response?

1. Slowly lower the patient to the floor.
2. Attempt to sit the patient down on a chair just a few steps away.
3. Try to hold the patient up until the dizziness passes.
4. Call for assistance in a loud but calm voice.

8. Which patient is most at risk of developing permanently impaired mobility?

1. A 72-year-old woman hospitalized for anemia associated with diabetic nephropathy (kidney disease)
2. A 55-year-old woman with mental illness who had become malnourished
3. An 11-year-old boy who sustained a fractured pelvis during a fall from his tree house
4. A 79-year-old man recovering from surgery to release a contracture of the connective tissue in his hand

9. Which instruction would the nurse give a patient who is able to assist with transfer from a bed to a wheelchair using a transfer belt?

1. “When I count to three, please rock yourself into a standing position.”
2. “Please hold on to my waist while I help you stand.”
3. “Please tell me how I can best help you get up off the bed and stand up.”
4. “Please push down onto the mattress with both hands and stand when I count to three.”

10. Which action would decrease a patient’s pain before a transfer with a hydraulic lift?

1. Stop the transfer if the patient expresses or displays physical signs of pain.
2. Explain the procedure to the patient before beginning the transfer.
3. Administer a prescribed analgesic 30 to 60 minutes before the transfer.
4. Postpone the transfer if the patient reports having physical pain or anxiety before the transfer.

11. When turning a patient to place a slide board, where do the assistants stand?

1. At the side of the bed to which the patient will be turned
2. At the side of the bed from which the patient will be turned
3. At the head and foot of the bed
4. At the foot of the bed only

12. The nurse is preparing to move a patient with hemiplegia into the prone position. What action should the nurse take when rolling the patient onto her side?

1. Place a small pillow under the shoulder.
2. Use the affected arm as a guide during rolling.
3. Place a pillow on the abdomen.
4. Place rolled bath blankets along the dependent leg.

13. The nurse is preparing to move a patient from a bed to a stretcher. What is the first action of the nurse?

1. Cross the patient’s arms over his or her chest.
2. Lower the side rails of the bed.
3. Make sure the bed brakes are locked.
4. Fanfold the draw sheet.

14. The nurse is ambulating a patient with a gait belt when he says he feels sick to his stomach. What would the nurse do?

1. Return the patient to the bed or chair (whichever is closer).
2. Encourage the patient to complete the distance of ambulation.
3. Help him to the restroom.
4. Ease him to the floor.

15. Which of the following are basic guidelines when assisting a patient with passive range of motion?

1. Exercises should be continued until the point of fatigue and pain.
2. Exercises should be done frequently to lessen pain for the patient.
3. Each joint is exercised to the point of resistance but not pain.
4. Exercises should be performed without the support to each joint.

16. Which position is used when applying the sling to transfer a patient from the bed to a chair with a hydraulic lift?

1. Prone
2. Side-lying
3. Supine
4. Sims

17. While preparing to apply an SCD for a postoperative patient, the nurse realizes that which assessment observation contraindicates the application of the device?

1. Having a low-grade fever
2. Taking a prescribed anticoagulant
3. Having dermatitis on the legs
4. Wearing elastic stockings

18. A patient will be moved up in bed with the use of a friction-reducing device. How will the nurse place this device under the patient?

1. Lift the patient to place the device directly under him or her.
2. Remove the draw sheet, and replace it with the device.
3. Roll the patient from side to side, and place the device under the draw sheet.
4. Sit the patient up in the bed, and place the device behind the shoulders.

19. When preparing to move a patient in bed with the help of an assistant, which posture will both caregivers use to ensure their own safety?

1. Stand with the knees locked.
2. Stand with the feet together.
3. Flex the hips and knees.
4. Shift the body weight from the back leg to the front leg.

20. The nurse is preparing to logroll a patient in bed. Why are two assistants needed on the side toward which the patient is being turned?

1. To position the pillows
2. To keep the spine in alignment
3. To roll the patient as a unit
4. To ease the patient back onto the support pillows

21. When using a hydraulic lift to transfer a patient from the bed to a chair, when does the nurse turn off the check valve?

1. After the patient crosses the arms over the chest
2. After the patient's eyeglasses are removed
3. As soon as the patient has been placed in the chair
4. When the nurse removes the straps

22. When preparing to delegate the application of an SCD to NAP, the nurse must do what first?

1. Ask the NAP to demonstrate the proper application of the SCD
2. Assess the patient's lower extremities for signs and symptoms of impaired circulation
3. Assess the patient's need for an SCD
4. Explain that the device is not to be removed

23. When repositioning a patient, what can the nurse do to prevent the patient’s hips from rolling outward?

1. Apply therapeutic boots to the feet.
2. Place sandbags along the legs.
3. Place a small pillow at the lumbar region of the back.
4. Place a pillow under the calves.

24. What does the nurse do after attaching the hooks to the holes in the sling on a hydraulic lift?

1. Lower the head of the bed.
2. Remove the patient’s eyeglasses.
3. Have the patient cross the arms over the chest.
4. Elevate the head of the bed.

25. In which position will the nurse place the patient to move him or her up in bed?

1. Supine with the head of the bed at a 30-degree angle
2. Sitting in the bed
3. Supine with the head of the bed flat
4. Prone with the head of the bed flat

26. When positioning a hemiplegic patient in the supported Fowler’s position, what is the primary reason a trochanter roll is placed alongside the patient’s legs?

1. To reduce the risk of a fall while the side rails are down
2. To reduce the risk of contracture
3. To control pain
4. To cushion the legs

27. A patient lying supine in bed is being transferred to a wheelchair using a transfer belt. Which action would the nurse perform just before moving the patient to the side of the bed?

1. Help the patient put on skid-resistant footwear.
2. Raise the head of the bed 30 degrees.
3. Place the transfer belt over the patient’s clothing.
4. Position the chair so that the patient will move toward his or her stronger side.

28. After determining the proper size stocking and assessing the patient’s circulatory status, a nurse delegates the application of elastic stockings to nursing assistive personnel (NAP). The nurse discovers that the NAP has been using moisturizer on the patient’s legs before applying the stockings. What is the best action by the nurse?

1. Explain that moisturizer may cause excessive skin softening, which can lead to skin breakdown.
2. Instruct NAP to use a small amount of cornstarch or powder.
3. Ask the patient if she is allergic to the moisturizer.
4. Inspect the patient’s skin for color variations.

29. The nurse is performing passive shoulder and elbow exercises for a patient who is recovering from surgery to remove a soft-tissue tumor in her upper arm. Why does the nurse cup one hand around the patient’s elbow and support the forearm and wrist during the ROM exercises?

1. To keep the arm above the level of the heart
2. To assess the patient’s muscle tension
3. To listen for crepitus in the joint
4. To ensure stability while exercising the joint

30. The nurse is preparing to initiate ambulation with a patient who is recovering from a stroke. What information will help the nurse determine how far to walk?

1. Ask the patient how far she would like to go.
2. Review the health care provider’s order.
3. Review the medical record to see how far the patient has walked during the past several therapeutic ambulations.
4. Review the records of other patients who are at a similar point in their stroke rehabilitation.

31. The nurse is preparing to delegate the ambulation of a patient with the use of a gait belt to nursing assistive personnel (NAP). Which statement made by NAP requires the nurse to follow up?

1. “I will be sure to put nonskid slippers on the patient before getting him up to ambulate.”
2. “I will use the under-axillae technique to help him up to a standing position.”
3. “Rocking the heavier patient into a standing position seems to work really well for me.”
4. “I will grasp the gait belt in the middle of the patient’s back.”

32. When preparing to safely transfer a patient from a bed to a wheelchair using a transfer belt, the nurse would do what first?

1. Coordinate extra help.
2. Assess the patient’s vital signs.
3. Assess the patient’s physiological capacity to transfer.
4. Determine whether to transfer the patient to a wheelchair or chair.

33. The nurse notes that a patient's left elbow is resistant to extention and flexion while performing range of motion exercises. What is the appropriate nursing action?

1. Move joint through full range of motion exercises.
2. Perform range of motion to the left elbow until resistance is met.
3. Omit all range of motion exercises until the health care provider is notified.
4. Inform the health care provider that the patient is uncooperative with exercising.

34. The nurse is helping a patient with hemiparesis take a few steps. A gait belt has been applied. The patient is using a cane. Where should the nurse stand in relation to the patient?

1. On the patient’s strong side
2. On the patient’s weak side
3. Behind the patient
4. In front of the patient

35. The nurse has applied an SCD to a postoperative patient. The most appropriate way for the nurse to confirm proper fit is to do what?

1. Ask the patient if the device is causing any pain.
2. Ensure that two fingers will fit between the patient's leg and the device.
3. Follow the manufacturer's instructions for the application of the device.
4. Ask another nurse to check the patient for proper application of the device.

36. A patient who weighs 200 lbs. needs to be moved up in bed with the aid of a friction-reducing device. The nurse will prepare for this move by assembling how many caregivers?

1. A minimum of two
2. None, since the device does all the lifting during the move.
3. At least three
4. The nurse can carry out this move without assistance.

37. When preparing for safe patient transfer using a hydraulic lift, the nurse performs which action first?

1. Assesses the patient for weakness, dizziness, or postural hypotension
2. Arranges for at least three healthcare personnel to assist in the transfer
3. Makes sure the patient agrees to the intervention
4. Applies clean gloves

38. A patient has been transferred to a wheelchair with a transfer belt. What is one action the nurse would take to position the patient safely in the chair?

1. Remove the wheelchair leg rests.
2. Ask the patient to rate his or her pain level.
3. Lower the foot rests, and place the patient’s feet on them.
4. Remove the transfer belt.

39. When preparing to apply elastic stockings, why does the nurse assess for skin discoloration?

1. To identify the potential risk for deep vein thrombosis (DVT)
2. To identify improper patient positioning
3. To select the proper stocking size
4. To determine whether a sequential compression device is needed

40. The nurse is preparing to use a slide board to transfer a patient from the bed to a stretcher. How many additional people will the nurse need to help with this transfer?

1. Four
2. Two
3. One
4. None

41. Why might a sequential compression device (SCD) be applied to the legs of an immobile patient?

1. To stimulate circulation in the deep arterial vascular system
2. To help prevent deep vein thrombosis (DVT)
3. To aid peripheral circulation to reduce the risk of skin breakdown
4. To assist in passive range-of-motion exercise of the patient's lower extremities

42. Why would the nurse ask a physical therapist to perform passive ROM exercises for a patient with lower extremity injuries sustained in a motor vehicle crash?

1. The patient is an older adult or has a chronic condition.
2. The patient is reluctant to perform the exercises because he is worried about reinjury.
3. The patient has orthopedic trauma.
4. The patient has pain exacerbated by exercise.

43. The nurse and his or her assistants are using a slide board to move a patient from the bed to a stretcher. The nurse, standing alone on the side of the bed opposite the stretcher, will perform which action during this move?

1. Hold the slide board stationary in place.
2. Pull the draw sheet.
3. Hold the patient’s head stationary.
4. Lock the brakes on the stretcher.

44. The nurse is preparing to transfer a patient with left-sided weakness from the bed to a wheelchair using a transfer belt. Which position would the nurse instruct the patient to assume?

1. Place both feet together on the floor.
2. Place your weaker foot forward and your stronger leg toward the back.
3. Extend both of your legs and feet.
4. Place your stronger leg forward and your weaker leg toward the back.

45. Which condition is not associated with venous stasis, part of Virchow’s triad?

1. Pregnancy
2. Obesity
3. Anxiety
4. Immobility