Mobility, Transfers and Positioning — practice questions

9% of the exam ≈6 real questions 8 free questions here

Nine percent: body mechanics, gait belts, bed-to-chair transfers, canes and walkers, falls, positioning and range of motion. Transfers and range of motion are on the federal list of skills a nurse must watch the aide perform.

Where people lose points

• The wheelchair goes on the client's strong side with the brakes locked and the footrests out of the way.
• The cane goes in the strong hand. On stairs: up with the good leg, down with the bad.
• Walk on the client's weak side, slightly behind, holding the gait belt. If they fall, ease them down; do not try to hold them up.
• Fowler's is about 45 to 60 degrees, semi-Fowler's 30 to 45, high Fowler's 60 to 90. Sims' is on the left side with the upper knee bent.
• Range of motion stops at pain or resistance. Abduction moves away from the body; adduction brings it back.

Questions and answers, explained

All 3 questions above, with the correct answer and why it is correct. Everything here is on mobility, transfers and positioning.

1. Which posture uses good body mechanics when lifting a box from the floor?

   • AFeet apart, knees bent, back straight, box held closeCorrect
   • BFeet together, legs straight, bending at the waist
   • CReaching out with the arms straight and the box far away
   • DTwisting the trunk to swing the box up onto a shelf

   Why: A wide base of support, bent knees and hips, a straight back, and holding the load close let the strong leg muscles do the work. Bending at the waist, reaching, and twisting are the classic causes of back injury in caregivers.

   Reference OSHA safe patient handling guidance

2. When walking with a client who has a weak side, where should the aide stand?

   • AOn the weak side, slightly behind, holding the gait beltCorrect
   • BDirectly in front, walking backward to face the client
   • CSeveral steps behind, watching from a distance
   • DOn the strong side, holding the client's hand

   Why: Clients tend to fall toward their weak side, so the aide walks on that side and slightly behind with a hand on the gait belt, ready to support. Holding a hand gives no real control if the client starts to fall.

   Reference 42 CFR 484.80(b)(3)(x); NNAAP ambulation skill

3. A client had recent spine surgery. How should the client be turned in bed?

   • ABy pulling the client's arm toward the aide
   • BBy twisting the shoulders toward the aide first, then bringing the hips along
   • CBy log rolling, keeping the body in a straight line as one unitCorrect
   • DBy having the client roll alone as fast as possible

   Why: Log rolling turns the head, shoulders, hips and legs together so the spine never twists. It usually takes two or more trained people, often with a pillow between the legs, and follows the care plan.

   Reference Safe patient handling; post-surgical precautions

Topics inside this domain

• Transfers, gait belts, canes and walkers for HHAs
• Pressure injuries and skin tears: what HHAs check and report
• Positioning and range of motion: Fowler's, Sims' and ROM terms

Drill other domains

• Role, Responsibilities and Ethics (15%)
• Observation, Vital Signs and Reporting (10%)
• Personal Care and Hygiene (13%)
• Nutrition and Fluids (5%)
• Infection Control (7%)
• Safety and Emergencies (7%)

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