Deck 18: Safe Lifting, Moving, and Positioning of Patients

Question 1

The charge nurse on the night shift of a skilled nursing facility is orienting a new aide to the unit. The LPN's most accurate information relative to moving patients is:

A) "Most of your assigned patients are able to move about a little. Don't wake them to change their positions in bed if they are sleeping."
B) "When you get Mrs. S up to the toilet, be sure to keep your feet together and your knees locked, or she will pull you over."
C) "Get one other aide to help and use the mechanical lift when you get Mr. A. out of bed in the morning. He is heavy and doesn't assist at all."
D) "Use your back muscles to lift-that will strengthen them and make it easier for you to lift or move heavy patients."

Answer 1

"Get one other aide to help and use the mechanical lift when you get Mr. A. out of bed in the morning. He is heavy and doesn't assist at all."

Question 2

While the nurse is assisting a patient to ambulate, the patient suddenly says, "I'm dizzy. I can't stand up." As the patient begins to fall, the nurse should:

A) tell the patient, "Look up, take some deep breaths, and stand up straight. You can do it."
B) call for another nurse or aide to get a wheelchair to return the patient to her room via wheelchair.
C) step behind the patient, grasp her around the waist or chest, and slide her down his leg gently to the floor.
D) look for the nearest chair and assist the patient to it.

Answer 2

step behind the patient, grasp her around the waist or chest, and slide her down his leg gently to the floor.

Question 3

A patient in the skilled nursing facility has left-sided paralysis from a stroke several years before, as well as generalized weakness. The nurse should ensure which of the following devices is in place to prevent flexion contractures?

A) A trochanter roll to keep her legs from turning outward
B) A rolled washcloth in the palm of her left hand or a hand splint
C) A protective vest to keep her sitting upright in the chair
D) A trapeze to permit her to change her position in bed more easily

Answer 3

A rolled washcloth in the palm of her left hand or a hand splint

Question 4

The patient for whom passive range of motion exercises would be most beneficial would be the:

A) 66-year-old patient with loss of mobility related to a recent cerebrovascular accident (CVA).
B) 72-year-old patient with chronic dementia who alternately sits in his wheelchair and wanders around the unit.
C) 80-year-old patient with chronic lung disease who can breathe only when he is sitting in a tripod position.
D) 94-year-old patient with increasing fatigue and weight loss who needs assistance to ambulate.

Question 5

An example of the principles of good body mechanics applied to patient care occurs when the nurse:

A) keeps his feet fixed, spread one in front of the other, and turns his upper body to move the patient up in bed with a rocking movement.
B) assists another nurse in pushing a patient from one side of the bed to the other.
C) bends at the waist to pick up and empty or move the urinary drainage bag attached to the lower end of the side rail.
D) works at arm's distance from the patient when lifting or transferring the patient.

Question 6

An emaciated semiconscious bed bound patient does not remain in a side lying position and repeatedly turns onto her back, where she is developing a pressure area over her sacrum. The nurse should add to the nursing care plan to:

A) raise the knees to keep the patient from sliding down.
B) position the patient on her side and use protective wrist and vest devices to keep her from turning onto her back.
C) assist the patient to sit in a wheelchair for short periods before returning her to bed.
D) place the patient on her stomach (prone position) using a small pillow below her diaphragm.

Question 7

A frail older patient is able to stand but not to ambulate. She has an order to be up in a wheelchair as desired during the day. A safe and appropriate way to assist her up to a chair is to:

A) use a mechanical lift to transfer her from the bed to a chair.
B) assist her to stand and pivot to a chair at right angles to the bed, using a transfer belt.
C) have another staff member help lift her out of bed to the chair on the count of three.
D) place a chair close to the bed and use a slide board to slide her into it.

Question 8

A patient who has had spinal surgery is not permitted to bend at the waist or to sit in a chair. To position the patient safely in bed, the nurse:

A) places her in low or semi-Fowler's position only.
B) uses logrolling to accomplish position changes from side to side.
C) moves the top half of her body first, then the middle, and finally her legs.
D) keeps her in a prone position to keep pressure off her back.

Question 9

The nurse caring for a patient with a nursing diagnosis of Injury, risk for, related to right-sided weakness as evidenced by unsteady gait, would accommodate the patient by:

A) keeping the right arm in a sling to prevent injury.
B) keeping bed rails up to prevent the patient from attempting to get up unassisted.
C) placing the wheelchair on the left side of the patient before transfer.
D) allowing unassisted ambulation with the support of a walker.

Question 10

To provide correct body alignment for a physically immobile patient in bed in the supine position, the nurse:

A) uses trochanter rolls between the patient's legs to prevent inward rotation.
B) places a large pillow behind the patient's head and neck to hyperflex the neck.
C) raises the head and knees to maintain as much flexion of the hips and knees as possible.
D) uses a footboard or places high top sneakers on the patient's feet to maintain dorsiflexion.

Question 11

A health care provider orders the nurse to place a patient in Fowler's position. The nurse should elevate the head of the patient's bed:

A) 60 to 90 degrees.
B) 30 to 60 degrees.
C) 15 to 30 degrees.
D) 10 to 15 degrees.

Question 12

The nurse uses professional knowledge about body mechanics to prevent the most common occupational disorder in nurses, which is:

A) carpal tunnel syndrome from use of computer keyboards in nursing documentation.
B) shoulder and elbow injuries from moving patients.
C) knee injuries from standing for long periods.
D) back injuries from lifting and twisting.

Question 13

A nurse is ambulating an unsteady patient from the bed to a chair in the patient's home. To do so safely, the nurse applies a gait belt and:

A) slides his hand from the bottom under the gait belt at the middle of the patient's back.
B) grasps the gait belt from the top at the middle of the patient's back, pulling it tight against the patient's abdomen.
C) has one person on each side grasp the belt from the top.
D) secures a regular man's belt snugly around the patient's waist to use if the patient starts to fall.

Question 14

The nurse explains to the unlicensed assistive personnel (UAP) that a shearing force is applied to the patient when:

A) a lifting sheet is used to move the patient to a stretcher.
B) the patient is pulled up in bed without being lifted.
C) the patient is seated in a wheelchair without a pressure cushion.
D) the patient is left in the supine position.

Question 15

A patient who is weak from inactivity following a car accident benefits most if the nurse provides for:

A) passive range of motion (ROM) exercises to all joints four times a day.
B) active ROM exercises to arms and legs several times a day.
C) active ROM exercises with weights twice a day with 20 repetitions each.
D) passive ROM exercises to the point of resistance or pain and then slightly beyond.

Question 16

The nurse assisting a weak patient from a bed to the wheelchair to go to physical therapy would:

A) seat the patient on the side of the bed with feet touching the floor.
B) place hands under the patient's elbows to assist in rising.
C) lock knees as the patient is lowered to the chair.
D) assist the patient to don a robe after being seated in the wheelchair.

Question 17

A nurse and an assistant are preparing to get a patient out of bed for the first time after a week of bed rest. They begin by having the patient dangle on the edge of the bed. The nurse should:

A) allow the patient to dangle for 10 to 15 minutes and then transfer her to a nearby chair.
B) perform passive range of motion exercises on the patient's arms and legs while she is dangling to improve circulation.
C) assess the patient's response to the changed position, looking for orthostatic hypotension, nausea, or dizziness before proceeding.
D) dangle the patient only momentarily and then assist her to ambulate as far as she is able.

Question 18

When the poststroke patient complains to the nurse, "I don't see why you are wasting your time doing the passive range of motion exercises on my legs," the nurse's most informative response would be based on the knowledge that the exercises:

A) guarantee the prevention of pressure ulcers.
B) are part of the basic care given to all patients.
C) prevent contractures of the hips.
D) maintain the muscle mass of the limb prior to the stroke.

Question 19

A nurse is instructing one of the facility's unlicensed assistive personnel (UAPs) regarding body mechanics for moving and lifting. The nurse recognizes that further instruction is warranted when the UAP states, "I will:

A) lift using my back muscles."
B) obtain help whenever possible."
C) ask the patient to help if able."
D) use a wide base of support."

Question 20

To place a patient in the Sims' or lateral lying position, the nurse would initially:

A) raise the head of the bed to a 45- or 60-degree angle.
B) raise the bed to a waist high working level.
C) bring the patient to the edge of the bed so that she will be centered when turned on her side.
D) place a pillow behind the patient's back to support her and prevent her from rolling onto her back.

Question 21

There are two main factors in the development of pressure ulcers. One is pressure and the other is __________.

Question 22

As the nurse is helping an 85-year-old man to stand and ambulate, he complains that he feels that he has lost all of his strength in the last several years and cannot do the things he could do when he was 80. The nurse's most informative response would be:

A) "An increase in testosterone will build your muscle bulk back to where it was when you were younger."
B) "As we age our muscle cells are lost and replaced by fat, which leads to loss of strength."
C) "Inactivity makes our muscles 'lazy' and they just won't do the work they used to do."
D) "Additional vitamins will build your strength back up in a few months."

Question 23

The nurse reminds a patient that one of the anatomic parts of a joint that allows the joint to move freely is the fluid filled ___________.

Question 24

The primary function of a joint is to provide ______________ to the skeleton.

Question 25

A 70-year-old immobile patient, who has right-sided weakness caused by a recent stroke, weighs approximately 250 pounds and needs to be moved up in bed. Which of the following actions should the nurse take? (Select all that apply.)

A) Summon at least one other person to assist.
B) Obtain a mechanical lift.
C) Perform the move by himself, because it should not be too difficult.
D) Obtain a lift sheet.
E) Put the bed in semi-Fowler's position.
F) Place the patient flat on her back.

Question 26

Complications or injury from incorrect alignment and positioning include which of the following? (Select all that apply.)

A) Pressure ulcers
B) Osteoporosis
C) Contractures
D) Increased blood pressure
E) Fluid in the lungs
F) Elevated temperature