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Question 1. Which term best defines the act of moving a patient from a supine position to a seated position on the edge of the bed? A) Transferring B) Rolling C) Pivoting D) Ambulation Answer: B Explanation: Rolling refers specifically to moving a patient while they remain on the same surface, such as from supine to a side-lying or seated position on the bed. Question 2. In the mobility continuum, which level describes a patient who can walk 50 feet with a walker but requires assistance for stairs? A) Total dependence B) Minimal assistance C) Supervision D) Modified independence Answer: D Explanation: Modified independence indicates the patient can perform the activity with a device (walker) but still needs assistance for a more complex task like stairs. Question 3. Which muscle-strength grade on the 0-5 scale indicates the ability to move a joint against gravity but not against resistance? A) 1 B) 2
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C) 3
D) 4
Answer: C Explanation: Grade 3 strength means the patient can move the joint through the full range of motion against gravity, but cannot overcome added resistance. Question 4. A nurse assesses a patient’s range of motion (ROM) and notes the patient can only move the knee passively. This finding is classified as: A) Active ROM B) Passive ROM C) Functional ROM D) Restricted ROM Answer: B Explanation: Passive ROM occurs when the examiner moves the joint without the patient’s muscle activation; the patient cannot initiate movement. Question 5. Which respiratory complication is most directly associated with prolonged immobility in a bedridden patient? A) Asthma exacerbation B) Atelectasis C) Pulmonary embolism D) Chronic bronchitis Answer: B
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A) Elevated serum calcium B) Decreased serum albumin C) Increased blood glucose D) Decreased white blood cell count Answer: B Explanation: Muscle breakdown leads to loss of protein, reflected as a decreased serum albumin level. Question 9. Constipation in immobile patients is primarily due to: A) Increased fluid intake B) Enhanced gastrointestinal motility C) Reduced fiber consumption and decreased physical activity D) Hyperactive bowel sounds Answer: C Explanation: Lack of movement slows intestinal transit, and immobile patients often have limited fiber and fluid intake, contributing to constipation. Question 10. Urinary stasis that can lead to renal calculi is most commonly associated with which type of immobility? A) Bed rest with a Foley catheter B) Ambulation with a walker C) Sitting upright in a chair D) Standing for prolonged periods
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Answer: A Explanation: Indwelling catheters and prolonged supine positioning promote urinary stasis, increasing the risk for stone formation. Question 11. The earliest skin change indicating pressure injury is: A) Full-thickness ulcer B) Blister formation C) Non-blanchable erythema D) Eschar Answer: C Explanation: Non-blanchable erythema is the first sign of tissue damage before breakdown occurs. Question 12. Which psychosocial effect is most likely in a patient who has become completely immobile after a recent stroke? A) Increased self-esteem B) Social isolation C) Heightened optimism D) Decreased anxiety Answer: B Explanation: Loss of independence often leads to feelings of isolation and reduced self-esteem.
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C) Place belt on the patient’s waist, stand to the side, and pull. D) Place belt on the patient’s waist, stand behind, and push. Answer: A Explanation: The gait belt is placed around the patient’s waist, the nurse stands behind, and uses a pulling motion to assist the patient safely. Question 16. A transfer board is most appropriate for which situation? A) Moving a patient from a low-height bed to a wheelchair of equal height. B) Assisting a patient with severe cognitive impairment to sit up. C) Lifting a patient from the floor to a stretcher. D) Supporting a patient during ambulation with a walker. Answer: A Explanation: Transfer boards bridge two surfaces of similar height to facilitate a sliding transfer. Question 17. When performing a controlled fall (lowering a patient to the floor), the nurse should: A) Allow the patient to drop quickly onto a mattress. B) Use a slide sheet and lower the patient slowly while maintaining a wide base of support. C) Push the patient forcefully onto a padded mat. D) Ignore the patient’s fear of falling. Answer: B
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Explanation: Controlled falls require slow, deliberate lowering using a slide sheet or similar device to prevent injury. Question 18. Which positioning technique best prevents hip contractures in a patient who must remain supine for several days? A) Prone positioning with a pillow under the hips. B) Supine with knees flexed at 90° and a pillow between the legs. C) Fowler’s with legs extended. D) Trendelenburg with hips flexed. Answer: B Explanation: Flexing the hips and knees with a pillow between the legs maintains joint alignment and reduces contracture risk. Question 19. The primary purpose of Fowler’s position is to: A) Reduce intra-abdominal pressure. B) Promote respiratory expansion and reduce aspiration risk. C) Prevent foot drop. D) Decrease cerebral venous pressure. Answer: B Explanation: Elevating the head of the bed in Fowler’s position improves lung expansion and helps prevent aspiration. Question 20. When positioning a patient in the lateral (Sim’s) position, which body part is protected from pressure?
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Answer: B Explanation: Repositioning every two hours helps prevent pressure injuries in immobile patients. Question 23. Passive range-of-motion (PROM) exercises are primarily performed to: A) Increase muscle bulk. B) Prevent joint contractures and stiffness. C) Improve cardiovascular endurance. D) Enhance cognitive function. Answer: B Explanation: PROM maintains joint flexibility and prevents contractures when the patient cannot move actively. Question 24. Sequential compression devices (SCDs) function by: A) Heating the limbs to increase blood flow. B) Providing intermittent pneumatic compression to promote venous return. C) Delivering electrical stimulation to calf muscles. D) Applying static pressure to the abdomen. Answer: B Explanation: SCDs cyclically inflate and deflate, mimicking muscle pump action to enhance venous return and reduce DVT risk.
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Question 25. The correct “COAL” principle for cane use stands for: A) Cane Opposite Affected Leg B) Cane Over All Limbs C) Cane On Ankle Level D) Cane Oriented Across Lateral Answer: A Explanation: The cane should be placed on the side opposite the weakened or injured leg to provide optimal support. Question 26. When fitting a walker, the correct height of the handles should be: A) Aligned with the patient’s hips. B) Approximately 2-3 inches above the patient’s wrist crease when arms are relaxed at the sides. C) Below the patient’s elbow. D) At the patient’s shoulder level. Answer: B Explanation: Handles 2-3 inches above the wrist crease allow a slight elbow flexion, promoting proper posture and balance. Question 27. Which gait pattern is appropriate for a patient using bilateral forearm crutches on flat ground? A) 2-point gait B) 3-point gait C) 4-point gait
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Question 30. A nursing diagnosis of “Risk for Disuse Syndrome” most appropriately includes which outcome? A) Patient will develop pressure ulcer within 24 hours. B) Patient will perform ROM exercises twice daily. C) Patient will experience increased pain during transfers. D) Patient will remain on bed rest for the entire hospitalization. Answer: B Explanation: Performing ROM exercises mitigates the effects of disuse, aligning with the goal of the diagnosis. Question 31. A SMART goal for a patient’s mobility should be: A) “Patient will walk more.” B) “Patient will ambulate 30 feet with a walker by day 3.” C) “Patient will be independent someday.” D) “Patient will try walking.” Answer: B Explanation: SMART goals are Specific, Measurable, Achievable, Relevant, and Time-bound; option B meets all criteria. Question 32. Joint protection education for a patient with osteoarthritis should emphasize: A) Repetitive high-impact activities. B) Using assistive devices and avoiding prolonged static positions.
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C) Ignoring pain during activity. D) Performing heavy lifting without support. Answer: B Explanation: Protecting joints involves using devices, maintaining movement, and avoiding sustained stress. Question 33. Which home-safety modification is most beneficial for a patient who uses a walker? A) Installing a bathtub with a high step. B) Removing all handrails. C) Placing a non-slip mat in the bathroom and ensuring a clear 3-foot path. D) Using low-profile furniture only. Answer: C Explanation: Non-slip surfaces and a clear path reduce fall risk for walker users. Question 34. Energy conservation for ADLs includes all EXCEPT: A) Sitting while dressing. B) Performing tasks in a well-lit area to reduce mistakes. C) Using adaptive equipment such as a long-handled reacher. D) Completing all tasks in a single, prolonged session. Answer: D
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A) Place the foot in a neutral position with a boot or footboard. B) Keep the foot in plantarflexion. C) Elevate the foot above heart level. D) Apply a tight bandage around the ankle. Answer: A Explanation: Neutral positioning with a boot or footboard maintains proper alignment and prevents contracture. Question 38. The primary goal of “prone positioning” in a ventilated patient is to: A) Increase intra-abdominal pressure. B) Improve oxygenation by recruiting dorsal lung units. C) Decrease cardiac output. D) Reduce risk of pressure ulcer on the sacrum. Answer: B Explanation: Prone positioning redistributes ventilation, enhancing oxygenation in ARDS patients. Question 39. Which assistive device requires the patient to keep the device’s weight-bearing points in constant contact with the floor? A) Cane B) Walker C) Crutches D) Wheelchair
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Answer: B Explanation: Walkers have four points that must stay on the floor for stability. Question 40. A patient using a 4-point crutch gait pattern should have the crutches: A) Placed under the armpits. B) Adjusted so the handgrips are at the level of the patient’s wrist when arms are relaxed. C) Set at a height that forces the elbows to be fully extended. D) Kept longer than the patient’s forearm. Answer: B Explanation: Proper crutch height aligns handgrips with the wrist crease, ensuring a slight elbow flexion for optimal support. Question 41. Which of the following best describes “setup assistance” during a bed-to-wheelchair transfer? A) The nurse lifts the patient entirely. B) The nurse positions the wheelchair, aligns the brakes, and places the gait belt. C) The patient performs the transfer without any help. D) The nurse only provides verbal instructions. Answer: B Explanation: Setup assistance involves preparing equipment and environment; the patient then executes the transfer.
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B) Deep vein thrombosis C) Cellulitis D) Compartment syndrome Answer: B Explanation: Firm, tender calves in immobile patients raise suspicion for DVT due to venous stasis. Question 45. A patient who has been on bed rest for 5 days shows decreased breath sounds at the bases. The nurse’s first intervention should be: A) Administer a bronchodilator. B) Encourage incentive spirometry and perform gentle cough assists. C) Place the patient in Trendelenburg. D) Increase the oxygen flow rate. Answer: B Explanation: Incentive spirometry and cough assistance promote lung expansion and prevent atelectasis. Question 46. Which of the following statements about “partial dependence” in a transfer is correct? A) The patient does all the work; the nurse only observes. B) The patient performs 50% of the effort while the nurse provides the remainder. C) The nurse does all the lifting; the patient remains passive. D) The patient can transfer only with a mechanical lift.
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Answer: B Explanation: Partial dependence means the patient contributes some effort, while the nurse assists with the rest. Question 47. When using a slide sheet for a supine-to-side transfer, the nurse should: A) Pull the sheet rapidly toward the head of the bed. B) Place the sheet under the patient’s torso, roll the patient onto their side, then slide them. C) Tie the sheet around the patient’s waist. D) Use the sheet to lift the patient off the bed. Answer: B Explanation: Proper technique involves positioning the sheet under the torso, rolling the patient, and sliding to reduce shear forces. Question 48. The most appropriate way to assess a patient’s ability to use a walker is to: A) Observe the patient walk a short distance while maintaining four points of contact. B) Have the patient stand still holding the walker. C) Ask the patient to push the walker while seated. D) Measure the patient’s grip strength. Answer: A Explanation: Observing gait with four-point contact confirms functional use of the walker.
