NURS 101L | Patient Positioning & Mobility Skills Comprehensive
Exam (2026 Update) WCU
1. A nurse is preparing to move a client up in bed. Which action is most
consistent with evidence-based Safe Patient Handling and Mobility (SPHM)
guidelines to prevent musculoskeletal injury?
A. Instructing the client to keep their legs straight while pushing.
B. Using a friction-reducing device and at least two caregivers.
C. Bending at the waist to gain better leverage during the pull.
D. Performing the move solo if the client weighs less than 200 lbs.
Answer: B
Rationale: Current SPHM standards mandate the use of friction-reducing devices (like
slide sheets) and multiple staff members to eliminate manual lifting and reduce the risk of
nurse injury and patient skin shear.
2. A patient with a stage 3 pressure injury on the sacrum requires positioning.
To minimize pressure on this area while the patient is in a side-lying position,
the nurse should place the patient at what angle?
A. 90-degree lateral position
B. 30-degree lateral position
C. Full prone position
D. High Fowler’s position
Answer: B
Rationale: The 30-degree lateral position is preferred because it avoids direct pressure on
the trochanter and the sacrum, unlike the 90-degree position which puts significant
pressure on the bony prominence of the hip.
,3. When assessing a client for orthostatic hypotension before ambulation, the
nurse finds the systolic blood pressure has dropped by 25 mmHg upon standing.
What is the priority nursing action?
A. Continue ambulation with a gait belt for safety.
B. Administer a PRN bolus of IV fluids.
C. Wait 5 minutes for the blood pressure to stabilize while the client remains standing.
D. Assist the client back to a sitting or supine position immediately.
Answer: D
Rationale: A drop in systolic BP of more than 20 mmHg or diastolic of more than 10 mmHg
indicates orthostatic hypotension. The priority is safety to prevent a fall; the patient must
be seated or laid back down.
4. The nurse is assisting a client with left-sided hemiparesis to transfer from the
bed to a chair. Where should the nurse place the chair?
A. On the client’s left side at a 45-degree angle.
B. At the foot of the bed facing away from the patient.
C. On the client’s right side at a 45-degree angle.
D. Directly in front of the patient to facilitate a straight pivot.
Answer: C
Rationale: The chair should be placed on the client’s stronger (unaffected) side. Since the
client has left-sided weakness, the right side is the strong side, facilitating a safer and more
stable pivot.
, 5. Which clinical finding is a direct contraindication for the use of a gait belt
during ambulation?
A. Chronic Obstructive Pulmonary Disease (COPD).
B. History of generalized anxiety disorder.
C. Recent abdominal surgery with a midline incision.
D. Right-sided weakness following a stroke.
Answer: C
Rationale: Gait belts are contraindicated for patients with recent abdominal surgery,
abdominal aneurysms, or certain respiratory conditions where pressure on the torso could
cause injury or dehiscence.
6. During a range-of-motion (ROM) exercise, the nurse moves the patient’s arm
away from the midline of the body. This movement is documented as:
A. Abduction
B. Flexion
C. Adduction
D. Supination
Answer: A
Rationale: Abduction is the movement of a limb away from the midline of the body.
Adduction is moving it toward the midline.
7. A patient is in the Sim’s position. Which of the following describes the correct
orientation of the limbs?
A. Lying on the back with knees flexed and feet flat.
B. Lying on the side with the upper leg flexed at the hip and knee.
C. Lying on the stomach with the head turned to the side.
D. Lying on the side with the lower arm extended behind the back.
Answer: B
Exam (2026 Update) WCU
1. A nurse is preparing to move a client up in bed. Which action is most
consistent with evidence-based Safe Patient Handling and Mobility (SPHM)
guidelines to prevent musculoskeletal injury?
A. Instructing the client to keep their legs straight while pushing.
B. Using a friction-reducing device and at least two caregivers.
C. Bending at the waist to gain better leverage during the pull.
D. Performing the move solo if the client weighs less than 200 lbs.
Answer: B
Rationale: Current SPHM standards mandate the use of friction-reducing devices (like
slide sheets) and multiple staff members to eliminate manual lifting and reduce the risk of
nurse injury and patient skin shear.
2. A patient with a stage 3 pressure injury on the sacrum requires positioning.
To minimize pressure on this area while the patient is in a side-lying position,
the nurse should place the patient at what angle?
A. 90-degree lateral position
B. 30-degree lateral position
C. Full prone position
D. High Fowler’s position
Answer: B
Rationale: The 30-degree lateral position is preferred because it avoids direct pressure on
the trochanter and the sacrum, unlike the 90-degree position which puts significant
pressure on the bony prominence of the hip.
,3. When assessing a client for orthostatic hypotension before ambulation, the
nurse finds the systolic blood pressure has dropped by 25 mmHg upon standing.
What is the priority nursing action?
A. Continue ambulation with a gait belt for safety.
B. Administer a PRN bolus of IV fluids.
C. Wait 5 minutes for the blood pressure to stabilize while the client remains standing.
D. Assist the client back to a sitting or supine position immediately.
Answer: D
Rationale: A drop in systolic BP of more than 20 mmHg or diastolic of more than 10 mmHg
indicates orthostatic hypotension. The priority is safety to prevent a fall; the patient must
be seated or laid back down.
4. The nurse is assisting a client with left-sided hemiparesis to transfer from the
bed to a chair. Where should the nurse place the chair?
A. On the client’s left side at a 45-degree angle.
B. At the foot of the bed facing away from the patient.
C. On the client’s right side at a 45-degree angle.
D. Directly in front of the patient to facilitate a straight pivot.
Answer: C
Rationale: The chair should be placed on the client’s stronger (unaffected) side. Since the
client has left-sided weakness, the right side is the strong side, facilitating a safer and more
stable pivot.
, 5. Which clinical finding is a direct contraindication for the use of a gait belt
during ambulation?
A. Chronic Obstructive Pulmonary Disease (COPD).
B. History of generalized anxiety disorder.
C. Recent abdominal surgery with a midline incision.
D. Right-sided weakness following a stroke.
Answer: C
Rationale: Gait belts are contraindicated for patients with recent abdominal surgery,
abdominal aneurysms, or certain respiratory conditions where pressure on the torso could
cause injury or dehiscence.
6. During a range-of-motion (ROM) exercise, the nurse moves the patient’s arm
away from the midline of the body. This movement is documented as:
A. Abduction
B. Flexion
C. Adduction
D. Supination
Answer: A
Rationale: Abduction is the movement of a limb away from the midline of the body.
Adduction is moving it toward the midline.
7. A patient is in the Sim’s position. Which of the following describes the correct
orientation of the limbs?
A. Lying on the back with knees flexed and feet flat.
B. Lying on the side with the upper leg flexed at the hip and knee.
C. Lying on the stomach with the head turned to the side.
D. Lying on the side with the lower arm extended behind the back.
Answer: B
