HESI LPN-to-ADN Mobility Exam – Comprehensive Mobility &
Safe Patient Handling Competency Assessment (Elsevier Evolve) |
Study Guide & Practice Questions 2026
This document is a comprehensive study resource designed for students preparing for the HESI
LPN-to-ADN Mobility Exam through Elsevier Evolve. It focuses on essential mobility and
patient-handling competencies required for successful transition from practical nursing to
associate degree nursing programs. Key topics include body mechanics, safe patient transfers,
assistive devices, range-of-motion exercises, positioning techniques, fall prevention, mobility
impairments, pressure injury prevention, rehabilitation principles, and evidence-based patient
safety practices. The guide includes practice questions, answer rationales, and competency-
focused review material to help learners strengthen clinical judgment and prepare for mobility-
related nursing assessments. HESI Mobility Exams are part of Elsevier's nursing assessment
solutions used to evaluate readiness and support student success.
Question 1
A nurse is caring for a patient who has been diagnosed with complete flaccid paralysis
of the lower extremities following a spinal cord injury. Which secondary musculoskeletal
complication must the nurse prioritize preventing through regular passive range-of-
motion (ROM) exercises?
A) Sarcopenia
B) Joint contractures
C) Fibromyalgia
D) Osteomalacia
Answer: B) Joint contractures
Rationale: Joint contractures occur when skeletal muscle fibres and connective tissues
permanently shorten due to prolonged immobility and a lack of joint movement. Regular
passive range-of-motion exercises maintain joint flexibility and help prevent these
permanent deformities, even when voluntary motor control is entirely absent.
Question 2
A nurse is preparing to transfer a bariatric patient who is completely dependent and
cannot bear any weight. According to safe patient handling guidelines, which device
,should the nurse use to perform this transfer safely?
A) A standard friction-reducing slide board with two assistants.
B) A mechanical total-body lift with an appropriately sized bariatric sling.
C) A ergonomic canvas gait belt with three assistants supporting the trunk.
D) A single-ended cane combined with a sit-to-stand lift device.
Answer: B) A mechanical total-body lift with an appropriately sized bariatric sling.
Rationale: National safe patient handling guidelines mandate the use of a mechanical
total-body lift for patients who are fully dependent and unable to bear weight, particularly
bariatric individuals. Utilizing manual techniques or gait belts in this scenario places the
nursing staff at an extreme risk for musculoskeletal injuries.
Question 3
A patient is recovering from an open reduction and internal fixation (ORIF) of the right
femur and is prescribed partial weight-bearing status. Which assistive device is most
appropriate to help this patient maintain balance while protecting the healing bone?
A) A single-tipped straight cane held on the left side.
B) A quad cane held on the right side.
C) A standard front-wheeled walker.
D) A pick-up walker with no wheels.
Answer: C) A standard front-wheeled walker.
Rationale: A front-wheeled walker provides an excellent base of support and stability for
patients with partial weight-bearing restrictions on a lower extremity. It allows the patient
to shift a portion of their body weight through their arms onto the frame, bypassing the
injured leg during ambulation.
Question 4
An older adult patient has been confined to bed rest for one week due to a severe
exacerbation of chronic obstructive pulmonary disease (COPD). The nurse notes that
the patient experiences extreme lightheadedness and a heart rate increase from 72 to
104 beats per minute upon sitting on the edge of the bed. Which physiological
mechanism explains this response?
A) Autonomic dysreflexia due to a full bladder.
B) Baroreceptor sluggishness causing orthostatic hypotension.
C) An acute myocardial infarction secondary to immobility.
D) Increased circulating blood volume shifting to the pulmonary tract.
,Answer: B) Baroreceptor sluggishness causing orthostatic hypotension.
Rationale: Prolonged bed rest deconditions the cardiovascular system, making the
baroreceptors in the aortic arch and carotid sinuses sluggish. When the patient
assumes an upright position, these receptors fail to trigger immediate vasoconstriction,
leading to venous pooling, a drop in blood pressure, and compensatory tachycardia.
Question 5
A nurse is performing a mobility assessment on an LPN-to-ADN transition student
during a peer competency check. Which action by the student demonstrates an
understanding of proper body mechanics while lifting a heavy equipment box?
A) Keeping the feet close together to create a narrow, aerodynamic base of support.
B) Bending forward cleanly at the waist while keeping both knees locked straight.
C) Holding the heavy equipment box at arm's length away from the chest.
D) Widening the stance, flexing at the knees, and holding the box close to the body.
Answer: D) Widening the stance, flexing at the knees, and holding the box close
to the body.
Rationale: Proper body mechanics dictate widening the base of support (feet shoulder-
width apart), lowering the center of gravity by bending at the knees and hips, and
keeping the workload as close to the body's center of gravity as possible to minimize
strain on the lumbar spine.
Question 6
A patient who is recovering from a total knee arthroplasty is utilizing a continuous
passive motion (CPM) machine. Which nursing intervention should be prioritized to
ensure the safe operation of this device?
A) Adjusting the settings independently based on the patient's immediate pain
tolerance.
B) Checking that the patient's joint alignment matches the machine’s hinge points
exactly.
C) Keeping the machine turned on continuously for 24 hours without any interruption.
D) Discarding the sheepskin padding between uses to expose the metal frame.
Answer: B) Checking that the patient's joint alignment matches the machine’s
hinge points exactly.
Rationale: For a continuous passive motion (CPM) machine to work effectively and
safely, the patient’s knee joint must be perfectly aligned with the machine's mechanical
, hinge. Misalignment can cause tissue shearing, severe joint pain, and improper
structural extension.
Question 7
A nurse is assessing a bedridden patient and notes localized redness over the right
calcaneus that does not blanch when light finger pressure is applied. How should the
nurse accurately document this finding?
A) Stage 1 pressure injury.
B) Stage 2 pressure injury.
C) Deep tissue pressure injury.
D) Normal reactive hyperemia.
Answer: A) Stage 1 pressure injury.
Rationale: A Stage 1 pressure injury is characterized by intact skin with localized, non-
blanchable erythema (redness). Non-blanchable means that the skin does not turn
white when pressed, indicating that localized capillary blood flow is structurally
compromised.
Question 8
An immobile patient is at risk for developing renal calculi (kidney stones) secondary to
prolonged bed rest. Which physiological change associated with immobility contributes
directly to this condition?
A) Increased excretion of potassium through the urinary tract.
B) Bone demineralization releasing excessive calcium into the bloodstream.
C) Hypertrophy of the detrusor muscle causing urinary retention.
D) Increased production of erythropoietin by the kidneys.
Answer: B) Bone demineralization releasing excessive calcium into the
bloodstream.
Rationale: Immobility removes the mechanical stress of weight-bearing from bones,
causing osteoclastic activity to outpace osteoblastic activity. This results in bone
demineralization, which releases massive amounts of calcium into the bloodstream
(hypercalcaemia), increasing the risk for renal calculi formation.
Safe Patient Handling Competency Assessment (Elsevier Evolve) |
Study Guide & Practice Questions 2026
This document is a comprehensive study resource designed for students preparing for the HESI
LPN-to-ADN Mobility Exam through Elsevier Evolve. It focuses on essential mobility and
patient-handling competencies required for successful transition from practical nursing to
associate degree nursing programs. Key topics include body mechanics, safe patient transfers,
assistive devices, range-of-motion exercises, positioning techniques, fall prevention, mobility
impairments, pressure injury prevention, rehabilitation principles, and evidence-based patient
safety practices. The guide includes practice questions, answer rationales, and competency-
focused review material to help learners strengthen clinical judgment and prepare for mobility-
related nursing assessments. HESI Mobility Exams are part of Elsevier's nursing assessment
solutions used to evaluate readiness and support student success.
Question 1
A nurse is caring for a patient who has been diagnosed with complete flaccid paralysis
of the lower extremities following a spinal cord injury. Which secondary musculoskeletal
complication must the nurse prioritize preventing through regular passive range-of-
motion (ROM) exercises?
A) Sarcopenia
B) Joint contractures
C) Fibromyalgia
D) Osteomalacia
Answer: B) Joint contractures
Rationale: Joint contractures occur when skeletal muscle fibres and connective tissues
permanently shorten due to prolonged immobility and a lack of joint movement. Regular
passive range-of-motion exercises maintain joint flexibility and help prevent these
permanent deformities, even when voluntary motor control is entirely absent.
Question 2
A nurse is preparing to transfer a bariatric patient who is completely dependent and
cannot bear any weight. According to safe patient handling guidelines, which device
,should the nurse use to perform this transfer safely?
A) A standard friction-reducing slide board with two assistants.
B) A mechanical total-body lift with an appropriately sized bariatric sling.
C) A ergonomic canvas gait belt with three assistants supporting the trunk.
D) A single-ended cane combined with a sit-to-stand lift device.
Answer: B) A mechanical total-body lift with an appropriately sized bariatric sling.
Rationale: National safe patient handling guidelines mandate the use of a mechanical
total-body lift for patients who are fully dependent and unable to bear weight, particularly
bariatric individuals. Utilizing manual techniques or gait belts in this scenario places the
nursing staff at an extreme risk for musculoskeletal injuries.
Question 3
A patient is recovering from an open reduction and internal fixation (ORIF) of the right
femur and is prescribed partial weight-bearing status. Which assistive device is most
appropriate to help this patient maintain balance while protecting the healing bone?
A) A single-tipped straight cane held on the left side.
B) A quad cane held on the right side.
C) A standard front-wheeled walker.
D) A pick-up walker with no wheels.
Answer: C) A standard front-wheeled walker.
Rationale: A front-wheeled walker provides an excellent base of support and stability for
patients with partial weight-bearing restrictions on a lower extremity. It allows the patient
to shift a portion of their body weight through their arms onto the frame, bypassing the
injured leg during ambulation.
Question 4
An older adult patient has been confined to bed rest for one week due to a severe
exacerbation of chronic obstructive pulmonary disease (COPD). The nurse notes that
the patient experiences extreme lightheadedness and a heart rate increase from 72 to
104 beats per minute upon sitting on the edge of the bed. Which physiological
mechanism explains this response?
A) Autonomic dysreflexia due to a full bladder.
B) Baroreceptor sluggishness causing orthostatic hypotension.
C) An acute myocardial infarction secondary to immobility.
D) Increased circulating blood volume shifting to the pulmonary tract.
,Answer: B) Baroreceptor sluggishness causing orthostatic hypotension.
Rationale: Prolonged bed rest deconditions the cardiovascular system, making the
baroreceptors in the aortic arch and carotid sinuses sluggish. When the patient
assumes an upright position, these receptors fail to trigger immediate vasoconstriction,
leading to venous pooling, a drop in blood pressure, and compensatory tachycardia.
Question 5
A nurse is performing a mobility assessment on an LPN-to-ADN transition student
during a peer competency check. Which action by the student demonstrates an
understanding of proper body mechanics while lifting a heavy equipment box?
A) Keeping the feet close together to create a narrow, aerodynamic base of support.
B) Bending forward cleanly at the waist while keeping both knees locked straight.
C) Holding the heavy equipment box at arm's length away from the chest.
D) Widening the stance, flexing at the knees, and holding the box close to the body.
Answer: D) Widening the stance, flexing at the knees, and holding the box close
to the body.
Rationale: Proper body mechanics dictate widening the base of support (feet shoulder-
width apart), lowering the center of gravity by bending at the knees and hips, and
keeping the workload as close to the body's center of gravity as possible to minimize
strain on the lumbar spine.
Question 6
A patient who is recovering from a total knee arthroplasty is utilizing a continuous
passive motion (CPM) machine. Which nursing intervention should be prioritized to
ensure the safe operation of this device?
A) Adjusting the settings independently based on the patient's immediate pain
tolerance.
B) Checking that the patient's joint alignment matches the machine’s hinge points
exactly.
C) Keeping the machine turned on continuously for 24 hours without any interruption.
D) Discarding the sheepskin padding between uses to expose the metal frame.
Answer: B) Checking that the patient's joint alignment matches the machine’s
hinge points exactly.
Rationale: For a continuous passive motion (CPM) machine to work effectively and
safely, the patient’s knee joint must be perfectly aligned with the machine's mechanical
, hinge. Misalignment can cause tissue shearing, severe joint pain, and improper
structural extension.
Question 7
A nurse is assessing a bedridden patient and notes localized redness over the right
calcaneus that does not blanch when light finger pressure is applied. How should the
nurse accurately document this finding?
A) Stage 1 pressure injury.
B) Stage 2 pressure injury.
C) Deep tissue pressure injury.
D) Normal reactive hyperemia.
Answer: A) Stage 1 pressure injury.
Rationale: A Stage 1 pressure injury is characterized by intact skin with localized, non-
blanchable erythema (redness). Non-blanchable means that the skin does not turn
white when pressed, indicating that localized capillary blood flow is structurally
compromised.
Question 8
An immobile patient is at risk for developing renal calculi (kidney stones) secondary to
prolonged bed rest. Which physiological change associated with immobility contributes
directly to this condition?
A) Increased excretion of potassium through the urinary tract.
B) Bone demineralization releasing excessive calcium into the bloodstream.
C) Hypertrophy of the detrusor muscle causing urinary retention.
D) Increased production of erythropoietin by the kidneys.
Answer: B) Bone demineralization releasing excessive calcium into the
bloodstream.
Rationale: Immobility removes the mechanical stress of weight-bearing from bones,
causing osteoclastic activity to outpace osteoblastic activity. This results in bone
demineralization, which releases massive amounts of calcium into the bloodstream
(hypercalcaemia), increasing the risk for renal calculi formation.
