HESI LPN-ADN Entrance Exam – Mobility Focus
2026/2027
Elsevier Evolve – Comprehensive Mobility & Safe
Patient Handling Competency Assessment for LPN-to-
ADN Transition
1. A nurse is assessing a patient’s risk for falls using the Morse Fall Scale. Which score
indicates a high risk?
A. 25
B. 45
C. 55
D. 70
ANSWER: D. 70
Rationale:
• A. 25 → Low risk (Morse scale: 0–24 low, 25–44 moderate, ≥45 high; but many
facilities use ≥55 as high; however 70 is clearly high risk)
• B. 45 → Moderate to high risk depending on policy
• C. 55 → High risk
• D. 70 → High risk; correct because 70 exceeds standard high-risk threshold
2. A patient with left-sided weakness needs to transfer from bed to wheelchair. Where
should the nurse place the wheelchair?
A. On the patient’s left side, angled 45 degrees toward the foot of the bed
B. On the patient’s right side, parallel to the bed
C. On the patient’s right side, angled 45 degrees toward the head of the bed
D. On the patient’s left side, parallel to the bed
ANSWER: C. On the patient’s right side, angled 45 degrees toward the head of the
bed
Rationale:
• A. Left side → Wrong; patient’s strong side is right, so wheelchair should be on
right
• B. Right side parallel → Less safe; angled position allows easier pivot
• C. Right side, angled 45 degrees toward head → Correct; uses strong side,
reduces shear
, • D. Left side parallel → Incorrect and unsafe
3. Which finding indicates proper use of a gait belt during transfer?
A. Belt is placed over the patient’s clothing, snug but allowing two fingers underneath
B. Belt is placed directly on skin to prevent slipping
C. Belt is positioned around the patient’s chest below the axillae
D. Belt is loose enough to slide easily around the patient’s waist
ANSWER: A. Belt is placed over the patient’s clothing, snug but allowing two
fingers underneath
Rationale:
• A. Correct → Prevents friction and ensures secure grip without restricting
breathing
• B. Direct skin → Causes skin breakdown
• C. Around chest → Restricts breathing and is incorrect placement
• D. Loose → Does not provide stability or safety
4. A patient post-stroke has unilateral neglect. Which intervention best promotes safe
mobility?
A. Place all personal items on the unaffected side
B. Remind the patient to scan the neglected side frequently
C. Restrain the affected arm to prevent injury
D. Keep the bed in lowest position with all side rails up
ANSWER: B. Remind the patient to scan the neglected side frequently
Rationale:
• A. Items on unaffected side → Reinforces neglect
• B. Scanning → Correct; trains attention to neglected side
• C. Restraint → Restrictive and not therapeutic
• D. Side rails up → Restraint if used for mobility prevention
5. A nurse is teaching a patient with osteoporosis about safe ambulation. Which
instruction is most important?
A. Wear slip-resistant socks at all times
B. Avoid twisting the trunk while standing
C. Walk only on carpeted surfaces
D. Use a walker with two wheels
ANSWER: B. Avoid twisting the trunk while standing
Rationale:
• A. Slip-resistant socks helpful but not most important
, • B. Avoid twisting → Prevents vertebral fractures in osteoporosis
• C. Carpet only → Not feasible; uneven carpets cause falls
• D. Two-wheel walker → May be appropriate but not most critical teaching
6. Which patient is at highest risk for deep vein thrombosis (DVT) and requires mobility
precautions?
A. 25-year-old post-appendectomy ambulating 4x daily
B. 68-year-old post-hip replacement with immobilizer
C. 45-year-old with pneumonia on room air
D. 30-year-old with ankle sprain wearing compression wrap
ANSWER: B. 68-year-old post-hip replacement with immobilizer
Rationale:
• A. Appendectomy, active → Low risk
• B. Hip replacement + immobilizer → High risk for stasis, DVT
• C. Pneumonia ambulatory → Lower risk
• D. Ankle sprain → Lower risk unless bedridden
7. The nurse assesses a patient using a cane. Which observation indicates correct cane
use?
A. Cane is held on the weak side, moved with the weak leg
B. Cane is held on the strong side, moved with the weak leg
C. Cane is held on the strong side, moved with the strong leg
D. Cane is held on the weak side, moved with the strong leg
ANSWER: B. Cane is held on the strong side, moved with the weak leg
Rationale:
• A. Weak side + weak leg → Poor stability
• B. Strong side + weak leg → Correct; reduces load on weak side
• C. Strong side + strong leg → No support for weak leg
• D. Weak side + strong leg → Increases fall risk
8. A patient with a fractured tibia is in a long leg cast and using crutches. Which gait
pattern is safest for non-weight-bearing?
A. Four-point gait
B. Two-point gait
C. Three-point gait
D. Swing-to gait
, ANSWER: C. Three-point gait
Rationale:
• A. Four-point → Partial weight-bearing both legs
• B. Two-point → Partial weight-bearing
• C. Three-point → Correct for non-weight-bearing one leg
• D. Swing-to → Used with bilateral crutches, partial weight-bearing
9. A nurse is delegating a patient’s transfer from bed to chair to a nursing assistant.
Which direction is essential to give?
A. “Use a mechanical lift if the patient feels heavy.”
B. “Apply the gait belt and lock the bed brakes before transfer.”
C. “Ask the patient to hold onto your neck for support.”
D. “Lift the patient under the axillae to prevent fall.”
ANSWER: B. Apply the gait belt and lock the bed brakes before transfer
Rationale:
• A. Mechanical lift only if assessed need → Not delegation instruction
• B. Correct essential safety steps
• C. Holding neck → Unsafe for assistant and patient
• D. Lifting under axillae → Can injure brachial plexus
10. A patient with Parkinson’s disease has a shuffling gait and freezing episodes. Which
action helps the patient initiate walking?
A. Place a cane in front of the patient’s feet
B. Ask the patient to step over an imaginary line
C. Push the patient gently from behind
D. Call out “Left, right, left, right” loudly
ANSWER: B. Ask the patient to step over an imaginary line
Rationale:
• A. Cane in front → Tripping hazard
• B. Imaginary line → Visual or auditory cue helps overcome freezing
• C. Push → Unsafe, can cause fall
• D. Loud commands → May startle, less effective than rhythmic cue
11. A postoperative day 1 patient has orders for “ambulate with assistance.” The
patient’s blood pressure is 90/60 mm Hg, and they report dizziness. What should the
nurse do first?
A. Assist the patient to stand slowly and walk to the doorway
2026/2027
Elsevier Evolve – Comprehensive Mobility & Safe
Patient Handling Competency Assessment for LPN-to-
ADN Transition
1. A nurse is assessing a patient’s risk for falls using the Morse Fall Scale. Which score
indicates a high risk?
A. 25
B. 45
C. 55
D. 70
ANSWER: D. 70
Rationale:
• A. 25 → Low risk (Morse scale: 0–24 low, 25–44 moderate, ≥45 high; but many
facilities use ≥55 as high; however 70 is clearly high risk)
• B. 45 → Moderate to high risk depending on policy
• C. 55 → High risk
• D. 70 → High risk; correct because 70 exceeds standard high-risk threshold
2. A patient with left-sided weakness needs to transfer from bed to wheelchair. Where
should the nurse place the wheelchair?
A. On the patient’s left side, angled 45 degrees toward the foot of the bed
B. On the patient’s right side, parallel to the bed
C. On the patient’s right side, angled 45 degrees toward the head of the bed
D. On the patient’s left side, parallel to the bed
ANSWER: C. On the patient’s right side, angled 45 degrees toward the head of the
bed
Rationale:
• A. Left side → Wrong; patient’s strong side is right, so wheelchair should be on
right
• B. Right side parallel → Less safe; angled position allows easier pivot
• C. Right side, angled 45 degrees toward head → Correct; uses strong side,
reduces shear
, • D. Left side parallel → Incorrect and unsafe
3. Which finding indicates proper use of a gait belt during transfer?
A. Belt is placed over the patient’s clothing, snug but allowing two fingers underneath
B. Belt is placed directly on skin to prevent slipping
C. Belt is positioned around the patient’s chest below the axillae
D. Belt is loose enough to slide easily around the patient’s waist
ANSWER: A. Belt is placed over the patient’s clothing, snug but allowing two
fingers underneath
Rationale:
• A. Correct → Prevents friction and ensures secure grip without restricting
breathing
• B. Direct skin → Causes skin breakdown
• C. Around chest → Restricts breathing and is incorrect placement
• D. Loose → Does not provide stability or safety
4. A patient post-stroke has unilateral neglect. Which intervention best promotes safe
mobility?
A. Place all personal items on the unaffected side
B. Remind the patient to scan the neglected side frequently
C. Restrain the affected arm to prevent injury
D. Keep the bed in lowest position with all side rails up
ANSWER: B. Remind the patient to scan the neglected side frequently
Rationale:
• A. Items on unaffected side → Reinforces neglect
• B. Scanning → Correct; trains attention to neglected side
• C. Restraint → Restrictive and not therapeutic
• D. Side rails up → Restraint if used for mobility prevention
5. A nurse is teaching a patient with osteoporosis about safe ambulation. Which
instruction is most important?
A. Wear slip-resistant socks at all times
B. Avoid twisting the trunk while standing
C. Walk only on carpeted surfaces
D. Use a walker with two wheels
ANSWER: B. Avoid twisting the trunk while standing
Rationale:
• A. Slip-resistant socks helpful but not most important
, • B. Avoid twisting → Prevents vertebral fractures in osteoporosis
• C. Carpet only → Not feasible; uneven carpets cause falls
• D. Two-wheel walker → May be appropriate but not most critical teaching
6. Which patient is at highest risk for deep vein thrombosis (DVT) and requires mobility
precautions?
A. 25-year-old post-appendectomy ambulating 4x daily
B. 68-year-old post-hip replacement with immobilizer
C. 45-year-old with pneumonia on room air
D. 30-year-old with ankle sprain wearing compression wrap
ANSWER: B. 68-year-old post-hip replacement with immobilizer
Rationale:
• A. Appendectomy, active → Low risk
• B. Hip replacement + immobilizer → High risk for stasis, DVT
• C. Pneumonia ambulatory → Lower risk
• D. Ankle sprain → Lower risk unless bedridden
7. The nurse assesses a patient using a cane. Which observation indicates correct cane
use?
A. Cane is held on the weak side, moved with the weak leg
B. Cane is held on the strong side, moved with the weak leg
C. Cane is held on the strong side, moved with the strong leg
D. Cane is held on the weak side, moved with the strong leg
ANSWER: B. Cane is held on the strong side, moved with the weak leg
Rationale:
• A. Weak side + weak leg → Poor stability
• B. Strong side + weak leg → Correct; reduces load on weak side
• C. Strong side + strong leg → No support for weak leg
• D. Weak side + strong leg → Increases fall risk
8. A patient with a fractured tibia is in a long leg cast and using crutches. Which gait
pattern is safest for non-weight-bearing?
A. Four-point gait
B. Two-point gait
C. Three-point gait
D. Swing-to gait
, ANSWER: C. Three-point gait
Rationale:
• A. Four-point → Partial weight-bearing both legs
• B. Two-point → Partial weight-bearing
• C. Three-point → Correct for non-weight-bearing one leg
• D. Swing-to → Used with bilateral crutches, partial weight-bearing
9. A nurse is delegating a patient’s transfer from bed to chair to a nursing assistant.
Which direction is essential to give?
A. “Use a mechanical lift if the patient feels heavy.”
B. “Apply the gait belt and lock the bed brakes before transfer.”
C. “Ask the patient to hold onto your neck for support.”
D. “Lift the patient under the axillae to prevent fall.”
ANSWER: B. Apply the gait belt and lock the bed brakes before transfer
Rationale:
• A. Mechanical lift only if assessed need → Not delegation instruction
• B. Correct essential safety steps
• C. Holding neck → Unsafe for assistant and patient
• D. Lifting under axillae → Can injure brachial plexus
10. A patient with Parkinson’s disease has a shuffling gait and freezing episodes. Which
action helps the patient initiate walking?
A. Place a cane in front of the patient’s feet
B. Ask the patient to step over an imaginary line
C. Push the patient gently from behind
D. Call out “Left, right, left, right” loudly
ANSWER: B. Ask the patient to step over an imaginary line
Rationale:
• A. Cane in front → Tripping hazard
• B. Imaginary line → Visual or auditory cue helps overcome freezing
• C. Push → Unsafe, can cause fall
• D. Loud commands → May startle, less effective than rhythmic cue
11. A postoperative day 1 patient has orders for “ambulate with assistance.” The
patient’s blood pressure is 90/60 mm Hg, and they report dizziness. What should the
nurse do first?
A. Assist the patient to stand slowly and walk to the doorway
