Patient Handling | Elsevier Evolve | Comprehensive Assessment |
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SECTION 1: Fundamentals of Mobility & Body Mechanics (Q1–Q12)
Q1: Which principle of body mechanics states that stability increases when the base of
support is widened and the center of gravity is lowered?
A. Alignment principle
B. Base of support principle [CORRECT]
C. Leverage principle
D. Friction principle
Correct Answer: B
Rationale: The base of support principle directly correlates stability with a wider stance
and lower center of gravity, which is foundational to safe patient handling. Option A
refers to body positioning, C to using body weight to reduce effort, and D to reducing
resistance between surfaces.
Q2: [Visual Identification] A nurse is preparing to lift a heavy box from the floor. Which
image demonstrates the correct starting stance for safe lifting?
A. Image A: Feet together, back rounded, looking down
B. Image B: Feet shoulder-width apart, back straight, knees bent [CORRECT]
C. Image C: One foot forward, back twisted to the side, knees locked
D. Image D: Feet crossed, back hunched, arms extended
Correct Answer: B
Rationale: Image B shows the correct body mechanics with a wide base of support,
straight back, and bent knees to use leg muscles rather than the back. The other images
demonstrate unsafe techniques that increase risk for musculoskeletal injury.
Q3: A nurse needs to move a 180-lb patient up in bed. The patient can assist minimally.
How many staff members should participate in this transfer using a friction-reducing
device?
,A. One nurse using proper body mechanics
B. Two nurses using a draw sheet and friction-reducing device [CORRECT]
C. Three nurses lifting manually from the patient's shoulders and hips
D. Four nurses performing a manual lift without assistive devices
Correct Answer: B
Rationale: Two nurses with a friction-reducing device is the evidence-based standard for
repositioning a partially dependent adult in bed, as it minimizes shear and caregiver
injury. Manual lifting without assistive devices violates safe patient handling protocols
and places staff at risk for back injury.
Q4: During a lateral transfer from bed to stretcher, the nurse keeps the patient close to
her body. What is the primary rationale for this action?
A. To increase the patient's comfort during movement
B. To decrease the moment of force and reduce back strain [CORRECT]
C. To allow the patient to see where they are going
D. To increase friction and prevent sliding
Correct Answer: B
Rationale: Keeping the load close to the body reduces the moment of force on the
lumbar spine, significantly decreasing the risk of musculoskeletal injury. While patient
comfort is important, the primary safety rationale is biomechanical protection of the
healthcare worker.
Q5: A patient weighs 220 lb and is fully dependent. According to safe patient handling
guidelines that recommend no manual lifting of patients over 35 lb, how many
caregivers are required at minimum when using a mechanical lift with a weight-rated
sling?
A. One caregiver to operate the lift
B. Two caregivers: one to operate the lift and one to guide the patient [CORRECT]
C. Three caregivers to manually support the patient during lift
D. Four caregivers: two on each side of the mechanical lift
Correct Answer: B
Rationale: A mechanical lift requires two trained caregivers—one to operate the controls
and one to guide and protect the patient's head and extremities during the transfer.
Manual support during a mechanical lift is unnecessary and introduces risk of caregiver
injury.
,Q6: A nurse is pivoting to turn a patient toward a chair. Where should the nurse position
her feet to maintain a stable base of support?
A. Close together with toes pointing away from the patient
B. Shoulder-width apart with one foot forward toward the direction of movement
[CORRECT]
C. Crossed at the ankles with knees locked
D. Together on tiptoes to increase reach
Correct Answer: B
Rationale: A shoulder-width stance with one foot forward in the direction of movement
provides the greatest stability and allows the nurse to use momentum safely during
pivoting. Locked knees, crossed ankles, or tiptoes create an unstable base and increase
fall risk for both nurse and patient.
Q7: Which ergonomic intervention is most effective for reducing repetitive strain injury
in nurses who perform frequent patient repositioning?
A. Increasing the number of manual lifts per shift
B. Using ceiling-mounted or mobile mechanical lifts for all dependent transfers
[CORRECT]
C. Bending at the waist to maintain eye contact with the patient
D. Rotating staff every 4 hours to different units
Correct Answer: B
Rationale: Mechanical lift technology eliminates manual lifting, which is the primary
cause of work-related musculoskeletal disorders in nursing. Bending at the waist
increases spinal compression forces, and staff rotation does not address the
biomechanical risk of the task itself.
Q8: The charge nurse has four patients requiring mobility assistance. Which patient
should the nurse prioritize for immediate mechanical lift transfer?
A. A 68-year-old who is independent and requests help standing from a chair
B. A 42-year-old post-op who is partially dependent and can bear 50% weight
C. A 78-year-old who is fully dependent, weighs 195 lb, and needs to be moved to a
stretcher for emergent imaging [CORRECT]
D. A 55-year-old who is partially dependent and needs repositioning in bed
Correct Answer: C
Rationale: The fully dependent patient who is heavy and requires emergent transfer
poses the highest immediate risk for both patient and staff injury without mechanical
, assistance. The emergent nature and complete dependency make this the priority over
patients who can partially assist or have non-urgent needs.
Q9: A pregnant nurse at 32 weeks gestation is caring for a patient who needs
assistance ambulating. What modification to body mechanics is most important for this
nurse?
A. Avoid all patient contact and delegate all mobility tasks
B. Maintain a wider base of support and avoid twisting due to an altered center of
gravity [CORRECT]
C. Lift patients from a seated position only
D. Hold her breath during all lifting tasks to stabilize the core
Correct Answer: B
Rationale: Pregnancy shifts the center of gravity anteriorly, necessitating a wider base of
support and avoidance of twisting to prevent falls and back strain. Breath-holding during
lifting can decrease venous return and is contraindicated in pregnancy.
Q10: A nurse observes a nursing assistant transferring a patient using the following
technique: the assistant bends at the waist, twists to the left while holding the patient,
and lifts with straight knees. What is the most serious safety concern with this
technique?
A. The patient may experience mild anxiety during the transfer
B. The assistant is performing multiple unsafe body mechanics simultaneously, creating
extreme lumbar compression risk [CORRECT]
C. The transfer will take longer than if proper technique were used
D. The patient may feel dizzy from the twisting motion
Correct Answer: B
Rationale: Bending at the waist, twisting, and lifting with straight knees are three
high-risk biomechanical errors that compound spinal compression forces and
dramatically increase the risk of serious back injury. The combination of these errors is
more dangerous than any single error alone.
Q11: What is the primary purpose of a "no-lift" policy in healthcare facilities?
A. To reduce the number of staff needed on each unit
B. To eliminate manual patient lifting and reduce caregiver musculoskeletal injuries
[CORRECT]
C. To increase the speed of patient transfers