NACC PSW Exam Review 2026/2027 |
Complete Exam Test Bank with Real Exam
Questions, Verified Correct Answers &
Detailed Rationales | Level A+ Ready!!
SECTION 1: SAFETY & MOBILITY (Questions 1-30)
Question 1
You are helping a client who has right-sided weakness after a stroke to transfer from the
bed to a wheelchair. The wheelchair is positioned at a 45-degree angle to the bed with
the brakes locked. You have placed a transfer belt around the client's waist. The client is
able to stand with minimal assistance. Which of the following actions should you take
next?
A) Place your hands under the client's armpits and lift upward as they stand.
B) Stand on the client's right (weak) side and pivot together toward the wheelchair.
C) Stand on the client's left (strong) side and pivot together toward the wheelchair.
D) Ask the client to put their arms around your neck and pull themselves up.
Answer: C
Rationale: When assisting a client with unilateral weakness, the PSW should stand on
the stronger side to provide support and stability. The transfer belt is used for grip, not
under the armpits (which can injure nerves). The client should not pull on the PSW's
neck as this can cause injury.
Question 2
A client with Parkinson's disease has a shuffling gait and episodes of "freezing" in
doorways. Which of the following interventions is most effective to help the client step
through a doorway?
A) Push the client gently from behind.
B) Tell the client to "step over an imaginary line" or place a visual cue on the floor.
C) Hold the client's walker and pull it forward.
D) Encourage the client to walk faster.
Answer: B
pg. 1
,Rationale: Visual or verbal cues (e.g., a line on the floor, counting "1-2-3") help
overcome freezing episodes in Parkinson's. Pushing or pulling can cause falls and is not
therapeutic.
Question 3
A client is recovering from hip replacement surgery and must keep the operative leg
abducted. Which of the following actions is correct when positioning this client in bed?
A) Place a pillow between the legs to maintain abduction
B) Keep the legs together to prevent dislocation
C) Position the client flat on the back with legs straight
D) Allow the client to cross the legs for comfort
Answer: A
Rationale: Clients post-hip replacement should maintain abduction (legs apart) to
prevent dislocation. A pillow between the legs maintains proper positioning. Crossing
legs is contraindicated.
Question 4
When using a mechanical lift to transfer a client, what is the PSW's primary
responsibility?
A) Operating the lift controls while another staff member secures the sling
B) Positioning the client and ensuring all straps are secure before lifting
C) Documenting the transfer after completion
D) Watching from the doorway to ensure safety
Answer: B
Rationale: The PSW must ensure the client is properly positioned and all straps are
secure before operating the lift. This prevents falls and injuries during transfers.
Question 5
What is the no-lift policy in long-term care?
A) A policy that prohibits all client lifting
B) A policy requiring the use of mechanical lifts and assistive devices to prevent injury
C) A policy that allows only nurses to lift clients
D) A policy that applies only to heavy clients
Answer: B
Rationale: The no-lift policy requires the use of mechanical lifts and assistive devices
to prevent injury to both the PSW and the client.
pg. 2
,Question 6
A client with dementia is wandering and attempting to leave the unit. What is the most
appropriate response?
A) Restrain the client to prevent elopement
B) Redirect the client to a safe activity and provide supervision
C) Allow the client to leave and call security
D) Tell the client they cannot leave
Answer: B
Rationale: Redirection to a safe activity is the most appropriate intervention for
wandering behavior. Restraints should be avoided; supervision and engagement are
preferred.
Question 7
When using a gait belt, where should the belt be positioned?
A) Around the client's chest
B) Around the client's waist
C) Around the client's hips
D) Around the client's knees
Answer: B
Rationale: The gait belt should be positioned snugly around the client's waist for
proper support and control during transfers.
Question 8
A client is experiencing a fall. The PSW should:
A) Immediately lift the client from the floor
B) Assess the client for injuries before moving them
C) Call for help before assessing the client
D) Leave the client to get a mechanical lift
Answer: B
Rationale: The PSW should assess the client for injuries before attempting to move
them. Moving an injured client can cause further harm.
Question 9
Which of the following is a sign that a client is at risk for falling?
A) Steady gait
pg. 3
, B) Use of assistive devices
C) Good balance
D) Clear mental status
Answer: B
Rationale: Use of assistive devices (cane, walker) indicates mobility impairment and
increased fall risk.
Question 10
The best position for a client who is experiencing shortness of breath is:
A) Supine
B) High Fowler's
C) Side-lying
D) Prone
Answer: B
Rationale: High Fowler's position (sitting upright) allows for maximum lung
expansion and easier breathing.
Question 11
A client with left-sided weakness is learning to use a cane. The PSW should instruct the
client to hold the cane on which side?
A) Left side
B) Right side
C) Both sides
D) Either side
Answer: B
Rationale: The cane should be held on the stronger (right) side when a client has left-
sided weakness. This provides better support and stability.
Question 12
The client states, "I feel dizzy." What should the PSW do first?
A) Leave the client to get water
B) Assist the client to sit or lie down immediately
C) Ask the client to stand up
D) Tell the client to take deep breaths
Answer: B
pg. 4
Complete Exam Test Bank with Real Exam
Questions, Verified Correct Answers &
Detailed Rationales | Level A+ Ready!!
SECTION 1: SAFETY & MOBILITY (Questions 1-30)
Question 1
You are helping a client who has right-sided weakness after a stroke to transfer from the
bed to a wheelchair. The wheelchair is positioned at a 45-degree angle to the bed with
the brakes locked. You have placed a transfer belt around the client's waist. The client is
able to stand with minimal assistance. Which of the following actions should you take
next?
A) Place your hands under the client's armpits and lift upward as they stand.
B) Stand on the client's right (weak) side and pivot together toward the wheelchair.
C) Stand on the client's left (strong) side and pivot together toward the wheelchair.
D) Ask the client to put their arms around your neck and pull themselves up.
Answer: C
Rationale: When assisting a client with unilateral weakness, the PSW should stand on
the stronger side to provide support and stability. The transfer belt is used for grip, not
under the armpits (which can injure nerves). The client should not pull on the PSW's
neck as this can cause injury.
Question 2
A client with Parkinson's disease has a shuffling gait and episodes of "freezing" in
doorways. Which of the following interventions is most effective to help the client step
through a doorway?
A) Push the client gently from behind.
B) Tell the client to "step over an imaginary line" or place a visual cue on the floor.
C) Hold the client's walker and pull it forward.
D) Encourage the client to walk faster.
Answer: B
pg. 1
,Rationale: Visual or verbal cues (e.g., a line on the floor, counting "1-2-3") help
overcome freezing episodes in Parkinson's. Pushing or pulling can cause falls and is not
therapeutic.
Question 3
A client is recovering from hip replacement surgery and must keep the operative leg
abducted. Which of the following actions is correct when positioning this client in bed?
A) Place a pillow between the legs to maintain abduction
B) Keep the legs together to prevent dislocation
C) Position the client flat on the back with legs straight
D) Allow the client to cross the legs for comfort
Answer: A
Rationale: Clients post-hip replacement should maintain abduction (legs apart) to
prevent dislocation. A pillow between the legs maintains proper positioning. Crossing
legs is contraindicated.
Question 4
When using a mechanical lift to transfer a client, what is the PSW's primary
responsibility?
A) Operating the lift controls while another staff member secures the sling
B) Positioning the client and ensuring all straps are secure before lifting
C) Documenting the transfer after completion
D) Watching from the doorway to ensure safety
Answer: B
Rationale: The PSW must ensure the client is properly positioned and all straps are
secure before operating the lift. This prevents falls and injuries during transfers.
Question 5
What is the no-lift policy in long-term care?
A) A policy that prohibits all client lifting
B) A policy requiring the use of mechanical lifts and assistive devices to prevent injury
C) A policy that allows only nurses to lift clients
D) A policy that applies only to heavy clients
Answer: B
Rationale: The no-lift policy requires the use of mechanical lifts and assistive devices
to prevent injury to both the PSW and the client.
pg. 2
,Question 6
A client with dementia is wandering and attempting to leave the unit. What is the most
appropriate response?
A) Restrain the client to prevent elopement
B) Redirect the client to a safe activity and provide supervision
C) Allow the client to leave and call security
D) Tell the client they cannot leave
Answer: B
Rationale: Redirection to a safe activity is the most appropriate intervention for
wandering behavior. Restraints should be avoided; supervision and engagement are
preferred.
Question 7
When using a gait belt, where should the belt be positioned?
A) Around the client's chest
B) Around the client's waist
C) Around the client's hips
D) Around the client's knees
Answer: B
Rationale: The gait belt should be positioned snugly around the client's waist for
proper support and control during transfers.
Question 8
A client is experiencing a fall. The PSW should:
A) Immediately lift the client from the floor
B) Assess the client for injuries before moving them
C) Call for help before assessing the client
D) Leave the client to get a mechanical lift
Answer: B
Rationale: The PSW should assess the client for injuries before attempting to move
them. Moving an injured client can cause further harm.
Question 9
Which of the following is a sign that a client is at risk for falling?
A) Steady gait
pg. 3
, B) Use of assistive devices
C) Good balance
D) Clear mental status
Answer: B
Rationale: Use of assistive devices (cane, walker) indicates mobility impairment and
increased fall risk.
Question 10
The best position for a client who is experiencing shortness of breath is:
A) Supine
B) High Fowler's
C) Side-lying
D) Prone
Answer: B
Rationale: High Fowler's position (sitting upright) allows for maximum lung
expansion and easier breathing.
Question 11
A client with left-sided weakness is learning to use a cane. The PSW should instruct the
client to hold the cane on which side?
A) Left side
B) Right side
C) Both sides
D) Either side
Answer: B
Rationale: The cane should be held on the stronger (right) side when a client has left-
sided weakness. This provides better support and stability.
Question 12
The client states, "I feel dizzy." What should the PSW do first?
A) Leave the client to get water
B) Assist the client to sit or lie down immediately
C) Ask the client to stand up
D) Tell the client to take deep breaths
Answer: B
pg. 4
