Basic Nursing Skills Practice Exam:
Hygiene, Mobility, and Transfers - Indiana
University School of Nursing Curriculum
Reference - 2026/, Answers & Rationales
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
98 exam-style multiple-choice questions. Each question includes the correct answer and a complete rationale
for focused revision.
COVERAGE
This practice exam assesses foundational nursing psychomotor and clinical-reasoning competencies in
hygiene, mobility, patient positioning, safe transfers, range of motion, skin and pressure-injury prevention,
body mechanics, fall prevention, and infection control. Items require synthesis of evidence-based guidelines
(Potter & Perry 11th ed., CDC 2024, AHRQ) and application to complex patient scenarios aligned with QSEN
competencies.
STUDY GUIDE
Recommended duration: 75 minutes. Passing target: 80% (40/50 correct).
HIGHP - Page 1 of 32
,1. Which transfer technique best prevents caregiver injury when a patient is partially
weight-bearing?
[ ] A. Manual lift with the caregiver's arms extended and back flexed
[ ] B. Use of a mechanical lift or gait belt with the bed at waist height
[ ] C. Pulling the patient upward by the shoulders from the side of the bed
[ ] D. Twisting the torso while pivoting the patient to a chair
CORRECT: B. Use of a mechanical lift or gait belt with the bed at waist height
Using a mechanical lift or gait belt with the bed at waist height keeps the load close, avoids spinal flexion,
and follows AHRQ safe patient-handling principles. Manual lifting with a flexed back, pulling by the shoulders,
and twisting while pivoting all increase musculoskeletal strain and risk of caregiver and patient injury.
2. A patient with hemiplegia needs positioning to prevent shoulder subluxation. Which
intervention is most appropriate?
[ ] A. Place the affected arm in a dependent position over the bed edge
[ ] B. Support the affected arm on a pillow in a neutral or slightly flexed position
[ ] C. Bind the affected arm tightly across the chest with a restraint
[ ] D. Encourage the patient to sleep only on the affected side
CORRECT: B. Support the affected arm on a pillow in a neutral or slightly flexed position
Supporting the affected arm on a pillow in neutral or slight flexion prevents gravitational pull on the shoulder
joint capsule and reduces subluxation risk. Dependent positioning, tight binding (which risks restraint
complications and contracture), and exclusive affected-side sleeping do not protect the joint and may worsen
outcomes.
3. Which finding most urgently indicates a need to revise a patient's fall-prevention plan?
[ ] A. Patient uses a walker correctly after instruction
[ ] B. Patient's Morse Fall Scale score increased from 35 to 60
[ ] C. Patient requests assistance before ambulating
[ ] D. Patient's call light is within reach at all times
CORRECT: B. Patient's Morse Fall Scale score increased from 35 to 60
A rise in the Morse Fall Scale from 35 (low risk) to 60 (high risk) signals a significant change in fall risk
requiring immediate plan revision, such as increased supervision or bed alarms. Correct walker use,
requesting assistance, and call-light accessibility are protective behaviors that do not necessitate urgent
revision.
4. During a bed bath, which sequence best reduces the risk of cross-contamination?
[ ] A. Wash the perineal area first, then the face, then the extremities
[ ] B. Wash from cleanest to dirtiest: face, arms, trunk, legs, then perineum
HIGHP - Page 2 of 32
, [ ] C. Use the same washcloth for the entire bath without rinsing
[ ] D. Wash the perineum last but reuse the basin water for the face
CORRECT: B. Wash from cleanest to dirtiest: face, arms, trunk, legs, then perineum
Cleansing from cleanest to dirtiest areas (face, arms, trunk, legs, then perineum) prevents transfer of
microorganisms from contaminated to clean sites. Perineal-first, reusing washcloths without rinsing, and
reusing contaminated basin water for the face all promote cross-contamination.
5. Which intervention is most effective for preventing ventilator-associated pneumonia in
an immobile patient?
[ ] A. Maintain the head of bed at 10 degrees continuously
[ ] B. Elevate the head of bed to 30-45 degrees unless contraindicated
[ ] C. Perform oral care once every 24 hours
[ ] D. Suction the patient routinely every 2 hours regardless of need
CORRECT: B. Elevate the head of bed to 30-45 degrees unless contraindicated
Elevating the head of bed to 30-45 degrees reduces aspiration of oropharyngeal secretions and is a core VAP
prevention measure. A 10-degree elevation is insufficient, once-daily oral care is inadequate (should be every
4 hours per CDC), and routine suctioning without indication increases mucosal trauma and infection risk.
6. A patient performs active range of motion but reports sharp pain at the end range. What
is the nurse's best action?
[ ] A. Continue the motion forcefully to prevent contracture
[ ] B. Stop the exercise, assess the pain, and document findings
[ ] C. Apply heat and immediately resume the same motion
[ ] D. Administer an analgesic and complete the full range regardless
CORRECT: B. Stop the exercise, assess the pain, and document findings
Sharp pain at end range may indicate joint or tissue injury; the nurse should stop, assess, and document
before proceeding. Forcing the motion, immediately resuming after heat, or masking pain with analgesia to
complete full range can worsen injury and does not address the cause.
7. Which principle of body mechanics best reduces lumbar strain during patient
repositioning?
[ ] A. Keep the feet together and bend at the waist
[ ] B. Maintain a wide base of support and bend at the knees
[ ] C. Twist the torso while pulling the patient upward
[ ] D. Hold the patient away from the body to improve leverage
HIGHP - Page 3 of 32
, CORRECT: B. Maintain a wide base of support and bend at the knees
A wide base of support with knee bending lowers the center of gravity and uses leg muscles, reducing lumbar
strain. Feet together with waist bending, torso twisting, and holding the patient away from the body all
increase spinal load and injury risk.
8. Which action best prevents catheter-associated urinary tract infection during perineal
care?
[ ] A. Cleanse the catheter tubing from the drainage bag toward the meatus
[ ] B. Cleanse the meatus and catheter from the meatus outward and downward
[ ] C. Disconnect the catheter from the drainage bag for thorough cleaning
[ ] D. Use the same washcloth for the meatus and the anal area
CORRECT: B. Cleanse the meatus and catheter from the meatus outward and downward
Cleansing from the meatus outward and downward prevents microorganisms from the perianal area from
migrating to the urinary tract. Cleansing from the bag toward the meatus, disconnecting the closed system,
and reusing a washcloth across contaminated areas all increase CAUTI risk.
9. A patient with a sacral pressure injury has a hydrocolloid dressing. Which assessment
finding requires immediate provider notification?
[ ] A. Dressing is intact and adherent at the edges
[ ] B. Wound bed is moist and granulation tissue is present
[ ] C. Dressing has a foul odor and purulent drainage is leaking
[ ] D. Patient reports mild discomfort during dressing change
CORRECT: C. Dressing has a foul odor and purulent drainage is leaking
Foul odor with purulent drainage indicates infection, possibly deep tissue or systemic involvement, requiring
immediate provider notification and likely culture or antibiotic therapy. An intact dressing, healthy granulation,
and mild discomfort are expected findings that do not require urgent escalation.
10. Which action best prevents pathogen transmission when removing contaminated
gloves after perineal care?
[ ] A. Remove gloves after leaving the room to avoid contaminating the environment.
[ ] B. Perform hand hygiene immediately after removing gloves, before touching any surface.
[ ] C. Wash gloved hands with soap and water before removal to reduce bioburden.
[ ] D. Snap gloves off forcefully to minimize contact time with contaminated material.
CORRECT: B. Perform hand hygiene immediately after removing gloves, before touching any
surface.
CDC hand hygiene guidelines require performing hand hygiene immediately after glove removal because
HIGHP - Page 4 of 32
Hygiene, Mobility, and Transfers - Indiana
University School of Nursing Curriculum
Reference - 2026/, Answers & Rationales
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
98 exam-style multiple-choice questions. Each question includes the correct answer and a complete rationale
for focused revision.
COVERAGE
This practice exam assesses foundational nursing psychomotor and clinical-reasoning competencies in
hygiene, mobility, patient positioning, safe transfers, range of motion, skin and pressure-injury prevention,
body mechanics, fall prevention, and infection control. Items require synthesis of evidence-based guidelines
(Potter & Perry 11th ed., CDC 2024, AHRQ) and application to complex patient scenarios aligned with QSEN
competencies.
STUDY GUIDE
Recommended duration: 75 minutes. Passing target: 80% (40/50 correct).
HIGHP - Page 1 of 32
,1. Which transfer technique best prevents caregiver injury when a patient is partially
weight-bearing?
[ ] A. Manual lift with the caregiver's arms extended and back flexed
[ ] B. Use of a mechanical lift or gait belt with the bed at waist height
[ ] C. Pulling the patient upward by the shoulders from the side of the bed
[ ] D. Twisting the torso while pivoting the patient to a chair
CORRECT: B. Use of a mechanical lift or gait belt with the bed at waist height
Using a mechanical lift or gait belt with the bed at waist height keeps the load close, avoids spinal flexion,
and follows AHRQ safe patient-handling principles. Manual lifting with a flexed back, pulling by the shoulders,
and twisting while pivoting all increase musculoskeletal strain and risk of caregiver and patient injury.
2. A patient with hemiplegia needs positioning to prevent shoulder subluxation. Which
intervention is most appropriate?
[ ] A. Place the affected arm in a dependent position over the bed edge
[ ] B. Support the affected arm on a pillow in a neutral or slightly flexed position
[ ] C. Bind the affected arm tightly across the chest with a restraint
[ ] D. Encourage the patient to sleep only on the affected side
CORRECT: B. Support the affected arm on a pillow in a neutral or slightly flexed position
Supporting the affected arm on a pillow in neutral or slight flexion prevents gravitational pull on the shoulder
joint capsule and reduces subluxation risk. Dependent positioning, tight binding (which risks restraint
complications and contracture), and exclusive affected-side sleeping do not protect the joint and may worsen
outcomes.
3. Which finding most urgently indicates a need to revise a patient's fall-prevention plan?
[ ] A. Patient uses a walker correctly after instruction
[ ] B. Patient's Morse Fall Scale score increased from 35 to 60
[ ] C. Patient requests assistance before ambulating
[ ] D. Patient's call light is within reach at all times
CORRECT: B. Patient's Morse Fall Scale score increased from 35 to 60
A rise in the Morse Fall Scale from 35 (low risk) to 60 (high risk) signals a significant change in fall risk
requiring immediate plan revision, such as increased supervision or bed alarms. Correct walker use,
requesting assistance, and call-light accessibility are protective behaviors that do not necessitate urgent
revision.
4. During a bed bath, which sequence best reduces the risk of cross-contamination?
[ ] A. Wash the perineal area first, then the face, then the extremities
[ ] B. Wash from cleanest to dirtiest: face, arms, trunk, legs, then perineum
HIGHP - Page 2 of 32
, [ ] C. Use the same washcloth for the entire bath without rinsing
[ ] D. Wash the perineum last but reuse the basin water for the face
CORRECT: B. Wash from cleanest to dirtiest: face, arms, trunk, legs, then perineum
Cleansing from cleanest to dirtiest areas (face, arms, trunk, legs, then perineum) prevents transfer of
microorganisms from contaminated to clean sites. Perineal-first, reusing washcloths without rinsing, and
reusing contaminated basin water for the face all promote cross-contamination.
5. Which intervention is most effective for preventing ventilator-associated pneumonia in
an immobile patient?
[ ] A. Maintain the head of bed at 10 degrees continuously
[ ] B. Elevate the head of bed to 30-45 degrees unless contraindicated
[ ] C. Perform oral care once every 24 hours
[ ] D. Suction the patient routinely every 2 hours regardless of need
CORRECT: B. Elevate the head of bed to 30-45 degrees unless contraindicated
Elevating the head of bed to 30-45 degrees reduces aspiration of oropharyngeal secretions and is a core VAP
prevention measure. A 10-degree elevation is insufficient, once-daily oral care is inadequate (should be every
4 hours per CDC), and routine suctioning without indication increases mucosal trauma and infection risk.
6. A patient performs active range of motion but reports sharp pain at the end range. What
is the nurse's best action?
[ ] A. Continue the motion forcefully to prevent contracture
[ ] B. Stop the exercise, assess the pain, and document findings
[ ] C. Apply heat and immediately resume the same motion
[ ] D. Administer an analgesic and complete the full range regardless
CORRECT: B. Stop the exercise, assess the pain, and document findings
Sharp pain at end range may indicate joint or tissue injury; the nurse should stop, assess, and document
before proceeding. Forcing the motion, immediately resuming after heat, or masking pain with analgesia to
complete full range can worsen injury and does not address the cause.
7. Which principle of body mechanics best reduces lumbar strain during patient
repositioning?
[ ] A. Keep the feet together and bend at the waist
[ ] B. Maintain a wide base of support and bend at the knees
[ ] C. Twist the torso while pulling the patient upward
[ ] D. Hold the patient away from the body to improve leverage
HIGHP - Page 3 of 32
, CORRECT: B. Maintain a wide base of support and bend at the knees
A wide base of support with knee bending lowers the center of gravity and uses leg muscles, reducing lumbar
strain. Feet together with waist bending, torso twisting, and holding the patient away from the body all
increase spinal load and injury risk.
8. Which action best prevents catheter-associated urinary tract infection during perineal
care?
[ ] A. Cleanse the catheter tubing from the drainage bag toward the meatus
[ ] B. Cleanse the meatus and catheter from the meatus outward and downward
[ ] C. Disconnect the catheter from the drainage bag for thorough cleaning
[ ] D. Use the same washcloth for the meatus and the anal area
CORRECT: B. Cleanse the meatus and catheter from the meatus outward and downward
Cleansing from the meatus outward and downward prevents microorganisms from the perianal area from
migrating to the urinary tract. Cleansing from the bag toward the meatus, disconnecting the closed system,
and reusing a washcloth across contaminated areas all increase CAUTI risk.
9. A patient with a sacral pressure injury has a hydrocolloid dressing. Which assessment
finding requires immediate provider notification?
[ ] A. Dressing is intact and adherent at the edges
[ ] B. Wound bed is moist and granulation tissue is present
[ ] C. Dressing has a foul odor and purulent drainage is leaking
[ ] D. Patient reports mild discomfort during dressing change
CORRECT: C. Dressing has a foul odor and purulent drainage is leaking
Foul odor with purulent drainage indicates infection, possibly deep tissue or systemic involvement, requiring
immediate provider notification and likely culture or antibiotic therapy. An intact dressing, healthy granulation,
and mild discomfort are expected findings that do not require urgent escalation.
10. Which action best prevents pathogen transmission when removing contaminated
gloves after perineal care?
[ ] A. Remove gloves after leaving the room to avoid contaminating the environment.
[ ] B. Perform hand hygiene immediately after removing gloves, before touching any surface.
[ ] C. Wash gloved hands with soap and water before removal to reduce bioburden.
[ ] D. Snap gloves off forcefully to minimize contact time with contaminated material.
CORRECT: B. Perform hand hygiene immediately after removing gloves, before touching any
surface.
CDC hand hygiene guidelines require performing hand hygiene immediately after glove removal because
HIGHP - Page 4 of 32
