HESI LPN-ADN EXAM MOBILITY FOCUS EXAM 200 ACTUAL
QUESTIONS AND CORRECT ANSWERS WITH RATIONALE
LATEST 2026 ALREADY GRADED A+
The HESI LPN-ADN Mobility Focus Exam is a specialized nursing
assessment testing safe patient handling, assistive devices, gait patterns, and
prevention of immobility complications . Key content includes correct use of
canes, walkers, and crutches with "up with the good, down with the bad"
principles . Students must recognize signs of compartment syndrome (pain,
paresthesia, pallor) and know hip precautions after arthroplasty to prevent
dislocation . The exam also covers deep vein thrombosis prevention
(anticoagulants, SCDs, early ambulation), pressure injury prevention
(repositioning every 2 hours), and proper body mechanics to protect both
patient and nurse from injury .
1. A nurse is preparing to ambulate a postoperative client 12 hours after cardiac
surgery. Based on Enhanced Recovery After Surgery (ERAS) principles, which
action should the nurse take FIRST to ensure the client tolerates the procedure?
A) Provide a standard walker and gait belt for safety
B) Disconnect the continuous telemetry monitor to prevent tripping
C) Administer the prescribed opioid-sparing analgesic 30 minutes prior to
ambulation
D) Instruct the client to perform deep breathing exercises during the walk
Answer: C
Rationale: Pain is the primary barrier to early mobilization after surgery. By pre-
medicating with analgesia approximately 30 minutes before activity, the nurse
manages incisional pain, reduces sympathetic stress, and optimizes the patient's
functional capacity to participate in ambulation.
2. A nurse is assisting a patient with left-sided weakness to transfer from the bed to
a wheelchair. Where should the nurse position the wheelchair?
A) Parallel to the bed on the patient's weak side
B) Parallel to the bed on the patient's strong side
C) At the foot of the bed
D) Facing away from the bed
Answer: B
,Rationale: Positioning the wheelchair on the strong side allows the patient to pivot
toward the stronger leg and push up with the stronger arm, making the transfer
safer and more stable.
3. A patient with right-sided hemiplegia following a cerebrovascular accident
requires transferring from bed to wheelchair. Based on biomechanical safety
standards, which placement of the wheelchair is most appropriate?
A) On the patient's left side (strong side), angled at 45 degrees to the bed
B) On the patient's right side, parallel to the bed
C) Directly facing the bed at the foot
D) Behind the patient near the head of the bed
Answer: A
Rationale: The wheelchair must be placed on the patient's unaffected (strong) side
to allow the patient to pivot toward the stronger leg. Angling the chair at 45
degrees reduces the degree of pivoting required and facilitates a safer transfer.
4. Which gait pattern is most appropriate for a patient with weakness in both legs
and poor coordination?
A) Two-point gait
B) Four-point gait
C) Swing-to gait
D) Three-point gait
Answer: B
Rationale: A four-point gait provides maximum stability because it keeps three
points of contact with the ground at all times. It is ideal for patients with bilateral
weakness or poor coordination, as it allows weight to be distributed across both
crutches and both legs in an alternating pattern.
5. A patient with a right below-knee amputation (BKA) is learning to use crutches.
Which gait should the nurse teach for weight bearing on the left leg only?
A) Two-point gait
B) Three-point gait
C) Four-point gait
D) Swing-to gait
Answer: B
Rationale: A three-point gait uses both crutches and the unaffected leg to bear
weight, with the affected leg lifted. This pattern is appropriate for a patient with a
right BKA who cannot bear weight on the right leg.
,6. When fitting a patient for axillary crutches, which finding indicates the crutches
are too long?
A) The patient's elbow is flexed 30 degrees when bearing weight on the hand grips
B) The patient's axillae are resting on the crutch pads
C) The patient can stand upright without slouching
D) The hand grips are at the level of the patient's wrists
Answer: B
Rationale: Axillae should never rest on the crutch pads, as this can cause nerve
compression and brachial plexus injury (crutch palsy). There should be 2-3 finger-
widths of space between the axilla and the crutch pad.
7. A patient is learning to climb stairs with crutches. Which instruction is correct?
A) "Up with the good, down with the bad"
B) "Up with the bad, down with the good"
C) Lead with crutches first going up
D) Lead with crutches first going down
Answer: A
Rationale: "Up with the good, down with the bad" — Going up, the good leg leads.
Going down, the bad leg leads with crutches. This mnemonic helps patients
remember the correct sequence for safety.
8. Which assistive device provides the greatest stability for a patient with lower
extremity weakness?
A) Single-point cane
B) Quad cane
C) Walker
D) Axillary crutches
Answer: C
Rationale: A walker provides the most support and stability because it offers the
broadest base of support. However, it requires upper body strength to use
effectively.
9. A patient with left-sided weakness is learning to use a cane. Which instruction is
most appropriate?
A) "Hold the cane in your left hand to support the weak knee."
B) "Move the cane and your right leg forward simultaneously."
C) "Hold the cane in your right hand and move it forward with your left leg."
D) "Step forward with your left leg first, then bring the cane forward."
Answer: C
, Rationale: The cane must be held on the unaffected (strong) side to widen the base
of support. The cane and the weak (affected) leg must advance simultaneously to
share the load and maintain a stable center of gravity.
10. A patient with a right total hip arthroplasty (posterior approach) is being taught
to transfer from the bed to a chair. Which action is contraindicated?
A) Using a raised toilet seat
B) Crossing the legs at the ankles
C) Leaning forward to grasp the armrests
D) Keeping the knees lower than the hips
Answer: B
Rationale: Crossing the legs at the knees or ankles can cause adduction and internal
rotation, which may dislocate a posterior hip prosthesis. The patient should avoid
crossing legs and should keep the knees apart (abduction).
11. To prevent foot drop (plantar flexion contracture) in a patient on strict bed rest,
the nurse should:
A) Place a pillow under the knees
B) Apply a footboard or high-top sneakers
C) Remove all bedding from the feet
D) Perform range of motion once a week
Answer: B
Rationale: Footboards or high-top sneakers maintain dorsiflexion, preventing foot
drop. Pillows under the knees increase the risk of flexion contracture.
12. Trochanter rolls are used to:
A) Prevent foot drop
B) Prevent external rotation of the hips
C) Maintain hand in functional position
D) Support the lumbar curve
Answer: B
Rationale: Trochanter rolls (rolled towels placed along the outer thighs) prevent
external rotation of the hips when the patient is supine.
13. To prevent pressure injuries in an immobile patient, how often should the nurse
reposition the patient?
A) Every 1 hour
B) Every 2 hours
C) Every 4 hours
D) Only when the patient complains of discomfort
QUESTIONS AND CORRECT ANSWERS WITH RATIONALE
LATEST 2026 ALREADY GRADED A+
The HESI LPN-ADN Mobility Focus Exam is a specialized nursing
assessment testing safe patient handling, assistive devices, gait patterns, and
prevention of immobility complications . Key content includes correct use of
canes, walkers, and crutches with "up with the good, down with the bad"
principles . Students must recognize signs of compartment syndrome (pain,
paresthesia, pallor) and know hip precautions after arthroplasty to prevent
dislocation . The exam also covers deep vein thrombosis prevention
(anticoagulants, SCDs, early ambulation), pressure injury prevention
(repositioning every 2 hours), and proper body mechanics to protect both
patient and nurse from injury .
1. A nurse is preparing to ambulate a postoperative client 12 hours after cardiac
surgery. Based on Enhanced Recovery After Surgery (ERAS) principles, which
action should the nurse take FIRST to ensure the client tolerates the procedure?
A) Provide a standard walker and gait belt for safety
B) Disconnect the continuous telemetry monitor to prevent tripping
C) Administer the prescribed opioid-sparing analgesic 30 minutes prior to
ambulation
D) Instruct the client to perform deep breathing exercises during the walk
Answer: C
Rationale: Pain is the primary barrier to early mobilization after surgery. By pre-
medicating with analgesia approximately 30 minutes before activity, the nurse
manages incisional pain, reduces sympathetic stress, and optimizes the patient's
functional capacity to participate in ambulation.
2. A nurse is assisting a patient with left-sided weakness to transfer from the bed to
a wheelchair. Where should the nurse position the wheelchair?
A) Parallel to the bed on the patient's weak side
B) Parallel to the bed on the patient's strong side
C) At the foot of the bed
D) Facing away from the bed
Answer: B
,Rationale: Positioning the wheelchair on the strong side allows the patient to pivot
toward the stronger leg and push up with the stronger arm, making the transfer
safer and more stable.
3. A patient with right-sided hemiplegia following a cerebrovascular accident
requires transferring from bed to wheelchair. Based on biomechanical safety
standards, which placement of the wheelchair is most appropriate?
A) On the patient's left side (strong side), angled at 45 degrees to the bed
B) On the patient's right side, parallel to the bed
C) Directly facing the bed at the foot
D) Behind the patient near the head of the bed
Answer: A
Rationale: The wheelchair must be placed on the patient's unaffected (strong) side
to allow the patient to pivot toward the stronger leg. Angling the chair at 45
degrees reduces the degree of pivoting required and facilitates a safer transfer.
4. Which gait pattern is most appropriate for a patient with weakness in both legs
and poor coordination?
A) Two-point gait
B) Four-point gait
C) Swing-to gait
D) Three-point gait
Answer: B
Rationale: A four-point gait provides maximum stability because it keeps three
points of contact with the ground at all times. It is ideal for patients with bilateral
weakness or poor coordination, as it allows weight to be distributed across both
crutches and both legs in an alternating pattern.
5. A patient with a right below-knee amputation (BKA) is learning to use crutches.
Which gait should the nurse teach for weight bearing on the left leg only?
A) Two-point gait
B) Three-point gait
C) Four-point gait
D) Swing-to gait
Answer: B
Rationale: A three-point gait uses both crutches and the unaffected leg to bear
weight, with the affected leg lifted. This pattern is appropriate for a patient with a
right BKA who cannot bear weight on the right leg.
,6. When fitting a patient for axillary crutches, which finding indicates the crutches
are too long?
A) The patient's elbow is flexed 30 degrees when bearing weight on the hand grips
B) The patient's axillae are resting on the crutch pads
C) The patient can stand upright without slouching
D) The hand grips are at the level of the patient's wrists
Answer: B
Rationale: Axillae should never rest on the crutch pads, as this can cause nerve
compression and brachial plexus injury (crutch palsy). There should be 2-3 finger-
widths of space between the axilla and the crutch pad.
7. A patient is learning to climb stairs with crutches. Which instruction is correct?
A) "Up with the good, down with the bad"
B) "Up with the bad, down with the good"
C) Lead with crutches first going up
D) Lead with crutches first going down
Answer: A
Rationale: "Up with the good, down with the bad" — Going up, the good leg leads.
Going down, the bad leg leads with crutches. This mnemonic helps patients
remember the correct sequence for safety.
8. Which assistive device provides the greatest stability for a patient with lower
extremity weakness?
A) Single-point cane
B) Quad cane
C) Walker
D) Axillary crutches
Answer: C
Rationale: A walker provides the most support and stability because it offers the
broadest base of support. However, it requires upper body strength to use
effectively.
9. A patient with left-sided weakness is learning to use a cane. Which instruction is
most appropriate?
A) "Hold the cane in your left hand to support the weak knee."
B) "Move the cane and your right leg forward simultaneously."
C) "Hold the cane in your right hand and move it forward with your left leg."
D) "Step forward with your left leg first, then bring the cane forward."
Answer: C
, Rationale: The cane must be held on the unaffected (strong) side to widen the base
of support. The cane and the weak (affected) leg must advance simultaneously to
share the load and maintain a stable center of gravity.
10. A patient with a right total hip arthroplasty (posterior approach) is being taught
to transfer from the bed to a chair. Which action is contraindicated?
A) Using a raised toilet seat
B) Crossing the legs at the ankles
C) Leaning forward to grasp the armrests
D) Keeping the knees lower than the hips
Answer: B
Rationale: Crossing the legs at the knees or ankles can cause adduction and internal
rotation, which may dislocate a posterior hip prosthesis. The patient should avoid
crossing legs and should keep the knees apart (abduction).
11. To prevent foot drop (plantar flexion contracture) in a patient on strict bed rest,
the nurse should:
A) Place a pillow under the knees
B) Apply a footboard or high-top sneakers
C) Remove all bedding from the feet
D) Perform range of motion once a week
Answer: B
Rationale: Footboards or high-top sneakers maintain dorsiflexion, preventing foot
drop. Pillows under the knees increase the risk of flexion contracture.
12. Trochanter rolls are used to:
A) Prevent foot drop
B) Prevent external rotation of the hips
C) Maintain hand in functional position
D) Support the lumbar curve
Answer: B
Rationale: Trochanter rolls (rolled towels placed along the outer thighs) prevent
external rotation of the hips when the patient is supine.
13. To prevent pressure injuries in an immobile patient, how often should the nurse
reposition the patient?
A) Every 1 hour
B) Every 2 hours
C) Every 4 hours
D) Only when the patient complains of discomfort
