Chapter 18: Safe Lifting, Moving, and Positioning of Patients Williams: deWit's Fundamental Concepts and Skills for Nursing, 5th Edition

1. The nurse uses professional knowledge about body mechanics to prevent the most common occupational disorder in nurses, which is: a. carpal tunnel syndrome from use of computer keyboards in nursing documentation. b. shoulder and elbow injuries from moving patients. c. knee injuries from standing for long periods. d. back injuries from lifting and twisting. 2. The nurse assisting a weak patient from a bed to the wheelchair to go to physical therapy would: a. seat the patient on the side of the bed with feet touching the floor. b. place hands under the patient’s elbows to assist in rising. c. lock knees as the patient is lowered to the chair. d. assist the patient to don a robe after being seated in the wheelchair. 3. A frail older patient is able to stand but not to ambulate. She has an order to be up in a wheelchair as desired during the day. A safe and appropriate way to assist her up to a chair is to: a. use a mechanical lift to transfer her from the bed to a chair. b. assist her to stand and pivot to a chair at right angles to the bed, using a transfer belt. c. have another staff member help lift her out of bed to the chair on the count of three. d. place a chair close to the bed and use a slide board to slide her into it. 4. The charge nurse on the night shift of a skilled nursing facility is orienting a new aide to the unit. The LPN’s most accurate information relative to moving patients is: a. “Most of your assigned patients are able to move about a little. Don’t wake them to change their positions in bed if they are sleeping.” b. “When you get Mrs. S up to the toilet, be sure to keep your feet together and your knees locked, or she will pull you over.” c. “Get one other aide to help and use the mechanical lift when you get Mr. A. out of bed in the morning. He is heavy and doesn’t assist at all.” d. “Use your back muscles to lift— that will strengthen them and make it easier for you to lift or move heavy patients.” 5. The patient for whom passive range of motion exercises would be most beneficial would be the: a. 66-year-old patient with loss of mobility related to a recent cerebrovascular accident (CVA). b. 72-year-old patient with chronic dementia who alternately sits in his wheelchair and wanders around the unit. c. 80-year-old patient with chronic lung disease who can breathe only when he is sitting in a tripod position. d. 94-year-old patient with increasing fatigue and weight loss who needs assistance to ambulate. 6. An emaciated semiconscious bed bound patient does not remain in a side lying position and repeatedly turns onto her back, where she is developing a pressure area over her sacrum. The nurse should add to the nursing care plan to: a. raise the knees to keep the patient from sliding down. b. position the patient on her side and use protective wrist and vest devices to keep her from turning onto her back. c. assist the patient to sit in a wheelchair for short periods before returning her to bed. d. place the patient on her stomach (prone position) using a small pillow below her diaphragm. 7. To place a patient in the Sims’ or lateral lying position, the nurse would initially: a. raise the head of the bed to a 45- or 60-degree angle. b. raise the bed to a waist high working level. c. bring the patient to the edge of the bed so that she will be centered when turned on her side. d. place a pillow behind the patient’s back to support her and prevent her from rolling onto her back. 8. To provide correct body alignment for a physically immobile patient in bed in the supine position, the nurse: a. uses trochanter rolls between the patient’s legs to prevent inward rotation. b. places a large pillow behind the patient’s head and neck to hyperflex the neck. c. raises the head and knees to maintain as much flexion of the hips and knees as possible. d. uses a footboard or places high top sneakers on the patient’s feet to maintain dorsiflexion. 9. A nurse and an assistant are preparing to get a patient out of bed for the first time after a week of bed rest. They begin by having the patient dangle on the edge of the bed. The nurse should: a. allow the patient to dangle for 10 to 15 minutes and then transfer her to a nearby chair. b. perform passive range of motion exercises on the patient’s arms and legs while she is dangling to improve circulation. c. assess the patient’s response to the changed position, looking for orthostatic hypotension, nausea, or dizziness before proceeding. d. dangle the patient only momentarily and then assist her to ambulate as far as she is able.