Question 1

Which situation(s) contributes to a person's inability to reposition without help? Select all that apply.

Accepted Answer

Some clients or residents may not be able to reposition themselves easily without the nursing assistant's help. Weakness, pain, disability, and coma (a state of unconsciousness) are all reasons why a person might need help with repositioning. Fever and nausea are less likely to affect a person's ability to move.

Question 2

The nursing assistant is caring for a client on bedrest. Which observation should the nursing assistant report to the nurse immediately? The client:

Accepted Answer

One of the worst complications of immobility is pressure ulcers. Pressure ulcers, also known as decubitus ulcers or bed sores, form when bony areas press against the mattress. The nursing assistant should report to the nurse immediately that the client has a newly developed reddened area on the coccyx that does not go away because the client is developing a pressure ulcer and will need interventions from the nurse before it gets worse. The other observations can wait until end of shift report.

Question 3

Which statement(s) is true regarding the complications of immobility? Select all that apply.

Accepted Answer

Pressure ulcers are a common complication of immobility. Contractures occur when a joint is held in the same position for too long a time. Contractures cause stiffness and shortening of the tendons, leading to loss of motion of the joint that may be permanent. Other complications of immobility can include decreased filling of the lungs (which can lead to pneumonia) and the formation of blood clots (hot, reddened, painful areas) in the lower legs (which can lead to embolism).

Question 4

The nursing assistant is caring for a client diagnosed with a stroke with right-sided paralysis (cannot move right side). While repositioning the client to their left side, what is the best action to take?

Accepted Answer

Supportive devices, such as pillows; rolled sheets, towels, or blankets; and devices designed specifically for the purpose of offering support, are used to help keep a person in proper body alignment. The nursing assistant is turning the client to their left side and the right side of the body needs support with pillows and a hand roll for the right hand. The ride side of the body is paralyzed and needs the supports to maintain correct body alignment and decrease stress on the joints. The nursing assistant should place a rolled sheet under the client to help the client to stay on their left side during the positioning in this scenario.

Question 5

The nursing assistant is helping the client with discomfort in their abdomen after surgery to a comfortable position to decrease strain on their abdominal muscles. What is the best position for the nursing assistant to use?

Accepted Answer

The nursing assistant should use the supine position with legs elevated on pillows to decrease strain on the abdominal muscles. The other positions would increase the strain on the abdominal muscles.

Question 6

The nursing assistant is caring for a resident with a diagnosis of chronic lung disease experiencing pain with a pressure ulcer on their coccyx. What is the best position for the nursing assistant place the resident to promote comfort?

Accepted Answer

The resident has both a chronic lung condition that may restrict lung expansion and a painful pressure ulcer on the coccyx (tail bone). The best position to help the resident with both conditions is the Sims position with the head of the bed elevated for the resident's comfort. High Fowlers will help with breathing but increase pressure on the painful skin breakdown and could increase the damage to that area. Prone position would decrease pressure on the painful ulcer but drastically limit chest expansion, making it difficult for the resident to breathe. Dorsal recumbent or supine position is lying flat and increases the pressure on the ulceration of the skin and decreases chest expansion.

Question 7

In what position would a nursing assistant place a resident who needs assistance with eating?

Accepted Answer

The high Fowlers position is useful when a person is eating a meal in bed and during grooming procedures. The semi-Fowlers position is comfortable for people who are resting in bed and want to read or watch television, or during tube feedings. Nursing assistants use the lateral position for people who are resting in bed and want to read, watch television, or talk with visitors. Prone is face down and supine is flat on the back; both are impractical and unsafe for eating.

Question 8

The nursing assistant is caring for an unconscious client who needs to be repositioned. Which means of moving a resident best helps minimize the risk of shearing and friction?

Accepted Answer

The best choice to reduce the risk of shearing and friction is to use the lift sheet and assist of two to help reposition the client in bed. Pulling, pushing, or dragging a person who needs to be moved causes friction and shearing of the skin as it comes into contact with the surface.

Question 9

The logrolling procedure involves positioning the person:

Accepted Answer

Logrolling involves moving a person in one fluid motion so that the head, torso, and legs move as one unit and the body is kept in alignment. Feet flat on the floor describe the sitting position. The flexing of the knee describes the Sims position. Using a gait belt describes proper technique for transferring.

Question 10

When assisting a non-weight-bearing person with transferring, the nursing assistant will:

Accepted Answer

Dangling allows time for the heart and blood vessels to make up for the change in position. Blood flow is sent to the head, reducing the person's risk of falling due to dizziness or loss of consciousness. A transfer belt is only an assist device and should never be used to "lift" a person who is unable to bear weight. Allowing a resident to use the nursing assistant's neck for support is likely to cause the nursing assistant a neck injury. A gait belt should be used when a resident who needs support is ambulating.

Question 11

Before helping a person to transfer from the bed to stretcher, the nursing assistant will:

Accepted Answer

Ideally, the nursing assistant should plan the transfer before helping a person to transfer. The nursing assistant might also need the help of colleagues during the transfer procedure. A doctor's permission is not usually required to transfer a resident. The bed should be in its highest position; side rails are down only if the nursing assistant is at the bedside performing the transfer. The resident's need for assistance should be known before the transfer is attempted.

Question 12

When a person has been lying in bed for a long time, they may experience what condition when suddenly standing up?

Accepted Answer

When a person has been resting in bed, especially for a long time, sitting up and then standing causes blood to flow to the legs and away from the head. This can lead to dizziness and fainting. The other options are necessarily related to periods of immobility and the resulting cardiac reactions.

Question 13

The nursing assistant is caring for a client who needs to be transferred from the bed to the chair using a transfer belt. What step should the nursing assistant modify to prepare the transfer belt correctly?

Accepted Answer

A transfer belt is applied around the person's waist, over the clothing, so this is the step that the nursing assistant needs to modify to help prevent friction and shear of the client's skin. Before tightening the belt, it is turned so that the buckle is off-center in the front, or to the side. The belt should be snug, but the nursing assistant should be able to slip their fingers between the belt and the person's waist.

Question 14

When assisting a person to walk, the nursing assistant will grasp the transfer belt:

Accepted Answer

When assisting a person to walk, the nursing assistant should grasp the transfer belt with an underhand grasp to provide the best support and stability.

Question 15

The nursing assistant is helping a resident with mild left-sided weakness to ambulate in the hall. What is the best method for the nursing assistant to use?

Accepted Answer

When helping a person to walk, the nursing assistant should grasp the transfer belt with an underhand grasp to provide the best support and stability. The nursing assistant should walk on the resident's weaker side slightly behind on the left side. The resident should use the handrail in the hall on their strong side, or right side. The transfer belt should be snug with a few fingers space between the transfer belt and the waist.

Question 16

Which procedure should be followed when using a mechanical lift?

Accepted Answer

Spreading the legs of the lift provides a solid base of support to the lift and helps to prevent accidents. The nursing assistant needs to raise the lift until the person and the sling are clear of the bed. Similarly, the assistant also needs to raise the lift so that it can be positioned over the person. Finally, the nursing assistant attaches the sling to the swivel bar with the short side attached to the top of the sling and the long side attached to the bottom of the sling.

Question 17

The nursing assistant will best prepare a resident for a transfer by:

Accepted Answer

Remember that a person who needs help during a transfer may feel weak and frightened. Always explain the transfer procedure to the person and allow the person to assist as much as possible. The nursing assistant should never make a promise that is not completely possible to keep. The procedure is safe when done appropriately, but accidents can happen even when done by experienced nursing assistants.

Question 18

Proper body alignment is most important to the resident experiencing problems with breathing because it:

Accepted Answer

Proper body alignment promotes lung function by allowing for proper expansion of the chest; this is especially important to a person experiencing problems breathing. The other options are correct, but not related as closely to breathing.

Question 19

Two nursing assistants need to move the resident up in bed and observe that the lift sheet was crumpled underneath the lower part of the resident's buttocks. What action should the nursing assistants take next to prevent shearing?

Accepted Answer

Shearing is the force created when something or someone is pulled across a surface that offers resistance. The nursing assistants should first roll the resident side to side until the lift sheet is in its correct place. Pulling the lift sheet out from underneath the resident would result in sheering. The lift sheet needs to be in its correct place before it may be used. Placing a pillow to pad the headboard prevents from accidently hitting the resident's head when moving the resident up in bed but does not prevent shearing.

Question 20

The risk for complications of immobility can best be decreased by:

Accepted Answer

The person is at risk for developing serious complications, including pressure ulcers, contractures, pneumonia, and blood clots. The nursing assistant can help prevent clients and residents from developing complications of immobility by assisting them with repositioning every 2 hours or according to the care plan. The other options are helpful but will not help prevent complications as much as repositioning.

Quiz 17: Assisting With Repositioning and Transferring