Test Bank for Mobility in Context : Principles of Patient Care Skills, 2nd Edition, Charity

Test Bank for Mobility in Context : Principles of

Patient Care Skills, 2nd Edition, Charity Johansson,
Susan A. Chinworth,

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Chapter 8: Transferring Dependent Patients: Safe Patient Handling and Mobility

Multiple Choice

1. Which of the following is most strongly related to injuries sustained when assisting patients?
A. The age and weight of the person completing the transfer
B. The diagnosis of the patient being transferred
C. The number of repetitions of the task completed by the person
D. Unexpected changes in the patient’s position during the transfer

ANS: C
Rationale: With proper equipment, the size of the person completing the transfer should not be the
primary issue. The patient’s diagnosis and unexpected changes in the patient’s position may increase the
risk of injury, but the number of times the person repeats the activity is more highly correlated with risk
of injury.

2. Which of the following maneuvers is considered to be the most physically stressful to the caregiver?
A. Repositioning a patient sideways in the bed
B. Transferring a patient from a bathtub to a chair
C. Repositioning a patient in a chair
D. Transferring a patient from chair to toilet

ANS: D
Rationale: Of the activities listed, the transfer from chair to toilet is the most stressful.

3. Which of the following patient situations is the best indication for a mechanical lift transfer?
A. The patient requires a level 3 transfer that does not involve a teaching component.
B. The patient requires level 0 transfer assistance and has lower-extremity weight-bearing restrictions.
C. The patient requires level 1 transfer assistance because of occasional loss of balance.
D. The patient requires level 1 transfer assistance and weighs more than 250 lbs.

ANS: A
Rationale: Mechanical lift transfers are better suited to dependent patient transfers (levels 3 and 4) than to
minimum assistance transfers. If an objective of the transfer is to teach the patient how to perform the
activity independently, a manual transfer is typically more appropriate. Mechanical lifts are not always
indicated for patients with weight-bearing restrictions, and weight alone does not determine the need for a
zero-lift transfer.

4. You are a therapist working in home health care. Your patient is a 23-year-old man who recently
sustained a spinal cord injury resulting in complete paralysis below the level of his upper chest. His
family is having significant difficulty transferring him between the bed and the chair. Which of the

Copyright © 2018 by F. A. Davis Company

following should you primarily consider when making recommendations to his family about transfer
methods?
A. The age of the persons assisting the patient with the transfer
B. The amount of help the patient requires for the transfer
C. The height of the surfaces involved in the transfers
D. The number of steps leading into the house

ANS: B
Rationale: The amount of assistance the patient requires to complete the transfer will be your primary
consideration. The ability of the person assisting with the transfer is important, but that cannot be
determined solely on the basis of the person’s age. The height of the surfaces can affect the choice of
assistance methods, but the patient’s abilities are more important. The number of steps leading into the
house does not affect the bed-to-chair transfers.

5. Your patient is a 47-year-old man with good upper-body strength and poor lower-extremity strength.
He weighs 385 lbs. and has just had surgery to repair a fractured left ankle. He also has a groin wound
that requires wound care. He is currently nonweight-bearing on the left lower extremity and needs to get
out of the bed for wound care. Which of the following is the most appropriate response regarding this
patient’s transfer?
A. Borrow a lift that is rated for 400 lbs. from the acute care unit and complete the transfer by yourself.
B. Defer the transfer because you do not have the appropriate equipment and do the wound care with the
patient remaining in the bed.
C. Use the lift you have in your department that has a weight limit of 350 lbs. and get an aide to help you.
D. Obtain the assistance of two or three other people and assist the patient in performing a lateral transfer
using a bariatric transfer board.

ANS: D
Rationale: Because this patient has good upper-body strength, he is likely to be able to participate in a
lateral transfer with the use of an appropriately rated transfer board without bearing weight on his left
lower extremity or relying on the strength of his right lower extremity. This method, which requires the
assistance of more than one person, is the only safe option that allows the patient to receive the necessary
wound care. The transfer should never be performed using equipment that is not rated for the patient’s
weight, and a transfer using a bariatric lift is best performed with at least two people.

6. Your patient is an 88-year-old man who underwent left total hip arthroplasty, posterior approach, 3
weeks ago because of severe joint degeneration. After his surgery he developed pneumonia. He is
recovering and does not have weight-bearing restrictions, but he continues to demonstrate generalized
weakness. You are going to transfer him from the bed to a bedside chair using a total body lift. Which of
the following is the best method for positioning the lift sling underneath him?
A. Ask the patient to use both legs to bridge the hips with assistance as necessary while you slide the sling
under him.
B. Ask the patient to lean forward into long-sitting and then place the sling behind his back.
C. Ask the patient to roll onto his left side, place the sling under his hips, and have him roll back into the
supine position.
D. Ask the patient to roll onto his right side, place the sling under his hips, and have him roll back into the
supine position.

Copyright © 2018 by F. A. Davis Company

ANS: A
Rationale: Leaning forward into long-sitting can result in excess hip flexion, a violation of one of the total
hip arthroplasty precautions. Similarly, sidelying is generally contraindicated for patients after total hip
arthroplasty. Lying on the left side places pressure on the patient’s surgical side, and lying on the right
side allows the left hip to move into adduction. Bridging is the best choice for positioning the sling under
this patient’s hips.

7. You have transferred a patient out of bed using a total body lift with a sling. You have positioned the
patient in a bedside chair and plan to return in 1 hr to assist the patient back into bed. Which of the
following choices is the best way to manage the sling upon the completion of this transfer?
A. Leave the sling under the patient, making sure to eliminate any wrinkles in the sling.
B. Place a sheet between the patient and the sling so you can keep the patient dry.
C. Place a sheet in the chair so you can use it to transfer the patient back into bed.
D. Remove the sling and replace it when you return to transfer the patient back into bed.

ANS: A
Rationale: Leaving the sling underneath the patient for 1 hour with the wrinkles smoothed out does not
create undue risk for the patient. Because it does not require additional effort to remove and then replace
the sling, this method poses the least risk to both the clinician and the patient. Placing a sheet between the
patient and sling adds effort to the task without any significant benefit. A sheet is a much riskier item to
use than a lift sling.

8. Which of the following is true of a sit-to-stand lift?

A. The sit-to-stand lift equipment does not include a foot plate.
B. The sling for the sit-to-stand lift supports only the upper body.
C. The sling for the sit-to-stand lift supports only the lower body.
D. The sling for the sit-to-stand lift is typically applied with the patient in a supine position.

ANS: B
Rationale: The sit-to-stand lift does include a foot plate. The sling supports only the upper body and is
typically applied when the patient is in a seated position.

9. Which of the following patients would be the best candidate for use of a sit-to-stand lift?
A. A 49-year-old man with multiple leg fractures and a full-leg cast
B. A 57-year-old woman who is able to comply with her right lower-extremity partial weight-bearing
restriction
C. A 62-year-old woman who has had a stroke and requires maximum assistance to maintain static sitting
balance
D. A 73-year-old man with severe dementia

ANS: B
Rationale: Patients with restricted weight-bearing on one lower extremity can use a standing lift as long as
they are able to comply with the restrictions. A full-leg cast would prevent the patient from achieving the
hip and knee flexion necessary for the standing lift. Good sitting balance and the ability to follow
instructions are required for this lift.

Copyright © 2018 by F. A. Davis Company

10. Which of the following is involved in the setup for a sit-to-stand lift transfer?
A. The anterior aspects of the patient’s lower legs are placed in contact with the leg pads.
B. The lower seam of the sling is placed at the patient’s gluteal fold.
C. The patient places both hands in his or her lap to avoid injury during the lift.
D. The patient’s knees are positioned in approximately 45° flexion.

ANS: A
Rationale: Contact between the patient’s lower legs and the leg pads is an essential aspect of lower-
extremity support during the standing process. The lower seam of the sling is placed at the patient’s waist,
not at the gluteal fold. The patient is generally instructed to grasp the handles of the lift with the hands
outside the sling, not to place the hands in the lap. A knee position of 90° is optimal for the transfer.

11. Your patient is a 48-year-old woman who fractured her pelvis when she fell off a porch. You have
been using a sit-to-stand lift to transfer her between the bed and the chair. You want to work with her on
standing tolerance. Which of the following would be your best option for accomplishing this goal?
A. Enlist the assistance of another clinician to help you block the patient’s knees while the patient
maintains a standing position for increasing lengths of time.
B. Have the patient sit at the edge of the bed and encourage her to push to standing while you block her
knees for stability.
C. Transfer her to standing in the sit-to-stand lift and work on standing tolerance in the device.
D. Wait until she can transfer out of bed independently and then work on standing tolerance with a
walker.

ANS: C
Rationale: A patient can perform therapeutic exercises, including the development of standing tolerance,
while standing in a sit-to-stand lift. This method requires no additional personnel. It also does not require
additional lifting and therefore poses less risk of injury to the patient and the clinician. Encouraging
standing from a seated position can be a valuable therapeutic exercise for achieving the goal of moving
from sitting to standing, but it does not contribute significantly to the development of standing balance.
Postponing the therapeutic intervention is not correct, as the goal is appropriate and should be pursued,
but safely.

12. Which of the following statements regarding the use of lateral transfer devices for supine patient
transfers is true?
A. During lateral transfers, the patient typically slides across the transfer device.
B. Most lateral transfer devices rely on pulling forces rather than on pushing forces.
C. Shearing on the skin is an unavoidable consequence of a dependent lateral transfer.
D. All lateral transfer devices require the assistance of four people.

ANS: B
Rationale: Most transfers rely on pulling rather than pushing. Typically the patient is placed on the
device, and, rather than moving the patient across the device, the device is moved across the surface. The
devices are designed to eliminate shearing forces on the skin during the transfer. The number of assistants
required for transfers varies.

Copyright © 2018 by F. A. Davis Company

13. You are performing a lateral transfer of your patient from the bed to a stretcher in the ICU. No one is
available to assist you with the transfer, but you do have an air cushion transfer device. Where should you
position yourself for the safest transfer once the device is in place?
A. At the foot of the device so that you can have maximum control of it
B. At the head of the device so you can protect the patient’s head
C. On the far side of the stretcher, positioned at the patient’s trunk
D. Beside the bed, positioned at the patient’s trunk

ANS: C
Rationale: Standing at the patient’s head or feet does not allow the clinician to control the majority of the
patient’s weight. Standing beside the bed would require the clinician to push the patient across it. Pulling
the patient from the far side of the stretcher and near the trunk is a more effective way to complete the
transfer.

14. Which of the following positions creates the greatest risk of injury to the clinician during a lateral
supine transfer requiring the assistance of two or more people?
A. Standing at the patient’s feet with nothing obstructing the lateral movement
B. Standing at the patient’s head with nothing obstructing the lateral movement
C. Standing beside the patient and leaning forward as the patient is moved laterally
D. Standing beside the patient and moving onto the transfer surface as the patient is moved laterally

ANS: C
Rationale: All these are possible positioning options during a multiperson assisted transfer, but flexing
forward as the patient is moved laterally places the greatest stress on the low back and therefore creates
the greatest risk of injury to the clinician.

15. When transferring a supine patient using a lateral transfer device, which of the following maneuvers
should always be avoided?
A. Lifting a patient with the device
B. Performing the transfer by yourself
C. Transferring between slightly uneven surfaces
D. Transferring patients heavier than 300 lbs.

ANS: A
Rationale: Lateral transfer devices are designed to facilitate lateral movement, not to lift the patient’s
body weight against gravity. Some lateral transfers can be performed by a single person, and lateral
transfer devices are especially useful when transferring a patient between slightly uneven surfaces. Many
devices are rated for patients weighing more than 300 lbs.

Copyright © 2018 by F. A. Davis Company

16. Which of the following lateral transfer devices is particularly well-suited for use with patients with
integumentary problems?
A. Air-assisted devices
B. Patient rollers
C. Semirigid transfer boards
D. Slippery sheets

ANS: A
Rationale: Of the devices listed, air-assisted devices are best suited for use with patients with
integumentary problems because the air layer greatly reduces friction and distributes the pressure over the
entire surface of the patient’s body. All other devices function with some kind of patient contact,
increasing the risk of injury to the skin.

17. Which of the following is appropriate when repositioning a patient who has slid down toward the foot
of the bed?
A. Lowering the overall height of the bed before repositioning the patient
B. Elevating the head of the bed 30° before repositioning the patient
C. Positioning yourself at the head of the bed, grasping the top edge of the drawsheet, and pulling the
patient up
D. Positioning yourself beside the bed in a semilunge stance

ANS: D
Rationale: The bed should be elevated to about the clinician’s waist level to minimize the necessary trunk
flexion during the activity. Elevating the head of the bed means the clinician will have the added task of
moving the patient upward against gravity. Having the head of the bed flat makes the repositioning
maneuver less difficult. The clinician should stand at the side of the bed, not at the head, and should enlist
the assistance of another person to reposition the patient. The semilunge stance is advised because it
allows weight-shifting from one leg to the other, minimizing the clinician’s need for trunk flexion and
rotation while repositioning the patient.

18. Which of the following items is generally not advised for repositioning of the seated patient?
A. Friction-reducing sheet
B. Sit-to-stand lift
C. Rigid transfer board
D. Total body lift

ANS: C
Rationale: Friction-reducing sheets, sit-to-stand lifts, and total body lifts are all routinely used to
reposition the seated patient. The rigid transfer board is not well-suited to this type of maneuver, because
it does not create any vertical movement, which is required to lift and shift the patient’s body weight. The
friction-reducing device, however, allows lateral movement without lifting.

Copyright © 2018 by F. A. Davis Company

19. You are about to transfer a patient who weighs 348 lbs. from the bed to a gurney. Which of the
following is the most appropriate method of transferring this patient?
A. Securing the assistance of one additional person and moving the patient laterally in one swift motion
B. Securing the assistance of two additional people and moving the patient laterally in one swift motion
C. Securing the assistance of two additional people and moving the patient laterally in a series of small
motions
D. Securing the assistance of three additional people and moving the patient in two motions

ANS: C
Rationale: This type of lateral transfer requires at least three people because of the patient’s weight. In
addition, heavier patients are generally easier to move in a series of smaller motions. If the transfer is
attempted in one movement, it is not likely to be successful, resulting in a less coordinated transfer.
Attempting to perform the transfer in two movements has the potential to leave the patient resting midway
across the gap between the two surfaces, the most vulnerable location in the transfer. Moving the patient
in multiple small moves allows the patient to feel more secure and the clinicians to reposition themselves
as the transfer progresses to avoid injury.

Short Answer

20. Describe the Trendelenburg position.

____________________.

ANS: When the bed is positioned with the foot of the bed higher than the head or with the head of the bed
lower than the foot of the bed

21. List three things you must consider when positioning a sling for a dependent transfer.
____________________

ANS: The area of the body the sling will support, where the seat edge of the sling fits on the body,
whether all wrinkles have been removed from the sling, the location of the leg straps, the position of the
overhead sling-bar, the diagnosis of the patient, and any associated precautions

22. ____________________ is the branch of medicine concerned with the management of obesity and
allied illnesses.

ANS: Bariatrics

Copyright © 2018 by F. A. Davis Company

Test Bank for Mobility in Context : Principles of Patient Care Skills, 2nd Edition, Charity

True/False

23. The use of friction-reducing devices to perform lateral patient transfers is recommended because it
eliminates the risk of injury to the clinician performing the transfer.

ANS: F
Rationale: This type of transfer does result in a lower load on the back, but the loading is still adequate to
result in injury to the therapist transferring the patient.

24. The most effective way to grip a drawsheet is with a pincher grip.

ANS: F
Rationale: A supinated, or underhand, grip is four times as powerful as a pinch grip.

Copyright © 2018 by F. A. Davis Company

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