Safe patient handling

When preparing to delegate the application of an SCD to assistive personnel, the nurse must first: 1. Have the personnel demonstrate the proper application of the SCD. 2. Review the steps for the proper application of the SCD with the personnel. 3. Determine the need for the application of the SCD for this particular patient. 4. Evaluate the personnel's ability to recognize the early signs of impaired circulation.

2. Review the steps for the proper application of the SCD with the personnel.

The nurse is preparing to delegate the transfer of a client from bed to a stretcher for transport to the physical therapy (PT) department to assistive personnel. Which of the following statements by the assistive personnel requires follow-up by the nurse? 1. "I'll use gloves for the transfer if the bed sheets have been soiled." 2. "She said her daughter was going to PT with her. I'll see if she's here." 3. "I noticed some red areas on her back, so I'll be extra careful to position her on her side." 4. "The PT department is chilly, I'll be sure to send an extra blanket with the client."

1. "I'll use gloves for the transfer if the bed sheets have been soiled."

Which of the following instructions provided by the nurse to ancillary staff assigned the responsibility of bathing a patient who has been prescribed elastic stockings is most likely to ensure the continued skin integrity of the patient's legs? 1. "Please let me know when the stockings are off so I can look at her legs." 2. "Be sure to tell me if you see any redness, dryness, or cracking on her legs." 3. "Turning the foot of the stockings inside out will make putting them on easier." 4. "Remember to apply a little powder to her legs before reapplying the stockings."

1. "Please let me know when the stockings are off so I can look at her legs."

The assistive personnel may be delegated the task of transferring a patient from bed to a stretcher. Which of the following patient's transfers should the nurse delegate to assistive personnel? 1. 92-year-old hospice patient who is being transferred to a skill nursing unit 2. 35-year-old patient who has been on bedrest for 15 days as a result of a neck injury 3. 26-year-old patient who experienced a closed-head injury resulting from a fall 3 days ago 4. 63-year-old patient who will be transferred for the first time since knee replacement surgery

1. 92-year-old hospice patient who is being transferred to a skill nursing unit

When preparing to safely transfer a patient using a hydraulic lift, the nurse should first: 1. Assess the patient for IV or catheter tubing. 2. Arrange for the appropriate number of staff to assist. 3. Inquire as to whether the patient agrees to the intervention. 4. Arrange for the equipment to be available at the agreed upon time.

1. Assess the patient for IV or catheter tubing.

When initially preparing to apply elastic stockings, the nurse must first: 1. Measure the patient's legs. 2. Select the appropriate size stockings. 3. Determining the patient's sensitivity to talcum powder. 4. Place the patient in a comfortable sitting position in the bed.

1. Measure the patient's legs.

The nurse knows that the primary objective for the application of a gait belt on a patient who is unstable when ambulating is to: 1. Minimize the risk of falls. 2. Reduce the weight-bearing load. 3. Provide a sense of physical security. 4. Aid in the support of lower extremities

1. Minimize the risk of falls.

The nurse is preparing to initiate ambulation for a patient who has been on bedrest for several weeks. To minimize the risk of the patient experiencing dizziness, the nurse first: 1. Raises the head of the patient's bed to 90 degrees. 2. Assists the patient into a sitting position on the side of the bed. 3. Asks the patient if he has felt dizzy when moving in the bed. 4. Assesses the patient's blood pressure before attempting to ambulate.

1. Raises the head of the patient's bed to 90 degrees.

When preparing to safely perform passive range-of-motion exercises, the nurse should first: 1. Review the physician's order prescribing the intervention. 2. Inquire as to whether the patient agrees to the intervention. 3. Agree upon a time for the performance of the intervention. 4. Examine the joints for inflammation, edema, or skin breakdown.

1. Review the physician's order prescribing the intervention.

The nurse is ambulating a patient with a gait belt. Which of the following events warrants returning the patient to bed immediately? 1. She complains of "feeling nauseous." 2. Her son arrives for a much awaited visit. 3. She states, "I don't want to get too tired." 4. The hospital chaplain responds to a referral.

1. She complains of "feeling nauseous."

The nurse has applied a gait belt to a post-operative patient to facilitate ambulation. Within a few feet of his bed the patient begins to complain of dizziness and leans heavily on the nurse. The nurse's initial response is to: 1. Use the gait belt to help slowly lower the patient to the floor. 2. Attempt to sit the patient down on a chair just a few steps away. 3. Ask the patient's roommate to use her call bell to alert additional staff. 4. Inform the staff that help is needed by calling out in a loud but calm voice

1. Use the gait belt to help slowly lower the patient to the floor.

A comatose patient who weighs 201 pounds requires repositioning in the bed. Which of the following actions is most likely to ensure that the client and staff will be safe during the move? 1. Accomplish the move in two or three small moves instead of one big move. 2. Place a repositioning aid (such as a lift sheet) from his shoulders to his thighs. 3. Enlist the help of two assistants since the patient weighs more than 200 pounds. 4. Assume a wide stance with the foot closest to the head of the bed behind the other

2. Place a repositioning aid (such as a lift sheet) from his shoulders to his thighs.

The nurse is preparing to delegate the ambulation of a patient with the use of a gait belt to assistive personnel. Which of the following statements by the assistive personnel requires follow-up by the nurse? 1. "I will be sure to put non-skid slippers on the patient before getting him up to ambulate." 2. "I use the under-axilla technique to get him up and then use the gait belt to walk him." 3. "Rocking the heavier patient into a standing position seems to work really well for me." 4. "The patient has a weak left side from a stroke. I'll position myself on that side for more support."

2. "I use the under-axilla technique to get him up and then use the gait belt to walk him."

Which of the following statements made by ancillary staff assigned to apply the elastic stockings of an elderly patient shows the best understanding of the importance of communicating the patient's reactions to the intervention with the nurse? 1. "She doesn't like the fact that she has to wear the stockings." 2. "She tells me that her legs are itching and there is a slight red rash." 3. "I asked her family to bring in a clean pair of stocking she has at home." 4. "Please explain to the patient why I can't remove the stockings all the time."

2. "She tells me that her legs are itching and there is a slight red rash."

When preparing to move or position a patient, the nurse should first: 1. Assemble adequate help to facilitate the change. 2. Assess the patient's ability to assist with the change. 3. Determine the effect of the patient's weight on the change. 4. Decide upon the most effective method to facilitate the change

2. Assess the patient's ability to assist with the change.

The nurse has applied an SCD to a postoperative patient. The most appropriate way for the nurse to determine proper fit is to: 1. Ask the patient if the device is causing him any pain. 2. Be able to slip two fingers between the patient's leg and the device. 3. Follow the manufacture's instruction for the application of the device. 4. Ask another nurse to check the patient for proper application of the device

2. Be able to slip two fingers between the patient's leg and the device.

Which of the following actions should have priority to best ensure that the patient will not fall while being transferred to the chair using a transfer belt? 1. Place skid-resistant shoes or slippers on the patient's feet. 2. Have the patient sit on the side of the bed with legs dangling for several minutes. 3. Apply the transfer belt snugly over outer clothing while not impairing breathing. 4. Position the chair so that the move will be toward the patient's stronger side.

2. Have the patient sit on the side of the bed with legs dangling for several minutes.

The nurse knows that the primary reason for the application of a sequential compression device (SCD) on the legs of an immobile patient is to: 1. Stimulate circulation in the deep arterial vascular system. 2. Help prevent the formation of deep vein thrombosis (DVT). 3. Aid in peripheral circulation to minimize the risk of skin breakdown. 4. Assist in passive range-of-motion exercises of the patient's lower extremities

2. Help prevent the formation of deep vein thrombosis (DVT).

The nurse is preparing to transfer a patient from her bed to a stretcher for transport to radiology for testing. The nurse realizes that a primary concern regarding patient safety is to: 1. Assess the patient's ability to actively participate in the actual transfer. 2. Minimize the risk of falls or other injury during the transfer procedure. 3. Assure the patient that the transfer will cause her as little pain as possible. 4. Reassure the patient that she will be safely transported to the radiology department.

2. Minimize the risk of falls or other injury during the transfer procedure.

The nurse can best determine the effect of elastic stockings on the patient's peripheral vascular circulation by assessing: 1. For pain or numbness in the legs when the stockings are on. 2. Pedal pulses before, during, and after application of the stockings. 3. The skin color of the legs immediately after removing the stockings. 4. The skin temperature of the legs frequently while the stockings are on.

2. Pedal pulses before, during, and after application of the stockings.

. Which of the following statements made by ancillary staff assigned to position an immobile patient reflects the best understanding of the importance of appropriately communicating with the nurse regarding this intervention? 1. "I'll let you know if I need your help with her positioning." 2. "Do you think she will be ready to be positioned before lunch?" 3."I noticed a small reddened area on her left hip when I turned her." 4. "Do you think I should use the mechanical lift when moving her?"

3. "I noticed a small reddened area on her left hip when I turned her."

It has been determined that a patient is capable of assisting with her own repositioning toward the head of the bed. Which of the following statements made by the nurse will be most effective in instructing the patient on how to best facilitate the move? 1. "When I count to 3, please push off with your feet." 2. "Please help by folding your arms across your chest." 3. "Please bend your knees so your feet are flat on the bed." 4. "Please let me know how I can best help you with this move."

3. "Please bend your knees so your feet are flat on the bed."

Which of the following statements made by the nurse will be most effective in instructing ancillary staff assigned the transfer of a patient using a hydraulic lift on how to best perform this intervention? 1. "Let me know if you need my help with the transfer." 2. "This patient can become agitated when she's anxious" 3. "Remember to position the horseshoe under the bed with its legs wide open." 4. "Be sure to put the wheelchair near the bed, but leave space to maneuver the lift."

3. "Remember to position the horseshoe under the bed with its legs wide open."

Which of the following statements made by ancillary staff assigned with the responsibility of performing range-of-motion exercises on an older adult patient reflects the best understanding of the importance of appropriately communicating with the nurse regarding this intervention? 1. "I'll let you know if I need your help with exercising her." 2. "Do you think I can wait until I bathe her to do the exercises?" 3. "She complained of a little pain when I flexed her chin toward her chest." 4. "Do you think that repeating the exercise on each joint five times is sufficient?"

3. "She complained of a little pain when I flexed her chin toward her chest."

Which of the following statements made by the nurse will be most effective in instructing ancillary staff in the most effective means of minimizing patient discomfort when applying elastic stockings? 1. "Please be sure that you smooth out any wrinkles in the stockings." 2. "It's easier to put them on if you turn them inside out up to the heels." 3. "She isn't allergic, so apply a little powder to the legs and feet before you start." 4. "There is a clean pair of stockings in her bedside stand; her family brought them."

3. "She isn't allergic, so apply a little powder to the legs and feet before you start."

Which of the following patient transfers using a hydraulic lift should not be assigned to ancillary staff without supervision by a nurse? 1. 47-year-old patient in the terminal stage of renal failure 2. 66-year-old comatose patient with a history of seizures 3. 26-year-old patient on the first day post-op for reduction of a fractured femur 4. 76-year-old hospice patient diagnosed with lung cancer and dementia

3. 26-year-old patient on the first day post-op for reduction of a fractured femur

Which of the following patient transfers should not be assigned to ancillary staff without supervision by a registered nurse? 1. 66-year-old patient receiving cancer radiation treatments 2. 47-year-old patient in the terminal stage of renal failure 3. 26-year-old patient who is 8 hours post- cesarean section 4. 76-year-old patient who has an intravenous fluid line in place

3. 26-year-old patient who is 8 hours post- cesarean section

Passive range-of-motion on which of the following clients should not be assigned to ancillary staff? 1. 47-year-old patient in the terminal stage of renal failure 2. 66-year-old comatose patient with a history of seizures 3. 26-year-old patient with multiple fractures resulting from a fall 4. 76-year-old hospice patient diagnosed with lung cancer

3. 26-year-old patient with multiple fractures resulting from a fall

Which of the following patients should not be assigned to ancillary staff for repositioning in bed? 1. A 66-year-old patient who is 2 days postcholecystectomy. 2. A 47-year-old patient in the terminal stage of lung cancer. 3. A 16-year-old patient with a concussion resulting from a bicycle accident. 4. A 76-year-old patient who has a Foley catheter and an intravenous fluid line.

3. A 16-year-old patient with a concussion resulting from a bicycle accident.

When preparing to delegate the transfer of a client from bed to stretcher to assistive personnel, the nurse must first: 1. Observe the assistive personnel while making the transfer. 2. Determine the most appropriate time for the assistive personnel to transfer the client. 3. Assess the assistive personnel's understanding of the proper technique for this task. 4. Inform the assistive personnel of any restrictions the patient may have regarding the transfer.

3. Assess the assistive personnel's understanding of the proper technique for this task.

When preparing to safely transfer a patient from a bed to a wheelchair, the nurse should first: 1. Determine the patient's arm strength. 2. Assess the patient's weight-bearing ability. 3. Assess the patient's willingness to cooperate. 4. Decide upon the most appropriate transfer method.

3. Assess the patient's willingness to cooperate.

The nurse is preparing to apply an SCD to the legs of a postoperative patient. The nurse realizes that which of the following assessment observations would contraindicate the application of these devices? 1. Low-grade fever 2. Prescribed anticoagulant 3. Dermatitis on patient's legs 4. Presence of elastic stockings

3. Dermatitis on patient's legs

The nurse realizes that precautions should be taken in order to minimize the risk of injury to those involved in the transfer. Which of the following apply? 1. Medicate the uncooperative patient before attempting the transfer. 2. Encourage the patient to help with the transfer as such as possible. 3. Have enough available staff members to assist with the patient transfer. 4. Transfer the patient when he or she is most willing to cooperate with staff.

3. Have enough available staff members to assist with the patient transfer.

Which of the following actions should have priority in order to best ensure that the patient will not experience unnecessary pain during a transfer facilitated with a hydraulic lift? 1. Stop the intervention if the patient expresses or displays physical signs of pain. 2. Explain the intervention to the patient before starting the transfer process. 3. Provide the patient with a dose of prescribed analgesic 30 minutes before the intervention if needed. 4. Postpone the intervention if the patient reports the presence of physical pain or anxiety at the time of the transfer.

3. Provide the patient with a dose of prescribed analgesic 30 minutes before the intervention if needed.

Which of the following actions should have priority to best ensure that the patient will not experience unnecessary pain during passive range-of-motion exercises? 1. Stop the intervention if the patient expresses or displays physical signs of pain. 2. Be careful to support each joints as it is moved slowly through its range of motion. 3. Provide the patient with a dose of prescribed analgesic 30 minutes before the intervention if needed. 4. Postpone the intervention if the joints appear inflamed or edematous, or if the skin is bruised or broken.

3. Provide the patient with a dose of prescribed analgesic 30 minutes before the intervention if needed.

The nurse is preparing to delegate the application of an SCD to assistive personnel. Which of the following statements by the assistive personnel requires follow-up by the nurse? 1. "I will check the tubing frequently for kinking or bending." 2. "I will remove the SCD before ambulating the patient." 3. "I will tell you if I see any signs of itching, redness, or irritation on the patient's legs." 4. "I will measure the patient's legs to determine what size of SCD to apply."

4. "I will measure the patient's legs to determine what size of SCD to apply."

Which of the following statements made by the nurse will be most effective in instructing ancillary staff assigned passive range-of-motion exercises on a patient on how to best perform this intervention? 1. "Let me know if you need my help." 2. "Stop if the patient complains of pain." 3. "Be aware that the patient has moderate arthritis in her wrists and fingers bilaterally." 4. "Please be sure to support each joint as you slowly put it through its range of motion."

4. "Please be sure to support each joint as you slowly put it through its range of motion."

It has been determined that a patient is capable and willing to assist with her own transfer from the bed to the chair. Which of the following statements made by the nurse will be most effective in instructing the patient on how to best facilitate the move? 1. "When I count to three, please rock yourself into a standing position." 2. "Please help me by holding onto my waist while I help you stand." 3. "Please let me know how I can best help you get up off the bed and stand up." 4. "Please push down onto the mattress with both hands and stand when I count to three."

4. "Please push down onto the mattress with both hands and stand when I count to three."

Which of the following statements made by ancillary staff assigned with the transfer of a mobility-impaired patient reflects the best understanding of the importance of appropriately communicating with the nurse regarding this intervention? 1. "I'll let you know if I need your help with her transfer." 2. "Do you think she will enjoy eating lunch in her chair?" 3. "Has she been complaining of pain or dizziness today?" 4. "She is less able to help with the transfer than she was yesterday."

4. "She is less able to help with the transfer than she was yesterday."

Which of the following statements made by ancillary staff assigned with the responsibility of transferring an elderly patient using a hydraulic lift reflects the best understanding of the importance of appropriately communicating with the nurse regarding this intervention? 1. "Do you think I really need the hydraulic lift to transfer her?" 2. "I'll let you know if I need your help with working the hydraulic lift." 3. "Do you think that she will be as anxious about the transfer as she was the first time?" 4. "The patient was really much stronger today than she was last time I transferred her."

4. "The patient was really much stronger today than she was last time I transferred her."