# Week 2: Skill Video Tests

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When preparing to move a patient in bed, what will the nurse do first?

A. Assemble adequate help to move the patient.
B. Assess the patient's ability to help with moving.
C. Determine the patient's weight.
D. Decide on the most effective means of moving the patient.
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B. Assess the patient's ability to help with moving.

Rationale: Assessing the patient's ability to help is the first thing the nurse must do, since the answer determines how much help is needed with the move. The patient's weight is important to know, but it is not the first action the nurse must take. The most effective means of moving the patient will be determined in part by whether the patient is able to help.
C. Flex the hips and knees.

Rationale: Flexing the hips and knees is the safest posture for both caregivers to assume when moving a patient in bed. Standing with the knees locked could injure the legs or the back. Standing with the feet together could injure the legs or the back. The body weight should be shifted from the back leg to the front leg.
A patient who weighs 200 lbs. needs to be moved up in bed with the aid of a friction-reducing device. The nurse will prepare for this move by assembling how many caregivers?

A. A minimum of two
B. None, since the device does all the lifting during the move
C. At least three
D. The nurse can carry out this move without assistance
C. At least three

Rationale: Since a friction-reducing device will be used and the client weighs 200 lbs., a minimum of three to four people are needed to move this patient safely. The device does not function independently, and the nurse cannot use it without the help of other caregivers. The nurse cannot carry out this move by himself or herself.
C. Supine with the head of the bed flat

Rationale: Placing the patient in the supine position with the head of the bed flat is the recommended position to use to move a patient up in bed. The patient should not be supine with the head of the bed at a 30-degree angle, sitting, or prone when being moved up in bed.
A patient will be moved up in bed with the use of a friction-reducing device. How will the nurse place this device under the patient?

A. Lift the patient to place the device directly under him or her.
B. Remove the drawsheet, and replace it with the device.
C. Roll the patient from side to side, and place the device under the drawsheet.
D. Sit the patient up in the bed, and place the device behind the shoulders.
C. Roll the patient from side to side, and place the device under the drawsheet.

Rationale: The patient will be rolled from side to side and the device placed under the drawsheet. The patient is not lifted in order to place the device under him or her. The device must be placed under the drawsheet. The device must be behind the entire length of the patient, and not just placed at the level of the shoulders.
B. To reduce the risk of contracture

Rationale: A trochanter roll is placed alongside the patient's legs to prevent external rotation of the hips, which contributes to contracture. The placement of a trochanter roll alongside the patient's legs will not reduce the risk of a fall while the side rails are down. The side rails must be raised to prevent the patient from falling. Although a trochanter roll placed alongside the patient's legs may assist to control pain and provide cushion to the legs, it is not the primary reason a trochanter roll is placed alongside of patient's legs.
C. Fowler's position

Rationale: In the Fowler's position the head of the bed is elevated and maximal breathing space in the thoracic cavity is promoted. Fowler's is the position of choice for a patient having breathing difficulties. A Sims' position would not facilitate maximal breathing space and respirations would be difficult for the patient. The 30-degree lateral or side-lying position requires the head of bed to be lowered completely or as low as the patient can tolerate. The patient is positioned on the side. Lying on the side will not promote maximal breathing space and respirations would be difficult for the patient. In the prone position, the patient is positioned flat and on the abdomen. Lying flat on the abdomen would not facilitate respirations and is a difficult position for the patient to maintain.
The nurse is preparing to move a patient with hemiplegia into the prone position. What action should the nurse take when rolling the patient onto her side?

A. Place a small pillow under the shoulder.
B. Use the affected arm as a guide during rolling.
C. Place a pillow on the abdomen.
D. Place rolled bath blankets along the dependent leg.
C. Place a pillow on the abdomen.

Rationale: When rolling a patient with hemiplegia onto her side while moving into the prone position, the nurse should place a pillow on the patient's abdomen. Placing a small pillow under the shoulder will not help when rolling a patient with hemiplegia onto her side while moving into the prone position. The nurse should not use the affected arm as a guide when rolling a patient with hemiplegia onto her side while moving into the prone position. The nurse should not place rolled bath blankets along the dependent leg when rolling the hemiplegic patient onto her side while moving into the prone position.
C. To roll the patient as a unit

Rationale: Two assistants are needed to roll the patient as a unit, using one smooth, continuous motion. One assistant grasps the draw sheet at the lower hips and thighs, and the other assistant grasps the draw sheet at the patient's shoulders and lower back. The pillows are positioned by the nurse who is standing on the side from which the patient was turned. Two assistants are not needed to keep the patient's spine straight while logrolling a patient. Two assistants are not needed to ease the patient back onto the support pillows.