PCA Patient Mobility & Transfers 3 — Questions and Answers
Question 1: A patient has a doctor's order that reads 'NWB left leg.' What does this mean for the PCA during transfers?
- The patient may place minimal weight on the left leg
- The patient must not put any weight on the left leg at all (Correct answer)
- The patient needs a walker for all transfers
- The patient should use the left leg only for balance
Correct answer: The patient must not put any weight on the left leg at all
NWB (Non-Weight-Bearing) means absolutely no weight is to be placed on that limb during transfers or ambulation.
Question 2: When repositioning a patient up in bed using a draw sheet with a co-worker, both caregivers should:
- Count to three and pull simultaneously on command (Correct answer)
- One pull while the other steadies the IV pole
- Lift the head of bed first then slide the patient
- Each independently slide one half of the patient
Correct answer: Count to three and pull simultaneously on command
Coordinating with a count ensures both caregivers move at the same time, reducing friction, preventing shear injury, and protecting both workers.
Question 3: The PRIMARY purpose of locking wheelchair brakes before a transfer is to:
- Keep the wheelchair from scratching the floor
- Prevent the wheelchair from rolling and causing the patient to fall (Correct answer)
- Make it easier for the patient to stand up from it
- Meet documentation requirements
Correct answer: Prevent the wheelchair from rolling and causing the patient to fall
Locking the brakes prevents the wheelchair from rolling away from the patient as they shift their weight during the transfer, which could cause a fall.
Question 4: A PCA is using a gait belt to help a patient walk down a hallway. The correct position for the PCA is:
- Walking directly in front of the patient, facing them
- Walking slightly behind and to one side of the patient (Correct answer)
- Walking arm-in-arm with the patient on the stronger side
- Walking behind the patient with both hands on the belt
Correct answer: Walking slightly behind and to one side of the patient
Standing slightly behind and to the side allows the PCA to monitor the patient, react to stumbles, and control the gait belt without obstructing the patient's path.
Question 5: Which of the following is a contraindication to using a gait belt on a patient?
- The patient uses a quad cane
- The patient has a colostomy or abdominal surgery incision in the belt area (Correct answer)
- The patient is over age 65
- The patient can only bear partial weight
Correct answer: The patient has a colostomy or abdominal surgery incision in the belt area
A gait belt should not be placed over wounds, surgical incisions, colostomies, or feeding tubes as it can cause pain or injury to those areas.
Question 6: A patient with Parkinson's disease freezes mid-stride during ambulation. The PCA should:
- Tug sharply on the gait belt to restart movement
- Instruct the patient to try marching in place or focus on stepping over a line (Correct answer)
- Seat the patient immediately on the floor
- Tell the patient to relax their muscles and wait
Correct answer: Instruct the patient to try marching in place or focus on stepping over a line
For Parkinson's-related freezing, cueing techniques such as marching in place or visual cues like stepping over an imaginary line can help restart movement.
Question 7: After completing a transfer, the PCA should document:
- Nothing unless an incident occurred
- How much the patient weighed at time of transfer
- The type of transfer, level of assistance required, and any patient complaints (Correct answer)
- Only the time the transfer took place
Correct answer: The type of transfer, level of assistance required, and any patient complaints
Accurate documentation of the transfer method, assistance level, and any patient concerns creates a legal record and informs continuity of care.
PCA Patient Mobility & Transfers 3
A patient has a doctor's order that reads 'NWB left leg.' What does this mean for the PCA during transfers?