PCT Assisting with ADLs and Mobility 2 — Questions and Answers
Question 1: Which technique should a PCT use when helping a patient transfer from bed to wheelchair?
- Pull the patient by their arms
- Use a gait belt and pivot technique (Correct answer)
- Drag the patient across the sheets
- Ask the patient to jump
Correct answer: Use a gait belt and pivot technique
A gait belt provides a secure grip and the pivot technique minimizes strain on both patient and caregiver while maintaining safety.
The gait belt (transfer belt) is placed snugly around the patient's waist. The PCT stands close, grips the belt, and helps the patient pivot on their stronger leg to turn into the wheelchair. This reduces fall risk and prevents back injuries to the caregiver.
Question 2: When assisting a patient with a weak left leg to walk with a cane, the cane should be held in which hand?
- Left hand
- Right hand (Correct answer)
- Either hand
- Both hands
Correct answer: Right hand
The cane is held on the stronger (opposite) side to provide support and balance when the weaker leg steps forward.
When a patient has left leg weakness, holding the cane in the right hand allows them to shift weight onto the cane and strong leg simultaneously while the weak leg advances. This creates a stable base of support during ambulation.
Question 3: A patient with hemiplegia needs help putting on a shirt. Which arm should be dressed first?
- The unaffected arm
- The affected (weak) arm (Correct answer)
- Either arm is fine
- Neither—use a gown instead
Correct answer: The affected (weak) arm
The affected arm is dressed first because it has limited mobility, making it easier to maneuver the garment over it before the stronger arm.
The dressing principle for patients with one-sided weakness is 'affected first, unaffected last' for dressing, and the reverse for undressing. This minimizes pain and difficulty because the garment can be more easily positioned around the limb with less range of motion.
Question 4: What is the primary purpose of range-of-motion (ROM) exercises for a bedridden patient?
- To build muscle mass
- To prevent contractures and maintain joint function (Correct answer)
- To increase heart rate for cardiovascular fitness
- To help the patient sleep better
Correct answer: To prevent contractures and maintain joint function
ROM exercises prevent joints from becoming stiff and contracted due to immobility, preserving the patient's functional ability.
When patients are immobile, muscles shorten and joints stiffen, leading to contractures that can become permanent. Passive or active ROM exercises move each joint through its full range regularly, maintaining flexibility, circulation, and joint health.
Question 5: When repositioning a patient in bed, how often should their position be changed to prevent pressure injuries?
- Every 4 hours
- Every 2 hours or more frequently (Correct answer)
- Once per shift
- Only when the patient requests it
Correct answer: Every 2 hours or more frequently
Repositioning at least every 2 hours redistributes pressure and prevents tissue breakdown that leads to pressure ulcers.
Pressure injuries develop when sustained pressure on bony prominences restricts blood flow to tissues. The standard of care requires turning or repositioning bedridden patients at minimum every 2 hours, with more frequent changes for high-risk patients.
Question 6: A patient using a walker should be instructed to move the walker forward how far with each step?
- As far as they can reach
- About one arm's length (12-18 inches) (Correct answer)
- At least 3 feet
- Only 2-3 inches at a time
Correct answer: About one arm's length (12-18 inches)
Moving the walker about one arm's length forward maintains stability and keeps the patient within a safe base of support.
Advancing the walker approximately 12-18 inches (one arm's length) keeps the patient's center of gravity within the walker's frame. Reaching too far forward causes the patient to lean and increases fall risk, while too short a distance is inefficient.
PCT Assisting with ADLs and Mobility 2
Which technique should a PCT use when helping a patient transfer from bed to wheelchair?