HESI LPN-ADN ENTRANCE
EXAM – MOBILITY FOCUS
2026/2027
Q1: A nurse is preparing to ambulate a postoperative client who weighs 180 lbs.
According to Safe Patient Handling and Movement (SPHM) guidelines, what is the
maximum weight a nurse should manually lift?
A. 25 lbs
B. 35 lbs
C. 50 lbs
D. 75 lbs
Correct Answer: B
Rationale: Correct because SPHM guidelines establish a 35-pound maximum manual
lift limit for healthcare workers to prevent musculoskeletal injuries. Per HESI mobility
guidelines, any client or object exceeding 35 lbs requires a mechanical assist device
such as a lift, transfer belt, or slide board. This standard applies regardless of the
nurse's perceived strength and is enforced by OSHA and The Joint Commission.
Q2: A nurse uses the Bedside Mobility Assessment Tool (BMAT 2.0) to evaluate a
client's mobility level. The client cannot sit upright in bed without assistance and
requires a mechanical lift for all transfers. What BMAT level does this represent?
A. Level 1
B. Level 2
C. Level 3
D. Level 4
Correct Answer: A
,Rationale: Correct because BMAT Level 1 indicates the client is unable to sit upright
in bed and requires maximum assistance, including a ceiling lift or mechanical lift, for
all transfers. Per HESI BMAT 2.0 guidelines, Level 2 requires moderate assistance to
sit, Level 3 requires minimal assistance, and Level 4 indicates the client is
independent. Level 1 failure triggers the need for a ceiling lift and full SPHM protocol.
Q3: A nurse is lifting a client from the bed using proper body mechanics. Which action
demonstrates correct body mechanics?
A. Bending at the waist and keeping the back straight
B. Bending at the knees, keeping the back straight, and holding the load
close to the body
C. Twisting the torso while lifting the client
D. Extending the arms fully to reach the client
Correct Answer: B
Rationale: Correct because proper body mechanics require bending at the knees (not
the waist), keeping the back straight, and holding the load close to the center of
gravity. Per HESI body mechanics guidelines, bending at the waist (A), twisting (C),
and extending arms fully (D) all increase the risk of musculoskeletal injury to the
nurse. The legs are the strongest muscle group and should bear the lifting force.
Q4: A nurse is applying a gait belt to a client for ambulation. Where should the gait belt
be placed?
A. Directly on the client's skin at the waist
B. Over the client's clothing at the waist or hips
C. Around the client's chest
D. Under the client's arms
Correct Answer: B
Rationale: Correct because the gait belt must be placed over the client's clothing at
the waist or hip level to protect the skin from friction and to provide a secure grip
point. Per HESI safe patient handling guidelines, placing the belt directly on skin (A)
can cause abrasions, and placement around the chest (C) or under the arms (D) does
,not provide effective control during ambulation. The belt should be snug enough to fit
two fingers underneath.
Q5: A client is learning to use axillary crutches. Which finding indicates correct crutch
fitting?
A. There is a 4-finger gap between the axilla and the crutch top
B. There is a 2-3 finger gap between the axilla and the crutch top
C. The crutch top sits directly in the axilla
D. The client's elbows are fully extended when gripping the handles
Correct Answer: B
Rationale: Correct because proper crutch fitting requires a 2-3 finger gap between the
axilla and the crutch top to prevent brachial plexus nerve damage, and the elbows
should be flexed at approximately 30 degrees when gripping the handles. Per HESI
assistive device guidelines, a 4-finger gap (A) is too wide and unstable, direct axillary
contact (C) causes nerve injury, and fully extended elbows (D) indicate incorrect height
adjustment and cause fatigue.
Q6: A client with right-sided weakness is prescribed a cane. On which side should the
cane be held, and which leg should advance first?
A. Cane on the weak side; weak leg advances first
B. Cane on the strong side; strong leg advances first
C. Cane on the strong side; weak leg advances first
D. Cane on the weak side; strong leg advances first
Correct Answer: C
Rationale: Correct because the cane is held on the strong side and moves with the
weak leg, meaning the weak leg advances first while the cane and strong leg provide
support. Per HESI assistive device guidelines, this provides a tripod base of support
and maximizes stability. Holding the cane on the weak side (A, D) eliminates the
support benefit, and advancing the strong leg first (B) destabilizes the client.
, Q7: A client with bilateral lower extremity weakness requires an assistive device for
ambulation. Which gait pattern provides the greatest stability?
A. Two-point gait
B. Three-point gait
C. Four-point gait
D. Swing-through gait
Correct Answer: C
Rationale: Correct because the four-point gait (right crutch, left foot, left crutch, right
foot) provides the greatest stability by ensuring three points of contact with the ground
at all times. Per HESI assistive device guidelines, the three-point gait (B) is used for
clients who cannot bear weight on one leg (e.g., BKA), the two-point gait (A) requires
more balance, and swing-through gait (D) is for clients with strong upper extremities.
Q8: A client with a below-knee amputation (BKA) on the right leg is learning to
ambulate. Which gait pattern should the nurse teach?
A. Four-point gait
B. Two-point gait
C. Three-point gait
D. Swing-to gait
Correct Answer: C
Rationale: Correct because the three-point gait is used for clients who cannot bear
weight on one leg, such as a BKA client. The sequence is: both crutches forward, then
the affected (prosthetic) leg. Per HESI assistive device guidelines, this ensures the
prosthetic leg is never weight-bearing during the swing phase. The four-point gait (A)
is for bilateral weakness, two-point (B) requires more balance, and swing-to (D) is for
bilateral above-knee amputations.
Q9: A client with severe balance deficits and no lower extremity weight -bearing ability
requires an assistive device. Which device provides the greatest base of support?
A. Cane
EXAM – MOBILITY FOCUS
2026/2027
Q1: A nurse is preparing to ambulate a postoperative client who weighs 180 lbs.
According to Safe Patient Handling and Movement (SPHM) guidelines, what is the
maximum weight a nurse should manually lift?
A. 25 lbs
B. 35 lbs
C. 50 lbs
D. 75 lbs
Correct Answer: B
Rationale: Correct because SPHM guidelines establish a 35-pound maximum manual
lift limit for healthcare workers to prevent musculoskeletal injuries. Per HESI mobility
guidelines, any client or object exceeding 35 lbs requires a mechanical assist device
such as a lift, transfer belt, or slide board. This standard applies regardless of the
nurse's perceived strength and is enforced by OSHA and The Joint Commission.
Q2: A nurse uses the Bedside Mobility Assessment Tool (BMAT 2.0) to evaluate a
client's mobility level. The client cannot sit upright in bed without assistance and
requires a mechanical lift for all transfers. What BMAT level does this represent?
A. Level 1
B. Level 2
C. Level 3
D. Level 4
Correct Answer: A
,Rationale: Correct because BMAT Level 1 indicates the client is unable to sit upright
in bed and requires maximum assistance, including a ceiling lift or mechanical lift, for
all transfers. Per HESI BMAT 2.0 guidelines, Level 2 requires moderate assistance to
sit, Level 3 requires minimal assistance, and Level 4 indicates the client is
independent. Level 1 failure triggers the need for a ceiling lift and full SPHM protocol.
Q3: A nurse is lifting a client from the bed using proper body mechanics. Which action
demonstrates correct body mechanics?
A. Bending at the waist and keeping the back straight
B. Bending at the knees, keeping the back straight, and holding the load
close to the body
C. Twisting the torso while lifting the client
D. Extending the arms fully to reach the client
Correct Answer: B
Rationale: Correct because proper body mechanics require bending at the knees (not
the waist), keeping the back straight, and holding the load close to the center of
gravity. Per HESI body mechanics guidelines, bending at the waist (A), twisting (C),
and extending arms fully (D) all increase the risk of musculoskeletal injury to the
nurse. The legs are the strongest muscle group and should bear the lifting force.
Q4: A nurse is applying a gait belt to a client for ambulation. Where should the gait belt
be placed?
A. Directly on the client's skin at the waist
B. Over the client's clothing at the waist or hips
C. Around the client's chest
D. Under the client's arms
Correct Answer: B
Rationale: Correct because the gait belt must be placed over the client's clothing at
the waist or hip level to protect the skin from friction and to provide a secure grip
point. Per HESI safe patient handling guidelines, placing the belt directly on skin (A)
can cause abrasions, and placement around the chest (C) or under the arms (D) does
,not provide effective control during ambulation. The belt should be snug enough to fit
two fingers underneath.
Q5: A client is learning to use axillary crutches. Which finding indicates correct crutch
fitting?
A. There is a 4-finger gap between the axilla and the crutch top
B. There is a 2-3 finger gap between the axilla and the crutch top
C. The crutch top sits directly in the axilla
D. The client's elbows are fully extended when gripping the handles
Correct Answer: B
Rationale: Correct because proper crutch fitting requires a 2-3 finger gap between the
axilla and the crutch top to prevent brachial plexus nerve damage, and the elbows
should be flexed at approximately 30 degrees when gripping the handles. Per HESI
assistive device guidelines, a 4-finger gap (A) is too wide and unstable, direct axillary
contact (C) causes nerve injury, and fully extended elbows (D) indicate incorrect height
adjustment and cause fatigue.
Q6: A client with right-sided weakness is prescribed a cane. On which side should the
cane be held, and which leg should advance first?
A. Cane on the weak side; weak leg advances first
B. Cane on the strong side; strong leg advances first
C. Cane on the strong side; weak leg advances first
D. Cane on the weak side; strong leg advances first
Correct Answer: C
Rationale: Correct because the cane is held on the strong side and moves with the
weak leg, meaning the weak leg advances first while the cane and strong leg provide
support. Per HESI assistive device guidelines, this provides a tripod base of support
and maximizes stability. Holding the cane on the weak side (A, D) eliminates the
support benefit, and advancing the strong leg first (B) destabilizes the client.
, Q7: A client with bilateral lower extremity weakness requires an assistive device for
ambulation. Which gait pattern provides the greatest stability?
A. Two-point gait
B. Three-point gait
C. Four-point gait
D. Swing-through gait
Correct Answer: C
Rationale: Correct because the four-point gait (right crutch, left foot, left crutch, right
foot) provides the greatest stability by ensuring three points of contact with the ground
at all times. Per HESI assistive device guidelines, the three-point gait (B) is used for
clients who cannot bear weight on one leg (e.g., BKA), the two-point gait (A) requires
more balance, and swing-through gait (D) is for clients with strong upper extremities.
Q8: A client with a below-knee amputation (BKA) on the right leg is learning to
ambulate. Which gait pattern should the nurse teach?
A. Four-point gait
B. Two-point gait
C. Three-point gait
D. Swing-to gait
Correct Answer: C
Rationale: Correct because the three-point gait is used for clients who cannot bear
weight on one leg, such as a BKA client. The sequence is: both crutches forward, then
the affected (prosthetic) leg. Per HESI assistive device guidelines, this ensures the
prosthetic leg is never weight-bearing during the swing phase. The four-point gait (A)
is for bilateral weakness, two-point (B) requires more balance, and swing-to (D) is for
bilateral above-knee amputations.
Q9: A client with severe balance deficits and no lower extremity weight -bearing ability
requires an assistive device. Which device provides the greatest base of support?
A. Cane
