HESI LPN-ADN Entrance Exam Mobility Safe
Patient Handling Focus Official Practice Exam
Actual Exam 2026/2027 with Detailed
Rationales | Complete Exam-Style Questions |
Pass Guaranteed – A+ Graded
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SECTION 1: MOBILITY ASSESSMENT & FUNCTIONAL ABILITY Q1 – Q10
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Question 1 of 50
A 78-year-old patient is admitted to the long-term care unit after a right hip fracture repair.
During the initial mobility assessment, the nurse observes that the patient can lift the right
leg off the bed but cannot maintain it against gravity. When documenting the patient's muscle
strength, which grade should the nurse assign to the right lower extremity?
A. Grade 0 — no muscle contraction detected
B. Grade 1 — visible muscle contraction but no movement
C. Grade 2 — full range of motion with gravity eliminated ✓ CORRECT
D. Grade 3 — full range of motion against gravity
Correct Answer: C
Rationale: Grade 2 muscle strength indicates the patient can move through full range of
motion when gravity is eliminated, such as sliding the leg on a smooth surface, but cannot lift
the limb against gravity. Grade 3 would require the patient to actively lift the leg against
gravity, which this patient cannot do. On the HESI exam, always match the observed
functional ability to the precise muscle strength grading scale: 0 = no contraction, 1 = flicker,
2 = gravity eliminated, 3 = against gravity, 4 = against some resistance, 5 = against full
resistance.
Question 2 of 50
A 45-year-old construction worker is recovering from a left knee arthroscopy in the acute
care unit. The physical therapist reports the patient has a "steppage gait" during ambulation.
When observing the patient walk, which finding would the nurse expect to see?
A. The patient drags the left foot and circumducts the leg outward during swing phase
,B. The patient lifts the left hip excessively to clear the foot from the floor during swing phase
✓ CORRECT
C. The patient leans the trunk toward the left side during stance phase on the affected leg
D. The patient takes short, shuffling steps with reduced arm swing bilaterally
Correct Answer: B
Rationale: A steppage gait is characterized by excessive hip and knee flexion during the swing
phase to lift the foot high enough to clear the floor, typically caused by foot drop or
weakness of the dorsiflexor muscles. Circumduction and hip hiking are compensatory
mechanisms for different gait disturbances, while shuffling steps with reduced arm swing are
classic signs of Parkinsonian gait. HESI frequently tests gait pattern recognition — remember
that steppage gait is specifically associated with peripheral nerve injury or foot drop and
requires the patient to lift the entire limb higher than normal.
Question 3 of 50
A 67-year-old patient with Parkinson disease is being evaluated for fall risk on the
medical-surgical unit. The nurse performs the Timed Up and Go (TUG) test and observes that
the patient takes 18 seconds to stand from a chair, walk 10 feet, turn, return, and sit down.
Based on this result, which nursing action is the priority?
A. Encourage the patient to ambulate independently with a standard walker
B. Implement close supervision and a fall prevention protocol because the patient is at high
risk for falls ✓ CORRECT
C. Document the result as normal and continue with standard mobility precautions
D. Restrict the patient to bed rest until physical therapy can perform a formal evaluation
Correct Answer: B
Rationale: A TUG test result of 18 seconds exceeds the 12-second threshold that indicates
increased fall risk in older adults, requiring immediate implementation of fall prevention
interventions including close supervision and environmental modifications. A score greater
than 12 seconds is not normal and does not warrant continued standard precautions, while
bed rest would cause further deconditioning and increase fall risk. On HESI mobility
questions, remember that any TUG score over 12 seconds signals high fall risk and requires
proactive nursing intervention, not waiting for another discipline to act.
Question 4 of 50
A 52-year-old patient with a spinal cord injury at T10 is being transferred from the ICU to the
rehabilitation unit. During the mobility assessment, the nurse asks the patient to perform a
straight leg raise while lying supine. The patient successfully raises both legs but reports
numbness and tingling in the groin area during the maneuver. Which nursing action is the
priority?
, A. Document the finding as expected for a T10 injury and continue the assessment
B. Immediately stop the maneuver and notify the physician because the finding suggests a
higher level of injury than T10 ✓ CORRECT
C. Have the patient continue the leg raise while monitoring vital signs
D. Apply a abdominal binder and repeat the assessment in 30 minutes
Correct Answer: B
Rationale: Numbness and tingling in the groin area indicates involvement of the T12-L1
dermatomes, suggesting the spinal cord injury may be more extensive or at a higher level
than initially diagnosed at T10, requiring immediate physician notification. Continuing the
maneuver or documenting it as expected could miss a worsening neurological condition,
while an abdominal binder addresses orthostatic hypotension, not sensory changes. HESI
prioritizes neurological assessment accuracy — any unexpected sensory finding during a
mobility evaluation warrants stopping the activity and reporting, as it may indicate an
ascending injury or incorrect initial level designation.
Question 5 of 50
A 34-year-old patient who underwent a total knee arthroplasty three days ago is being
prepared for discharge home. The nurse is assessing the patient's ability to perform a
sit-to-stand transfer from a standard chair. Which observation by the nurse indicates the
patient is ready for independent home mobility?
A. The patient uses the armrests to push up and bears full weight through the operative leg
without assistance ✓ CORRECT
B. The patient requires minimal assistance from one person and uses a walker for standing
C. The patient rocks forward three times before standing and requires verbal cueing
D. The patient uses the non-operative leg primarily to push up from the seated position
Correct Answer: A
Rationale: Independent sit-to-stand ability requires the patient to bear full weight through the
operative extremity and use proper body mechanics without physical assistance, indicating
readiness for safe home discharge. Requiring assistance, rocking multiple times, or
offloading weight to the non-operative leg indicates insufficient strength and stability for
independent mobility. HESI discharge planning questions often test whether the patient can
perform functional mobility tasks safely without caregiver assistance — full weight-bearing
through the surgical limb with proper technique is the standard for independent home
mobility after total knee arthroplasty.
Question 6 of 50
A 71-year-old patient with a history of chronic heart failure is being evaluated for safe
ambulation in the cardiac rehabilitation unit. The nurse uses the Functional Ambulation
Category (FAC) scale to assess the patient's walking ability. The patient can walk on level
Patient Handling Focus Official Practice Exam
Actual Exam 2026/2027 with Detailed
Rationales | Complete Exam-Style Questions |
Pass Guaranteed – A+ Graded
══════════════════════════════════════
SECTION 1: MOBILITY ASSESSMENT & FUNCTIONAL ABILITY Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 78-year-old patient is admitted to the long-term care unit after a right hip fracture repair.
During the initial mobility assessment, the nurse observes that the patient can lift the right
leg off the bed but cannot maintain it against gravity. When documenting the patient's muscle
strength, which grade should the nurse assign to the right lower extremity?
A. Grade 0 — no muscle contraction detected
B. Grade 1 — visible muscle contraction but no movement
C. Grade 2 — full range of motion with gravity eliminated ✓ CORRECT
D. Grade 3 — full range of motion against gravity
Correct Answer: C
Rationale: Grade 2 muscle strength indicates the patient can move through full range of
motion when gravity is eliminated, such as sliding the leg on a smooth surface, but cannot lift
the limb against gravity. Grade 3 would require the patient to actively lift the leg against
gravity, which this patient cannot do. On the HESI exam, always match the observed
functional ability to the precise muscle strength grading scale: 0 = no contraction, 1 = flicker,
2 = gravity eliminated, 3 = against gravity, 4 = against some resistance, 5 = against full
resistance.
Question 2 of 50
A 45-year-old construction worker is recovering from a left knee arthroscopy in the acute
care unit. The physical therapist reports the patient has a "steppage gait" during ambulation.
When observing the patient walk, which finding would the nurse expect to see?
A. The patient drags the left foot and circumducts the leg outward during swing phase
,B. The patient lifts the left hip excessively to clear the foot from the floor during swing phase
✓ CORRECT
C. The patient leans the trunk toward the left side during stance phase on the affected leg
D. The patient takes short, shuffling steps with reduced arm swing bilaterally
Correct Answer: B
Rationale: A steppage gait is characterized by excessive hip and knee flexion during the swing
phase to lift the foot high enough to clear the floor, typically caused by foot drop or
weakness of the dorsiflexor muscles. Circumduction and hip hiking are compensatory
mechanisms for different gait disturbances, while shuffling steps with reduced arm swing are
classic signs of Parkinsonian gait. HESI frequently tests gait pattern recognition — remember
that steppage gait is specifically associated with peripheral nerve injury or foot drop and
requires the patient to lift the entire limb higher than normal.
Question 3 of 50
A 67-year-old patient with Parkinson disease is being evaluated for fall risk on the
medical-surgical unit. The nurse performs the Timed Up and Go (TUG) test and observes that
the patient takes 18 seconds to stand from a chair, walk 10 feet, turn, return, and sit down.
Based on this result, which nursing action is the priority?
A. Encourage the patient to ambulate independently with a standard walker
B. Implement close supervision and a fall prevention protocol because the patient is at high
risk for falls ✓ CORRECT
C. Document the result as normal and continue with standard mobility precautions
D. Restrict the patient to bed rest until physical therapy can perform a formal evaluation
Correct Answer: B
Rationale: A TUG test result of 18 seconds exceeds the 12-second threshold that indicates
increased fall risk in older adults, requiring immediate implementation of fall prevention
interventions including close supervision and environmental modifications. A score greater
than 12 seconds is not normal and does not warrant continued standard precautions, while
bed rest would cause further deconditioning and increase fall risk. On HESI mobility
questions, remember that any TUG score over 12 seconds signals high fall risk and requires
proactive nursing intervention, not waiting for another discipline to act.
Question 4 of 50
A 52-year-old patient with a spinal cord injury at T10 is being transferred from the ICU to the
rehabilitation unit. During the mobility assessment, the nurse asks the patient to perform a
straight leg raise while lying supine. The patient successfully raises both legs but reports
numbness and tingling in the groin area during the maneuver. Which nursing action is the
priority?
, A. Document the finding as expected for a T10 injury and continue the assessment
B. Immediately stop the maneuver and notify the physician because the finding suggests a
higher level of injury than T10 ✓ CORRECT
C. Have the patient continue the leg raise while monitoring vital signs
D. Apply a abdominal binder and repeat the assessment in 30 minutes
Correct Answer: B
Rationale: Numbness and tingling in the groin area indicates involvement of the T12-L1
dermatomes, suggesting the spinal cord injury may be more extensive or at a higher level
than initially diagnosed at T10, requiring immediate physician notification. Continuing the
maneuver or documenting it as expected could miss a worsening neurological condition,
while an abdominal binder addresses orthostatic hypotension, not sensory changes. HESI
prioritizes neurological assessment accuracy — any unexpected sensory finding during a
mobility evaluation warrants stopping the activity and reporting, as it may indicate an
ascending injury or incorrect initial level designation.
Question 5 of 50
A 34-year-old patient who underwent a total knee arthroplasty three days ago is being
prepared for discharge home. The nurse is assessing the patient's ability to perform a
sit-to-stand transfer from a standard chair. Which observation by the nurse indicates the
patient is ready for independent home mobility?
A. The patient uses the armrests to push up and bears full weight through the operative leg
without assistance ✓ CORRECT
B. The patient requires minimal assistance from one person and uses a walker for standing
C. The patient rocks forward three times before standing and requires verbal cueing
D. The patient uses the non-operative leg primarily to push up from the seated position
Correct Answer: A
Rationale: Independent sit-to-stand ability requires the patient to bear full weight through the
operative extremity and use proper body mechanics without physical assistance, indicating
readiness for safe home discharge. Requiring assistance, rocking multiple times, or
offloading weight to the non-operative leg indicates insufficient strength and stability for
independent mobility. HESI discharge planning questions often test whether the patient can
perform functional mobility tasks safely without caregiver assistance — full weight-bearing
through the surgical limb with proper technique is the standard for independent home
mobility after total knee arthroplasty.
Question 6 of 50
A 71-year-old patient with a history of chronic heart failure is being evaluated for safe
ambulation in the cardiac rehabilitation unit. The nurse uses the Functional Ambulation
Category (FAC) scale to assess the patient's walking ability. The patient can walk on level
