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Certified Nursing Assistant (CNA) Exam: Positioning, Transfers, and Body Mechanics Concepts

Importance ★★★★☆ · 12% (estimate)

Overview

This chapter covers how to move residents and yourself safely. Questions often ask about good body mechanics, the names of basic positions, and how to set up a transfer.

Good body mechanics protect the aide's back. Keep the feet about shoulder-width apart, bend at the knees and hips, keep the back straight, and hold the load close to your body. Turn by moving your feet instead of twisting, push or pull instead of lifting when you can, and raise the bed to a comfortable working height.

Know the basic positions. Supine is lying flat on the back. Prone is lying face down. Fowler's position is on the back with the head of the bed raised. Sims' position is on the left side, rolled partly forward, with the upper leg bent. Logrolling turns the resident as one unit to keep the spine straight, and a lift sheet with two workers moves a resident up in bed with less friction.

Before a transfer, lock the brakes on the bed and wheelchair, and place the wheelchair close to the bed on the resident's strong side. A transfer belt goes over clothing at the waist, snug but with room for your fingers. When walking with a resident who has a weak side, stand on the weak side, slightly behind.

Key concepts

  • Body mechanics

    Using the body safely when lifting and moving: wide base, knees bent, back straight, load close, no twisting.

    Memory tipLift with the legs, not the back.

  • Supine and prone

    Supine is lying flat on the back; prone is lying face down on the stomach.

    Memory tipSupine on the spine.

  • Fowler's position

    Lying on the back with the head of the bed raised, which helps breathing and eating.

    Memory tipHead up on the back = Fowler's.

  • Sims' position

    Lying on the left side, turned partly toward the front, with the upper leg bent toward the chest.

    Memory tipSims' = left side, upper leg bent.

  • Logrolling

    Turning a resident with the head, shoulders, hips, and legs moving together as one unit so the spine does not twist.

    Memory tipRoll like a log.

  • Transfer belt

    A belt put around the resident's waist over clothing, snug but with room for your fingers, to hold during transfers and walking.

    Memory tipWaist, over clothes, snug.

  • Strong-side transfer

    For a stand-and-pivot transfer, the wheelchair goes close to the bed on the resident's strong side with the brakes locked.

    Memory tipChair on the strong side, brakes on.

See it in a picture

Two stick figures lifting a box. Left, labeled poor body mechanics: legs straight, back bent forward flat, box on the floor far in front. Right, labeled good body mechanics: knees bent, back upright, feet apart, box held close to the chest.
Poor and good body mechanics when lifting a load

Often tested

  • Bend the knees and keep the back straight when lifting.
  • Lock the bed and wheelchair brakes before a transfer.
  • Walk on the resident's weak side, slightly behind.
  • Use a lift sheet and two workers to move a resident who cannot help.
  • Never reach far across the bed to lift; move closer.

3 sample questions

Verified practice questions from this unit.

Practice questionReviewedPhysical Care Skills › Positioning, Transfers, and Body Mechanics★★★★☆

Question 1. Look at the picture. What is the name of the resident's position?

Side view of a hospital bed with the head end on the left and the foot end on the right. The head section of the mattress is raised steeply. A resident lies on the back against the raised section with the knees slightly bent and the feet toward the foot of the bed.
  1. ① Prone position
  2. ② Lateral (side-lying) position
  3. ③ Supine position
  4. ④ Fowler's position
▼ Show answer and explanation▲ Hide answer and explanation

Answer: ④ Fowler's position

Key point: Head of bed raised, resident on back = Fowler's

In Fowler's position the resident lies on the back with the head of the bed raised, often about 45 to 60 degrees, and the knees may be slightly bent. It helps with breathing, eating, and talking.

Wrong choices

  • Prone position: Prone means lying face down on the stomach.
  • Lateral (side-lying) position: In the lateral position the resident lies on one side.
  • Supine position: Supine means lying flat on the back with the head of the bed down.
Practice questionReviewedPhysical Care Skills › Positioning, Transfers, and Body Mechanics★★★★☆

Question 2. Before a resident moves from the bed to a wheelchair, what must the aide do?

  1. ① Remove the resident's shoes
  2. ② Lock the brakes on the wheelchair and the bed
  3. ③ Raise the bed to its highest position
  4. ④ Release the brakes so the chair can roll closer
▼ Show answer and explanation▲ Hide answer and explanation

Answer: ② Lock the brakes on the wheelchair and the bed

Key point: Lock the wheelchair and bed brakes before a transfer

If the bed or wheelchair rolls during a transfer, the resident can fall. Lock all brakes first, lower the bed so the feet are flat on the floor, and have the resident wear non-skid footwear.

Wrong choices

  • Remove the resident's shoes: Non-skid shoes help the resident stand safely.
  • Raise the bed to its highest position: The bed should be low so the resident's feet are flat on the floor.
  • Release the brakes so the chair can roll closer: An unlocked chair can roll away during the transfer.
Practice questionReviewedPhysical Care Skills › Positioning, Transfers, and Body Mechanics★★★★☆

Question 3. A resident lying flat on the back is in which position?

  1. ① Sims'
  2. ② Fowler's
  3. ③ Prone
  4. ④ Supine
▼ Show answer and explanation▲ Hide answer and explanation

Answer: ④ Supine

Key point: Supine = flat on the back; prone = face down

Supine means lying flat on the back. A memory tip: you lie on your spine when supine. Prone is the opposite: face down.

Wrong choices

  • Sims': Sims' means lying on the left side with the upper leg bent.
  • Fowler's: Fowler's means lying on the back with the head of the bed raised.
  • Prone: Prone means lying on the stomach.
Practice 5 questions from this unit →

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