Он держит сумку в руке.

Questions & Answers about Он держит сумку в руке.

Since the lesson is about carrying (нести / носить), why does this sentence use держит?
Держать means "to hold" rather than "to carry". Нести (to carry in one direction) implies motion—you are transporting an object from one place to another. Держать just describes the physical grip. If he is standing still with the bag, use держит. If he is walking down the street with it, you would use несёт.
Why does the word for bag change to сумку here?
The dictionary form is сумка (bag). Because it is the direct object—the thing being held—it must be in the Accusative case. For feminine nouns ending in -а, the Accusative ending is -у.
Why is it в руке (Prepositional case) instead of в руку (Accusative case)?
The preposition в takes the Prepositional case when answering the question "where?" (static location) and the Accusative case when answering "where to?" (direction or motion). Since the bag is already located in his hand, we use the Prepositional case руке.
The verb is держать (to hold). Since it ends in -ать, why does it conjugate to держит instead of держет?
Держать is a famous exception verb. Even though it ends in -ать (which usually signals a "Type 1" verb with -е- endings like делает or знает), it actually follows the "Type 2" conjugation pattern. That is why it takes the -ит ending.

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