Basic Nursing Skills and Personal Care
What the exam expects
Basic nursing skills questions test whether you can perform routine care safely, in the correct order, and with the resident's preferences built in. Know the sequence of a bed bath: eyes first with plain water (wipe inner to outer corner, use a different part of the cloth each stroke), then face, neck, arms, chest, abdomen, legs, back, and perineal care last. Learn the front-to-back rule for perineal care and the principle of cleansing from the cleanest area outward. Know denture care: line the sink or fill it with water first, and store dentures in a labeled cup with water when out of the mouth. Know positioning terms (supine, lateral, Sims, Fowler's, prone) and why repositioning at least every two hours prevents pressure injury. Understand active versus passive range of motion and that a joint is never forced past resistance. Know which observations are emergencies you report immediately - sudden shortness of breath, chest pain, one-sided weakness, new confusion, a fall - versus routine findings you record.
Traps
Questions love to offer "rub the reddened area" - wrong; never massage a pressure area. Diabetic residents' toenails are not trimmed by a nursing assistant. Heating pads and hot water bottles are risky for anyone with numbness or poor circulation. Offering a bedpan is not the same as insisting on one; a resident may refuse. Also watch for wording that tells the resident what to do instead of offering choices - dignity-based care always offers choices.
Rule of thumb
Work clean to dirty and head to toe: start at the cleanest part of the body and finish with the dirtiest, and never carry a soiled washcloth back to a clean area. If your stroke would move contamination toward the face or the urinary meatus, you are going the wrong direction.