Physical Care Skills
What this domain covers
Physical care questions cluster into a few skill families: infection control (hand hygiene, standard precautions, PPE sequence), hygiene and grooming, safe mobility (body mechanics, gait belt, transfers, range of motion), positioning and skin integrity (repositioning at least every two hours, pressure-point checks), nutrition and fluids (intake and output, aspiration precautions, prescribed diets and thickened liquids), elimination (bedpan, catheter and ostomy care, toileting schedules), and vital signs with knowing which values to report rather than interpret.
Concepts you must know
Active, passive, and active-assistive range of motion; never force a joint past resistance or pain. Use large leg muscles and keep the resident close when lifting. Transfer toward the resident's stronger side. Dress the weak side first and undress the weak side last. Measure intake and output in the same units and record promptly. Know normal adult ranges well enough to recognize a change worth reporting.
Traps the exam uses
- "First action" items: resident safety and privacy come before completing the task. If a resident becomes dizzy, pale, or complains of pain, stop and lower them to a safe position before anything else.
- Hand hygiene is the answer far more often than gloves alone; gloves never replace handwashing.
- Questions describing a finding (fever, reddened heel, cloudy urine) expect report to the nurse, not a diagnosis or a treatment you invent.
- Do not skip a step because a resident refuses part of care; respect refusal and report it.
Worked example
You count a radial pulse and notice it is irregular. The correct response is to count for a full minute, note the rate and the irregularity, and report it to the licensed nurse. The trap answer is to record the number and move on, or to count for 15 seconds and multiply.
Rule of thumb
Ask yourself: Is the resident safe, is their dignity protected, and did I report what I found? If an answer choice skips any of those three, it is usually wrong.