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Maryland CNA practice questions

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Question 1Physical Care Skills

When should a nursing assistant perform hand hygiene during a resident's care?

  1. Only after removing gloves
  2. Before and after contact with the resident Correct answer.
  3. Only when the hands are visibly dirty or after toileting
  4. Once at the start of the shift

Explanation

Hand hygiene is required before and after every contact with a resident, regardless of whether gloves were worn. Gloves do not replace hand washing because they can have tiny defects and can be contaminated during removal. Soiled hands are only one reason to wash; germs are not visible.

Question 2Physical Care Skills

In what order does a nursing assistant usually wash a resident during a bed bath?

  1. Perineum first, then face, then arms and chest, then legs and back
  2. Feet, legs, face, then perineum
  3. Face, then arms and chest, then legs, then perineum Correct answer.
  4. Back, then face, then hands, then perineum

Explanation

Bathing proceeds from the cleanest area to the dirtiest so that germs are not carried back to clean skin. The face is washed first with clear water, and the perineal area is saved for last with a fresh washcloth. Washing the perineum first would contaminate the cloth and water used on the rest of the body.

Question 3Physical Care Skills

A resident who cannot move independently should be repositioned at least every:

  1. 30 minutes
  2. 2 hours Correct answer.
  3. 15 minutes
  4. 8 hours

Explanation

Pressure on the skin blocks circulation, so a dependent resident is turned or repositioned at least every two hours, and more often if the skin is fragile. Frequent small shifts of position also relieve pressure on the heels and sacrum. Intervals longer than two hours allow tissue damage to begin.

Question 4Physical Care Skills

When providing perineal care, the nursing assistant should:

  1. Wear no gloves if hands are washed afterward
  2. Wear clean gloves and wash hands after removing them Correct answer.
  3. Wash gloves with soap and water and reuse them
  4. Use the same pair of gloves for another resident in the next room

Explanation

Perineal care involves contact with urine, stool, and body fluids, so clean gloves are worn and hands are washed after the gloves come off. Gloves are discarded after one resident and one task; they cannot be washed and reused. Gloves are never shared between residents.

Question 5Physical Care Skills

Mouth care should be provided to a dependent resident:

  1. Once a week, usually right after the resident's weekly bath
  2. At least twice a day, including after meals Correct answer.
  3. Only if the resident wears dentures
  4. Only when the resident asks for it

Explanation

Routine mouth care is given at least twice daily and after meals to remove food and plaque and to keep the mouth moist. Residents who cannot ask for care still need it on a schedule. Denture wearers and residents with their own teeth both require oral care.

Question 6Physical Care Skills

Which pulse rate is within the normal adult resting range?

  1. 110 to 130 beats per minute
  2. 60 to 100 beats per minute Correct answer.
  3. 140 to 160 beats per minute
  4. 30 to 50 beats per minute

Explanation

A normal adult resting pulse is about 60 to 100 beats per minute and should be regular in rhythm. Rates outside this range are reported to the nurse. Both very slow and very fast rates can signal a problem.

Question 7Physical Care Skills

To help prevent falls, the nursing assistant should:

  1. Keep the call light within the resident's reach Correct answer.
  2. Keep the bed raised to waist height
  3. Use a wheelchair for all trips
  4. Leave side rails down on both sides at all times

Explanation

A resident who can reach the call light is less likely to try an unsafe unassisted trip to the bathroom. The bed is kept low with wheels locked and the area free of clutter. Side rails are used only as the care plan directs, because full rails can be a restraint and an injury risk.

Question 8Physical Care Skills

When recording fluid intake, the nursing assistant should record:

  1. All fluids the resident drinks, including those with medications Correct answer.
  2. Only water and juice, since other drinks are not counted
  3. Only the fluids the resident drinks with meals and between-meal snacks
  4. Only fluids that the nurse hands out from the medication cart

Explanation

Intake includes every fluid taken by mouth, such as water, juice, coffee, soup, gelatin, and the water used to swallow pills. The amounts are measured and recorded at the time they are taken. Leaving out any source makes the record inaccurate for the nurse.

Question 9Physical Care Skills

When measuring blood pressure, the nursing assistant should place the cuff:

  1. On the bare upper arm, about one inch above the elbow Correct answer.
  2. On the lower arm below the elbow
  3. On the forearm, level with the wrist
  4. Over the sleeve of a thick sweater so that the arm stays warm

Explanation

The cuff belongs on bare skin over the upper arm, with its lower edge about an inch above the bend of the elbow and the bladder centered over the artery. Clothing under the cuff or a misplaced cuff changes the reading. The arm is supported at heart level.

Question 10Physical Care Skills

A resident's radial pulse is irregular. The nursing assistant should:

  1. Wait 10 minutes and recheck once
  2. Count for a full minute and report the irregularity Correct answer.
  3. Use the carotid pulse instead
  4. Count for 15 seconds and multiply the number by 4, as with a regular pulse

Explanation

An irregular pulse must be counted for a full minute because beats are not evenly spaced, and a short count multiplied out would be wrong. The irregularity itself is reported to the nurse. The rate and rhythm are both recorded.

Question 11Physical Care Skills

When using a transfer belt to move a resident from bed to chair, the nursing assistant should:

  1. Leave the belt on and use it to lift the resident into bed
  2. Grasp the belt at the sides and move at the resident's pace Correct answer.
  3. Pull the resident up by the belt until the resident is fully standing
  4. Place the belt around the resident's chest under the arms

Explanation

The belt goes around the waist over clothing, and the assistant grips it at the sides while the resident does as much of the work as possible. The movement is slow and matches the resident's ability. The belt guides and supports; it is never used to lift or drag a person.

Question 12Physical Care Skills

A resident needs to be moved up in bed. The nursing assistant should:

  1. Lower the head of the bed and use a draw sheet with a coworker Correct answer.
  2. Pull the resident by the arms
  3. Raise the head of the bed first to make pulling easier
  4. Ask the resident to hold the side rail while being pulled

Explanation

Moving a resident up is done with the bed flat, using a draw sheet and at least two caregivers so the body is lifted rather than dragged. Dragging shears the skin and can cause pressure injuries. Pulling on the arms can dislocate a shoulder.

Question 13Physical Care Skills

When providing catheter care, the nursing assistant should:

  1. Wash from the urinary opening outward with a clean cloth for each stroke Correct answer.
  2. Wash from the anus toward the urinary opening
  3. Disconnect the tubing from the bag to clean it
  4. Pull gently on the tubing to check that the balloon is inflated

Explanation

Catheter care always moves from the urinary opening toward the outside so that organisms from the rectal area are not carried to the meatus. A clean area of the cloth is used for each stroke. The closed drainage system is never disconnected, and the tubing is not pulled.

Question 14Physical Care Skills

When cleaning a resident's dentures, the nursing assistant should:

  1. Line the sink with a towel or fill it with water before cleaning Correct answer.
  2. Use hot water to sterilize them
  3. Hold them over the bare sink to check the fit
  4. Scrub them with the resident's toothbrush and bleach

Explanation

Dentures are slippery and break easily, so the sink is padded or partly filled with water before cleaning. Cool or lukewarm water and a denture brush or cleanser are used. Hot water can warp the plastic, and bleach damages the material and leaves a harmful residue.

Question 15Physical Care Skills

A dressing over a healing wound has come loose. The nursing assistant should:

  1. Replace it with a fresh sterile dressing from the supply closet
  2. Clean the wound with alcohol and apply a bandage
  3. Tape the old dressing back in place without looking at the wound underneath
  4. Tell the nurse so the dressing can be changed by licensed staff Correct answer.

Explanation

Changing a sterile or complex dressing is outside the nursing assistant's scope, so the finding is reported to the nurse, who will inspect the wound and change the dressing. The assistant may hold a loose dressing in place with a clean covering if directed. Never re-tape a soiled dressing or put alcohol into a wound.

Question 16Physical Care Skills

A resident has a cold pack applied to a swollen ankle. The nursing assistant should:

  1. Leave it in place for one hour
  2. Check the skin often and remove the pack after 15 to 20 minutes Correct answer.
  3. Apply it to the opposite ankle as well
  4. Place it directly against the skin

Explanation

Cold applications are limited to about 15 to 20 minutes at a time, with the skin checked frequently for pale, white, or numb areas. A cloth barrier protects the skin from direct cold. Longer or unprotected use can cause tissue damage.

Question 17Physical Care Skills

A resident begins having a seizure in bed. The nursing assistant should:

  1. Leave the room to get help and return as quickly as possible
  2. Hold the resident's arms and legs still
  3. Stay, protect the head, and turn the resident to the side Correct answer.
  4. Place a spoon or a padded tongue blade between the resident's teeth

Explanation

During a seizure the caregiver stays with the resident, cushions the head, and turns the person to the side so secretions can drain. Nothing is placed in the mouth, and the limbs are not restrained. Help is summoned with the call light or by calling out rather than by leaving.

Question 18Physical Care Skills

A resident coughs and chokes while being fed. The nursing assistant should:

  1. Lay the resident flat and continue feeding slowly
  2. Give the resident a sip of water to clear the throat
  3. Stop feeding, sit the resident upright, and report to the nurse Correct answer.
  4. Pat the resident on the back and offer the next bite

Explanation

Feeding stops at the first sign of choking, the resident is positioned upright to keep the airway open, and the nurse is told. Further bites are not offered until the resident has been assessed. Thin liquids given during choking can be aspirated.

Question 19Physical Care Skills

Before using a mechanical lift to transfer a resident, the nursing assistant should:

  1. Check the sling and straps for damage and confirm the resident's weight limit Correct answer.
  2. Raise the bed to the highest position
  3. Have the resident hold the lift bar with both hands
  4. Leave the wheels of the lift unlocked so that it can move freely during the transfer

Explanation

A lift is inspected before each use, and the resident's weight is matched to the lift's rated capacity. The bed is kept low, the lift's wheels are locked during the transfer, and the resident's arms stay inside the sling.

Question 20Physical Care Skills

When performing range-of-motion exercises with a resident, the nursing assistant should:

  1. Support the limb, move slowly, and stop if the resident reports pain Correct answer.
  2. Skip joints that the resident says are stiff
  3. Move each joint quickly to finish before the resident tires
  4. Force the joint past the point of resistance to improve flexibility

Explanation

Range-of-motion exercise is done slowly with the limb supported, moving only to the point of mild resistance and never past pain. The resident is encouraged to do as much as possible. Fast or forced movement can injure joints and muscles.

Question 21Physical Care Skills

After caring for a resident on contact precautions, the nursing assistant should:

  1. Remove gloves and gown together while still standing beside the bed
  2. Remove gloves in the hallway and the gown in the soiled utility room
  3. Remove the gown first, then the gloves, and leave the room without washing your hands
  4. Remove gloves first, then the gown, and perform hand hygiene after both are off Correct answer.

Explanation

Gloves are removed first because they are the most contaminated, then the gown is untied and pulled off so that the clean side stays inside. Hand hygiene follows immediately after both are off. All removal happens at the doorway of the room, before leaving.

Question 22Physical Care Skills

A resident wears elastic compression stockings. Which action is correct?

  1. Roll them down to the ankle whenever the resident complains of tightness
  2. Check the skin, then apply them before the resident gets out of bed Correct answer.
  3. Apply lotion to the legs before putting them on
  4. Apply them at bedtime and remove them in the morning

Explanation

Compression stockings are applied in the morning before the resident gets up, while swelling is at its lowest, and the skin and circulation are checked first. They are removed at intervals during the day for skin care. Rolling them down creates a tight band that reduces circulation.

Question 23Physical Care Skills

A resident is receiving oxygen by nasal cannula. The nursing assistant should:

  1. Keep the tubing free of kinks and post no-smoking signs in the room Correct answer.
  2. Keep the oxygen running at a higher rate if the resident feels short of breath
  3. Use petroleum jelly on the nostrils to prevent dryness
  4. Store the oxygen tank lying flat on its side under the bed

Explanation

Oxygen supports combustion, so no-smoking signs are posted, the tubing is kept untangled so the flow is not blocked, and the tank is secured upright. The rate is set only by the nurse or physician. Petroleum products are avoided near oxygen.

Question 24Physical Care Skills

A resident needs a clean-catch urine specimen. The nursing assistant should:

  1. Have the resident urinate into the toilet and dip the cup in the bowl
  2. Touch the inside of the cup and lid to check that they are clean
  3. Collect the specimen from the urine in the drainage bag
  4. Give the cup and have the resident collect a midstream sample Correct answer.

Explanation

A clean-catch specimen is collected after the resident starts to void, so the urine that is tested is not contaminated by organisms at the opening of the urethra. The inside of the cup and lid is never touched, and the specimen is sent to the lab promptly. Urine from a drainage bag is not suitable because it has sat and may contain organisms from the bag.

Question 25Physical Care Skills

A resident has a reddened area on the sacrum that does not blanch when pressed. The nursing assistant should:

  1. Apply a heating pad to the area several times a day
  2. Wait a week or more to see whether the redness fades before reporting it to the nurse
  3. Massage the red area briskly to increase blood flow
  4. Keep the area clean and dry, avoid massaging it, and report it to the nurse Correct answer.

Explanation

Non-blanching redness is an early sign of pressure injury, which is reported to the nurse right away. The area is kept clean, dry, and off-loaded, and it is never massaged because that damages tissue that is already compromised. Heat is not applied to a pressure area.

Question 26Physical Care Skills

When washing the hands with soap and water, the nursing assistant should scrub the hands together for at least:

  1. 5 seconds
  2. 10 seconds
  3. 45 seconds
  4. 20 seconds Correct answer.

Explanation

Soap and water handwashing should last at least 20 seconds with friction covering palms, backs of hands, between the fingers, and under the nails. The hands are then rinsed under running water and dried with a paper towel.

Question 27Physical Care Skills

A resident has an infection caused by Clostridioides difficile. Which hand hygiene method should the nursing assistant use after giving care?

  1. Rub the hands with an alcohol-based hand sanitizer
  2. Use either method, because both destroy the bacteria
  3. Wash the hands with soap and running water Correct answer.
  4. Wipe the hands with a disinfecting surface wipe

Explanation

Alcohol-based rubs do not destroy C. difficile spores, so soap and water with friction is required. The mechanical action of washing removes the spores from the skin.

Question 28Physical Care Skills

The nursing assistant is removing soiled gloves. Which action is correct?

  1. Peel the first glove off, then remove the second glove inside out Correct answer.
  2. Pull both gloves off at the same time by the fingertips
  3. Wash the gloved hands with soap before removing them
  4. Remove each glove by pulling it off by the cuff

Explanation

The first glove is removed by touching only its outer surface, and the bare hand is then slid under the second glove so it turns inside out as it comes off. This keeps bare skin from contacting contaminated material. Hands are washed immediately afterward.

Question 29Physical Care Skills

Which action best protects the nursing assistant's back when lifting a heavy object?

  1. Twisting the trunk while lifting the object
  2. Bending the knees and holding the load close Correct answer.
  3. Bending at the waist to reach down for the object
  4. Holding the object out away from the body

Explanation

Bending the knees and keeping the load close to the body uses the strong leg muscles and keeps the weight near the center of gravity. A wide base of support and keeping the back straight further reduce strain.

Question 30Physical Care Skills

When counting a resident's respirations, the nursing assistant should:

  1. Count for 10 seconds and multiply the number by six
  2. Tell the resident that breathing is being counted so the count stays accurate
  3. Ask the resident to breathe deeply and cough during the count
  4. Keep the resident unaware that respirations are being counted Correct answer.

Explanation

Residents who know their breathing is being watched often change the rate or depth without meaning to. The assistant counts without saying so, usually for 30 seconds and doubling, or for a full minute when the rhythm is irregular.

Question 31Physical Care Skills

A resident has just finished drinking a cup of hot coffee. How should the nursing assistant obtain the temperature?

  1. Wait about 15 minutes, then take the temperature by mouth Correct answer.
  2. Rinse the mouth with cold water, then take an oral temperature
  3. Take the oral temperature right away
  4. Take a rectal temperature right away instead

Explanation

Hot or cold liquids in the mouth change the oral reading, so the assistant waits about 15 minutes before placing the thermometer. This allows the mouth to return to its baseline temperature.

Question 32Physical Care Skills

For which resident should the nursing assistant avoid taking a rectal temperature?

  1. A resident who wears upper dentures
  2. A resident who is hard of hearing
  3. A resident who has diarrhea Correct answer.
  4. A resident who is receiving oxygen by nasal cannula

Explanation

Diarrhea, recent rectal surgery, and bleeding problems are reasons to choose another route, because inserting a thermometer can irritate or injure the rectum. The assistant reports this and uses an oral, axillary, or tympanic route as directed.

Question 33Physical Care Skills

A resident is receiving a warm compress to the lower back. How often should the nursing assistant check the skin?

  1. Every 20 minutes
  2. Only when the compress is removed
  3. Every 5 minutes Correct answer.
  4. Once at the start of the treatment

Explanation

Heat increases the risk of burns, so the skin under a warm compress is checked every 5 minutes. The compress is removed and the nurse notified if the skin becomes red, blistered, or the resident reports pain.

Question 34Physical Care Skills

A resident has a prescribed wrist restraint. How often should the nursing assistant check the circulation in the restrained hand?

  1. Every 2 hours
  2. Once per shift
  3. Every 4 hours
  4. Every 15 minutes Correct answer.

Explanation

Circulation, skin condition, and function are checked at least every 15 minutes, and the restraint is released and repositioned according to the care plan. Any coolness, pallor, or numbness is reported right away.

Question 35Physical Care Skills

When assisting with a cleansing enema, the nursing assistant positions the resident:

  1. Sitting upright on a bedpan
  2. Lying on the back with the hips raised on a pillow
  3. Lying on the right side with the knees bent
  4. Lying on the left side in Sims' position Correct answer.

Explanation

The left side-lying (Sims') position follows the natural curve of the descending colon, which helps the solution flow into the bowel and be retained. Privacy, draping, and a call light within reach are also provided.

Question 36Physical Care Skills

A resident's colostomy pouch is about half full of stool. The nursing assistant should:

  1. Change the whole pouch and skin barrier system
  2. Empty the pouch into a measuring container Correct answer.
  3. Flush the pouch contents back through the stoma
  4. Wait until the pouch is completely full before emptying it

Explanation

The pouch is emptied when it is about one-third to one-half full so that its weight does not pull on the abdomen or cause leakage. Output is measured and recorded, and the opening is cleaned before it is closed again.

Question 37Physical Care Skills

When a resident has an indwelling urinary catheter, the drainage bag should be:

  1. Set on the floor beside the bed
  2. Raised above the bladder during transfers
  3. Kept below the level of the bladder Correct answer.
  4. Hooked over the side rail of the bed

Explanation

Keeping the bag below bladder level prevents urine from flowing back into the bladder and causing infection. The bag hangs from the bed frame, stays off the floor, and the tubing is kept free of kinks.

Question 38Physical Care Skills

Which action is correct when helping a resident use a bedpan?

  1. Warm the bedpan and raise the head of the bed before placing it. Correct answer.
  2. Place the bedpan on top of the bottom sheet without a cover.
  3. Keep the head of the bed flat with the resident's knees straight.
  4. Place the bedpan and leave the resident alone without a call light.

Explanation

Warming the pan prevents chilling, and raising the head of the bed into a semi-Fowler's position helps the resident use the pan comfortably. Privacy is provided and the call light is placed within reach before the assistant steps away.

Question 39Physical Care Skills

When making an occupied bed, the nursing assistant should:

  1. Raise the side rail on the side where the resident is turned Correct answer.
  2. Shake the dirty linen in the air before placing it in the hamper
  3. Hold the soiled linen against the uniform while working
  4. Place the clean linen on the floor until it is needed

Explanation

The side rail is raised whenever the assistant steps to the other side of the bed, so the resident cannot roll out. Soiled linen is folded inward and carried away from the body without shaking, and clean linen never touches the floor.

Question 40Physical Care Skills

A resident with diabetes asks the nursing assistant to trim his toenails. The nursing assistant should:

  1. Trim the nails only if there is no drainage present
  2. Soak the feet in hot water and then trim the nails
  3. Cut the toenails in a rounded shape with the clippers
  4. Report the request and check the feet for redness or injury Correct answer.

Explanation

Diabetes causes poor circulation and reduced sensation, so nail trimming is done by a podiatrist or nurse and any break in the skin must be reported. The assistant inspects the feet during routine care and reports redness, swelling, or sores.

Question 41Physical Care Skills

A resident who takes a blood-thinning medication needs a shave. The nursing assistant should use:

  1. Warm water alone, without any razor
  2. An electric razor Correct answer.
  3. A straight razor with warm water
  4. A disposable razor with shaving cream

Explanation

Electric razors cut hair close to the skin without nicking it, which matters when a resident bleeds easily because of anticoagulant medication. Any cut is reported and pressure applied as directed.

Question 42Physical Care Skills

When a resident is not wearing a hearing aid, the nursing assistant should:

  1. Turn the aid off and store it in its labeled case Correct answer.
  2. Store the aid in a glass of water to keep it clean
  3. Wrap the aid in a tissue before setting it on the overbed table
  4. Leave the aid uncovered on the bedside table

Explanation

Hearing aids are turned off, the battery is removed if the aid will be unused for a long time, and the device is kept in its labeled case away from heat and moisture. This prevents loss and damage.

Question 43Physical Care Skills

When cleaning the eyes of an unconscious resident, the nursing assistant should wipe:

  1. From the inner corner toward the outer corner Correct answer.
  2. From the outer corner toward the inner corner
  3. Back and forth across both eyes with the same cloth
  4. In a circle around the eye using soapy water

Explanation

Wiping from the inner to the outer corner moves secretions away from the tear duct and prevents them from entering it. A separate area of the cloth or a separate cloth is used for each eye to prevent cross-contamination.

Question 44Physical Care Skills

A resident who had a stroke has weakness on the left side. When helping the resident walk with a gait belt, the nursing assistant should:

  1. Walk in front and pull the resident forward by the belt
  2. Stand on the left side, slightly behind, holding the gait belt Correct answer.
  3. Stand behind and hold the resident by the shoulders
  4. Stand on the right side and hold the resident's hand

Explanation

Standing on the weak side and slightly behind lets the assistant support the affected leg and control the resident's balance through the gait belt. The resident is never pulled, and the assistant stays close to a wall or chair for safety.

Question 45Physical Care Skills

A resident is lying on the side. To maintain body alignment, the nursing assistant places a pillow:

  1. Between the knees and ankles Correct answer.
  2. Under the hips and lower back
  3. Under the abdomen
  4. Behind the head only

Explanation

A pillow between the knees and ankles keeps the hips, knees, and ankles aligned and prevents the top leg from pressing on the bottom leg. Pillows are also used to support the upper arm and back as needed.

Question 46Physical Care Skills

To help prevent pressure injuries, a resident who cannot move independently in bed should be repositioned at least:

  1. Every 30 minutes
  2. Every 15 minutes
  3. Every 4 hours
  4. Every 2 hours Correct answer.

Explanation

Repositioning at least every 2 hours relieves pressure on the skin and tissues over bony areas. The assistant also checks the skin at each turn and reports any redness that does not fade.

Question 47Physical Care Skills

A resident needs to provide a sputum specimen. The nursing assistant should collect it:

  1. By swabbing the inside of the cheek
  2. Right after a meal, when coughing is easiest
  3. In the early morning after the resident coughs deeply Correct answer.
  4. From the saliva the resident spits into the cup

Explanation

Sputum comes from deep in the lungs, so the resident is asked to cough deeply and raise material into the container, ideally early in the morning. The specimen is sent to the laboratory promptly and is not mixed with saliva.

Question 48Physical Care Skills

A 24-hour urine collection begins at 7 a.m. What should the nursing assistant do with the urine the resident voids at 7 a.m.?

  1. Save it along with all urine for the next 24 hours
  2. Send it to the laboratory in a separate container
  3. Discard it, then save all urine produced after that Correct answer.
  4. Save half of it and discard the rest

Explanation

The first voided specimen is discarded because it formed before the collection period began, and every specimen after that is saved until the period ends. The container is kept cool and labeled with the start and stop times.

Question 49Physical Care Skills

A resident is receiving a tube feeding. The head of the bed should be elevated:

  1. 30 to 45 degrees Correct answer.
  2. 10 to 15 degrees
  3. Flat, with the resident lying on the back
  4. 15 to 20 degrees

Explanation

An elevation of 30 to 45 degrees during the feeding and for about 30 minutes afterward reduces the risk of formula flowing back up and being aspirated. The resident is not repositioned flat while the feeding is infusing.

Question 50Physical Care Skills

A resident is learning to use a walker. Which sequence is correct?

  1. Hold the walker on the strong side and step with the weak leg first
  2. Move the walker forward, then the weak leg, then the strong leg Correct answer.
  3. Move the walker forward, then the strong leg, then the weak leg
  4. Step with the weak leg, then move the walker, then the strong leg

Explanation

The walker is moved forward first, then the weaker leg steps into it, and finally the stronger leg bears the weight and catches up. The resident holds both handles and looks forward, not down at the feet.