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Question 1Physical Care Skills
A nursing assistant is about to care for a resident. When should hand hygiene be performed?
- At the end of the shift only
- Before and after each contact Correct answer.
- Only when the resident asks
- Whenever gloves are unavailable
Explanation
Hand hygiene is performed before and after every resident contact and after touching body fluids or contaminated items. It is the single most effective step in preventing the spread of infection.
Question 2Physical Care Skills
How often should a dependent resident who cannot move independently be repositioned?
- At least every 2 hours Correct answer.
- Once during each eight-hour shift
- Every 30 minutes around the clock
- Every 4 hours
Explanation
Turning and repositioning at least every 2 hours relieves pressure on the skin and helps prevent pressure injuries. Residents at higher risk may need to be turned more often, as directed by the care plan.
Question 3Physical Care Skills
A resident is unconscious. How should the nursing assistant give mouth care?
- Delay mouth care until the resident is awake
- Turn the resident to the side and use little fluid Correct answer.
- Use a firm toothbrush with the bed flat
- Place the resident flat and rinse with plenty of water
Explanation
An unconscious resident cannot swallow or protect the airway, so the head is turned to the side and only a small amount of fluid is used. Suction equipment should be available during the procedure.
Question 4Physical Care Skills
How should the nursing assistant store a resident's dentures when they are not in the mouth?
- In hot water to keep them clean
- In a labeled cup filled with cool water Correct answer.
- In a dry cup on the bedside table
- Wrapped in a dry paper towel in a drawer
Explanation
Dentures are stored in a labeled container with cool water so they stay moist and are not lost or thrown away. Hot water can warp or crack the plastic.
Question 5Physical Care Skills
Where does a gait belt go when helping a resident walk?
- Under the arms and across the chest
- Around the upper thighs
- Around both wrists
- Around the waist, over the clothing Correct answer.
Explanation
A gait belt is fastened snugly around the resident's waist over clothing, giving the assistant a secure hold near the resident's center of gravity. It should be tight enough that two fingers fit under it.
Question 6Physical Care Skills
A resident has an indwelling urinary catheter. Where should the drainage bag be kept?
- Below the bladder, off the floor Correct answer.
- Resting on the floor beside the bed
- Hanging on the side rail of the bed
- Raised to the level of the bladder
Explanation
The bag must stay below the level of the bladder so urine drains out and cannot flow back into the bladder. It is also kept off the floor to prevent contamination.
Question 7Physical Care Skills
A resident has just finished a cup of hot coffee. How long should the nursing assistant wait before taking an oral temperature?
- About 15 to 30 minutes Correct answer.
- No wait is needed
- About 2 hours
- About 2 minutes
Explanation
Hot or cold food and drink change the temperature inside the mouth, so oral temperature is delayed about 15 to 30 minutes. Another route may be used if the temperature is needed sooner.
Question 8Physical Care Skills
A resident's respirations are regular. How should the nursing assistant count them?
- Count for 30 seconds and multiply by two Correct answer.
- Count for 15 seconds and multiply by four
- Count for 5 seconds and multiply by twelve
- Count for 10 seconds and multiply by six
Explanation
For regular respirations, counting for 30 seconds and doubling the number gives an accurate rate. If the rhythm is irregular, the respirations are counted for a full minute.
Question 9Physical Care Skills
A resident drinks 8 ounces of water. How many milliliters should the nursing assistant record?
- 80 mL
- 240 mL Correct answer.
- 120 mL
- 480 mL
Explanation
One ounce equals 30 milliliters, so 8 ounces multiplied by 30 equals 240 mL. Fluid intake is recorded in milliliters on the intake and output sheet.
Question 10Physical Care Skills
When should elastic stockings be applied to a resident?
- In the morning, before the resident gets up Correct answer.
- At bedtime, after the legs are elevated
- After the resident has walked to the bathroom
- Only when the legs look swollen
Explanation
Elastic stockings are applied before the resident gets out of bed, when swelling is at its lowest. They are removed as ordered, usually at least once per shift, to check the skin and circulation.
Question 11Physical Care Skills
A resident with diabetes has dry, cracked skin on the feet. Which action is appropriate for the nursing assistant?
- Soak the feet in hot water to soften the skin
- Rub lotion generously between the toes
- Cut the corns off with a sterile blade
- Dry carefully between the toes and report cracks Correct answer.
Explanation
Residents with diabetes have poor circulation and slow healing, so the feet are washed, dried thoroughly between the toes, and any breaks in the skin are reported. Nail and callus care is done by a nurse or podiatrist.
Question 12Physical Care Skills
A resident has poor circulation in the legs. What should the nursing assistant do about trimming the toenails?
- Round the corners to prevent ingrown nails
- Trim them straight across with cuticle scissors
- Soak the feet first, then cut deeply into the corners
- Report to the nurse and do not trim them Correct answer.
Explanation
Residents with diabetes, poor circulation, or blood thinners are at high risk for infection and bleeding, so nail care is done by a nurse or podiatrist. The assistant reports the need rather than cutting the nails.
Question 13Physical Care Skills
Which resident should not receive a hot pack without a specific order and extra precautions?
- A resident with a mild headache
- A resident with muscle stiffness in the back
- A resident with numbness in the feet Correct answer.
- A resident with a stiff neck
Explanation
Heat is unsafe where sensation is reduced or circulation is poor, because the resident cannot feel pain or heat and the skin may burn before anyone notices. A specific order and close monitoring are required.
Question 14Physical Care Skills
While a cold pack is in place, the nursing assistant notices that the skin looks pale and gray. What should be done?
- Add another layer of cloth over the pack
- Remove the pack and tell the nurse Correct answer.
- Rub the area to bring back the color
- Leave the pack in place for the full ordered time
Explanation
Pale, gray, white, or blue skin means blood flow is being reduced too much, so the cold application is stopped and the nurse is informed. The area is then checked and documented.
Question 15Physical Care Skills
Which action shows good body mechanics when lifting a heavy object?
- Bend the knees and keep the load close Correct answer.
- Twist the trunk while lifting
- Bend at the waist and reach forward
- Keep the feet together and lean over
Explanation
Bending the knees and holding the load close keeps the back straight and uses the strong leg muscles. This reduces strain on the spine and lowers the risk of injury to both the resident and the assistant.
Question 16Physical Care Skills
A resident needs to be moved up in bed. Which approach is best?
- Use a draw sheet and get a coworker to help Correct answer.
- Pull the resident by the arms toward the head of the bed
- Lower the bed to knee height before starting
- Have the resident hold the side rail and pull alone
Explanation
A draw sheet reduces friction against the skin, and having a coworker help spreads the effort and protects both backs. The bed is raised to a comfortable working height with the head of the bed flat.
Question 17Physical Care Skills
Which position is used when giving a resident an enema?
- Prone
- Supine with legs flat
- High Fowler's position
- Sims' position on the left side Correct answer.
Explanation
Sims' position on the left side, with the right knee drawn up, follows the natural curve of the colon. This helps the solution flow into the bowel and be retained.
Question 18Physical Care Skills
A pulse oximeter reading seems low on a resident with cold hands and dark nail polish. What should the nursing assistant do first?
- Warm the hand and try another finger Correct answer.
- Ask the resident to hold their breath briefly
- Record the low reading as it stands
- Report that the resident needs oxygen started
Explanation
Cold fingers, poor circulation, and nail polish interfere with the light signal the oximeter uses. Warming the hand and trying another site gives a reliable value before anything is reported.
Question 19Physical Care Skills
A resident has an ordered wrist restraint. How often should the nursing assistant check the skin and circulation in the restrained hand?
- Every 4 hours
- Once at the end of each shift
- Every 15 minutes Correct answer.
- Every hour
Explanation
Circulation, color, warmth, and pulse are checked at least every 15 minutes. The restraint is released, the limb is exercised, and the resident is repositioned at least every 2 hours.
Question 20Physical Care Skills
In which direction is perineal care given?
- From the rectum toward the urethra
- In a circular motion around the anus
- From the urethra toward the rectum Correct answer.
- Back and forth across the perineum
Explanation
Washing from front to back moves bacteria away from the urethra, reducing the risk of urinary tract infection. A clean area of the cloth is used for each stroke.
Question 21Physical Care Skills
After a stroke, a resident coughs at meals and pockets food on one side of the mouth. Which action is best during meals?
- Feed quickly so the resident does not tire
- Offer thin liquids with meals to help wash food down
- Put food on the stronger side and check the cheek Correct answer.
- Lay the resident back so that swallowing is easier
Explanation
The unaffected side has better sensation and chewing, and checking the cheek for pocketed food helps prevent aspiration. The resident stays upright during the meal and for a period afterward.
Question 22Physical Care Skills
Which item must be kept away from a resident who is using oxygen?
- Petroleum jelly Correct answer.
- A cotton blanket
- A plastic water pitcher
- A metal spoon
Explanation
Oxygen supports combustion, and oil-based products such as petroleum jelly can ignite and cause a serious burn. A water-based lubricant is used instead, and no one smokes near the oxygen.
Question 23Physical Care Skills
Which action is correct when removing soiled bed linens?
- Shake the soiled linen open in the air
- Place the soiled linen on the floor
- Hold the linen against your uniform
- Roll soiled linen inward Correct answer.
Explanation
Soiled linens are rolled inward with the dirty side inside and carried away from the body and uniform. They are never shaken, because shaking sends microorganisms into the air and onto nearby surfaces.
Question 24Physical Care Skills
A reddened area over a resident's hip does not fade after repositioning. What should the nursing assistant do?
- Apply a hot water bottle over the redness
- Keep pressure off it and report to the nurse Correct answer.
- Wait a few days to see whether it clears
- Massage the area firmly to increase blood flow
Explanation
Redness that does not blanch after pressure is relieved is an early pressure injury. Pressure must be kept off the area and the nurse notified so treatment can begin, and the area is never massaged.
Question 25Physical Care Skills
When leaving a resident's room, which piece of personal protective equipment is removed first?
- The gloves Correct answer.
- The goggles
- The mask
- The gown
Explanation
Gloves are the most contaminated item, so they are removed first, followed by goggles, gown, and mask. Hand hygiene is performed after removal and between steps.
Question 26Physical Care Skills
When washing hands with soap and water, how long should the nursing assistant rub the hands together?
- For about 5 seconds
- For about 10 seconds
- For at least 20 seconds Correct answer.
- For at least 2 minutes
Explanation
Soap and water handwashing should last at least 20 seconds, covering palms, backs, between fingers, and under nails. This contact time helps remove transient microorganisms. Longer scrubbing is needed only when visible soil requires it.
Question 27Physical Care Skills
How should the nursing assistant clean a resident's dentures?
- Brush with a soft brush and cool water. Correct answer.
- Use mouthwash only and skip brushing.
- Soak them in hot water and household bleach.
- Place them in the dishwasher with the regular dishes.
Explanation
Dentures are brushed with a soft brush and cool water, ideally over a basin lined with a towel to prevent breakage. Hot water can warp dentures, and bleach or dishwasher cleaning can damage them. Mouthwash alone does not remove plaque.
Question 28Physical Care Skills
How often should a dependent resident generally be repositioned to help prevent pressure ulcers?
- At least every 2 hours Correct answer.
- Once per shift
- Every 30 minutes
- Every 6 hours
Explanation
Dependent residents are typically repositioned at least every 2 hours, and more often if skin is fragile or the surface is not pressure-relieving. A schedule is used and the skin is checked with each turn. Waiting longer increases pressure injury risk.
Question 29Physical Care Skills
Before helping a resident into a wheelchair, what should the nursing assistant do?
- Leave the wheels unlocked so the chair can be adjusted.
- Tip the chair back on its rear wheels.
- Lock the wheels and move the footrests out of the way. Correct answer.
- Lower the footrests and keep the brakes off.
Explanation
Locking the wheels keeps the chair from rolling during transfer, and moving the footrests aside prevents tripping. The chair should be close to the bed and stable. Brakes are released only after the resident is safely seated.
Question 30Physical Care Skills
How should the nursing assistant count a radial pulse?
- Count for 15 seconds and multiply by 4.
- Count for 30 seconds and multiply by 2.
- Count for a full minute, noting rate and rhythm. Correct answer.
- Count for 10 seconds and multiply by 6.
Explanation
A full-minute count is most accurate and allows the nursing assistant to note an irregular rhythm. Shorter counts multiply errors, especially if the pulse is irregular. Rate, rhythm, and strength are recorded.
Question 31Physical Care Skills
How should the nursing assistant check the temperature of bath water for a resident?
- Use a bath thermometer; keep water near 105°F. Correct answer.
- Estimate the temperature by touching the faucet handle.
- Add ice until the water feels cold to the wrist.
- Use the hottest water the resident can tolerate.
Explanation
Water at about 105°F (40.5°C) is generally safe and comfortable; a bath thermometer gives an objective check. Hotter water can burn fragile skin, especially in older adults. The resident's comfort and skin condition are also monitored.
Question 32Physical Care Skills
Which position is usually best for a resident who is short of breath?
- Fowler's Correct answer.
- Prone
- Trendelenburg
- Supine
Explanation
Fowler's position raises the head of the bed, allowing the chest to expand more easily and improving breathing. Prone and supine can make breathing harder, and Trendelenburg lowers the head. The height is adjusted for comfort and safety.
Question 33Physical Care Skills
When assisting a resident to use a bedpan, which action is correct?
- Warm the pan, place it under the hips, and raise the head if allowed. Correct answer.
- Leave the resident alone and close the door without a call light.
- Keep the head of the bed flat during use.
- Slide the bedpan under the resident's shoulders.
Explanation
Warming the bedpan improves comfort, placing it under the hips positions it correctly, and raising the head if permitted helps with elimination. The resident should have privacy, a call light, and be checked promptly. The bedpan is not placed under the shoulders.
Question 34Physical Care Skills
A resident is unconscious. How should the nursing assistant provide mouth care?
- Use a hard toothbrush and brush vigorously.
- Turn the resident's head to the side and use a small amount of water. Correct answer.
- Sit the resident upright and have the resident rinse and spit.
- Place the resident flat on the back and use a large amount of water.
Explanation
An unconscious resident cannot swallow safely, so the head is turned to the side to allow drainage and only a small amount of fluid is used. The mouth is inspected and cleaned gently with sponge swabs or a soft brush. Never give fluids to swallow or place the resident flat.
Question 35Physical Care Skills
When making an occupied bed, what should the nursing assistant do first?
- Pull the dirty linens out from under the resident quickly.
- Remove all pillows from under the resident's head.
- Raise the bed and lower the near side rail. Correct answer.
- Ask the resident to roll to the side of the bed being made.
Explanation
Raising the bed to working height protects the nursing assistant's back, and lowering the near side rail gives access while the far rail stays up for safety. The resident is then assisted to turn toward the far side. Dirty linens are rolled away from the resident, not pulled quickly.
Question 36Physical Care Skills
A resident must be logrolled. What should the nursing assistant do?
- Raise the head of the bed before turning.
- Turn the resident as a unit, keeping the spine straight. Correct answer.
- Pull the resident by the arms toward the edge of the bed.
- Have the resident twist at the waist to help turn.
Explanation
Logrolling keeps the head, trunk, and hips aligned and turns the resident as a unit, usually with several helpers. Twisting or pulling by the arms can injure the spine or shoulders. The bed is kept flat for the turn unless ordered otherwise.
Question 37Physical Care Skills
When using a gait belt to help a resident stand, where should the belt be placed?
- Around the upper thighs
- Loose around the hips so it can slide
- Under the resident's arms around the chest
- Snug around the waist over clothing Correct answer.
Explanation
A gait belt is placed snugly around the waist over clothing, where it can support the resident without pressing on the ribs or breasts. It should allow a hand to slide underneath but not be loose. The nursing assistant grasps the belt, not the resident's arms.
Question 38Physical Care Skills
A resident is too weak to bear weight. How should the nursing assistant move the resident from bed to chair?
- Ask the resident to stand and pivot quickly.
- Place the resident's arms around the nursing assistant's neck and lift.
- Drag the resident onto a sheet toward the chair.
- Use a mechanical lift with enough staff. Correct answer.
Explanation
A mechanical lift is used when the resident cannot bear weight, and enough staff must operate it according to the manufacturer's instructions. Lifting with the resident's arms around the neck can injure both people. Dragging or forcing a pivot risks falls and skin damage.
Question 39Physical Care Skills
When weighing a resident who uses a wheelchair, which action is correct?
- Estimate the weight if the resident cannot stand.
- Use the same scale and weigh at about the same time of day. Correct answer.
- Weigh the resident with shoes on and subtract a fixed amount.
- Weigh the resident after a large meal each time.
Explanation
Consistency matters, so the same scale and similar time of day and clothing are used for comparison. The resident is weighed accurately, not estimated, and the wheelchair weight is subtracted if a chair scale is used. Shoes and meals can change readings.
Question 40Physical Care Skills
When taking a blood pressure, where should the nursing assistant place the cuff?
- One inch above the antecubital space, over the brachial artery. Correct answer.
- Around the wrist on the same side as the pulse.
- Over the resident's sleeve on the upper arm.
- Over the antecubital space so the stethoscope fits under the cuff.
Explanation
The cuff goes on the bare upper arm about one inch above the antecubital space, with the bladder centered over the brachial artery. It should be snug but not tight. The stethoscope is placed over the artery below the cuff, not under it.
Question 41Physical Care Skills
A resident vomits 200 mL. How should the nursing assistant record this on the intake and output sheet?
- As output of 200 mL Correct answer.
- Not at all, because vomit is not urine
- As intake of 200 mL
- As 100 mL of output because half is water
Explanation
Emesis is measured and recorded as output because it is fluid leaving the body. The amount is recorded in milliliters on the output side. It is not counted as intake or ignored.
Question 42Physical Care Skills
A resident needs a clean-catch midstream urine specimen. What should the nursing assistant do?
- Collect all urine for 24 hours and send the whole container.
- Collect the first urine that comes out into the container.
- Take urine from the drainage bag of a catheter.
- Clean the area, then collect urine after the stream has started. Correct answer.
Explanation
For a midstream specimen, the area is cleaned and the first portion of urine is allowed to pass, then the middle portion is collected to reduce contamination. The first urine is not collected, and drainage bag urine is not used for a clean-catch specimen. A 24-hour collection is a different test.
Question 43Physical Care Skills
When emptying a colostomy pouch, what should the nursing assistant do?
- Empty it when it is one-third to one-half full. Correct answer.
- Flush the pouch contents into the resident's drinking water.
- Clean the stoma with alcohol after each emptying.
- Wait until the pouch is completely full to avoid odor.
Explanation
A colostomy pouch is emptied when it is about one-third to one-half full to prevent weight, leaking, and skin problems. The stool is observed and the pouch opening is cleaned with mild soap and water. Alcohol can irritate the stoma and skin.
Question 44Physical Care Skills
How should the nursing assistant perform routine catheter care?
- Wash from the anus toward the catheter.
- Use alcohol on the meatus every day.
- Wash from the catheter outward toward the anus. Correct answer.
- Pull gently on the catheter to check the balloon.
Explanation
Catheter care is cleaned from the catheter outward toward the anus to avoid bringing bacteria to the meatus. Mild soap and water are used, and the catheter is not tugged. Pulling can injure the urethra and dislodge the balloon.
Question 45Physical Care Skills
When helping a resident with range-of-motion exercises, what should the nursing assistant do?
- Support the limb and move it gently through its range. Correct answer.
- Skip the joint if the resident says it is sore.
- Move the joint quickly to the point of pain.
- Force the joint past resistance to improve flexibility.
Explanation
Range-of-motion exercises are done slowly with the limb supported, stopping at pain or resistance. Forcing a joint can cause injury, and sudden movement can hurt. Soreness is reported and the nurse is told before deciding to skip a joint.
Question 46Physical Care Skills
A resident begins to have a seizure. What should the nursing assistant do?
- Place something in the mouth to keep the tongue from being bitten.
- Hold the resident's arms and legs still.
- Give the resident water to swallow.
- Lower the resident to the floor and protect the head. Correct answer.
Explanation
During a seizure, the priority is to protect the resident from injury by lowering them to the floor if needed and cushioning the head. Nothing is placed in the mouth, and the limbs are not restrained. The seizure is timed and the nurse is called.
Question 47Physical Care Skills
A resident is choking and cannot speak or cough. What should the nursing assistant do?
- Lay the resident flat and check the mouth blindly.
- Wait to see if the resident can cough.
- Give the resident a glass of water.
- Give abdominal thrusts. Correct answer.
Explanation
Ineffective coughing, inability to speak, and distress indicate severe airway obstruction, so abdominal thrusts are given. Water is not given, blind finger sweeps are avoided, and waiting can lead to unconsciousness. The nurse is called and CPR started if the resident becomes unresponsive.
Question 48Physical Care Skills
A resident starts to fall while walking. What should the nursing assistant do?
- Ease the resident to the floor while protecting the head. Correct answer.
- Catch the resident under the arms and hold them upright.
- Pull the resident back to the bed by the gait belt.
- Run to get the nurse before helping.
Explanation
When a fall is already happening, the nursing assistant lowers the resident to the floor in a controlled way and protects the head rather than trying to catch or hold them upright. This reduces injury to both people. The nurse is called after the resident is safe.
Question 49Physical Care Skills
When should a rectal temperature generally be avoided?
- When the resident is on a clear liquid diet.
- When the resident has a mild cold.
- When the resident has diarrhea or rectal surgery. Correct answer.
- When the resident is receiving physical therapy for an ankle sprain.
Explanation
Rectal temperatures are avoided with diarrhea, rectal surgery, bleeding, or other rectal conditions because insertion can cause injury or discomfort. Another route is chosen. A cold, diet, or ankle sprain does not directly contraindicate rectal temperature.
Question 50Physical Care Skills
A resident with an indwelling catheter has an order for a urine specimen. Where should the nursing assistant obtain it?
- From the urine that leaks around the catheter.
- From the drainage bag after it has been emptied.
- By disconnecting the catheter from the tubing.
- From the catheter's sampling port. Correct answer.
Explanation
A catheter urine specimen is obtained from the sampling port with a sterile syringe to avoid contamination. Drainage bag urine is not fresh and may contain bacteria, and the closed system is not disconnected. Leakage around the catheter is not a proper specimen.