Physical Care Skills
Hygiene, mobility, nutrition, elimination, and vital signs
Physical care questions test whether you can keep a resident clean and safe while protecting yourself and the resident's dignity. Expect a skill to be described step by step, and expect the question to ask for the first action, the next action, or the best action.
Core concepts: hand hygiene before and after every resident contact and before and after glove use; standard precautions with every resident, not just those with a known infection; perineal care always front to back; range-of-motion exercises done gently, stopping at the point of resistance or pain; repositioning at least every two hours, with good body mechanics (wide base, bend at the knees, load close to the body, never twist); intake and output measured in milliliters; thickened liquids and upright positioning to prevent aspiration; catheter bags kept below the level of the bladder; vital signs taken with correct technique and reported when abnormal.
Traps to watch for: answers that force a joint, massage a reddened area, cut a diabetic resident's toenails, rush a resident, or skip identification. Hand hygiene is almost always the correct first step. Never chart a task before you perform it. If a resident refuses care, respect the refusal, document it, and report it; you do not overrule the resident.
Rule of thumb: when two answers both seem reasonable, pick the one that protects safety and dignity. Any option saying 'force,' 'hurry,' or 'skip' is wrong.
Worked example: asked for the order of perineal care, wash the urethral area first, using a fresh part of the washcloth for each stroke, always moving front to back, and wash the anal area last. Contamination is never carried toward the urinary opening.