Providing Personal Care and Basic Nursing Skills
What the exam expects
Personal care - bathing, grooming, oral care, toileting and perineal care, dressing - is the largest part of your shift and the source of most skill questions. Every task has a defensible order and a built-in safety check.
Provide privacy first: close the door or curtain, drape the resident, and expose only the area being washed. Check bath water with your inner wrist (comfortably warm, roughly 100–105°F). Wash from cleanest to dirtiest, and wash the perineum last during a bath. In perineal care, wipe front to back, away from the urethra, with a fresh part of the washcloth for each stroke. For dentures, wear gloves, line the sink with a washcloth or fill it with water, and use cool water - hot water warps denture material. Never cut the fingernails or toenails of a resident with diabetes or poor circulation; file only and report.
Basic nursing skills include temperature, pulse, respirations, blood pressure, height and weight, intake and output, specimen collection, and non-sterile simple dressings. Wait about 15 minutes after a hot or cold drink before taking an oral temperature. Count respirations for a full minute without announcing it, because breathing changes when a person knows it is being counted. Your job with abnormal findings is to observe, record, and report - not to treat.
Traps
The exam often rewards the answer that protects privacy, safety, and independence over speed. If a resident can wash their own face, let them.
Rule of thumb: if what you found would be news to the nurse, report it - tell the charge nurse before the end of the shift, and immediately if it is urgent.