Basic Nursing Skills and Personal Care Skills
Concepts you must understand
This domain tests sequence and technique. Always begin and end with hand hygiene and safety checks. Know the general principles:
Bathing: wash eyes from the inner to the outer corner using a different part of the cloth; wash from clean to dirty (face and upper body before legs and feet); wash the perineal area last. Perineal care: front to back, one stroke per cloth, gloves worn, and report any redness, discharge, or odor.
Skin and pressure injuries: reposition at least every two hours (more if policy requires), inspect skin at each turn, keep skin clean and dry, and never massage reddened bony areas. Report any broken skin immediately.
Mouth care at least twice daily and after meals; dentures are removed, brushed, and stored in labeled containers in water (not hot water).
Nails: do not cut the toenails of a resident with diabetes or circulatory problems - report to the nurse or the designated provider.
Vital signs, weights, and intake/output must be measured accurately and reported if outside the range set for that resident. Report changes rather than interpreting them.
Traps in questions
Sequence questions usually hinge on hand hygiene or on clean-before-dirty. Powder in skin folds, hot water bottles, and massaging red areas are wrong. Never chart a value you did not measure, and never "estimate" a weight or intake.
Rule of thumb
Clean to dirty, front to back, and report what you see.
Worked example: You are giving perineal care to a female resident. The correct order is: hand hygiene, gloves, expose only the area needed, wipe front to back with a clean portion of cloth for each stroke, rinse and dry, remove gloves, hand hygiene, and document. Wiping back to front risks introducing bowel organisms into the urinary tract.