22 Personal Care in the Home Practice Questions & Answers

1. 1. A home health aide is running a tub bath and the written care plan states the water must not be hotter than 105°F. What should the aide do?

   • A.Test the water with a bath thermometer and have the client confirm it feels comfortable.✓ Answer
   • B.Let the client step in first and say whether the temperature should be adjusted.
   • C.Run the water hotter than 105°F, since the tub will cool while the client undresses.
   • D.Judge the water by hand, since a thermometer is not needed when the tub fills quickly.

   Older and chronically ill clients often have thin skin and reduced heat sensation, so they may not feel a burn until injury has occurred. An objective thermometer reading at or below 105°F plus the client's own confirmation gives two independent safeguards before any skin contact.

   Source: 42 CFR 484.80(b)(3)(ix)(B) (tub/shower bath); standard HHA bathing procedure, water at or below 105°FReport a problem with this question

2. 2. A client tells the aide she does not want her shower today and asks that it be skipped, although the care plan schedules one. What should the aide do?

   • A.Accept her decision, write it in the notes, and tell the supervising nurse.✓ Answer
   • B.Ask her daughter to talk her into it, then bathe her before leaving.
   • C.Skip it quietly and mark the shower as done to keep the record simple.
   • D.Insist gently until she agrees, since the care plan schedules a shower.

   A patient has the right to refuse care, and pressuring or overriding that refusal violates the right and can constitute mistreatment. The aide's obligation is to honor the refusal, document exactly what happened, and report it so the nurse can reassess the plan of care.

   Source: 42 CFR 484.50(b) patient rights (right to refuse care); 42 CFR 484.80(b)(3)(ii) and (viii)Report a problem with this question

3. 3. A female client has just had an episode of urinary incontinence. How should the aide perform perineal care?

   • A.Wipe from back to front, using firm strokes to remove all traces of urine.
   • B.Wipe the outer folds only, leaving the inner folds for the next full bath.
   • C.Wipe in circles around the anus first, then move forward with the same cloth.
   • D.Wipe from front to back, using a clean area of the cloth for each stroke.✓ Answer

   The female urethra is short and sits just in front of the anus, so any stroke moving backward to forward carries rectal bacteria toward the bladder opening and causes urinary tract infections. Using a fresh area of the washcloth for every stroke keeps already-soiled cloth from re-contaminating clean skin.

   Source: 42 CFR 484.80(b)(3)(ix)(F) toileting and elimination; standard perineal care procedureReport a problem with this question

4. 4. The aide is giving perineal care to an uncircumcised male client. Which sequence is correct?

   • A.Clean the scrotum first, then wipe around the urethral opening with the same cloth.
   • B.Retract the foreskin, clean from the urethral opening outward, and leave it retracted.
   • C.Wash over the foreskin without retracting it, then dry the penis and the scrotum.
   • D.Retract the foreskin, clean from the urethral opening outward, then replace the foreskin.✓ Answer

   Cleaning outward from the urethral opening moves organisms away from the entry point to the bladder rather than toward it. Leaving the foreskin retracted is the step most often forgotten and can cause painful swelling and constriction of blood flow, so replacing it is a required part of the skill.

   Source: 42 CFR 484.80(b)(3)(ix)(F); standard male perineal care procedureReport a problem with this question

5. 5. The aide is cleaning a client's dentures at the bathroom sink. Which action is correct?

   • A.Fill the sink with hot water and soak the dentures in it to loosen debris.
   • B.Hold the dentures over the empty sink and rinse them under hot running water.
   • C.Line the sink with a towel and wash the dentures in cool or lukewarm water.✓ Answer
   • D.Scrub the dentures with diluted bleach and store them dry in a covered cup.

   Hot water warps the acrylic base of dentures so they no longer fit, and dentures dry out and crack when stored without water. A towel in the sink cushions the fall if they slip, because dentures are costly to replace and are the client's property.

   Source: 42 CFR 484.80(b)(3)(ix)(E) oral hygiene; (b)(3)(viii) respect for the patient's propertyReport a problem with this question

6. 6. A client is unconscious and the care plan assigns mouth care twice a day. What should the aide do?

   • A.Hold the mouth open with your gloved fingers and swab far back on the tongue.
   • B.Skip mouth care while the client is unconscious and nothing is taken by mouth.
   • C.Turn the client on the side with the head turned and use very little fluid.✓ Answer
   • D.Lay the client flat on the back and rinse the mouth with a full cup of water.

   An unconscious client has no gag or swallow reflex to protect the airway, so side-lying with the head turned lets fluid drain out of the mouth instead of into the lungs. Minimal fluid limits the volume available to be aspirated, and swabbing far back or using bare fingers risks gagging and a bite injury.

   Source: 42 CFR 484.80(b)(3)(ix)(E) oral hygiene; standard unconscious oral care procedureReport a problem with this question

7. 7. A client with diabetes has dry feet and thick, yellowed toenails. What should the aide do during foot care?

   • A.Trim the nails straight across after the bath and apply lotion between the toes.
   • B.Soak the feet twenty minutes to soften the nails, then file them and report.
   • C.File the nails short and use a heating pad afterward to warm the cold feet.
   • D.Dry between the toes, apply lotion to the tops and soles, and report the nails.✓ Answer

   Diabetes brings poor circulation and reduced sensation, so a nick from clipping can become a non-healing ulcer that the client never feels. Moisture trapped between the toes macerates skin and invites fungal infection, and soaking or heat sources cause burns and skin breakdown, so thick or discolored nails are reported rather than treated.

   Source: 42 CFR 484.80(b)(3)(ix)(D) nail and skin care; (b)(3)(xiii) reporting changes in skin conditionReport a problem with this question

8. 8. A client who takes a prescribed blood thinner asks the aide for help shaving. What is the safest approach?

   • A.Use an electric razor and shave against the hair growth to save time.
   • B.Use a safety razor and shave against the hair growth for a closer result.
   • C.Use a safety razor with plenty of lather and shave with the hair growth.
   • D.Use an electric razor and shave in the direction the hair grows.✓ Answer

   Anticoagulants prevent clot formation, so a small razor nick can bleed for a long time and is difficult to control in a home with no clinical supplies. An electric razor has no exposed blade against the skin, and shaving with the direction of growth avoids the pulling that causes cuts and irritation.

   Source: 42 CFR 484.80(b)(3)(ix) personal hygiene and grooming; standard shaving precautions for clients on anticoagulantsReport a problem with this question

9. 9. A client has left-sided weakness after a stroke and is putting on a pullover shirt. What is the correct order?

   • A.Put both arms in together and pull the shirt over the head in one motion.
   • B.Put the left sleeve on first; when undressing, take the right sleeve off first.✓ Answer
   • C.Put the left sleeve on first and take the left sleeve off first as well.
   • D.Put the right sleeve on first; when undressing, take the left sleeve off first.

   The weak arm is dressed first because the garment is still loose and open, so the joint can be guided through with the least stretching or twisting. It comes out last for the same reason: by then the strong arm is free and the fabric is slack, which protects a shoulder that cannot protect itself.

   Source: 42 CFR 484.80(b)(3)(ix) personal hygiene and grooming; standard hemiplegia dressing sequenceReport a problem with this question

10. 10. The aide has just finished changing a soiled incontinence brief and the next task is combing the client's hair. What should the aide do?

    • A.Keep the same gloves on, since the hands stayed clean inside of them.
    • B.Remove the gloves, wash the hands with soap and water, then comb the hair.✓ Answer
    • C.Remove the gloves, rub on hand sanitizer, and comb the hair right away.
    • D.Change into fresh gloves without washing, then comb the client's hair.

    Gloves develop unseen tears and hands become contaminated during removal, so gloves never replace hand hygiene. After contact with stool or urine the hands are visibly or potentially soiled, and soap and running water physically remove that soil in a way an alcohol rub does not.

    Source: 42 CFR 484.80(b)(3)(iv) basic infection prevention and control procedures; CDC hand hygiene guidanceReport a problem with this question

11. 11. A client with an indwelling urinary catheter is being moved from the bed to an armchair at home. Where should the drainage bag be placed?

    • A.On the chair frame below the bladder, with the tubing free of kinks.✓ Answer
    • B.Above the bladder briefly so the tubing drains back before the move.
    • C.On the side rail of the bed at the level of the hip, coiled loosely.
    • D.On the client's lap during the move, then on the floor beside the chair.

    Urine drains by gravity, so a bag held at or above bladder level lets contaminated urine flow back toward the bladder and cause infection. The floor contaminates the bag, a moving side rail can pull the catheter, and kinks stop drainage and let urine back up in the tubing.

    Source: 42 CFR 484.80(b)(3)(ix)(F) toileting and elimination; standard closed urinary drainage system careReport a problem with this question

12. 12. The catheter bag has collected no urine since the aide arrived, and the client says her lower abdomen feels full and uncomfortable. What should the aide do?

    • A.Flush the tubing with water to clear it, then note it in the record.
    • B.Report it to the supervising nurse now and record what was observed.✓ Answer
    • C.Offer extra fluids to increase output and report it at the next visit.
    • D.Pull the catheter back an inch to reposition it and report it later.

    Irrigating, repositioning or removing a catheter is a skilled nursing procedure outside the aide's assignment, and opening the closed system introduces bacteria. Absent output with abdominal fullness can mean obstruction or retention, which is a change in body function that must be reported to the supervisor at once.

    Source: 42 CFR 484.80(g)(2) written patient care instructions; 484.80(b)(3)(ii) and (b)(3)(v) observation and reportingReport a problem with this question

13. 13. Thirty minutes after the aide turned a bed-bound client off her back, the skin over her tailbone is still red and the color does not fade. What should the aide do?

    • A.Keep pressure off the area, tell the nurse, and write down what was seen.✓ Answer
    • B.Rub the red area to bring in circulation, then turn her back onto it.
    • C.Put lotion and a bandage on the area and check it again in two days.
    • D.Turn her again in four hours and mention the redness at the next visit.

    Redness that does not fade after pressure is relieved means the capillaries are already damaged and the tissue injury has begun, which is the earliest reportable stage of a pressure injury. Massaging that tissue tears fragile capillaries further, and covering or treating a wound is a nursing task, so the aide relieves pressure and reports.

    Source: 42 CFR 484.80(b)(3)(xiii) recognizing and reporting changes in skin conditionReport a problem with this question

14. 14. The aide is about to transfer a client from the bed to a wheelchair in the client's home. What should be done before the client stands?

    • A.Leave the chair unlocked to slide it closer, and lower the bed to the floor.
    • B.Lock both sets of brakes, keep the footrests down, and lift under both arms.
    • C.Lock both sets of brakes, lower the bed, and put non-skid shoes on the client.✓ Answer
    • D.Lock the wheelchair brakes, raise the bed high, and let the client stand in socks.

    Any surface that can roll or slide during weight-bearing turns a transfer into a fall, so both the bed and the chair are locked and the bed is low enough that the feet rest flat on the floor. Socks slip on hard home flooring, and lifting under the arms can dislocate a shoulder or injure the nerves there.

    Source: 42 CFR 484.80(b)(3)(x) safe transfer techniques and ambulationReport a problem with this question

15. 15. Using a gait belt, the aide is helping a client with right-sided weakness stand and pivot into a chair. Which action is correct?

    • A.Apply the belt loosely over the hips and let the client lead with the right leg.
    • B.Apply the belt over clothing at the waist and pivot toward the left side.✓ Answer
    • C.Apply the belt over clothing at the waist and pivot toward the right side.
    • D.Apply the belt on bare skin at the chest and lift under the arms to pivot.

    Pivoting toward the stronger side lets the client bear weight and step on the leg that can hold him, so the aide is guiding rather than lifting. The belt sits at the waist over clothing to protect fragile skin and to grip the body's center of gravity, and it must not ride up onto the ribs or slip down over the hips.

    Source: 42 CFR 484.80(b)(3)(x) safe transfer techniques and ambulationReport a problem with this question

16. 16. While walking to the kitchen with the aide, a client's knees buckle and she begins to fall against the aide. What should the aide do?

    • A.Hold her up under the arms and walk her backward to the nearest chair.
    • B.Ease her down to the floor, protect her head, and stay with her.✓ Answer
    • C.Step aside so she is not pulled down, then go and phone the nurse.
    • D.Lift her onto the couch, then check whether she is able to walk again.

    A falling adult's full weight cannot be held safely, and trying injures both the client's shoulders and the aide's back. Controlling the descent to the floor protects the head, and the client is left in place because lifting or walking someone who may have a fracture or a cardiac cause can make the injury far worse.

    Source: 42 CFR 484.80(b)(3)(vii) recognizing emergencies; (b)(3)(x) ambulationReport a problem with this question

17. 17. The written care plan assigns passive range-of-motion exercises to a client's right shoulder and elbow. How should the aide carry this out?

    • A.Move each joint slowly, then push a little past resistance to gain motion.
    • B.Move the joints quickly through a long set so the session is over sooner.
    • C.Move each joint slowly, supporting above and below, and stop at resistance.✓ Answer
    • D.Coach the client to move the joints herself while you count the repetitions.

    In passive range of motion the aide moves the joint for a client who cannot move it, which is why the limb is supported above and below to keep the joint from bending sideways. Resistance and pain mark the end of safe motion, and forcing past that point tears muscle and ligament instead of preventing contractures.

    Source: 42 CFR 484.80(b)(3)(xi) normal range of motion and positioningReport a problem with this question

18. 18. The aide is helping a client who has trouble swallowing eat lunch at home. Which positioning is correct?

    • A.Sit her upright at about 90 degrees and keep her up 30 minutes after.✓ Answer
    • B.Feed her reclined with the head turned, alternating bites and sips.
    • C.Sit her at about 45 degrees and lay her flat as soon as she finishes.
    • D.Sit her upright and give only liquids, since solid food is riskier.

    Sitting fully upright uses gravity to carry food down the esophagus and keeps the airway above the food path, and staying up afterward prevents reflux of stomach contents into the throat while the stomach is still full. Thin liquids are actually the hardest thing to control, so restricting the client to liquids increases the aspiration risk rather than reducing it.

    Source: 42 CFR 484.80(b)(3)(xii) adequate nutrition and fluid intake; standard aspiration precautionsReport a problem with this question

19. 19. The care plan orders nectar-thick liquids. The client says the thickened juice is unpleasant and asks for plain water instead. What should the aide do?

    • A.Give plain water between meals and thickened juice only with meals.
    • B.Serve the liquid at the ordered thickness and tell the nurse what she said.✓ Answer
    • C.Add a little water to thin the juice, since her preference comes first.
    • D.Hold all fluids until the nurse visits so the order is not broken.

    Thickened liquids are an ordered treatment for an unsafe swallow: thin liquids move too fast to control and can enter the airway silently. The aide cannot change the consistency, which would be altering the plan of care, but the complaint is real information about intake and belongs with the nurse, who can reassess it.

    Source: 42 CFR 484.80(g)(1) services in accordance with the plan of care; (b)(3)(xii) nutrition and fluid intakeReport a problem with this question

20. 20. The supervising nurse asked the aide to take a blood pressure each visit and to report anything above 150/90. Today's reading is 168/94 and the client says she feels fine. What should the aide do?

    • A.Write 168/94 on the form and phone the supervising nurse about it.✓ Answer
    • B.Suggest an extra dose of her pressure pill and recheck in an hour.
    • C.Chart the usual reading, since the client has no symptoms today.
    • D.Retake it on the other arm until it is under 150/90, then chart that.

    The aide's role in measurement is to obtain the value accurately, record exactly what was measured, and report a value outside the range the nurse set. Charting anything other than the actual reading falsifies the record, and advising a medication change is a clinical decision far outside the aide's scope.

    Source: 42 CFR 484.80(b)(3)(iii) reading and recording temperature, pulse and respiration; (b)(3)(ii) observation, reporting and documentationReport a problem with this question

21. 21. A client with arthritis cannot open her pill bottle and asks the aide for help taking her morning medication, which she normally takes herself. What may the aide do?

    • A.Open the bottle, hold the pill until the nurse's next visit that day.
    • B.Open the bottle, hand it to her, and let her take the pill herself.✓ Answer
    • C.Open the bottle, place the pill on her tongue, and give her water.
    • D.Open the bottle, count the dose out, and crush it into applesauce.

    Federal rules allow an aide to assist with medications the patient ordinarily self-administers, which means reminding, bringing the container, opening it, and handing it over. The moment the aide puts the pill into the mouth, counts out a dose, or alters the form of the drug, the act becomes administering medication, a licensed task.

    Source: 42 CFR 484.80(g)(3)(iv) assistance in administering medications that are ordinarily self-administeredReport a problem with this question

22. 22. A client's son asks the aide to change the sterile dressing on his father's surgical wound because the nurse is not scheduled until tomorrow. What should the aide do?

    • A.Tell the son to find an agency whose aides do the dressings.
    • B.Change the dressing this once, since the family in the home asked.
    • C.Explain the task is not on the written plan and call the nurse now.✓ Answer
    • D.Change it and add the task to the plan so the record matches.

    An aide works only from the written patient care instructions prepared by the nurse and cannot add to or change the plan of care; a sterile dressing change is a skilled nursing procedure. Family members cannot authorize a task outside that written assignment, but the son's concern is real, so the aide contacts the nurse who can respond or adjust the visit.

    Source: 42 CFR 484.80(g)(1)-(2) aide services follow the plan of care and written patient care instructions prepared by a registered nurseReport a problem with this question

Practice questions based on the federal HHA competency requirements (42 CFR 484.80). Not affiliated with any training program or registry, and not medical advice. State requirements vary. Federal HHA rule →