Hands-On Nursing Competency Test

Please take the time to answer all of the following questions to the best of your ability. This test is used to form a baseline of general competency for applicants. It is not timed.

If you have any questions or concerns regarding the test, please feel free to direct all inquires to either contact Steve or Terri at sfortna@handsonnursingpa.com or twarfield@handsonnursingpa.com.

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Confidentiality:
1. Mrs. Davis, a home health aide, leaves the home of Mr. Leahy, a terminally ill client. A neighbor stops her and says, Mr. Leahy is very sick, isn’t he? I hear he is near death. What is it best for Mrs. Davis to say?*
- Yes, Mr. Leah is very ill.
- How do you know Mr. Leahy is so sick?
- I’m sorry, I can’t discuss Mr. Leahy.
- Mr. Leahy is doing as well as can be expected.
2. Which is an example of confidential information?*
- Is a former bank president in town
- Was a professional athlete
- Has AIDS
- All the above
Consumer control and the independent living philosophy:
1. A client is receiving oxygen through a nasal tube. What safety precautions should the home health aide take?*
- Keep the television set at least 5 feet from the oxygen tank
- Do not permit the client to drink soda
- Allow no smoking in the client's room
- Do not use any lotions that contain oil in the client’s care
2. In communication with a client who is hard of hearing (HOH), the aide should?*
- Stand directly in front of the client so he/she can hear you speak
- Speak in higher pitched tones
- Shout into the client’s ear
- Whisper
3. The home health aide encourages Mrs. Queely to assist with meal planning, to choose the clothing she is to wear and in general to plan her daily schedule. Why is this a good approach?*
- It keeps Mrs. Queely from complaining
- It lessens the aide’s work load
- It shows Mrs. Queely how much she needs the aide’s help.
- It helps Mrs. Queely maintain a sense of control of her life.
Instrumental activates of daily living (IADL’s):
1. The telephone numbers of all the following are important to a client. Which number must the home health aide have next to the telephone?*
- The client’s clergyman.
- The drugstore.
- 911
- The next-door neighbor
2. When working with persons who are disabled, the general goal of care is to:*
- Provide constant supervision
- Provide total care
- Promote maximum self-care and independence within the limits of the person’s ability.
- Promote the complete return of the person’s abilities.
3. Part of your duties as a home health aide is to assure a safe home environment. This includes:*
- Proper infection control with good hand washing
- Electrical and fire safety
- Clear walkways; no throw rugs; stairs. Halls and exits free from clutter
- All of the above
Recognizing changes in the consumer that need to be addressed:
1. The RN sees the client once a month for a catheter change, and the home health aide gives personal care three times a week. On this visit you notice blood in the catheter tubing. What should you do first?*
- Collect a urine sample
- Force fluids
- Notify your supervisor
- Empty the drainage bag
2. The client tells you he has had a red rash for three days. What should you do?*
- Tell him not to worry about it
- Put an antibiotic cream on it
- Report it to your supervisor
- Tell him he may be allergic to fruit
3. It is Mrs. Queely’s usual time for lunch, but she says she is not hungry yet. This is the first time that Mrs. Queely has made this type of statement. What should the home health aide do?*
- Insist that Mrs. Queely eat at this time
- Tell Mrs. Queely to let the aide know when she wants to eat, and remind her that it is important that she have lunch
- Tell Mrs. Queely that if she does not eat by herself, she will have to be fed.
- Tell Mrs. Queely that it took a lot of time to prepare the food and that she should eat it while it is fresh.
Basic Infection Control:
1. During a visit, you need to wash your hands:*
- Before you give physical care to the client
- After you empty a bedpan
- Before you leave the client’s home
- All of the above
2. When taking a client’s temperature by mouth (orally), which of the following temperature readings should be reported to the nursing supervisor?*
- 97.6
- 98.6
- 100.2
- 99.5
3. Signs of infection should be reported to the nursing supervisor. Which of the following would not be considered a sign of infection?*
- Elevated Temperature
- Increased appetite
- Redness or swelling of an area
- Pain
4. In what situations should gloves be used?*
- When emptying a urinary drainage bag
- When the client has been incontinent of stool
- When the client has a draining wound
- All of the above
Universal Precautions:
1. What is the main reason for covering your mouth or nose when coughing or sneezing?*
- To prevent the escape of bad odors
- To prevent the spread of germs
- To avoid injury to the lining of the nose and mouth
- To avoid getting clothing dirty.
2. When soiled linen is removed from the client’s bed, it should be:*
- Shaken, then folded
- Folded hem to hem
- Held away from one’s clothes
- Inspected for any tears
3. In caring for a client with HIV/AIDS. You must practice which of the following Standard Precautions?*
- Wear gloves at all times when caring for the client
- Wear a gown when handling linens that contain body fluids
- Dispose of infectious wastes in a leak-proof container
- All of the above
Handling of emergencies:
1. A client suddenly complains of intense, squeezing pain in the chest that goes down the arm. The client is sweating profusely. The home health aide should:*
- Massage the client’s chest and arm
- Telephone for emergency help immediately
- Place the client in a side lying position
- Apply warm compresses to the client’s chest
2. If a client stops breathing, what should be done first?*
- Remove any materials from the client’s mouth or nose
- Place the client’s legs higher than the client’s chest
- Try to stimulate the client’s pain sensation by pinching the client’s arm
- Apply even firm pressure to the client’s neck veins
3. Which of these substances could be used to put out a fire in pan of bacon fat?*
- Sugar
- Vinegar
- Baking soda
- Water
Documentation:
1. After arriving to care for Mr. Jones, he complains he has had severe cramping pains in the calf of his left leg for the last three hours. You call your supervisor to report this and then record on your progress notes:*
- States he has leg cramps
- Complains of pain
- Left leg hurts a lot
- States he’s had severe cramping in the calf of his left leg for the last three hours
2. One morning shortly after the home health aide arrives, Mr. O’Brien says, “I have had cramping pains in the calf of my right leg for the last two hours." In addition to reporting this complaint to the agency supervisor, what is the best way for the aide to write this on the chart?*
- Complains of pain
- Right leg hurts
- States he has had cramping pains in the calf of his right leg for 2 hours
- Says he has leg cramps.
3. The principles of charting include:*
- If a task is not charted, it is assumed not to have been
- If you make a charting mistake, draw a line through the mistake and write error
- You may not chart activities performed by other personnel
- All of the above
Recognizing and reporting abuse or neglect:
1. Types of abuse*
- Physical
- Emotional
- Financial
- All the above
2. Types of neglect*
- Physical
- Emotional
- Financial
- All the above
3. Who do you report SUSPECTED abuse too?*
- Call/Report to your supervisor or agency
- Call family
- Call doctor
- Tell the client
Dealing with difficult behaviors:
1. The client with dementia:*
- Loses the ability to make judgments
- Loses the ability to perform self-care
- May be angry, restless, or irritable
- All of the above
2. When basic psychological and physical needs of clients, no matter what age, are met, the client will feel:*
- Aggressive
- Discouraged
- A sense of well-being
- A sense of insecurity
3. A home health aide is assigned to a family in which the mother; Mrs. Roth, has recently been discharged from a mental health unit. It is essential for the aide to notify the agency supervisor if Mrs. Roth makes which of these comments?*
- I overslept today because I forgot to set my alarm clock
- This morning I couldn’t remember my neighbor’s first name.
- I’m as hungry as a bear
- Even though I shut the radio off, I still hear a voice telling me what to do.
Bathing, shaving, grooming & dressing:
1. The home health aide is helping Mrs. Ragan with her bed bath. Mrs. Ragan prefers to wash her genital and rectal areas herself. Which of these measures should the aide take?*
- Have Mrs. Ragan use cold water only in washing her genitals.
- Have Mrs. Ragan use no soap when washing her rectal area
- Remind Mrs. Ragan to wash from the vaginal area toward the rectal area
- Remind Mrs. Ragan not to wash in between the labia of her genitals
2. Mr. Walters was recently sent home from the hospital with an IV in his left arm. He is weak and needs assistance in bathing and dressing. Which procedure is incorrect when giving his care?*
- Wash the arm to taped area, but do not get the tape wet
- Lower the IV bag below his waist, so that you can put his arm through the shirt sleeve
- Keep the IV tubing free of tangles
- Report any complaint of pain in the arm with the IV
3. When giving a bed bath, how often should the water be changed?*
- As often as needed to have warm, clean water at all times
- Once is all that is necessary
- Only after washing the perennial area
- Only after washing the front half of the client
4. In giving foot care to a client who has diabetes, the home health aide should NOT take which of these actions?*
- Clean under the toenails
- Cut the toenails
- Soak the client’s feet for more than 5 minutes in a basin of warm water
- Put lotion on the client’s feet after drying them
Hair, skin & mouth care:
1. Why is it important that a client have good mouth care?*
- Bacteria in the mouth can cause tooth decay and gum infections
- The saliva in the mouth is the source of stomach juices
- Poor oral hygiene causes more saliva to be made
- Poor oral hygiene interferes with the sense of smell
2. When caring for a client who is on bed rest; what should the aide do to prevent bedsores?*
- Keep the top sheets well tucked in
- Keep the bottom sheet free of wrinkles
- Use only sheets that are 100% cotton on the client’s bed
- Use only woolen blankets to cover the client
3. Which of the following is the most appropriate practice to promote good skin care in the elderly?*
- Keep the skin clean and well-moisturized
- Apply alcohol to moist areas of the skin
- Wash daily with scented soaps
- All of the above
4. Any change in the condition of a client’s skin should be:*
- Reported to the nursing supervisor
- Treated by rubbing with lotion
- Covered with a bandage
- Reported to the doctor
Assistance with ambulation and transferring:
1. A client has had a stroke and has a right sided weakness. The client can walk with a little assistance. It is best for the home health aide to assist the client by walking in which of these positions?*
- Directly in front of the client
- Directly in back of the client
- On the client’s left side
- On the client’s right side
2. Mr. Nelson is to use a rigid walker (walker that does not have wheels) when he walks. When he uses the walker, the home health aide should be sure that Mr. Nelson:*
- Moves both feet forward together while leaning on the walker
- Lifts the walker and moves it forward
- Does not bend his elbows.
- Does not place any weight on his hands while leaning on the walker
3. Mr. Phillips is 76 years old, he needs help with bathing, and he has a Foley catheter in place. He has great difficulty walking and uses a wheelchair. He is on a low salt diet. When helping Mr. Phillips from the bed to the wheelchair, which of these actions is essential?*
- Have the brakes on the wheelchair in a locked position
- Place the foot supports of the wheel chair so that he can step up on them
- Have a blanket draped in the wheelchair
- Place a pillow on the seat of the wheelchair
Meal Preparation and feeding:
1. If a client is to have a fluid intake record kept, the right time to record the client’s fluid is*
- When the fluids are served to the client
- After they finish drinking the fluids
- Every 2 hours
- After each meal
2. Milk is a good source of calcium. Which of these foods is also high in calcium?*
- Cheese
- Bananas
- Orange juice
- Raisins
3. Good source of protein is:*
- Green salad and cooked greens
- Potatoes and noodles
- Apples and oranges
- Beans, peanut butter, and eggs
Toileting:
1. Mr. Phillips’s Foley catheter is attached to a drainage bag. The drainage bag should always be kept:*
- At the level of his bladder
- Below the level of his bladder
- 12 inches above the level of his bladder
- 3 feet above the level of his bladder
2. Urinary leg bags are used for:*
- Males only
- Females only
- Confined to bed
- Decreased Urinary output.
3. An elderly male client occasionally wets his trousers. What should the home health aide do?*
- Give him fluids with his meals only
- Avoid giving him coffee and tea
- Tell him that if he urinates on himself he will have to be put in diapers
- Encourage him to go to the bathroom at least every 2 hours
Assistance with self-administered medications:
1. A client’s prescription for heart pills has recently been changed. The home health aide should notify the agency supervisor immediately if the client makes which of these comments?*
- The pills are very expensive
- These pills are a different shape from the pills
- I have a rash on my stomach since I’ve been taking these pills
- I can’t take these pills unless I have really cold water to drink
2. Which statement is incorrect*
- The home health aide may get a pill bottle from a cabinet and bring the bottle to the client at the client’s request
- The home health aide should observe and document if the client takes his/her medication
- If the nurse or family forgets, the home health aide may take the right dose of medication out of the bottle & give it to the client with Alzheimer's
- The home health aide may help clients to remember to take their medications
3. Which of these actions is the home health aide permitted to take in relation to drug administration?*
- Recording and reporting the client’s reaction to the medication
- Giving nonprescription medications whenever the client asks for them
- Adjusting the dosage of medications given to the client
- Adjusting the times medications are given to fit into the client’s activities scheduled
Basic Math
1. 5+2=*
2. 10+7=*
3. 150+275=*
4. 10-2=*
5. 175-44=*
6. 974-973=*
7. 5x2=*
8. 10x0=*
9. 1000x1=*
10. 20 divided by 4 =*
11. 100 divided by 10 =*
Written Answer Questions
1. Write out the following: 1,526*
If you have 5 red balls, 3 green balls, 10 purple balls and you take 2 balls from each, how many red, green and purple balls do you have left?*

Hands-On Nursing Competency Test

Confidentiality:

Consumer control and the independent living philosophy:

Instrumental activates of daily living (IADL’s):

Recognizing changes in the consumer that need to be addressed:

Basic Infection Control:

Universal Precautions:

Handling of emergencies:

Documentation:

Recognizing and reporting abuse or neglect:

Dealing with difficult behaviors:

Bathing, shaving, grooming & dressing:

Hair, skin & mouth care:

Assistance with ambulation and transferring:

Meal Preparation and feeding:

Toileting:

Assistance with self-administered medications:

Basic Math

Written Answer Questions