NHA Patient Care Technician (CPCT) — All Questions

A patient care technician counts a resting adult patient's radial pulse and gets 78 beats per minute. How should this finding be classified?

• a.Below normal, indicating possible shock
• b.Bradycardia requiring immediate provider notification
• c.Tachycardia requiring immediate provider notification
• d.Within the normal adult range of 60-100 beats per minute✓

The normal resting heart rate for an adult is 60 to 100 beats per minute, so 78 bpm is normal. Bradycardia is a rate below 60 bpm and tachycardia is a rate above 100 bpm. No urgent notification is needed for a normal reading.

What is the normal respiratory rate range for a resting adult?

• a.6 to 10 breaths per minute
• b.30 to 40 breaths per minute
• c.12 to 20 breaths per minute✓
• d.24 to 30 breaths per minute

A normal adult resting respiratory rate is 12 to 20 breaths per minute. Rates below 12 indicate bradypnea and rates above 20 indicate tachypnea. Count respirations for a full minute for the most accurate result when the rate is irregular.

According to widely accepted guidelines, a normal adult blood pressure reading is closest to which value?

• a.140 over 90 mm Hg or higher
• b.120 to 129 over less than 80 mm Hg
• c.Less than 120 over less than 80✓
• d.About 90 over 50 mm Hg at rest

Under the 2017 ACC/AHA categories, normal adult blood pressure is a systolic below 120 mm Hg AND a diastolic below 80 mm Hg. The closest competitor, 120 to 129 over less than 80, is a real category but it is called elevated, not normal. Stage 1 hypertension begins at 130 to 139 systolic or 80 to 89 diastolic, and 140 over 90 or higher is stage 2. A reading around 90 over 50 is low and may represent hypotension in a symptomatic patient.

A technician takes an oral temperature and records 98.6°F. Which statement about this reading is correct?

• a.It is the accepted normal average oral body temperature✓
• b.Oral temperature is always 1 degree higher than rectal
• c.It is below normal and suggests hypothermia
• d.It indicates a low-grade fever

98.6°F (37°C) is the accepted average normal oral body temperature. Rectal temperatures typically run about 1°F higher than oral, and axillary temperatures run about 1°F lower. A fever is generally defined as an oral temperature of 100.4°F or higher.

A technician is checking a patient for orthostatic hypotension. After measuring blood pressure while the patient is lying down, what is the correct next step?

• a.Measure the pulse only and not the blood pressure
• b.Wait 30 minutes before taking the next reading
• c.Have the patient stand and re-measure pressure and pulse✓
• d.Give the patient fluids before any further readings

Orthostatic, or postural, vital signs are taken with the patient lying down, then repeated after the patient sits or stands, and both the blood pressure and the pulse are recorded at each position. A drop of 20 mm Hg systolic or 10 mm Hg diastolic, or a rise in pulse of about 20 beats per minute, suggests orthostatic hypotension. Recording only the pulse loses the measurement the test is built around, and waiting half an hour lets the pressure re-equilibrate so the change is missed. Fluids are a treatment decision, not part of taking the readings. Guard the patient against falling during the position change.

A pulse oximeter reads 97% on room air for a stable adult. How should the technician interpret this value?

• a.Normal only for patients receiving oxygen
• b.Abnormally high, remove the sensor
• c.Within the normal range of 95-100%✓
• d.Critically low, apply oxygen immediately

A normal oxygen saturation (SpO2) for a healthy adult on room air is 95% to 100%. Readings below 90% generally indicate hypoxemia and require prompt attention. Cold fingers, nail polish, and poor perfusion can produce falsely low readings.

A patient with difficulty breathing is most likely to be positioned in which way to ease respiration?

• a.Trendelenburg, with the head positioned lower than the feet and hips
• b.High-Fowler's, with the head of the bed at 60 to 90 degrees✓
• c.Prone, with the face turned to one side and the arms down
• d.Flat supine with no pillow under the head or the knees

High-Fowler's position raises the head of the bed to roughly 60 to 90 degrees, which lets the diaphragm drop and the lungs expand, easing the work of breathing. Semi-Fowler's, at about 30 to 45 degrees, is the milder version of the same idea. Lying flat, prone, or in Trendelenburg pushes the abdominal contents against the diaphragm and makes dyspnea worse.

Before transferring a weak but weight-bearing patient from bed to a wheelchair, the technician applies a gait belt. Where should the belt be positioned?

• a.Loosely fastened around the neck and both shoulders
• b.High under the armpits and across the chest
• c.Around the patient's thighs, just above both knees
• d.Snugly around the patient's waist over clothing✓

A gait belt, also called a transfer belt, goes snugly around the patient's waist over clothing so the technician can grasp it with an underhand grip and control the transfer. Placing it under the arms puts the lifting force on the rib cage and shoulder joints, and around the neck it can strangle. A belt around the thighs gives no control over the trunk, which is where the patient's balance is lost. Clothing under the belt protects the skin.

A technician is assisting a patient to ambulate with a cane. On which side should the patient hold the cane?

• a.In whichever hand feels most comfortable
• b.Directly in front of the body, centered
• c.On the weaker side, next to the weak leg
• d.On the stronger side, opposite the weak leg✓

A cane is held on the strong side of the body, opposite the affected leg, and the cane and the weak leg move forward together so that support arrives at the same moment the weak leg takes weight. Holding it on the weak side crowds the leg it is meant to help and narrows the base of support. Holding it in front or in whichever hand feels natural gives no consistent support and is a common cause of falls.

When providing oral care to an unconscious patient, which action best prevents aspiration?

• a.Lay the patient flat on the back during care
• b.Pour a full cup of water into the mouth to rinse
• c.Position the patient side-lying with the head turned✓
• d.Use large amounts of toothpaste and foam

An unconscious patient cannot protect the airway, so oral care is given side-lying with the head turned to the side, which lets fluid drain out of the mouth instead of pooling in the throat. Only small amounts of moisture are used, with suction available. Lying flat pools fluid at the back of the throat, and flooding the mouth with water or foam gives the patient more to aspirate rather than less.

When performing perineal care on a female patient, in which direction should the technician cleanse?

• a.From side to side repeatedly with the same cloth
• b.From back to front, toward the urethra
• c.In a circular scrubbing motion
• d.From front to back, away from the urethra✓

Perineal care on a female patient is performed front to back, moving away from the urethra toward the rectum. This prevents transferring bacteria from the anal area to the urethra, reducing the risk of urinary tract infection. A clean section of the washcloth is used with each stroke.

A technician is measuring fluid intake and output (I&O). Which of the following is counted as output?

• a.Urine and emesis (vomit)✓
• b.Intravenous fluids infused
• c.Gelatin eaten at lunch
• d.Water consumed with medications

Output includes measurable fluids leaving the body such as urine, emesis, liquid stool, and wound drainage. Intake includes oral fluids, IV fluids, and foods that are liquid at room temperature like gelatin and ice cream. Accurate I&O helps monitor a patient's fluid balance.

A patient drank 240 mL of juice, 120 mL of water, and a 180 mL cup of broth. What is the total recorded intake?

• a.360 mL
• b.600 mL
• c.420 mL
• d.540 mL✓

Adding the fluids: 240 + 120 + 180 = 540 mL. Broth is a liquid and is counted as intake. Accurate addition of all consumed fluids is essential for reliable I&O documentation.

To reduce the risk of catheter-associated urinary tract infection, how should the technician position the urinary drainage bag?

• a.Below the level of the bladder at all times✓
• b.On the bed beside the patient's legs
• c.Hooked to the movable upper side rail
• d.Level with the bladder on the bed frame

The drainage bag is kept below the level of the bladder at all times so urine flows away by gravity and cannot run back into the bladder, which is how bacteria are carried upward. Hanging it level with the bladder stops the downhill flow, and hooking it to a movable side rail means the bag rises above the bladder every time the rail goes up. Putting the bag on the bed places it above bladder level and on a contaminated surface. The bag must also never touch the floor, and the tubing is kept free of kinks.

A bedbound patient is at risk for pressure injuries. How often should the technician typically reposition the patient?

• a.Only when the patient asks
• b.Once per shift
• c.At least every 2 hours✓
• d.Every 6 hours

Repositioning an immobile patient at least every 2 hours relieves prolonged pressure over bony prominences and helps prevent pressure injuries. A turning schedule and pressure-relieving surfaces support skin integrity. Frequently at-risk areas include the sacrum, heels, and hips.

A technician notices an area of intact skin over the sacrum that is reddened and does not blanch (turn white) when pressed. This finding is most consistent with which stage of pressure injury?

• a.Stage 1✓
• b.Unstageable
• c.Stage 4
• d.Stage 3

A Stage 1 pressure injury is intact skin with non-blanchable redness, usually over a bony prominence. In darker skin, it may appear as a change in color or temperature rather than redness. It should be reported and pressure relieved immediately to prevent progression.

While assisting with a dressing change, a technician observes that the patient's wound has increased redness, warmth, swelling, and yellow-green drainage with odor. What is the most appropriate action?

• a.Cover it and say nothing, since drainage is expected
• b.Report the findings to the nurse as possible infection✓
• c.Apply a warm heating pad to the area for comfort
• d.Cleanse the wound with alcohol independently

Increased redness, warmth, swelling, purulent yellow-green drainage, and odor together are classic signs of a wound infection, and the technician reports them promptly to the nurse. Some drainage can be expected from some wounds, which is what makes the do-nothing answer tempting, but purulent drainage with odor and spreading warmth is not the expected kind. Assessing a wound, applying heat, and choosing a cleansing agent are all outside the technician's scope.

Restorative care focuses primarily on which goal for the patient?

• a.Helping the patient regain the highest possible independence✓
• b.Completing every task for the patient so that the unit saves time
• c.Discouraging self-care so that the patient avoids fatigue
• d.Keeping the patient in bed to prevent any risk of injury

Restorative care aims at restoring and maintaining function, mobility, and dignity by having the patient do as much as they safely can for themselves. Doing everything for a capable patient is faster in the moment and is the answer that feels kind, but it produces dependence and deconditioning. Bed rest and discouraged self-care accelerate the same decline, costing muscle strength and balance within days.

A technician performs passive range-of-motion (ROM) exercises on a patient who cannot move a joint independently. What defines this type of exercise?

• a.The technician moves the joint through its normal range✓
• b.Weights are added to the joint to increase resistance
• c.The patient moves the joint without any assistance
• d.The joint is moved quickly past the resistance point

Passive range of motion means the technician moves the patient's joint through its normal range because the patient cannot do it independently. The movements are slow and gentle and stop at the point of pain or resistance, which is what prevents injury to a joint that cannot signal well. A patient moving the joint alone is active range of motion, and adding resistance is strengthening exercise. Passive range of motion helps prevent contractures and maintains joint mobility.

When feeding a patient who has had a stroke with left-sided weakness, which action promotes safe swallowing?

• a.Have the patient lie down flat while eating and drinking slowly
• b.Tilt the head back so that the food goes down more easily
• c.Feed at a quick pace to finish before the patient gets tired
• d.Place food on the stronger side and sit the patient upright✓

Food is placed on the unaffected, stronger side of the mouth and the patient sits upright at about 90 degrees, which reduces pocketing of food in the weak cheek and lowers aspiration risk. The chin is slightly tucked, not tilted back: tilting the head back opens the airway and makes aspiration more likely, even though it feels like it helps gravity. Eating flat is unsafe for the same reason, and rushing removes the time the patient needs to clear each bite.

Before assisting a patient into a tub bath, what is the safest water temperature range?

• a.About 80-85°F (cool)
• b.Whatever temperature the patient prefers, without checking
• c.About 100-105°F (comfortably warm)✓
• d.About 120-130°F (very warm)

Bath water should be about 100 to 105°F, comfortably warm but not hot enough to burn fragile skin. The technician should always check the temperature with a thermometer or the inner wrist before the patient enters. Older adults and those with reduced sensation are especially vulnerable to scald burns.

When making an occupied bed, which action best protects the technician's back and the patient's safety?

• a.Raise the bed to hip height and keep the far rail raised✓
• b.Lower the bed fully and bend at the waist to work
• c.Work alone no matter how large the patient is
• d.Keep the far side rail lowered while turning

Raising the bed to about hip height lets the technician work with a straight back instead of bending, and keeping the far side rail up stops the patient from rolling off the far edge during the turn. The bed is returned to its lowest position once care is finished. Working at a low bed forces sustained forward flexion, which is how back injuries happen, and turning a patient toward a lowered rail removes the only barrier on that side.

Where is the apical pulse best auscultated with a stethoscope?

• a.Fifth intercostal space, left midclavicular line✓
• b.At the wrist, on the thumb side of the forearm
• c.Over the carotid artery in the neck
• d.At the antecubital fossa of the inner arm

The apical pulse is heard over the apex of the heart at the fifth intercostal space in the left midclavicular line, and it is counted with a stethoscope for a full 60 seconds. It is the most accurate site when the rhythm is irregular, because irregular beats that are too weak to reach the wrist are still heard at the chest. The radial site at the wrist, the carotid in the neck, and the brachial site at the antecubital fossa are palpated or used for blood pressure rather than for an apical count.

A technician palpates a patient's radial pulse and notes it is regular. For how long may the pulse be counted, and what is done with the result?

• a.Count for 15 seconds and multiply by 3
• b.Count for 30 seconds and multiply by 2✓
• c.Count for 10 seconds and multiply by 4
• d.Estimate without counting

A regular radial pulse may be counted for 30 seconds and multiplied by 2 to obtain the rate per minute. If the pulse is irregular, it must be counted for a full 60 seconds for accuracy. The radial pulse is palpated with the fingertips, never the thumb, which has its own pulse.

A patient states they feel dizzy and unsteady while walking in the hallway. What should the technician do first?

• a.Have the patient bend forward and keep moving
• b.Leave the patient to go and get the nurse
• c.Tell the patient to keep walking to the room
• d.Ease the patient to the floor or a chair and stay✓

A patient who becomes dizzy while walking is eased to the floor or into a nearby chair, using the gait belt and protecting the head, and the technician stays with the patient and calls for help. Trying to hold a falling adult fully upright injures both people. Leaving an unsteady patient alone to fetch help is the answer that sounds responsible and is the one that produces an unwitnessed fall.

The Sims' position is most commonly used for which purpose?

• a.Administering an enema or rectal care✓
• b.Measuring blood pressure accurately
• c.Feeding a patient an entire meal
• d.Promoting maximal lung expansion

Sims' position is a left side-lying position with the upper knee flexed toward the chest, used for enemas, rectal examinations, and rectal care, because it gives access to the rectal area and follows the natural curve of the sigmoid colon. Lung expansion is promoted by Fowler's positions, and a patient is fed sitting upright. Pillows are used to support the upper arm and leg so the patient stays comfortable and aligned.

A patient lying flat on the back facing upward is in which position?

• a.Fowler's
• b.Lateral
• c.Supine✓
• d.Prone

Supine is lying flat on the back facing upward. Prone is lying on the abdomen facing downward, and lateral is side-lying. Knowing standard positioning terms ensures clear communication and correct patient care.

When a patient is in the lateral (side-lying) position, which bony areas require padding to prevent pressure injuries?

• a.The greater trochanter, the shoulder, and the ankles✓
• b.The abdomen and the entire front surface of the chest wall
• c.The sacrum, the heels, and the back of the head and ears
• d.The elbows and the back of the head alone

Side-lying puts the body weight on the greater trochanter of the hip, the shoulder, the ear, and the ankles, so those are the points that need padding. The sacrum, heels, and back of the head are the pressure points of the supine position, which is why that answer is close but describes a different position. Pillows placed between the knees and behind the back hold the alignment and take load off the bony points.

A patient with dysphagia (difficulty swallowing) is about to eat. Which position best reduces the risk of aspiration during and after the meal?

• a.Lying flat on the back with the head turned to one side
• b.Upright at 90 degrees, and upright 30 minutes after✓
• c.Reclined at about 30 degrees throughout the entire meal
• d.Lying on the left side during and after the whole meal

A patient with dysphagia sits fully upright at about 90 degrees to eat and stays upright for at least 30 minutes afterward, so gravity carries food and fluid down and reflux does not reach the airway. Reclining part way is the near-miss: it is better than flat but still allows pooling and reflux in a patient who cannot protect the airway. Thickened liquids, small bites, and a slow pace may also be ordered by the care team.

A patient drank 4 ounces of water. How many milliliters should the technician record, knowing that 1 ounce equals approximately 30 mL?

• a.90 mL
• b.60 mL
• c.40 mL
• d.120 mL✓

Multiplying 4 ounces by 30 mL per ounce gives 120 mL. Converting household measures to milliliters ensures consistent I&O documentation. One ounce is roughly 30 mL, one cup (8 oz) is about 240 mL.

A patient's chart states 'NPO after midnight' for a scheduled procedure. In the morning the patient asks for water. What should the technician do?

• a.Offer ice chips freely, because ice is not counted as fluid
• b.Provide the full breakfast tray, since the patient is hungry
• c.Withhold food and fluids and tell the nurse of the request✓
• d.Give a small glass of water, because water is not really food

NPO means nothing by mouth, and that includes water and ice chips, which melt into fluid in the stomach exactly like a drink. The technician explains the reason kindly and tells the nurse that the patient is asking, so the team can decide whether anything may be given. Giving fluid can force the procedure to be cancelled or, under anesthesia, cause aspiration of stomach contents into the lungs.

A patient reports constipation. Which intervention, within the technician's role, generally supports normal bowel elimination?

• a.Discourage movement until the constipation resolves
• b.Encourage fluids, fiber, and activity as allowed✓
• c.Restrict all oral fluids until the bowel moves again
• d.Encourage prolonged bed rest until the problem resolves

Adequate fluid intake, fiber-rich foods, and as much activity as the patient is allowed all promote normal bowel function, and all three are within the technician's role. Immobility and dehydration are two of the most common causes of constipation in a hospitalized patient, so restricting fluids or enforcing rest makes the problem worse. Laxatives and enemas require an order and are given per facility policy.

To obtain the most accurate and consistent daily weight for a patient, the technician should weigh them:

• a.At the same time daily, before breakfast, similar clothing✓
• b.At different times each day, whenever the unit happens to be quiet
• c.Only when the patient reports feeling bloated or newly swollen
• d.Immediately after the patient finishes drinking fluids

Daily weights are taken at the same time each day, usually in the morning before breakfast, on the same scale and in similar clothing, and the patient voids first when possible. That consistency is the whole point: a two-pound change only means something if nothing else changed. Weighing at scattered times, or right after a drink, buries a real trend under normal daily variation, and weighing only when the patient feels swollen produces no trend at all.

Before ambulating a patient who has been on bed rest, the technician has the patient sit on the edge of the bed and dangle the legs for a few minutes. What is the main purpose of dangling?

• a.To count the patient’s respiratory rate before standing up
• b.To measure the patient’s leg strength before walking
• c.To give the patient’s feet time to warm up first
• d.To let the body adjust and avoid a dizzy spell✓

Dangling lets the patient sit with the legs over the side of the bed so the cardiovascular system can adjust to being upright, which is what prevents the orthostatic drop in pressure that causes dizziness and falls. The technician uses the time to ask about lightheadedness and to watch the patient's color before assisting to stand. Checking leg strength is a reasonable thing to notice but is not why the patient dangles, and respirations and warmth are not the purpose at all.

A technician records a rectal temperature of 100.4°F on an adult patient. How does a rectal reading typically compare with an oral reading taken on the same patient?

• a.It runs about 1°F lower, because the probe sits away from the body core
• b.It matches the oral reading, so the site does not have to be charted
• c.It runs about 1°F higher than the oral reading at the same moment✓
• d.It runs about 2°F lower and is charted as an axillary value

Rectal temperature is measured closest to the body core, and it reads roughly 1°F above an oral reading taken at the same time, so 100.4°F rectally corresponds to about 99.4°F by mouth. Axillary is the site that reads about 1°F below oral, which is why the answer that reverses the offset and the answer that shifts it to 2°F both describe the wrong site. Sites are not interchangeable, so the route must be documented beside the value or the next reading cannot be compared with this one. A technician reports the number and the site and lets the nurse interpret the difference.

A patient cannot hold a probe in the mouth, and the technician is directed to use the axillary route. Which statement about that site is correct?

• a.It reads about 1°F above the oral route and is the preferred adult site
• b.It reads the same as the tympanic route and needs no site notation
• c.It reads about 1°F below the oral route and is the least accurate site✓
• d.It reads about 1°F below the rectal route and suits confused patients

The axilla is a surface site with no enclosed cavity, so it reads roughly 1°F below the same patient's oral temperature and is considered the least accurate of the common routes. Raising rather than lowering the offset inverts the relationship; the rectal route is the one that reads above oral. Axillary sits about 2°F below rectal, not 1°F, so the answer pairing it with the rectal route understates the gap. The probe must stay in skin-to-skin contact with the arm held down against the chest for the full measuring time, and the site is charted with the value.

A patient finishes a glass of ice water just as the technician arrives to take an oral temperature. What should the technician do?

• a.Take the reading now and note that the patient drank cold water first
• b.Wait about 15 minutes before placing the probe under the tongue✓
• c.Take the reading now and add one degree to the recorded result
• d.Switch to the axillary route because the mouth is now unusable

Cold or hot fluids, smoking, and chewing gum change the temperature of the oral cavity, so an oral reading taken immediately is not a measure of the patient. Waiting about 15 minutes lets the mouth return to body temperature and gives a value that can be trusted and trended. Charting the reading with a note about the ice water still leaves an inaccurate number in the record, and adding a fixed degree invents a correction that no one can verify. Switching sites is unnecessary here because the mouth becomes usable again after a short wait, and a changed site would break the comparison with earlier oral readings.

A technician is taking a tympanic temperature on a 40-year-old patient. How should the ear be handled before the probe is inserted?

• a.Pull the outer ear straight down before inserting
• b.Pull the outer ear up and back to straighten the canal✓
• c.Leave the ear untouched and insert the probe gently
• d.Pull the outer ear down and back before inserting the probe

An adult ear canal curves, so the pinna is pulled up and back to straighten it and aim the sensor at the tympanic membrane instead of the canal wall. Pulling down and back is the maneuver used on a child under about three years old; on an adult it tilts the probe away from the membrane and tends to read low. Pulling straight down does not open the adult canal either. Inserting the probe without repositioning the ear risks an off-target reading and discomfort. Probe depth and technique vary by device, so the manufacturer's instructions for the thermometer in use govern the details.

After counting a patient's radial pulse, the technician needs a respiratory rate. Which technique gives the most accurate count?

• a.Explain that breathing will now be counted, then watch the chest for a full minute
• b.Ask the patient to count breaths aloud so the two totals can be compared
• c.Place a hand on the abdomen and say that breathing is being counted
• d.Keep the fingers on the wrist as if still taking the pulse and count chest rises✓

Breathing is partly under voluntary control, so a patient who knows the breaths are being counted will usually slow down, speed up, or breathe more deeply. Leaving the fingers on the radial site after the pulse count keeps the patient unaware and yields a natural rate; one rise and one fall together count as one respiration. Announcing the count, whether by explaining it first or by placing a hand on the abdomen and saying so, produces the very change the technique is designed to avoid. Having the patient count aloud makes the problem worse, because speaking itself alters the breathing pattern.

A nurse asks a technician to help obtain a pulse deficit on a patient with an irregular heartbeat. How is that measurement made?

• a.One person counts the radial pulse twice and averages the two totals
• b.One person counts the apical rate, then the radial rate an hour later
• c.Two people count the radial pulse at both wrists and add the counts
• d.Two people count the apical and radial rates at once, and the radial is subtracted✓

A pulse deficit is the difference between the heart rate heard at the apex and the rate felt at the radial artery, and it exists because some contractions are too weak to send a palpable wave to the wrist. Both rates must be counted during the same full minute, which normally takes two people and one shared start signal; the radial count is then subtracted from the apical count. Counting the two sites an hour apart compares different minutes and can only produce a meaningless number. Averaging radial counts or adding the two wrists never involves the apical rate, so no deficit can be derived from either.

A technician counts an apical rate of 44 beats per minute on an adult whose rate has been in the 70s and who now says the room is spinning. What should the technician do?

• a.Chart the rate, finish the remaining vital signs, and hand off at shift change
• b.Report the rate to the nurse or supervisor before leaving the bedside✓
• c.Recount for a full minute and chart the lower of the two counts
• d.Chart the rate and recheck it at the next scheduled round of vital signs

An adult resting pulse below 60 beats per minute is outside the 60 to 100 range, and 44 beats per minute together with new dizziness is a finding that has to reach a licensed nurse immediately rather than sit in a chart. Charting is documentation; escalating is communication, and an abnormal value paired with a symptom requires both, in that order of urgency. Recounting for accuracy is reasonable practice, and it is the strongest wrong answer here, but confirming a number the technician already believes must not delay the report, and charting the lower of two counts is not a real verification rule. Waiting for the next round or for shift change leaves a symptomatic patient unmonitored.

A technician documents that a patient's radial pulse feels thready. Which description matches that term?

• a.A pulse that feels strong and full and bounds against the fingertips
• b.A pulse that is weak and rapid and disappears under light pressure✓
• c.A pulse that can be felt only with a stethoscope at the apex
• d.A pulse that alternates between strong and weak beats in a regular pattern

Thready describes pulse quality, not rate or rhythm: the wave is weak and often rapid, feels thin under the fingers, and is easily obliterated by slight pressure, which is why it is commonly seen with low blood volume or poor perfusion. A strong, full, forceful wave that pushes back against the fingertips is called bounding, the opposite quality. A pulse audible only at the apex describes a site, and a regular alternation of strong and weak beats describes a distinct finding rather than thready quality. Quality is charted alongside the rate, and a newly thready pulse is reported to the nurse.

A patient returns from surgery with a cast on the right lower leg, and the nurse asks the technician to check circulation to that foot. Which pulse site is used?

• a.The dorsalis pedis pulse on the top of the affected foot✓
• b.The brachial pulse at the inner bend of the elbow on that side
• c.The carotid pulse at the side of the neck, counted for a full minute
• d.The apical pulse heard over the left side of the chest

Circulation below a cast is checked at a pulse site distal to the injury, and the dorsalis pedis on the dorsum of the foot is the standard pedal site; the posterior tibial behind the medial ankle is the usual alternative. The site is often marked so that every shift palpates the same spot, and it is compared with the other foot for strength, color, warmth, and capillary refill. The brachial site lies in the arm and reports nothing about a leg. The carotid and apical sites measure how fast the heart is beating overall, which can be perfectly normal while blood flow past a tight cast is compromised.

A technician cannot palpate a radial pulse on an adult who is pale, cool, and barely responsive. Which action is correct?

• a.Palpate both carotid arteries at the same time to compare the sides
• b.Rub the carotid area firmly until a pulse becomes easy to feel
• c.Palpate one carotid artery gently and get help for the patient right away✓
• d.Wait ten minutes and try the radial site on the other wrist

When peripheral perfusion drops, the carotid is the last pulse to be lost, so it is the site checked on an adult who is pale and barely responsive. Only one side is palpated, with light pressure, because compressing both carotids at once can reduce blood flow to the brain, and firm rubbing over the artery can slow the heart further. A patient in that condition needs immediate help at the same time the pulse is being assessed, not a ten-minute wait; the other wrist will be just as difficult to palpate if perfusion is poor. The technician stays with the patient and calls out for the nurse rather than leaving the room to look for one.

A technician is applying a manual blood pressure cuff to an adult's upper arm. Where do the cuff bladder and the stethoscope belong?

• a.The bladder over the outer arm, with the stethoscope at the radial artery of the wrist
• b.The bladder centered over the brachial artery, about 1 inch above the elbow crease✓
• c.The bladder over the brachial artery, with the lower edge touching the elbow crease
• d.The bladder over the inner arm, with the stethoscope tucked under the cuff edge

The bladder is centered over the brachial artery on the inner aspect of the upper arm, and its lower edge sits roughly 1 inch above the antecubital crease so the stethoscope can rest flat on the artery without touching the cuff. Bringing the lower edge down to the crease is the closest wrong answer, because the diaphragm then has no clear skin to sit on and rubs the cuff, adding noise that mimics or masks Korotkoff sounds. Tucking the diaphragm under the cuff produces the same artifact. Listening at the radial artery is wrong for auscultation; the wrist is used for palpating a systolic estimate, not for hearing sounds.

A patient has an arteriovenous fistula for dialysis in the left arm and an IV infusing in the right arm. The technician is asked for a blood pressure. What should the technician do?

• a.Use the left arm, because a fistula is not affected by cuff pressure
• b.Ask the supervisor or nurse which site to use, since both arms are restricted✓
• c.Use the right arm and pause the IV pump while the cuff inflates
• d.Use a wrist cuff on the fistula side and chart the site used

A cuff is not applied over a dialysis access, an arm on the side of a mastectomy with lymph node removal, an arm with an infusing IV, or an injured limb, and this patient has a restriction on each side. When every usual site is excluded, the technician does not improvise a site; the nurse or supervisor decides whether a thigh or forearm measurement is appropriate under facility policy. Inflating over a fistula can damage the access the patient depends on for dialysis, and a wrist cuff on that same arm still compresses the limb. Stopping an infusion to free the other arm changes the patient's therapy, which is outside the technician's scope.

A technician uses a standard adult cuff on a patient whose upper arm is far larger than the cuff bladder. How does the mismatch affect the reading?

• a.It produces a falsely low reading, because a small bladder under-compresses
• b.It produces a falsely low diastolic number with an accurate systolic value
• c.It has little effect if the arm is supported at heart level
• d.It produces a falsely high reading of both the systolic and diastolic✓

A cuff that is too narrow or too short for the arm must be pumped to a higher pressure before it compresses the brachial artery, so both numbers come out higher than the patient's true pressure; a cuff that is too large has the opposite effect and reads low. The bladder width should cover roughly 40 percent of the arm circumference and its length should wrap about 80 percent of the way around. Assigning the error to the diastolic alone is wrong, since the whole compression curve shifts. Supporting the arm at heart level is good technique but does not correct a sizing error, and mis-sizing is the most common reason a patient is labeled hypertensive in error.

A technician takes a blood pressure while the patient's arm hangs unsupported at the side, well below heart level. What effect does that arm position have on the result?

• a.Gravity makes both numbers come out low
• b.The numbers come out falsely high✓
• c.The systolic falls but the diastolic holds
• d.Only the diastolic number is affected

Hydrostatic pressure adds to the measured pressure when the cuff sits below the level of the heart, so a dependent arm raises both the systolic and the diastolic, often by several mm Hg for every inch of drop. An arm held above heart level does the reverse and reads low, which is the misconception behind the answer that blames gravity for a low result. Holding the arm up without support adds isometric muscle work, another source of error. Correct technique seats the patient with feet flat, back supported, and the mid-arm resting at the level of the heart, and both numbers are affected together rather than one alone.

While inflating the cuff, a technician palpates the radial pulse and finds that it disappears at 130 mm Hg. To what pressure should the cuff then be inflated for the auscultated reading?

• a.To 130 mm Hg, which is the point where the pulse disappeared
• b.To about 160 mm Hg, or 30 mm Hg above that point✓
• c.To 200 mm Hg for an adult, then deflate slowly
• d.To about 145 mm Hg, which is 15 mm Hg above that point

The palpated systolic estimate tells the technician where the sounds will begin, and the cuff is inflated about 30 mm Hg above that point so the first Korotkoff sound is not missed and an auscultatory gap cannot be mistaken for the systolic. Here 130 plus 30 gives 160 mm Hg. Stopping at the palpated point or only 15 mm Hg above it risks starting to listen after the true first sound, particularly in an older patient with a wide gap. Routinely pumping every adult to 200 mm Hg is unnecessarily uncomfortable and can itself alter the reading, which is why the palpated estimate is obtained first.

Deflating the cuff on an adult, a technician hears clear tapping begin at 138 mm Hg, the sounds become muffled at 112 mm Hg, and all sound disappear at 86 mm Hg. What is recorded?

• a.112/86 mm Hg, taking the midpoint of the sounds as the systolic
• b.138/86 mm Hg, the first clear tapping over the last sound✓
• c.138/112 mm Hg, taking the muffling point as the true diastolic
• d.86/138 mm Hg, with the diastolic written first

The first clear tapping heard as the cuff deflates is Korotkoff phase I and marks the systolic pressure, and in adults the point where sound disappears, phase V, is charted as the diastolic, giving 138/86 mm Hg. Muffling is phase IV, and using it as the diastolic is the strongest wrong answer because phase IV is in fact used in some pediatric measurement and is recorded as a third number when the gap between muffling and disappearance is wide. Treating the muffling point as a systolic ignores the sounds already heard at 138 mm Hg. Blood pressure is always written systolic over diastolic, so reversing the two numbers misreports the value.

A technician records 44 breaths per minute and a pulse of 138 beats per minute on a 2-day-old newborn who is sleeping quietly. How should these values be handled?

• a.Report both values, because a rate above 20 breaths is too fast
• b.Report the pulse alone, because 138 exceeds the adult upper limit
• c.Recount both values after waking the newborn for accuracy
• d.Chart both values, which fall inside the expected ranges for a newborn✓

A newborn breathes roughly 30 to 60 times a minute and carries a pulse of roughly 100 to 160 beats per minute, so 44 and 138 are both ordinary findings in a quiet infant and are simply charted. Applying adult limits of 12 to 20 breaths and 60 to 100 beats is the classic error, and it generates false alarms that pull a nurse away from a patient who needs one. Vital signs are counted for a full minute in an infant because the rhythm is normally irregular. Waking the newborn would raise both rates and give a less useful baseline than the resting values already obtained.

A technician counts an apical pulse of 118 beats per minute on a calm, playing 2-year-old. Which interpretation is correct?

• a.It is above normal, since 100 is the upper limit at any age
• b.It should be rechecked, because a toddler's rate rarely passes 90
• c.It falls inside the range expected for a toddler and is charted as such✓
• d.It is too slow for a 2-year-old and should be reported

A toddler's resting heart rate runs roughly 90 to 140 beats per minute, well above the adult range, so 118 in a calm 2-year-old is an expected finding rather than tachycardia. Heart rate falls gradually with age, and only in adolescence does it approach the adult 60 to 100 range, which is why treating 100 as a ceiling at every age produces unnecessary reports. Ninety is near the lower edge of the toddler range, not a maximum, so a recheck for a rate above it is not indicated. Calling 118 slow inverts the relationship between age and heart rate entirely.

A pulse oximeter on the index finger reads 86 percent for a patient who is alert, speaking in full sentences, and breathing 16 times a minute. The hand is cold and the nails carry dark polish. What should the technician do first?

• a.Report the 86 percent to the nurse or supervisor and chart it as a true value
• b.Warm the hand and move the probe to a clean, polish-free finger✓
• c.Start oxygen at 2 liters per minute and recheck in ten minutes
• d.Chart 86 percent and recheck it on the next round of vitals

A pulse oximeter reads the percentage of hemoglobin saturated with oxygen by shining light through tissue, so a cold, poorly perfused finger, dark nail polish, motion, or a loose probe all corrupt the signal. When the number contradicts a patient who is alert and speaking comfortably at 16 breaths a minute, the technique is corrected first: warm the hand, remove the polish or use an unpolished digit, an earlobe, or a toe, then read again. Charting or reporting an artifact as a true value passes bad data to the nurse and can trigger an unneeded intervention. Starting or titrating oxygen is outside the technician's scope, and a saturation that stays low after the probe is corrected is reported immediately.

A technician wraps an automatic cuff over a patient's thick sweater sleeve, using the only cuff on the cart that will fasten over the bulky sleeve. The machine reports 156/94 mm Hg for a patient whose readings have all been near 120/70. What should the technician do first?

• a.Chart 156/94 now and tell the supervisor the pressure has climbed sharply
• b.Wait ten minutes and repeat the reading over the sleeve
• c.Repeat the measurement on the bare arm with a properly sized cuff✓
• d.Let the patient rest quietly for an hour and recheck

Bulky clothing under a cuff keeps the bladder from lying flat against the artery and typically inflates the result, so this number describes the technique rather than the patient. A value obtained with faulty technique is repeated correctly before it is charted or passed on, since reporting it as a real change can prompt a medication decision built on an artifact: the arm is bared and a cuff whose bladder fits that arm is used. Waiting ten minutes or an hour and measuring over the sleeve again repeats the same error and reproduces the same inflated result. If the corrected reading is still 156/94 it is charted and reported, and under the 2017 ACC and AHA thresholds a reading at or above 140/90 mm Hg falls in the stage 2 category, with any diagnosis resting on the provider's review of repeated measurements.

A patient with advanced dementia cannot report pain in words. During morning care the patient grimaces, moans, and guards the right hip whenever it is moved. What should the technician do?

• a.Record that the patient denies pain, since no number was given
• b.Ask the patient to rate the pain from zero to ten until an answer comes
• c.Document the specific behaviors observed and report them to the nurse✓
• d.Wait for the next shift to try the pain scale again

Pain is treated as the fifth vital sign, and a patient who cannot self-report is assessed through behavior: facial grimacing, moaning or crying out, guarding or bracing a body part, restlessness, and changes in appetite or sleep. The technician charts what was seen and what triggered it, in objective terms, and reports it so the nurse can complete an assessment. Recording that the patient denies pain is a false entry, because no denial was made, and absence of a number is not absence of pain. Repeating a numeric scale the patient cannot use, or postponing the concern to another shift, leaves observed pain untreated.

A patient who is laughing with visitors rates the pain as 8 on a 0-to-10 scale when the technician asks. What pain score should be charted and passed on?

• a.A 3, to match how comfortable the patient appears
• b.No pain, since the patient is laughing with guests
• c.The 8 exactly as the patient reported it✓
• d.An 8, with a note that the patient may be exaggerating

A numeric pain rating is a self-report measurement, and the value charted is the number the patient states; behavior is not a substitute for it, because people distract themselves from pain with conversation, laughter, and visitors. Substituting a lower number, or charting no pain at all, alters a vital sign to match an observation and can delay treatment. Adding a comment that the patient may be exaggerating is the closest wrong answer, since it does preserve the 8, but it inserts a judgment the technician is not licensed to make and colors how the nurse reads the record. Objective observations, such as the patient laughing and moving freely, may be charted separately as observations.

A patient weighs 165 pounds. Using the conversion 1 kg equals 2.2 lb, what weight should the technician record in kilograms?

• a.363 kg
• b.75 kg✓
• c.82.5 kg
• d.165 kg

Pounds are converted to kilograms by dividing by 2.2, so 165 divided by 2.2 equals 75 kg. Multiplying instead of dividing gives 165 times 2.2, or 363 kg, a weight no adult carries, which is why the direction of the operation should be sanity-checked against the fact that a kilogram is heavier than a pound. Dividing by 2 rather than 2.2 gives 82.5 kg, a small enough error to slip through and large enough to matter when a weight-based dose is calculated from it. Recording the same number in both units treats the units as equal and more than doubles the true value.

A patient on daily weights measured 168 lb yesterday and 173 lb this morning, on the same scale, at the same hour, in the same gown. What should the technician do?

• a.Chart 173 lb and note that daily weights vary by a few pounds
• b.Chart yesterday's weight again, since a 5 lb gain overnight is impossible
• c.Chart 173 lb and report the 5 lb overnight gain to the nurse or supervisor✓
• d.Reweigh the patient after breakfast and chart the lower number

Daily weights exist to reveal a trend, and because a liter of retained fluid weighs about 2.2 lb, a 5 lb gain in 24 hours points to roughly 2 liters of fluid rather than to body mass; that pattern matters in heart failure, kidney disease, and any patient on a fluid restriction. The conditions described rule out the usual technical explanations, so the value is charted and the change is reported the same shift instead of being left in the record for someone to notice later. Dismissing the jump as normal variation, or copying forward yesterday's number, destroys the trend the measurement was ordered to capture. Reweighing after a meal adds the weight of food and fluid and biases the comparison further.

A technician is giving a complete bed bath and starts with the patient's face. How should the eyes be washed?

• a.From the inner corner outward, with a clean area of the cloth for each eye✓
• b.From the outer corner inward, using the same soapy corner of the cloth for both eyes
• c.With mild soap lathered over the closed lids, then rinsed and patted dry
• d.With a cotton ball moistened in the basin water used later for the perineum

The eyes are washed with plain water from the inner canthus toward the outer canthus, and a different part of the washcloth is used for the second eye, so that drainage and organisms are not carried into the tear duct or across to the other eye. Wiping toward the nose pushes debris into the duct, and reusing the same soiled corner of the cloth carries organisms from one eye to the other. Soap stings and dries the lids and is not used on the eyes. Water that will later be used for the perineal area is the most contaminated water on the tray and is never the water an eye is washed with.

A technician is shaving a patient's face with a safety razor after softening the beard with a warm, moist towel. Which technique is correct?

• a.Hold the skin taut and shave in the direction the hair grows✓
• b.Shave against the direction of growth to leave the skin smoother for longer
• c.Apply the razor to dry skin without soap so the strokes are easier to see
• d.Let the skin stay loose and use long strokes without rinsing the blade

Holding the skin taut gives a flat surface and shaving with the grain reduces nicks, razor burn, and ingrown hairs, which matters most in a patient who bleeds easily or takes an anticoagulant. Shaving against the grain does cut closer, which is why candidates pick it, but it lifts and cuts the hair below the skin line and irritates the follicle. A dry shave without lather drags on the skin and abrades it. Loose skin folds into the blade, and a blade clogged with hair and lather pulls rather than cuts.

A technician is giving foot care to a patient who has diabetes. Which action is appropriate?

• a.Dry gently between the toes and leave nail cutting to the nurse✓
• b.Trim the toenails straight across with clippers once they have softened
• c.Soak the feet in hot water for 20 minutes to loosen thickened calluses
• d.Rub a thick layer of lotion between the toes to keep the skin from cracking

Diabetes brings reduced sensation and reduced circulation, so a small cut heals poorly and can become a serious infection; most facilities restrict nail cutting for these patients to a nurse or podiatrist, and the technician's job is washing, careful drying, and inspecting for redness, cracks, or breaks in the skin. Straight-across trimming is the right technique in general, which is what makes it tempting here, but the restriction is on who cuts the nails, not on how. Hot soaks are a burn risk in a foot with neuropathy and also macerate the skin. Lotion is applied to the tops and soles but not between the toes, where trapped moisture promotes skin breakdown and fungal growth.

A patient has an intravenous line running in the left arm and needs a clean gown put on. How should the technician manage the sleeve on that side?

• a.Slide the right arm in first and drape the gown loosely over the left shoulder
• b.Disconnect the tubing at the hub, dress the left arm, then reconnect the line
• c.Have the patient hold the bag below the arm while the sleeve is pulled up
• d.Pass the bag and tubing through the sleeve first, then the left arm✓

The affected side is dressed first: the technician takes the sleeve of the clean gown, passes the IV bag and tubing through it from the inside out, rehangs the bag, and then guides the arm into the sleeve, so the line is never pulled or disconnected. Dressing the free arm first and leaving the IV side draped is a common shortcut but leaves the patient uncovered and the line unsupported. Disconnecting the tubing breaks a closed sterile system and is outside the technician's scope. Lowering the bag below the insertion site allows blood to back up into the tubing.

A technician finds a patient lying on linens that are soaked with urine. What should the technician do first?

• a.Ask the supervisor whether an incontinence brief may be started
• b.Wash and dry the skin, then put on dry linens and clothing✓
• c.Spread barrier cream over the wet skin and recheck in an hour
• d.Chart the episode and finish the morning rounds

Urine on the skin raises the surface pH and softens the stratum corneum, and pressure or friction on wet, macerated skin causes breakdown within hours, so the first action is to clean the skin with a mild cleanser, dry it thoroughly, and replace the wet linen and clothing. Barrier products belong on skin that is already clean and dry; applying them over wet skin seals the moisture in. Asking about a brief is a reasonable conversation later, but it is not what the patient needs while lying in urine. Documenting the episode is required, and so is telling the nurse about any redness found, but neither comes before getting the patient clean and dry.

A technician is shampooing the hair of a patient who must remain in bed. Which action is part of the correct procedure?

• a.Put a shampoo trough under the head and cover the eyes with a washcloth✓
• b.Raise the head of the bed as high as it goes so the water drains toward the back
• c.Use water as hot as the patient can tolerate to help loosen scalp oil and flakes
• d.Comb the hair only after it dries fully so that the wet strands do not break off

A shampoo trough or inflatable basin channels the water into a collection container and keeps the bed dry, and a folded washcloth over the eyes keeps shampoo and water out of them. Raising the head of the bed sends water down the neck and back instead of into the trough; the head is supported and slightly extended over the trough with the bed flat or nearly flat. Water temperature is checked the same way as for a bath, at about 105°F, since a patient with reduced sensation can be scalded before saying so. Wet hair is combed out from the ends upward while it is still damp, because dried tangles are harder on the hair and the scalp.

A technician takes a patient's dentures to the sink to clean them. Which action protects the dentures from damage?

• a.Line the sink with a towel and run a little water in it before starting✓
• b.Rinse and then store the dentures in hot water so that the heat kills bacteria
• c.Scrub the dentures with abrasive scouring powder to lift stains
• d.Wrap the dentures in a dry paper towel at the bedside between meals

Dentures are slippery when wet and crack or chip easily, so the sink is padded with a towel and partly filled with water to cushion a drop, and they are held firmly over that surface while being brushed. Hot water warps the acrylic base and changes the fit, so cool or tepid water is used for both cleaning and storage. Abrasive powders scratch the surface, and the scratches then collect stain and organisms. Dentures left in a dry paper towel dry out, warp, and are thrown away with the trash more often than any other patient belonging; they belong in a labeled denture cup with water or solution.

A patient's family asks a technician to take out the patient's indwelling urinary catheter because it is uncomfortable. What is the appropriate response?

• a.Report the request to the nurse or supervisor, since removal needs an order✓
• b.Remove the catheter after deflating the balloon, because the patient is uncomfortable
• c.Clamp the drainage tubing for an hour and see whether the discomfort settles down
• d.Tell the family that only a physician may take out a catheter at the bedside

Discontinuing an indwelling catheter requires a provider's order; whether a technician may then perform the removal depends on state rules, facility policy, and the certification held, so the request goes to the nurse or supervisor rather than being acted on at the bedside. Deflating the balloon and pulling the catheter on a family's request removes a device that no one has ordered discontinued. Clamping the tubing obstructs drainage, raises the risk of infection and bladder distention, and is not done without an order. Saying that a physician must do it is wrong on the facts, because in many facilities a nurse, or a technician under policy, carries out the removal once it is ordered.

While changing an ostomy pouch, a technician sees that the stoma, pink and moist the day before, now looks dusky purple. What should the technician do?

• a.Apply the new pouch and note the color change in the chart at the end of the shift
• b.Rub the stoma gently with a warm cloth to bring the circulation back
• c.Stop and report the color change to the nurse or supervisor before going on✓
• d.Leave the pouch off and cover the stoma with a dry gauze square

A healthy stoma is beefy red or pink and moist; a dusky, purple, or black stoma suggests that its blood supply is compromised, which is an urgent finding and is reported immediately rather than at the end of the shift. Finishing the pouch change and charting it later is the trap, because the pouch change itself is a normal technician task and the color is easy to write off as bruising. Rubbing the stoma will not restore perfusion and can injure the fragile mucosa, which bleeds readily. Leaving the stoma open under gauze lets output soil the skin and the bed and does nothing about the cause.

A technician is teaching a patient how to collect a clean-catch midstream urine specimen. Which instruction is correct?

• a.Cleanse first, void briefly into the toilet, then collect the middle of the stream✓
• b.Void the first portion into the cup and the rest of the stream into the toilet
• c.Collect the entire voiding in the sterile cup from start to finish
• d.Wipe with plain dry tissue and collect the last drops of the voiding

Only the middle portion of the stream is kept. The first portion flushes organisms out of the distal urethra and the perineum into the toilet, which is what makes the specimen usable for culture, and cleansing with the supplied antiseptic wipes comes before any of it. Catching the first portion gathers exactly the contamination the technique is designed to wash away. A complete voiding is what a routine or a timed collection wants, not a midstream culture specimen. Plain dry tissue does not clean the meatal area, and the last drops are the smallest and least useful part of the voiding.

A 24-hour urine collection is ordered to begin at 0700. How should the collection be started and ended?

• a.Discard the 0700 voiding and note the start time, then save all urine through 0700 the next day✓
• b.Save the 0700 voiding as the first specimen and stop collecting at 0700 the next morning
• c.Start saving urine after breakfast and end the collection at bedtime on the same day
• d.Save only the first and the last voiding of the 24 hours and discard everything between

The bladder has to be empty when the clock starts, so the voiding at the start time is discarded, the time is recorded, and every voiding afterward is saved, including one final voiding at the end of the 24 hours. Saving the first voiding adds urine the kidneys produced before the collection period and makes the result too high. A collection that runs from after breakfast to bedtime is not 24 hours and misses the overnight portion entirely. Saving only two voidings loses the rest of the period, and if any voiding is discarded by accident the whole collection is restarted.

A technician is collecting a stool specimen from a patient who uses the bathroom. Which action keeps the specimen usable?

• a.Collect the sample out of the toilet bowl water after the patient has flushed once
• b.Have the patient pass urine and stool into the container together
• c.Wrap the specimen in toilet tissue before it is placed into the container
• d.Have the patient void first, then pass the stool into a clean collection hat✓

Urine, toilet water, and toilet paper all invalidate a stool specimen, so the patient voids first, the bladder is empty, and the stool is passed into a clean collection container or a hat set in the toilet and then transferred with the tongue blade in the kit. Bowl water dilutes the sample and adds organisms and disinfectant residue. Urine mixed into the container is the single most common reason a stool specimen is rejected. Toilet tissue absorbs the specimen and introduces fibers and chemicals that interfere with occult blood and culture testing.

A patient receiving a continuous tube feeding tells the technician that he feels nauseated, and the feeding pump is alarming. What should the technician do?

• a.Leave the pump settings alone, keep the head of the bed up, and report both to the supervisor✓
• b.Turn the feeding rate down until the nausea settles and mention it at the next rounds
• c.Stop the pump, lay the head of the bed flat, and offer the patient small sips of water
• d.Silence the alarm and flush the tube with warm water to clear the obstruction

Rate changes, tube flushes, and troubleshooting a feeding pump belong to licensed staff; the technician keeps the patient safe by leaving the settings untouched, maintaining the elevated head of the bed that protects against aspiration, and reporting the nausea and the alarm right away. Turning the rate down is an adjustment to a therapy the technician did not order and cannot order. Lying the patient flat while formula is in the stomach increases the aspiration risk, and oral fluids are not given to a patient whose tolerance is in question. Flushing the tube assumes an obstruction that has not been confirmed and is a licensed task in most facilities.

A patient has an order for a clear liquid diet. Which tray item is consistent with that order?

• a.A bowl of cream of chicken soup, which is thin enough to pour
• b.A half pint of skim milk, since the fat has been taken out of it
• c.Plain gelatin with a cup of beef broth and a glass of apple juice✓
• d.A carton of orange juice with pulp and a cup of hot cocoa

A clear liquid diet is made up of items that are liquid at body temperature and that a light can be seen through, such as clear broth, plain gelatin, tea, black coffee, ice pops without pulp, and clear juices like apple or white grape. Cream soup is the closest distractor because it pours like a liquid, but the dairy and the puree make it opaque and put it on the full liquid diet instead. Milk is likewise a full liquid, not a clear one. Pulp makes orange juice opaque, and cocoa is a milk drink.

A tray arrives for a patient whose diet order reads pureed. Checking the tray against the order, which item should the technician question before it is served?

• a.Pureed peaches served in a dish beside the main course
• b.A soft dinner roll with butter set on the side of the plate✓
• c.Whipped potatoes blended smooth with a little warm gravy over them
• d.Strained cream soup thickened to a smooth and lump-free consistency

A pureed diet is limited to foods blended to a smooth, pudding-like texture that need no chewing, which is why it is ordered for patients with dysphagia or with no ability to chew. A dinner roll keeps its bread texture, forms a bolus in the mouth, and does not belong on the tray, so the technician holds it and checks the order with the nurse rather than serving it. Pureed fruit, smooth whipped potatoes, and strained thickened soup all meet the texture requirement. Comparing the diet card with the order on every tray before it reaches the patient is part of the technician's routine, and the same check catches salt on a low-sodium tray.

A technician is restocking a supply cart when a call light comes on and the patient states over the intercom that she needs the urinal now. What should the technician do?

• a.Ask the supervisor which of the waiting call lights should be taken first
• b.Finish restocking the cart and answer the light on the way back down
• c.Tell her over the intercom that someone will come soon
• d.Go to the room now, screen the patient, and hand her the urinal✓

A call light is answered promptly, and a request to void is answered promptly for a reason beyond courtesy: a patient who waits is the patient who climbs over the rail unassisted, and falls and incontinence episodes both track with slow call light response. Restocking a cart is not time-critical and waits. Telling the patient over the intercom to wait leaves her alone with the same choice between waiting and getting up. Asking the supervisor how to prioritize turns a task the technician can complete in under a minute into a delay, and the supervisor is not the person holding the urinal.

A patient is on a 1,200 mL daily fluid restriction and tells the technician that his mouth feels dry. Which action is appropriate?

• a.Fill the water pitcher as usual and record whatever the patient drinks
• b.Hold all fluids until the provider reviews the restriction in the morning
• c.Offer a large glass of water now and give nothing more this evening
• d.Give frequent mouth care and space the allowed fluid across the three shifts✓

The allowance is divided across the day, commonly with the largest share on the day shift and the smallest overnight, and dry mouth is managed with frequent oral care, lip moisturizer, and rinses that are not swallowed, so the patient is comfortable without exceeding the limit. Leaving a full pitcher at the bedside makes it nearly impossible to keep the total at 1,200 mL. Withholding fluids altogether is not what the order says and pushes the patient toward dehydration. Giving a large glass at once uses up much of the day's allowance in a single serving and leaves nothing for the hours that follow.

Which set of findings should a technician report as possible dehydration?

• a.A bounding pulse, moist skin, and urine that is pale and nearly colorless
• b.Dark scant urine, a dry mouth, and skin that tents when pinched✓
• c.Puffy ankles, a moist cough, and a weight gain of 2 pounds since yesterday
• d.Warm flushed cheeks, a full pulse, and frequent large voidings

Fluid loss concentrates the urine so it turns dark and small in amount, dries the mucous membranes, and reduces skin elasticity, so a pinched fold over the sternum or forearm stays tented instead of falling back; a rapid weak pulse and sudden weight loss go with the same picture. Puffy ankles with a moist cough and an overnight weight gain point the other way, toward fluid overload, and that pairing is the one candidates most often confuse with dehydration because both are fluid problems that must be reported. Pale, plentiful urine with moist skin is the picture of adequate hydration. Frequent large voidings are not a sign of fluid deficit.

A patient eats about half of the solid food on the lunch tray and drinks part of the beverage. How should the technician record the meal?

• a.Record the meal as refused, since the tray came back unfinished
• b.Record the percentage of the meal eaten and enter fluids in mL on the I&O sheet✓
• c.Record the weight of the food left on the tray in the intake column
• d.Record half of the tray's calorie count in the intake total for the shift

Meal intake is charted as the portion of the served food consumed, usually as a percentage or in fourths, while liquids are measured separately in milliliters on the intake and output record, since only fluids belong in the I&O total. Charting the meal as refused is inaccurate and can trigger a nutrition consult the patient does not need. Leftover food is not weighed on a routine tray, and weight is not what the intake column asks for. Calorie counts are calculated by dietary staff from the recorded portions, not estimated by the technician at the bedside.

A patient on strict intake and output finishes a 240 mL cup that was filled with ice chips. How much intake should be recorded?

• a.240 mL, because the cup held that volume when it was filled
• b.480 mL, since melting roughly doubles the volume of the chips
• c.0 mL, because ice chips are counted as a solid on the record
• d.120 mL, because ice chips are recorded as about half their volume✓

Ice chips do not fill a container completely; air occupies the spaces between them, so the melted volume is about half the volume of the cup, and 240 mL of chips is charted as roughly 120 mL. Recording the full 240 mL is the most common error and overstates intake by about double. Melting does not increase volume, so a figure above the cup size cannot be right. Ice chips are fluid once melted and are counted on the intake side rather than ignored.

At the end of the shift a technician empties a patient's urinary drainage bag. Which action is correct?

• a.Rest the drain spout on the rim of the graduate to hold the stream steady
• b.Use a graduate kept for that patient and keep the spout from touching it✓
• c.Take the bag off the catheter tubing so that it can drain completely
• d.Empty the bag into the toilet and estimate the amount for the record

Each patient has a dedicated graduated container, and the drain spout is wiped, opened without contact with the graduate or the floor, and re-clamped and wiped again afterward, which keeps organisms from traveling up the spout into a closed system. Letting the spout rest on the rim contaminates it against the very surface urine has been sitting in. Separating the bag from the catheter tubing breaks the closed system and is a leading cause of catheter-associated infection. Emptying into the toilet destroys the measurement, and an estimated volume is of no use on an output record.

A technician is assisting with postmortem care shortly after a patient's death. Which action is part of the technician's role?

• a.Remove the wedding ring and put it into the drawer of the bedside stand
• b.Lay the body flat and turn it face down to slow the color change
• c.Position the body in normal alignment with the head slightly raised✓
• d.Open the curtain so that family can be seen from the hallway

The body is straightened into normal alignment before rigor mortis sets in, and the head and shoulders are raised on a pillow so that blood settling in the face does not discolor it. Personal belongings and valuables are inventoried and released according to facility policy, usually with a second person as witness and documentation of who received them, rather than being slipped into a drawer. Turning the body face down is not done and would worsen the discoloration of the face. Privacy and dignity continue after death exactly as before it, so the curtain and the door stay closed while care is given and while the family is at the bedside.

During a stand-pivot transfer from the bed to a chair, a patient's knees buckle and the patient begins to slide toward the floor. What should the technician do?

• a.Grip the patient under both arms and lift back onto the bed
• b.Hold the patient upright and call the supervisor to the room
• c.Ease the patient down to the floor, protecting the head✓
• d.Step away quickly so the technician is not pulled down too

A falling adult cannot be held up safely, and trying to hold or lift the patient is how both the patient and the technician get hurt. The technician widens the stance, brings the patient close to the body, and slides the patient down the technician's leg to the floor while supporting and protecting the head, then stays with the patient and calls for help. Lifting a buckling patient under the arms risks shoulder injury to the patient and a back injury to the technician. Standing there holding the patient while calling for help only delays the controlled descent, and stepping away leaves the patient to fall unprotected.

A technician is assigned to move a patient with a full-body mechanical lift, a model the technician has not been trained to operate. The patient is waiting to be moved into the chair. What is the best action?

• a.Ask the supervisor for training on this lift before using it with a patient✓
• b.Read the instruction label on the lift and then operate it with a second aide
• c.Do a stand-pivot transfer with a gait belt instead of the lift
• d.Tell the patient the transfer is delayed and go to another task

Mechanical lifts are only safe in the hands of staff trained on that specific model, and a patient in a sling is entirely dependent on correct sling selection, hook placement, and boom control. Asking the supervisor for training keeps the task inside the technician's competence and still gets the patient moved. Reading the label is not training and does not cover sling sizing or the facility's two-person rule. Substituting a stand-pivot transfer overrides the care plan for a patient the plan says cannot bear weight. Simply walking away leaves the patient waiting with no plan and no one informed.

A technician must move a heavy loaded linen cart down a corridor. Which technique best protects the technician's back?

• a.Pull the cart while walking backward, keeping the arms straight
• b.Lift the front wheels slightly and pivot at the waist to steer the cart
• c.Push the cart, keeping it close to the body and using the leg muscles✓
• d.Twist at the waist to start the cart moving, then walk forward

Pushing lets the technician use body weight and the large muscles of the legs and hips, and it keeps the load close and in view; pulling shifts the work onto the back and shoulders and means walking backward into whatever is behind. Bending or lifting the cart adds unnecessary load to the lumbar spine. Twisting at the waist under load is one of the most common mechanisms of back injury in health care; the technician should pivot with the feet instead. Keeping the back straight, the knees slightly bent, and the feet about shoulder-width apart completes safe body mechanics.

A patient with right-sided weakness after a stroke is being transferred from the bed to a wheelchair. Where should the technician place the chair?

• a.At the foot of the bed facing the patient, with the brakes released
• b.On the patient's right side, so the weaker leg leads into the chair
• c.On either side of the bed, because a gait belt is used for the move
• d.On the patient's left side, which is the stronger side✓

The chair goes on the stronger side so the patient stands and pivots toward the leg and arm that can bear weight and can help push off; here the left side is the strong side. Placing the chair on the weak right side forces the pivot onto the leg that may give way. A chair at the foot of the bed is out of reach for a short pivot, and leaving the brakes off lets the chair roll away as the patient sits. A gait belt gives the technician a hold on the patient but it does not make the direction of the pivot unimportant.

A rolled towel is tucked alongside a supine patient's hip and thigh as a trochanter roll. What is this device intended to prevent?

• a.Plantar flexion of the ankle, which leads to foot drop over time
• b.Flexion contracture of the knee in a patient confined to bed
• c.A pressure injury forming over the greater trochanter of the hip
• d.External rotation of the hip while the patient is lying supine✓

A trochanter roll is a firm roll placed from the top of the iliac crest to mid-thigh; it blocks the leg from rolling outward, keeping the hip in neutral alignment. Its name comes from where it sits, not from what it protects, so choosing pressure relief over the greater trochanter is a natural trap; pressure over that bony point is relieved by turning schedules and side-lying support, not by a roll wedged against it. Foot drop is prevented by a footboard or ankle support, and knee contracture by limiting how long the knee is left flexed over a pillow.

A footboard is placed against the soles of a supine patient's feet. Which complication is this intended to prevent?

• a.External rotation of the hips while the patient is lying flat
• b.Foot drop from plantar flexion contracture✓
• c.Pressure injury on both heels from resting on the mattress
• d.Swelling of the feet and ankles during prolonged bed rest

Left unsupported, the weight of the bedding pulls the feet into plantar flexion, and over weeks the calf muscles and Achilles tendon shorten into a fixed contracture called foot drop that prevents a normal heel-to-toe gait. A footboard, or high-top shoes, holds the ankles near 90 degrees. Heel pressure injuries are prevented by floating the heels off the mattress with a pillow under the calves, not by pushing the soles against a board. External hip rotation is controlled by trochanter rolls, and dependent swelling by elevation and position changes.

A patient with left-leg weakness is learning to walk with a standard pickup walker. Which sequence should the technician reinforce?

• a.Step forward with the right leg, then lift the walker ahead
• b.Move the walker ahead, step with the weaker left leg, then the right✓
• c.Move the walker and both legs forward together in one smooth motion
• d.Step with the weaker left leg, then lift the walker ahead of both feet

With a pickup walker the device is placed first, about an arm's length ahead with all four legs on the floor, and only then does the patient step in: weaker leg first into the frame, then the stronger leg. The weak leg moves while the walker and the strong leg are both stable, which is where the support is needed. Stepping with the strong leg first leaves the weak leg to carry the body alone at the end of the step. Moving the walker while stepping, or moving the walker after the weak leg, means the patient is unsupported at the least stable moment. The patient should stay inside the frame and not step past the front legs.

A patient using crutches with a non-weight-bearing left leg is going up a flight of stairs. What should move up onto the step first?

• a.Both crutches move up onto the step, and the right leg follows
• b.The left leg is lifted up onto the step with the crutches held clear
• c.The stronger right leg steps up to the next step first✓
• d.The crutches and the left leg move up onto the step at the same time

The teaching phrase is up with the good, down with the bad: going up, the stronger leg leads onto the step while the crutches and the affected leg stay on the lower step to bear the load, and the crutches then come up. Going down, the crutches and the weaker leg go down first, and the stronger leg follows. Leading with the crutches or with the affected leg on the way up forces the weak side to lift the body's weight. The technician stands behind and slightly to the affected side going up, and one step below the patient going down.

A patient with severe shortness of breath is helped into the orthopneic position. How is this patient positioned?

• a.Sitting upright and leaning forward onto an overbed table, arms resting on it✓
• b.Lying flat on the back with a pillow under the head and under both knees
• c.Side-lying with the lower arm behind the back and the upper knee flexed
• d.Flat on the back with the whole bed tilted so the head is lower

In the orthopneic position the patient sits and leans forward over a padded overbed table, which lets the chest expand fully and lets the arms and shoulders anchor the accessory muscles of breathing, so it is often chosen by patients with COPD or heart failure who cannot breathe lying down. Lying flat with a pillow under the knees is dorsal recumbent positioning and worsens dyspnea. The side-lying description with the lower arm behind the back is Sims' position. Tilting the whole bed head-down is Trendelenburg, which pushes the abdominal organs against the diaphragm and makes breathing harder.

While repositioning a patient, a technician finds a 3 cm area of intact, deep purple skin on the left heel that does not blanch. What should the technician do?

• a.Massage the discolored area with lotion to restore circulation to the heel
• b.Cover the heel with a dressing and document it at end of shift
• c.Chart the heel as a stage 2 pressure injury and continue the turn schedule
• d.Keep pressure off the heel and report it to the nurse or supervisor now✓

Intact skin that is deep purple or maroon and non-blanchable suggests a deep tissue pressure injury, meaning damage has already occurred in the tissue under the surface, and such an area can deteriorate quickly even with treatment. Relieving pressure by floating the heel and reporting the finding promptly are both required, and staging or charting a diagnosis is the nurse's assessment, not the technician's. Massaging discolored skin over a bony point is an old practice now avoided because it can worsen the underlying tissue damage. Waiting until the end of shift to document delays the nursing assessment on a lesion that can open within hours. A stage 2 injury involves partial-thickness skin loss, which this intact area does not show.

The head of a patient's bed is raised to 45 degrees and the patient slowly slides toward the foot of the bed. The skin over the sacrum stays against the sheet while the deeper tissue and bone move downward. Which mechanism does this describe?

• a.Friction, the rubbing of the skin surface against the bed linens
• b.Moisture damage from perspiration trapped under the patient's body
• c.Direct pressure from body weight on skin over a bony prominence
• d.Shear, in which deeper tissue slides while the surface skin holds still✓

Shear happens when two layers move in opposite directions: the sacral skin is held by the sheet while the skeleton slides down, so the blood vessels between the layers stretch and kink and the tissue under intact skin loses its supply. Friction is the surface injury from skin dragging across linen, which scrapes the epidermis but does not distort the deeper layers. Direct pressure describes the load itself rather than this sliding motion, and moisture softens skin and makes it more vulnerable but is not what the scenario shows. Keeping the head of the bed at 30 degrees or lower when the condition allows, and lifting rather than dragging the patient, are the main defenses.

A nurse is completing a Braden Scale score for a newly admitted patient. Which action is the technician's appropriate contribution?

• a.Assign the sensory perception and moisture subscores from the shift's care
• b.Decide which pressure-redistribution mattress the patient needs
• c.Repeat the Braden score at end of shift and chart the total
• d.Report observations of moisture, meal intake, and mobility to the nurse✓

The Braden Scale is a nursing assessment with six subscales, and scoring it, repeating it, and acting on the total are nursing responsibilities. The technician is at the bedside for the care that generates the raw information, so accurate reporting of how much of the meal was eaten, how often the patient was incontinent or diaphoretic, and how much the patient moved is a genuine and valuable contribution. Assigning subscores or repeating the total is scoring the tool. Selecting a support surface is a clinical decision made by the nurse or the provider based on the score and the patient's condition.

A patient is placed in the prone position for a short period. Which sites should the technician check most closely for pressure?

• a.The cheek and ear, the chest, the knees, and the toes✓
• b.The sacrum, both heels, and the back of the head
• c.The greater trochanter, the down-side ear, and the outer ankle
• d.The ischial tuberosities and the backs of the patient's thighs

Pressure points follow whatever bone is nearest the mattress. Face down, the load falls on the cheek and ear, the chest, the iliac crests, the knees, and the dorsal surface of the toes, so a small pillow under the lower legs to lift the toes clear and a flat pillow under the abdomen are standard. The sacrum, heels, and occiput are the supine points. The trochanter, the down-side ear, and the lateral ankle are the side-lying points. The ischial tuberosities carry the load when a patient is sitting up in a chair, which is why chair time is limited and weight shifts are encouraged.

A patient recovering from a shoulder injury starts to raise the arm but cannot finish the movement, so the technician supports the elbow through the rest of the arc. This exercise is best described as:

• a.Active-assisted range of motion, since the patient starts the motion and the technician completes it✓
• b.Passive range of motion, because the technician's hands are on the joint during the movement
• c.Resistive exercise, because the support the technician gives opposes the patient's movement
• d.Active range of motion, since the patient begins the movement without any help

Active-assisted range of motion is the middle category: the patient supplies as much of the movement as possible and the caregiver or a device supplies the rest, which is exactly what happens when the technician carries the arm through the last part of the arc. Passive range of motion means the patient contributes no muscle effort at all, and active range of motion means the patient completes the movement unaided. Resistive exercise means the patient works against an opposing force to build strength, while here the technician is helping rather than opposing. Movements are carried out slowly, to the point of resistance and no further.

During range-of-motion exercises the technician turns a patient's forearm so that the palm faces upward. Which movement is this?

• a.Pronation, the rotation that turns the palm face down
• b.Supination, rotation of the forearm to a palm-up position✓
• c.External rotation, turning the whole arm out at the shoulder
• d.Radial deviation, bending the wrist toward the thumb

Supination is the forearm rotation that carries the palm to face up, the position in which a bowl of soup could be held in the hand; pronation is the opposite rotation, palm down, and the two words are easy to reverse under time pressure. External rotation occurs at the shoulder and turns the whole arm outward, so a palm can end up facing forward without the forearm rotating at all, which makes it a close competitor here. Radial deviation is a wrist movement toward the thumb side. During passive range of motion the technician supports the joint above and below, stops at resistance or at the patient's report of pain, and works within the plan set by the nurse or therapist.

Under a typical facility policy, which patient is the best candidate for a transfer performed with a slide board?

• a.A patient who cannot bear weight but has strong arms✓
• b.A patient who can stand briefly and take small pivot steps to the chair
• c.A patient who is unresponsive and cannot assist with the transfer at all
• d.A patient who walks with a walker but tires after a short distance

A slide board bridges the gap between two surfaces so the patient can scoot across without standing; it depends on the patient having enough upper body strength and trunk control to push and shift weight, which is the classic picture of a patient with a spinal cord injury or bilateral lower extremity weakness. A patient who can stand and pivot does not need a board and should use that remaining strength. An unresponsive patient who cannot help at all needs a full-body mechanical lift and at least two staff. A patient who ambulates with a walker transfers by standing, with the walker or a gait belt for support.

The bed has been lowered and a patient in non-skid footwear is sitting on the edge of the bed. The technician has just rolled the wheelchair up to the patient's stronger side. What should the technician do next?

• a.Apply the gait belt and have the patient stand on the count of three
• b.Lock the wheel brakes and move the footrests aside✓
• c.Ask the patient to rest both hands on the technician's shoulders
• d.Raise the bed slightly so the patient can push up off the mattress

Securing the chair comes before the patient is anywhere near it: an unlocked chair rolls backward at the moment the patient's weight arrives, and footrests left down are the classic tripping and shin-injury hazard during a pivot. The gait belt is applied next, and it is the right action, only not the first one here. A patient should hold the technician's forearms or the chair rather than the shoulders, because pulling on the shoulders or neck destabilizes both people. The bed is left low enough that the patient's feet are flat on the floor, so raising it again removes that stable base.

As a technician settles a patient into a chair, the patient's peripheral IV catheter is pulled out by the tubing and the site begins to bleed steadily. What should the technician do first?

• a.Ask the supervisor whether the catheter may go back into the same vein
• b.Wipe the blood away and cover the site with a large adhesive bandage
• c.Raise the patient's arm overhead and wait for the bleeding to stop
• d.Hold direct pressure on the site with clean gauze✓

Active bleeding is controlled first, with gloves on and firm direct pressure over the puncture site until it stops, and only then is the nurse notified and the event documented. Restarting an IV is outside the technician's role and is not a first action while the site is bleeding, so the escalation here delays the one thing that has to happen immediately. Covering a bleeding site with a bandage without pressure lets blood collect under the dressing and hides how much is being lost. Raising the arm alone does not close a punctured vein. Elevation may be added after pressure is applied.

A technician is ambulating a patient who has left-sided weakness, using a gait belt. Where should the technician walk?

• a.In front of the patient, holding both of the patient's hands
• b.Slightly behind and on the patient's weaker left side✓
• c.On the patient's right side, holding the belt with one hand
• d.Beside the patient at arm's length, ready to catch a fall

The technician walks slightly behind and to the weaker side, holding the gait belt underhand at the back, because that is the side the patient will drift or fall toward and that position lets the technician control the descent to the floor. Walking on the strong side leaves the weak side unguarded. Walking backward in front of the patient blocks the path, prevents the technician from seeing where either of them is going, and gives no way to lower a falling patient. Staying an arm's length away is too far to control a fall that starts without warning.

During passive range-of-motion exercises the technician meets firm resistance in a patient's shoulder, and the patient grimaces and says it hurts. What should the technician do?

• a.Move the joint a little further with each repetition to stretch the tissue
• b.Hold the stretch at the painful point for a slow count of ten, then let go
• c.Stop at that point and report the pain to the supervisor✓
• d.Finish the remaining shoulder movements faster to shorten the discomfort

Range-of-motion exercises are carried out slowly to the point of resistance or the first sign of pain, and no further; forcing past that point can tear soft tissue, dislocate a joint, or fracture a bone in a patient with osteoporosis or spasticity. New pain or new resistance is a change in condition, so exercise stops and the finding goes to the nurse or supervisor before it is repeated. Pushing further each repetition and holding a painful stretch both continue the very force that caused the pain. Moving faster increases the risk rather than reducing it, because momentum takes the joint past its safe limit.

A resident recovering from a stroke is relearning to put on a shirt and takes several minutes to work the weaker arm into the sleeve. Which approach best supports restorative care?

• a.Allow the extra time and cue the resident through each step of the task✓
• b.Dress the resident quickly now and practice on another day
• c.Slide the shirt onto the stronger arm first so the task takes less effort
• d.Complete the sleeve for the resident after the first attempt fails

Restorative care is built on the resident doing the task at the resident's own pace, with verbal cues, adaptive equipment, and setup rather than hands-on completion, because every repetition maintains the function that was regained. Taking over the task, whether at the start or after one failed attempt, is faster for the shift and costs the resident the skill. Dressing the weaker arm first is the correct technique and dressing the stronger arm first makes the task harder, since the weak arm then has to be pushed through a sleeve that is already anchored. Progress is reported so the plan of care can be updated.

Two technicians need to move a patient who has slid toward the foot of the bed back up toward the head of the bed. Which method best protects the patient's skin and the technicians' backs?

• a.Use a friction-reducing lift sheet with one technician on each side✓
• b.Grasp the patient under both arms and pull toward the headboard
• c.Raise the head of the bed and have the patient pull up on the side rails
• d.One technician lifts the shoulders and the other the hips

A lift sheet or friction-reducing slide sheet lets two people move the patient as one unit without dragging skin across the linen, and it keeps the load close to each technician's center of gravity. The bed is flattened first and raised to waist height, the technicians face the head of the bed with feet apart and knees bent, and they move on a count. Pulling under the arms puts traction on the shoulder joints and can injure the brachial plexus. Raising the head of the bed works against the move and increases shear. Lifting a patient by the shoulders and hips by hand strains both backs and grinds the skin along the sheet.