CHPNA Personal Care and Activities of Daily Living 2 — Questions and Answers
Question 1: A hospice patient with dysphagia is being assisted with a meal. What position is safest to reduce aspiration risk?
- Lying flat in bed
- Sitting upright at 90 degrees or as close as tolerated (Correct answer)
- Semi-reclined at 30 degrees
- Turned to the left side
Correct answer: Sitting upright at 90 degrees or as close as tolerated
An upright position of 90 degrees uses gravity to direct food and liquid down the esophagus rather than into the airway, reducing aspiration risk.
Question 2: When assisting a patient with a weak left arm to get dressed, which arm should be dressed first?
- The right (stronger) arm first for patient comfort
- Either arm — it does not matter
- The left (weaker) arm first (Correct answer)
- Have the patient dress themselves starting with either side
Correct answer: The left (weaker) arm first
Dressing the weaker arm first reduces the amount of manipulation needed and makes it easier to get the garment on without overstretching the affected limb.
Question 3: Which skin care measure is most effective in preventing pressure injuries in a bedridden hospice patient?
- Massaging bony prominences vigorously to increase circulation
- Keeping the skin clean and dry and using a moisture barrier as needed (Correct answer)
- Applying talcum powder liberally to all skin folds
- Leaving protective dressings in place indefinitely without changing
Correct answer: Keeping the skin clean and dry and using a moisture barrier as needed
Keeping skin clean and dry while using moisture barriers prevents maceration and skin breakdown that leads to pressure injuries.
Question 4: When performing a back massage for a hospice patient, which area should be avoided?
- The lower back
- The shoulders and upper back
- Directly over the spine and bony prominences (Correct answer)
- The sides of the back
Correct answer: Directly over the spine and bony prominences
Massaging directly over the spine or bony prominences can cause tissue damage, especially in patients with fragile skin or compromised circulation.
Question 5: What is the recommended water temperature when bathing a hospice patient?
- Cool water around 65 to 70°F to prevent overheating
- Hot water around 115°F for thorough cleansing
- Warm water around 105 to 110°F tested with a thermometer or the wrist (Correct answer)
- Whatever temperature the patient requests without independent verification
Correct answer: Warm water around 105 to 110°F tested with a thermometer or the wrist
Warm water around 105 to 110°F is comfortable and safe; testing with a thermometer or wrist prevents burns, especially for patients with decreased sensation.
Question 6: What is the nursing assistant's appropriate role when providing nail care for a diabetic hospice patient?
- Trim nails short and straight across using standard nail clippers
- File nails gently and report any abnormalities to the nurse; do not cut nails without specific orders (Correct answer)
- Soak feet extensively before trimming nails
- Use scissors to shape nails into a rounded form
Correct answer: File nails gently and report any abnormalities to the nurse; do not cut nails without specific orders
Diabetic patients have impaired circulation and healing; nail cutting requires a nurse or podiatrist order, and the nursing assistant should only file and report concerns.
Question 7: In hospice care, which principle should guide the nursing assistant when prioritizing personal care activities for a patient?
- Complete all tasks on the care plan in the listed order regardless of patient preference
- Focus on tasks the nursing assistant considers most important for hygiene
- Follow the patient's preferences and adjust care to what they can tolerate that day (Correct answer)
- Limit care to essential tasks only to conserve staff time
Correct answer: Follow the patient's preferences and adjust care to what they can tolerate that day
Hospice philosophy centers on patient autonomy and comfort; care should always be guided by the patient's current wishes and daily tolerance level.
CHPNA Personal Care and Activities of Daily Living 2
A hospice patient with dysphagia is being assisted with a meal.
What position is safest to reduce aspiration risk?