PCT General Patient Care 2 — Questions and Answers
Question 1: When providing oral care to an unconscious patient, the PCT should position the patient:
- Flat on their back (supine)
- On their side with the head slightly lowered (Correct answer)
- In a sitting position
- In the prone position
Correct answer: On their side with the head slightly lowered
The lateral position with a slightly lowered head allows fluids to drain from the mouth by gravity, preventing aspiration.
Unconscious patients have no gag reflex or ability to spit, making aspiration a serious risk during oral care. Position the patient on their side (lateral) with the head turned slightly downward. Use a soft toothbrush or foam swab moistened with water or prescribed solution. Apply thin layers—never pour liquid into the mouth. Suction equipment should be at bedside. Perform oral care every 2 hours.
Question 2: The normal adult body temperature taken orally is approximately:
- 95.6°F (35.3°C)
- 97.0°F (36.1°C)
- 98.6°F (37.0°C) (Correct answer)
- 100.4°F (38.0°C)
Correct answer: 98.6°F (37.0°C)
The standard reference for normal oral body temperature is 98.6°F (37.0°C), with a normal range of 97.8-99.1°F.
Normal oral temperature averages 98.6°F (37.0°C) with a range of 97.8-99.1°F (36.5-37.3°C). Temperature varies by measurement site: rectal is 1°F higher (most accurate), axillary is 1°F lower (least accurate), and tympanic approximates core temperature. Factors affecting temperature include time of day (lowest early morning), exercise, hormones, and age. Report temperatures above 100.4°F (38°C) as fever.
Question 3: When bathing a patient in bed, the water temperature should be:
- As hot as the PCT can tolerate
- 105-110°F (40.5-43.3°C) (Correct answer)
- 120°F (48.9°C)
- Room temperature
Correct answer: 105-110°F (40.5-43.3°C)
Water at 105-110°F is warm enough for comfort and cleaning effectiveness without risk of scalding the patient.
Bath water temperature of 105-110°F (40.5-43.3°C) provides comfort without burning. Always test water with a thermometer or on the inside of your wrist before patient contact. Elderly patients and those with diabetes or neuropathy have decreased temperature sensation and are at higher risk for burns. Change water when it becomes cool, soapy, or dirty. Wash from cleanest to dirtiest areas.
Question 4: A blood pressure reading of 148/96 mmHg in an adult would be classified as:
- Normal
- Elevated
- Hypertension Stage 1
- Hypertension Stage 2 (Correct answer)
Correct answer: Hypertension Stage 2
Per ACC/AHA guidelines, systolic ≥140 or diastolic ≥90 mmHg is classified as Stage 2 hypertension.
Blood pressure categories (ACC/AHA 2017): Normal (<120/<80), Elevated (120-129/<80), Stage 1 HTN (130-139 or 80-89), Stage 2 HTN (≥140 or ≥90), Hypertensive Crisis (>180 and/or >120). A reading of 148/96 exceeds both the systolic (≥140) and diastolic (≥90) thresholds for Stage 2. The PCT should report this to the nurse immediately and recheck as directed.
Question 5: When measuring a patient's respiratory rate, the PCT should:
- Tell the patient to breathe normally while counting
- Count respirations without the patient's awareness for one full minute (Correct answer)
- Count for 15 seconds and multiply by four only
- Only observe chest movement, never watch the abdomen
Correct answer: Count respirations without the patient's awareness for one full minute
Patients who know their breathing is being counted may unconsciously alter their rate, so unobtrusive observation for a full minute gives the most accurate result.
The respiratory rate should be counted discreetly—typically while appearing to still take the pulse. Count for a full 60 seconds, noting rate, depth, rhythm, and any abnormal sounds or effort. Normal adult rate is 12-20 breaths/minute. The 15-second method may be used for regular respirations but misses irregularities. Observe both chest and abdomen, as some patients (especially those in distress) use abdominal muscles for breathing.
Question 6: When providing perineal care, the PCT should always wipe:
- Back to front to follow the natural anatomy
- Front to back to prevent urinary tract infections (Correct answer)
- In circular motions
- In any direction since it does not matter
Correct answer: Front to back to prevent urinary tract infections
Wiping front to back prevents fecal bacteria from contaminating the urethral area, reducing the risk of urinary tract infections.
Perineal care follows the clean-to-dirty principle: wipe from the urethral meatus toward the rectum (front to back) using a clean area of the washcloth with each stroke. This is especially critical for female patients due to the shorter urethra and proximity of the vaginal and urethral openings to the rectal area. Use warm water with mild soap, rinse thoroughly, and pat dry. Provide perineal care during baths, after incontinence episodes, and with each catheter care.
PCT General Patient Care 2
When providing oral care to an unconscious patient, the PCT should position the patient: