Free HHA Practice Test (2026)

What should an HHA do before starting any personal care procedure?

Wash hands with soap and water for at least 20 seconds. Hand hygiene is the single most effective way to prevent infection.

Alcohol-based hand sanitizer is effective against:

Most bacteria and viruses, but NOT C. difficile (C. diff) spores. Always use soap and water after caring for a client with C. diff.

A client has MRSA. The HHA enters the room to provide care. What PPE is required?

Gown and gloves (contact precautions). MRSA spreads through direct contact.

What is the correct order to PUT ON (don) PPE?

Gown first → Mask/respirator → Goggles/face shield → Gloves last.

What is the correct order to REMOVE (doff) PPE?

Gloves first → Goggles/face shield → Gown → Mask last. Remove from most to least contaminated.

A client has tuberculosis (TB). What type of precaution and mask are required?

Airborne precautions. An N95 respirator (not a surgical mask) is required.

Which of the following DOES NOT kill C. difficile spores?

Alcohol-based hand sanitizer. C. diff spores can only be removed by washing with soap and water.

Standard Precautions require the HHA to wear gloves when:

Any time there is possible contact with blood, body fluids, non-intact skin, or mucous membranes — regardless of the client's diagnosis.

A client has droplet precautions. The HHA should:

Wear a surgical mask when within 3 feet of the client. The client should also wear a mask when leaving the room.

What does "breaking the chain of infection" mean in practice?

Performing an action that stops the transmission of germs — most commonly hand hygiene, which interrupts the mode of transmission.

When giving a bed bath, in which direction should the HHA wash?

Clean to dirty — starting with the face and eyes (inner to outer corner), then body, ending with the perineal area.

In which direction should perineal care be performed for a female client?

Front to back (from urethra to rectum) to prevent urinary tract infections.

A client refuses a bath. What should the HHA do?

Respect the right to refuse. Document it, and report to the supervisor. Never force personal care.

When handling dentures, the HHA should:

Hold them over a basin of water or a towel. Use cool or lukewarm water — never hot, which can warp dentures.

How often should a completely bed-bound client be repositioned?

Every 2 hours, or per the care plan, to prevent pressure sores (decubitus ulcers).

What water temperature is appropriate for bathing a client?

Around 105°F (40.5°C). Always test temperature before bathing, especially for clients with reduced sensation (e.g., diabetic neuropathy).

The HHA should NOT trim a diabetic client's toenails because:

Poor circulation and reduced sensation in diabetics makes even small cuts high-risk for serious infection. Report the need to the supervisor.

When assisting with shaving, the HHA should:

Shave in the direction of hair growth. Use an electric razor for clients on blood thinners (anticoagulants) to reduce bleeding risk.

A client has a foley catheter. The drainage bag must be:

Below the level of the bladder at all times to allow gravity drainage and prevent backflow of urine.

What bony prominences are most at risk for pressure sores?

Heels, sacrum (tailbone), hips, ankles, elbows, and shoulder blades. Check these areas frequently in bed-bound clients.

A fire starts in a client's home. What is the FIRST step (RACE)?

R = Rescue — remove the client from immediate danger. Then Alarm, Contain, Extinguish/Evacuate.

How do you use a fire extinguisher (PASS)?

Pull the pin, Aim at the base of the fire, Squeeze the handle, Sweep side to side.

The HHA finds a client on the floor complaining of hip pain. The FIRST action is:

Do NOT move the client. Call 911 and keep the client calm and still until EMS arrives.

A client is on home oxygen. The most critical safety rule is:

No smoking and no open flames within 10 feet of the oxygen equipment. Oxygen dramatically increases fire risk.

The correct body mechanics for lifting a heavy object are:

Bend knees (not waist), keep back straight, hold load close to body, avoid twisting. Use a wide base of support.

A client starts choking and cannot speak, cough, or breathe. The HHA should:

Call 911, then immediately perform abdominal thrusts (Heimlich maneuver) until the object is dislodged or EMS arrives.

During a tornado warning, the HHA should move the client to:

An interior room on the lowest floor, away from windows. A bathroom or closet on the ground floor is ideal.

A client is having a seizure. The HHA should:

Clear hard objects away, cushion the head, do NOT restrain, do NOT put anything in the mouth. Time the seizure. Call 911 if it lasts more than 5 minutes.

When leaving a client's bedside, the bed should be:

In the lowest position, with side rails up per the care plan, and the call light within the client's reach.

Correct hand washing requires scrubbing for at least:

20 seconds (about as long as singing "Happy Birthday" twice) — covering all surfaces including between fingers and under nails.

How should a client be positioned when eating to reduce aspiration risk?

Sitting upright at a 90-degree angle (high Fowler's position). Keep them upright for at least 30 minutes after eating.

A client with dysphagia requires which type of diet?

A modified texture diet with thickened liquids (nectar-thick or honey-thick) as specified in the care plan. Follow the speech therapist's recommendations.

A client is NPO (nothing by mouth). They ask for water. The HHA should:

Deny the request, explain the NPO order, offer mouth care to keep lips moist, and notify the supervisor.

Signs of dehydration the HHA should report include:

Dark yellow/amber urine, dry mouth and lips, sunken eyes, dizziness, confusion, rapid heartbeat, and decreased urine output.

A diabetic client refuses breakfast after taking insulin. The HHA should:

Report to the supervisor IMMEDIATELY — not eating after insulin can cause hypoglycemia, which is a medical emergency.

Signs of hypoglycemia (low blood sugar) include:

Shakiness, sweating, pale skin, rapid heartbeat, confusion, irritability, and weakness. This requires immediate action and reporting.

The care plan specifies a 1500 mL fluid restriction per day. The HHA should:

Track fluid intake carefully throughout the day, distribute fluids evenly, and offer ice chips (which count toward intake) if allowed.

A client on a low-sodium diet is brought salty chips by a family visitor. The HHA should:

Politely explain the dietary restriction, do not allow the food, and report the situation to the supervisor.

Dark amber urine with a strong odor in a client may indicate:

Dehydration or a urinary tract infection (UTI). Document the observation and report to the supervisor.

A client's care plan says to encourage fluids. How much fluid should a typical adult drink daily?

Approximately 6–8 cups (1.5–2 liters) daily, unless the care plan specifies a different amount.

A client tells the HHA they feel depressed and life is not worth living. The HHA should:

Listen without judgment, take the statement seriously, stay with the client, and report to the supervisor immediately. All expressions of hopelessness must be taken seriously.

A client's family member asks for details about the client's medical condition. The HHA should:

Refer them to the supervising nurse or the client's physician. Medical information sharing is outside the HHA's scope.

What is the most effective way to communicate with a hearing-impaired client?

Face them directly, speak clearly at a normal pace (not loudly), minimize background noise, and use written notes or visual aids when helpful.

Objective documentation means recording:

What you directly observe — measurable, factual information. Example: "client's skin is red and warm to touch over the left heel." Avoid opinions.

When should the HHA document care?

Promptly after care is provided — never in advance, and never delayed until end of shift. Timely documentation prevents errors and ensures care continuity.

A client speaks a different language. The HHA should:

Request a professional interpreter service approved by the agency. Do not use family members, especially children, as medical interpreters.

Which of the following is an example of non-verbal communication?

Facial expressions, eye contact, body posture, and touch are all non-verbal communication. Pay attention — these often reveal more than words.

The HHA notices the client seems more confused than usual today. The HHA should:

Document the observation and report to the supervising nurse. Acute confusion can indicate a stroke, infection, medication issue, or other emergency.

A client's family gives the HHA instructions that contradict the care plan. The HHA should:

Follow the care plan (not family instructions) and report the conflict to the supervisor. The clinical team sets the care plan.

The HHA must report which of the following observations to the supervisor?

Any change in the client's condition — new symptoms, vital sign changes, behavioral changes, skin breakdown, unusual odors, or refusal of care.

A family member asks the HHA to give the client an extra dose of prescribed medication. The HHA should:

Decline — medication administration is outside the HHA's scope of practice. Report the request to the supervising nurse.

An HHA suspects a client is being financially exploited by a relative. The HHA should:

Report it to the supervisor immediately. HHAs are mandatory reporters — you are legally required to report suspected abuse, neglect, or exploitation.

What does HIPAA protect?

Protected Health Information (PHI). Never share client health information with anyone not directly involved in their care, including family without the client's consent.

A client with a DNR order stops breathing. The HHA should:

Call 911 and notify the supervisor. Follow the DNR — do NOT initiate CPR. Follow agency policy and the care plan.

What is an advance directive?

A legal document stating a client's wishes for medical care if they can no longer communicate. HHAs should know if a client has one and its location.

Restraints may be used by an HHA:

Only with a physician's order and documented consent — never at the HHA's own initiative. Always try restraint alternatives first.

What is the difference between abuse and neglect?

Abuse is an intentional act causing harm. Neglect is failure to provide necessary care (intentional or not). Both are reportable offenses.

A client asks the HHA to witness their signature on a legal document. The HHA should:

Decline. Witnessing legal documents (such as wills or power of attorney) is outside the HHA's scope and may create a conflict of interest.

The HHA is asked by a supervisor to perform a skill they were not trained to do. The HHA should:

Politely decline and explain the lack of training. An HHA must never perform tasks outside their scope, even when asked by a supervisor.

A client has the right to refuse care. If a client refuses, the HHA should:

Respect the refusal without arguing. Document it clearly and report to the supervisor. Never attempt to force, trick, or guilt a client into accepting care.

What is the normal adult resting pulse rate?

60–100 beats per minute. Below 60 = bradycardia. Above 100 = tachycardia. Both should be reported.

What is the normal adult blood pressure?

Under 120/80 mmHg is normal. 130–139/80–89 is Stage 1 hypertension. 180/110+ is a hypertensive crisis — report immediately.

What is the normal adult respiratory rate?

12–20 breaths per minute. Under 12 or over 20 should be reported.

What is the normal adult oral temperature?

97.8–99.1°F (36.5–37.3°C), with 98.6°F being the standard. Above 100.4°F (38°C) is a fever — report.

When taking blood pressure, the arm should be:

At heart level, patient seated or lying comfortably, cuff placed 1 inch above the elbow on bare skin.

A client's blood pressure reading is 190/115 mmHg. The HHA should:

Report immediately to the supervising nurse. This is in hypertensive crisis range and requires urgent medical evaluation.

Why should the HHA not tell the client when counting respirations?

People unconsciously change their breathing when they know it's being counted. Count covertly for a full minute for accuracy.

What is a normal oxygen saturation (SpO2) reading?

95–100%. Below 90% is low and requires immediate reporting. Some COPD clients have a prescribed acceptable range lower than this.

When should an HHA be concerned about a client's weight change?

A gain or loss of more than 2 lbs in one day, or 5 lbs in one week, should be reported. Weigh clients the same time each day, on the same scale, in similar clothing.

A client's pulse is irregular and weak. The HHA should:

Document the pulse rate and characteristics (rhythm, strength) and report to the supervising nurse. Never ignore abnormal vital signs.