HHA Exam Questions and Answers (2026)

An HHA is about to assist a client with a bed bath. What should the HHA do first?

Wash hands thoroughly with soap and water before beginning care. Hand hygiene is always the first step before any client contact.

When is it acceptable to use alcohol-based hand sanitizer instead of soap and water?

When hands are not visibly soiled. Use soap and water when hands are visibly dirty, after using the bathroom, before eating, and after caring for a client with C. diff.

A client has MRSA. What type of precaution is required?

Contact precautions — gown and gloves are required when entering the room and before touching the client or their environment.

In what order should PPE be removed (doffed)?

Gloves → Goggles/face shield → Gown → Mask. Remove the most contaminated items first to avoid self-contamination.

What kills C. difficile (C. diff) spores?

Soap and water. Alcohol-based hand sanitizer does NOT kill C. diff spores — this is a critical exam fact.

Which action breaks the chain of infection most effectively?

Hand hygiene. It is the single most important measure to prevent infection transmission.

A client has tuberculosis (TB). What level of precaution is required?

Airborne precautions — an N95 respirator is required. A standard surgical mask is not sufficient for TB.

When should an HHA wear gloves?

Any time there is potential contact with blood, body fluids, non-intact skin, or mucous membranes (Standard Precautions).

What is the correct order for putting on (donning) PPE?

Gown → Mask/respirator → Goggles/face shield → Gloves. The gown goes on first because it protects the body.

A client is on droplet precautions. What does this require?

A surgical mask must be worn when within 3 feet of the client. The client should also wear a mask when being transported.

When performing a bed bath, the HHA should wash from:

Clean to dirty areas — starting with the face and ending with the perineal area.

A client refuses to bathe. What should the HHA do?

Respect the client's right to refuse, document the refusal, and report it to the supervisor. Never force personal care.

When assisting a client with oral care who has dentures, the HHA should:

Handle dentures over a basin of water or a towel to prevent breakage. Rinse with cool or lukewarm water — never hot, as heat can warp dentures.

How should an HHA position a client during perineal care?

On their back (supine) with knees bent and hips slightly flexed, with privacy maintained throughout.

When washing a female client's perineal area, the HHA should wipe:

Front to back — from the urethra toward the rectum — to prevent urinary tract infections.

When trimming a client's toenails, the HHA should:

Not trim toenails of diabetic clients without a specific nursing order. Report the need to the supervisor — circulatory issues make this high-risk.

How often should a bed-bound client be repositioned to prevent pressure sores?

Every 2 hours, or as directed by the care plan. Document each repositioning.

What water temperature is safe for a client's bath?

Approximately 105°F (40.5°C). Always test water temperature before bathing a client, especially for those with reduced sensation.

When shaving a male client, the HHA should:

Shave in the direction of hair growth to prevent skin irritation. Use an electric razor if the client is on blood thinners.

A client has a foley catheter. The HHA should:

Keep the drainage bag below the level of the bladder, check for kinks in the tubing, and perform perineal/catheter care as directed.

A fire breaks out in the client's home. What is the FIRST thing the HHA should do?

Rescue — remove the client from immediate danger. R-A-C-E: Rescue, Alarm, Contain, Extinguish/Evacuate.

How should a fire extinguisher be used?

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

The HHA finds the client on the floor, conscious and complaining of hip pain. What should the HHA do?

Do NOT move the client. Call 911 and keep the client calm until EMS arrives. Moving a client with a possible fracture can cause serious injury.

A client is on home oxygen. Which safety rule is most important?

No smoking within 10 feet of oxygen equipment. Oxygen dramatically increases flammability and fire risk.

What is correct body mechanics when lifting a heavy object?

Bend at the knees (not the waist), keep the back straight, hold the load close to the body, and avoid twisting the spine.

A tornado warning is issued while the HHA is with a client. What should the HHA do?

Move the client to an interior room on the lowest floor, away from windows.

A client begins choking and cannot speak or cough. What should the HHA do?

Perform abdominal thrusts (Heimlich maneuver) immediately and call 911.

When leaving a client's bedside, the HHA should place the bed in what position?

Lowest position, with side rails as directed by the care plan, and the call light within reach.

A client is having a grand mal seizure. What should the HHA do?

Clear the area of hard objects, place something soft under their head, do not restrain them, do not put anything in their mouth, and call 911 if the seizure lasts more than 5 minutes.

What is the correct response if a client threatens to harm themselves?

Take all threats seriously. Stay with the client, remove any means of self-harm if possible, call for help, and report immediately to the supervisor and/or 911.

A client has dysphagia (difficulty swallowing). What should the HHA do before offering food or drink?

Follow the care plan — thickened liquids or specific food textures may be required. Report any swallowing difficulties to the supervisor immediately.

The care plan specifies a low-sodium diet. A family member brings salty snacks. What should the HHA do?

Politely explain the dietary restriction and do not allow the food. Report the incident to the supervisor.

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

Explain they cannot have anything to eat or drink per their care plan, offer mouth care instead, and notify the supervisor.

Which of the following is a sign of dehydration the HHA should report?

Dark yellow urine, dry mouth, decreased urine output, confusion, rapid heart rate, or dizziness.

When assisting a client with eating, the HHA should position them:

Sitting upright at a 90-degree angle (high Fowler's position) to reduce aspiration risk.

What diet is used for clients with dysphagia who need thickened liquids?

Thickened liquid diets (nectar-thick or honey-thick) as specified by the care plan. Always follow the speech therapist's recommendations.

A client with diabetes refuses to eat breakfast after taking their insulin. The HHA should:

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

What are signs of hypoglycemia (low blood sugar) the HHA should recognize?

Shakiness, sweating, confusion, rapid heartbeat, pale skin, and irritability. This is an emergency — report immediately.

A client on a fluid restriction is thirsty. What should the HHA do?

Offer only the amount of fluid allowed per the care plan. Explain the restriction and offer ice chips if permitted to relieve thirst.

What does it mean if a client's urine is dark amber with a strong odor?

Likely dehydration or a possible urinary tract infection. Document and report to the supervisor.

A client tells the HHA they are feeling depressed and hopeless. The HHA should:

Listen attentively, acknowledge the client's feelings without judgment, and report to the supervisor right away. Do not provide medical advice.

A client's family member asks what medications the client is taking. The HHA should:

Refer them to the supervising nurse or the client's physician. Sharing medical details is outside the HHA's scope.

Which of the following is the most effective way to communicate with a hearing-impaired client?

Face the client directly, speak clearly at a normal pace, reduce background noise, and use written notes or visual aids when needed.

What information must the HHA document after every client visit?

All care provided, vital signs taken, the client's response to care, any changes in condition, and any incidents or refusals — recorded promptly and accurately.

An HHA notices a change in a client's mental status (sudden confusion). The HHA should:

Document the observation and report it to the supervising nurse immediately. Sudden confusion can indicate stroke, infection, or medication issues.

The client uses a call light but the HHA is busy. The HHA should:

Respond promptly. Client safety always takes priority over other tasks.

What is the difference between objective and subjective documentation?

Objective: what you observe directly (e.g., "client's skin is red"). Subjective: what the client tells you (e.g., "client states pain is 7/10"). Both are important.

How should an HHA communicate with a client who speaks a different language?

Use an interpreter service approved by the agency. Do not use children or family members as medical interpreters.

When the HHA disagrees with a family member's instructions about care, the HHA should:

Follow the care plan — not the family member's instructions — and report the conflict to the supervisor. The care plan is set by the clinical team.

A client asks the HHA to keep a secret about something concerning. The HHA should:

Explain they cannot keep secrets that involve safety. Report to the supervisor. Client safety overrides confidentiality in these situations.

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

Decline. Medication administration is outside the HHA's scope. Report the request to the supervising nurse.

An HHA suspects a client is being financially abused by a family member. What should they do?

Report the concern to the supervisor immediately. HHAs are mandatory reporters in most states — suspicion alone is enough to report.

A client with dementia becomes physically aggressive during care. What should the HHA do?

Ensure both the client and HHA are safe, do not restrain the client, speak calmly, and report the incident to the supervisor. Document what happened.

Restraints may be used by an HHA:

Never without a specific physician's order and documented consent. HHAs should use restraint alternatives (repositioning, distraction, activity) first.

A client has a Do Not Resuscitate (DNR) order. The client stops breathing. The HHA should:

Call 911 and notify the supervisor. The DNR means CPR should not be initiated. Follow the care plan and agency policy.

What is an advance directive?

A legal document that outlines a client's wishes for medical care if they become unable to communicate. HHAs should know if a client has one and where it is kept.

A client asks the HHA to witness their will. The HHA should:

Decline. Witnessing legal documents is outside the HHA's scope and may create a conflict of interest. Report to the supervisor.

What does HIPAA protect?

Protected Health Information (PHI). HHAs cannot share client information with anyone not involved in the client's care, including family members, without the client's consent.

The HHA is instructed by the supervisor to do a task they are not trained to perform. The HHA should:

Politely decline and explain they are not trained for that task. An HHA should never perform tasks outside their scope, even when asked by a supervisor.

What is the difference between neglect and abuse?

Abuse is an intentional act causing harm (physical, emotional, sexual, financial). Neglect is failure to provide necessary care (intentional or unintentional). Both must be reported.

What is the normal adult resting pulse rate?

60–100 beats per minute. Below 60 (bradycardia) or above 100 (tachycardia) should be reported.

What is the normal adult blood pressure?

Less than 120/80 mmHg is normal. Stage 1 hypertension = 130–139/80–89. A reading of 180/110+ is a hypertensive crisis — report immediately.

What is the normal adult respiratory rate?

12–20 breaths per minute. Fewer than 12 or more than 20 should be reported to the supervisor.

What is the normal adult oral temperature?

98.6°F (37°C), with a normal range of 97.8°F–99.1°F. A temperature above 100.4°F (38°C) is considered a fever.

When measuring blood pressure, the arm should be:

At heart level, with the client seated or lying down and relaxed. The cuff is placed 1 inch above the elbow.

An HHA takes a client's blood pressure and gets 180/110 mmHg. What should the HHA do?

Report this reading to the supervisor immediately. This is a hypertensive crisis range and requires urgent medical attention.

When counting respirations, the HHA should:

Count breaths for one full minute, without telling the client — people unconsciously alter their breathing when they know it's being counted.

What is the normal oxygen saturation (SpO2) for a healthy adult?

95–100%. Below 90% is considered low and should be reported. Clients on supplemental oxygen should maintain levels per the care plan.

A client has a pulse that is irregular and weak. What should the HHA do?

Document the findings and report to the supervising nurse immediately. Do not ignore abnormal vital signs.

How should the HHA measure a client's weight accurately?

Same scale, same time of day, same clothing. Report unexpected weight gain or loss of more than 2–3 lbs in a day or 5 lbs in a week.