HHA Exam Topics: All 7 Competency Areas Explained (2025)
The HHA certification exam tests knowledge across 7 competency domains. Understanding the weight of each section helps you focus your study time where it counts most.
Infection Control
16–22% of examInfection control is consistently one of the highest-weighted topics on the HHA exam. You'll need to understand Standard Precautions, hand hygiene, PPE usage, how infections spread, and proper disposal of contaminated materials.
- Standard Precautions and Transmission-Based Precautions
- Proper hand washing technique (20+ seconds)
- When and how to use gloves, masks, gowns, and eye protection
- Chain of infection and how to break it
- Bloodborne pathogen safety (HIV, Hepatitis B/C)
- Sharps disposal and biohazard waste
- MRSA, C. diff, and other healthcare-associated infections
Exam Tip: The single most common exam question in this category is about hand hygiene. Know when to wash hands vs. use sanitizer, and know the 5 moments for hand hygiene.
Personal Care
18–24% of examPersonal care is typically the largest section of the HHA exam. It covers everything related to assisting clients with activities of daily living (ADLs) including bathing, grooming, dressing, oral hygiene, and toileting.
- Bathing: bed bath, tub bath, shower assistance
- Oral hygiene including denture care
- Hair care, shaving, nail care
- Dressing and undressing — affected side first or last
- Perineal care and catheter care
- Positioning and turning in bed
- Range of motion exercises
Exam Tip: Remember: when dressing a client with a weak side, put the weak arm/leg in first. When undressing, remove the strong side first.
Safety & Emergency
14–20% of examSafety questions cover fall prevention, fire safety, disaster preparedness, and emergency response. Knowing what to do (and what NOT to do) in an emergency is tested heavily.
- Fall prevention: environment assessment, bed rails, proper footwear
- Fire safety: RACE and PASS acronyms
- Emergency response: when to call 911
- Oxygen safety rules
- Restraint use and alternatives
- Reporting abuse and neglect
- Home safety hazards
Exam Tip: RACE = Rescue, Alarm, Confine, Extinguish/Evacuate. PASS = Pull pin, Aim, Squeeze, Sweep. These are common exam questions.
Nutrition
10–14% of examNutrition questions focus on special diets, meal assistance, fluid intake, and recognizing nutritional problems. HHAs are often responsible for meal preparation and documenting intake.
- Special diets: low-sodium, diabetic, mechanical soft, pureed
- Dysphagia (swallowing difficulty) precautions
- Thickened liquids and aspiration risk
- Recording intake and output (I&O)
- Caloric needs and nutritional deficits
- Tube feeding assistance
- Dehydration signs and hydration encouragement
Exam Tip: Know the different diet textures for dysphagia (regular, minced, pureed) and who orders diet changes. HHAs follow the care plan — they do not make diet decisions independently.
Communication
10–14% of examCommunication covers both verbal and nonverbal communication, documentation requirements, reporting observations, and how to interact with clients who have cognitive or sensory impairments.
- Active listening and therapeutic communication
- Objective vs. subjective reporting
- Documenting care accurately and in real time
- Communicating with clients who have dementia
- Nonverbal communication cues
- Reporting changes in condition to a supervisor
- Cultural sensitivity in communication
Exam Tip: On exams, "objective" means what you observe directly (vital signs, appearance); "subjective" is what the client tells you. Document both accurately.
Legal & Ethics
10–14% of examLegal and ethics questions cover client rights, HIPAA, advance directives, scope of practice, and mandatory reporting. HHAs must know their legal obligations and professional boundaries.
- Client Bill of Rights
- HIPAA and patient confidentiality
- Informed consent
- Advance directives: living wills, DNR, healthcare proxy
- HHA scope of practice — what you can and cannot do
- Mandatory reporting of abuse, neglect, and exploitation
- Negligence vs. intentional misconduct
Exam Tip: A very common exam trap: an HHA cannot perform a task that is outside their scope of practice even if a client or family member asks them to. Always follow the care plan and consult a supervisor.
Basic Skills
10–16% of examBasic skills cover clinical procedures HHAs perform regularly: vital signs, specimen collection, assisting with medications (in states where allowed), wound care observation, and mobility assistance.
- Taking temperature, pulse, respirations, and blood pressure
- Normal ranges for adult vital signs
- Assisting with ambulation and transfers
- Proper body mechanics to prevent injury
- Collecting urine and stool specimens
- Observing and reporting skin changes (pressure injuries)
- Compression stockings application
Exam Tip: Normal adult vital signs to memorize: Temp 97–99°F, Pulse 60–100 bpm, Respirations 12–20/min, BP below 120/80 mmHg.
Practice these topics with real exam questions
PassHHA has hundreds of practice questions across all 7 domains — with detailed explanations in English and Spanish.