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PassHHA / HHA Scope of Practice
Exam Study Guide · 2026

HHA Scope of Practice: What You Can and Cannot Do

Scope of practice defines the boundaries of what an HHA is legally authorized to do. Staying within your scope protects your client, protects your certification, and protects you legally. It's also one of the most heavily tested topics on the HHA certification exam.

Exam tip: When the exam asks "what should the HHA do?" and the task involves medication, wound care, or clinical decision-making — the answer is almost always "decline and report to the supervisor."

✓ What HHAs ARE Authorized to Do

Personal Care
✓Bathing and showering assistance
✓Grooming (hair, nails, shaving)
✓Dressing and undressing
✓Oral hygiene and denture care
✓Perineal care
✓Skin care and moisturizing
Mobility & Exercise
✓Transfers (bed to chair, chair to standing)
✓Ambulation assistance
✓Passive and active range-of-motion exercises (as directed)
✓Repositioning every 2 hours
✓Wheelchair assistance
Nutrition
✓Meal preparation (following dietary plan)
✓Feeding assistance
✓Encouraging fluid intake
✓Documenting intake and output
✓Following modified-texture and thickened-liquid diets as directed
Household Tasks
✓Light housekeeping
✓Laundry
✓Grocery shopping
✓Errands as part of care plan
✓Maintaining a safe home environment
Health Monitoring
✓Taking and recording vital signs (BP, pulse, temp, respirations, SpO2)
✓Monitoring and documenting weight
✓Observing and reporting changes in condition
✓Documenting care provided
Medication
✓Reminding clients to take medication
✓Reading medication labels aloud
✓Observing and reporting side effects
Emotional Support
✓Companionship
✓Listening and communicating
✓Reporting emotional changes to supervisor
✓Supporting cognitive activities (as directed)

✗ What HHAs Are NOT Allowed to Do

Medical Procedures
✗Administer medications (oral, injection, IV, topical)
✗Insert or remove catheters
✗Perform wound care or dressing changes (except as specifically trained and delegated)
✗Suction airways
✗Operate IV pumps or infusion equipment
✗Perform tube feeding independently
✗Draw blood or perform lab procedures
✗Give injections of any kind
Clinical Decision-Making
✗Diagnose any condition
✗Interpret lab results
✗Make changes to the care plan without nurse approval
✗Advise on medical treatment options
✗Recommend prescription or OTC medications
✗Decide when a client needs a doctor
Nursing Tasks
✗Perform sterile dressing changes
✗Insert or irrigate catheters
✗Colostomy or ostomy care (unless specifically trained and delegated in some states)
✗Adjust oxygen flow rates
✗Administer oxygen (set up and adjust)
Legal & Financial
✗Witness legal documents (wills, power of attorney)
✗Handle client finances or bank accounts without explicit written authorization
✗Borrow money or property from clients
✗Accept gifts of significant value
Physical Restraints
✗Apply physical restraints of any kind (without physician order and consent)
✗Use chemical restraints
✗Restrict a client's freedom of movement independently

Scope of Practice Exam Scenarios

These types of scenarios appear on every HHA exam. The correct answer always stays within scope.

Q: A client asks the HHA to give them an extra pain pill. The HHA should:
A:Decline and report the request to the supervising nurse. Medication administration is outside HHA scope regardless of who asks.
Q: The nurse asks the HHA to change a complex wound dressing. The HHA should:
A:Decline if not specifically trained and delegated for this task. Performing tasks outside your scope is unsafe even when asked by a supervisor.
Q: A client's family asks the HHA to manage the client's checkbook. The HHA should:
A:Decline. Financial management is outside the HHA's scope and creates a high-risk situation for financial exploitation.
Q: A client asks the HHA to adjust their oxygen flow rate because they feel short of breath. The HHA should:
A:Deny the request, contact the supervising nurse immediately, and report the symptom. Adjusting oxygen settings is a nursing/physician decision.
Q: The HHA notices a wound is looking worse. The HHA should:
A:Document the observation and report it to the supervising nurse immediately. They should NOT attempt to treat the wound independently.
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