PCA CERTIFICATION TEST
You must pass each section with a score of 70%. You may retake the test.
1. Preventing Emergency Situations and What to do in an Emergency
You should call 911 when the individual:
Is complaining of chest pain.
complains about a family member.
is having trouble breathing.
Emergency Procedures. When there is an emergency you should:
Take the individual to the hospital in your own car.
Lift an individual up to a chair after a fall.
Immediately report the incident to your supervisor and the individual’s care manager.
Never let an individual smoke near oxygen.
Look for all accessible exits in case there is a fire.
Wait in the emergency room with individuals who have dementia or Alzheimer’s disease so you can assist hospital staff. Clear this with your agency.
Encourage the individual to use his/her walker or cane to prevent falls.
Let the individual navigate around furniture and clutter to get to the bathroom.
Let the individual turn the lights down low when she/he is walking.
Let the individual try to get up on her/his own after falling. You do not need to report falls when the individual seems to be okay.
2. Universal Precautions
Gloves. When you are caring for the individual, you should always wear gloves when:
You touch urine or stool.
An individual is toileting.
It’s cold outside.
Taking out the garbage.
Hand Washing. When should you wash your hands?
After changing the individual’s Depends.
After toileting the individual.
After you have used your cell phone.
After taking out the garbage.
After cleaning and disinfecting surfaces.
To communicate well with your individual, you should:
Allow the individual to express what he/she needs or wants.
Tell the individual your life story and your problems.
Ask questions if you don’t understand.
Pay attention of the individual’s body language such as facial expressions, tone of voice or body posture.
Spend time on your cell phone.
With individuals with dementia or Alzheimer’s disease, don’t use too many words or long explanations because this may be confusing.
Some individuals may not be able to speak so you just smile and go about your business.
Contact your supervisor and the care manager if you notice a difference in the individual’s ability to move, gestures, pained facial expressions.
Interrupt the individual if they are talking too long to tell you what they need and tell him/her to get to the point.
You should let the individual know how you feel about politics and religion.
4. Change in Individual’s Condition
When there are changes in an individual’s condition:
You should report changes in condition immediately to your supervisor and the individual’s care manager. Do not leave a voice mail. Speak to a live individual.
If you see red spots on the individual’s skin, it is okay to wait to report it until it gets worse.
A sudden change of appetite should be reported immediately to your supervisor and the care manager.
If the individual has difficulty urinating, constipation or frequent diarrhea, you can wait to see if it will get better.
If the individual starts yelling, saying mean things and is angry all the time, you should report this to your supervisor and the care manager.
You notice that the individual is starting to sleep a lot more. You don’t need to report this to your supervisor. Since the individual is tired, you put the individual in bed for naps more often.
Individuals who cannot change position in bed or in a chair should be repositioned every two hours.
A loss of appetite may be due to poor fitting dentures which make it hard for the individual to chew food.
It is important for an individual to drink enough fluids to prevent dehydration unless there is a fluid restriction in the individual’s care plan.
Older people’s skin tears very easily and it is important to prevent bumps and scrapes.
Why is Proper Positioning Important?
To relieve the pressure on various body parts.
To help the individual see the television.
To help the individual be comfortable.
To prevent health problems from being in bed a long time.
To prevent bed sores.
What are the Procedures for Proper Positioning?
Have all necessary assistive equipment ready.
Make sure the individual is safe and comfortable.
Pull the individual across the bed.
Reposition the individual every two hours unless the individual is sleeping.
Take note of redness or irritation on the skin so you can report it if it gets worse.
Get assistance if the individual is too heavy.
What are the Proper Procedures for Lifting?
Bend over, grab the individual under the arms and lift
Stand close to the individual.
Use as many muscle groups as possible for moving the individual to reduce the stress on the back.
Squat and stand to lift a heavy individual.
Figure out on your own how to use a Hoyer lift to lift a heavy individual
Coordinate your movements with the individual’s movements.
To change the direction of the individual’s movement, twist your body, bend over and lower the individual.
Keep your back straight, knees and hips flexed, with weight distributed on both feet.
When you are lifting, you should hold the individual about 12 inches away from you.
Do not attempt to lift an individual who is too heavy for you.
How do you transfer an individual safely?
The individual should be wearing shoes or slippers.
The position of the wheelchair is not important as long as the wheels are locked.
The individual’s commode should be next to the bed so the individual can be transferred easier.
When toileting the individual, you should assist the individual to a standing position, help the individual pull down her/his pants, and safely place the individual on the toilet.
If the individual appears to be steady, you can allow the individual to transfer himself/herself.
What are the proper procedures for helping an individual to take medication?
The PCA may take the pills out of the containers and give her/him to the individual.
A PCA never gives the individual injections.
The PCA may assist the individual with opening the pill bottle and remind the individual to take the medication as prescribed.
The PCA may take some of the individual’s pills.
The PCA may give the individual medications even though the pills have fallen on the floor.
If you drop the med box, do not give the individual the pills and contact your supervisor.
It is okay for the PCA to crush medicine and put it in applesauce or pudding if the individual doesn’t want to take their pills.
If the medications look different or messed up, you should notify your supervisor after you give the medication to the individual.
Do not give any pills or medicine, like cold medicine, you get from the store.
9. Caregiver Boundaries
Which of these are considered good boundaries?
You and the individual give each other gifts for holidays, birthdays and other occasions.
The individual needs some items at the store so you take the debit card to shop during the individual’s nap. You can also buy some items for yourself if the individual says it’s okay.
You should always get a receipt when using the individual’s money to buy things.
You ask your friend to deliver food for you at the individual’s home.
You are an employee in the individual’s home.
If the individual goes to a nursing home, you should visit the individual while you are off duty.
If you can’t find a babysitter and there is no one to replace you, it is okay to bring your children to the individual’s home while you are working.
You can tell the individual when you are having problems like not having enough money, problems with your boyfriend/girlfriend or your children.
If you don’t have a car and don’t want to take the bus, you can have your boyfriend/girlfriend take you to work at the individual’s home.
You should never friend the individual on Facebook and never post anything about her/him like pictures or comments, good or bad.
10. Individuals with Acquired Brain Injury
An individual with an acquired brain injury might:
Might not understand what you say.
Remember everything he/she hears you and others say.
Not be able to say what they want to say.
Be very focused and totally concentrate on things.
If an individual becomes angry, you should:
Tell the individual he/she needs to calm down and stop talking.
Move fast and stand close to the individual.
Remain calm and speak softly.
Threaten the individual with negative consequences if he/she doesn’t calm down.
Put the individual in a corner of the room and limit where he/she can move.
Causes of Agitation and Aggression in Individuals with Dementia or Alzheimer’s Disease
Individuals usually get angry for a reason so it is helpful if you can figure out the reason the individual is angry.
If the individual starts getting stressed and frustrated, try to help before the individual gets upset.
Individuals who need PCA services are usually lonely so you should encourage a lot of people to come over and have a lot of loud music in the home to cheer her/him up.
If you are a new PCA just meeting the individual for the first time and they get upset and say mean things to you, it’s just because the individual is unfriendly and grouchy.
The individual may not be able to tell you that he/she is sitting on a wet Depends®, has to go to the bathroom and start getting angry and upset.
11. Reporting Abuse, Neglect, Exploitation and Abandonment
For individuals who are aged 65 and older, you and your agency are legally required to report abuse, neglect, exploitation and abandonment to Protective Services for the Elderly.
You should contact your supervisor and the care manager immediately if you see or suspect abuse.
You arrive for your shift in the morning and discover that no one has been with the individual since the evening before. Since the individual is fine, there is no need to report this.
The individual tells you that a relative has been taking money out of his/her bank account, using the individual’s EBT card to buy their own groceries and using the individual’s credit card to shop. This is an example of neglect.
When you arrive for your shift, you see the individual’s neighbor yelling, threatening to hit the individual and shove him/her. This is an example of abuse.
Safety in the bathroom is very important.
It is okay to leave the individual alone in the bathtub or shower if you have to answer the phone.
Never have the individual step into the bathtub or shower until you check the water temperature.
You should wash the genital area from back to front.
Do not cut fingernails or toenails.
13. Bathing Individuals with Dementia, Alzheimer’s Disease or Cognitive Deficits
You should give the individual a bath or shower at a different time every day because they get bored with the same daily routine.
Many older Individuals don’t like bathing because they are afraid of being too hot.
If the individual does not want to bathe, don’t argue. Instead, use a calm, soothing tone of voice.
If the individual does not want to bathe, talk about something the individual likes or something positive and they may change their mind.
Tell the individual what you are doing to keep her/him calm.
14. How to Give a Bed Bath
You do not need to check water temperature since the water is in a basin and it will cool off.
Make sure the individual cannot fall out of bed.
Report any sores or redness to your supervisor.
You should wash the soap off of the individual.
Wash the genital area first.
15. Washing Hair
Ask if they want to wash their hair first. The individual can wash their own hair if they are able to do it.
If the individual doesn’t ever want their hair washed they don’t have to. This is easier than trying to convince the individual to wash their hair and stressing over it.
You should report any redness, a lot of dandruff or concerns over lice to your supervisor.
Many people don’t like water in their face so you should face the individual away from direct water to the face.
If the individual seems steady in the shower, it is okay to leave and put the dirty clothes in the laundry and fold the clothes from the dryer.
16. How to Wash Hair in Bed
Make sure you have all of the supplies you need before you get started.
You should start pouring water on the individual’s head. Don’t worry about the pillows getting wet.
Try to keep the floor dry by putting a bucket or large bowl on the floor and put a sheet or towel underneath.
If the individual has short hair, instead of pouring water to wet the hair; you can rub a wet washcloth over the hair.
Make sure the room temperature is warm and check the water temperature before starting.
17. Mouth Care
Good mouth care is important for an individual’s general health, to prevent gum disease, cavities, toothaches, pain and other health problems.
Wearing gloves isn’t necessary because you won’t be touching the individual’s mouth.
Brush the teeth really hard to make sure they get clean.
Start brushing at the top and move downward because it moves plaque away from the gums.
Report any redness, bleeding or sores to your supervisor.
18. Mouth Care for Individuals with Dementia, Alzheimer’s Disease or Cognitive Impairment
Smile, ask the individual if they want to have their teeth brushed.
Tell the individual their teeth are dirty so you have to brush their teeth.
If the individual gets upset, ask what is upsetting her/him
Tell your supervisor if you see redness, sores, bleeding or broken teeth.
If the individual refuses, tell her/him all of the good things about brushing their teeth. If this doesn’t work, try again at another time.
Wash your hands before you begin dressing the individual.
You should set out a lot of different clothes with a variety of shirts, pants, skirts, dresses, suits and ties.
If the clothes won’t come off, you can push and pull them off.
Make sure the individual does not get too tired or dizzy. Help her/him to sit down if they need to.
It is easiest to use simple elastic clothing or clothes with Velcro fasteners.
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