Emergencies for home health aides: choking, stroke, seizures

Recognizing emergencies and knowing how to respond is on the federal subject list, and an aide is often the only person in the home when one happens. These questions test recognition, such as the signs of a stroke or low blood sugar, and the first action, which is nearly always to call 911 or get help and then notify the agency.

Questions and answers, explained

All 12 questions above, with the correct answer and why it is correct. Everything here is on emergencies for home health aides: choking, stroke, seizures.

1. How should a client be positioned for a meal to reduce the risk of choking?

   • ALying flat with the head turned toward the aide
   • BReclined halfway back with the knees raised high on two pillows
   • COn one side with the arm tucked under the body
   • DSitting upright, as close to 90 degrees as possibleCorrect

   Why: Sitting upright lets gravity help food travel down the esophagus instead of into the airway. Clients at risk of aspiration usually stay upright for about 30 minutes after eating, as the care plan directs.

   Reference 42 CFR 484.80(b)(3)(xii); aspiration precautions

2. A client grabs her throat, cannot speak, and cannot cough. What should the aide do?

   • AGive her a glass of water to wash the food down
   • BPat her gently on the back and wait to see if it passes on its own
   • CGive abdominal thrusts and have 911 calledCorrect
   • DLay her flat on the floor and raise her legs

   Why: A person who cannot speak, cough or breathe has a severe airway obstruction. The aide calls or has someone call 911 and gives abdominal thrusts until the object comes out or the person becomes unresponsive, in which case the aide lowers her to the floor and begins CPR if trained.

   Reference American Red Cross / AHA choking guidance; 42 CFR 484.80(b)(3)(vii)

3. While eating, a client coughs and clears food after a moment, then keeps eating normally. What should the aide do next?

   • AGive abdominal thrusts right away
   • BEncourage slow, small bites and report the coughingCorrect
   • CGive a large drink of thin water to wash it down
   • DLay the client flat until the coughing stops

   Why: A client who can cough forcefully is moving air, so the aide does not interfere with thrusts. Coughing during meals can signal swallowing trouble, so the aide encourages small bites and an upright position, and reports it to the nurse. Abdominal thrusts are for a client who cannot cough, speak or breathe.

   Reference American Red Cross choking care; dysphagia warning signs

4. A client's face suddenly droops on one side and one arm is weak. What should the aide do?

   • ACall 911 right away and note the time symptoms beganCorrect
   • BHave the client lie down and nap for an hour, then check whether things look better
   • CGive an aspirin from the client's cabinet
   • DCall the client's daughter and ask her what to do

   Why: Face drooping, arm weakness and speech trouble are stroke warning signs (BE FAST: balance, eyes, face, arms, speech, time). Stroke treatments work only within hours of onset, so 911 is called immediately and the time symptoms started is noted. The aide does not give medication.

   Reference American Stroke Association BE FAST

5. A client with diabetes skips lunch because she is not hungry. Why should the aide report this?

   • ASkipping lunch means she will overeat and gain weight later in the day
   • BSkipping meals has no effect on diabetes
   • CShe must eat a full meal by law
   • DMissing a meal while on diabetes medicine can cause low blood sugarCorrect

   Why: Many diabetes medicines, including insulin and some pills, lower blood sugar whether or not the person eats. A skipped meal can lead to hypoglycemia, so the aide reports it and watches for shakiness, sweating, confusion or unusual behavior.

   Reference ADA hypoglycemia guidance

6. A client with diabetes is shaky, sweaty and confused but awake and able to swallow. If the care plan allows, what should the aide give?

   • AAbout 4 ounces of regular juice, then reportCorrect
   • BAn extra dose of the client's insulin to steady the sugar
   • CA glass of diet soda, since it has no calories
   • DNothing at all; wait until the next scheduled meal

   Why: Shakiness, sweating and confusion suggest low blood sugar. If the client is alert and can swallow, about 15 grams of fast sugar (such as 4 ounces of regular juice or regular soda) is given per the care plan, and the nurse is notified. Diet soda has no sugar, and insulin lowers blood sugar further. An unconscious client gets nothing by mouth and 911 is called.

   Reference ADA hypoglycemia treatment (rule of 15)

7. A client has a seizure with jerking movements. Which action is correct?

   • AHold the arms and legs down firmly to stop the jerking
   • BPut a spoon or folded cloth between the teeth so the client does not bite the tongue
   • CGive water as soon as the jerking slows down
   • DProtect the head, move objects away, and time the seizureCorrect

   Why: During a seizure, cushion the head, move hard objects away, loosen tight clothing, and time it. Never restrain the person or put anything in the mouth, which can break teeth or block the airway. Afterward, turn the person on their side. Call 911 if it lasts more than 5 minutes or per agency policy.

   Reference Epilepsy Foundation seizure first aid

8. A client spills hot coffee on her hand. What first aid is correct?

   • ACool it under cool running water for at least 10 minutesCorrect
   • BRub butter on it to keep the air off
   • CHold ice directly on the burn until it stops hurting completely
   • DPop any blisters so the skin can breathe

   Why: Cool, not cold, running water for about 10 to 20 minutes stops the burning and eases pain. Butter and ointments trap heat, ice damages tissue, and broken blisters invite infection. Cover loosely with a clean dry cloth and report it; call 911 for large or serious burns.

   Reference American Red Cross burn first aid

9. A client complains of chest pressure spreading to the left arm, with sweating and nausea. What should the aide do?

   • ADrive the client to the hospital in the aide's own car
   • BCall 911, keep the client resting, and stay with themCorrect
   • CHave the client walk around the block to see whether the pain goes away
   • DGive a heavy meal so the nausea settles

   Why: Chest pressure or pain spreading to the arm, jaw or back with sweating, nausea or shortness of breath are heart attack warning signs. Call 911 right away; paramedics can start treatment on the way. Keep the client calm and resting, stay with them, and notify the nurse.

   Reference AHA heart attack warning signs

10. While cleaning, the aide wants to make a stronger cleaner. Which combination must never be mixed?

    • ADish soap and warm water
    • BPlain water and a fresh cloth
    • CBleach and ammoniaCorrect
    • DBaking soda and plain water, mixed into a paste for scrubbing

    Why: Mixing bleach with ammonia (or with acids such as some toilet bowl cleaners) releases toxic gases that damage the lungs. Use one product at a time, as labeled, in a ventilated room, and keep chemicals in their original labeled containers.

    Reference CDC / EPA household chemical safety

11. A confused client drinks some liquid dish detergent. What number can the aide call for expert advice?

    • APoison Help at 1-800-222-1222Correct
    • BThe detergent company's customer service line, printed on the bottle's label
    • CThe client's pharmacy
    • DNo one; just give milk and wait

    Why: Poison Help (1-800-222-1222) connects to a local poison center 24 hours a day. If the client is unresponsive, having trouble breathing, or having a seizure, call 911 first. Do not make the client vomit unless told to by the poison center or 911.

    Reference HRSA Poison Help line

12. A client cuts his hand and it is bleeding heavily. What should the aide do first?

    • ARinse it under the faucet for several minutes and watch how fast it bleeds
    • BPut on gloves and press firmly with a clean clothCorrect
    • CWrap a tight cord around the wrist right away
    • DLeave it uncovered so the blood can clot in the air

    Why: Firm, direct pressure with a clean cloth stops most bleeding. If blood soaks through, add more cloth on top without removing the first layer. Gloves protect the aide from bloodborne pathogens. Call 911 for bleeding that will not stop, and report the injury.

    Reference American Red Cross bleeding control

Drill the whole domain

• Safety and Emergencies (7%)
• Nutrition and Fluids (5%)

Other topics

• HHA vital signs: normal ranges and how to measure them
• Perineal and catheter care: the steps HHAs get tested on
• Transfers, gait belts, canes and walkers for HHAs
• Pressure injuries and skin tears: what HHAs check and report
• Food safety for home health aides: the temperatures to know
• HHA scope of practice: what a home health aide can and cannot do
• Dementia care for home health aides: communication that works
• Hand hygiene, gloves and PPE order for home health aides
• Fire, oxygen and electrical safety in a client's home
• Positioning and range of motion: Fowler's, Sims' and ROM terms
• Client rights, abuse and neglect: what HHAs must report
• Assisting with medications: an HHA's role and limits

See all topics · Study Guides · Full practice exam