Hand hygiene, gloves and PPE order for home health aides

Basic infection prevention and control is on the federal subject list, and hand hygiene is the step skills evaluators watch most closely. The written questions test exact rules: how long to scrub, when alcohol rub is not enough, the order PPE goes on and comes off, and which mask a given germ requires.

Questions and answers, explained

All 10 questions above, with the correct answer and why it is correct. Everything here is on hand hygiene, gloves and ppe order for home health aides.

1. How should the aide handle trash that contains used gloves and soiled dressings?

   • ABag it securely and place it in the outdoor trash per agency policyCorrect
   • BLeave it in an open basket in the bedroom
   • CBurn it in the backyard
   • DPut it in the recycling bin so it is collected and processed separately from the trash

   Why: Soiled items are placed in a securely closed plastic bag, often double-bagged, and taken to the outdoor trash, following agency policy and local rules. This prevents odors, pests and the spread of germs inside the home.

   Reference Infection control in home care; local waste rules

2. How long should hands be scrubbed with soap and water during handwashing?

   • AAt least 20 secondsCorrect
   • BAbout 5 seconds, just long enough to rinse the soap off
   • CExactly 2 minutes by the clock, every time without exception
   • DUntil the water runs hot

   Why: CDC recommends scrubbing all surfaces of the hands, between the fingers and under the nails for at least 20 seconds, then rinsing and drying with a clean towel. Turning the faucet off with a paper towel keeps clean hands from being recontaminated.

   Reference CDC hand hygiene guidance; 42 CFR 484.80(b)(3)(iv)

3. After helping a client use the bedside commode, what should the aide do first once the client is settled?

   • ALeave the bucket for the next visit
   • BEmpty the bucket in the kitchen sink
   • CHelp the client clean their handsCorrect
   • DSpray air freshener in the client's face

   Why: Hand hygiene after toileting is offered to every client. The aide then empties the commode bucket into the toilet (never a sink used for food), notes anything unusual about the urine or stool, cleans the bucket, and performs hand hygiene.

   Reference CDC hand hygiene guidance

4. When must the aide wash with soap and water instead of using alcohol-based hand rub?

   • ABefore putting on gloves for a routine task
   • BAfter touching the client's clean, dry bedside table
   • CBefore taking a blood pressure on intact skin
   • DWhen hands are visibly soiled or the client has C. diff diarrheaCorrect

   Why: Alcohol rub does not remove visible dirt and does not kill C. difficile spores well, so soap and water are used in those cases, and after using the restroom or before eating. Otherwise, a rub with at least 60% alcohol, rubbed until dry, is effective.

   Reference CDC hand hygiene guidance

5. To which clients do standard precautions apply?

   • AOnly clients with a known infection listed in the care plan
   • BEvery client, every time, regardless of diagnosisCorrect
   • COnly clients who are coughing or running a fever that day
   • DOnly clients in the hospital, not at home

   Why: Standard precautions treat all blood, body fluids (except sweat), nonintact skin and mucous membranes as potentially infectious for every client, because infection status is often unknown. They include hand hygiene, PPE, safe handling of sharps and cleaning.

   Reference CDC standard precautions; 42 CFR 484.80(b)(3)(iv)

6. Which statement about gloves is correct?

   • AGloves replace hand hygiene, so washing is not needed
   • BOne pair can be worn for the whole visit to save supplies
   • CHand hygiene is done after taking gloves offCorrect
   • DTorn gloves are fine as long as the tear is small and on the palm

   Why: Gloves can have tiny holes and hands get contaminated while removing them, so hand hygiene is always done after glove removal. Gloves are changed between tasks, when moving from a dirty to a clean area on the same client, and whenever torn.

   Reference CDC standard precautions

7. In what order does CDC recommend putting on personal protective equipment?

   • AGown, mask, goggles or face shield, glovesCorrect
   • BGloves, gown, goggles, mask
   • CMask, gloves, gown, goggles, then a second pair of gloves underneath
   • DGoggles, gloves, mask, gown

   Why: CDC's donning sequence is gown, mask or respirator, goggles or face shield, then gloves last, so the gloves can cover the gown cuffs. Removal starts with the most contaminated items: gloves first, then goggles, gown and mask, followed by hand hygiene.

   Reference CDC Sequence for Putting On and Removing PPE

8. Which item of PPE is removed first, because it is usually the most contaminated?

   • AThe mask, so the aide can breathe more easily
   • BThe goggles, because they fog up
   • CThe gown, pulled off over the head while still gloved and touching the front
   • DThe glovesCorrect

   Why: Gloves have touched the client and contaminated surfaces, so they come off first (or together with the gown, rolling them inside out). The mask or respirator is removed last by its ties or ear loops, never by touching the front, and hands are cleaned afterward.

   Reference CDC Sequence for Putting On and Removing PPE

9. Handwashing breaks which link in the chain of infection?

   • AThe infectious agent's ability to multiply inside the client
   • BThe mode of transmissionCorrect
   • CThe susceptible host's immune system
   • DThe reservoir in which germs live and grow in the home

   Why: The chain is infectious agent, reservoir, portal of exit, mode of transmission, portal of entry and susceptible host. Hands are the most common way germs travel from one person or surface to another, so hand hygiene breaks the mode of transmission.

   Reference CDC chain of infection

10. A client has MRSA in a wound. Which precautions does the care plan most likely add to standard precautions?

    • AAirborne precautions with an N95 respirator at all times in the home
    • BContact precautions, with gown and gloves for contactCorrect
    • CNo precautions, since MRSA is harmless
    • DAvoiding the client's room for the whole visit

    Why: MRSA spreads by direct and indirect contact, so contact precautions add gown and gloves for contact with the client or contaminated items, plus careful cleaning of shared equipment. Transmission-based precautions are always added to standard precautions, never instead of them.

    Reference CDC transmission-based precautions (contact)

Drill the whole domain

• Personal Care and Hygiene (13%)
• Home Management and Meals (12%)
• Infection Control (7%)

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
• 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
• Emergencies for home health aides: choking, stroke, seizures
• Assisting with medications: an HHA's role and limits

See all topics · Study Guides · Full practice exam