1. Which of the following is the CORRECT order for putting on (donning) personal protective equipment (PPE)?
- A. Mask, gown, gloves, eye protection
- B. Gown, mask, eye protection, gloves ✓
- C. Gloves, gown, eye protection, mask
- D. Eye protection, gloves, gown, mask
The correct donning sequence per IPAC Canada and Public Health Ontario guidelines is: Gown first (to protect clothing), then Mask (to protect the respiratory tract), then Eye protection (goggles or face shield), then Gloves last (as gloves are the most likely to become contaminated and should be the final barrier applied). This sequence minimizes self-contamination.
2. When assisting a client with a bed bath, which area should the PSW wash LAST?
- A. Face and neck
- B. Arms and chest
- C. Perineal area ✓
- D. Legs and feet
The perineal area is washed last to prevent cross-contamination of cleaner body areas with microorganisms from the genital/anal region. This follows the clean-to-dirty principle of infection prevention.
3. When preparing to lift a heavy object from the floor, which foot position best supports safe body mechanics for a PSW?
- A. Stand with feet together and knees straight
- B. Place feet shoulder-width apart with one foot slightly forward ✓
- C. Stand on the balls of the feet with heels raised
- D. Cross one foot in front of the other for balance
A wide base of support with feet shoulder-width apart and one foot slightly forward lowers the centre of gravity and increases stability, which is a foundational principle of safe body mechanics to prevent back injury.
4. A PSW notices that a client with dementia becomes very agitated every afternoon around 4:00 PM. This pattern is BEST described as:
- A. Perseveration
- B. Sundowning ✓
- C. Confabulation
- D. Apraxia
Sundowning (or late-day confusion) refers to the pattern of increased agitation, confusion, and behavioural symptoms in people with dementia that typically worsen in the late afternoon and evening. Perseveration is repetitive action or speech. Confabulation is the unconscious fabrication of information to fill memory gaps. Apraxia is the loss of ability to carry out purposeful movements.
5. When documenting care in a client's written record, a PSW makes an error. What is the correct way to correct this error?
- A. Use correction fluid (white-out) to cover the mistake and write the correct information
- B. Erase the error completely and rewrite the entry
- C. Draw a single line through the error, write the correct information beside it, and initial it ✓
- D. Tear out the page and rewrite the entire entry on a new page
Professional documentation standards require that errors be corrected by drawing a single line through the mistake so the original text remains legible, then writing the correct information and initialling it. White-out, erasure, or destroying records are unacceptable as they compromise the integrity of the legal document.
6. A client with Type 2 diabetes complains of feeling shaky, sweaty, and confused. As a PSW, what is your FIRST action?
- A. Offer a fast-acting carbohydrate such as 125 mL of juice or regular soft drink ✓
- B. Administer insulin as directed on the care plan
- C. Have the client lie down and rest until the feeling passes
- D. Contact the nursing supervisor before doing anything
Shakiness, sweating, and confusion are classic signs of hypoglycemia (low blood sugar). The PSW's immediate response for a conscious client who can swallow is to provide a fast-acting carbohydrate (e.g., 125–175 mL juice). Administering insulin is outside PSW scope; waiting without intervention is dangerous when hypoglycemia is suspected.
7. A client with capacity refuses to take a bath even though they have not bathed in several days. The PSW should:
- A. Proceed with the bath anyway to maintain hygiene and prevent skin breakdown.
- B. Respect the client's decision, document the refusal, and report it to the supervisor. ✓
- C. Call the client's family to override the refusal.
- D. Threaten to report the client to a doctor if they do not cooperate.
A competent adult with decision-making capacity has the legal and ethical right to refuse any care, including personal hygiene tasks. The PSW's role is to respect this autonomy, document the refusal accurately, and inform the supervisor so the care plan can be reviewed. Providing care against a capable client's wishes constitutes assault.
8. An older adult tells a PSW, 'My daughter controls all my money and won't let me buy anything for myself.' This statement MOST likely describes which type of elder abuse?
- A. Physical abuse
- B. Emotional abuse
- C. Financial abuse ✓
- D. Neglect
Financial abuse involves the unauthorized or improper use of a person's funds, property, or assets. Controlling a person's access to their own money without consent is a classic indicator of financial abuse. Physical abuse involves bodily harm, emotional abuse involves psychological harm, and neglect involves failure to meet basic needs.
9. When assisting a client with a one-sided weakness (hemiplegia) to dress, the PSW should follow which principle?
- A. Dress the stronger side first, undress the weaker side first
- B. Dress the weaker side first, undress the stronger side first ✓
- C. Dress the stronger side first, undress the stronger side first
- D. Dress the weaker side first, undress the weaker side first
When dressing a client with hemiplegia, the affected (weaker) side is dressed first because it has less range of motion; this makes it easier to guide clothing over the limb. When undressing, the stronger side is removed first, leaving clothing on the weaker side until last.
10. A PSW notices a client has a respiratory infection with a productive cough. Which type of transmission-based precaution is MOST appropriate to implement?
- A. Contact precautions
- B. Airborne precautions
- C. Droplet precautions ✓
- D. Reverse isolation
Droplet precautions are used for pathogens spread through large respiratory droplets (>5 microns) produced by coughing, sneezing, or talking, such as influenza. A surgical mask worn by the PSW within 2 metres of the client is the primary protective measure. Airborne precautions are reserved for pathogens transmitted via small droplet nuclei (e.g., tuberculosis, measles).