CPCT/A EXAM 2026/2027 | 100% Correct Answers with
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Domain 1: Patient Care & Safety (20 Questions)
Q1
A 78-year-old patient with a history of falls and osteoporosis is admitted for hip fracture
repair. The nurse assistant is assigned to assist with ambulation. Which action
demonstrates proper fall prevention technique?
A. Walk slightly behind the patient, holding their waist for control.
B. Walk at the patient's side on their weaker side, using a gait belt properly fitted around
the waist, maintaining correct body mechanics. [CORRECT]
C. Allow the patient to use furniture for support while walking independently.
D. Walk in front of the patient pulling them forward to set the pace.
Correct Answer: B
Rationale: Proper fall prevention during ambulation requires: positioning at the patient's
side on the weaker/ affected side (allows support if they lose balance), using a properly
fitted gait/transfer belt (snug, two fingers fit between belt and patient, positioned over
clothing at waist/natural waistline), maintaining wide base of support, knees bent, and
using leg muscles rather than back. This provides optimal support while maintaining
patient dignity and safety.
Distractor Analysis:
, ● A is incorrect: Walking behind prevents observing the patient's face for
distress/fatigue and provides poor leverage for support; waist holding without a
belt is unsafe.
● C is incorrect: Furniture is unstable and can tip; this is a known fall risk and
violates safety protocols.
● D is incorrect: Pulling forward disrupts patient balance and center of gravity;
patients must set their own pace to maintain stability.
Q2
A patient requires repositioning every 2 hours to prevent pressure injuries. The patient is
currently supine. Which position change is most appropriate for the next scheduled
turn?
A. Prone position to relieve all pressure from the back.
B. Lateral (side-lying) position with proper alignment and support pillows. [CORRECT]
C. Trendelenburg position to improve circulation.
D. Maintain supine position but elevate the head of bed to 45 degrees only.
Correct Answer: B
Rationale: Repositioning every 2 hours follows the 30-degree lateral tilt rule for pressure
injury prevention. Side-lying with pillows supporting the upper leg (maintaining hip
alignment), behind the back, and under the upper arm maintains proper body alignment,
relieves pressure from sacrum and heels, and prevents shear forces. This is the
standard of care for immobile patients.
Distractor Analysis:
● A is incorrect: Prone position is contraindicated for many patients (respiratory
compromise, recent spinal/ abdominal surgery, pregnancy) and is not part of
routine repositioning schedules.
● C is incorrect: Trendelenburg (head down) is a specific treatment position for
shock or certain surgeries, not for routine pressure relief; it increases intracranial
and intraocular pressure.
, ● D is incorrect: 45-degree head elevation causes shearing forces on sacrum; 30
degrees or less is recommended, and full repositioning is required, not just head
elevation.
Q3
A confused patient repeatedly attempts to remove their indwelling urinary catheter and
intravenous line. After alternative interventions fail, the provider orders wrist restraints.
Which nursing action is required by the Joint Commission and CMS regulations?
A. Apply restraints tightly to prevent any movement or removal.
B. Check circulation every 15 minutes, release restraints every 2 hours for range of
motion, and reassess need every 24 hours with provider re-order. [CORRECT]
C. Apply restraints only at night when staffing is lower.
D. Document that restraints are applied but do not perform regular checks if the patient
appears comfortable.
Correct Answer: B
Rationale: Restraint regulations require: least restrictive alternative attempted first,
provider order within 1 hour of application, 15-minute checks (circulation, skin integrity,
positioning, basic needs), 2-hour release for range of motion and care, face-to-face
provider evaluation within 1 hour, and order renewal every 24 hours maximum.
Violations constitute patient abuse and regulatory non-compliance.
Distractor Analysis:
● A is incorrect: Tight restraints cause neurovascular compromise, compartment
syndrome, and tissue necrosis; one finger should fit between restraint and wrist.
● C is incorrect: Restraints must be applied based on assessed need, not staffing
convenience; continuous need must be documented.
● D is incorrect: Failure to perform required checks is neglect and violates patient
safety standards; "appearing comfortable" is not an assessment.
, Q4
A patient requires transfer from bed to wheelchair using a mechanical lift (Hoyer lift).
The patient is partially weight-bearing. Which step is essential for safe operation?
A. Attach sling while patient is standing beside the bed.
B. Use the lift without checking weight capacity if the patient appears average size.
C. Ensure sling is properly positioned under patient using draw sheet method, check all
hooks/connections, and have two caregivers operate the lift. [CORRECT]
D. Lift the patient high above the bed to clear obstacles quickly.
Correct Answer: C
Rationale: Mechanical lift safety requires: proper sling size and type (divided leg, full
body, toileting), positioning sling under patient using draw sheet (log roll method)
without dragging, ensuring all clips/hooks are secure, verifying lift capacity exceeds
patient weight, using two caregivers (one operating lift, one guiding patient), and
lowering slowly into chair with proper positioning (hips back, feet on floor).
Distractor Analysis:
● A is incorrect: Slings are positioned while patient is in bed using log-roll
technique; standing patients use different transfer methods.
● B is incorrect: Weight capacity must be verified for every use; mechanical failure
and patient injury result from exceeding limits.
● D is incorrect: Lifting higher than necessary increases fall risk and creates
instability; lift only to clear bed/ chair surfaces.
Q5
A patient with a Braden Scale score of 12 (high risk for pressure injury) is being bathed.
Which technique protects skin integrity?
A. Use hot water to ensure thorough cleaning and vigorous scrubbing to remove dead
skin.
Complete Solutions | NHA Aligned | Certified Patient Care
Technician/Assistant | Clinical Competencies | Pass
Guaranteed - A+ Graded
Domain 1: Patient Care & Safety (20 Questions)
Q1
A 78-year-old patient with a history of falls and osteoporosis is admitted for hip fracture
repair. The nurse assistant is assigned to assist with ambulation. Which action
demonstrates proper fall prevention technique?
A. Walk slightly behind the patient, holding their waist for control.
B. Walk at the patient's side on their weaker side, using a gait belt properly fitted around
the waist, maintaining correct body mechanics. [CORRECT]
C. Allow the patient to use furniture for support while walking independently.
D. Walk in front of the patient pulling them forward to set the pace.
Correct Answer: B
Rationale: Proper fall prevention during ambulation requires: positioning at the patient's
side on the weaker/ affected side (allows support if they lose balance), using a properly
fitted gait/transfer belt (snug, two fingers fit between belt and patient, positioned over
clothing at waist/natural waistline), maintaining wide base of support, knees bent, and
using leg muscles rather than back. This provides optimal support while maintaining
patient dignity and safety.
Distractor Analysis:
, ● A is incorrect: Walking behind prevents observing the patient's face for
distress/fatigue and provides poor leverage for support; waist holding without a
belt is unsafe.
● C is incorrect: Furniture is unstable and can tip; this is a known fall risk and
violates safety protocols.
● D is incorrect: Pulling forward disrupts patient balance and center of gravity;
patients must set their own pace to maintain stability.
Q2
A patient requires repositioning every 2 hours to prevent pressure injuries. The patient is
currently supine. Which position change is most appropriate for the next scheduled
turn?
A. Prone position to relieve all pressure from the back.
B. Lateral (side-lying) position with proper alignment and support pillows. [CORRECT]
C. Trendelenburg position to improve circulation.
D. Maintain supine position but elevate the head of bed to 45 degrees only.
Correct Answer: B
Rationale: Repositioning every 2 hours follows the 30-degree lateral tilt rule for pressure
injury prevention. Side-lying with pillows supporting the upper leg (maintaining hip
alignment), behind the back, and under the upper arm maintains proper body alignment,
relieves pressure from sacrum and heels, and prevents shear forces. This is the
standard of care for immobile patients.
Distractor Analysis:
● A is incorrect: Prone position is contraindicated for many patients (respiratory
compromise, recent spinal/ abdominal surgery, pregnancy) and is not part of
routine repositioning schedules.
● C is incorrect: Trendelenburg (head down) is a specific treatment position for
shock or certain surgeries, not for routine pressure relief; it increases intracranial
and intraocular pressure.
, ● D is incorrect: 45-degree head elevation causes shearing forces on sacrum; 30
degrees or less is recommended, and full repositioning is required, not just head
elevation.
Q3
A confused patient repeatedly attempts to remove their indwelling urinary catheter and
intravenous line. After alternative interventions fail, the provider orders wrist restraints.
Which nursing action is required by the Joint Commission and CMS regulations?
A. Apply restraints tightly to prevent any movement or removal.
B. Check circulation every 15 minutes, release restraints every 2 hours for range of
motion, and reassess need every 24 hours with provider re-order. [CORRECT]
C. Apply restraints only at night when staffing is lower.
D. Document that restraints are applied but do not perform regular checks if the patient
appears comfortable.
Correct Answer: B
Rationale: Restraint regulations require: least restrictive alternative attempted first,
provider order within 1 hour of application, 15-minute checks (circulation, skin integrity,
positioning, basic needs), 2-hour release for range of motion and care, face-to-face
provider evaluation within 1 hour, and order renewal every 24 hours maximum.
Violations constitute patient abuse and regulatory non-compliance.
Distractor Analysis:
● A is incorrect: Tight restraints cause neurovascular compromise, compartment
syndrome, and tissue necrosis; one finger should fit between restraint and wrist.
● C is incorrect: Restraints must be applied based on assessed need, not staffing
convenience; continuous need must be documented.
● D is incorrect: Failure to perform required checks is neglect and violates patient
safety standards; "appearing comfortable" is not an assessment.
, Q4
A patient requires transfer from bed to wheelchair using a mechanical lift (Hoyer lift).
The patient is partially weight-bearing. Which step is essential for safe operation?
A. Attach sling while patient is standing beside the bed.
B. Use the lift without checking weight capacity if the patient appears average size.
C. Ensure sling is properly positioned under patient using draw sheet method, check all
hooks/connections, and have two caregivers operate the lift. [CORRECT]
D. Lift the patient high above the bed to clear obstacles quickly.
Correct Answer: C
Rationale: Mechanical lift safety requires: proper sling size and type (divided leg, full
body, toileting), positioning sling under patient using draw sheet (log roll method)
without dragging, ensuring all clips/hooks are secure, verifying lift capacity exceeds
patient weight, using two caregivers (one operating lift, one guiding patient), and
lowering slowly into chair with proper positioning (hips back, feet on floor).
Distractor Analysis:
● A is incorrect: Slings are positioned while patient is in bed using log-roll
technique; standing patients use different transfer methods.
● B is incorrect: Weight capacity must be verified for every use; mechanical failure
and patient injury result from exceeding limits.
● D is incorrect: Lifting higher than necessary increases fall risk and creates
instability; lift only to clear bed/ chair surfaces.
Q5
A patient with a Braden Scale score of 12 (high risk for pressure injury) is being bathed.
Which technique protects skin integrity?
A. Use hot water to ensure thorough cleaning and vigorous scrubbing to remove dead
skin.
