CNA Physical Care Skills: Top Practice Questions for the NNAAP Exam

Physical Care Skills makes up 45% of the NNAAP written exam — approximately 31 of the 70 questions. No other category comes close. If you master this section, you can fail every other topic at an average rate and still pass. The reason it carries so much weight is straightforward: physical care is what CNAs spend most of their time doing. Bathing, grooming, feeding, transfers, positioning, elimination care — these are the daily tasks that directly affect resident safety and dignity. This guide covers the most frequently tested physical care concepts with the same question format you will see on the real exam.

Bathing questions on the NNAAP focus on correct technique, water temperature, and the order of steps. Q: What is the correct water temperature for a bed bath? A: 105–115°F (warm to the touch, not hot). Always test the water temperature on your inner wrist before applying it to the resident. Never assume the temperature is correct without testing. Q: When giving a bed bath, which area should you wash first? A: Start with the face (eyes first, inner to outer corner), then work toward the feet. The principle is clean to dirty. The perineal area is washed last. Q: A resident has a right-sided weakness. When washing the resident's back, where should the CNA position themselves? A: On the resident's stronger side to provide support. Always work from the stronger side when assisting with transfers and positioning. Q: What should the CNA do before removing the bath blanket to begin a bed bath? A: Explain the procedure to the resident and provide privacy by closing the curtain and door. Resident dignity requires that you never expose a resident unnecessarily.

Q: When performing oral care on an unconscious resident, what position should the resident be in? A: Turn the head to one side (lateral position). This prevents aspiration if secretions pool in the mouth. Never perform oral care with an unconscious resident lying flat on their back. Q: How often should the CNA provide oral care for an unconscious resident? A: At least every 2 hours. Unconscious residents are at high risk for dry mouth and aspiration pneumonia. Q: A resident wears dentures. When cleaning dentures, where should the CNA hold them? A: Over a basin or sink lined with a washcloth to cushion a drop. Hold dentures firmly but gently. Clean them away from the resident's bedside. Q: Before inserting a resident's dentures, what should the CNA check? A: Check that the dentures belong to that resident (dentures should be labeled) and check the condition of the resident's mouth and gums.

Nail care questions on the NNAAP frequently test the distinction between what CNAs can and cannot do. Q: A resident asks the CNA to cut their toenails. What should the CNA do? A: Decline and inform the charge nurse. Cutting toenails is outside the CNA scope of practice — it requires a nurse or podiatrist, particularly for residents with diabetes or circulation problems. Q: Which nail care task IS within the CNA scope of practice? A: Filing fingernails with an emery board and cleaning under fingernails with an orange stick. CNAs may also push back cuticles gently. Q: A diabetic resident has a small cut on their foot noticed during nail care. What should the CNA do? A: Do not attempt to treat the wound. Report it to the charge nurse immediately. Diabetic residents have impaired circulation and healing — any wound on the feet is a serious concern.

Positioning questions test your knowledge of the standard positions and when each is used. Q: A resident needs to be positioned to reduce the risk of aspiration during tube feeding. Which position is correct? A: Fowler's position (head of bed elevated 45–60 degrees). This is also the standard position for eating and drinking. Q: What is the Sims' position used for? A: Left lateral position with the upper knee flexed. Used for enemas, rectal exams, and some perineal care procedures. Q: A resident has a pressure injury on their sacrum. Which position should be avoided? A: Any position that places direct pressure on the sacrum — including lying flat on the back (supine). Reposition the resident every 2 hours and use positioning devices to offload the area. Q: When positioning a resident in the lateral (side-lying) position, what should be placed between the knees? A: A pillow. This prevents pressure between bony prominences and reduces the risk of skin breakdown.

Transfer questions are among the most tested physical care items on the NNAAP exam. Q: Before transferring a resident from bed to wheelchair, what must the CNA do first? A: Lock the wheelchair wheels. This is a safety requirement — an unlocked wheelchair can roll during the transfer and cause a fall. Q: When applying a gait belt for a transfer, where should it be positioned? A: Around the resident's waist, over clothing (never on bare skin), snug enough that two fingers fit underneath. The buckle should be off-center to avoid pressing on the spine. Q: A resident has left-sided weakness. When transferring to a wheelchair, where should the wheelchair be placed? A: On the resident's stronger (right) side. The resident pivots toward their stronger side. Q: What is the correct body mechanic technique for a CNA when assisting with a transfer? A: Keep your back straight, bend at the knees (not the waist), keep the load close to your body, and avoid twisting. Use a wide stance for stability.

Q: When performing perineal care on a female resident with an indwelling catheter, in which direction should the CNA wipe? A: Front to back — always. This prevents fecal bacteria from contaminating the urethra and catheter insertion site. Q: When cleaning around a urinary catheter, how far from the insertion site should the CNA clean? A: At least 4 inches (10 cm) from the urethral opening, moving away from the body. Use a clean stroke each time — do not wipe back and forth. Q: Where must the urinary drainage bag always be positioned? A: Below the level of the bladder at all times. Raising the bag above bladder level causes urine to flow back into the bladder, increasing infection risk. Q: A resident complains of burning during urination and the urine appears cloudy. What should the CNA do? A: Report these signs to the charge nurse immediately. These are classic symptoms of a urinary tract infection (UTI) and require prompt nursing assessment. Q: When assisting a resident with a bedpan, what position should the resident be in? A: Fowler's position if possible — head of bed elevated. If the resident cannot be positioned upright, use the fracture bedpan in a supine position. Provide privacy and do not leave the call light out of reach.