Challenge Questions

Which of the following best helps reduce pressure on the bony prominences?

A bedridden client can quickly develop pressure sores if allowed to remain in one position. To prevent the skin from breaking down, reposition the client at least every two hours. Use pillows to support the client and to relieve places where skin can rub, such as between the legs or at the tailbone. Always keep the skin clean and dry. A sheepskin on the bed or wheelchair provides extra padding, but does not replace repositioning. Observe the skin for reddened areas and report them to the nurse. Special beds and flotation mattresses are helpful in preventing pressure sores. Floation Mattress

A contracture is caused by

A contracture is a deformity that develops when muscles, joints, and connective tissue become stiff from lack of active exercise. It prevents the normal movement of the joints. The muscles get shorter, so arms or legs are unable to straighten. Some causes are paralysis, from stroke or injury, cerebral palsy, or muscular dystrophy. Range of motion exercises are essential to prevent contractures.

Which statement about sitz baths is true?

A sitz bath cleans and soothes the perineum, promotes healing, and reduces pain. It is often recommended after rectal surgery or vaginal births. The water is about 100 degrees, at a level of about up to the hips. The sitz bath lasts about 15-20 minutes.

Ms. Fleming, a resident who has recently been diagnosed with terminal pancreatic cancer, has accused the nursing assistants in her unit of taking poor care of her and causing her disease to get worse. What stage of grief is Ms. Fleming in?

Anger When Dr. Elisabeth Kubler-Ross identified the five stages of grief and dying, she stated that anger is the only stage that everyone goes through. Residents can show anger in different ways. They can be angry with themselves, or with with others, especially those close to them or those who try to help them. If a resident becomes angry, undersand why. Stay detached and non-judgemental when experiencing the anger of someone who is very upset.

What is Code Blue?

As a CNA, you must call for help, get the patient into a flat position, and begin CPR. When the Code Blue team arrives, allow them to take over. Be available for any requests, such as documenting the code, getting equipment, keeping the area clear, taking blood to the lab, or making phone cals.

What type of fire can be put out with water?

Paper Fire extinguishers are classified by the materials they can snuff out. Think "ABC." Class A fire extinguishers are used for paper, wood, textiles, and some plastics. Class B is used for flammable liquids, such as oil or gasoline. Class C extinguishers are for electrical fires. All fire extinguishers have labels on them to identify which type of fire they can be used for.

Why do residents with Parkinson's disease require assistance when walking?

Parkinson's disease is a chronic movement disorder that gets worse over time. Patients develop tremors in the hands, arms, legs, and face. They walk slowly with a shuffling gait. About 70% of patients fall because of balance problems, so assisting them when walking may be necessary. They have a shuffling gait and have tremors

The term used when a person repeats a phrase or action over and over is called

Perseveration is the repetition of a word, phrase, or gesture. The person cannot control the repetition and continues to say or do it even after the reason to say or do it has stopped. For example, a person may answer a question, but then repeats the answer for every other question or after questioning stops. Perseveration can be caused by a brain injury or in schizophrenia.

Clean bed linen placed in a client's room but NOT used should be

Put dirty linen container. Once linen has been in a client's room, it is no longer considered to be clean. Each client's room can have pathogens or sources of possible infection that could be spread by objects from that room. Opened supplies or items with sterile packaging that has been opened should also be discarded, even if not used.

Mr. Mac begins to fall as you are ambulating him. The first thing you do is

If a patient begins to fall while walking or standing, do not try to catch them or prevent the fall. Control the fall by easing them to the floor. This prevents injury to both the patient and the CNA. It also allows you to protect the patient's head from hitting the floor or an object. Stay with the patient until help arrives. Lower him to the floor

A bedsore or decubitus ulcer is caused by

Inadequate turning One of the primary responsibilities of a nurse aide is to monitor the client's skin for any signs of breakdown that could develop into bedsores, also called decubitus ulcers or pressure sores. During baths, dressing, or position changes, inspect the skin for redness, pallor, warmth, or bruising. Reposition at least every two hours, protecting areas that rub together, as well as the bony prominences. Massages to the back and buttocks can promote circulation. Range-of-motion exercises are also helpful. Always report any signs of breakdown to the nurse.

A way to care for a resident suffering from depression would be to

Make sure the resident wears his glasses and hearing aids. Residents who are depressed may tend to withdraw and avoid activities. If their symptoms last more than a week, tell the nurse. Encourage the resident to sit in a common space, even if they don't actively participate. Make sure they have their glasses and hearing aids so they are not isolated from communication. Another important thing staff can do is to allow residents with depression to express their feelings. Use active listening and respond in a kind tone of voice. Studies have shown that depressed people remember the tone of voice more than the words that were spoken.

On admission to a nursing home or a long-term care facility, a resident must be given

Nursing homes and long-term care facilities must give every new resident a copy of the Resident Bill of Rights in a language they understand. The document must also be posted in a visible place. While each facility may have different wording, the rights protect and assure the resident of respectful treatment.

Hospice specializes in the care of persons who are

Terminally ill Hospice is specialized care for clients who are terminally ill. The care includes the family and caregivers. It does not attempt to cure the client. Hospice is intended to improve the quality of life for everyone involved, by taking care of their physical, emotional, and spiritual needs.

A patient with Stage IV lung cancer has not been eating or sleeping well and has lost interest in activities. These behaviors may indicate

The five stages of grief and dying are a model that explain the emotional response to death. Both the client and the client's loved ones can experience these emotions. The stages are denial, anger, bargaining, depression, and acceptance. Depression serves as the beginning of the client's understanding that they are going to die. It is also called "preparatory grieving" as the client feels sadness, fear, and uncertainty about what is ahead.

One of the major reasons the elderly person is incontinent of urine is

The muscle that keeps urine in bladder weakens As part of the aging process, a client may experience urinary incontinence because of weakness of the muscle that keeps the urine in until the client can get to the toilet. Other reasons are that the bladder itself doesn't contract to expel all the urine. Bladder infections and prostate problems can contribute to incontinence. Diseases such as Alzheimer's or multiple sclerosis can also be causes.

Whenever a patient visits the care facility for a short period of time only, to give their usual caregivers a 'break,' this is called

Caregiving is demanding, both physically and mentally. Respite care gives family and caregivers a chance to temporarily rest while the patient is cared for in a facility. Respite care can be during the day, for a weekend, or for a few days. It can also take place in the patient's home.

When caring for a client who uses a protective device (restraint), the nurse aide SHOULD

Check the body's alignment When a physician orders a restraint for a client, staff must strictly follow the protocols to maintain the client's safety. The nurse aide should become familiar with the policies regarding restraints. The policy will state the defined times to monitor the client, directions for reporting on the client's status, as well as directions for documenting all observations.

Delusions are defined as

Delusions are false beliefs that involve a misinterpretation of experiences. A person may believe that they are being followed, tricked, or spied on. They may also be convinced that songs or books contain special information meant for them. Attempts to show the person that their belief is wrong or irrational are not accepted by the person.

TED hose (anti-embolism) are applied

Elastic stockings, or anti-embolism stockings, are used for patients who have had surgery or are unable to ambulate. Make sure the size is correct for the patient before starting. Assist the patient to lie down in a supine position. The patient's feet and legs should be dry. Roll the stocking inside out all the way to the heel. Fit it on the foot and heel, then roll it up onto the patient's leg. Smooth any wrinkles and make sure the stockings are straight. Talcum powder can be helpful to prevent friction and rubbing on the skin. Before the resident gets out of bed

Urinary incontinence is a predisposing factor to

Exposure to feces and urine is one of the most common causes for skin irritation and breakdown. Thorough cleaning after a client has had an incontinent episode is important for several reasons. If perineal skin stays wet, it becomes waterlogged and fragile. Urine contains ammonia, a harsh chemical that damages skin. Many clients have dry skin which can develop tiny cracks, allowing bacteria to enter the body. Clean the client, dry the area, and apply a barrier ointment to minimize any future contact by feces and urine.

The patient who has suffered from a stroke usually _________.

Following a stroke, paralysis occurs on the side of the body opposite the side of the brain where the stroke happened. 9 out of 10 stroke patients have some type of paralysis, which can require months or years of rehabilitation. One-sided paralysis

Which of the following is true about caring for a resident who wears a hearing aid?

Hearing aids are expensive devices and care must be taken to avoid getting them wet. If a hearing aid does accidentally get wet, turn it off and remove the battery. Dispose of the battery. Open the battery door and allow the battery to completely dry out, which can take a day or two. Insert a new battery before using it again. Remove the hearing aid before showering

A nursing assistant is performing the heimlich maneuver. Which of the following is not true regarding this procedure? A Perform the upward thrusts until the foreign object comes out or the resident loses consciousness If the resident loses consciousness but has a pulse, begin CPR and continue until relieved C Make a fist with the hand D Quickly pull inward and outward on the abdomen with a quick thrus

Question 5 Explanation: When performing the heimlich maneuver, perform the upward thrusts until the foreign object comes out or until the resident losses consciousness. Make a fist with the hand instead of leaving it open. Also, quickly pull inward and upward on the abdomen with a quick thrust. Lastly, if the resident loses consciousness and doesn't have a pulse or respirations, then begin CPR and continue until relieved. B

Mr. Smith, a 72-year-old male Alzheimer's patient, has been stopped several times today while wandering from unit. He is ambulatory, but confused and combative. The CNA would first

Re-direct the client and provide an alternate activity. Aways assess a resident's mental status before asking about restraints. The resident may feel restless, but still be able to be redirected to another activity. Restraint orders are only used when residents are a threat to themselves or others.

As you finish your shift, a patient with a history of bowel incontinence has a strong odor. Your responsibility is to

Residents have a right to physical care and comfort, regardless of the time. As long as a nurse aide is on duty, they are responsible for providing excellent care. As a team member, the nurse aide should cooperate with other shifts to keep the resident's care a priority.

Which statement is true about residents who are restrained?

Residents have a right to physical care and comfort, regardless of the time. As long as a nurse aide is on duty, they are responsible for providing excellent care. As a team member, the nurse aide should cooperate with other shifts to keep the resident's care a priority. They could create greater risk for pressure sores

Mr. Brown has been a resident in your facility for two years. His wife has broken her hip and will soon be a resident, too. What is the policy for married couples?

Residents have the right to share a room with their spouse, even if they have different needs. Their room is considered private, and staff must knock before entering. The spouse who needs the most care can determine the type of facility where the couple lives. Studies have shown that when couples are able to remain together, they experience overall greater health and happiness.

Sexuality includes all of the following EXCEPT

Sexuality is expressed in many ways besides having sex. People are molded by their cultural and religious beliefs, as well as how they see themselves. Sexuality develops through all relationships. It includes how we look, dress, walk, smile, laugh, and cry. Sexuality continues to develop throughout our entire lives.

Who should manage the resident's finances?

The resident has the right to manage their money or to designate someone else to do it. Sometimes a resident will ask the facility to hold their money. If so, the facility must give the resident full access to their account and protect the funds.

Mr. Hawkins tells you that his hearing aid isn't working properly. The first thing that you should do is _

When a device, such as a hearing aid, does not seem to be working, begin by checking to see if it is turned on, if the volume is correct, and if the battery is inserted properly. Often the solution is something simple that the patient has overlooked. If it still doesn't work, try a new battery. Finally, tell the nurse. Insert a new battery

Mr. Francis is blind. When ambulating him, you should walk

When assisting a client who is blind or has low vision, allow them to hold your arm so you can guide them. Touch the back of your hand to the back of theirs, so they can move their hand and locate your upper arm. They should hold on above your elbow, and walk half a step behind you. Walk at a pace that is comfortable for both of you. In front of him.

When giving a bed bath, the last area to be cleaned is the

When giving a bed bath, the perineum is the last area to be washed. After bathing the patient's body, empty the basin and refill with warm water. Place a towel under the patient's hips and buttocks. For females, wash front to back, from labia to perineum. For males, wash the penis and scrotum. For both genders, turn the patient on their side to wash the buttocks and anal area. Dry the area well. Perieum