CNA practice exam #8

5. How much sleep do older adults typically require?

A. 8 to 9 hours B. 12 to 14 hours C. 5 to 7 hours D. 10 to 12 hours C Older adults generally need less sleep than younger people, requiring only about 5 to 7 hours of sleep within a 24-hour period. Infants 4 weeks to 1-year-old require 12 to 14 hours of sleep, and adolescents ages 12 to 18 years require 8 to 9 hours of sleep.

4. Which of the following best defines constipation?

A. A condition in which the stool becomes hard and dry and requires straining for elimination B. A condition in which there is a daily bowel movement of a small amount C. A condition in which the stool is moist and soft and requires a laxative for elimination D. A condition in which the individual is unable to have a bowel movement for a day A Constipation is a condition in which the stool becomes hard and dry and requires straining for elimination. The frequency of stool passage is not always a factor. Some people may be constipated and still have daily bowel movements.

24. You are caring for a patient whose IV flow rate is too slow. What should you do next?

A. Adjust the flow rate to the rate that the doctor ordered. B. Provide the nutrients or sugar for the resident that she did not receive from her IV. C. Report it STAT to the nurse. D. Help the resident adjust the catheter. C When IV therapy is ordered, the doctor will set the flow rate. This is the amount of fluid to provide in a given amount of time, or the number of drops per minute. If you observe that a client's flow rate has stopped, is too fast, or too slow, report it immediately to the nurse. Only nurses and doctors are able to adjust the flow rate or move the catheter at the site of insertion. Doctors order an IV when a patient is unable to take nutrients or sugar through her mouth, so providing additional nutrients should not be the next step to take in this scenario. STAT is a common medical abbreviation for urgent or right away.

18. To prevent the spread of infection, contaminated surfaces should be cleaned at the following times, except:

A. After spilling urine B. After taking off gloves C. When blood has dripped D. After completing a task B A contaminated surface must be cleaned when it comes into contact with a bodily fluid, or, for instance, after providing care and placing items on a resident's table. Gloves should be worn while cleaning, so it is not appropriate to clean a contaminated surface after taking off gloves.

16. You are monitoring the urine of a resident; he may be suffering from urinary retention. Urinary retention refers to:

A. An inability to urinate B. Incontinence C. A normal output of urine D. A large output of urine A Urinary retention refers to an inability to urinate. Retention of urine is a symptom that should be reported to the nurse as soon as it is noted.

28. A patient's care plan states: "Help the patient to the bedside commode PRN." When should the patient receive assistance to the commode?

A. As needed B. In the middle of the night C. During the day D. At bedtime A PRN is the accepted abbreviation for as needed or whenever necessary.

23. A resident's health is getting worse, and she fears that she is going to die alone. Her family does not come to visit often, but they are aware of her health situation. What can the CNA do for the resident?

A. Ask someone visiting another resident to talk to this resident. B. Spend as much time as possible with the resident, listening to her if she wants to talk. C. Tell the family that they must stay with the resident around the clock. D. The CNA can't do anything. B As much as the CNA's schedule allows, she should keep the resident company and listen to her talk if she chooses to. This should help the resident feel less alone. It is not appropriate to ask other visitors to keep the resident company. You cannot demand that family members stay with the resident. You can encourage them to stay, however, if you feel comfortable doing so.

25. Threatening to withhold treatment and/or making fun of a resident are examples of which type of abuse?

A. Assault B. Neglect C. Physical abuse D. Emotional abuse D Threatening to withhold treatment and/or making fun of a patient are examples of emotional abuse. Emotional or psychological abuse is usually the most difficult to discover because it is subtle and ongoing. Patients who are experiencing this type of abuse may exhibit behavioral changes.

33. The RN has assigned you the task of emptying urinary drainage bags for a group of patients. You should take which of the following actions?

A. Complete this task and report its completion to the nurse. B. Tell the RN that CNAs are NOT permitted to do this. C. Kink the tubing before emptying the drainage bags. D. Disconnect the catheter tubing from the drainage bags. A CNAs are able to empty urinary drainage bags. They have been trained to do this task and it is within the scope of practice for a CNA. They should also report to the nurse when they have completed the assignment. Disconnecting catheter tubing is a sterile procedure done only by the nurse, and kinking drainage tubing is NOT appropriate because it causes backflow into the bladder.

10. What physical symptom is common for CNA to provide comfort measures for when patients near the end of their lives?

A. Depression B. Fear C. Fever D. Chills D A common symptom patients have near the end of their lives is chills. A CNA could provide a blanket or extra clothing or help to control the temperature in the room. Fever is not a common symptom for patients near the end of their lives. Fear and depression are emotional, not physical, concerns.

11. A resident's ostomy drainage bag needs to be changed. What should you do first?

A. Empty the collection bag B. Clean around the stoma gently with soap and water C. Apply a skin protector around the stoma D. Reattach the clean bag to the apparatus around the stoma A An ostomy is a surgical procedure to remove part of the bowel or bladder. A stoma is an artificial opening created at the end of the ureter or small intestine through which waste passes into an ostomy bag or pouch. The first step in changing an ostomy bag is to empty the bag and then remove it. Then, apply a skin protector around the stoma, and follow this by reattaching the clean bag to the apparatus around the stoma.

6. What is the first thing a CNA must do before transferring a resident from a bed to a wheelchair?

A. Ensure that the environment is safe. B. Ask the patient to place his feet on the floor. C. Make sure that the wheels on both the bed and wheelchair are locked. D. Have the patient sit up in bed to get ready to move. C Before transferring a resident, the CNA must ensure that the wheels on the bed and wheelchair are locked. This is a basic safety measure designed to reduce falls. Once the wheels on the bed and wheelchair are locked, the CNA can help the resident sit up, let his legs dangle for a moment, and then help the patient stand and move to the wheelchair.

32. Although the patient refused the procedure, the nursing assistant insisted and inserted the urinary catheter. The nursing assistant is guilty of which of the following?

A. False imprisonment B. Invasion of privacy C. Battery D. Assault C Battery is the willful touching of a person without permission. Assault is the attempt or threat to touch another person unjustifiably or without permission. Invasion of privacy injures the feelings of a person and doesn't take into consideration how revealing information or exposing the person will affect his feelings. False imprisonment is holding a person against his will.

9. Ms. Miller has fragile skin and has experienced skin tears in the past. The CNA is getting ready to transfer her from her bed to a chair. What should the CNA do?

A. Find another person to help with the transfer. B. Put plenty of lotion on Ms. Miller's arms. C. Put plenty of petroleum jelly on the CNA's hands before starting the transfer. D. Grip Ms. Miller firmly during the transfer so the CNA's hands do not move and cause friction. A To prevent skin tears, the CNA should ask another person to help with the transfer. The CNA should hold Ms. Miller's arms gently, not firmly, to avoid harming her. The use of lotion or petroleum jelly is a safety risk - Ms. Miller could slip from the CNA's hands and fall.

15. Which of the following is NOT considered appropriate handling of linens?

A. Folding the soiled portion inward B. Carrying the linens away from your body C. Depositing the soiled linens on the floor D. Changing linens promptly when soiled C Depositing soiled linens on the floor contaminates the floor and makes it a hazard. When linens are soiled, they are promptly removed, the contaminated side is folded inward, and they are carried away from the body to avoid contaminating the CNA's uniform.

3. Which of the following foods would be best for a patient with diarrhea?

A. Fried chicken, tomatoes, and tea B. Bananas, applesauce, and gelatin C. Applesauce, coffee, and lettuce D. Bananas, bran flakes, and orange juice B For patients with diarrhea, the nurse should temporarily limit the consumption of solid foods and provide clear liquids until the number and consistency of stools improve. CNAs can help patients avoid fried foods, highly-seasoned foods, or foods high in fiber.

14. When disposing of emesis, what protective equipment should be worn?

A. Goggles B. Gloves C. Mask D. Gown B Gloves are the only protective equipment needed when emptying an emesis basin. A mask, gown, or goggles is not necessary.

22. A patient rings the call bell for the fourth time in the first 40 minutes of a CNA's shift. What should the CNA do?

A. Ignore the call bell so the CNA can focus on more important tasks. B. Remove the call bell from the patient's reach. C. Kindly reassure the patient that he will be checked on frequently. D. Ask the nurse manager to speak with the patient. C Although a patient repeatedly ringing a call bell can be frustrating, it is important to understand the cause of this behavior. The patient may be anxious and need reassurance about his care. CNAs should establish clear guidelines for the use of call bells with the patient.

8. Which of the following is the most important step a CNA can take to prevent a resident from falling out of bed?

A. Keeping the bed low to the floor B. Regular monitoring C. Padded briefs D. Mats on the floor B Regular and frequent monitoring is an effective prevention method for patients at risk of falling out of bed. Mats on the floor, a low bed, and briefs with padding may lessen injuries from falls, but they do not prevent falls.

13. Which of the following is an example of neglect?

A. Leaving the floor to do your daily tasks after reporting to your supervisor B. Changing the resident as soon as you discover she is soiled C. Calling for assistance to care for the resident D. Applying a restraint too tightly D Applying a restraint too tightly might cause injury to the resident and is considered neglect.

20. Providing restorative care includes:

A. Making long-term goals with the resident B. Enabling the resident's dependence on assistive devices C. Reminding the resident of his limitations D. Doing everything for the resident A The goal of restorative care is to help the resident regain function in the long term, so creating long-term goals is an important part of the process. Doing everything for the resident and reminding him of his limitations negatively impacts the resident's ability to reach his care plan goals. To help the resident regain function, restorative care discourages dependence on assistive devices.

29. Which of the following is the right terminology when referring to residents with developmental disabilities?

A. Mental retardation B. Mentally retarded C. Slow D. Intellectually disabled D The Omnibus Budget Reconciliation Act of 1987, or OBRA, protects people with developmental disabilities and requires staff to receive special training in order to meet their care needs. You should avoid using the terms "mental retardation" or "mentally retarded," and instead use the terms "intellectual disabilities" or "intellectually disabled" to refer to these residents.

7. Which is an example of neglect?

A. Not giving a patient solid food when she is on a liquid diet. B. Letting a patient sit in soiled briefs for an entire shift. C. Using restraints under doctor's orders. D. All of the above B Patients who are incontinent should be changed at least every two hours. Letting a patient sit in soiled briefs for an eight-hour shift is neglect.

17. You are emptying urinary drainage bags for patients who need their output recorded. Where are you most likely to document the amount of urinary output?

A. On the front of the chart B. In a patient's progress notes C. In the nurse's notes D. On the I and O form D You are most likely to document the amount of urinary output, as well as oral fluid intake, on the Intake and Output (I and O) form used in your place of work.

12. After emptying a urinary drainage bag, which of the following substances should you use to clean its drain tip?

A. Peroxide B. Air dry C. Alcohol D. Soap and water C You should use alcohol to clean the tip of the urinary drainage bag before replacing it. Soap and water, air-drying, and peroxide don't adequately clean the drainage tip.

19. A resident has urinary incontinence. This same resident wears glasses and needs a hearing aid. Which of the following increases her risk of falling?

A. Poor hearing B. Urinary incontinence and poor vision C. Incontinence only D. Poor vision only B Both urinary incontinence and poor vision contribute to the resident's risk for falling. The resident will have to get up and walk to the bathroom often because of the incontinence, and her poor vision may make it difficult for her to see items in her path.

2. A resident who had a stroke a few years ago needs help getting dressed. The resident chooses to wear a long-sleeved shirt with buttons. How should you help the resident?

A. Put the shirt on the resident; do not allow him to help. B. Choose a different shirt that is easier for him to put on. C. Ask another CNA to help you; it is difficult to help the patient by yourself as he has weakness on one side. D. Help him put on the shirt he chose, providing as much help as he needs. D It is important for residents to feel as independent as possible. It is best to help the resident put on the chosen shirt and allow him to do what he can to get dressed. Choosing another shirt, asking another CNA for help, or not allowing the resident to help dress himself will make him feel too dependent on others and could affect his self-esteem.

1. While providing oral care, a CNA notices a fruity odor in an elderly patient's mouth. What should the CNA do?

A. Report the fruity odor to the nurse. B. Skip the oral care because the patient will need a sputum specimen. C. Tell the patient to use mouthwash. D. Do nothing. A The fruity mouth odor is not normal and could be a sign of high blood sugar. Therefore, this should be reported to the nurse immediately.

34. You are caring for Ms. Hernandez, a resident who has trouble talking as a result of a stroke she experienced several months ago. Which of the following health team members would be assigned to provide treatment for this difficulty?

A. Respiratory therapist B. Occupational therapist C. Physical therapist D. Speech therapist D A speech therapist treats people who have speech, voice, hearing, communication, and swallowing disorders. An occupational therapist assists people in learning or maintaining their ability to perform daily activities such as self-care skills, working, and social interaction. A physical therapist treats people with musculo-skeletal problems. A respiratory therapist assists in treating lung and heart disorders; which includes performing respiratory treatments and therapies.

21. You are helping a resident who had a stroke a year ago. She requires the use of a gait belt when trying to stand. Which of the following should you do when using a gait belt with the resident?

A. Stand an arms-length away from the resident when helping her ambulate. B. Bend your back to pull the resident to the standing position. C. Twist your body when attaching and removing the belt. D. Keep the person as close to you as possible. D It is important to keep the resident as close to you as possible when using a gait belt. Twisting or bending your body when attaching, removing, or pulling up a resident could cause you injury and should be avoided.

26. A resident who is near the end of her life asks a CNA to pray with her. The CNA is not comfortable praying with the resident. What should the CNA do?

A. Tell the resident that she will have to pray alone. B. Speak with the nurse to find a religious volunteer or counselor to help the resident express her spirituality. C. Ask the resident's roommate to pray with her instead. D. Pray with the resident anyway. B It is perfectly acceptable for a CNA to pray with a resident if the CNA is comfortable doing this. However, if the CNA would rather not pray with the resident, he should speak with the nurse about having a spiritual counselor or volunteer pray with the resident instead.

30. A standard of care tells a CNA:

A. The details of a procedure, including all of the steps B. The minimum care you need to provide C. The job description of a CNA D. State laws that affect the CNA B Standards of care explain the minimal, critical steps that must be done to provide safe, effective care. A standard of care for a patient who has fallen will describe the minimum care necessary for that patient: calling for help, staying with the patient, and observing him to see if he is hurt.

27. When a CNA cares for a patient with diarrhea, which of the following should the CNA record?

A. Types and amount of fluid the patient is taking in B. Number of stools C. Odor of the stool D. All of the above D A patient who has diarrhea is at risk for dehydration. The CNA must monitor the frequency of bowel movements, the odor of bowel movements, and the amount of fluid that the patient is taking in. All of this information is important for the care of the patient.

31. A nursing assistant answers a call at the nursing station from a friend of Mr. Long, a resident at the facility. The friend asks how Mr. Long is doing. The CNA tells the caller that Mr. Long's condition is declining without determining if Mr. Long wants his medical information shared with the friend. The CNA has:

A. Violated HIPAA laws B. Done her job correctly C. Acted outside the scope of her job D. Helped Mr. Long A HIPAA is a law that oversees patient privacy and confidentiality. The CNA violated the HIPAA law when discussing any medical information without Mr. Long's consent.

35. You and your co-worker are working together to remove a bag contaminated with bodily fluids from a resident's room. Which is the correct process for removing the contaminated bag?

A. You remove the bag and mark it contaminated, while your co-worker brings in a large trashcan to dump the bag into. B. You remove the bag, close it, and carry it to the door, while your co-worker prepares a clean bag by folding down a cuff at the top of the clean bag and labeling the bag "contaminated." C. You remove the bag while your co-worker holds the door open for you. D. Your co-worker removes the bag and carries it outside while you begin to clean the contaminated area. B All health care workers, including CNAs should double-bag bags that contain contaminated body fluids. To do this, first remove the bag, close it, and carry it to the door, while your co-worker prepares a clean bag to contain the contaminated bag by folding down a cuff at the top of the clean bag and labeling the bag "contaminated." You then end the procedure by washing your hands.