CNA Final Exam
A patient is dissatisfied with the level of care she is receiving within a facility, saying that the nurses don't respond to her in a timely manner when she presses the call button. The patient's complaint, in regard to her care, is considered: A. A grievance B. An insult C. Defamation D. Slander
A
In American culture, when meeting someone for the first time, how close should you stand to the person? A. Approximately 4 feet from the person B. Approximately 12 feet from the person C. Approximately 1 foot from the person D. Approximately 2 feet from the person
A
During your shift, your charge nurse asks you to meet with her to give you feedback on some of the procedures you provided to patients at the center. During this meeting, you should: A. Take notes so you can learn from your mistakes B. Make sure the charge nurse understands that someone else was to blame C. Make sure that your union representative is present at the meeting D. Prepare a defense of the actions you took when providing care
A
What is the name for the intellectual disability caused by the presence of an extra chromosome? A. Down syndrome B. Autism C. Cerebral palsy D. Hypoxia
A
Which of the following is an example of a HIPAA violation? A. A speech therapist reads a patient's entire medical record. B. A CNA is asked by a patient's friend about the patient's condition. The CNA explains politely that she cannot share that information with the friend. C. A nurse assesses a patient's medical record only for the information she needs to prepare the patient for surgery. D. A doctor logs off of the computer immediately after updating a patient's medical record.
A
You are taking a female resident's height and weight. The woman is obese. She begins crying uncontrollably, "I'm so fat, I'm ugly!" A nursing assistant's best response would be? A. You say you feel ugly? B. You should start eating less. C. Right now you feel ugly, but you'll feel better if you lose weight. D. No, you're not ugly.
A
Which of the following is NOT part of postmortem care? A. Leave tubes and catheters in the body. B. Bathe soiled areas of the body with water and dry thoroughly. C. Gather the person's belongings and put them in a labeled bag. D. Put a clean gown on the body.
A A nursing assistance provides care for a patient's body after he dies. The nursing assistant should clean the person's room, clean the body, close the mouth and eyes, gather and label personal belongings (including valuables), brush and comb the person's hair if necessary, and fill out ID tags. As part of all of this, the nursing assistant must remove all tubes and catheters from the body. Many family members will want to say goodbye to the person and grieve by the bedside. Taking care of the body is an important first step in creating an environment where a family member can grieve. It is also a final act of respect for the person who has passed away.
Which of the following is NOT part of the nursing assistant's responsibilities for catheter care? A. Insert the catheter into the resident B. Empty the drainage bag and measure the output C. Keep the drainage tube below the bladder D. Follow standard precautions
A A nursing assistant is NOT allowed to insert a catheter into a patient. This is above the standard of care of a nursing assistant. When caring for a patient with a catheter, which is a small tube used to drain a resident's urine, the nursing assistant must follow standard precautions to prevent bloodborne pathogens. The nursing assistant must ensure that the drainage bag is below the bladder so that no urine flows back into the bladder. This can cause an infection. The nursing assistant is responsible for emptying the drainage bag and accurately recording the patient's output.
The nursing assistant places a lap belt around Mr. Glenn's waist in the wheelchair, even though the care plan does not require this measure to keep him from wandering. In this case, the nursing assistant can be charged with which of the following? A. False imprisonment B. Neglect C. Slander D. All of the above
A In this case, using a restraint of this kind (that restricts the resident's freedom of movement) is false imprisonment. This is a form of abuse. Slander is making false statements (orally) about a person. Neglect is the failure to provide the person with goods or services needed to avoid physical harm, mental anguish, or mental illness.
A fire breaks out in the facility. You are alone with a resident who is immobile and in immediate danger. What should you do? A. Place a blanket on the floor. Place the resident in the blanket, wrap it around the resident, and pull the person to a safe area. B. Leave the room, run down the hall, and find a co-worker to help you carry the resident to safety. C. Close the door and stay with the resident until help arrives. D. Run down the hall, find a lift and a co-worker who can help you, and go back to rescue the resident.
A Remember RACE (Rescue, Alarm, Confine, Extinguish). If a fire breaks out and an immobile resident is in immediate danger, you must rescue the resident. Place a blanket on the floor. Place the resident in it, wrap the blanket around the resident, and pull the person to a safe area. Remember, the resident is in immediate danger. Leaving the room to find a colleague and/or a lift will take precious time and put the resident in further danger. Closing the door of a room on fire will put you both in danger.
Which of the following is NOT one of the 5 "rights" of delegation? A. The right medication B. The right supervision C. The right person D. The right task
A The 5 rights of delegation are: The right task - can this task be delegated? The right circumstances - what are the patient's needs at this time? The right person - does the provider have the training and experience required to serve this patient? The right directions - are the directions/instructions clear? The right supervision - does the nurse give proper supervision and support? The right medication is not one of the 5 rights of delegation, in part because the nursing assistant may not give a resident medication.
What is the acronym that stands for the order "nothing by mouth"? A. NPO B. MDS C. BM D. I & O
A The acronym for nothing by mouth is NPO. MDS stands for minimum data set. I & O stands for intake and output forms. BM stands for bowel movement.
Which of the following is NOT a helpful strategy for managing stress? A. Drinking 5 glasses of wine each night. B. Planning personal time for yourself each week. C. Getting regular exercise 3 or more times per week. D. Getting 8 hours of sleep each night.
A The role of a nursing assistant can be stressful at times. It is important to learn to manage stress. Getting 8 hours of sleep each night, getting regular exercise 3 or more times a week, and planning personal time for yourself (reading, journaling, taking a walk, taking a bath, etc.) are all healthy ways to manage stress. Drinking 5 glasses of wine is defined as binge drinking. This is not a healthy way to manage stress.
A CNA is asked to help transfer a patient from the bed to a stretcher and then escort him to surgery using the stretcher. What should the CNA do to prevent the patient from falling from the stretcher? A. Place a safety belt or strap around the patient while using the stretcher. B. Move the bed to the low position before transferring the patient to the stretcher. C. Unlock the wheels of the stretcher while transferring the patient from the bed to the stretcher. D. All of the above
A To prevent the patient from falling from the stretcher, the bed should be raised, not lowered, to the height of the stretcher to make the transfer easier, and the wheels should be locked on both the bed and the stretcher. The CNA should place a safety belt/strap around the patient and raise the rails on the stretcher while escorting him to the operating room. This is a routine procedure when moving patients on a stretcher.
Which of the following is a good strategy for communicating with a resident who has dementia? A. Using simple words and short sentences B. Asking open-ended questions C. Correcting the person's errors D. Giving orders
A Using simple words and short sentences is a good strategy for communicating with a person who has dementia. It is also helpful to speak in a calm and quiet manner, use the person's name when speaking with the person, speak slowly, give the person time to respond, do not interrupt or rush the person, and use gestures and cues when speaking. You do not want to give orders, correct the person's errors, ask open-ended questions, use "baby talk", or give the person too many choices.
When offering restorative care to a severely disabled resident, which of the following should the nursing assistant do? A. Have a positive outlook and focus on what the person can do, rather than what the person cannot do. B. Pity the person and explain how badly you feel for her. C. Communicate with the healthcare team in public settings, even if it means violating the patient's confidentiality, because the person's care is important. D. All of the above
A When offering restorative care, it is really important to have a positive outlook and focus on what the person can do, rather than what the person cannot do. Do not pity the person. Rather, try to understand the person's condition, limitations, and challenges in order to provide excellent care. Do not violate patient confidentiality; instead, communicate with other healthcare providers in a private and professional manner. In short, offer the same professional and kind care that you offer to all residents with close attention to detail and a keen awareness of the person's healthcare needs.
Which of the following is NOT part of the handwashing process? A. Hold your hands above your elbows during handwashing. B. Wash hands for at least 20-30 seconds. C. Clean fingernails by rubbing your fingertips against your palms. D. Dry hands starting at your fingertips.
A You should NOT lift your hands above your elbows during the handwashing process. Your hands are dirtier than your forearms. If you do this, dirty water from your hands will spread down to your forearms and will contaminate this area. You must wash your hands for at least 20-30 seconds. Be sure to clean your fingernails by scrubbing your fingertips against your palms. Dry your hands with a clean, dry paper towel, starting at your fingertips and working your way up your forearms.
A resident ate an 8-ounce Italian ice and drank 6 ounces of orange juice this morning. What do you record as the resident's fluid intake on the I & O form? A. 420 mL B. 200 mL C. 48 mL D. 14 mL
A You would record 420mL on the I & O form. Italian ice is considered a fluid and therefore is added to the amount of orange juice the patient drank, which would equal 14 ounces total. This amount is then converted into mL, which is the unit of measurement used when recording intake and output. Multiply the total number of fluid ounces by 30, so 14oz x 30mL/oz = 420mL.
It is 3:00 AM and a resident, Ms. Lindley, asks for a cup of water. What should the nursing assistant do? A. Convert the cup of water to mL for the input sheet. B. Check the care plan. C. Get Ms. Lindley a cup of water. D. All of the above
B Some residents have restricted fluid intakes; for example, a resident who is having a surgical procedure the following day can have no food or fluids approximately 12 hours before the procedure. Thus, it is important to check the patient's care plan before giving a resident food or fluids.
All the following devices can be used to help clients use regular toileting facilities except: A. Grab bars B. Bedrails C. Mechanical lifts D. Slide boards
B Bedrails are guards along the side of the bed and prevent patients from getting out of bed. Bed rails could prevent clients from using regular toileting facilities. Slide boards are used to transfer residents to and from a bed, chair, toilet, or wheelchair. Grab bars are attached to the wall and residents can hold onto them while moving to the toilet. Mechanical lifts are used to transport patients who cannot move themselves or are too heavy to be transported by a staff member. They are used for transfers to and from toilets, beds, chairs, tubs, or vehicles.
Which of the following words or phrases best describes a professional nursing assistant? A. Works efficiently and alone B. Collaborative and helpful C. Does only what is required D. All of the above
B Providing excellent healthcare requires the work of many people cooperating on behalf of residents. A professional nursing assistant is collaborative and helpful, which means that this person works well with others and is willing to help out.
A client in long-term residential nursing care mentions that he is having a date this evening with his girlfriend and would like to be alone with her from 6-8 PM this evening. What should the nursing assistant do? A. Tell the resident, "There isn't going to be any foolishness, is there? Because I DO NOT want to deal with any of that." B. Honor the client's request and let the team know that he will need some privacy during this time period. C. Remind the resident that this is normally his bath time and he needs to bathe at 7:15 PM. D. Tell the nurse about his request so that she can put a stop to it.
B
As you are shaving Mr. King, you accidentally nick his neck. You should: A. Take Mr. King to the emergency room. B. Apply pressure to the cut and report it to the nurse. C. Only use electric razors from now on. D. Squeeze the skin and apply an antibiotic cream.
B
Mrs. Godfrey has moderate dementia. She is often confused and sometimes doesn't remember who you are. Which communication style could cause more frustration for her? A. Using gestures and pointing to objects. B. Correcting Mrs. Godfrey when she makes the wrong assumption. C. Holding Mrs. Godfrey's hand while you talk to her. D. Speaking slowly, using simple words and sentences.
B
Which of the following types of care should a nursing assistant NOT provide to a resident with diabetes? A. Checking skin for cuts and ulcers B. Clipping toenails C. Measuring blood glucose D. Monitoring food and fluid intake
B
Which of the following is NOT a step in securing and using a gait belt? A. Help the person to a sitting position. B. Ensure that the gait belt is very tight around the person's waist so that it does not come undone. C. Apply the gait belt around the person's waist and over clothing. D. Tuck any excess strap under the gait belt.
B A gait belt (or transfer belt) should be snug around the person's waist, but not so tight as to restrict breathing or circulation. A good rule of thumb is for the nursing assistant to be able to place two fingers comfortably under the gait belt to ensure that it is not too tight. When applying the gait belt, help the person to a sitting position, fasten the belt around the person's waist, tuck any excess strap under the gait belt so that it does not get tangled, and then help transfer the person.
Which of the following is true about intake? A. Foods that melt at room temperature (Jell-O, popsicles, ice, etc.) are not considered fluids B. An adult needs 2000-2500 mL of fluid daily for a normal fluid balance C. Fluid intake should not equal fluid output D. 1 fluid ounce equals approximately 60 mL
B An adult needs 2000-2500 mL of fluids each day for a normal fluid balance (depending on the person's activity level and the room temperature). A fluid ounce equals 30 mL. A person's fluid intake should equal the person's fluid output. If the intake is higher than the output, body tissues swell with water. This is called edema, which is the retention of excess fluid. If the output exceeds the input, dehydration occurs. Items that melt at room temperature are considered fluids.
Ms. May, who has mild Alzheimer's disease, has a nephew named Tom. Ms. May mentions that she is giving him her possessions because he is nice. She just gave him her wedding ring because he asked for it. You know that Ms. May loves her two children and is putting them in her will. You also know that her wedding ring has sentimental value. What should you do? A. Nothing. Wills and financial matters of this kind are private matters and are not your business. B. Check in with the nurse because you suspect financial exploitation in this case. C. Run down the hall to get Ms. May's wedding ring back. D. Call Ms. May's daughter Rita and tell her that Tom just took Ms. May's wedding ring.
B As you work with residents, you will get to know many of them quite well. There are times when friends or family members may try to take advantage of a resident financially. You must report any suspected abuse (including financial abuse or exploitation) to your supervisor immediately. You should not call Ms. May's daughter since this is not part of the reporting requirements. You should not chase Tom down the hall, as you do not know how this situation will play out. Since you have some suspicion of financial exploitation in this matter, you should not ignore the issue.
Which of the following is free from all bacteria and other living microorganisms? A. Clean bed linens just out of the laundry B. A sterilized scalpel C. A floor that was just washed with disinfectant D. Your clean uniform
B Sterile means free from all bacteria and other living microorganisms. In this case, only the sterilized scalpel is free of bacteria and other living microorganisms. A scalpel needs to be sterile because it is a tool used to perform surgical procedures. Always assume that your uniform is dirty and carries microorganisms. Although bed linens coming out of the laundry are clean, they are not sterile. Similarly, a floor recently washed with chemicals may be disinfected, but it is not sterile.
The definition of surgical asepsis is: A. The process of destroying pathogens. B. A work area free of all pathogens and non-pathogens. C. A microbe that is harmful and can cause infection. D. Practices used to remove or destroy pathogens, and to prevent their spread from one person or place to another.
B Surgical asepsis is a work area free of all pathogens and non-pathogenic microbes. For example, an operating room must be free of all pathogens and non-pathogens. Medical asepsis is the process used to remove or destroy pathogens, and to prevent their spread from one person or place to another. The process of destroying pathogens is called "disinfecting." A pathogen is a microbe that is harmful and can cause infection.
You are taking care of a Muslim resident, Mr. Abbas. He is celebrating Ramadan, which means that Muslims fast (no food or drink) from sunrise to sunset each day for a month. The facility is having an Ice Cream Social in the dining room. Mr. Abbas is in his room and asks about the music coming from the dining hall. What should you say? A. That is a party for people who want to eat and drink. B. The music is for the Ice Cream Social. I know that it is Ramadan and you are fasting, but would you like to come by anyway to socialize? C. That's for the Ice Cream Social, but I know that you are not interested because you are fasting now. D. Are you allowed to have food today? That's the music for the Ice Cream Social.
B The best response is: The music is for the Ice Cream Social. I know that it is Ramadan and you are fasting, but would you like to come by anyway to socialize? It is important to respect the religions and cultural practices of residents and respect and empower them as people at the same time. In this case, it is important to share that you know it is Ramadan and that Mr. Abbas is fasting, but you should also empower him and give him the choice to join in facility activities in whatever way he would like to participate.
Bluish skin, lips, mucous membranes, and nail beds, increased rate and depth of breathing, fatigue, disorientation, dizziness, confusion, and restlessness are signs and symptoms of which of the following? A. Bradypnea B. Hypoxia C. Tachypnea D. Cyanosis
B The bluish color of the skin, lips, and nail beds, increased rate and depth of breathing, fatigue, disorientation, dizziness, confusion, and restlessness are signs and symptoms of hypoxia, which means that cells are not getting enough oxygen. Hypoxia is life threatening. Report signs and symptoms of hypoxia at once. Cyanosis is the bluish color of the skin, lips, nail beds, and mucous membranes as a result of hypoxia. Tachypnea is the medical term for rapid breathing. This occurs when a resident's respiration rate is above 20 breaths per minute. Bradypnea is the medical term for slow breathing. This occurs when a resident's respiration rate falls below 12 breaths per minute.
Which of the following is a goal of rehabilitative or restorative care? A. Doing things for the resident so he does not have to do them for himself. B. Helping a resident become as independent as possible. C. Teaching a resident to use aids like crutches and walkers because he cannot walk without them. D. Ensuring that the resident becomes dependent on the support of assistive devices.
B The goal of rehabilitative or restorative care is to help the resident become as independent as possible. Healthcare providers will use many assistive devices (walkers, crutches, Velcro tabs for dressing, handwriting aids, graspers, etc.) but these are all in service of resident independence, NOT dependence. Healthcare providers should help residents become as independent as possible, even if that means that an activity for daily living - such as dressing, eating or bathing - takes longer to accomplish.
You are working with Mr. Darling. Over the course of the last two hours, he has had 8 oz. of hot tea, ½ of a 6 oz. cup of water, and ½ of a 12 oz. can of ginger ale. What should you record on Mr. Darling's I and O sheet? A. 780 mL B. 510 mL C. 90 mL D. 360 mL
B There are 30 mL in each fluid ounce. The nursing assistant should convert the hot tea, water, and ginger ale to mL and add all of these numbers together to get the total amount of fluid that Mr. Darling took in. 8 fluid ounces of hot tea x 30 mL per ounce = 240 mL 3 fluid ounces of water (½ of a 6 fluid ounce cup) x 30 mL per ounce = 90 mL 6 fluid ounces of ginger ale (½ of a 12 fluid ounce can) x 30 mL per ounce = 180 mL 240 mL + 90 mL + 180 mL = 510 mL of fluid
Which of the following is essential when providing perineal care? A. Wipe from back to front. B. Explain the procedure to the resident in language that she can understand. C. Make sure that the water temperature is 120 degrees Fahrenheit. D. All of the above
B When providing perineal care, be sure to explain the procedure to the resident in language that she can understand. Do not use clinical terms like "perineal;" rather, use language like "private parts." You want to wipe the person from front to back, NOT back to front. Wiping a resident from back to front can cause infections. The perineal area is extremely sensitive and a water temperature of 120 degrees Fahrenheit will scald the resident. The water temperature should be 105-109 degrees Fahrenheit.
Which of the following does NOT apply when transferring a resident to a stretcher? A. Raise the bed to the level of the stretcher. B. Have one staff member stand between the stretcher and the bed. C. Ask one or two staff members to help you. D. Lower the head of the bed to the flat position.
B When transferring a resident from a bed to a stretcher, you will need 2-4 staff members. You will also need to raise the bed to the height of the stretcher and lower the bed to a flat position. Staff members should stand on opposite sides of both the bed and the stretcher at the patient's head and feet (no one should stand between the bed and the stretcher, as this is the space where you are going to transfer the person). On the count of three, gently slide the person from the bed to the stretcher. Be sure that the person does not fall.
You are working with a new patient who only speaks Russian. You need to prep the patient for a physical exam. What should you do? A. Ask the family to translate as you prepare the patient for the physical exam. B. Call for the hospital's translation service and wait for a translator who speaks Russian. C. Ignore the order to prepare the patient for a physical exam. D. Use pictures to explain the procedure.
B When working with a patient who speaks another language, call for the translation service and wait before beginning any procedure. Do not depend on the family to translate for you, as sensitive information may need to be communicated. Do not use pictures or gestures to explain the procedure, as this may cause the patient to be confused or frustrated. Do not ignore an order for care.
A resident asks to see her medical chart. What should you do? A. Have the resident develop specific questions about her chart, so the nurse may look up and read her the answers to these questions B. take the resident to the nurses' station to see her chart C. inform the charge nurse of her request D. leave the chart in her room so she may review it at her leisure
C
Mr. Lancet is a resident with moderate Alzheimer's disease. He is singing the same phrase, "I need a beer, I want a beer, I must have a beer," over and over again. Mr. Lancet's repetition is beginning to bother other residents and their family members. What should the nursing assistant do? A. Lock Mr. Lancet in an empty room so he won't bother anyone. B. Ignore Mr. Lancet. C. Ask Mr. Lancet about his childhood in Texas. D. Argue with Mr. Lancet, remind him that he is not allowed to have beer, and tell him that he should stop talking.
C
Which of the following is true about hair care? A. lice cannot be transmitted through contact B. dandruff should be treated and removed by using tweezers C. rubbing oil on the strands can help loosen tangled hair D. the CNA decides how to style a residents' hair
C
A red wristband on a patient signifies that the patient: A. Has a DNR order B. Is at risk for falls C. Has an allergy D. None of the above
C A red wristband on a patient signifies that the patient has an allergy. A yellow wristband signifies a fall risk. A purple wristband signifies a DNR (or do not resuscitate) order.
Which of the following ONLY applies to airborne precautions? A. Gloves are used when entering the person's room. B. A mask is used when entering the person's room. C. An approved respirator is used when entering the patient's room. D. Hand hygiene is practiced before entering the person's room.
C Airborne precautions are used when a person is infected (or thought to be infected) with pathogens transmitted from person-to-person through the air, such as TB, measles, and SARS. The person must be placed in an airborne infection isolation room, and healthcare providers must use an approved respirator when entering the room.
All of the following are part of assisting a resident with the use of a bedpan EXCEPT: A. Report and record your observations. B. Raise the head of the bed so that the person is in a sitting position when it is time to use the bedpan. C. At the beginning of the procedure, place the person in the prone position. D. Note the color, amount, and character of the urine and/or feces in the bedpan.
C Bedpans are used for residents who cannot get out of bed to go to the bathroom. At the beginning of the procedure, place the person in the supine position (lying on her back) - NOT the prone position (lying on her stomach). Then, place the bedpan under her hips, raise the bed to a sitting position, and leave the room to provide for privacy. When the person is finished, provide perineal care, empty the contents of the bedpan into the toilet, note the color, character, and consistency of the urine and/or feces, and report and record all observations.
Which of the following is NOT part of the procedure for applying elastic stockings? A. Remove twists, crinkles, or creases from the stockings. B. Apply the stockings so that the opening in the toe area is over the top of the toes. C. Apply the elastic stockings when the resident's legs are dangling over the bed. D. Ensure that the stockings fit snugly.
C Elastic stockings are used to help promote blood flow in the legs of patients with poor blood flow, patients who have had surgery, or pregnant patients who are at risk of blood clots. Be sure to remove twists, wrinkles, or creases from the stockings, as these can affect circulation or lead to skin breakdown. Make sure that the opening of the stockings in the toe area is over the toes so that healthcare providers can check the circulation of the resident. Make sure that the stockings fit snugly to promote circulation. You do NOT want to apply elastic stockings when the person's legs are dangling over the bed. Instead, apply elastic stockings while the patient is lying down.
Bill is an 83-year-old resident who has had a stroke and has some paralysis on his left side. It takes Bill about 15 minutes to get dressed in the morning. His nursing assistant, Linda, has him do almost all of his own dressing, even though, if she helped him, Bill could get dressed in 5 minutes. Why doesn't she give more help to Bill? A. Linda is a lazy nursing assistant. B. Linda knows that the day is long and wants to fill it with activities. C. Linda is empowering Bill to do things for himself. D. Linda does not want to help Bill.
C In this case, Linda is empowering Bill to do as much for himself as possible, even if it takes longer than if Linda were to provide more assistance. Empowering residents to do as much for themselves as possible is a way to help them focus on their abilities and not their disabilities.
Which of the following best describes Sims' position? A. The resident lies on his back with a pillow under his head and pillows under each one of his arms. B. A resident sits up in bed with a pillow under her head and a pillow under each arm. C. The resident lies on his stomach with his right leg and arm bent with a pillow under each, while the left leg and arm are straight and facing down. A pillow is under the resident's head, and the head is turned to the side. D. The resident lies on her stomach with a pillow under her head. Her head is turned to the side and there is a pillow under her feet.
C The Sims' position is when the resident lies on his stomach with his right leg and arm bent with a pillow under each, while the left leg and arm are straight and facing down. A pillow is under the resident's head, and the head is turned to the side. A resident lying flat on his stomach is in the prone position. A resident lying on her back is in the supine position. A resident sitting up in bed is in Fowler's position.
You've taken the following vital signs for a group of elderly residents. Which of the following is considered an abnormal vital sign and should be reported to the nurse immediately? A. A temperature of 98.4 degrees Fahrenheit B. A respiratory rate of 16 C. An irregular apical pulse D. A blood pressure of 120/80
C The irregular pulse is the greatest concern and should be reported immediately. A regular resting pulse rate of an adult is 60-100 beats per minute. All of the other vital sign measurements are within the normal limits set for elderly patients. Normal blood pressure for an adult is defined as having a systolic pressure of below 120 mm Hg and a diastolic pressure of less than 80 mm Hg. An average adult temperature is 98.6 degrees Fahrenheit and the average respiration rate is 12-20.
Which of the following is within the nursing assistant's scope of practice? A. Diagnosing clinical depression in a patient B. Conducting speech therapy with a patient who has had a stroke C. Performing active-assistive ROM exercises with a patient D. Applying a prescription ointment to a patient's wound
C The scope of practice indicates what a healthcare provider legally can and cannot do. In this case, the nursing assistant may perform active-assistive ROM exercises with a patient. A nurse dispenses medication (even prescription ointments) and administers wound care. A doctor will diagnose depression. A speech therapist conducts speech therapy.
Which of the following would be an appropriate reason for a CNA to refuse a delegated task? A. The CNA does not want to help a certain patient. B. The CNA does not like the nurse who delegated the task. C. The CNA does not know how to use the equipment to perform the task. D. The CNA does not like to do the task.
C When a CNA accepts a task, he accepts responsibility for it. Therefore, the CNA has the right to refuse a task if: The task is outside of the legal limits of a nursing assistant. The task is not in the CNA's job description. The task could harm the person. The directions are neither clear, legal, nor ethical. The CNA does not know how to use the supplies or the equipment. The nurse is unavailable for supervision.
Which of the following is false? A. Decontaminate hands after removing gloves B. The exterior of gloves is contaminated C. Put on gloves first when you are donning other PPE D. Change gloves whenever moving from a contaminated body site to a clean body site
C When donning PPE, put your gloves on AFTER donning other PPE (gown, mask, face shield, etc.). The exterior of gloves is contaminated. Be sure to change gloves whenever moving from a contaminated body site to a clean body site. Be sure to practice hand hygiene after you remove gloves.
Which of the following is true about documentation? A. If one of your co-workers is busy, it is OK to document the care the co-worker gave so that it is recorded. B. If you make a mistake, erase the mistake and write the correct entry on the same line. C. You must sign and date all entries that you write. D. Documentation in a healthcare setting is not a legal document.
C You must sign and date all the entries that you write. Documentation in a healthcare setting is a legal document. Only document your observations and the care you give. Be sure to sign and date each entry. If you make a mistake, cross out the entry with one line (in black ink), note that this is an error and initial it. Then write the correct entry in the line below. It is important to accurately document the care you provide.
When is it NOT appropriate to use a lift? A. When the person is too heavy to transfer B. When a person has a dependence level of 4 C. When a person is paralyzed D. When you are working alone
D
Where can a nursing assistant work? A. Hospitals B. Nursing homes C. Rehabilitation facilities D. All of the above
D
Which of the following is NOT part of the procedure for using hand sanitizer? A. Once you apply hand sanitizer, rub your hands together. B. Continue rubbing your hands together until they are dry. C. Be sure to cover all the surfaces of your hands. D. Use hand sanitizer when your hands are visibly soiled.
D
Which of the following is a complication resulting from immobility? A. Nerve damage B. Tuberculosis C. Heart attack D. Contractures
D
Which of the following is proper advice for the safe handling of sharps? A. Recap a needle using both hands. B. Use a cardboard box when a sharps container is not available. C. Dispose of safety razors in the trash. D. Dispose of sharps in a sharps container immediately after use.
D
Which of the following is true about families with a loved one who has Alzheimer's disease that lives in residential nursing care? A. They do not care about the family member with Alzheimer's disease. B. All family members will need some kind of therapy to cope with their loved one's Alzheimer's disease. C. They are no longer an important part of the care team for the resident. D. Family members may have a variety of feelings, including anger, guilt, sadness, and hopelessness.
D
Which is NOT a way to develop a therapeutic relationship with a patient? A. Ask the patient about how she is feeling and her thoughts about her care. B. Encourage the patient when she makes even small improvements in her physical therapy. C. Provide assistive devices to help the patient groom herself. D. Flirt with the patient to make her feel attractive and feel good about herself.
D A therapeutic relationship differs from a social or intimate relationship. The goal of a therapeutic relationship is to help the patient achieve the best health possible by effectively communicating with the patient, providing assistance, and encouraging the patient to be as independent and hopeful as possible. Flirting is often associated with an intimate relationship and is not appropriate behavior with a patient - it could be considered sexual harassment.
Which of the following is true about ostomy care? A. An ostomy is a surgically-created opening for the elimination of body wastes. B. When changing an ostomy pouch, follow standard precautions. C. Observe the stoma and the skin around the stoma for signs of infection, and report bleeding, skin irritation, or skin breakdown to the nurse. D. All of the above
D All of the above are true. An ostomy is a surgically-created opening for the elimination of body wastes. This can be temporary or permanent depending on the patient's needs. Since the nursing assistant has the potential to come into contact with body fluids, she must follow standard precautions when caring for an ostomy pouch or ostomy site. It is important to closely monitor the ostomy site for signs of irritation, skin breakdown, or infection.
Which of the following is true regarding suicide? A. If a resident mentions or talks about suicide, take the resident seriously and call for the nurse at once. Do not leave the person alone. B. Among older people, white men over the age of 85 have the highest rates of suicide. C. A history of alcohol or drug abuse is a risk factor for suicide. D. All of the above
D All of the above are true. If a resident mentions suicide, take him seriously and call for a nurse immediately. White males over 85 have the highest rates of suicide. There are many risk factors for suicide, including: depression or other mental illness, a stressful life event, a prior suicide attempt, a family history of suicide, mental illness, drug/alcohol abuse, or family violence, among others.
Some residents with dementia or Alzheimer's may feel threatened by bathing. They may not know what is happening to them and might resist care or become combative. Which of the following is a good strategy for helping a resident with dementia bathe? A. Let the person help as much as possible. B. Play soft music to help the person relax. C. Schedule bathing during times in which the person is calm. D. All of the above
D Bathing a resident with dementia or Alzheimer's can be challenging. The person may not know what is going on and may act out due to this fear and anxiety. To reduce fear, anxiety, and uncertainty: explain what you are going to do, play soft music, schedule bath time during the person's calm periods, have the person help as much as possible, keep the room warm and ensure that the bath water is not too hot or too cold, be calm, distract the person if necessary, and be gentle.
What is dysphagia? A. A communication disorder that results from damage to the brain B. The process of inserting an artificial airway C. The stiffness or rigidity of skeletal muscles that occurs after death D. Difficulty or discomfort in swallowing as a symptom of disease
D Dysphagia is difficulty or discomfort in swallowing as a symptom of disease. Patients with dysphagia need a special diet. Their food should either be thickened, medium thick, extra thick, yogurt-like, or pureed to prevent choking or aspiration. Aphasia is a communication disorder that results from damage to the brain. Rigor Mortis is the stiffness or rigidity of skeletal muscles that occurs after death. Intubation is the process of inserting an artificial airway.
Holly Smith is a 79-year-old resident with Alzheimer's disease (AD). Her AD has been getting worse, and her grown son, William, doesn't like that all of the doors to the facility where Holly lives are locked. He accuses the CNA of "imprisoning" his mother and demands an explanation. What should the CNA say? A. The nursing assistant should say nothing. It is not her responsibility to talk to family members. B. "Mr. Smith, for heaven's sake, we're taking care of your mother, not imprisoning her!" C. "Don't get angry with me! Your mom's Alzheimer's is progressing and it is getting much worse." D. "Mr. Smith, I hear that you are upset. I cannot comment on your mother's care. Would you like to speak with the nurse?"
D Having loved ones with dementia or Alzheimer's disease can be very difficult for family members. If a family member is upset, do not get angry, frustrated, or defensive, and do not comment on the patient's condition. Instead, acknowledge the family member's concern and direct the person to the nurse to speak further about the patient.
Intravenous therapy is used for which of the following: A. To give drugs or blood B. To provide nutrition C. To prevent dehydration D. All of the above
D Intravenous therapy is used to prevent dehydration by providing fluids when these cannot be taken by mouth, to provide sugar for energy (nutrition), or to give drugs or blood to a patient. Doctors order IV therapy, nurses are responsible for setting up and administering IV therapy, and nursing assistants are responsible for monitoring the site of an IV.
The definition of medical asepsis is: A. Being free of all microorganisms B. A urinary infection C. Having difficulty breathing D. Being free of disease-causing germs
D Medical asepsis aims to remove or destroy pathogens (disease-causing germs) to prevent reinfection or the spread of infection to other people or places. Surgical asepsis is aimed at all microbes —pathogenic and non-pathogenic—as microbes cannot be present during surgery. The foundation of medical asepsis is handwashing. Other measures include following standard precautions, cleaning, and disinfection. To achieve surgical asepsis, objects must be sterilized using boiling water, radiation, liquid or gas chemicals, dry heat, or steam under pressure. A urinary infection is one type of infection that can be caused by germs. Dyspnea describes a patient who is having difficulty breathing.
Which of the following is true about all older people? A. Older people lose their mental functions as they age. B. Older people are ill and disabled. C. Older people lose interest in sex. D. Older people have decreased bone mass.
D Older people have decreased bone mass. As people age, they gradually lose bone mass and bones become weaker and more brittle. This means that older people are more at risk for fractures. Many older people enjoy sex and have active sex lives. Although older people may process information more slowly than younger people, many older people have excellent mental functions. Though older people are at a greater risk for health problems and disability, most older people are healthy.
Which of the following is a risk of using restraints? A. Falls B. Injury C. Legal action D. All of the above
D Restraints are dangerous and many facilities are working to become restraint-free. The dangers of restraints include: legal action by the resident or the resident's family members, injury (or even death), falls, and the loss of respect and/or trust of patients.
Which of the following are signs of infection? A. Confusion B. Vomiting C. Rapid heart rate D. All of the above
D There are many signs and symptoms of infection, including: confusion, rapid heart rate, vomiting, chills, fever, increased respiratory rate, loss of appetite, fatigue, diarrhea, rash, redness, swelling, discharge from the wound, heat in the affected area, muscle aches, headache, and joint pain.
Which of the following is the nursing assistant responsible for when a resident is on oxygen therapy? A. Setting the flow rate. B. Ordering oxygen therapy. C. Turning on the oxygen. D. Ensuring that there are no kinks in the tubing.
D When caring for a resident who is on oxygen therapy, the nursing assistant should check the tubes to make sure that there are no kinks in the tubing. Additionally, the nursing assistant should maintain an adequate water level in the humidifier (if used), make sure the oxygen apparatus is clean and free of mucus, monitor the resident and report any changes in his condition at once, and check for signs of skin irritation from the device. The doctor orders oxygen therapy. The nurse turns on the oxygen and sets the flow rate.
Which of the following is NOT part of changing bed linens? A. Assume that your uniform is dirty. B. Never shake linens. C. Roll dirty linens away from you. D. Bring extra linens into the room with you.
D You should NOT bring extra linens into the room with you, as these are considered dirty once they enter a resident's room and must then be washed again. Assume that your uniform is dirty and hold linens away from your uniform. Never shake linens, as this can spread pathogens throughout the room. When removing soiled bed linens, be sure to roll dirty linens away from you, one linen at a time.