Nursing Assistant Exam

hand hygiene

-address client by name and introduce self to client by name -turns on water at skin -wets hands and wrists thoroughly -applies soap to hands *-lathers all surfaces of wrists, hands, and finders producing friction, for at least 20 seconds, keeping hands lower than the elbows and the fingertips down -cleans fingernails by rubbing fingertips against palms of the opposite hand *-rinse all surfaces of wrists, hands, and fingers, keeping hands lower than the elbows and the fingertips down -uses clean, dry paper towels to dry all surfaces of fingers, hands, and wrists starting at fingertips then disposes of paper towel into waste container -uses clean, dry paper towel to turn off faucet then disposes of paper towel into waste container or uses knee/foot to turn off faucet -does not touch inside of skin at any time

feeds client who cannot feed self

-explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible -before feeding, looks at name card on tray and asks client to state name *-before feeding client, client is in an upright sitting position (75-90 deg) -place tray where the food can be easily seen by client -candidate cleans client's hands before beginning feeding -candidate sits in a chair facing client during feeding -tells client what foods and beverages are on tray -asks client what he/she would like to eat first -using spoon, offers client one bite of each type of food on tray, telling client the content of each spoonful -offers beverage at least once during meal -candidate asks client if they are ready for next bite of food or sip of beverage -at end of meal, candidate cleans client's mouth and hands -removes food tray -leaves client in upright sitting position (75-90 deg) with signaling device within client's reach -after completing skill, washes hands

measures and records weight of ambulatory client

-explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible -client has non-skid shoes on before walking to scale -before client steps on scale, candidate sets scale to 0 -asks client to step on center of scale and obtains client's weight -asks client to step off scale -before recording, washes hands *-records weight based on indicator of scale. weight is within +/- 2 lbs

counts and records respirations

-explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible -counts respirations for 1 full min -signaling device is within reach -before recording, washes hands *-records respiration rate within +/- 2 breaths

counts and records radial pulse

-explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible -places fingertips on thumb side of client's wrist to locate radial pulse -counts beats for 1 full min -signaling device is within reach -before recording, washes hands *-records pulse rate within +/- 4 bpm

dresses client with affected (weak) right arm

-explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible -privacy is provided with a curtain, screen, or door -asks which shirt he/she would like to wear and dresses him/her in shirt of choice -avoids overexposure of client by ensuring client's chest is covered -removes gown from the left (unaffected) side first, then removes gown from the right (affected/weak) side -before dressing client, dispose of gown into soiled linen container *-assists to put the right (affected/weak) arm through the right sleeve of the shirt before placing garment on the left (unaffected) arm -while putting on the shirt, moves body gently and naturally, avoiding force and over-extension of limbs and joints -finishes with clothing in place -signaling device is within reach and bed is low position -after completing skill, washes hands

assists with use of bedpan

-explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible -privacy is provided with a curtain, screen, or door -before placing bedpan, lowers HOB -puts on clean gloves before placing bedpan under client -places bedpan correctly under client's buttocks -removes and disposes of gloves (without contaminating self) into waste container and washes hands -after positioning client on bedpan and removing gloves, raises HOB -toilet tissue is in reach -hand wipe is within reach and client is instructed to clean hands with hand wipe when finished -signaling device is within reach and client is asked to signal when finished -puts on clean gloves before removing bedpan -HOB is lowered before bedpan is removed -ensures client is covered except when placing and removing bedpan -empties and rinses bedpan and pours rinse into toilet -places bedpan in designated dirty supply area -removes and disposes of gloves (without contaminating self) into waste container and washes hands -signaling device is within reach and bed is low position

assists to ambulate using transfer belt

-explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible -privacy is provided with a curtain, screen, or door *-before assisting to stand, client is wearing non-skid shoes/footwear -before assisting to stand, bed is at a safe level -before assisting to stand, checks and/or locks bed wheels *-before assisting to stand, client is assisted to sitting position with feet flat on the floor -before assisting to stand, applies transfer belt securely at the waist over clothing -before assisting to stand, provides instructions to enable client to assist in standing including prearranged signal to alert client to begin standing -stands facing client positioning self to ensure safety of candidate and client during transfer. counts to three to alert client to begin standing -on signal, gradually assists client to stand by grasping transfer belt on both sides with an upward grasp maintaining stability of client's legs by standing knee to knee, or toe to toe with client -walks slightly behind and to one side of the client for a distance of 10 ft, while holding the belt -assists client to bed and removes transfer belt -signaling device is within reach and bed is low position -after skill, wash hands

The nurse aide is preparing to bathe a client. What should the nurse aide do FIRST? (A) Test the temperature of the water (B) Help the client undress (C) Tell the client what the nurse aide is going to do (D) Close the door and windows

(C) Tell the client what the nurse aide is going to do

A client wakes up during the night and asks for something to eat. The nurse aide SHOULD: (A) check client's diet before offering nourishment. (B) tell the client nothing is available at night. (C) explain that breakfast is coming in 3 hours. (D) tell the client that eating is not allowed during the night.

(C) explain that breakfast is coming in 3 hours.

when ambulating the client, the nurse aide should -ask the nurse for help -be sure the client is wearing non-skid footwear -ask a family member for assistance -walk in front of the client and show the client the way

be sure the client is wearing non-skid footwear

articles contaminated with blood or body fluids should be disposed of in the -soiled linen basket -biohazard container -soiled utility room -client's room trash container

biohazard container

when collecting a 24-hr urine sample for a client, the nurse aide should request that the client -take a bath or shower before starting the urine collection -select food items that do not contain red meat -drink 2 L of water -discard the first voided urine

discard the first voided urine

the only purpose for using a restraint is to -ensure the safety of the client or others -make the nurse aide's job easier -calm a client who is verbally abusive -help the client be quiet

ensure the safety of the client or others

which of the following is the best PPE item for the nurse aide to wear when handling infectious waste that could splash or spray -shoe covers -a mask -goggles -face shield

face shield

how should the nurse aide communicate with a client who has hearing loss? -face the client when speaking -repeat the statement -shout so that the patient can hear -use a high-pitched voice

face the client when speaking

the nurse aide has raised the height of the client's bed to provide care to the client, but the nurse aide forgot to bring the supplies needed. what should the nurse aide do next -instruct the client to lie still -quickly go to get the supplies -lower the bed, and place the call light within reach -ask the roommate to watch the client while the nurse aide gets the supplies

lower the bed, and place the call light within reach

a client requests that the nurse aide call the client's spiritual advisor. the nurse aide should -ask the client why the client wants the nurse aide to call the client's spiritual advisor -tell the client that this is not part of the nurse aide's job -tell the client that the nurse aide will inform the nurse of the client's request -call the spiritual advisor for the client

tell the client that the nurse aide will inform the nurse of the client's request

to avoid pulling the indwelling catheter when turning a client, the catheter tubing should be secured to the client's -bed sheet -upper thigh -bed frame -hip

upper thigh

the client's call light should always be placed: -on the bed -within the client's reach -on the client's right side -over the side rail

within the client's reach

which of the following would be an appropriate response for the nurse aide to make if a client expresses anger during care -why are you being so mean today -you should not say such mean things to people -i will come back when your bad mood is over -you seem upset. would you like to talk about it

you seem upset. would you like to talk about it

when getting read to make a bed, the nurse aide should place the clean linens on -a chair or table beside the bed -the roommate's bed -a clean surface in the bathroom -the floor beside the bed

a chair or table beside the bed

what does the abbreviation ABL mean? -ad Lib - as doctor likes -activities of daily living -after daylight

activities of daily living

which of the following items is used in the prevention and treatment of bedsores or pressure ulcers? -rubber sheet -air mattress -emesis basin -restraint

air mattress

when caring for a dying client, the nurse aide should -keep the client's room dark and quiet: -allow the client to express his feelings -change the subject if the client talks about death -contact the client's minister, priest, or rabbi

allow the client to express his feelings

after giving a client a back rub, the nurse aide should always note: -the last time the client had a back rub -any changes in the client's skin -client's weight -amount of lotion used

any changes in the client's skin

applies one knee-high elastic stocking

-explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible -privacy is provided with a curtain, screen, or door -client is in supine position (lying down in bed) while stocking is applied -turns stocking inside out, at least to the heel -places foot of stocking over toes, foot, and heel -pulls top of stocking over foot, heel, and leg -moves foot and leg gently and naturally, avoiding force and over-extension of limb and joints *-finishes procedure with no twists or wrinkles and heel of stocking, if present, is over heel and opening in toe area is either over or under toes (if mannequin, may state that it should be wrinkle-free) -signaling device is within reach and bed is in low position -after completing skill, wash hands

transfers from bed to wheelchair using transfer belt

-explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible -privacy provided with a curtain, screen, or door -before assisting to stand, wheelchair is positioned alongside bed, at HOB facing foot or foot of bed facing head -before assisting to stand, footrests are folded up or removed *-before assisting to stand, locks wheels on wheelchair -before assisting to stand, bed is at a safe level -before assisting to stand, check and/or locks bed wheels *-before assisting to stand, client is assisted to a sitting position with feet flat on the floor -before assisting to stand, client is wearing shoes -before assisting to stand, applies transfer belt securely at the waist over clothing -before assisting to stand, provides instructions to enable client to assist in transfer including prearranged signal to alert when to being standing -stand facing client positioning self to ensure safety of candidate and client during transfer. counts to 3 to alert client to begin standing -on signal, gradually assists client to stand by grasping transfer belt on both sides with an upward grasp and maintaining stability of client's legs by standing knee to knee, or toe to toe with the client -assists client to turn to stand in front of wheelchair with back of client's legs against wheelchair -lowers client into wheelchair -positions client with hips touching back of wheelchair and transfer belt is removed -positions feet on footrests -signaling device is within reach -after completing skill, washes hands

provides mouth care

-explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible -privacy provided with a curtain, screen, or door -before providing mouth care, client is in upright sitting position (75-90 deg) -puts on clean gloves before cleaning mouth -places cloth across chest before providing mouth care -secures cup of water and moistens toothbrush -before cleaning mouth, applies toothpaste to moistened toothbrush *-cleans mouth (including tounge and all surfaces of teeth), using gentle emotions -maintains clean technique with placement of toothbrush -candidate holds emesis basin to chin while client rinses mouth -candidate wipes mouth and removes clothing protector -disposes of used linen into soiled linen container -rinses toothbrush and empties, rinses, and dries basin -removes and disposes of gloves (without contaminating self) into waste container and washes hands -signaling device is within reach and bed is in low position

positioning on side

-explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible -privacy provided with a curtain, screen, or door -before turning, lowers HOB -raises side rail on side to which body will be turned -candidate assists client to slowly roll onto side toward raised side rail -places or adjusts pillow under head for support -candidate repositions arm and shoulder so that client is not lying on arm -supports top arm with supportive device -places supportive device behind client's back -places supportive device between legs with top knee flexed; knee and ankle supported -signaling device is within reach and bed is in low position -after completing skill, washes hands

provides perineal care for female

-explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible -privacy provided with a curtain, screen, or door -before washing, check water temperature for safety and comfort and asks client to verify comfort of water -puts on clean gloves before washing perineal area -places pad/linen protector under perineal area including buttocks before washing -exposes perineal area (only exposing between hips and knees) -applies soap to wet washcloth *-washes genital area, moving front to back, while using a clean area of the washcloth for each stroke *-using clean washcloth, rinses soap from genital area, moving from front to back, while using a clean area of the washcloth for each stroke -dries genital area moving front to back with dry cloth -after washing genital area, turns to side, then washes rectal area moving from front to back using a clean area of the washcloth for each stroke -using a clean washcloth, rinses soap from rectal area, moving from front to back, while using a clean area of the washcloth for each stroke -dries rectal area moving from front to back with dry cloth -repositions client -empties, rinses, and dries basin -places basin in designated dirty supply area -disposes of used linen into soiled linen container and disposes of linen protector appropriately -avoids contact between candidate clothing and used linen -removes and disposes of gloves (without contaminating self) into waste container and washes hands -signaling device is within reach and bed is in low position

provides catheter care for female

-explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible -privacy provided with a curtain, screen, or door -before washing, checks water temperature for safety and comfort and asks client to verify comfort of water -puts on clean gloves before washing -places linen protector under perineal area including buttocks before washing -exposes area surrounding catheter (only exposing client between hip and knee) -applies soap to wet washcloth *-while holding catheter at meatus without tugging, cleans at least 4 in of catheter from meatus, moving in only one direction, away from meatus using a clean area of the washcloth for each stroke *-while holding catheter at meatus without tugging, using a clean washcloth, rinses at least 4 in of catheter from meatus, move only in the direction away from meatus, using a clean area of the washcloth for each stroke -while holding catheter at meatus without tugging, fries at least 4 in of catheter moving away from meatus using a dry cloth -empties, rinses, and dries basin -places basin in designated dirty supply area -disposes of used linen into soiled linen container and disposes of linen protector appropriately -avoids contact between candidate clothing and used linen -removes and disposes of gloves (without contaminating self) into waste container and washes hands -signaling devices is within reach and bed is in low position

provides foot care on the foot

-explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible -privacy provided with a curtain, screen, or door -before washing, checks water temperature for safety and comfort and asks client to verify comfort of water -basin is in a comfortable position for client and on protective barrier -puts on clean gloves before washing foot -client's barefoot is placed into the water -applies soap to wet washcloth -lifts foot from water and washes food (including between toes) -foot is rinsed (including between toes) -dries foot (including between toes) with dry cloth -applies lotion to top and bottom of foot (excluding between the toes) removing excess with a towel -supports foot and ankle during procedure -empties, rinses, and dries basin -places basin in designated dirty supply area -disposes of used linen into soiled linen container -removes and disposes of gloves (without contaminating self) into waste container and washes hands -signaling device is within reach

preforms modified passive ROM for one knee and one ankle

-explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible -privacy provided with a curtain, screen, or door -ensures that client is supine in bed and instructs client to inform candidate if pain is experienced during exercise *-while supporting the leg at knee and ankle, bends the knee and then returns leg to client's normal position (at least 3x). moves joints gently, slowly, and smoothly through the ROM, discontinuing exercise if client verbalizes pain *-while supporting the foot and ankle close to the bed, pushes/pulls foot toward head, and pushes/pulls foot down, toes point down (at least 3x). moves joints gently, slowly and smoothly through the ROM discontinuing exercise if client verbalizes pain -signaling device is within reach and bed is in low position -after completing skill, washes hands

preforms modified passive ROM for one shoulder

-explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible -privacy provided with a curtain, screen, or door -instructs client to inform candidate if pain experienced during exercise *-while supporting arm at elbow and at the wrist, raises client's straightened arm from side position down to side of body (at least 3x). moves joint gently, slowly, and smoothly through the ROM, discontinuing exercise if client verbalizes pain) *-while supporting arm at the elbow and the wrist, moves client's straightened arm away from the side of the body to shoulder level and returns to side of body (at least 3x). moves joint gently, slowly, and smoothly through the ROM, discontinuing exercise if client verbalizing pain -signaling device is within reach and bed is in low position -after completing skill, washes hands

gives modified bed bath (face and one arm, hand, and underarm)

-explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible -privacy provided with a curtain, screen, or door -removes gown and places directly in soiled linen container while ensuring client's chest and lower body is covered -before washing, checks water temperature for safety and comfort and asks client to verify comfort of water -puts on clean gloves before washing client *-beginning with eyes, washes eyes with met washcloth (no soap), using a different area of the washcloth for each stroke, washing the inner aspect to outer aspect then proceeds to wash face -dries face with dry cloth towel/washcloth -exposes one arm and places cloth towel -applies soap to wet washcloth -washes finger (including nails), hand, arm, and underarm keeping the rest of the body covered -rinses and dries fingers, hand, arm, and underarm -moves body gently and naturally, avoiding force and over-extension of limbs and joints -puts clean gown on client -empties, rinses, and dries basin -places basin in designated dirty supply area -disposes of linen into soiled linen container -avoids contact between candidate clothing and used linen -removes and disposes of gloves (without contaminating self) into waste container and washes hands -signaling device is within reach and bed is in low position

donning and removing PPE (gown and gloves)

-picks up gown and unfolds -facing the back opening of the gown places arms through each sleeve -fastens neck opening -secures gown at waist making sure that back of clothing is covered by gown -puts on gloves -cuffs of gloves overlap cuffs of gown *-before removing gown, with one gloved hand, grasps the other glove at the palm, remove glove *-slips fingers from ungloved hand underneath cuff of remaining glove at wrist, and removes glove turning it inside out as it is removed -dispose of gloves into designated waste container without contaminating self -after removing gloves, unfastens gown at waist and neck -while removing gloves, removes gown without touching outside of gown -while removing gown, holds gown away from body without touching the floor, turns gown inward and keeps it inside out -after completing skill, washes hands

cleans upper or lower denture

-puts on clean gloves before handling denture -bottom of sink is lined and/or sink is partially filled with water before denture is held over sink -rinses denture in moderate temperature running water before brushing them -applies denture toothpaste to toothbrush -brushes all surfaces of denture -rinses all surfaces of denture under moderate temperature running water -rinses denture cup and lid -places denture cup with moderate temperature water/solution and places lid on cup -rinses toothbrush and places in designated toothbrush basin/container -maintains clean technique with placement of toothbrush and denture -skin liner is removed and disposed of appropriately and/or sink is drained -removes and disposes of gloves (without contaminating self) into waste container and washes hands

measures and records urinary output

-puts on clean loves before handling bedpan -pours the contents of the bedpan into measuring container without spilling or splashing urine outside of container -rinses bedpan and pours rise into toilet -measures the amount of urine at eye level with container on flat surface (if between lines, round up to nearest 25 mL/cc) -after measuring urine, empties contents of measuring container into toilet -rinses measuring container and pours rinse into toilet -before recording output, removes gloves and disposes of gloves (without contaminating self) into waste container and washes hands *-records contents of container within +/- 25 mL/cc