CNA - Basic Nursing Skills (Unit 2)
Your patient is in contact precautions. What does this mean?
Contact precautions signal that a patient has an infection that can be transmitted through touch. It is necessary to wear a gown, gloves, and sometimes a mask when caring for these patients, as their infection could be transmitted to you or others.
Rose Position
In Rose's position the head is over the end of a table.
All of the following might be used in dealing with contractures EXCEPT: Physical therapy. Repositioning. Hand Roll. Bandaging.
The correct answer is: Bandaging. Correct Explanation: Contractures involve the degeneration and stiffening of joints. Bandaging is not used as a method of prevention and treatment. The other options are all possible ways of preventing contractures from happening or loosening joints after contraction has occurred.
A nursing assistant is instructed to take the oral temperature of a patient who just had a cold drink. When should the patient's temperature be taken? 3-5 minutes 10-20 minutes after the drink was finished Immediately. A cold drink should not affect the reading of most oral thermometers. 20-30 minutes
The correct answer is: 10-20 minutes after the drink was finished Explanation: 10-20 minutes should be enough time for the oral cavity to return to a more accurate body temperature.
How far should an enema be inserted into the anus?
The correct answer is: 2-4 inches Explanation: If you feel resistance or if the patient complains of pain, stop inserting the enema and report the incident to the nurse.
Applying friction in the hand washing process is very important. According to CDC recommendations, how long should the scrubbing portion of hand washing take? 10 seconds 20 seconds 60 seconds There is not a set time recommended; scrub until hands feel clean.
The correct answer is: 20 seconds Explanation: 20 seconds is the suggested recommendation for proper friction. To make sure you are scrubbing for the correct amount of time, it is often suggested you sing or hum "Happy Birthday" to yourself twice while washing.
A resident drinks 8 ounces of milk during lunch, but the standard measurement of documentation in the facility is cubic centimeters (cc). What value would the nursing assistant record? 120 cc 360 cc 8 cc 240 cc
The correct answer is: 240 cc Explanation: There are approximately 30 cc in every ounce, so 8 ounces is equal to approximately 240 cc of fluid.
What is the normal pulse rate in the average adult?
The correct answer is: 60-100 beats per minute Explanation: The average adult should have a pulse rate of 60 beats to 100 beats per minute.
A CNA is recording the 24-hour urine output of a patient with kidney issues. What 24-hour urine value would warrant a report to the nurse? 800 cc 600 cc 1900 cc 1400 cc
The correct answer is: 600 cc Explanation: The normal 24-hour urine output for a patient should between 800 and 2000 cc a day. 600 cc of urine in 24 hours could indicate a complication and should be reported.
The normal pulse rate for an adult is 60-100 beats per minute. The normal pulse rate for children is: 60-100 beats per minute. 70-120 beats per minute. 40-60 beats per minute. 55-105 beats per minute.
The correct answer is: 70-120 beats per minute. Explanation: A range of 70-120 is normal for young children. Babies up to 1 year old can have even higher pulse rates. The other options could apply to adults or conditioned athletes so are incorrect for children.
A resident is supposed to have 240 milliliters of juice every 2 hours. Which one of these choices would be the most convenient to meet this requirement? 5 oz. can of juice. 4 oz. can of juice. 12 oz. can of juice. 8 oz. can of juice.
The correct answer is: 8 oz. can of juice. Explanation: There is approximately 30 milliliters for every ounce so an 8 oz. can of juice is the exact requirement. The other options could be used but are not the most convenient.
When muscle tissues shorten and then a joint becomes hard to move it is called: A perforation. A twitch. A rupture. A contracture.
The correct answer is: A contracture. Explanation: Contracture is the shortening of muscle tissue making stretching difficult. A rupture is when something bursts open. A twitch is a sudden, jerking movement. A perforation is an opening.
What is the medical term for a device with two soft plastic prongs that attach to a plastic tube delivering oxygen? A nasal antihistamine. A nasal cannula. An oxygen diffuser. A nasal shunt.
The correct answer is: A nasal cannula. Explanation: A nasal cannula is the device that goes into the nose and helps deliver oxygen. The other options are all incorrect.
Convulsions are associated with: A spasm. A tear. A seizure. A sprain.
The correct answer is: A seizure. Explanation: Convulsion is a term often used interchangeably with seizures. The other options are all incorrect.
Which of the following is NOT a signal for notifying the charge nurse regarding a resident's ostomy bag: A sudden increase in the amount of stool in the pouch. Skin around the stoma is bulging. A temperature of 98.8. Pus draining out of a stoma.
The correct answer is: A temperature of 98.8. Explanation: A temperature of 98.8 is considered within a normal range. Pus or bulging around the stoma or a sudden increase in stool should all be reported to the charge nurse immediately.
Transmission-based precautions are: Part of the standard-based precautions for all residents. Added to standard-based precautions when a resident is known or suspected of having a communicable disease. Only used during times when an epidemic is declared. Not as stringent as other precautions.
The correct answer is: Added to standard-based precautions when a resident is known or suspected of having a communicable disease. Explanation: When a resident is suspected or confirmed of having a disease that can be transmitted to others, transmission-based precautions are added to standard-based precautions and are designed to interrupt the spread of disease. The other options are not true as transmission-based precautions are not applicable for all residents, can be more stringent than other precautions and are used more than just during an epidemic.
Which of the following is incorrect in reference to wearing gloves? Upon removal, avoid letting the outer layer of the gloves contact your skin. Peel the glove away from you so it comes off inside out. Wash your hands before putting on, and after removing, gloves. Always wear latex gloves because they are the most impermeable option.
The correct answer is: Always wear latex gloves because they are the most impermeable option. Explanation: Latex gloves may not necessarily be the best choice because of latex allergies. The other options are all necessary precautions that should be used.
A resident is ill with the following symptoms: Fever, swelling, redness and chills. The resident most likely has: An allergy. Arthritis. An infection. Food poisoning.
The correct answer is: An infection. Explanation: Given all of these symptoms combined, infection is the correct answer. The swelling and redness coupled with the fever indicate a local infection. The other options do not commonly have all of these symptoms combined.
Which of the following is a false statement about condom catheters? Are more effectively used if pubic hair is removed around the area. Are a treatment used to avoid urine infections. Are internal catheters and not as effective as external catheters. Should be changed frequently.
The correct answer is: Are internal catheters and not as effective as external catheters. Explanation: Condom Catheters are external catheters and often described as more convenient than internal catheters. All of the other options are facts about their use.
Which of the following is the best advice if you are uncertain you are able to move an obese patient on your own when it is time for their scheduled re-positioning? Ask another nursing aide to help. Ask the family members to assist you. Try to move the client alone. Give the patient something sturdy to grab onto and encourage him move to himself
The correct answer is: Ask another nursing aide to help. Explanation: Always ask another nursing aide to help if a resident is too heavy and you are not sure if you can manage on your own. You do not want to risk injury to the patient or yourself. The same applies to family members. The patient is not able to move himself/herself, so this option is not appropriate in this scenario.
Which of the following examples demonstrates using proper body mechanics when helping to lift a resident in bed? Bending at the waist, knees unlocked, using back muscles to lift. Bending at the waist, knees locked, using arm muscles to lift. Bending at the waist, knees unlocked, using arm muscles to lift. Bending at the waist, knees partially flexed, using leg muscles to lift.
The correct answer is: Bending at the waist, knees partially flexed, using leg muscles to lift. Explanation: Keeping knees flexed and using leg muscles to lift are the best options to avoid injury. The other options are not using body mechanics and increase the likelihood for injury.
A nursing assistant may help in alleviating the use of restraints on a resident using all of the following suggestions, EXCEPT: Becoming aware of the triggers that make a resident agitated. Learning what activities calm a resident down. Redirect or distract a resident. Bringing out a restraint so the resident is reminded they will be used if the behavior continues.
The correct answer is: Bringing out a restraint so the resident is reminded they will be used if the behavior continues. Explanation: Threatening the use of restraints makes it a punishment and is not the appropriate action. Restraints are only used when a physician has prescribed them and is not determined by a nursing assistant. The other options can be used to help diffuse the use of restraints and may or may not work depending on the situation.
Which of the following treatments would be best to decrease swelling? Dry bandage pressure. Moist bandages. Heat compression. Cold compression.
The correct answer is: Cold compression Explanation: Cold packs are applied to reduce swelling. Heat compressions are common treatments for back pain. Dry bandage pressure is used to stop bleeding. Moist bandages are used on burns.
What is the standard unit of measurement to record fluid intake and output?
The correct answer is: Cubic centimeters (cc) or milliliters (ml) Explanation: Although cc and ml are equal units of measurement, always use the value that is preferred by your facility.
Which medical term is often used for, "Burping, belching and passing gas"? Flatus. Flank. Fascia. Familial.
The correct answer is: Flatus. Explanation: The medical term for intestinal gas is Flatus. Familial is a condition more common in certain families than the general population. Fascia is the medical term for a tissue lining under the skin. Flank is used for a side of the back.
Which medical position can be described as, "The patient's head is elevated with legs either bent or straight." Trendelenburg position. Rose's position. Sims' position. Fowler's position.
The correct answer is: Fowler's position. Explanation: In Fowler's position the head is elevated. In Trendelenburg's position the head is lower than the feet. In Sims' position the resident is lying on one side. In Rose's position the head is over the end of a table.
If you smell smoke and discover a resident smoking in his room, it is best to: Call the family contact and ask them to deal with their loved one on this issue. Ignore the first incident but report it if it happens again with the same resident. Have him stop and remind him of the facility policies because of the hazards it creates to every resident. Tell the resident you will allow him to finish his cigarette but you are obligated to report it if it happens again.
The correct answer is: Have him stop and remind him of the facility policies because of the hazards it creates to every resident. Explanation: The resident needs to stop and to know you will not allow his behavior to continue. He also may need to be reminded of the policies and hazards. The other options are not the proper way to immediately deal with the situation.
A resident in your care is suffering chest pains. Which of the following is NOT a direction to follow? Offer support and reassurance. Call for help immediately. Have the resident take small sips of water and place them in a downright position. Talk and act in a calm manner.
The correct answer is: Have the resident take small sips of water and place them in a downright position. Explanation: Patients suffering chest pains should not have water or foods until they can be assessed by other members of the healthcare team. A prone position is not appropriate for chest pains. All of the other options are important in the treatment of your resident.
If you are walking with a resident and they fall, which of the following is NOT an action you should take: Keep the resident from moving until you can assess if they have injuries. Supply information for the nurse so proper documentation can be made. Inform the nurse. Help the resident off the floor and in to the nearest chair.
The correct answer is: Help the resident off the floor and in to the nearest chair. Explanation: Helping the resident off the floor and in to the nearest chair is not an immediate action to take. A serious injury might become worse if the resident is moved. The other actions are all necessary in the process of dealing with a resident who has fallen.
Hypertension is a medical term for: High anxiety. Hyperactivity. High blood pressure. Tense muscles.
The correct answer is: High blood pressure. Explanation: The medical term for high blood pressure is hypertension. The other options are incorrect.
A resident has the following symptoms: Dizziness—feels faint, blood pressure below 90/60 and cold, sweaty skin. They are most likely suffering from: Hypoglottis Hypertension Hypodermia Hypotension
The correct answer is: Hypotension Explanation: Hypotension is low blood pressure and all these symptoms are associated with it. Hypodermia is the medical term for tissue under the epidermis, Hypoglottis is the underside of the tongue and Hypertension is high blood pressure.
Which statement is incorrect regarding the Heimlich maneuver? If the resident is coughing violently proceed with the Heimlich maneuver immediately. Place your hands around the resident between the xiphoid and the umbilicus. If you are alone and choking you can perform the Heimlich maneuver on yourself using the back of a chair. To properly apply the Heimlich maneuver, make a fist with your hands.
The correct answer is: If the resident is coughing violently proceed with the Heimlich maneuver immediately. Explanation: If the resident can cough there is a good chance the object will be dislodged. If the resident cannot speak or cough it is a sign you need to do the maneuver. All of the other options are correct.
A nursing assistant is caring for a patient with MRSA and is wearing a gown and gloves whenever she provides the patient care. Where should she dispose of her gown and gloves when she needs to go care for another patient? In the dirty utility room In the patient's room In the hallway In the next patient's room before touching the patient
The correct answer is: In the patient's room Explanation: Taking the gown off in the patient's room helps reduce the spread of infection to staff and other patients
Why is an axillary reading generally lower than the other forms of taking a temperature? It is taken at the back of the body. It is not inside the body. It is taken for a shorter period of time. It is placed deeper in the body.
The correct answer is: It is not inside the body. Explanation: Axillary temperatures are taken in the armpit. They are not actually inside the body such as in the mouth, rectum or ear. The other answers are incorrect.
Why is taking a resident's oral temperature the most common means of obtaining a reading? It is the most cost effective means of taking a temperature. It is more accurate than other methods. It offers the most ease of access and least inconvenience to the resident. It is the only method residents will accept.
The correct answer is: It offers the most ease of access and least inconvenience to the resident. Explanation: Ease of using this method makes it the most preferable. The other options are not necessarily true.
Which of the following could be considered neglectful when assisting a resident with showering? Being sensitive to water temperature and testing it before beginning the procedure. Respecting the fact that bathing and showering can be a scary activity for residents and assuring them you will help them through the process. Being patient and calm and explaining what you are going to do before you do it. Leaving the resident alone so they are motivated to care for themselves.
The correct answer is: Leaving the resident alone so they are motivated to care for themselves. Explanation: Residents left alone in the shower could slip and fall and leaving a resident alone is considered neglect. All of the other options show care for the patient and his/her rights.
Which of the following is least likely to contribute to skin tears? Equipment. Length of nails. Length of hair. Resident falls.
The correct answer is: Length of hair. Explanation: The length of a resident or caregiver's hair is the least likely to cause a skin tear. The other options are all considered common causes of skin tears for both the elderly and very young.
Which statement is false in regards to taking a rectal temperature? Wipe the resident's rectum when finished, if needed. Mercury thermometers are preferred for accuracy. A rectal temperature reading may be slightly higher than an oral temperature reading. The thermometer should be inserted 1-1.5 inches in an adult.
The correct answer is: Mercury thermometers are preferred for accuracy. Explanation: Mercury thermometers are no longer used in a care facility. The other answers are all correct pertaining to rectal temperatures.
A resident in your care has called you for help. They claim they can't find their dentures. As a nursing assistant, what is your responsibility? Document the loss in the patient's medical record. Notify the supervising nurse. Tell the resident that you will notify the family contact member. Ask the resident to refrain from eating until they are located.
The correct answer is: Notify the supervising nurse. Explanation: The supervising nurse should be notified, as well as the decision about the appropriate documentation of the incident. It is not a nursing assistant's role to contact the family members nor make a decision whether the resident should stop eating.
Which of the following would be inappropriate when caring for a diabetic patient? Offering the patient a thermal foot soak once a day to relax Ensuring the patient has plenty of snacks to eat throughout the day Carefully monitoring and reporting the patient's food consumption Keeping the patient's feet clean and dry
The correct answer is: Offering the patient a thermal foot soak once a day to relax Explanation: Patients with diabetes can have diabetic neuropathy, which means they have a decreased sensation in their extremities. If the patient soaks his feet in hot water he could sustain tissue damage as he may not be able to tell if the water is too hot. Keeping the feet clean and dry is an appropriate care tactic for diabetic patients. Diabetic patients should eat several snacks throughout the day to keep their blood sugar stable, and their overall intake should be monitored and reported to prevent large blood sugar swings.
Where would you take a radial pulse?
The correct answer is: On the radial (thumb) side of the patient's wrist Explanation: The radial pulse should be taken using the index and middle fingers.
Which of the following describes stage 4 of a decubitus ulcer? Open area with damage reaching to the bone, joint or tendons. Redness on the skin. Superficial ulcer that looks blackened or like a deep crater. Open area with redness.
The correct answer is: Open area with damage reaching to the bone, joint or tendons. Explanation: Damage to the bone, joint or tendons signals stage 4; stage 1 being just redness, stage 2 being both redness and an open sore, and stage 3 may indicate a blackened or crater-like appearance.
You are caring for a patient with a strict dysphagia diet. Which item on the patient's tray would you question? Applesauce Peanut butter Mashed potatoes and gravy Chocolate pudding
The correct answer is: Peanut butter Explanation: Those with a strict dysphagia diet have difficult swallowing, so the foods they eat must be pureed and of thin consistency. Peanut butter, jell-o, and fruited yogurt would all be considered too textured for someone on a strict dysphagia diet.
Which of the following should NOT be part of the process for cleaning a resident's dentures: Washing your hands. Padding the sink. Rinsing thoroughly. Placing clean dentures on top of a Kleenex on the resident's table.
The correct answer is: Placing clean dentures on top of a Kleenex on the resident's table. Explanation: Placing dentures on a Kleenex could lead to dentures being knocked off and damaged or a housekeeper sweeping up a Kleenex and inadvertently throwing them in the trash. The other options are extremely important to the washing process.
Which of the following is the correct step in taking a radial pulse? Press lightly on the side of the neck with the pads of two fingers. Press lightly against the radial bone with your fingers. If the pulse rate is erratic, count an extra 90 seconds. Count the amount of beats in 30 seconds and then triple it.
The correct answer is: Press lightly against the radial bone with your fingers. Explanation: Taking a radial pulse requires fingers placed on the inside of the wrist against the radial bone. The count is for 60 seconds. The other options are incorrect.
What is another term that is often interchangeable with "decubitus ulcer"? Ulcerated Tumor. Pressure Sore. Perforation. Ulcerated cyst.
The correct answer is: Pressure Sore. Explanation: Pressure Sore is actually a more accurate term to use than decubitus ulcer. The other options are incorrect.
The following precautions should be followed when using a transfer-gait belt, except: Proper body mechanics are not necessary when using a gait belt. Transfer belts should be placed around the resident's waist. Never use a frayed or worn transfer-gait belt. Slight rocking and pulling when using a gait belt on a resident in a sitting position can be helpful.
The correct answer is: Proper body mechanics are not necessary when using a gait belt. Explanation: Proper body mechanics are always used to avoid injury and should never be ignored. The other options are all useful precautions.
If you are helping a resident put on a clean night shirt and it falls to the ground before you get started, it is best to: Ask the resident if they want to go ahead and use the dropped shirt. Tell the resident to wear the shirt until you can go and get a clean one. Place the shirt on the chair and go to get a clean garment. Put the shirt in the hamper for cleaning and get another clean garment.
The correct answer is: Put the shirt in the hamper for cleaning and get another clean garment. Explanation: Picking up something that has dropped to the floor and then using it on a resident can cause contamination and infection. The resident may not make the best decision and should not choose. Placing the shirt on a chair can be easily forgotten and the resident could pick it up at a later time and put it on.
What acronym can be used to direct your actions in the event of a fire?
The correct answer is: RACE Explanation: R - Rescue everyone in danger. A - Pull the fire alarm. C - Confine or contain the fire. E - Extinguish the fire if you can safely do so.
After assisting a resident onto a bedpan it will help to make the patient more comfortable if you: Have a trusted love one assist with the procedure. Raise the head of the bed. Lower the head of the bed. Turn on the television for distraction.
The correct answer is: Raise the head of the bed. Explanation: Raising the head of the bed once a resident is set on a bedpan will make them more comfortable. Turning on the television may actually interfere with the process and the other options may make the resident more uncomfortable.
Which of the following is the most likely used to protect a resident from inflicting immediate harm to themselves in a care facility setting? Restraints. Additional staff. Isolation. A watch schedule 24/7.
The correct answer is: Restraints. Explanation: Restraints are only used with an order from the physician and only when the resident is in danger of harm to themselves or others. Isolation increases the chance for harm and additional staff or a 24/7 watch schedule are likely unmanageable with the amount of residents and staff in a care facility.
Which of the following incidences necessitates a nursing assistant to wait for a 15 minute period: Assisting a resident in the bathroom so they don't feel rushed. Going to the resident's room when they've pulled a "help cord" to see if they can help themselves first. Taking an oral temperature if the resident has had a cold drink. Reporting a fall to the supervising nurse.
The correct answer is: Taking an oral temperature if the resident has had a cold drink. Explanation: If a resident has just had a cold or hot drink it is best to wait 15 minutes before taking an oral temperature reading. All of the other options require an immediate response.
A pulse can be taken in all these areas EXCEPT: The back of the head. The side of the neck. Behind the knee. The inner wrist.
The correct answer is: The back of the head. Explanation: A pulse is not taken at the back of the head, but can be taken at any of the other options.
A fractured hip is: The injury that generates the most complaints from residents. The most difficult injury to recover from. The most frequent injury when a resident falls. The most expensive injury for rehabilitation.
The correct answer is: The most frequent injury when a resident falls. Explanation: A fractured hip is the most frequent of all injuries when a resident falls. The other options are varied depending on the resident's age, the overall health of the resident or how fractured the hip may be.
Which of the following is considered an accurate method for counting respiration rate? The nursing assistant looks at the resident's abdomen and a watch at the same time. The nursing assistant counts to 30 while watching the resident's abdomen. The nursing assistant watches the abdomen while the nurse looks at her watch to time 30 seconds. The resident counts to 30 while the nursing assistant counts respirations.
The correct answer is: The nursing assistant looks at the resident's abdomen and a watch at the same time. Explanation: The nursing assistant monitors a watch for a 30 second interval while observing the resident's abdomen. The other options could produce an inaccurate result.
Which of the following is NOT true when taking a blood pressure reading? The optimum position for the resident is lying down with their feet elevated. Blood pressure readings can be a little higher in the mornings. The optimum position for the resident is sitting with both feet on the floor. It is best if the resident does not talk while their blood pressure reading is being taken.
The correct answer is: The optimum position for the resident is lying down with their feet elevated. Explanation: It is not optimum to have a resident lying down for a blood pressure reading. All of the other options are true considerations for optimum results.
There is a sign that says "NPO" on your patient's door. You know this means: The patient can only have liquids. The patient can not have anything by mouth The patient is at risk for falls. The patient is under isolation precautions.
The correct answer is: The patient can not have anything by mouth Explanation: If patients are "NPO," they are not allowed to have any food or fluids by mouth.
A bedridden patient has a urinary catheter. Where should the drainage bag be stored?
The correct answer is: The urinary drainage bag should be secured to the bed frame. Explanation: Never place the urinary drainage bag on a movable part of the bed (such as a side rail) because that may dislodge the catheter.
Which of the following best describes the purpose of padded side rails? To protect a resident from injury To keep a resident in the proper temperature To prevent skin breakdown To use them as a restraint
The correct answer is: To protect a resident from injury Explanation: Padded side rails are to protect the resident from injury. The other answers are incorrect.
To avoid pulling the catheter when turning a patient, the catheter tube should be taped to the patient's: Knee Upper thigh Bed frame Outer thigh
The correct answer is: Upper thigh Explanation: Taping the catheter to the upper thigh can help prevent inadvertent removal and physical trauma. Taping it to the outer thigh, bed frame, or knee can cause pulling and removal when you are turning a patient.
Which of the following applies to proper hand washing procedures? Use friction for 15 seconds. Use a towel to turn off the faucet. Use only antibacterial soap when washing hands. If the soap doesn't lather, it is important to use longer friction time.
The correct answer is: Use a towel to turn off the faucet. Explanation: Using a towel to turn off the faucet prevents transferring germs. The other options are incorrect because friction needs to be longer than 15 seconds; using only antibacterial soap may not be an option; some soaps can be effective even if they do not produce a lot of lather.
What is the most important thing you can do to prevent infection?
The correct answer is: Wash your hands. Explanation: Frequent hand washing is the number one way to prevent the spread of infection.
To minimize the spreading of bacteria, further infection and contamination, the following procedure should be used for washing the perineum of a resident with a catheter: Washing from the meatus out. Washing with peroxide. Washing from the rectum to the scrotum. Washing from the rectum to the meatus.
The correct answer is: Washing from the meatus out. Explanation: Washing from the meatus out is correct because it avoids further spreading of contamination. Peroxide is not a cleanser and the other two options are in the opposite direction they should be in.
Making a bed, whether occupied or unoccupied, should end with which of the following? Moving the call light. Adjusting the height of the bed. Washing your hands. Mitering the corners.
The correct answer is: Washing your hands. Explanation: Hands should be washed after making the bed. The other options are part of the process but not the last step.
Which of the following tasks related to intravenous therapy is in the scope of responsibilities for a nursing assistant? Get the intravenous feed into the patient and then call the supervising nurse to assess. Nursing assistants are not allowed to be involved in the intravenous process. Prepare the proper solution. Watch the drip and report any problems.
The correct answer is: Watch the drip and report any problems. Explanation: A nursing assistant can watch the flow of solution and then report any problems to the charge nurse. The nursing assistant cannot start the feed nor prepare the solution.
The best use of alcohol-based sanitizer is: When hands have blood from a cut. When hands are visibly soiled. When hands are not visibly soiled. When helping with catheterization.
The correct answer is: When hands are not visibly soiled. Explanation: Alcohol-based sanitizers are best used for hands that are not visibly soiled. Soap and water are used when soiling is visible. The other options are not appropriate times to use alcohol-based sanitizer.
Alcohol-based hand cleanser is appropriate for all of the following EXCEPT: When soap and water are not available. When hands have observable dirt. After walking a resident down the hall. After handling a resident's clothes.
The correct answer is: When hands have observable dirt. Explanation: Observable dirt that is visible on hands require soap and water. The other options are all considered times that alcohol-based hand cleanser could be used.
A resident with venous stasis has developed pressure sores under elastic stockings. What is the most likely cause? Wrinkles in the elastic stockings. The resident is allergic to the elastic. The elastic stockings are the wrong treatment and should be removed. The resident has been scratching their legs.
The correct answer is: Wrinkles in the elastic stockings. Explanation: Wrinkles in stockings or bed sheets are a common cause of pressure sores. While the other options may cause different symptoms, pressure sores develop when there is an article pressing against the body for a period of time.
A resident has the following symptoms: Expelled brown fluid from the rectum, excessive amounts of flatus and light abdominal cramping. Which of the following is the likely cause of these symptoms? a blood clot a heart attack a stroke an enema
The correct answer is: an enema Explanation: These are common symptoms following an enema procedure. If the cramps become severe contact the charge nurse. These are not primary symptoms indicating a heart attack, blood clot or stroke.
How often should you reposition an immobile patient?
The correct answer is: at least every 2 hours Explanation: Prolonged exposure to pressure is the primary factor of a pressure ulcer, and repositioning an immobile patient every 2 hours helps avoid or minimize this exposure.
To obtain the most accurate patient weight, the nursing assistant should weigh the patient ____. directly after a meal at the same time every day with two different scales 3-4 hours after eating
The correct answer is: at the same time every day Explanation: Weighing the patient at the same time every day will yield the most accurate results, as the patient is likely in similar circumstances.
Your patient has a low pulse, seems slightly confused, and has sweet, fruity-smelling breath. You suspect: hypertension hypoglycemia hypotension hyperglycemia
The correct answer is: hyperglycemia Explanation: Hyperglycemia, or high blood sugar, is marked by slurred speech, low pulse, warm skin, sluggish or confused demeanor, deep respirations, and fruity or sweet-smelling breath.
When transferring a resident from a wheelchair to stationary chair, where should the nursing assistant stand? to the right side of the wheelchair in front of the wheelchair to the left of the side of the wheelchair behind the wheelchair
The correct answer is: in front of the wheelchair Explanation: Standing in front of the wheelchair is the most ergonomic way for the nursing assistant to pivot a resident into a stationary chair. The other options are not as effective for allowing this.
Which of the following is the least likely to signal impending death? increase in appetite cooled extremities unstable blood pressure labored breathing
The correct answer is: increase in appetite Explanation: Impending death will often lead to a decreased appetite rather than an increase. The other options are all common signs of a body shutting down.
Which of the following is the standard for measuring urinary output? ounces liters cups mililiters
The correct answer is: mililiters Explanation: Urinary output is measured in milliliters (ml). Some facilities may still use cubic centimeters (cc), which are volumetrically equivalent to milliliters. However, the use of cubic centimeters is not considered best practice due to the abbreviation "cc" often being confused for the abbreviation "u" (meaning units). The other answers are not the correct standard of measure for this type of output.
All of the following are ways to prevent pressures sores EXCEPT: changing soiled sheets quickly avoiding wrinkles in sheets providing extra blankets changing positions regularly
The correct answer is: providing extra blankets Explanation: Providing extra blankets will not necessarily help with pressure sores. The other options all assist in pressure sore prevention.
The medical term tetraplegia—meaning paralysis of all 4 extremities—is often used interchangeably with the term: cardioplegia. hemiplegia. quadriplegia. paraplegia.
The correct answer is: quadriplegia. Explanation: Quadriplegia is another word used for tetraplegia—both which mean paralysis of all 4 extremities. Hemiplegia is paralysis of one side. Cardioplegia is paralysis of the heart and Paraplegia is paralysis of just the legs.
What is the first sign a patient may be developing a pressure sore?
The skin appears reddened or discolored, and it does not blanch (turn white) when touched. It also may feel hard or warm.