Basics & Hypotheticals of CNA

When using a fire extinguisher, the hose is *aimed* at the

*base* of the fire

Which of the following is a correct measurement of urinary output? 2 cups 300 cc 1 quart 40 oz

300 cc is a metric measurement meaning 300 cubic centimeters. In medicine around the world, the metric system is used for all length, weight, volume, and temperature measurements. The metric system is based on units of ten, and is more precise than other methods of measurement.

A client is to be assisted out of bed to sit in a wheelchair. Which action would make this procedure safe? place a pillow on the wheelchair seat lower both footrest pedals place the bed in the low position release the wheel brakes

Client safety during transfer begins with the bed in the lowest position. This allows the client to easily reach the floor when standing and pivoting to sit in the wheelchair. The brakes of the wheelchair should be locked and the footrests completely out of the way.

Aids to position a patient include all the following except Footboard Hoyer lift Pillows Bath blankets and towels

Hoyer lift

When dry, hard stool fills the rectum and will not pass, it is called edema atrophy incontinence impaction

IMPACTION

If your home health client refuses to take their medication, you should Notify your supervisor about their refusal. Sneak the medication into some pudding. Remove the medication so the client can't save it. Tell them you will get into trouble if they don't cooperate.

Notify your supervisor about their refusal

A sodium-restricted diet for heart disease does NOT include Fish and potatoes Hamburger and pears Carrots and bananas Pickles and olives

Pickles and olives (they are salty)

Restraints should be unfastened or released Never Q 1-2 hours Q 3-5 hours Daily

Q 1-2 hours

Which of the following is a right of residents in a nursing facility? Refusing treatment ordered by the doctor Smoking in their room To take all the drugs they want Making as much noise as they want

Refusing treatment ordered by the doctor

Which of the following *best helps reduce pressure* on the bony prominences? Flotation mattress Repositioning every shift Several pillows Sheepskin

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

When operating a manual bed, the nurse aide should remember to lock the wheels when the cranks are folded. fold cranks under bed. elevate the client's head at all times. keep the bed in the neutral position.

fold cranks under bed When working a manual bed, be sure to first lock the bed by pressing down the levers on the wheels at the head and foot of the bed. At the end of the bed there are three cranks which control the bed height, as well as raising and lowering the head and feet. Cranks are turned clockwise (left to right) to raise each section, and counter-clockwise to lower them. After positioning the client, always fold the cranks under the bed to prevent others from tripping or falling.

The most comfortable position for a resident with a respiratory problem is Fowler's Supine Lateral Prone

fowlers When a client is having difficulty breathing, Fowler's position can provide relief. When sitting in Fowler's position, the client is upright at 90 degrees, allowing the chest to expand as much as possible. Prone (on the abdomen), supine (on the back), and lateral (on the side) are all flat positions, which can make respiratory distress worse.

The nursing care plan states, "Transfer with mechanical lift." however, the client is very agitated. To transfer the client, the nurse aide SHOULD get assistance to move the client. place the client in the lift. keep wheels unlocked so the lift can move with the client. lift the client without the mechanical device.

get assistance to move the client Client safety is always the top priority. When a patient is not able to cooperate for any reason, do not try to accomplish a task alone. It is important to follow the nursing care plan, including all steps of operating any equipment being used to move or transfer the client. Ask a co-worker to help if you have any concerns about keeping the client safe. If the client remains agitated, notify the nurse before proceeding.

When caring for a patient with *MRSA*, the nurse aide should wear

gown and gloves

While an unsteady resident is showering you should ambulate another resident while you wait. have the client use a shower chair. leave to respect the client's privacy. go start another client's shower.

have the client use a shower chair.

The last sensation that is lost when dying is Taste Sight Smell Hearing

hearing (interesting)

If a client is confused, the nurse aide should

help the client to *recognize* familiar things and people (NEVER restrain unless necessary - last option)

Sexuality includes all of the following EXCEPT Holding hands when in pain How you speak and smile Cultural and religious expectations Caring about your appearance

holding hands when in pain (this actually hurt my mind but thats the answer so i'm just gonna move on w my points)

A health care agency or program for patients who are dying is Case management Hospice A preferred provider organization Managed care

hospice

Used disposable supplies and equipment should be discarded in the resident's wastebasket. outside the resident's room. in the clean utility room. in a designated receptacle.

in a designated receptacle

A client is paralyzed on the right side. The nurse aide should place the signaling device on the right side of the bed near the client's hand. under the pillow. on the left side of the bed near the client's hand. at the foot of the bed.

on unaffected side Clients who have had a stroke often have one-sided weakness or paralysis. They may not be able to use that side of their body, or may not even be aware of the affected side. This is called "one-side neglect." Rehabilitation services will help the patient recover as well as possible, but as the client's caregiver, you can encourage the client to use the unaffected side by placing the signaling device where the client can reach it to call for assistance.

Elderly residents sometimes appear stooped over and like they have lost height. This is due to the resident's increased difficulty in breathing decreased cardiac output osteoporosis in the spinal column the deterioration of muscle tissue

osteoporosis in the spinal column

Which of the following is NOT considered to be a way to restrain a client? Lap buddy/tray A hand mitt A sedative Pain management

pain management A restraint may be either physical or chemical. Its purpose is to protect the client from harming himself or others. Only a physician may order a restraint, and guidelines are strict. A pain medication may help calm a client or relieve behavior associated with severe pain, but it is not in the restraint category.

What type of fire can be put out with water? Paper Chemical Electrical Grease

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

All behavior has meaning to the facility psychologist. person doing the behavior. person who is talking. person observing the behavior.

person doing the behavior (strange question)

It is appropriate for a nurse aide to share the information regarding a client's status with Anyone who knows the client The staff on the next shift The client's roommate The client's family members

the staff on the next shift

To lift an object using good body mechanics, the nurse aide SHOULD bend knees and keep back straight. Keep both feet close together. lift with abdominal muscles. hold the object away from the body.

bend knees and keep back straight It is important to maintain proper spinal position with lifting. The risk of injury to the low back increases when using the back muscles, bending at the waist, twisting, or trying to lift when the load is too heavy. Common injuries associated with lifting are strains, sprains and herniated discs. For heavy loads, always find another person to help.

A normal adult blood pressure is 80/40 180/80 134/90 116/70

116/70

If a resident drinks four ounces of water with a meal, how many milliliters (ml) has he consumed? 16 30 64 120

120 (yer thats 4 x 30)

Which of the following should be reported immediately? A blood pressure of 90/40 Temperature of 99.4 Respirations of 12 A pulse of 90

A blood pressure of 90/40

A fracture-type bedpan is used for residents who Have a back injury Have had hip surgery Are in traction All of the above

ALL SIS

You observe two adult residents sharing the same bed after lunch. You know these residents are capable of exercising their own rights. This means they have the right to privacy. they are probably seeking intimacy. they are free to make decisions. all of the above

ALL THE ABOVE

The nurse aide notices that the client's *radio cord* is draped *across* a chair in order to reach the nearest outlet. The FIRST thing the nurse aide should do is

All facilities must comply with the electrical safety standards of governmental and accrediting agencies. Client devices, including radios or televisions, must be approved according to the facility's policies. Cords cannot cause any potential hazards, such as tripping or falls. Extension cords are usually not allowed. The nurse aide can help the client find a place for the radio where the cord to be safely plugged in, so the client can continue to enjoy listening.

To avoid pulling the catheter when turning a male client, the catheter tube must be taped to the client's upper thigh hip bed frame bed sheet

An indwelling urinary catheter is used to drain the bladder into a bag outside the body. In males, it is a long tube with a balloon that is inflated after being inserted. The tube that drains the urine must not be tugged or become kinked. In males, it is attached to the client's inner thigh by tape or a special fastening device. Never attach the tube to anything except the client's inner thigh. The drainage bag should remain lower than the client's bladder to prevent backflow of urine.

Which is the best way to talk to a resident with a vision impairment? Announce your presence when entering the room. Turn on all the lights to enhance the remaining vision. Touch the resident before you begin talking. Speak loudly and use exaggerated mouth movements.

Announce your presence when entering the room

When you are caring for an elderly resident who has dentures, but seldom wears them, what should you do? Force the resident to wear the dentures. Ask him why he doesn't wear his dentures. Offer to bring in some denture adhesive. Call the resident's dentist.

Ask him why he doesn't wear his dentures

What is the CNA's responsibility after calling a Code Blue? Leave as soon as the Code Blue team arrives. Be available for any necessary tasks. Participate as a full team member. Assume responsibility for the Code Blue.

Be available for any necessary tasks

Who orders a *warm or cold application*? You as a CNA can if you think it is necessary Director of nursing Nurse doctor

DOCTOR HOUSE M.D the doc dr

Which of the following is NOT a sleep aid? Following bedtime rituals Eating a bedtime snack Reducing noise Drinking alcohol

DRANKIN' ALCOHOL

All are types of pathogens EXCEPT bacteria virus Ebola fungus

EBOLAA

What would be the BEST way for the nurse aide to promote client independence in bathing a patient who has had a stroke? Teach the patient to wash their hands properly before doing anything else. Leave the patient alone and tell them to call you if they need any help. Do everything for the patient so they can watch how to do tasks properly. Encourage the patient to do as much as possible, offering help as needed.

Encourage the patient to do as much as possible, offering help as needed.

A major risk factor for a stroke is Hypertension Overuse of vitamins Being underweight Hypotension

HYPERTENSION

To help prevent resident falls, the nurse aide should Tell residents to wear larger-sized, loose-fitting clothing. Leave residents' beds at the lowest level when care is complete. Remind residents who use call lights that they need to wait patiently for staff. Always raise side rails when any resident is in their bed.

Leave residents' beds at the lowest level when care is complete.

The resident's weight is obtained routinely as a way to check the resident's __________. nutrition and health ability to stand and balance growth and development adjustment to the facility

NUTRITION N HEALTH

Which of the following is NOT true of dementia? Grooming is difficult for patients with dementia. People with dementia are often frightened and anxious. Patients can have vivid hallucinations. People with dementia act uncooperative in order to be spiteful.

People with dementia act uncooperative in order to be spiteful

Which statement is *false*? Religious and cultural practices are not allowed in the health care agency. A person's culture influences health and illness practices. A person may not follow the beliefs and practices of their religion or culture. Culture and religion influence food practices.

Religious and cultural practices are not allowed in the health care agency

The nurse aide gave a client the *wrong diet*. What will the nurse aide do after realizing this error? Remove evidence of the error. Blame another nurse aide for the error Ask the client to stop eating. Report the error immediately to the nurse.

Report the error immediately to the nurse

The nurse aide is going to help the client walk from the bed to a chair. What should the nurse aide put on the client's feet? Cloth-soled slippers Nothing Socks or stockings only Rubber-soled slippers or shoes

Rubber-soled slippers or shoes Preventing a fall is important when helping a client ambulate. Proper footwear should always be worn for any type of walking, even a short distance. Rubber-soled slippers or shoes provide traction to prevent falls. Socks, stockings, or slippers made from fabric can make the client slip or lose balance. Walking in bare feet can lead to foot injuries, which is especially dangerous for diabetic clients.

Which stage of a pressure sore or ulcer involves breakdown of the subcutaneous layer of the skin? Stage IV Stage III Stage II Stage I

STAGE III (IT PIERCES THE DERMIS)

When helping a client use the commode, it is essential that Stay with the client until they have finished using the commode The door is locked so they have privacy The call button/light is within easy reach in case they need help They are restrained to prevent a fall

The call button/light is within easy reach in case they need help

What are your legal and ethical responsibilities if you have access to medical records? To share information with anyone who asks To keep all information confidential To write everything down accurately To only tell your family about a patient

To keep all information confidential

The Heimlich maneuver (abdominal thrust) is administered to the patient if they have internal abdominal bleeding a blocked airway become inebriated ingested a toxic substance

a *blocked* airway The Heimlich maneuver (abdominal thrusts) is the first aid method for helping people who have food or an object caught in their upper airway. When a client appears to be choking, the nurse aide must act quickly to clear the airway. Call for help. To perform abdominal thrusts, stand behind the client. Make a fist with your dominant hand. Place this fist just above the client's navel. Wrap your other hand firmly around the fist. Pull inward and upward, pressing into the client's abdomen with quick and forceful upward thrusts, as if you are trying to lift the client off his or her feet from this position. Continue the abdominal thrusts in quick succession until the object is expelled.

A client needs to be repositioned but is heavy, and the nurse aide is not sure she can move the client alone. The nurse aide should try to move the client alone have the family do it go on to another task ask another nurse aide to help

ask another nurse aide to help Clients or objects which are heavy should never be moved or lifted by one person. The risk for falls or injuries, for both client and nurse aide, increases with heavy loads. Ask for assistance before attempting to pull or roll a heavy patient. Use good body mechanics by using your leg muscles to avoid back injury.

While eating dinner a client starts to choke and turn blue. The nurse aide SHOULD give the client a drink of water. immediately remove the client's food tray and go find the nurse in charge. call for assistance and perform the Heimlich maneuver (abdominal thrusts). slap the client on the back until the food dislodges.

call for assistance and perform the Heimlich maneuver (abdominal thrusts) Abdominal thrusts (the Heimlich maneuver) is the best response to choking. Calling for assistance as you prepare to do abdominal thrusts will alert others of the emergency. A quick back slap can be tried, but if the food does not immediately dislodge, the nurse aide must quickly move to start abdominal thrusts. Performing abdominal thrusts involves standing behind the client and using hands to exert upward pressure on the bottom of the diaphragm.

When caring for a client who uses a protective device (restraint), the nurse aide SHOULD assess the client once every hour. assure the protective device is tight. release the protective device once a shift. check the client's body alignment.

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

The nurse aide sees a client spill water on the floor in the hall. Another client is walking down the hall. The nurse aide SHOULD

clean up the spill. Falls can lead to serious injury and complications, especially among elderly or very ill clients. Every staff member should be constantly alert for potential hazards, including spills, and immediately take care of the situation. Never ignore the possible source of a fall. If the spill is caused by blood or body fluid, follow the protocol for decontamination and wear Personal Protective Equipment (PPE).

How would a nursing aide identify a problem with a diabetic patient? Increased alertness Gasping Cold, clammy skin Seizures

cold, clammy skin

The nurse aide is walking with a client confined to a wheelchair when the facility fire alarm system is activated. The client becomes excited from the noise. The nurse aide SHOULD lock the client's wheelchair and check the surrounding area for smoke. comfort the client while moving to a safe place. leave the client to search for help. push the wheelchair out of the hallway and carry the client out of the facility.

comfort the client while moving to a safe place The nurse aide should be familiar with all fire safety policies and protocols. When a fire alarm sounds, all staff must respond to keep clients safe. Remember "R.A.C.E." to quickly act. R = Rescue/Remove all people who can not take care of themselves. A = Alarm, if it has not already been done. Pulling the alarm can be done at the same time as rescue. C = Confine/Contain the fire or smoke by closing doors to prevent or slow the spread. Smoke is especially dangerous for everyone. E = Extinguish the fire if possible, using a handheld fire extinguisher. Attempt to extinguish only small fires, as long as you can remain safe and have an escape route.

When transferring a client, MOST of the client's weight should be supported by the nurse aide's wrists back shoulders legs

legs When transferring a client, the nurse aide should be positioned to support the client by using the legs. Keep your back straight and locked; do not turn or twist. If you bend, do so at the hips, not the waist. Before beginning the transfer, assess how much the client is able to do. If you have any doubts, always ask for assistance from a co-worker.

How should the nurse aide position the patient to apply elastic stockings? sitting on the edge of the bed sitting in a wheelchair lying down in bed standing at the side of the bed

lying down in bed

The purpose for padding side rails on the client's bed is to have a place to connect the call signal keep the client warm use them as a restraint protect from injury

protect the client from injury Side rails are important for keeping clients from falling out of bed. They also allow a way for clients to grab on to the railing to reposition themselves. However, if the client is agitated, confused, has a head injury or history of seizures, padding the side rails can prevent injuries or entrapment. Some facilities have bed rail pads or bumpers in stock. Use a mattress pad to make a side rail pad. Make sure the bed is always in the lowest position.

Clean bed linen placed in a client's room but NOT used should be used for a client in the next room taken to the nurse in charge put in the dirty linen container returned to the linen closet

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

While making an empty bed, the nurse aide sees that the side rail is broken. The nurse aide SHOULD report the broken side rail immediately. tie the side rail in the raised position until it is fixed. warn the client to be careful when she gets back into bed. wait for the next safety check to report the broken side rail. Every staff member is responsible for keeping clients safe at all times. This includes monitoring all equipment and reporting when anything needs repair. Never use broken equipment or try to create a temporary solution if equipment is not working properly. Tag the broken bed and move it so that another client can't use it. Replace it immediately with one that has functioning side rails.

report

For safety, when leaving a client alone in a room, the nurse aide SHOULD leave the bed elevated in highest position. keep the door tightly closed. place signaling device within client's reach. apply a restraint to the client.

signaling device in reach After giving care, or when leaving the client's room, always ensure that the client's call signal is within reach. Clients must always have access to caregivers. For safety, bed should be in the lowest position, with bed rails up. Restraints may never be applied without an order from the client's doctor.

Which of the following people provide treatment for persons who have difficulty talking due to disorders such as a stroke or physical defects? Speech therapist Physical therapist Registered nurse Occupational therapist

speeach therapist stroke = loss of clear speech When a client is unable to speak clearly or has trouble forming words, a speech therapist can help improve problems from strokes, physical defects, and swallowing disorders. Speech therapists work with both adults and children. They are qualified to evaluate, diagnose, and treat clients.

What are the parts that make up the whole person? spiritual, physical, emotional, cognitive, social emotional, social, historical, cognitive, health physical, social, religious, psychological, education spiritual, social, physical, psychological, relationships

spiritual, physical, emotional, cognitive, social

In report the nurse aide is told that one of her patients has been ordered NPO after midnight. The aide should take away the water pitcher at midnight. ask the patient if he is having any pain. offer frequent snacks. note all water the patient drinks and all output.

take away the water pitcher at midnight.

The nurse aide is responsible for all of the following fire prevention measures EXCEPT participating in fire drills. taking cigarettes and matches away from all clients and visitors. being aware of the locations of fire extinguishers. reporting all damaged wiring and/or sockets in clients' rooms.

takin' cigars away While smoking by clients and visitors may not be appropriate, the nurse aide *may not take away their cigarettes or matches*. However, the nurse aide can certainly *report these actions to the charge nurse*. The nurse aide should also be familiar with policies regarding smoking or smoking areas, to inform smokers if there are designated places. All staff must be aware of fire extinguisher locations and what to do in the event of a fire. Notifying the nurse or maintenance department of any damaged electrical wiring or sockets, as well as faulty electrical equipment can prevent a fire.

Who is in charge of delegating the work assignment? The head of the clinic The registered nurse on duty The patient's family The head CNA

the RN ON DUTY

Although a resident says "Fine" when asked how she feels, the nurse aide suspects the resident is in pain because: the resident often mixes up language. the resident is grimacing. the resident is dependent on analgesics. the resident has a high tolerance for pain.

the resident is *grimacing*.

A slipknot is used when securing a restraint so that ________. the restraint cannot be removed by the resident. body alignment is maintained while wearing the restraint. the restraint can be removed quickly when needed. it can be easily observed whether the restraint is applied correctly.

the restraint can be removed quickly when needed

What is the purpose of using the chain-of-command in a long-term care facility to prevent residents from going behind the nurses' station To provide more jobs in nursing to be sure residents follow the rules to keep communication about a problem flowing smoothly

to keep communication about a problem flowing smoothly

Physical restraints are used MOST often to prevent client injury. at the roommate's request. at the family's request. when staff is short.

to prevent client injury Physical restraints are devices or equipment that prevent normal movement. Examples are arm or leg restraints, hand mitts, or vests. It is against the law to use restraints unless necessary to treat a client's medical symptoms, or if there is a risk of harming self or others. Restraints are not used for punishment, convenience, or a method of control. Either a physician's order or the client's consent is required before a restraint can be applied.

The equipment you need to gather to do unconscious oral care would include Toothpaste toothette/mouth swab Toothbrush All of the above

toothette/mouth swab Because an unconscious client is not able to assist with oral care, the nurse aide must take extra precautions to prevent choking or aspirating while giving oral care. The client's head should be turned to the side. If possible, lower the head of the bed. Gently clean the teeth and gums with a separate moist toothette or mouth swab for each area of the mouth. Wipe the client's mouth when finished and raise the head of the bed to its prior position

What is the condition when patients are unable to control their bladder? Urinary tract infection Urinary inflammation Urinary retention Urinary incontinence

urinary incontinence

When helping a client who is recovering from a stroke to walk, the nurse aide should assist with a wheelchair on the client's weak side from behind the client on the client's strong side

weak side assist When helping a client walk who is recovering from a stroke, the nurse aide should stay on the client's weak side. Walk next to, and slightly behind, the client in order to be ready to suddenly support the weak side. If the client is using a walker or cane, allow space for the device. While walking, be alert to avoid possible fall hazards. The client should wear slippers or shoes with rubber soles for traction.