WA CNA written exam
what is the normal systolic blood pressure range for adults?
100-120
For most residents, the range of normal respiration is
12-20 inspirations per minute
if a resident drinks four ounces of water with a meal, how many milliliters (mL) of water has he consumed?
120 mL
which blood pressure reading would you report to the nurse?
144/92
A patient has just finished consuming a cold beverage. How long should you wait before taking the patients oral temp?
15-20 minutes
Mr. Burns just smoked a cigarette. How long should you wait to take his oral temperature?
15-20 minutes
Mr. greens water pitcher holds 1000 mL. it was full when you came on shift. You refill it once during your shift. At the end of the shift, it is half full. How much water has Mr. Green had to drink?
1500 mL
Mr. Martin drank 6 ounces of coffee and 3 ounces of orange juice during breakfast. How many milliliters (mL) did he drink?
270 mL
if a patient has not had a bowel movement in more than _____, the patient is at an increased risk for developing constipation and the nurse should be notified.
3 days
To convert four ounces (oz) of liquid to milliliters (mL), the nurse aide should multiply 4 by
30 mL
Three fluid ounces equals how many milliliters?
90
To lift an object using good body mechanics, the nurse aide SHOULD
bend the knees and keep the back straight
when a new client is admitted, which of the following should a nurse aide observe and record?
bruises
which of the following best helps reduce pressure on the bony prominences?
floatation mattress
when a patient is dying, the last sensation that is lost is
hearing
Signs of poor circulation include
paleness; cold skin, and edema
what is the term for a device used to take the place of a missing body part?
posthesis
clean bed linen placed in a clients room but NOT used should be
put in the dirty linen container
when cleaning a males genitals area during perineal care, the nurse aide should do which of the following?
replace the foreskin after pushing it back to wash an uncircumcised penis
What does R.A.C.E stand for?
rescue/remove, alarm, confine/ contain, extinguish
a patient visits a care facility for only a short period to give his or her usual caregivers a "break". What is this called?
respite care
Physical restraints are used MOST often
to prevent client injury
Mrs. Hernandez had a hip replacement and is admitted to the long-term care facility for rehab. Her condition is considered
Acute
Mrs. Sparks is an 83 year old female patient who suffers from the late effects of a CVA. She has {L} sided hemiplegia. This is...
Paralysis on the left side of the body
how often should restraints be unfastened or released?
Q1-2 hours
who can order a warm or cold application?
a doctor
which of the following is the most comfortable position for a client with a respiratory problem?
fowlers (90 degrees sitting up)
when wearing gloves, you should remember that
gloves are worn when using disinfectants
on which side should the patient lie for an enema?
left
which type of fire can be put out with water?
paper
which of the following people provide treatment for persons who have difficulty talking due to disorders such as a stroke or physical defects?
speech therapists
which of the following are the parts that make up the whole person?
spiritual, physical, emotional, cognitive, social
which state of a pressure sore or ulcer involves breakdown of the subcutaneous layer of the skin?
stage 3
infection control practices that prevent the transmission of disease are called
standard precautions
what is rigor mortis?
stiffening and locking of the joints after death
you are instructed to strain Mr. Powers urine. The purpose of straining the urine is to detect
stones
Towards the end of the day, residents with dementia commonly experience which of the following?
sundown syndrome
post partum refers to
the period of time after the delivery of a baby
which of the following is a correct measurement of urinary output?
300 mL
how many tips does a quad-cane base have?
4
Mrs. Shumway has an order for I&O. You have picked up her breakfast and note that she drank half of a 6 oz. glass of juice, 4oz. of milk, and 8 oz. of coffee. Therefore, you document
450 mL (1 oz = 30 mL)
which of the following measurements is an example of the proper way to record urinary output?
480 ml
your resident consumed a bowl of soup that was 180 cc of liquid. How many ounces was that?
6 oz
In long-term care facilities, which shift usually gets the residents ready for their appointments, X-rays, and other procedures?
7 am - 3:30 pm
There are two kinds of restraints
Physical and chemical
when lifting, the nurse aide should have his or her feet separated in the standing position to
Provide a wide base of support
A resident is NPO for tests. The nurse aide should
Remove the water pitcher and glass from the room
You are caring for Mr. Brown, who has a diagnosis of COPD. His SpO2 is 82%. He is currently receiving O2 via Nasal Cannula @ 2 liters/min. What do you do?
Report it STAT to the nurse
for safety, when leaving a client alone in a room, the nurse aide SHOULD
place the signaling device within the clients reach
to take an oral temperature the nurse aide should
place the thermometer under the tongue
which does NOT prevent or reduce odors?
placing fresh flowers in the room
A resident who is incontinent of urine is at increased risk of developing
pressure sores
the purpose of padding side rails on the clients bed is to
protect the client from injury
The goal of the health care team is to
provide quality care
restorative nursing care is the process of
providing care for the needs of the whole person
A nurse aide is pushing a resident in a wheelchair down the hall when a call light lights up. What should the aide do?
push the patient to a safe place, apply the wheel locks, then answer the call light
when you empathize with residents, you are
putting yourself in their place
drainage bags from urinary catheters should always
be kept below the level of the bladder
a resident is on a bladder training program. The nurse aide can expect the resident to
be on a scheduling for toileting
During dinner, an HIV-positive client accidentally breaks a glass and cuts himself. What is the proper procedure?
block off the area until it can be cleaned
when caring for a client who uses a protective device (restraint), the nurse aide SHOULD
check the clients body alignment
which of these actions helps prevent skin breakdown around a stoma if the resident has had a colostomy?
clean the stoma with water and mild soap
which is the most accurate way to measure a residents temperature?
rectal
A client who is on a low-cholesterol diet should not eat
red meat
Personal protective equipment (PPE) is used to
reduce exposure for health care workers
which of the following diets has not food restrictions?
regular
if the nurse aide discovers fire in a clients room, the FIRST thing to do is
remove the client
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
The nurse aide notices on the flow sheet that a resident has not had a bowel movement for 5 days. The nurse aide should
report this to the charge nurse
You have taken Ms. Clarks resting pulse and it is 106 beats per minute, which is significantly higher than her normal pulse. You should
report this to the charge nurse
Mr. Brown has an ankle brace. When you remove the brace, you notice a reddened area on the ankle. You should
report your observations to the nurse
considering the residents level of activity, which of the following sets of vital signs should be reported to the charge nurse immediately?
resting: 98.6-98-32
the nurse aide sees a client spill water on the floor in the hall. Another client is walking down the hall. The burse aide SHOULD...
clean up the spill
a professional and safe working appearance would include which of the following?
clean, wrinkle free uniforms, and short fingernails, and off the shoulder hair
what is the main purpose of continuing education for the nurse aide?
client safety
which of the following signs indicates a problem with a diabetic patient
cold, clammy skin
The nurse aide is walking with a client confined to a wheel chair when the facility fire alarm system is activated. The client becomes excited from the noise. The burse aide SHOULD
comfort the client while moving the person to a safe place
Food moves more slowly through the digestive tract of older people. What is a common consequence?
constipation
The learnings and behaviors of a group that are passed down from one generation to the next are known as
culture
Mrs. Shumway's nursing care plan lists CHF (congestive Heart Failure) as her primary dx. (Diagnosis). You would expect her ADL routine to include which of the following?
daily am weight measurement
which of the following is considered a normal age-related change?
decreased bladder capacity
Wrinkles in the bed linens can lead to problems for residents. Which is the most serious problem that they can cause?
decubitus ulcer
if a resident exhibits paranoid behavior, what should the nurse aide know?
delusions are a normal part of the progression of the dementia process
All of the following are signs of aggressive behavior EXCEPT
depressed mood
incidents reports are written in order to
determine patterns and trends
The thinning of the fatty layer under the skin could cause a resident to
develop pressure sores
which of the following methods is the correct way to remove a dirty isolation gown?
roll it dirty side in and away from the body
To encourage blood circulation in a resident who must remain in bed, you can do all of the following EXCEPT
rub the skin vigorously during a bed bath
the nurse aide is going to help the client walk from the bed to a chair. What should the nurse aide put on the clients feet?
rubber-soled slippers or shoes
In Maslow's hierarchy of needs, which of the following basic needs are most essential?
safety and secruity
Which one of these conditions require Contact isolation precautions?
scabies
The nurse aide notices that the clients radio cord is draped across a chair to reach the nearest outlet. The FIRST thing the nurse aide should do is...
see if any changes can be made so that the radio can be plugged in safely
a resident has diabetes. Which is a common sign of a low blood sugar level?
shakiness
which of the following is NOT a sleep aid?
drinking alcohol
when starting a job, when is HIPAA training mandatory?
during initial orientation
which device does NOT make toileting easier?
egg crate toilet cover
what is the best way to keep a skilled nursing facility from having an unpleasant odor?
empty bedpans and change linens in a timely manner
What type of isolation precautions are necessary for a patient with a gastrointestinal infection?
enteric precautions
if you see a fire, what should you do first?
evacuate patients in the area
mouth care should be given to an unconscious person
every two hours
various factors will change pulse rate. An increased pulse rate can be caused by
exercise
before performing any procedure, a nurse aide must
explain the procedure, wash his or her hands, identify the patient
which of the following is true regarding the use of side rails on a bed?
side rails should not be raised unless stated in the care plan
what position is Fowlers position?
sitting up
A patient chokes while eating and is unable to cough or speak. What is the first thing the nurse aide should do?
slap the patient between the shoulder blades
Constipation and indigestion can result from
slowed peristalsis
A Nurse aide is going to take Mr. Heath's vital signs. What should the nurse aide do to reduce Mr. Heath's anxiety and get him to cooperate?
explain the procedures to Mr. Heath
You are assigned to give Mr. Brown a partial bath. Which parts of his body should you wash?
face, hands,, underarms, back, perineum
Mrs. Harvey complains of abdominal discomfort. Watery stool has been leaking from her rectum. This could be a sign on
fecal impaction
Used disposable supplies and equipment should be discarded
in a designated receptacle
The exchange of oxygen and carbon dioxide takes place
in the lungs
A bed sore or decubitus ulcer is caused by
inadequate turning
Residents who are bedridden face all of the following risks EXCEPT
increased muscle strength
Diabetes mellitus makes a resident more prone to develop
infections
when a new ambulatory patient is admitted, the nurse aide should always
instruct the patient on how to use the call light
Besides hearing, what other function does the ear have?
it controls balance and equilibrium
to help prevent resident falls, the nurse aide should do which of the following?
leave residents beds at the lowest level when care is complete
which of the following is the recommended position for giving an enema
left sims
when transferring a client, MOST of the clients weight should be supported by the nurse aide's
legs
The nurse aide reports directly to the
licensed nurse
Intake and output deal with
liquids
signs and symptoms of shock may include
low blood pressure; tachycardia; and clammy, pale skin
how should the nurse aide position the patient to apply elastic stockings?
lying down in bed
supine position is
lying on the back
which of the following is a way to care for residents suffering from depression
make sure the residents wear their glasses and hearing aids
A resident who has stress incontinence
may leak urine when laughing or coughing
You notice that a patient has passed a black, tarry stool. This is called
melena
proper use of a waist restraint requires that the nurse aide
monitor for skin irritation
when interacting with clients, the nurse aide should remember that
more than half of all communication is nonverbal
which of the following statements about blindness are false?
most legally blind or visually limited people have no sight at all
charting is an accurate record of all medical care while the patient is in the hospital, including therapies given, treatments performed, and the patients progress. Information typically found in the chart includes all of the following EXCEPT
names of visitors
continuing education is
necessary for recertification in many states, important for keeping abreast of new development, a professional standard
the brain is part of the
nervous system
what does "afebrile" mean?
no fever
what can the nurse aide give a resident who has an order for NPO?
no foods or liquids
The normal aging process is BEST defined as the time when
normal body functions and senses decline
NPO means
nothing by mouth
Once a nurse aides name is placed on the abuse registry for neglect, the nurse aide may
petition the state nursing board for reinstatement
what is the branch of medicine that deals with physical medicine and rehab called?
physiatry
a client is to be assisted out of bed to sit in a wheelchair. How can this procedure be made safe?
place the bed in the lowest position
The nervous system changes as people get older. Which change is considered normal?
slower response time
the term atrophy refers to an organ or tissue becoming
smaller because of underuse
which of the following human needs are considered basic?
social, spiritual, sexual
Communication with a resident who has late stage dementia or Alzheimer's includes
speaking in one or two word sentences
a patient is nearing death. What should the nurse aide focus on?
supporting the patient and keeping the person comfortable
All body fluids are considered infectious except
sweat
Headaches, nausea, and pain are considered
symptoms
in a 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
when taking a blood pressure reading, you should do all of the following EXCEPT?
take the blood pressure reading in an arm with an IV
the nurse aide is responsible for the following fire prevention measures EXCEPT
taking cigarettes and matches away from all clients and visitors
why must the Foley bag be kept lower than the patients bladder?
to prevent urine returning to the bladder
when you're documenting in a patients record, which statement is FLASE?
to save time, chart a procedure before doing it
The equipment you need for oral care of an unconscious client includes
toothette /mouth swab
a patient has a diagnosis of psoriasis. her nurse aide should
treat her the same way as any other patient with a non-infectious disease
when taking a clients radial pulse, the nurse aides fingertips should be placed on the clients
wrist
Normal urine color is
yellow
Long term care facilities can provide which of the following types of service?
Home care
a nurse aide notices blood in a patients IV tubing. The aide should
notify the IV nurse
a complains that her hand hurts where the IV is running. The nurse assistant notices that the hand is puffy. The nurse aide assistance should
notify the IV nurse that the infusion appears to have infiltrated
you observe that a patient is bleeding from an IV site. You should
notify the RN immediately
The preferred way to remove a bedpan from a client who is unable to lift their buttocks is to
turn the client on their side while holding the bedpan
The normal heart rate or pulse rate for an adult human is 60-100 bpm. An elevated heart rate can be expected with
uncontrolled bleeding
The electric shaver that the nurse aide is using to shave a client begins to spark and smoke. what should the nurse aide do FIRST?
unplug the shaver
to avoid pulling on the catheter while you're turning a male client, the catheter tube must be taped to his
upper thigh
what is the condition when patients are unable to control their bladder?
urinary incontinence
hypothermia is a
very low body temperature
If the resident is smoking and the nurse aide needs to take an oral temperature, what should the nurse aide do?
wait 15 minutes to take their temperatures
which conditions promote the growth of bacteria?
warm, dark, moist
which of the following symptoms is most associated with rheumatoid arthritis?
warm, red, painful, and swollen joints
while emptying the trash in a clients room, you get stuck by a needle that should have been placed in the sharps container. What is the first thing you should do?
wash the site for several minutes
when assisting a resident with a weak left side from a wheelchair, the nurse aide should support the clients
weak side
As dementia progresses, incontinence can become an issue. How can the nurse aide assist?
what for signs of discomfort so you can take the resident to the bathroom
A sitting or semi-sitting position with the head of bed elevated is called
Fowler's
Mrs. Allen has had a gastrostomy, and the nurse just put Ensure through the feeding tube. The CNA needs to put her in which position for the next one to two hours?
Fowler's
a client who requires a high-fiber diet should eat
Fruits, vegetables, and whole grains
When lifting a heavy object, which muscle groups should you use?
Muscles of the legs
The nurse aide knows to wear which of the following when performing care for clients?
Name badge with job title, clean uniform or scrubs, shows with non-skid soles
when caring for a patient with MRSA, a nurse aide should wear
a gown and gloves
An elderly resident who is inactive is at risk of constipation. In addition to increased activity and exercise, which of the following actions helps prevent constipation?
adequate fluid intake
A sit bath is helpful
after rectal surgery
when calculating total fluid intake over a 24 hour period, all of the following should be included EXCEPT
all eye or skin ointments that are absorbed
which statement about gait belts is FALSE?
all gait belts have reversible buckles
when assisting a blind resident to walk, you should
allow the resident to hold your arm
The medical term for hair loss is called
alopecia
A restraint attached to a patients body and to a stationary object is
an active physical restraint
The type of bed used for a patient arriving by stretcher or wheelchair is
an open bed
in what position should the nurse aide place the unconscious person when giving oral care?
Lateral
Which vegetable is not allowed on a low-sodium diet?
Sauerkraut
What is a pulse oximeter used to measure?
The amount of O2 in the blood
who supervises the work of a nurse aide?
a nurse
what are the main components of successful communication?
a sender, a message, and a reciever
The loss of the ability to express oneself is known as
aphasia
A client needs to be repositioned but is heavy, and the nurse aide is not sure that she can move the client alone. The nurse aide should
ask another nurse aide to help
The nurse asks you to change the urine drainage bag for a patient with an indwelling catheter. If you aren't sure how to change it, what should you do?
ask the nurse to show you
Breathing liquids or solids into the airway or lungs is called
aspirations
As nurses aides begin their assignments, which should they do first?
assist a resident that needs assistance to get off the toilet
to be sure that a clients weight is measured accurately, the client should be weighed
at the same time of the day
wasting or a decrease in the size of a muscle is called
atrophy
while eating dinner, a client starts to choke and turn blue. The nurse aide SHOULD
call for assistance and perform the Heimlich maneuver (abdominal thrusts)
A resident has an indwelling urinary catheter. While making the rounds, the nurse aide notices that there is no urine in the drainage bag. What should the nurse aide do first?
check for kinks in the tubing
which of the following is the safest way to confirm a residents identity?
check the ID bracelet or tag attached to the resident
when caring for a resident with an indwelling Foley catheter, you should
check the bag and tubing frequently for adequate urinary flow
what is the FIRST thing a nurse aide should do when finding an unresponsive client?
call for help
you arrive at a clients home for care. She shows you a burn on her arm. It is blistered and the client is complaining of severe pain. You should
call the Home Health manager
Most of our calories should come from
carbohydrates
The earliest identifying sign for a developing pressure sore is a local
change in color
if your patient is in traction, you should NOT
change the position of the weights
A patient suffering from pneumonia might exhibit symptoms such as
chest pains and discomfort, persistent coughing, thick sputum
using touch as a way to communicate with a clinet
depends on the clients culture
when a patient is receiving a nasogastric (NG) tube feeding, what should the nursing assistant do?
immediately report any signs of choking or vomitting
a patient appears paler than usual. The nurse aide should
Ask the patient how he feels and take his vital signs immediately
in a reality orientation program, which of the following should you NOT do?
Ask the residents about their childhood
Mrs. Andrews has an indwelling urinary catheter. Which of the following statements is INCORRECT?
Attach the drainage bag to the bed rail
which of the following measurements that you obtained from Mrs. Shumway should be reported immediately to the charge nurse?
B/P 190/114
meal trays have arrived. Before serving each tray, the nurse aide should
Check each armband, even on familiar pateints
swollen ankles and legs may be signs of
Congestive heart failure
When operating a manual bed, the nurse aide should remember to...
Fold the cranks under the bed (This prevents others from tripping or falling)
Many elderly residents lose their appetite because of
Depression, decrease in number of taste buds, social isolation
why should heat NOT be applied to a diabetic residents feet?
Diabetics have decreased sensitivity to heat
Which of following is a proper way to correct an error in charting?
Draw a single line through it
A diabetic resident asks the nurse aide to cut her toenails. The burse aide should
Tell the resident that the nurse aide cannot do it but will report it to the charge nurse
The RN assigns you a task that is in your job description. Which of the following statements is FALSE?
The RN should delegate every non-RN task to you
A person with dementia is being admitted to your facility. Which of the following statements are correct?
The admission process will be completed as quickly as possible, the persons confusion may increase in these new surroundings, and family members will be asked to leave to help the person adjust
Who is responsible for the entire nursing staff and the activities involved in providing safe care?
The director of nursing
A hepatitis B vaccination protects the person receiving it against a disease that affects
The liver
which of the following is a major reason for urinary incontinence in elderly?
The muscle that keeps urine in the bladder weakens
A nursing aide has four patients to assist. Whom should she address first?
The patient who needs to be taken to the bathroom
objective data is any information that is fact. This means that the info is unbiased and multiple people should be able to interpret the info in the same way. Which f the following is NOT an example of objective data?
The patients pain level is 3 out of 10
who is in charge of delegating the work assignment?
The registered nurse on duty
When dry, hard stool fills the rectum and will not pass, it is called
impaction
To secure a restraint, a slipknot is used so that
The restraint can be removed quickly when needed
What is a CNA's scope of practice?
The skills that the CNA is legally allowed to perform
The opening of the colostomy to the outside of the body is called
The stoma
The safety device used to transfer a weak or dependent patient from a bed to a chair is called a
Transfer/ gait belt
what does the acronym "BID" stand for?
Two times a day
All of the following statements about type 2 diabetes are true EXCEPT
Type 2 diabetes is very rare in adults
which symptoms best indicate an instance of urinary tract infection?
Urine that appears cloudy, the need to urinate more frequently, burning or stinging sensation when urinating
which is INCORRECT when your recording on a patients chart?
Use a pencil in case you make a mistake
The Heimlich maneuver (abdominal thrusts) is performed on a patient who has
a blocked airway
The Heimlich maneuver (abdominal thrusts) is used on a client who has
a blocked airway
what is an embolism?
a blood clot that moves through the bloodstream and causes obstruction
which of the following should be reported immediately
a blood pressure of 90/40
A common eye disorder involving a cloudy condition of the lends that impairs eyesight is known as
a cataract
On admission to a nursing home or a long-term care facility, a resident must be given
a copy of the Residents Bill of Rights
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
to help ensure adequate circulation to prevent patient skin breakdown, you should
give back massages, perform active or passive range of motion exercises, change the patients position frequently
a patient who was given insulin in the morning is pale and sweaty and appears confused two hours later. It would be helpful to find out whether the patinet
had breakfast
which of the following are associated with smoking
heart attacks, vitamin C deficiency, pneumonia
The circulatory system consists of the
heart, arteries, veins, and capillaries
Paralysis on one side of the body is called
hemiplegia
to take a rectal temperature, the nurse aide should insert the thermometer and
hold on to the thermometer until is can be removed
A health care agency or program for patients who are dying is
hospice
settings where a CNA can work includes
hospitals, hospices, home care
a patient with a persistent blood pressure measurement above 140/90 has
hypertension
the charge nurse has asked you to take Mrs. Shumway's vital signs. Before doing so, you must
identify the patient and introduce yourself, gather all appropriate equipment, wash your hands
a resident with an ileostomy evacuates feces through the
ileum
The residents weight is measured routinely as a way to check the persons
nutrition and health
The best way for a nurse aid to gather information about the safety and well-being of a resident is
observation
Which specialist is responsible for assisting residents to perform everyday activities?
occupational therapist
when helping a client who is recovering from a stroke to walk, the nurse aide should assist
on the clients weak side
a client is paralyzed on the right side. The nurse aide should place the signaling device
on the left side of the bed near the clients hand
To count respirations, one respiration includes
one inhalation and one exhalation
Elderly residents sometimes appear stooped over and seem to have lost height. This is due to
osteoporosis in the spinal column
which of the following is NOT considered a way to restrain a client
pain managment
which of the following is an appropriate task for the nurse aide?
participating in resident care plan conferences
you patient is on bed rest. You can help percent development of contractures by
performing ROM exercises, positioning in a good body alignment, and using supportive devices
repeating a phrase or action over and over is called
perseveration
all behavior has meaning to the
person doing the behavior
a hospice specializes in the care of people who are
terminally ill
Insulin, a hormone, regulates
the amount of sugar in the blood
strokes are seen in the elderly. A stroke occurs when
the brain is deprived of oxygen
The plan that starts on the residents admission and assists when the resident goes home is called
the discharge plan
what is aphasia?
the inability to speak or articulate words
if your patient has bradycardia, what does that mean?
the patients heart rate is abnormally slow (below 60 bpm)
who should manage the residents finances?
the resident
A nurse aide is assigned to a stroke patient with a diagnosis of aphasia. The nurse aide knows that
the resident cannot talk
in the nursing care plan, you note that it is written, "02 per N/C @3L, Orthopnea pos. as needed". As a CNA, you know that this means which of following?
the resident is an oxygen with a nasal cannula of three liters. Assist to sit in Fowlers postion
a nurse assistant notices red marks on a residents back and buttocks. The aide acts in the knowledge that
the skin can break down if nothing is done
a patient who is lying on his or her back is in
the supine position
An important rule of communication is to always use the proper "register". This means
the way we talk to different people
why do residents with Parkinson's disease require assistance when walking?
they have a shuffling gait and often get tremors
a Foley catheter is used
to drain urine from the bladder
what is the purpose of the chain of command in a long-term care facility?
to keep communication about a problem flowing smoothly
