CERTIFIED NURSING ASSISTANT (CNA) EXAMS, PRACTICE EXAMS AND STUDY GUIDE EXAMS, Exams of Nursing

Download CERTIFIED NURSING ASSISTANT (CNA) EXAMS, PRACTICE EXAMS AND STUDY GUIDE EXAMS and more Exams Nursing in PDF only on Docsity! 1 | P a g e CERTIFIED NURSING ASSISTANT (CNA) EXAMS, PRACTICE EXAMS AND STUDY GUIDE EXAMS WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED RATIONALES ANSWERS 2024 (NEWEST) ALREADY GRADED A+ CERTIFIED NURSING ASSISTANT (CNA) EXAMS The most serious problem that wrinkles in the bed clothes can cause is... a. restlessness. b. sleeplessness. c. decubitus ulcers. d. bleeding and shock. c. decubitus ulcers. Restorative care begins... a. as soon as possible. b. when the client is ready. c. when the client is discharged. d. when the client is diagnosed as terminally ill. a. as soon as possible. Before placing a client in Fowler's position, the nurse aide should... a. open the window. b. explain the procedure to the client. c. check with the client's family. d. remake the bed. b. explain the procedure to the client. During hand washing, the nurse aide accidentally touches the inside of the sink while rinsing the soap off. The next action is to... a. allow the water to run over the hands for two minutes. b. dry the hands and turn off the faucet with the paper towel. 2 | P a g e c. repeat the wash from the beginning. d. repeat washing, but for half the time. c. repeat the wash from the beginning. How should a nurse aide dress for a job interview? a. wearing a clean t-shirt and casual slacks b. wearing a nurse aide uniform c. wearing a business suit, dress, or pants and dress shirt d. wearing formal attire c. wearing a business suit, dress, or pants and dress shirt An ambulatory client is newly admitted. Before leaving the client alone, the nurse aide should... a. ask if the client is hungry. b. inspect the client's skin. c. assess the client's intake and output. d. make sure the client knows how to use the call bell. make sure the client knows how to use the call bell. When lifting a heavy object, the correct method would be to bend at the... a. waist, keeping your legs straight. b. waist, rounding your shoulders. c. knees, keeping your back straight. d. knees and waist c. knees, keeping your back straight. When should nurse aides wash their hands? a. after eating b. before using the bathroom c. after client care d. before cleaning a bedpan c. after client care When assisting a client with eating, one of the first things the nurse aide should do is... a. cut the food into bite-size pieces. b. wash his own hands and the client's hands. c. butter the client's bread. d. provide the client with privacy. b. wash his own hands and the client's hands. A patient has a new cast on her right arm. While caring for her, it is important to first observe for... a. pulse above the cast. b. color and hardness of the cast. c. warmth and color of fingers. d. signs of crumbling at the cast end. 5 | P a g e The hot water bottle is an example of a... a. local dry heat application. b. generalized dry heat application. c. local moist heat application. d. generalized moist heat application. a. local dry heat application. Clients receiving an enema are usually placed... a. on the right side. b. on the left side. c. flat on the back. d. in a semisitting position. b. on the left side. A female client's perineal area should be cleansed before which specimen is collected? a. 24-hour urine specimen b. midstream clean-catch urine specimen c. pediatric routine urine specimen d. routine urine specimens b. midstream clean-catch urine specimen. 42. The most common site for counting the pulse is the... a. carotid artery. b. femoral artery. c. brachial artery. d. radial artery. d. radial artery. When counting respiration, the nurse aide should... a. wait until after the client has exercised. b. not tell the patient what he is going to do. c. count five respirations and then check his watch. d. have the client count respirations while the aide takes her pulse.. b. not tell the patient what he is going to do. Which of the following is NOT the nurse aide's responsibility when caring for clients who have urinary catheters? a. inserting the catheter. b. ensuring that the catheter drains properly. c. preventing infection. d. recording urinary output. a. inserting the catheter. 6 | P a g e When giving information to the charge nurse for an incident report, the nurse aide should... a. write in the client's chart that an incident occurred. b. keep the report in her personal file. c. state the facts clearly. d. give her opinions as to the cause of the incident. c. state the facts clearly. All long-term-care nurse aides must be competency evaluated and must complete a distinct educational course. These requirements are set by... a. OBRA. b. OSHA. c. CDC. d. FDA. a. OBRA. A resident is blind. It is important not to... a. leave the door completely opened. b. rearrange the furniture. c. announce yourself before entering the room. d. explain the location of food on the plate, using the face of the clock to assist. b. rearrange the furniture. When family members visit a client, the visitors should... a. stay in the day room. b. stay a short while so as not to tire the client. c. be expected to help with care. d. be allowed privacy with the client. d. be allowed privacy with the client. A resident asks, "If I need help during the night, who will be there?" The nursing assistant should respond,... a. "Don't worry, you'll be okay." b. "Just yell; someone will hear you." c. "Your roommate will probably ring the call bell." d. "There are people here all night to help you." d. "There are people here all night to help you." Which of the following is a client's right? a. having personal information kept confidential b. obtaining private duty staff if desired c. knowing what is wrong with the client's roommate d. treating the staff any way he or she pleases a. having personal information kept confidential 7 | P a g e A resident often cries while she is receiving herP.M. care. What should the nurse aide do?a. Tell her to stop crying.b. Ignore her and continue with her carq.c. Tell her jokes to make her laugh.d. Tell her that it's all right to cry, and that theaide is there for her if she wants to talk. d. Tell her that it's all right to cry, and that the aide is there for her if she wants to talk. When providing denture care, the nurse aidemusta. wash them in boiling water.b. hold them under warm running water.c. dunk them in and out of cool water.d. place them on a towel in the sink with coolwater. d. Sexuality in long-term-care clients may includeall of the following EXCEPTa. needing private time with a partner.b. caring about one's physical appearance.c. engaging in public fondling.d. desiring sexual interaction c. engaging in public fondling. A client is scheduled for a partial bed bath. Thismeans that the nurse aide must wash theclient'sa. face, neck, ears, arms, and hands.b. face, axillae, hands, and buttocks.c. face, hands, axillae, and legs.d. face, hands, axillae, genitals, and buttocks. d. face, hands, axillae, genitals, and buttocks An agitated resident must be turned every twohours all night long. The first action of thenurse aide when waking up this resident is toa. turn on the light.b. speak quietly and calmly.c. touch her shoulder.d. shout her name. b. speak quietly and calmly. If a client objects to certain food for religiousor cultural reasons, the appropriate actionwould be toa. tell him to wait for the next meal.b. offer to substitute something different forhim.c. call the dietician the next day.d. tell him he needs to eat what is on his tray. b. offer to substitute something different for him. The client's religion forbids eating pork. Baconis being served for breakfast. The mostappropriate response is toa. encourage the client to eat it because sheneeds protein.b. tell the client it is all right since her doctorordered the diet.c. call the kitchen for a tray without bacon.d. tell the client that restrictions are not asimportant as her health. c. call the kitchen for a tray without bacon. Which type of communication can often be most powerful? a. writtenb. verbalc. silentd. tactile c. silent A client refuses to allow the nurse aide to batheher. The nurse aide tells the client that she willnot be allowed to eat lunch or go to bingo if shedoes not have her bath. This is an example ofa. rehabilitation.b. discipline.c. verbal abuse.d. physical abuse. 10 | P a g e The preferred way to remove a bedpan from a client who is unable to lift her buttocks is toA) use a mechanical lifting deviceB) have another nursing assistant lift the clientC) turn the client to the side while holding the panD) slowly slide the pan from under the client c After shaving a patient with a safety razor, the nurse aide shouldA) cover it before discardingB) wrap it up in a paper towel and drop it into the trash canC) dispose of it in a sharps containerD) place it in the patient's drawer for reuse C c When a client complains that his dentures are hurting, the appropriate action is toA) encourage him to wear the dentures more oftenB) report the complaint to the charge nurseC) report the complaint to the physicianD) put the dentures on the bedside tabel b A female resident's husband has asked for sometime alone with his wife in her room. Whatshould the nurse aide do?(A) Let the husband visit but listen outside thedoor.(B) Let the husband visit and leave the dooropen.(C) Tell the husband not to disturb his wife.(D) Let the husband visit in private. b A resident needs range of motion (ROM)exercises every day. When the nurse aide tries to help her do the exercises, the resident says she will not do them. She says that they are too hard. What is the nurse aide's best response? (A) "Try harder and the exercises will be easier." (B) "I understand, but try working slowly and resting often." (C) "The doctor ordered the exercises because they are important." (D) "Think of something good during the exercises and maybe they won't be so hard." b Upon entering a room, the nurse aide notices that a patient is not breathing. The aide's first action is toA) call for helpB) lay the patient down on his backC) give four quick breathsD) give ten abdominal thrusts a A patient is on bed rest, wearing a TED hose. How often should the hose be removed?A) neverB) q2hC) at least twice a dayD) q6h c A nurse aide enters a room to check on a residentwho is in restraints. The nurse aide finds that theresident has gotten out of the restraint and ispartly out of the bed. What should the nurseaide do?(A) Call for help to get the resident back into bedand put the restraint back on.(B) Put the restraint back on tightly so that theresident cannot move.(C) Leave the restraint off and report theproblem to the charge nurse.(D) Put a different type of restraint on theresident.hard." 11 | P a g e a Decubitus ulcers can be prevented byA) changing the client's position frequentlyB) placing an egg-crate mattress on top of the mattressC) increasing the patient's vitamin CD) both a and b d A resident does not want to wear her dentures.She says she has a sore in her mouth. The nurseaide should(A) tell her to leave her dentures out for a fewdays.(B) have the resident rinse her mouth with saltwater.(C) tell her that she will feel better if she wearsthe dentures.(D) leave the dentures out and ask the nurse tocheck the resident's mouth. d After a resident has died, the nurse aide is oftenassigned to do which of the following?(A) Prepare the resident's body.(B) Call the resident's family.(C) Call the resident's doctor.(D) Call the undertaker. a A nurse aide notices that a water pitcher has spilled onto the floor. The best action for the aide to perform is toA) wipe it up immediatelyB) cover it with a towelC) notify the charge nurseD) contact housekeeping a A resident complains that he cannot fall asleep.What can the nurse aide do first to help himrelax?(A) Move him to the day room.(B) Give the resident a back rub.(C) Give the resident a sleeping pill.(D) Report the resident's complaint to the chargenurse. b Upon entering a room, the nurse aide notices that a patient is not breathing. The aide's first action is toA) call for helpB) lay the patient down on his backC) give four quick breathsD) give ten abdominal thrusts a A resident is to start range of motion (ROM)exercises. When performing ROM exercises on aresident, what does the nurse aide do to eachjoint?(A) Stretch it until it hurts.(B) Rotate it in both directions until it hurts.(C) Bend it to a 90-degree angle whilesupporting the limb.(D) Move it to its fullest range or until theresident feels discomfort. d A sign on the resident's door says NPO. Whatdoes this sign tell the nurse aide about theresident?(A) The resident is receiving AM care.(B) The resident is receiving oxygen therapy.(C) The resident is not to be given any solidfood.(D) The resident is not to be given anything bymouth. d A resident is smoking a cigarette in the smokingarea on the outside porch of the nursing home.The resident keeps dropping the cigarette in hislap. What should the nurse aide do first?(A) Stay with the 12 | P a g e resident until he is finishedsmoking.(B) Tell the resident that he must be morecareful.(C) Check on the resident every few minutes.(D) Go and report it to the charge nurse. a A nurse aide is assigned to care for a residentwho asks her to stay with her because she thinksshe is dying. What should the nurse aide do?(A) Scold the resident for talking that way.(B) Ask the resident why she feels this way.(C) Tell the resident, "That isn't true."(D) Ignore the resident's behavior. b A resident is able to dress himself, but he is veryslow. What should the nurse aide do to assist thisresident to get to breakfast on time?(A) Dress the resident.(B) Tell the resident to hurry.(C) Start the resident dressing earlier.(D) Warn the resident he is going to missbreakfast. c A nurse aide is caring for a resident on bedrest.The resident is not able to turn herself. What isthe longest time that the nurse aide is allowed toleave the resident in one position?(A) 1 hour(B) 2 hours(C) 3 hours(D) 4 hours b A resident's care plan calls for the resident toambulate 50 feet twice a day. The resident tellsthe nurse aide that she is unable to do it now.What should the nurse aide do?(A) Ask the resident to be more helpful.(B) Ask the charge nurse to change the careplan.(C) Tell the resident that she can skip her walktoday.(D) Allow the resident to choose a better time toambulate. d A nurse aide notices that a resident has very dryskin on the feet. How should the nurse aide carefor the resident's feet?(A) Raise them on a pillow.(B) Wash and dry them only.(C) Keep socks on them at all times.(D) Apply lotion after washing and drying thefeet. d An elderly resident is normally alert, but today she is slightly confused. What should the nurse aide do? (A) Say, "It is not like you to act like this." (B) Report the confusion to the charge nurse. (C) Not worry because all old people get confused sometimes. (D) Ignore the confusion because the resident may only be trying to get extra attention. b A nurse aide has found a fire in a resident's wastecan. What should the nurse aide do first?(A) Pull the fire alarm.(B) Pour water on the fire.(C) Move residents out of immediate danger.(D) Use the fire extinguisher to put out the fire. c 15 | P a g e b A nurse aide wants to get a resident involved inher own care. Which of these statements wouldbest encourage the resident's involvement?(A) "Stop feeling sorry for yourself."(B) "It's time for us to eat our breakfast."(C) "I want to brush your hair right now."(D) "Do you want to take your bath now or afterbreakfast?" d A resident has an indwelling catheter. As thenurse aide cares for him, which of these should the nurse aide report to the charge nurse immediately?(A) The resident complains of pain and burning.(B) The urine in the collection bag is clear andlight yellow in color.(C) The resident tells the nurse aide that he hatesto have a catheter.(D) The urine in the collection bag is hangingbelow the level of the bladder a What is the best source of information about thecare a nurse aide needs to give a resident?(A) The resident's family(B) The resident's roommate(C) The resident's plan of care(D) Other nurse aides on the unit. c A resident tells the nurse aide that her hearing aidis not working. What should the nurse aide dofirst?(A) Turn up the volume.(B) Change the battery.(C) Tell the charge nurse.(D) Check to see that the hearing aid is turnedon. d While making rounds at 3:00 A.M., a nurse aidehears a resident crying softly. How should thenurse aide respond?(A) Tell the resident that everything will bebetter in the morning.(B) Tell the resident that everything is fine andto cheer up.(C) Pretend not to notice that the resident iscrying.(D) Ask the resident what is wrong. d A resident is being discharged from the nursinghome. He tells the nurse aide that he feelsworried about the change. What is the nurseaide's most helpful response?(A) Encourage the resident to talk about hisfeelings.(B) Tell the resident not to worry as things willwork out fine.(C) Tell the resident that he should be happy toleave the nursing home.(D) Suggest to the resident that his worries willgo away if he ignores them. a A nurse aide is called away from a resident'sbeside. When the nurse aide returns, the residentscreams, "I'm too old and too sick to be leftalone." How should the nurse aide respond?(A) "You're fine. Don't carry on so."(B) "I understand, but I have other things to do."(C) "Why don't you just forget it and restawhile?"(D) "I'm sorry I had to leave. Can I help younow?" d 16 | P a g e A nurse aide is cleaning a resident's closet. Hefinds moldy food and throws it away. Theresident shouts, "Leave my food alone." What isthe best response by the nurse aide?(A) "Why are you saving this food? Do you gethungry between meals?"(B) "You should eat all your meals, so that youare not hungry later on."(C) "Hiding food is against health laws."(D) "This moldy food smells awful. a A nurse aide observes that a new resident is upsetand frightened while getting ready for bed. Theresident tells the nurse aide that a dark roomfrightens her. What is the nurse aide's bestresponse?(A) "Darkness can't hurt you."(B) "As old as you are, you should not beafraid."(C) "You will soon get used to sleeping in thedark."(D) "I will leave the door open so the light cancome in." d A nurse aide is assisting a resident with lunch.The resident grabs his throat and cannot speak.What should the nurse aide do first?(A) Offer the resident a drink.(B) Perform the Heimlich maneuver.(C) Place the resident on the floor and elevatehis feet.(D) Keep the resident warm by putting a blanketon him. b A nurse aide realizes from the assignment sheet,that a resident has not has a bowel movement formore than 3 days. What should the nurse aide do?(A) Ignore the problem.(B) Give the resident an enema.(C) Report the finding to the charge nurse.(D) Sit the resident on the toilet until he has abowel movement. c A resident has had a stroke and has weakness onher right side. Where should the nurse aide standwhen helping the resident walk?(A) On the resident's right side(B) On the resident's left side(C) In front of the resident(D) Behind the resident a A resident is grieving over the recent death of herhusband. How can the nurse aide best offersupport to the resident?(A) Leave the resident alone as much aspossible.(B) Encourage the resident to express her feelings.(C) Change the subject when the resident speaksabout her husband.(D) Tell the resident about the nurse aide's ownexperiences with death. b A nurse aide is assigned to care for a residentwho has wandered over to another unit. What isthe nurse aide's most helpful response, when thenurse aide brings the resident back?(A) "Let me walk with you."(B) "How did you get over here?"(C) "Don't you know where you belong?"(D) "Don't you realize I have a lot to do?" a A resident has a cold and is using tissues for hisnose. There are used tissues on the resident'sbed, floor, and bedside stand. What should thenurse aide do to control the spread of infection?(A) Report the resident's behavior to the residentcouncil.(B) Ask the resident to throw his used tissues inthe toilet.(C) Pick up the used tissues in the resident'sroom once a day.(D) Attach a paper bag to the resident's bed and ask him to put the used tissues in it. 17 | P a g e d A resident tells a nurse aide he is going to killhimself. What should the nurse aide do?(A) Nothing, because people who threatensuicide usually do not kill themselves.(B) Call the resident's family and ask them tocome and sit with him.(C) Tell the resident that things are not as bad asthey seem.(D) Stay with the resident and call for help d A nurse aide sees the charge nurse swallowmedication that belongs to a resident. Whatshould the nurse aide do?(A) Ignore the incident because the charge nursemight get the nurse aide fired.(B) Tell the resident's family that the chargenurse is stealing medication.(C) Report the incident to the administrator or nursing supervisor.(D) Suggest the nurse get help immediately. c Which of the following should the nursing assistant observe and record when admitting a client? a. frecklesb. wrinklesc. short nailsd. bruises d. Bruising may be due to accidents, abuse, medications, or illness. When responding to a client on the intercom,the nursing assistant should saya. "Hello, who is calling, please?"b. "What is it that you want?"c. "This is [nursing assistant name andposition], can I help you?"d. "Please hold; I'll have the nurse answer yourcall." c When arranging a client's room, the nursingassistant should do all of the followingEXCEPTa. checking the placement of the call bell.b. adjusting the back rest as directed.c. administering the client's medications.d. adjusting the lighting as appropriate. c. Nursing assistants are not allowed to administer medications. When assisting a client out of bed, the nurse aide should always... a. employ body mechanic techniques. b. get another nurse aide to assist.c. raise the bed to its maximum height.d. lower all safety rails. a. Always use proper body mechanics when moving clients How often should clients be repositionedduring an eight-hour shift?a. qlhb. q2hc. q3hd. q4hon/x-ms b. Clients should be turned every two hours to prevent decubitus ulcers Which of the following is the correct procedurefor serving a meal to a client who must be fed?a. Serve the tray along with all the other trays,and then come back to feed the client.b. Bring the tray to the client last; feed afteryou have served all the other clients.c. Bring the tray into the room when you areready to feed the client.d. Have the kitchen hold the tray for one hour. c. An aide should not bring the tray into the room until he has time to feed the client. 20 | P a g e a. substitute diet soda for the ice cream.b. hold the afternoon snack and report to the charge nurse.c. call the kitchen and report the error.d. allow the client to have half of the ice cream. b. The nursing assistant should report this error to the charge nurse, who in turn will contact the kitchen and obtain the correct nourishment. When assisting a client who is using the commode, it is important to... a. leave the call light within reach.b. lock the door to promote privacy.c. stand next to the client until the client isfinished.d. restrain the client to prevent a fall. a. The client should always have access to get help when needed Ensuring adequate circulation to tissues is amajor factor in preventing skin breakdown.This can be accomplished by doing all of thefollowing EXCEPTa. positioning the patient every four hours.b. using mechanical aids.c. giving backrubs.d. performing active or passive ROM exercises. a. The patient must be positioned every two hours to prevent skin breakdown due to poor circulation The purpose of cold applications is usually toa. speed the flow of blood to the area.b. prevent heat exhaustion.c. prevent or reduce swelling.d. prevent the formation of scar tissue. c The hot water bottle is an example of a a. local dry heat application. b. generalized dry heat application. c. local moist heat application. d. generalized moist heat application. a Clients receiving an enema are usually placeda. on the right side.b. on the left side.c. flat on the back.d. in a semisitting position. b. enema=left A female client's perineal area should be cleansed before which specimen is collected?a. 24-hour urine specimenb. midstream clean-catch urine specimenc. pediatric routine urine specimend. routine urine specimen b The most common site for counting the pulse is thea. carotid artery.b. femoral artery.c. brachial artery.d. radial artery b When counting respirations, the nurse aide shoulda. wait until after the client has exercised.b. not tell the patient what he is going to do.c. count five respirations and then check hiswatch.d. have the client count respirations while theaide takes her pulse. b 21 | P a g e When providing denture care, the nurse aide musta. wash them in boiling water.b. hold them under warm running water.c. dunk them in and out of cool water.d. place them on a towel in the sink with cool water. d. place them on a towel in the sink with cool water. A goal for an extended care facility (ECF) resident is that she not swear at the nurses oraides. When she calls an aide by his name, the appropriate action is toa. smile and give the appropriate reward.b. continue whatever task that is being done.c. tease the resident about not swearing.d. tell all of the staff that she didn't swear. a. smile and give the appropriate reward. A client's dentures are lost. The first actionshould be toa. notify the administrator.b. look for them.c. notify the doctor.d. notify the charge nurse. d. Nursing assistants are responsible fora. planning client care.b. doing tasks assigned by the charge nurse.c. performing without ever asking for help.d. comparing assignments with coworkers. .b. doing tasks assigned by the charge nurse. A nurse aide who applies restraints on a client without directions from the charge nurse may be accused of a. slander .b battery. c. false imprisonment. d. negligence. c The best food choices for a geriatric client withno teeth would includea. hamburger, french fries, corn, and ice cream.b. baked chicken, dressing, green beans, andcoconut macaroons.c. spare ribs, macaroni and cheese, coleslaw,and fruit cocktail.d. baked fish, whipped potatoes, spinach souffle, and tapioca. d .d. baked fish, whipped potatoes, spinach souffle, and tapioca. 70. A client's family wants to talk about the client'simpending death, but the client does not wantto talk about it. The family should beencouraged toa. carry on the conversation away from the client.b. talk freely in front of the client in order tohelp the client to accept it.c. wait until the client dies to talk about it.d. force the client to talk about it with them. .a. carry on the conversation away from the client. 22 | P a g e When assisting a client in learning how to use a cane, the nurse aide stands... a. approximately two feet directly behind the client. b. about one foot from the client's weak side. c. about one foot from the client's strong side. d. slightly behind the client on the client's weak side. d. slightly behind the client on the client's weak side. When working with a client who has urinary retention, the nurse aide can expect that the client will... a. urinate large volumes. b. be unable to urinate. c. urinate frequently. d. be incontinent of urine. b. be unable to urinate. Aging-related hearing changes result in older clients gradually losing their ability to hear... a. high-pitched sounds. b. low-pitched sounds. c. slow sounds. d. rapid sounds. a. high-pitched sounds. The best way to safely identify your patient is by a. asking his name. b. calling his name and waiting for his response. c. checking the bed plate. d. checking the name tag. d. checking the name tag. A client is on a bowel and bladder training program and has not had a bowel movement in three days. The nurse aide should... a. report it to the charge nurse. b. give the client an enema. c. offer the client prune juice. d. encourage the client to drink more fluids. a. report it to the charge nurse. The proper medical abbreviation for before meals is... a. p.c.b. b. i.d. c. a.c. d. t.i.d. 25 | P a g e Medically necessary care given by a skilled nurse or therapist- available 24 hours of the day Ordered by a doctor and involves a treatment plan What are some examples of chronic conditions? Conditions that last a long period of time, even a lifetime Physical disabilities, heart disease, and dementia, Alzheimer's disease, AIDS, diabetes, COPD, cancer, and congestive heart failure What are assisted living facilities? For people who need some help with daily tasks, such as showering, meals and dressing These people do not need 24 hour skilled care What is acute care? 24 hour skilled care given in hospitals and ambulatory surgical centers for people who require short- term, immediate care for illnesses or injuries What is subacute care? Care given in hospitals or long-term care facilities for people who need less care than for an acute illness but more care for than a chronic illness Treatment normally ends when the condition has stabilized or after the set time for treatment has been completed What is outpatient care? Given to people who have had treatments, procedures or surgeries and need short-term skilled care What is rehabilitation? Care given by specialists and professionals Physical, occupational and speech therapists What is hospice care? Given in facilities or homes for people who have 6 months or less to live Workers give physical and emotional care and comfort until a person dies (for both the patient and the family) Can be at any location What are examples of activities of daily living (ADLs)? 26 | P a g e Skin, nail and hair care Mouth care Assistance with walking, eating, and drinking Assistance with dressing, transferring and elimination Physical, occupational, and speech therapy Wound care Care of different types of tubes Nutrition therapy Management of chronic diseases What is person-centered care? Emphasizes the individuality of the person who needs care, and recognizes and develops the person's capabilities Revolves around the resident and promotes their individual preferences, choices, dignity and interests What is trauma-centered care? An approach to patient care that recognizes that people may have experienced trauma in their lives Trauma can come from witnessing or experiencing abuse or neglect, witnessing violence, unstable home environments, poverty, discrimination, life-threatening illnesses or negative experiences in the medical setting What is CMS? The Center for Medicare and Medicaid Services A federal agency within the US Department of Healthy and Human services that helps pay for health care and health insurance for millions of Americans What is Medicare? A federal health insurance program that was established in 1965 for people aged 65 and older It also covers people of any age with permanent kidney failure or certain disabilities It helps pay for care facilities, helps pay for doctor services and medical equipment, allows private health insurance companies to provide Medicare benefits and helps pay for medications What is Medicaid? A medical assistance program for people who have low income, as well for people with disabilities It is funded by both the federal government and each state What are common nursing assistant duties? 27 | P a g e Bathing residents Helping with elimination needs Assisting with range of motion exercises Transferring residents from a bed to a chair Assisting with meals Measuring vital signs Helping residents with ambulating Helping residents dress/ undress Giving back rubs Helping with mouth care Making and changing beds Keeping residents' areas neat and clean Caring for supplies and equipment Charting What is an LPN? Licensed Practical Nurse Gives medications and treatments What is a PA? Physician Assistant A licensed professional who diagnoses disease or disability and develops treatments plans, as well as prescribes medications Works under the supervision of a doctor What is an OT? Occupational Therapist Helps residents learn to adapt to disabilities What is an MSW? Medical Social Worker Determines residents' needs and helps get them support services, such as counseling and financial assistance What is the chain of command? Describes the line of authority and helps to make sure that residents get proper health care Protects employees from liability 30 | P a g e Uneaten food Dehydration Weight loss What should you do if a resident is in a life-threatening situation? Remove the resident to a safe place and report it What is the OAA? The Older Americans Act Requires all states to have an ombudsman program- assigned by law as the legal advocate for residents Ombudsmen can help resolve conflicts and settle disputes concerning government residents' health, safety, welfare and rights What is PHI? Protected Health Information Information that can be used to identify a person andd relate to the patient's condition What is an incident? An accident, problem or unexpected event during the course of care Must be reported in an incident report How do you properly do an incident report? Tell what happened-state the time State the physical and mental condition Describe the person's reaction to the incident State the facts- don't give opinions Do not document on the medical record Describe the action taken to give care What are examples of conditions that should be reported immediately? Falls Chest pain Severe headache Trouble breathing Abnormal pulse rate Abnormal respiratory rate Abnormal blood pressure Change in mental status Sudden weakness or loss of mobility Fever 31 | P a g e Loss of consciousness Change in level of consciousness Bleeding Swelling of a body part Change in resident's condition Bruises, abrasions and other signs of abuse What are the 2 kinds of factual information needed in proper reporting? Objective information: based on what a person sees, hears, touches or smells (signs) Subjective information: something a person cannot observe (symptoms) "he says he has a headache" Both are valuable How do you use the senses to create an accurate report? Sight: look for changes in their appearance (rashes, swelling, discharge, weakness, sunken eyes and posture changes) Hearing: listen to what the resident is saying, their emotions and if they are speaking clearly/ having breathing problems Smell: smell for body odor or breath odor What is incontinence? The inability to control the bladder or bowels What are defense mechanisms? Unconscious behaviors used to release tension or cope with stress Denial: completely rejecting a feeling Projection: Seeing feelings in others that are really one's own Displacement: transferring a strong negative feeling to a sager environment Rationalization: making excuses to justify a situation Repression: blocking painful thoughts or feelings from the mind Regression: going back to an old, usually immature behavior What is an impairment? A loss of function or ability- can be a complete or partial loss 32 | P a g e Hearing impairment Visual impairment Mental health disorder How often should a hearting aid be cleaned? Everyday What are tips for helping a resident who has a hearing impairment? Do not submerge the hearing aid in water Reduce or remove background noises Get the resident's attention before speaking Speak clearly, slowly and in good lighting Directly face the person Do not shout or mouth words Keep the pitch or your voice low Use short sentences and simple words Repeat what you have said Use a notepad as needed What are tips for helping a resident who has a vision impairment? Encourage the use of glasses or contact lenses Clean glass lenses with water and a soft tissue Don't touch the resident until you have said your name Face the resident when speaking Talk to the resident as you are caring for them Use an imaginary clock as a guide Do not move personal items Encourage the use of other senses What are signs and symptoms of a mental health disorder? Confusion Disorientation Agitation Anxiety What are some common causes of anger? Disease Fear Pain Loneliness Loss of independence Where is the center of gravity in the body? 35 | P a g e Pale, gray, bluish or discolored skin Staring Increased pulse Increased respiration rates Low blood pressure Extreme thirst How do you position a person who is bleeding from the mouth of vomiting? On their left side How should you position a person in shock? Have the person lie down on their back (unless they are bleeding from the mouth or vomiting) Elevate the legs about 8 to 12 inches (unless the person has a heads, neck, back spinal or abdominal injury, breathing difficulties or fractures)- this allows blood to flow back to the brain and other vital areas Never elevate a body if the person has a broken bone or if it causes pain What care can you do for a person in shock? Cover them with a blanket or provide shade Position the patient properly Control bleeding Begin CPR if they go unconscious No food or liquids! What are signs and symptoms of an MI? Sudden, severe pain, pressure or squeezing in the chest, usually on the left side or in the center behind the breastbone Pain or discomfort in other areas of the body, such as one of both arms, the back, neck, jaw or stomach Ingestion or heartburn Nausea and vomiting Shortness of breath Dizziness Pale of cyanotic color of skin Perspiration Cold and clammy skin Weak and irregular pulse rate 36 | P a g e Low blood pressure Anxiety and a sense of doom Denial of a heart problem Crushing, pressing, squeezing, stabbing, piercing pain Pain usually does not go away What symptoms are more common in women than men when they are having an MI? May not have chest pressure Shortness of breath Nausea and vomiting Light-headedness Fainting Dizziness Stomach pain Sweating Fatigue Back, neck or jaw pain How should you respond to a MI? Notify the nurse Place the person in a comfortable posiiton Loosen clothing around the neck No food or liquids Monitor breathing and pulse Begin CPE if they become unconscious How can you slow bleeding? Raise the wound above the level of the heart Prop up limb if the wound is on an arm, leg, hand or foot What are some common causes of fainting? Abnormal heart rhythm Hunger Hypoglycemia Dehydration Fear Pain Fatigue Standing for a long time Poor ventilation Certain medications 37 | P a g e Pregnancy Overheating What are some signs and symptoms of fainting? Dizziness Light-headedness Nausea Perspiration Pale skin Weak pulse Shallow respirations Blackness in the visual field How can you help a person in danger of fainting? Sit them down If they are in a sitting position, have them bend forward If they are on their back, elevate their legs 12 inches Loosen tight clothing After 5 minutes, help them get up slowly What is hypoglycemia? Too much insulin or too little food It occurs when insulin is given and the person skips a meal or does not eat enough food May be from vomiting and diarrhea What are signs and symptoms of hypoglycemia? First signs: feeling weak or different, nervousness, dizziness and perspiration- a glass of juice or a glass of milk could help Hunger Headache Rapid pulse Low blood pressure Cold, clammy skin Confusion Trembling Blurred vision Numbness of the lips and tongue Unconsciousness What is diabetic ketoacidosis? 40 | P a g e Turn the on their left side and provide them with a basin What are the 2 general types of infections? Localized: limited to a specific location in the body (causes red, swollen, warm and painful infection site) Systematic: affects the entire body and travels through the bloodstream (causes fever, chills, mental confusion or lower than normal blood pressure) What is HAI? Healthcare associated infection An infection acquired in a healthcare setting during the delivery of medical care What is the chain of infection Causative agent: a pathogenic microorganism that causes diseases including bacteria, viruses and fungi Reservoir: where the pathogen lives and multiplies (could be a human, plant, soil or substance) Portal of exit: any body opening on an infected person that allows pathogens to leave (could be the nose, mouth, eyes or a cut on the skin) Mode of transmission: how the pathogen travels (contact, droplet or airborne) Portal of entry: any body opening on an uninfected person that allows pathogens to enter (including mucous membranes) Susceptible host: an uninfected person who could get sick: What are mucous membranes? The membranes that line body cavities that open to the outside of the body Include linings of the mouth, nose, eyes, rectum and genitals What is medical asepsis? Sterile technique Making an object or area free of all microorganisms What are the 2 levels of precautions within the infection prevention system? Standard precautions Transmission based precautions 41 | P a g e What are standard precautions? Treating blood and other body fluids, non intact skin and mucous membranes as if they are infected Does not include sweat Interrupt the mode of transmission What is don and doff? Don: putting on PPE Doff: removing PPE What is the correct order of donning? Wash hands Gown Mask Goggles Gloves What is the correct order of doffing? Gloves Goggles Gown Mask Wash hands What are the 3 categories of transmission based precautions? Airborne precautions Droplet precautions Contact precautions When should you remove PPE? Before leaving the resident's room What are the 2 major bloodborne diseases in the US? AIDS and the viral hepatitis family What is hepatitis? Inflammation of the liver caused by certain viruses and other factors, such as alcohol abuse, some medications and trauma Liver function can be permanently damaged Hepatitis B (HBV): spread through sexual contact, sharing infected needles and from her baby during 42 | P a g e delivery (there is a vaccine for HBV) Hepatitis C (HCV): transmitted through blood or body fluids and can lead to cirrhosis, liver cancer and even death (these is no vaccine for HCV) What are symptoms of tuberculosis? Coughing Trouble breathing Weight loss Fatigue Chest pain Coughing up blood Loss of appetite Slight fever Chills Night sweats What is AIIR? Airborne infection isolation room What kind of precautions should you take with COVID? Airborne and droplet What are signs and symptoms of COVID? Fever Chills Cough Fatigue Shortness of breath Muscle aches Sore throat Loss of taste or smell Nausea or vomiting Diarrhea Headache Potentially no symptoms What are signs and symptoms that.a COVID patient is worsening? Difficulty breathing Persistent pain or pressure in the chest Confusion Difficulty walking or remaining alert 45 | P a g e Improving sleep quality Improving the ability to cope with stress Increasing energy Increasing appetite and promoting better eating habits What are results of inactivity and immobility? Low self-esteem Anxiety Depression Boredom Pneumonia Urinary tract infection Skin breakdown and pressure injuries Constipation Blood clots Dulling of the senses What are normal changes of aging? Skin in thinner, drier, more fragile and less elastic Muscles weaken and lose tone Sensitivity of never endings in the skin decreases Responses and reflexes slow Short-term memory loss occurs Vision, hearing, taste, touch and smell weaken Heart pumps less efficiently Lung strength and lung capacity decrease Oxygen in the blood decreases Appetite decreases Urinary elimination is more frequent Digestion takes longer and is less efficient Levels of hormones decreases Immunity weakens Lifestyle changes occurs What are not normal changes in aging? Signs of depression Suicidal thoughts Loss of ability to think logically Poor nutrition Shortness of breath Incontinence What are developmental disabilities? 46 | P a g e Disabilities that are present at birth and emerge during childhood up to age 22 Language, mobility, learning, and the ability to perform self-care may be affected What are common signs and symptoms of clinical depression? Pain (headaches, stomach pain, body aches) Low energy or fatigue Apathy or lack of interest in activities Irritability Anxiety Loss of appetite or overeating Problems with sexual functioning and desire Sleeplessness, trouble sleeping, excessive sleeping Lack of attention to basic personal care tasks Intense feelings of despair Guilt Trouble concentrating Withdrawal and isolation Repeated thoughts of suicide and death What are symptoms of anxiety? Shaking Muscle aches Sweating Cold and clammy hands Dizziness Chest pain Rapid heartbeat Cold and hot flashes Choking or smothering sensation Dry mouth What are the differences between hallucinations and delusions? Hallucinations: false or distorted sensory perceptions Delusions: persistent false beliefs What are the 5 stages of the grief process? Denial Anger Bargaining Depression Acceptance What is an advance directive? 47 | P a g e A legal document that allows a person to decide what kind of medical care they wish to have if they are unable to make the decision themselves May name someone else to make the medical decisions Example: living wills and durable powers of attorney for health care What is a living will? Outlines the medical care a person wants, or does not want, in case the person is unable to make those decisions What is a durable power of attorney for healthcare? A signed, dated and witnessed legal docu,emt that appoints someone else to make medical decisions for a person in the event they are unable to What is normally the last sense to go? Hearing How often should you give mouth care to an unconscious resident? Every 2 hours What are common signs of approaching death? Blurred and failing vision Unfocused eyes Impaired speech Diminished sense of touch Loss of movement, muscle tone and feeling A rising or below-normal body temperature Decreasing blood pressure Weak pulse that is abnormally slow or rapid Cheyne-Stokes respirations A rattling or gurgling sound when they breathe Cold, pale skin Mottling Perspiration Incontinence Disorientation or confusion What are Cheyenne-Stokes respirations? Alternating periods of slow, irregular respirations and rapid, shallow respirations, along with short periods of not breathing Sign that death is approaching 50 | P a g e They perspire less and do not need to bathe as much Most elderly adults only need a complete bath twice a week, with sponge baths everyday How many bones are in the human body? 206 What is it called when 2 bones meet? Joint How are muscles connected to bones Tendons Can muscles produce heat? Yes What is atrophy? When muscle wastes away, decreased in size and becomes weak What is a contracture? When the muscle or tendon shortens, becomes inflexible or freezes in position Causes permanent disability of the limb Range of motion exercises can help prevent these conditions What are normal changes of the musculoskeletal system during the aging process? Muscles weakens and lose tone Body movement slows Bones lose density and become more brittle Joints may stiffen and become painful Height is gradually lost What is rheumatoid arthritis? Inflammation or swelling on the joints Joints may becomes red, swollen and very painful Deformities can result Fever, fatigue and weight loss are symptoms Autoimmune disease What is an autoimmune illness? When the body's immune system attacks normal tissue in the body What is osteoarthritis? 51 | P a g e Degenerative arthritis Affects hips and knees Joints in fingers, thumbs and spines may be affected Occurs in the elderly Pain and stiffness increase in cold, damp water What are common ways arthritis is treated? Anti-inflammatory medication such as aspirin Local applications of heat to reduce swelling and pain Range of motion exercises Regular exercise Diet to reduce weight or maintain strength Why is stomach irritation or heartburn common is people with arthritis? They are often on anti-inflammatory drugs, such as aspirin What is osteoporosis? A condition in which bones lose density They become porous and brittle More common after menopause Exercise can strengthen bones May be caused from a lack of calcium in a diet, the loss of estrogen, a lack of exercise, reduced mobility or age Associated with low back pain, stooped posture, becoming shorter overtime and fractures What is THR? Total hip replacement Surgical replacement of the head of the long bone of the leg (femur) where it joins the hip What does non-weight bearing mean? The resident is unable to touch the floor or support any weight on one or both legs What is an abduction pillow? Used for patients after a hip replacement Immobilizes and positions the hips and lower extremities What are things to look out for after a resident gets hip replacement surgery? Redness, drainage, bleeding or warmth in incision area An increase in pain Numbness or tingling 52 | P a g e Tenderness or swelling in the calf of the affected leg Shortening and/ or external rotation of the affected leg Abnormal vital signs, including a change in temperature Any problems with appetite Any improvements, such as increased strength What is TKR? Total knee replacement A surgical replacement of the knee with a prosthetic knee to relieve pain and restore motion to a knee damaged by injury or arthritis May require a special stocking for circulation after Ankle pumps can help with circulation as well What are normal changes to the nervous system during the aging process? Responses and reflexes slow Sensitivity to nerve endings in skin decreases Some short-term memory loss may occur What is a CVA? Cerebrovascular accident/ stroke/ brain attack Occurs when blood supply to a part of the brain is blocked or a blood vessel leaks or ruptures within the brain Ischemic: most common; blood supply is blocked and part of the brain does not receive oxygen/ additional damage can occur due to leaking blood, clots and swelling of the tissues What are some common symptoms AFTER a stroke? Paralysis on one side of the body Weakness on one side of the body Tendency to ignore a weak or paralyzed side Loss of ability to tell where affected body parts are Trouble communicating thoughts, speech or writing Difficulty understanding spoken or written words Inappropriate or unprovoked emotional responses Loss of sensations, such as temperature or touch Loss of bowel or bladder control Cognitive problems, such as memory loss/ confusion Difficulty swallowing What is emotional lability? 55 | P a g e ROM exercises are very important for circulation What is HTN? High hypertension High blood pressure When blood pressure is consistently 130/80 or higher Can develop at any age May cause headaches, blurred vision and dizziness May use diuretics and be on special diets Major causes are atherosclerosis (hardening and narrowing of the blood vessels), kidney disease, tremors of the adrenal gland, pregnancy and certain medications What is atherosclerosis? A hardening and narrowing of the blood vessels Causes hypertension What can untreated hypertension lead to? Cerebral vascular accident Blurred vision Dizziness What are diuretics? Medications that reduce fluid in th body and increase the need to urinate What is CAD? Coronary artery disease When the blood vessels in the coronary arteries narrow Reduces the supply of blood to the heart muscles Deprives the heart of oxygen and nutrients Over time, fatty deposits block the arteries Eventually, the muscles that are not being supplied die Can lead to heart attack or stroke When does the heart need more oxygen? Exercise Stress Excitement Digesting a heavy meal What is angina? Chest pain, pressure or discomfort Happens when the heart is not getting enough oxygen 56 | P a g e Described as pressure or tightness Occurs in the left side or the center of the chest Some have pain inside the left arm/ left side of the jaw Symptoms include sweating, dizziness and paleness Can be a sign of a heart attack Rest is extremely important What is a myocardial infarction? When blood flow to the heart muscle is blocked Oxygen and nutrients fail to reach the cells Waste products aren't removed and muscle cells die A medical emergency that can cause heart damage Can lead to death What does a program for a person who just had a heart attack look like? Diet low in saturated fats and sodium Diet rich in fruits, vegetables and whole grains A regular exercise program Medications to regulate heart rate/ blood pressure Regular blood testing Stopping smoking Avoiding cold temperatures A stress management program Mental health care What is CHF? Congestive heart failure When the heart muscle is damaged and doesn't pump effectively When the left side is affected, blood backs up in the lungs When the right side is affected, blood backs up into the legs, feet or abdomen When one of both sides of the heart stop pumping properly Can be caused y coronary artery disease, myocardial infarction, hypertension and other disorders that may damage the heart Can be treated and controlled What is PVD? Peripheral vascular disease Legs, feet, arms & hands don't have enough circulation 57 | P a g e When fatty deposits in blood vessels harden overtices Legs feet, arms and hands become cold Nail beds or feet become ashen and blue Swelling occurs in the hands and feet Ulcers of the legs and feet may develop Pain is relieved with rest Risk factors include smoking, diabetes, high cholesterol, hypertension, inactivity and obesity Treatment includes quitting smoking, medications, exercise and surgery What is respiration? Inspiration + expiration Brings oxygen in and eliminates carbon dioxide What are normal changes of the respiratory system during the aging process? Lung strength decreases Lung capacity decreases Oxygen in the blood decreases Voice weakens What is difficulty breathing called? Dyspnea People will normally be more comfortable sitting down rather than lying down What system is most likely affected when the lips, arms and legs are pale, bluish or gray colored? Respiratory system What is COPD? Chronic obstructive pulmonary disease A chronic, progressive condition with no cure People have trouble getting air out of the lungs 2 types: chronic bronchitis and emphysema High risk for acute lung infections, such as pneumonia What is bronchitis? Irritation and inflammation of the lining of the bronchi Usually caused by cigarette smoking Symptoms include coughing up phlegm and music Breathlessness and wheezing may be present Treatment includes stopping smoking and medications 60 | P a g e Common causes include chronic constipation, chronic diarrhea, obesity, pregnancy, overuse of laxatives and enemas Symptoms include rectal itching, burning, pain and bleeding during bowel elimination Treatment includes increasing fiber and fluid intake, medications, compresses and sits baths Surgery may be necessary What is GERD? Gastroesophageal reflux disease A chronic condition where the liquid contents of the stomach go back up into the esophagus that causes a burning sensation, often called heartburn It can inflame the liming of the esophagus and can cause bleeding, ulcers and scars from tissue damage Most common symptom is heartburn What are ways to prevent GERD? Don't have them lie down for 3-4 hours after eating Use extra pillows to keep them upright during sleep Serve the largest meal at lunchtime Stop smoking and drinking alcohol Reduce fatty foods and spicy foods have them wear loose-fitting clothes What is a stoma? The artificial opening in the abdominal wall What is the difference between a colostomy and ileostomy? Colostomy: surgically creating an opening into the large intestine to allow semi-hard stool to be expelled Ileostomy: surgically creating an opening into the small intestine to allow liquid stool to be expelled What is the difference between glands and hormones? Glands: organs that produce and secrete hormones Hormones: chemical substances created by the body that control numerous body functions What are the functions of hormones? Maintain homeostasis through hormone secretion Influence growth and development Maintain blood sugar levels 61 | P a g e Regulate levels of calcium and phosphate in the body Regulate the body's ability to reproduce Determine how fast cells burn food for energy What are normal changes in the endocrine system during the aging process? :Engels of hormones, such as estrogen, decrease Insulin production lessens The body is less able to handle stress What is insulin? A hormone that works to move glucose from the blood and into the cells for the energy of the body What is glucose? Sugar What us diabetes mellitus? When the pancreas produces no insulin, too little insulin or does not properly use insulin Without insulin, sugars collect in the blood and cannot get to the cells, which causes problems with circulation and damage to vital organs Common in people with a family history, in the elderly and in people who are obese What is type 1 diabetes? Diagnosed in children and young adults The pancreas procures either no insulin or too little Managed with daily injections of insulin What is the most common form of diabetes? Type 2 What is type 2 diabetes? Either the body does not produce enough insulin or the body fails to properly use insulin (insulin resistance) Usually develops slowly in people who are obese or have a family history of the disease Can be controlled with medication or diet What is prediabetes? Occurs when a person's blood glucose levels are above normal but not enough for a diabetes diagnosis Some damage to the heart and circulatory system may have already occurred 62 | P a g e What is gestational diabetes? Diabetes during pregnancy What are common signs and symptoms of people who have diabetes? Excessive thirst Extreme hunger Frequent urination Unexplained weight loss High blood sugar levels Glucose in urine Sudden vision changes Tingling and numbness in the hands or feet Feeling very tired much of the time Very dry skin Sores that are slow to heal More infections than normal What are complications of severe diabetes? Heart attack, reduced circulation or stroke Poor wound healing and kidney/nerve damage Vision loss and blindness Leg and foot ulcers Gangrene Insulin reaction and diabetic ketoacidosis What is gangrene? Decay of dead tissue May need amputation If the nurse aide is concerned about client care, who should the nurse aide speak to FIRST? The nurse in charge You observe your charge nurse holding a resident's nose to get him to take his medications. You should report the incident immediately to the D.O.N. After the end of the shift, some nurse aides go to a restaurant. Acceptable topics of conversation would include the weather Incident reports are written in order to Determine patterns and trends 65 | P a g e Standing with the legs shoulder-width apart is using good body mechanics Aftr an amputation, a resident may experience phantom sensation. Phantom sensation is pain or sensation caused by remaining nerve endings How should a fracture pan be positioned? with the handle toward the foot of the bed What does palliative care involve? pain relief and comfort Nursing assistants do not usually perform procedures that require sterile technique Insulin reaction can be caused by too little food Which of the following is a requirement of OBRA? nursing assistants must have at least 75 hours of training What is a good way for a nursing assistant to care for a mentally ill resident? support the resident and his or her family and friends When should sheets be changed? whenever they are soiled, wrinkled, or damp What does the chain of command do? describes the line of authority What is a good way for a nursing assistant to respond to inappropriate sexual behavior? take the resident to a private area What should a nursing assistant do if she suspects a resident is being abused? she should report it to the nurse immediately and let him/her handle it from there What is one good way a nursing assistant can assist residents with normal changes of aging related to the urinary system? offer frequent trips to the bathroom 66 | P a g e Which of the following is true of Transmission-Based Precautions? they are practiced in addition to Standard Precautions What can nursing assistants do in regards to IVs? Nursing assistants will observe the IV site for problems Passive range of motion exercises are done when a resident cannot move on her own Which of the following is used when documenting the amount of fluid a resident drinks? milliters When encountering a fire, a nursing assistant should first remove resident from danger What is a common "cliche"? It will all work out in the end. What member of the care team might help a resident learn to use adaptive devices for eating or dressing? occupational therapist A way to prevent aspiration during oral care of unconscious residents include: using as little liquid as possible when giving oral care Providing privacy while giving care is a patient's legal right What is something a nursing assistant needs to observe and report regarding the musculoskeletal system: white, shiny, red, or warm areas over a joint What is one way a nursing assistant can promote a resident's independence? allowing a resident to do a task by himself no matter how long it takes hime To treat a minor burn, a nursing assistant should use cool, clean water For a nursing assistant, confidentiality means 67 | P a g e keeping private things private When leaving a resident's room, a nursing assistant should restock supplies and leave the call light within reach What should a nursing assistant do each time a patient is repositioned? should check residents skin each time they are repositioned Which is the most essential nutrient for life? water Which sense is usually last to leave the body when a person is dying? hearing What is a function of the nervous system? senses and interprets information from outside the body During a seizure an NA should keep the resident safe The ability to think logically and quickly is called cognition How can a nursing assistant help residents with their spiritual needs? learn about resident's beliefs and listen carefully If a resident with Alzheimer's disease has problems with dressing, the nursing assistant should: lay out clothes in the order they should be put on What is a type of advance directive: Durable Power of Attorney for Health Care Which type of urine speciment does not include the first and last urine in the sample? clean catch ___________is maintaining equal intake and output. fluid balance How should a resident with chronic obstructive pulmonary disease (COPD) be positioned? sitting upright 70 | P a g e Where should the nursing assistant stand when helping a resident who is recovering from a stroke to walk? on the resident's weaker side When communicating with a resident who is visually-impaired, the nursing assistant should tell the resident what the nursing assistant is doing while careing for him A nursing assistant should wear gloves when giving perineal care to a resident In order to communicate with a resident who is hearing-impaired, the nursing assistant should face the resident directly when speaking Before helping a resident eat, how should the nursing assistant position the resident? sitting as upright as possible sundowner's syndrome confusion that affects people with dementia around sundown pulse heart rate blood pressure pressure of blood in the circulatory system anti-embolism hose therapeutic treatment to increase blood flow in the legs malignant a tumor that invades and destroys near by tissues and can spread to other parts of the body benign a non harmful tumor in effect cyanosis blue or grey of the skin, lips, nails, and/or eyes jaundice yellow of the skin/whites or eyes 71 | P a g e constipation passing hard stool or difficulty passing stool angina chest pain caused by reduce blood flow dementia thought or skills affecting daily functions cardiac heart disease colostomy surgical operation to take out parts of the colon and make an artificial opening stroke damage to the brain, forms blood clots alzheimer's disease that destroys memory and mental functions congestive heart failure chronic condition where the heart doesn't pump blood as well as it should. heart attack(myocardial infarct) blockage of blood flow to the heart muscle obesity excess body fat causing increase in health problems terminal illness shingles painful rash caused by chicken pox diabetes condition where the pancreas can't produce insulin properly kidney stones small hard deposit that forms in the kidney hepatitis inflammation of the liver 72 | P a g e HIV interferes with the body's ability to fight infections colitis inflammation reaction in the colon acute illness sudden illness, expect recovery chronic illness ongoing illness, can be treated asepsis the absence of a disease producing microbes geriatric field in medicine concerned about peoples health coma a state at which someone doesn't know or is unaware and unable to react or respond to people, places, or things hemiplegia paralysis on one side of the body medical asepsis practice to minimize number of microbes surgical asepsis practice to remove all microbes vaccine a shot containing dead or weakened microbes contamination unclean process nosocomial disease originating in a hospital immunity protection against a disease or condition 75 | P a g e arthritis inflammation of a joint arthroplasty surgical repair of a joint compound fracture bone breaks through the skin simple fracture bone is broken cleanly in place; the ends do not penetrate the skin open fracture compound fracture; broken bone with an open wound fracture broken bone or cartilage autoimmune A disease where the body produces antibodies that attack its own tissues, leading to the deterioration of tissue amputation partial or complete removal of a limb closed fracture broken bone with no open wound vomitus/emesis food and fluids expelled from the stomach through the mouth gallstone a hard deposit formed in the gallbladder and bile ducts due to the concretion of bile components gallbladder small organ under the liver pyuria puss in the urine dysuria process of passing urine in large amounts. painful urination 76 | P a g e diuresis painful or difficulty urinating cystitis infection in any part of the urinary system calculi kidney stones polyuria excessive urination(large amounts) post mortem care after death rigor mortis stiffening of muscles and joints after death 5 steps to accepting terminal illness 1. denial 2. anger 3. depression 4. bargaining 5. acceptance hypertension when blood pressure is above 140/90 pulse rate heart beats per minute aspirations Breathing fluid, food, vomitus, or an object into the lungs (anything besides air) anorexia loss of appetite calorie the fuel or energy value of food dehydration exessice loss of water dysphasia difficulty swallowing graduate 77 | P a g e measuring container for fluids nutrient a substance eaten, difested and absorbed by the body nutrition same as nutrient., just the process bradycardia slow heart rate (less than 60 bpm) tachycardia rapid heart rate over 100 beats per minute Diastolic blood pressure lowest number in blood pressure, minimum pressure systolic blood pressure highest number in blood pressure, highest pressure hypotension blood pressure below 90/60 vital signs temperature, pulse, respirations, blood pressure, and pain adduction moving body part towards the body atrophy shrinking, decreasing in size extension Straightening a body part flexion bending a body part ambulation walking PM care 80 | P a g e near arm and hand far leg and foot near leg and foot back buttock perineum circumcised no foreskin around penis (just the head) uncircumcised glans is covered by foreskin. Foreskin around penis halitosis bad breath mechanical soft diet liquids and semisolid foods, easily chewed hernia when a structure pushes out of noramal position continent Ability to control the passage of stool and urine incontinent experiencing involuntary or uncontrolled loss of urine or feces normal urine amount 200-300 mL types of way to take temp temporal(forehead), tympanic(eardrum), rectal average pulse rates adult men=60-70 bpm, adult women 65- 80 bpm, children older than 7=75-100 bpm, preschoolers= 80- 110 bpm, and infants= 120-160 bpm normal respiration rate for adults 12- 120 bpm diastole heart retraction 81 | P a g e systole heart contraction temp of water 105-110 weighing at same time everyday= more efficient results wash hands for at least 20 secs. hand hygiene after taking off gloves normal ranges for: temp= 98.5 pulse= 60-100 bpm respirations= 12-20 breaths per minute blood pressure= 120-80 mmHg arranging tasks vital signs height weight arranging tasks complete bed bath back rub nail care bed making arranging tasks transfer to chair, oral care, feeding prone laying on stomach supine laying on back side laying laying on side 82 | P a g e high-fowlers sitting up when doing cares look for.. sores, pain, cuts, bruises elderlys lose their appetite due to decrease in saliva and decrease in # of taste buds the thinning of the fatty layer under the skin could cause the resident to develop pressure sores residents stooped over= loss of calcium causing changes in the spinal column major reasons the elderly person is incontinent of urine is the muscle that keeps urine in the bladder weakens constipation and indifestion can be result from slowed peristalsis wasting or decrease in size of muscle is called atrophy mouth care should be given to unconscious person every 2 hours to removing hearing aide turn it off with volume set on low proper way to remove a dirty isolation gown roll the gown dirty side in and away from body wait _____ minutes after cold drink or hot to take vital signs 20 minutes if resident had hip surgery, her legs should be abducted if resident has enema, should lie on left sidet the brain is part of the