CNA WRITTEN EXAM (PROMETRIC PRACTICE TEST) LATEST 2023-2024 EXAM WITH 300+ Q & A UPDATED, Exams of Nursing

Download CNA WRITTEN EXAM (PROMETRIC PRACTICE TEST) LATEST 2023-2024 EXAM WITH 300+ Q & A UPDATED and more Exams Nursing in PDF only on Docsity! D. Fowler's - ANSWER- Fowlers speaking - ANSWER- look directly at the client when speaking (D) look directly at the client when (C)speak in a loud and slow man speaking (B)stand behind the client wh CNA WRITTEN EXAM (PROMETRIC PRACTICE TEST) LATEST 2022-2023 EXAM WITH 300+ QUESTIONS AND ANSWERS (VERIFIED ANSWERS) Which of the following best helps reduce pressure on the bony prominences? A. Several pillows B. Sheepskin C. Flotation mattress D. Repositioning every shift - ANSWER- Flotation mattress The most comfortable position for a resident with a respiratory problem is: A. Prone B. Supine C. Lateral prone - ANSWER- is a position of the body lying face down. supine - ANSWER- Lying on back with head supported on a pillow. fowlers - ANSWER- is a position where the head is raised above the feet In order to communicate clearly with a client who has hearing loss, the nurse aide should: (A) speak in a high pitched tone of voice en ner Which of the following is a correct measurement of urinary output? (A)40 oz (B)300 cc The best way to control the spread of C. difficile is – (B) after the procedure (A) before the procedu nurse aide should wash (D) check (C) offer the client a drink of water for signs of injury - ANSWER- B (C) 2 cups (D)1 quart - ANSWER- 300 cc = 300 ml = about 10 oz or about 1.25 cups . When changing an unsterile dressing, the hands : re (C) before and after the procedure (D)before, after removal of the soiled dressing, and after the procedure - ANSWER- D The nurse aide finds a conscious client lying on the bathroom floor. The FIRST thing the nurse aide should do is: (A) help the client into a sitting position (B) call for assistance from the nurse in charge a. by limiting contact of the infected resident and family with others b. by using more powerful antibiotics and antivirals c. by giving more enemas and fiber to clean out the GI tract *d. through proper handwashing and handling of contaminated wastes The government agency helping to define Utah's nursing assistant scope of responsibility in long-term care facilities is - ANSWER- a. JCAHO b. OBRA c. OSHA d. UNAR*** Oral care performed: - ANSWER- a. at least three times a week b. once daily c. only when requested by the resident d. at least twice a day****** Mr. King cannot get out of bed. You place him in position for meal. - ANSWER- semi or high fowlers? SEMI Transfers and discharge preparations are the responsibility of the – a. Social Worker Mrs. Jones just had a stroke and is unable to swallow. The type of diet she should have is – - a. NCS b. NAS c. low fat d. NPO normal oral temperature – ANSWER- a. 95.5 - 96.5 b. 96.5 - 97.5 c. 96.0 - 97.0 d. 97.6 - 99.6 You find an extra set of headphones in your resident's room. He said he doesn't need 2 pair and gives them to you. You may be charged with - ANSWER- a. inappropriate handling of resident's property b. mishandling of resident's property c. misappropriation of resident's property*** d. inappropriate professional behavior- A pulse requiring a stethoscope to obtain is a(n) - ANSWER- a. apical* b. carotid A typical sign of Parkinson's disease would be - ANSWER- A SHUFFLING GAIT Dry mouth, sweating, nausea, diarrhea, rapid pulse and respirations, increased blood pressure, difficulty sleeping, and loss of appetite are symptoms of - ANSWER- ANXIETY DISORDER If a resident with Alzheimer's disease has problems with bathing, the nursing assistant should - ANSWER- a. schedule bathing when the resident is least agitated*** b. rush the resident through the bath c. insist that the resident bathes even if they don't want to d. suggest to the resident that he needs a bath INSUFFICIENT AMOUNT OF INSULIN - ANSWER- NOT DIABETES?? SAYS HYPERTHYROIDISM A nursing assistant can be charged in a court of law if they - ANSWER- TAKE MONEY 5 STAGES GREIF - ANSWER- DENIAL ANGER BARGAINING DEPRESSION ACCEPTANCE c. radial d. they must be provided with a written copy of these rights** c. the right to refuse medication is not one of these rights b. greater than 100 bpm a. greater than 60 bpm The best description of Tachycardia is a heart rate c. less than 60 bpm d. less than 100 bpm - ANSWER- B REHABILITATION - ANSWER- BEGINS WHEN RESIDENT IS MEDICALLY STABLE The master gland that controls the hormone production of other glands is known as the gland. - ANSWER- PITUITARY OBRA requires that on admission, residents must be told of their legal rights. You know that – a. the right to file a complaint is not one of these rights b. a lawyer must be present to witness the giving of the rights Transfers and discharge preparations are the responsibility of the - ANSWER- RN* Peripheral Vascular Disease affects the – - a. muscloskeletal system b. respiratory system* c. endocrine system d. cardiovascular system THIRD STAGE OF GREIVING PROCESS IS? - ANSWER- ANGER WHAT SHOWS EMPATHY a. "I wonder what is making the resident so uncooperative." b. "Is that resident as disrespectful to everyone as he is to me?" c. "I'll spend extra time with the resident to help him feel welcomed." d. "He must be in pain; I'll let the nurse know he needs medication." - ANSWER- C ITCHY COND WHERE MITE BURROWS IN SKIN. - ANSWER- IS SCABIES BUT TEST SAYS PINWORMS TUBURCOLOSIS IS MOST LIKELY SPREAD BY - ANSWER- COUGHING ANGINA PECTORIS - ANSWER- ANXIETY (CHEST PAIN OCCURING W STRESS) The federal regulation that was established to improve the quality of care given in long- term care facilities is called - ANSWER- OBRA best source of carbs d. provide perineal care QOD *Before entering a patient's room, a CNA should:* K Check the resident's care plan. nock on the resident's door before entering. B When caring for a female resident with an indwelling catheter. You should - a. attach the drainage bag to the bed rail b. insure the resident is lying on the tubing c. keep the drainage bag below the bladder* Hospice is available to the resident and their family - ANSWER- whenever needed A student fails a test and blames a friend for not helping with studying. This is an example of a defense mechanism called - ANSWER- rationalization a. candy, fish , pasta, peas b. meat, bread, broccoli , beans c. beef, fish, peanut butter, beans d. pasta, cereal, bread, candy**** - ANSWER- ... Cystitis is an inflammation of the - ANSWER- bladder Disorder that causes reocurring seizures - ANSWER- i say epilepsy. they say cva *What should a CNA do if he or she sees a small fire in an unoccupied patient room?* A. Extinguish the fire. B. Rescue residents in the rooms next door. C. Activate the fire alarm. D. Close all fire doors. - ANSWER- C. Activate the fire alarm. When encountering a fire use the acronym RACE (Rescue, Activate the alarm, Confine the fire, Extinguish the fire). Since no residents are in immediate danger, the CNA should activate the alarm. . C. Make sure that the supplies are stocked for the unit. D. All of the above. - ANSWER- A. Knock on the resident's door before entering. It is important to remember that the residents live in the facility. This is their home. Thus, it is important to knock on the door of a resident's room before walking in. Understanding the care plan is very important, but the CNA may not need to A personal disagreement with a patient's family is not a valid reason for refusing to undertake a task. If the task is outside of the CNA's standard of care, the task is dangerous, or if the CNA believes it is unethical, then the CNA should explain to the nurse, in a calm professional manner, why she is refusing to undertake If a patient refuses treatment and the CNA performs this care on the patient anyway, what could happen to the CNA? A. Nothing. CNAs should always perform care on patients regardless of patient wishes. B. The CNA could be given an award for performing care under challenging conditions. C. The CNA could be promoted as leader on the floor because he can get things done. D. The CNA could be charged with assault or battery. - ANSWER- D. The CNA could be charged with assault or battery. A CNA can be charged with assault for threatening to perform care or battery for touching a patient (providing care) without the patient's consent. A patient must give consent for treatment. Treating a patient without the patient's consent violates the patient's rights. A CNA could be fired or arrested for this kind of behavior. Which is NOT a reason why a CNA should refuse an assignment? A. The CNA is upset because of a personal conflict with the patient's family. B. The CNA believes the task is unethical. C. The task is outside of the CNA's standard of care. D. Performing the task could be harmful to the CNA. - ANSWER- A. The CNA is upset because of a personal conflict with the patient's family. Which should the CNA NOT do as a healthcare professional? A. Arrive to work on time, or even 5-10 minutes early. B. Work single-handedly to take care of patients. C. Eat well and get plenty of exercise and sleep. D. Arrive at work well groomed in a clean uniform. - ANSWER- B. Work single- handedly to take care of patients. A professional CNA is well groomed, arrives on time, and takes care of himself or herself outside of work. A CNA must be part of the healthcare team and not do the job alone. While standing in the elevator, a CNA overhears his colleagues speaking about a resident's care. What is this a violation of? A. The patient's right to medical care. B. A DNR order C. Patient confidentiality D. It is not a violation of anything as professionals are discussing resident care. - ANSWER- C. Patient confidentiality D. Assault - ANSWER- C. Negligence C. Negligence Discussing a resident's care in a public space, like an elevator, is a violation of the patient's right to confidentiality under the HIPAA guidelines. DNR stands for do not resuscitate, which is when a patient does not want to receive care if he or she stops breathing. Patients have the right to receive medical care, but they also have the right to refuse medical care if they wish. 10. How is residential nursing care paid for? A. Medicare B. Medicaid C. Private health insurance D. All of the above - ANSWER- D. All of the above Residential nursing care is paid for in a variety of ways including Medicare, Medicaid, private insurance and/or family savings depending on the resident's unique circumstances. While helping a resident sip hot tea, the CNA slips and accidentally spills hot tea on the resident causing a burn. This is an example of: A. Battery B. Abuse Accidentally burning a resident with hot tea is an example of negligence because the CNA did not take appropriate safety measures and the resident was injured as a result of this. Abuse, assault, and battery are all intentional acts that cause harm to residents. A CNA falsely reports that one of his colleagues accepted an expensive gift from the family of a resident. This is an example of: A. Defamation B. Insubordinati on C. Negligence D. Malpractice - ANSWER- A. Defamation Lying about a colleague's behavior is considered defamation of character. Negligence and malpractice are legal terms relating to health care providers; work with residents (not co-workers), and insubordination is a term used to describe someone who does not follow orders. C. An environment completely free from microorganisms. preventing disea The term medical asepsis means: Practices designed to reduce the number of pathogenic microorganisms and limit their growth and transmission in the patient's environment. The injection of a killed microbe in order to stimulate the immune system, thereby se. keeping living areas clean, and emptying trash are all important, but they are not the first step in preventing the spread of infection. In which of the following facilities do CNAs work? A. Hospitals B. Long-term residential nursing care C. Rehabilitative care D. All of the above - ANSWER- D. All of the above CNAs can work in a wide array of medical settings including: long-term residential nursing care, hospitals, and others (such as assisted living facilities). D. The process of killing microorganisms using chemicals or heat. - ANSWER- A. Practices designed to reduce the number of pathogenic microorganisms and limit their growth and transmission in the patient's environment. Medical asepsis is defined as: practices designed to reduce the number of pathogenic microorganisms and limit their growth and transmission in the patient's environment. An environment completely free of microorganisms is called a sterile environment. Disinfection is the term used to describe the process of killing microorganisms using chemicals or heat. A vaccination is the injection of a killed microbe in order to stimulate the immune system, thereby preventing disease. When is a cold pack used? A. To stop pain B. To stop bleeding C. To decrease swelling D. To increase circulation - ANSWER- C. To decrease swelling A cold pack is used to decrease swelling. A hot pack can improve circulation. Medical professionals use direct pressure to slow or stop bleeding. A cold pack can help temporarily decrease pain, but it will not stop pain. Which of the following practices ensures adequate protection when wearing gloves? A. Hand-washing before and after glove use. B. Only use gloves when touching a resident's blood. C. A small tear in the glove will still keep out germs. resident's skin, as this could hurt the resident or damage more susceptible to that you may come into contact with a resident's body fluids, including: blood, mucus, urine, feces, semen, or vaginal discharge. them will not ensure adequate protection. You should use gloves any time you suspect protection. Washing your hands only after glove use or using gloves with a small tear in You must wash your hands before and after using gloves to ensure adequate B. Older residents have slower reaction times A. Older residents sleep less deeply Which of the following is true about older residents? Scrub the resident's skin vigorously to make sure she is clean. When assisting a resident with a bed bath, what should the CNA do? D. Wash hands only after removing gloves. - ANSWER- A. Hand-washing before and after glove use. C. Older residents have reduced sensitivity to touch and to pain D. All of the above - ANSWER- D. All of the above As people age, their reaction times slow down, they sleep less deeply and may sleep for fewer hours each night, and they have reduced sensitivity to touch and to pain. All of this means that CNAs must be aware that: residents could slip and/or fall more easily because of their slower reaction times, some residents may nap during the day or go to bed early and wake early, and residents may not notice pain as quickly, so they are A. B. Close the curtain to provide privacy. C. Make sure that the water temperature is between 85-95 degrees Fahrenheit. D. Start bathing the resident's feet first. - ANSWER- B. Close the curtain to provide privacy. Before giving the resident a bed bath, the CNA should close the curtain to provide for resident privacy. The CNA should not start the bed bath at the resident's feet. The CNA should start the bed bath starting at the head and moving down the body (wash from the cleanest to the dirtiest areas of the body). A water temperature of 85-95 degrees Fahrenheit is too cold and will chill the resident. The CNA should not scrub the While a nursing assistant is caring for a resident, the CNA notices a foul smell coming from the resident's wound. What should the CNA do? A. Clean the wound immediately. B. Give the resident an antibiotic because the wound may be getting infected. C. Inform the nurse. D. Nothing, wound care is not part of the role of the CNA. - ANSWER- C. Inform the nurse. to B. On the side with a pillow under the head, a seco On the back with the bed at a 45-degree angle. nd pillow under the top arm, and a pillow under the top leg. C. On the stomach with the head to one side and pillows under the belly and feet. D. Flat on the back with a pillow under the lower back. - ANSWER- B. On the side with a pillow under the head, a second pillow under the top arm, and a pillow under the p leg. A. Diastolic blood pressure is the patient's blood pressure when it is too high. What does the diastolic blood pressure number, or bottom number, refer to? If a CNA notices a foul smell coming from a wound, the CNA should inform the nurse immediately, as this could signal an infection. CNAs should not clean wounds unless this is part of the standard care in the facility that they work in. CNAs should never give a resident medication. A resident's health and wellness is part of the CNAs job, so the CAN should always pay close attention to the resident's health. Which of the following is not part of the admissions process? A. Making the resident feel comfortable and welcome in the facility. B. Preparing the resident's room. C. Signing admitting papers and consent for treatment. D. The resident goes home. - ANSWER- D. The resident goes home. The admission process helps the resident begin her stay in the facility, thus it is important to: sign admitting paperwork and a consent for treatment, prepare the resident's room, and make her feel welcome and comfortable. The resident goes home after the discharge process. If a patient's chart notes that he be placed in a lateral position, he should lie: A. In a lateral position, a patient lies on the side. In a prone position, a resident lies on the stomach. In the supine position, a resident lies on the back. In the semi-Fowler's position, a resident lies on the back with the bed at a 45- degree angle. B. Diastolic blood pressure is the pressure in the arteries when the heart contracts. C. Diastolic blood pressure is the pressure in the arteries when the heart rests. D. Diastolic blood pressure is the patient's blood pressure when it is too low. - ANSWER- C. Diastolic blood pressure is the pressure in the arteries when the heart rests. Diastolic blood pressure (the bottom number) measures the pressure when the heart is at rest between beats. Systolic blood pressure (the top number) D. All of the above - ANSWER- B. A soft toothette An unconscious resident cannot spit. Therefore, a CNA should not use mouthwash because there is a risk of aspiration. An unconscious resident cannot move or respond, so a hard toothbrush could harm a resident's mouth. A soft toothette is the approved tool for oral care of unconscious residents. If a resident can sit up, pivot, and get out of bed with little assistance but has difficulty reaching the bathroom, which device is the most appropriate to use for elimination? B. Regular toilet A. Portable commode A. Place dentures on a shelf next to the sink to dry. dentures? Which is the proper safety technique for a CNA to use when cleaning a resident's Place a paper towel in the sink while cleaning the dentures. After cleaning, place the dentures in a glass next to the sink. Place a cloth towel in the sink while cleaning the dentures. - ANSWER- D. Place a cloth towel in the sink while cleaning the dentures. Dentures are expensive and hard to replace if they break, so a CNA must place a cloth D. Every 8 hours - ANSWER- A. For eating C. Every 2 hours C. Bedpan D. All of the above - ANSWER- A. Portable commode Since the resident can sit up and turn independently, a portable commode, which is placed near the bed, is the most appropriate device. It is important to use the device that gives the resident the most independence. Bedpans are used for residents who cannot get out of bed. The regular toilet is not appropriate because the bathroom is too difficult for the resident to get to. towel in the sink to cushion any falls should the dentures be dropped during cleaning; paper towels will not cushion the fall. A resident receives oxygen therapy through a face mask. When should the face mask be removed? A. For eating B. For sleeping The face mask covers the resident's nose and mouth. It should be removed to allow the resident to eat. Removing the mask every 2 hours, 8 hours, or while sleeping interrupts oxygen delivery and may delay or harm the resident's recovery. Which of the following is an objective sign or symptom and can be directly observed by a CNA? The pulse oximeter is a sensor that measures the amount of oxygen in a person's blood. It can be attached to any of these sites. The nurse and the care plan will state the best site to use the pulse oximeter for each patient. B. Ensure that the stockings have no wrinkles in them. Pull the stockings up quickly from the resident's foot. When putting anti-embolism stockings on a patient, the CNA should: bubbles or wrinkles in them. antiembolism stockings on "quickly," rather it is important to ensure that they have A. Raising the patient's extremity above the heart Which intervention will NOT help a patient with edema? C. Using an ice pack or cold pack to reduce swelling B. Massaging the extremity with lotion to stimulate blood flow A. Nausea B. Chills C. Blood pressure measurement D. Pain level - ANSWER- C. Blood pressure measurement A CNA can directly observe and measure a resident's blood pressure, and so it is considered an objective measurement. Subjective symptoms like pain, nausea, and chills cannot be observed, but instead residents must tell CNAs about these symptoms. A pulse oximeter can be effective when attached to a person's: A. Toe B. Finger C. Earlobe D. All of the above - ANSWER- D. All of the above A. C. Ensure that the stockings are very tight. D. All of the above - ANSWER- B. Ensure that the stockings have no wrinkles in them. Anti-embolism stockings should have no wrinkles, twists, or creases when they are worn. Wrinkles and creases can cause skin to breakdown and twists can affect circulation. They should not be so tight as to limit circulation, and the CNA should remove the stockings at least once every eight hours to encourage circulation and check the resident's skin for signs of rash or breakdown. It is not necessary to put no D. Encouraging the patient to complete range of motion (ROM) exercises - ANSWER- C. Using an ice pack or cold pack to reduce swelling Edema is the swelling of an extremity due to poor circulation. Applying ice or cold packs to reduce swelling will not help manage edema. Interventions that stimulate circulation, such as raising the body part above the heart, range of motion exercises (ROM), and massaging the affected area can help. goal is to allow dying patients to live out the B. To provide assistance with activities for daily living A. To restore a person's range of motion Which of the following is the goal of hospice care? C. To meet the emotional, spiritual, and physical needs of a dying person D. To cure a person's illness - ANSWER- C. To meet the emotional, spiritual, and physical needs of a dying person Hospice care is for terminally ill patients who often have less than 6 months to live. The A new resident is having difficulty getting dressed. The CNA helps the resident. Which B. Minimum data set A. Progress notes document should the CNA use to record this information? What is the expected order of the five stages of grief? - ANSWER- Denial, anger, bargaining, depression, acceptance The expected order of the stages of grief is: denial, anger, bargaining, depression, and acceptance. However, not all patients express all of these stages explicitly to caregivers and family members. Additionally, not all patients go through every stage. Some stay in one stage or cycle back to an earlier stage in the process. ir remaining days with dignity and peace. No curative or restorative measures are taken. How should a CNA conduct oneself regarding a resident's religious beliefs? A. Leave it to the family to support the resident's religious beliefs. B. Provide support and allow the resident to practice his religious beliefs. C. Ignore the resident's religious beliefs. D. Try to convert the resident to the CNA's religious beliefs. - ANSWER- B. Provide support and allow the resident to practice his religious beliefs. The Residents' Bill of Rights protects the resident's right to practice his religious beliefs. The CNA must adhere to the Resident Bill of Rights. It is inappropriate for the CNA to ignore the resident's religious beliefs or try to convert the resident to another religion. The family may have different religious beliefs than the resident, so the CNA should allow the resident to practice their religious beliefs. C. Admission sheet D. Flow sheet - ANSWER- D. Flow sheet The flow sheet is used to record a patient's ability to perform activities of daily living (ADL), such as getting dressed. The admission sheet provides information about a new resident, including his or her marital status, insurance information, doctor's name, and religion. The minimum data set includes medical information and information about a resident's memory, communication abilities, and social behavior. Progress notes include information about a person's treatments and medications, procedures performed by the doctor, and visits by other health team members. If a CNA makes a mistake recording a patient's temperature, what should he do to correct this notation? A. Draw a single line through the notation, write the word "error" beside this line and initial it. Then, write the correct number next to the notation. B. Erase the incorrect notation and write the new notation in pencil. C. Cross out the mistake and write the correct number next to the mistake. D. Use liquid paper to cover the mistake and then write the correct notation over the mistake. - ANSWER- A. Draw a single line through the notation, write the word "error" beside this line and initial it. Then, write the correct number next to the notation. Making an error in documentation is a common occurrence. However, it is important to correct these errors appropriately. The CNA must put a single line through the error, write the word "error" next to the line and initial this error. Then, the CNA should write the correct notation next to the error. Which of the following actions protects a resident's right to privacy? A. While assisting a resident in the shower, a CNA leaves the door cracked open. B. A CNA helps a resident dress behind a curtain. C. A CNA forgets to close the curtain when assisting a resident using a bedpan. D. A CNA remains in the room while a resident has visitors. - ANSWER- B. A CNA helps a resident dress behind a curtain. A resident has a right to privacy. Pulling the curtain closed while the resident is getting dressed provides for privacy. Remaining in the room while the resident has visitors, forgetting to pull the curtain, and not shutting the door completely during procedures does not provide for privacy. After signing the consent forms for an upcoming invasive procedure, a patient has a few questions. What should the CNA say to the patient? A. I am so sorry, but you already signed the consent forms so the time for questions has passed. B. I am sure you can ask the doctor right before the procedure begins. C. I'll speak to the nurse to ask the doctor to speak with you. D. What are your questions? I'll see if I can answer them. - ANSWER- C. I'll speak to the nurse to ask the doctor to speak with you. Which is a safety measure that a CNA should employ when helping a resident shower? Make sure the resident has access to the call light. Check the temperature of the water. Lock the wheels of the shower chair. All of the above - ANSWER- D. All of the above be taken when helping a resident shower. making sure the resident has access to the call light are all safety measures that should Checking the temperature of the water, locking the wheels of the shower chair and determine why the patie communicate - ANSWER- A. In a calm and clear manner, while attempting to D. The CNA should not communicate with the patient, as he or she does not want to Patients can become agitated for many reasons, including: fear, anxiety, pain, confusion, boredom, or restlessness. The best way for a CNA to help a patient who is agitated is to speak in a calm and clear tone, and work to determine what is wrong and how to help the patient. You should not communicate to patients through other patients as you have the responsibility and training to address agitated patients. In this instance, the CNA could be charged with negligence because she did not follow standard practice while performing the task. Malpractice only applies to doctors and nurses. Assault would not apply, as the CNA did not threaten the patient. Battery is the purposeful act of physical abuse, and, in this case, the CNA did not purposefully forget to lock the wheels. How should a CNA speak to a patient who is in an agitated state? A. In a calm and clear manner, while attempting to determine why the patient is agitated. B. Through the patient's roommate who may be able to calm or comfort the patient. C. The CNA should report this behavior to the RN on duty, who will then manage the patient. nt is agitated. What is one way to emotionally connect with your residents without crossing boundaries? A. Doing favors for residents, such as calling banks to get financial information and making online purchases. B. Taking time to listen to the resident. C. Meeting with residents' families in the community to develop closer relationships. D. Receiving gifts from residents' families. - ANSWER- B. Taking time to listen to the resident An effective way for a CNA to show she cares is to take time to listen to a resident. Receiving gifts from residents, meeting residents' families, and doing favors for residents, such as conducting financial transactions, may come from a place of Shaving someone with a completelydry f visibly dirty. What should A resident refuses to wash his hair even though it is beginning to become tangled and the CNA do? A. Nothing—it is his hair. C. Respect the resident's wishes and inform the charge nurse of his decision. B. Tell the resident that he must bathe in order to stay in long-term care. C. Wash the resident's face completely and make sure it is dry before shaving. B. Shave the resident's hair in the opposite direction of the hair's growth. A. Use shaving cream to soften the hair and prevent nicks and cuts. Which of the following should a CNA do when shaving a resident? D. All of the above - ANSWER- A. Use shaving cream to soften the hair and prevent nicks and cuts. It is important to use shaving cream to soften the hair and prevent nicks and cuts. goodwill, but these actions cross professional boundaries with residents. When a resident is placed in restraints, which of the following statements is true: A. The resident is being punished for poor behavior. B. A nurse decided to put the resident in restraints. C. The healthcare team should leave the resident alone because the resident is usually violent. D.The healthcare team must check the resident's circulation at the site of restraint at least once every thirty minutes. - ANSWER- D. The healthcare team must check the resident's circulation at the site of restraint at least once every thirty minutes. It is important to check on the restraints every thirty minutes to ensure proper circulation at the site of the restraint. Only a doctor can order restraints, and they are never used as a punishment. Moreover, healthcare providers should reposition the resident every two hours and regularly check on the resident's food and fluid needs. D. Wash the resident's hair anyway—he needs it. - ANSWER- C. Respect the resident's wishes and inform the charge nurse of his decision. Residents have the right to refuse treatment, even if this is not medically advisable. Touching the resident without the resident's consent, or permission, is battery. It is best to accept and let the nurse know the resident's decision. ace and shaving in the opposite direction of the hair's growth can cause skin irritation. Which is the proper protocol for droplet precautions? A. Healthcare providers must wear special masks called High Efficiency Particulate Arrestance (HEPA) masks, and the patient is placed in a negative pressure room. D. Dyspnea - ANSWER- B. An elevated temperature temperature elevatedAnB. A. A rapid pulse rate Which of the following is NOT a sign of hypoxia? B. A prior suicide attempt A. A history of alcohol or drug abuse Which of the following is NOT a risk factor for suicide? D. Give Mr. Smith the ibuprofen because it is important to work together as a healthcare A. P do? who is not your patient, two ibuprofen because, "he has a headache." What should you olitely remind the nurse that you cannot give Mr. Smith ibuprofen and ask if there is anything else you can help with. B. Ignore the nurse—Mr. Smith is not your responsibility. C. Ask the CNA who is caring for Mr. Smith to give him the ibuprofen because it is important to keep members of the healthcare team informed about patient care. give Mr. Smith ibuprofen and ask if there is anything else you can he team to care for residents. - ANSWER- A. Politely remind the nurse that you cannot C. Cyanosis Hypoxia means that the body's cells do not have enough oxygen. If someone is hypoxic, they can have bluish skin (cyanosis), a rapid pulse rate, and dyspnea (labored breathing). An elevated temperature is NOT a sign of hypoxia. If someone is hypoxic, tell the nurse at once. C. A stressful life event (the death of a loved one, for example) D. A quiet personality - ANSWER- D. A quiet personality A quiet personality is NOT, in and of itself, a risk factor for suicide. A history of alcohol or drug abuse, a prior suicide attempt, a family history of suicide, speaking about suicide, or a recent stressful life event are all risk factors. If you suspect that a patient is suicidal, tell the nurse immediately. A nurse is very busy working with a disruptive resident and asks you to give Mr. Smith, lp with. CNAs cannot give medication to residents. This is outside of their scope of care. The CNA should politely remind the nurse that she cannot give Mr. Smith ibuprofen and ask if there is anything else she can help with. All healthcare providers should work as a team to help all patients, but they must stay within the legal bounds of their roles. A person lying on his abdomen with his head turned to one side is in the position. A. Sims' B. Fowler's C. Prone A person lying on his abdomen with his head turned to one side is in the prone position. The Sims' position is a left-side lying position where the person's right leg is flexed, his left arm is behind his body, and the pillow is under his head and shoulder. The Fowler's position is a semi-sitting position in which the bed is raised to a 45-60 degree angle and Which of these procedures must you pay special attention to when helping a patient who has diabetes? A. Getting dressed B. Washing hair C. Clipping toenails D. Brushing teeth - ANSWER- C. Clipping toenails B. The ombudsman certifies CNAs. Which of the following is NOT true about the ombudsman program? A. The ombudsman investigates concerns and resolves complaints. C. The ombudsman represents a resident's interests before the local, state, and federal governments. D. The ombudsman is not a nursing center employee. - ANSWER- B. The ombudsman certifies CNAs. The ombudsman does not certify CNAs—that is the state's responsibility. The Which of the following can a CNA do to help reduce the spread of infection? A. Keep patients' rooms clean B. Keep soiled sheets away from one's uniform C. Hand-washing D. All of the above - ANSWER- D. All of the above Nursing assistants can do many things to help reduce the spread of infection, including: handwashing, holding soiled linens away from one's uniform, and keeping patients' rooms clean. Proper handwashing is the most important way for CNAs to help reduce the spread of infection. ombudsman is someone who helps protect the health, safety, and welfare of nursing home residents. Ombudsmen can be volunteers or are employed by a state agency. They are not employees of nursing home centers. B. Ear infection A. Diabetes Which of the following is an acute illness? C. Help the patient stand up and walk to the scale. B. Ask the patient to remove their shoes. Wash his hands. Before measuring the patient's height and weight, what should a CNA do? D. Give the patient a gown to change into before the physical exam. - ANSWER- A. Wash his hands. D. Broken wrist - ANSWER- C. Fractured hip A broken wrist, sprained ankle, and strained ligament all could occur as a result of a fall; however, the most common injury occurs to the hip, usually in the form of a fracture. C. Obesity D. Arthritis - ANSWER- B. Ear infection An acute illness like an ear infection can be treated or cured, and sometimes it just needs to run its course, such as with a cold. Cancer, obesity, and arthritis are examples of chronic conditions that are ongoing and cannot be cured. Which is NOT a treatment for gastroesophageal reflux disease (GERD)? A. Losing weight B. Eating spicy foods C. Avoiding smoking and alcohol D. Not lying down for 3 hours after meals - ANSWER- B. Eating spicy foods Residents who have GERD should avoid smoking, drinking alcohol, and eating spicy foods. These can all irritate the esophagus. Remaining upright for 3 hours after meals and losing weight can help reduce symptoms of GERD. A. Before beginning any procedure in which a CNA will touch a resident, they should wash their hands and then explain the procedure to the resident. What is the recommended position for taking a resident's blood pressure? A. The resident is standing up. B. The resident is sitting with his feet elevated. C. The resident is lying down with his feet elevated. D. The resident is sitting with his feet on the floor. - ANSWER- D. The resident is sitting with his feet on the floor. The recommended position for a resident when taking his blood pressure is sitting with specimen has been collected should it be disposed of. When caring for a patient who has started vomiting, a CNA should: Place a basin next to the patient's chest. C. Dispose of all of the vomitus immediately. B. Tilt the patient's head up. Apply heat to red areas of the skin. Which is the best method of skin care to prevent pressure ulcers? Keep the skin clean and dry. Apply pressure to the affected area. Massage red areas of the skin. - ANSWER- B. Keep the skin clean and dry. his feet on the floor. This position will give the healthcare provider the most accurate measurement of the resident's blood pressure. A. D. Measure, report, and record the amount of vomitus. - ANSWER- D. Measure, report, and record the amount of vomitus. When caring for a patient who has started vomiting, a basin should be placed under the patient's chin, not at chest level. The patient's head should not be tilted up; rather, it should be turned to one side to prevent aspiration. After checking the vomitus for color, odor, and undigested food, the CNA must measure, report, and record the amount of vomitus on the I & O record. Only after the nurse observes the vomitus and a A. Moisture on the skin can increase a resident's risk for a pressure ulcer. Take precautions to keep the skin clean and dry. Use moisture barriers for residents who are incontinent and be sure to change linens as needed. Applying heat or pressure to red areas can irritate or cause rubbing of the skin and lead to a pressure ulcer. Passive range of motion exercises are helpful for patients who cannot voluntarily move their limbs because: A. They prevent contractures. B. They increase the strength of muscles. C. They increase muscle flexibility. D. All of the above - ANSWER- D. All of the above Passive range of motion exercises are performed when the resident cannot move his muscles without assistance. These exercises can increase the resident's range of motion, strength, and prevent contractures (when muscles shorten and stiffen from lack of movement). What should the CNA do to create a physically and/or emotionally safe environment for a resident who is visually impaired? A. Make sure that the resident's glasses and other visual aids are within reach. are a written description of care and the patient's response to the care. Kardex summarizes information found in the patient's medical record. Progress Notes In a circular motion from back to front. From front to back. From back to front. - ANSWER- C. From front to back. A. With significant force to make sure the area is clean. When cleaning a patient's perineal area, the CNA should be sure to wipe the resident: C. The operator must be trained to use each type of mechanical lift. D. The type of sling used depends on the person's size, condition, and other needs. - ANSWER- B. There must be at least one staff member to operate the lift. There must be at least two staff members to operate a mechanical lift safely. There are different types of lifts and the operator must be trained to use each specific type of lift. It is important to make sure the lift and sling are in good condition. If they are not, tell the nurse. The nurse or care plan will explain which type of sling to use with each resident, as this depends on the person's size, condition, and other needs. If a CNA sees that a resident is not eating enough, what should the CNA do? A. Recommend to the nurse that the resident get nutrition through an IV. B. Give the resident vitamins to help supplement their diet. C. Offer the resident prescribed dietary supplements according to the care plan. D. Get the resident a new tray with tastier food. - ANSWER- C. Offer the resident prescribed dietary supplements according to the care plan. Since CNAs work closely with residents around meal times, they are often best positioned to see what the resident is or is not eating. If a resident is not eating, CNAs should check for doctor-prescribed dietary supplements first, and then offer them to the resident as part of the care plan. CNAs should not offer vitamins or recommend intravenous nutrition, as this is outside their standard of care. CNAs should not find tastier food for the resident because the new food may not fit a medically-prescribed diet. A nursing assistant is recording a resident's ability to bathe independently. Which document will the nursing assistant use to record this information? A. The Flow Sheet B. The Care Plan C. The Kardex D. Progress Notes - ANSWER- A. The Flow Sheet The nursing assistant should record a resident's ability to perform activities for daily living (ADLs) in the Flow Sheet. The Care Plan is a document that the interdisciplinary team (IDT) revisits at least once every 3 months to develop a plan for the patient's care. The Before bringing a tray into a patient's room, a CNA should: D. Make sure that the resident is being given the correct food tray labeled with his name and room number. - ANSWER- D. Make sure that the When cleaning the perineal area, CNAs should wipe from front to back. This reduces the chance of a urinary tract infection. A. Make sure that the resident is able to swallow the food on the tray. B. Record all of the items on the tray in the input/output log. C. Make sure that the resident is awake and alert for meal time. correct food tray labeled with his name and room number. A CNA must check that each resident's tray has the correct: name, room number and diet, aligned with the resident's care plan. Many residents are on special diets that are vital to their well-being. For example, a resident with dysphasia, a condition where one has difficulty chewing and swallowing, will have a special diet unique to that resident's needs. Gloves should always be worn as personal protective equipment (PPE) when: A. Transferring a person from the bed to a wheelchair. B. Feeding a resident who is unable to feed himself. C. Helping a patient walk down the hall. D. Assisting a resident with the use of a urinal. - ANSWER- D. Assisting a resident with the use of a urinal. Gloves are worn whenever there is a possibility that you will come into contact with blood, mucous membranes, or other bodily fluids, and urinals are used to collect urine from a male patient. The other three instances do not require gloves as the CNA will not come into contact with the patient's body fluids (under normal circumstances). Which of the following actions should a nursing assistant always perform when helping a resident to use a bedpan? A. Raise the bed rails so the person won't fall out of the bed B. Place an absorbent pad on the bed for protection C. Place the individual in the genupectoral position D. Use a fracture pan - ANSWER- B. Place an absorbent pad on the bed for protection When helping a resident use a bedpan, it is important to use an absorbent pad on the bed to keep the resident's bed clean and infection free. The genupectoral position is used to examine a resident's rectal area during a physical exam. It is not used when helping a resident to use a bedpan. Fracture pans are used without turning the patient. They are often used by patients with casts, in traction, or with limited back motion, after help him? A. Oxygen therapy B. Defibrillation should you turn her to prevent skin breakdown? A resident has just suffered a stroke, or a CVA, and has limited mobility. How often B. Every hour A. Every 4 hours B. Use standard tape to secure the condom catheter into place A. Ensure that the condom is lubricated after it is placed on the penis a condom catheter? Which of the following steps should the nursing assistant take to care for a resident with C. Connect the catheter to the drainage bag D. Attach the drainage bag to the side table - ANSWER- C. Connect the catheter to the drainage bag C. Heimlich maneuver D. CPR - ANSWER- C. Heimlich maneuver The Heimlich maneuver is used to help a person who is choking. The universal sign for choking is a person with her hands around her throat who is unable to speak. If the person is coughing, she is not choking. Encourage the person to keep coughing to try to dislodge the object from her airway. Do not perform CPR on a person who is choking. This procedure is used on an unconscious person whose heart has stopped beating. Defibrillation is when a person uses a defibrillator to shock a heart back to its regular rhythm. Oxygen therapy is a treatment that provides extra oxygen; it does not clear a person's airways. C. Every ½ hour D. Every 2 hours - ANSWER- D. Every 2 hours Persons who have just suffered from a stroke may experience loss of mobility. To prevent pressure ulcers, these individuals should be turned and repositioned at least every 2 hours. After rolling the condom catheter down the shaft of the penis and securing the condom catheter, the nursing assistant must connect the catheter to the drainage bag. A CNA should never place a condom catheter or a drainage bag on the side table, as these items could contaminate the table. Adding lubricant to a condom catheter could cause the condom catheter to slip off of the resident's penis. A vehicle of transmission is the means by which organisms are carried and spread. B. Locate the AED and use it to provide emergency care. Remove her clothing to provide for comfort. when a resident is showing signs that she may be experiencing a stroke? In addition to calling 911, what is one of the first things a nursing assistant should do When securing a condom catheter, only use the tape included in the condom catheter's packaging. Other types of tape must not be used as these products could restrict blood flow to the resident's penis. Which of the following is a vehicle of transmission? A. A person's nose B. A bedpan C. A break in a person's skin D. An animal - ANSWER- B. A bedpan Bedpans are vehicles of transmission because they can transmit pathogens contained in urine from one person to another. Noses or animals are not vehicles of transmission. Rather, the droplets released from the person's nose when he sneezes or the animal's body fluids are the vehicles of transmission. A break in the skin is not a vehicle of transmission. Rather, the blood coming from the break in the skin is the vehicle of transmission. A. C. Perform rescue breathing on the patient. D. Take note of when the symptoms began, monitor the patient's breathing, and look for any other changes in her condition. - ANSWER- D. Take note of when the symptoms began, monitor the patient's breathing, and look for any other changes in her condition. If it looks as if a patient is experiencing a stroke, be sure to take note of when the symptoms began, monitor the patient's breathing and look for any other changes in her condition, so that you can provide this information to other healthcare providers. An AED is an automated external defibrillator. It is used to shock a heart back to its regular rhythm when it is defibrillating or beating abnormally. Rescue breathing is used for someone who has stopped breathing or has very shallow and interrupted breathing. When providing emergency care, do not remove the person's clothes unless this is necessary to provide care. When transferring a resident using a gait belt, where should you stand in relation to the resident? A. Facing him D . her sche resident about her C. Ask her who she would like to spend this "alone time" with so that you can help A resident with diabete intentions and actions. Take the cupcakes away from her, and tell her that she is not all ordered for her, and report the addition to her ordered diet to the nurse. D. Ask the patient in private about his bowel movements in a calm, clear and professional tone. - ANSWER- D. Ask the patient in private about his bowel movements in a calm, clear and professional tone Speaking to patients about sensitive matters related to their care is an important skill for CNAs to learn. It is generally best to speak with patients in a calm, clear, quiet, and professional tone. A widowed client asks if you could assist her in scheduling some "alone time" with another client in the facility. You should: A. Inform the nurse of her request. B. Offer to help arrange some private time for this resident when her roommate is not present. dule this time. D. Offer to have her speak to the facility's pastor to help her "guide her future plans" regarding intimacy in the facility. - ANSWER- B. Offer to help arrange some private time for this resident when her roommate is not present Patients have the right to express their sexuality as long as it does not infringe on the rights of others. As a CNA, you can assist by helping the resident arrange times to engage in intimacy privately with other consenting residents. This means NOT sharing this information with the nurse, knowing who your clients are involved with, or attempting to have other adults, including religious leaders, interfere with your client's s needs to lower her blood glucose levels, and this goal is part of her care plan. You see her eating cupcakes in her room. What should you do? A. Contact the ombudsman because you're worried that this may constitute a type of self-abuse. B. Do nothing. You have been present with her during sessions with the nutritionist and assume she understands the consequences of her actions. she does not follow the diet owed to eat them. - ANSWER- C. Tell her that you are afraid her health will get worse if she does not follow the diet ordered for her, and report the addition to her ordered diet to the nurse. Each resident has the right to make her own decisions, even if these decisions could be detrimental to her health. In this case, you should speak to the resident about the potential consequences of her actions and frame Tell her that you are afraid her health will get worse if C. the conversation in terms of her health. You must also report her behavior to the nurse because eating cupcakes will likely alter the resident's blood glucose levels, and the RN should follow up with the to CNAs work in a variety of health care settings. If a CNA works in a long-term care facility where residents need minimal assistance with activities for daily living (ADLs), what type of health care setting is this? B. Hospice care facility A. Assisted living residence A. Move an intravenous tube for a client receiving nutrients via an IV Which of the following tasks may the CNA legally perform? Diagnose signs and symptoms of a resident showing potential hyperglycemia Administer oxygen therapy Position bed rails as instructed by the nurse and the care plan - ANSWER- D. Position bed rails as instructed by the nurse and the care plan CNAs can legally move a client's rails on the bed. Before moving bed rails, you sh C. Stop trying to get Mr. Potter to bathe and wait until he calms down. B. Call for another CNA to help you get Mr. Potter to bathe. A. Tell him that he is disturbing others and threaten to restra evening bath. What should you do? You should not take food away from this resident. Moreover, contacting the ombudsman in this case would not be appropriate as this is not a case of neglect or abuse, nor is there a grievance being filed. C. Nursing home D. Skilled nursing facility - ANSWER- A. Assisted living residence Assisted living residences are for individuals who need minimal assistance with activities for daily living (ADLs). A nursing home is designed for residents who need continuous 24-hour care. Residents at a skilled nursing facility have severe health issues or need rehabilitation. A hospice care facility provides services for terminally ill patients. These patients usually have less than 6 months to live and no longer respond ould read the care plan or consult with the nurse. CNAs cannot administer oxygen, as oxygen is treated as a medication. Only nurses or doctors should move IV tubes, as this is a sterile procedure. CNAs cannot diagnose patients, but CNAs should be able to recognize the signs and symptoms of hyperglycemia and report these signs and symptoms to the nurse. You are about to bathe Mr. Potter, but he begins screaming and refuses to take his in him. D. Be firm and insist that he bathe. - ANSWER- C. Stop trying to get Mr. Potter to bathe When a doctor orders a patient to be placed in restraints, what should the CNA NOT do? A. Offer water and toileting every two hours. B. Check on the patient at least every 30 minutes to ensure that there is proper circulation where the restraints are placed. C. Tie the restraints directly to the bed frame. D. Ensure that the restraints are very tight so the patient does not escape. - ANSWER- first pay attention to their increased Making restraints overly tight may injure the resident and cause emotional and psychological distress. Only restrain residents if a doctor orders this procedure. Be sure to check on the resident at least every 30 minutes to ensure that the restraints are not cutting off circulation. Be sure to offer Screamingandaggressive behavior Difficulty swallowing Increased confusion and possible agitation at night Increased risk of falling - ANSWER- C. Increased confusion and possible agitation at night When a patient is sundowning, what should a CNA be especially aware of? The transfer will be easier if the resident is able to help using her stronger side, in this case her right side. Therefore, the wheelchair should be placed at the head of the bed on the resident's right side. Many residents who are sundowning will be confused at night. CNAs should try to prevent residents who are at risk of sundowning from sleeping during the day, so that they can sleep at night. Additionally, if a patient is sundowning a CNA should regularly check in with this resident to reorient her. Patients who are sundowning may also have: an increased risk for falls, difficulty swallowing, and/or aggression, however, CNAs must D. Ensure that the restraints are very tight so the patient does not escape two hours). Which of these symptoms is a sign that a person is about to die? A. Irregular and shallow breathing B. Increased respiration C. Sudden hunger or thirst A. Wait until the confusion subsides Mrs. Bornstein is a resident with Alzheimer's disease. You notice she is confused. What can you do to reduce her confusion? C. Put on a television B. Encourage the resident to participate in a group activity D. Increased heart rate and blood pressure - ANSWER- A. Irregular and shallow breathing Signs of impending death include: irregular and shallow breathing, cool and moist skin, and decreased heart rate and blood pressure. The other answer choices are not signs of impending death. Where do you tape the catheter on a male patient to make sure it stays in place when you turn him over? A. Bed frame B. Upper thigh C. Stomach D. Around the knee - ANSWER- B. Upper thigh When turning a patient over, the upper thigh is the most secure place to tape the catheter. There is a higher chance of the catheter coming loose if it is taped to any other location. D. Keep the level of stimulation to a minimum - ANSWER- D. Keep the level of stimulation to a minimum Keeping the level of stimulation to a minimum and creating a quiet space are effective methods for calming and reducing confusion with Alzheimer's patients. These practices are much more effective than waiting for the confusion to subside. In this instance, Mrs. Bornstein might not be able to participate in a group activity, and the television might promote additional confusion. The nurse on duty asks you to empty a urinary drainage bag for a resident. What should you do? A. Refuse to do this task and explain to the nurse that CNAs are not permitted to perform this task. B. Empty the urinary drainage bag and let the nurse know the task is completed. C. Detach the catheter tube from the drainage bag. D. Twist the tubing in a clockwise direction before emptying the bag. - ANSWER- B Empty the urinary drainage bag and let the nurse know the task is completed Emptying urinary drainage bags is within a CNA's scope of practice. If you are unsure how to perform the task, ask the nurse for help. When you have emptied the urinary drainage bag, report this to the nurse. Twisting the tubing in any direction should not be A. Convert the 21 ounces to cubic centimeters (CCs) It is the end of your shift. You just measured the 8-hour urinary output of your patient and there are 21 ounces of urine. What is your next step? C. Convert from ounces to lbs. B. Compare this patient's urinary output with that of other patients done since this may cause urine to flow back into the patient's bladder. You should not detach the catheter tube as this is a sterile procedure and should be performed by the nurse. Below are three stages of Alzheimer's disease accompanied by specific symptoms. Which stage is matched with its correct symptoms? A. Mild Alzheimer's Disease: Memory loss concerning recent events. B. Moderate Alzheimer's Disease: Need help with multi-step tasks, such as getting dressed, bathing, grooming, or using the bathroom. C. Severe Alzheimer's Disease: Loss of ability to communicate coherently. D. All of the above - ANSWER- D. All of the above During the early stage of Alzheimer's Disease (AD), a person experiences shortterm memory loss. As AD progresses, the person begins to suffer from long-term memory loss as well. Moreover, a patient with moderate Alzheimer's disease becomes more dependent on others and needs help with multi-step tasks like getting dressed and grooming. In the final stage of AD, the person can no longer communicate coherently, though the patient may say occasional words or phrases. D. Call a nurse immediately - ANSWER- A. Convert the 21 ounces to cubic centimeters (CCs) CCs is the unit of measurement used when recording intake and output. Therefore, you must convert the ounces into CCs. There would be no reason to immediately call the nurse because 21 ounces of urine over an 8-hour period falls within the normal range. You are with a female patient who has urinary and fecal incontinence. How should you provide perineal care and hygiene to this patient? A. Clean from the rectum towards the labia B. Clean from the labia towards the rectum C. Clean only the rectum D. Clean the labia and have the patient clean the rectum - ANSWER- B. Clean from the labia towards the rectum When providing perineal care to a female patient, you always start at the cleanest area and then move to the dirtiest area to prevent infection. Thus, you begin with the internal labia, then continue with the external labia, and lastly clean the groin from front to back towards the rectum. Joint pain Intense fear Chest pain Loss of hearing - ANSWER- C. Chest pain Chest pain can be a sign of a panic disorder. Intense fear can be related to a phobia, which is a kind of anxiety disorder. Loss of hearing and joint pain are not usually signs of an anxiety disorder. A. Does not let the resident's culture inform appropriate care. A CNA who is culturally aware: C. Leaves consideration for the resident's cultural beliefs to the nurse. B. Ensures that the resident conforms to the CNA's culture. A. Call other members of the family to see if they can convince her to change her mind. bodies in the morgue. What is the best way to handle this situation? leave the deceased's body alone before burial. At your facility, the policy is to store all The wife of a resident who has just died informs you that in their culture it is forbidden to A common sign of a panic disorder is: D. Provides care that is appropriate to the resident's culture. - ANSWER- D. Provides care that is appropriate to the resident's culture. Culture is an important part of a resident's life, and it can influence their choice of food, dress, speech patterns, religion, concept of family, interests, and values. CNAs must be sensitive to a resident's cultural preferences and beliefs when providing care. B. Notify the nurse about the wife's concern. C. Tell the wife that she must stay with the deceased until the burial. D. Explain that in America, rules are rules. - ANSWER- B. Notify the nurse about the wife's concern. Every effort must be made to respect the religious and cultural needs of patients - even after they die. You should report this cultural need to the nurse who will see if it is possible to accommodate the family's wishes. Which is the best way to communicate with a resident with memory loss? A. Sit beside the resident and listen to her. B. Ask a social worker to speak with the resident. C. Ask the resident to stop talking. She is likely repeating the same information. D. Ignore the resident and continue working. She will not remember the interaction. - ANSWER- A. Sit beside the resident and listen to her. An important part of the CNA's role is to build a trusting, caring environment for the resident. Because the CNA works closely with the resident, it is important that they sit leave the room with the door close by and listen to her. Only after a CNA listens to the resident should a social worker be called in. Ignoring the resident or asking the resident to stop talking is disrespectful. Remind the resident that there is to be absolutely no "hanky panky" and thenC. in the resident's roo Which of the following must a CNA report immediately to a nurse? A. Significant emotional changes in a patient B. Significant behavioral changes in a patient C. Significant physical changes in a patient D. All of the above - ANSWER- D. All of the above CNAs should immediately report significant physical, behavioral, and emotional changes to the nurse. The nurse will then begin to assess the resident's condition and take appropriate action. If a resident asks the CNA for time alone with his wife, what should the CNA do? A. Check with the nurse about the resident's health before making a decision. B. Remind the resident that the CNA has important work to finish, and keep working m. open. D. Leave the resident's room and close the door. - ANSWER- D. Leave the resident's room and close the door. Many residents will have an active sex life and the facility should provide the resident with privacy for sexual expression. The CNA should leave the room and close the door. It is disrespectful (and a violation of a resident's privacy) to stay in the room, comment on the resident's sex life, and/or leave the door open. The nursing assistant should not check in with the nurse in this situation. A resident has decided that he does not want any lifesaving measures to be taken in the event that he stops breathing. What should be noted in his medical record to reflect this desire? A. WBC B. ADL C. DNR D. PMC - ANSWER- C. DNR DNR stands for "Do Not Resuscitate." WBC stands for "White Blood Count." PMC stands for "Postmortem Care." And ADL stands for "Activities of Daily Living." DNR indicates that the resident does not want measures taken to help him start breathing again. "Health care proxy" is also referred to as: A. Medical power of attorney only B. A living will should the CNA report this to? A. Doctor B. Nurse C. The most experienced CNA on the shift D. The family of the resident - ANSWER- B. Nurse C. Durable power of attorney only D. Durable power of attorney and medical power of attorney - ANSWER- D. Durable power of attorney and medical power of attorney "Health care proxy" is also referred to as medical power of attorney and/or durable power of attorney. A "health care proxy" is a document in which a person names a trusted person to oversee her medical care and make health care decisions for her if she cannot make the decisions for herself. If a resident says that he is leaving the facility without the consent of a p ysician, who When a resident threatens to leave the facility against medical advice, the CNA should tell the nurse immediately. The nurse will notify the appropriate personnel. Ms. Oliver has had a stroke and is having difficulty feeding herself. She will be getting assistive devices to help her eat. Which of the following healthcare workers will be getting Ms. Oliver the devices? A. Occupational therapist B. Physical therapist C. Registered nurse D. Social worker - ANSWER- A. Occupational therapist Occupational therapists evaluate patients in terms of their needs for performing activities of daily living. They can offer assistive devices, such as weighted plates and special utensils, to help patients feed themselves or be more independent. While providing oral care, a CNA notices a fruity odor in an elderly patient's mouth. What should the CNA do? A. Report the fruity odor to the nurse. B. Skip the oral care because the patient will need a sputum specimen. C. Tell the patient to use mouthwash. D. Do nothing. - ANSWER- A. Report the fruity odor to the nurse The fruity mouth odor is not normal and could be a sign of high blood sugar. Therefore, this should be reported to the nurse immediately. What is the first thing a CNA must do before transferring a resident from a bed to a wheelchair? A. Ensure that the environment is safe. C. Make sure that the wheels on both the bed and wheelchair are locked. B. Ask the patient to place his feet on the floor. wheelchair. his legs dangle for a moment, and then help the patient stand and move to the D. 10 to 12 hours - ANSWER- C. 5 to 7 hours Older adults generally need less sleep than younger people, requiring only about 5 to 7 hours of sleep within a 24-hour period. Infants 4 weeks to 1- year-old require 12 to 14 hours of sleep, and adolescents ages 12 to 18 years require 8 to 9 hours of sleep. D. Have the patient sit up in bed to get ready to move. - ANSWER- C. Make sure that the wheels on both the bed and wheelchair are locked Before transferring a resident, the CNA must ensure that the wheels on the bed and wheelchair are locked. This is a basic safety measure designed to reduce falls. Once the wheels on the bed and wheelchair are locked, the CNA can help the resident sit up, let Which is an example of neglect? A. Not giving a patient solid food when she is on a liquid diet. B. Letting a patient sit in soiled briefs for an entire shift. C. Using restraints under doctor's orders. D. All of the above - ANSWER- B. Letting a patient sit in soiled briefs for an entire shift. Patients who are incontinent should be changed at least every two hours. Letting a patient sit in soiled briefs for an eight-hour shift is neglect. Which of the following is the most important step a CNA can take to prevent a resident from falling out of bed? A. Keeping the bed low to the floor B. Regular monitoring C. Padded briefs D. Mats on the floor - ANSWER- B. Regular monitoring Regular and frequent monitoring is an effective prevention method for patients at risk of falling out of bed. Mats on the floor, a low bed, and briefs with padding may lessen injuries from falls, but they do not prevent falls. C. Alcohol A common symptom patients have near the end of their lives is chills. A CNA could provide a blanket or extra clothing or help to control the temperature in the room. Fever is not a common symptom for patients near the end of their lives. Fear and depression are emotional, not physical, concerns. An ostomy is a surgical procedure to remove part of the bowel or bladder. A stoma is an artificial opening created at the end of the ureter or small intestine through which waste passes into an ostomy bag or pouch. The first step in changing an ostomy bag is to empty the bag and then remove it. Then, apply a skin protector around the stoma, and friction. - ANSWER- A. Find another person to help with the transfe D. Grip Ms. Miller firmly during the transfer so the CNA's hands do not move and cause C. Put plenty of petroleum jelly on the CNA's hands before starting the transfer. A. Empty the collection bag A resident's ostomy drainage bag needs to be changed. What should you do first? C. Apply a skin protector around the stoma B. Clean around the stoma gently with soap and water Ms. Miller has fragile skin and has experienced skin tears in the past. The CNA is getting ready to transfer her from her bed to a chair. What should the CNA do? A. Find another person to help with the transfer. B. Put plenty of lotion on Ms. Miller's arms. r. To prevent skin tears, the CNA should ask another person to help with the transfer. The CNA should hold Ms. Miller's arms gently, not firmly, to avoid harming her. The use of lotion or petroleum jelly is a safety risk - Ms. Miller could slip from the CNA's hands and fall. What physical symptom is common for CNA to provide comfort measures for when patients near the end of their lives? A. Depression B. Fear C. Fever D. Chills - ANSWER- D. Chills D. Reattach the clean bag to the apparatus around the stoma - ANSWER- A. Empty the collection bag After emptying a urinary drainage bag, which of the following substances should you use to clean its drain tip? A. Peroxide B. Air dry Which of the following is an example of neglect? A. Folding the soiled portion inward Which of the following is NOT considered appropriate handling of linens? C. Depositing the soiled linens on the floor B. Carrying the linens away from your body C. A normal output of urine D. A large output of urine - ANSWER- A. An inability to urinate B. Incontinence A. An inability to urinate Urinary retention refers to: You are monitoring the urine of a resident; he may be suffering from urinary retention. D. Soap and water - ANSWER- C. Alcohol You should use alcohol to clean the tip of the urinary drainage bag before replacing it. Soap and water, air-drying, and peroxide don't adequately clean the drainage tip. A. Leaving the floor to do your daily tasks after reporting to your supervisor B. Changing the resident as soon as you discover she is soiled C. Calling for assistance to care for the resident D. Applying a restraint too tightly - ANSWER- D. Applying a restraint too tightly Applying a restraint too tightly might cause injury to the resident and is considered neglect. When disposing of emesis, what protective equipment should be worn? A. Goggles B. Gloves C. Mask D. Gown - ANSWER- B. Gloves Gloves are the only protective equipment needed when emptying an emesis basin. A mask, gown, or goggles is not necessary. D. Changing linens promptly when soiled - ANSWER- C. Depositing the soiled linens on the floor Depositing soiled linens on the floor contaminates the floor and makes it a hazard. When linens are soiled, they are promptly removed, the contaminated side is folded inward, and they are carried away from the body to avoid contaminating the CNA's uniform. The goal of restorative care is to help the resident regain function in the long term, so creating long-term goals is an important part of the process. Doing everything for the resident and reminding him of his limitations negatively impacts the resident's ability to reach his care plan goals. To help the resident regain function, restorative care discourages dependence on assistive devices. You are helping a resident who had a stroke a year ago. She requires the use of a gait belt when trying to stand. Which of the following should you do when using a gait belt with the resident? A. Stand an arms-length away from the resident when helping her ambulate. B. Bend your back to pull the resident to the standing position. C. Twist your body when attaching and removing the belt. D. Keep the person as close to you as possible. - ANSWER- D. Keep the person as close to you as possible. It is important to keep the resident as close to you as possible when using a gait belt. Twisting or bending your body when attaching, removing, or pulling up a resident could cause you injury and should be avoided. A patient rings the call bell for the fourth time in the first 40 minutes of a CNA's shift. What should the CNA do? A. Ignore the call bell so the CNA can focus on more important tasks. B. Remove the call bell from the patient's reach. C. Kindly reassure the patient that he will be checked on frequently. D. Ask the nurse manager to speak with the patient. - ANSWER- C. Kindly reassure the patient that he will be checked on frequently. Although a patient repeatedly ringing a call bell can be frustrating, it is important to understand the cause of this behavior. The patient may be anxious and need reassurance about his care. CNAs should establish clear guidelines for the use of call bells with the patient. A resident's health is getting worse, and she fears that she is going to die alone. Her family does not come to visit often, but they are aware of her health situation. What can the CNA do for the resident? A. Ask someone visiting another resident to talk to this resident. B. Spend as much time as possible with the resident, listening to her if she wants to talk. C. Tell the family that they must stay with the resident around the clock. D. The CNA can't do anything. - ANSWER- B. Spend as much time as possible with the resident, listening to her if she wants to talk. As much as the CNA's schedule allows, she should keep the resident company and listen to her talk if she chooses to. This should help the resident feel less alone. It is not appropriate to ask other visitors to keep the resident company. You cannot demand tha t family members stay with the resident. You can encourage them to stay, however, if you feel comfortable doing so. You are caring for a patient whose IV flow rate is too slow. What should you do next? A. Adjust the flow rate to the rate that the doctor ordered. B. Provide the nutrients or sugar for the resident that she did not receive from her IV. C. Report it STAT to the nurse. D. Help the resident adjust the catheter. - ANSWER- C. Report it STAT to the nurse. When IV therapy is ordered, the doctor will set the flow rate. This is the amount of fluid to provide in a given amount of time, or the number of drops per minute. If you observe that a client's flow rate has stopped, is too fast, or too slow, report it immediately to the nurse. Only nurses and doctors are able to adjust the flow rate or move the catheter at the site of insertion. Doctors order an IV when a patient is unable to take nutrients or sugar through her mouth, so providing additional nutrients should not be the next step to take in this scenario. STAT is a common medical abbreviation for urgent or right away. Threatening to withhold treatment and/or making fun of a resident are examples of which type of abuse? A. Assault B. Neglect C. Physical abuse D. Emotional abuse - ANSWER- D. Emotional abuse Threatening to withhold treatment and/or making fun of a patient are examples of emotional abuse. Emotional or psychological abuse is usually the most difficult to discover because it is subtle and ongoing. Patients who are experiencing this type of abuse may exhibit behavioral changes. A resident who is near the end of her life asks a CNA to pray with her. The CNA is not comfortable praying with the resident. What should the CNA do? A. Tell the resident that she will have to pray alone. B. Speak with the nurse to find a religious volunteer or counselor to help the resident express her spirituality. C. Ask the resident's roommate to pray with her instead. D. Pray with the resident anyway. - ANSWER- B. Speak with the nurse to find a religious volunteer or counselor to help the resident express her spirituality. When a CNA cares for a patient with diarrhea, which of the following should the CNA record? B. Number of stools A. Types and amount of fluid the patient is taking in Which of the following is the right terminology when referring to residents with B. Mentally retarded A. Mental retardation developmental disabilities? It is perfectly acceptable for a CNA to pray with a resident if the CNA is comfortable doing this. However, if the CNA would rather not pray with the resident, he should speak with the nurse about having a spiritual counselor or volunteer pray with the resident instead. C. Odor of the stool D. All of the above - ANSWER- D. All of the above A patient who has diarrhea is at risk for dehydration. The CNA must monitor the frequency of bowel movements, the odor of bowel movements, and the amount of fluid that the patient is taking in. All of this information is important for the care of the patient. A patient's care plan states: "Help the patient to the bedside commode PRN." When should the patient receive assistance to the commode? A. As needed B. In the middle of the night C. During the day D. At bedtime - ANSWER- A. As needed PRN is the accepted abbreviation for as needed or whenever necessary. C. Slow D. Intellectually disabled - ANSWER- D. Intellectually disabled The Omnibus Budget Reconciliation Act of 1987, or OBRA, protects people with developmental disabilities and requires staff to receive special training in order to meet their care needs. You should avoid using the terms "mental retardation" or "mentally retarded," and instead use the terms "intellectual disabilities" or "intellectually disabled" to refer to these residents. A standard of care tells a CNA: A. The details of a procedure, including all of the steps B. The minimum care you need to provide C. The job description of a CNA information or exposing the person will affect his feelings. False imprisonment is holding a person against his will. You are caring for Ms. Hernandez, a resident who has trouble talking as a result of a stroke she experienced several months ago. Which of the following health team members would be assigned to provide treatment for this difficulty? A. Respiratory therapist B. Occupational therapist C. Physical therapist D. Speech therapist - ANSWER- D. Speech therapist A speech therapist treats people who have speech, voice, hearing, communication, and swallowing disorders. An occupational therapist assists people in learning or maintaining their ability to perform daily activities such as self-care skills, working, and social interaction. A physical therapist treats people with musculoskeletal problems. A respiratory therapist assists in treating lung and heart disorders; which includes performing respiratory treatments and therapies. You and your co-worker are working together to remove a bag contaminated with bodily fluids from a resident's room. Which is the correct process for removing the contaminated bag? A. You remove the bag and mark it contaminated, while your co-worker brings in a large trashcan to dump the bag into. B. You remove the bag, close it, and carry it to the door, while your co- worker prepares a clean bag by folding down a cuff at the top of the clean bag and labeling the bag "contaminated." C. You remove the bag while your co-worker holds the door open for you. D. Your co-worker removes the bag and carries it outside while you begin to clean the contaminated area. - ANSWER- B. You remove the bag, close it, and carry it to the door, while your co-worker prepares a clean bag by folding down a cuff at the top of the clean bag and labeling the bag "contaminated." All health care workers, including CNAs should double-bag bags that contain contaminated body fluids. To do this, first remove the bag, close it, and carry it to the door, while your co-worker prepares a clean bag to contain the contaminated bag by folding down a cuff at the top of the clean bag and labeling the bag "contaminated." You then end the procedure by washing your hands. Which of the following is NOT part of standard precautions? B. Removing organic material before disinfection or sterilization procedures Which of the following is NOT part of oral care for an unconscious person? An unconscious resident may be able to hear the healthcare provider, so the CNA should explain the procedure and speak to the resident throughout the procedure. The CNA should not insert fingers inside the resident's mouth, as the resident could bite down and injure the CNA during the procedure. To protect the resident from aspiration (breathing food, fluid, or vomitus into the lungs), the CNA should position the person to A. Using PPE from items before disinfecting or sterilizing them. C. Placing the resident in a single room D. Hand hygiene - ANSWER- C. Placing the resident in a single room Standard precautions are part of the Centers for Disease Control and Prevention's (CDC's) guidelines to reduce the risk of spreading pathogens from blood, body fluids, open wounds, and mucous membranes. CNAs should practice standard precautions whenever they give care to residents. These include using PPE (personal protective equipment), practicing hand hygiene, and removing organic material (such as blood) Placing a resident in a single room is not part of standard precautions; this action is part of airborne precautions, which are designed to protect people from infections transmitted through respiratory droplets. A. Use a toothbrush to clean the resident's teeth B. Protect the resident from aspiration C. Assume the resident can hear you D. Avoid inserting fingers inside the resident's mouth - ANSWER- A. Use a toothbrush to clean the resident's teeth A CNA should never use a toothbrush to clean an unconscious resident's teeth because the CNA could accidentally hurt the resident. Instead, the CNA should check the center's policy and use the approved tool (usually a sponge swab). Which of the following is the correct temperature for a resident's bath? A. 130 Degrees Fahrenheit B. 110 Degrees Fahrenheit C. 120 Degrees Fahrenheit D. 100 Degrees Fahrenheit - ANSWER- B. 110 Degrees Fahrenheit Before giving a resident a bath, the CNA must always check the water temperature to ensure that the water is not too hot or too cold. A temperature D. All of the above - ANSWER- D. All of the Pneumonia is an acute disorder. It comes on quickly and can be treated and cured. Alzheimer's disease, Type 1 Diabetes, and MS (Multiple Sclerosis) are all chronic conditions that can be treated, but cannot be cured. the patient's medical reco Which of the following is true about a patient's medical record? A. It is not important for healthcare providers to protect patient confidentiality regarding rd. C. The medical record is only important for the patient in the first three months of B. A patient has the right to see her medical record. The five stages of grief are: Denial, Anger, Bargaining, Depression, and Acceptance. Not all patients go through every stage. Some patients cycle through one or more stages or remain in one stage for a period of time. Many patients who are dying may go through one, multiple, or all of the five stages of grief. Although some patients may donate, or give away, their possessions, this is not one of the five stages of grief. Which of the following is true about the use of gloves? A. The outsides of gloves are contaminated. B. Nursing assistants must use gloves every time they may come into contact with body fluids. C. Nursing assistants must change gloves every time they move from a contaminated body site to a clean body site. Gloves act as a barrier to protect the wearer from pathogens. The outsides of gloves are a patient's body and before moving to a clean area of the body. Which of the following is an acute disorder or illness? residential nursing care. D. All of the above - ANSWER- B. A patient has the right to see her medical record. Patients' medical records include many documents, such as the admissions sheet, health history, physical examination results, progress A. Type 1 Diabetes B. Multiple Sclerosis C. Alzheimer's disease D. Pneumonia - ANSWER- D. Pneumonia c ntaminated. Healthcare providers must use gloves every time that theycouldpotentially come into contact with human body fluids. Moreover, healthcare provide rs should change gloves after they provide care to a dirty area (i.e. the notes, flow sheets, laboratory results, etc. Patients' medical records are confidential, and healthcare workers must work to protect the confidentiality of these records. Medical records are updated When bathing a resident, it is important to provide privacy before beginning the bed bath. Bathing can be a stressful or embarrassing activity for residents. Pulling the curtain, covering areas not being bathed, and remaining professional will help maintain the resident's privacy. B. Position the resident according to the care plan. A. Inspect the resident's skin during routine care and report concerns at once. Which of the following is a strategy for preventing decubitus ulcers? regularly and may track patients over many years. Patients have the right to see their medical records, and each facility has policies in place to allow patients to view their medical records. Which of the following demonstrates neglect of a resident? A. The nursing assistant provides no treatment to the resident, and does not speak to or acknowledge her in any way. B. The nursing assistant threatens to hit the resident. C. The nursing assistant locks the wheels of the resident's wheelchair, so that the resident "won't get into trouble." D.The nursing assistant slaps the resident for "talking back." - ANSWER- A. The nursing assistant provides no treatment to the resident, and does not speak to or acknowledge her in any way. Neglect is the failure to provide a resident with the care or services needed to avoid physical harm or mental anguish. Failing to provide treatment and ignoring a resident demonstrates neglect. Threatening to hit a resident is assault and a form of verbal abuse. Slapping a resident is battery and a form of physical abuse. Locking the wheels of a resident's wheelchair is false imprisonment and a form of physical abuse. When giving a resident a bed bath, which of the following should the nursing assistant perform first? A. Wash around the resident's eyes B. Put on gloves C. Lower the head of the bed D. Provide for privacy - ANSWER- D. Provide for privacy C. Keep linens dry and wrinkle free. D. All of the above - ANSWER- D. All of the above Preventing pressure ulcers (decubitus ulcers) is much easier than treating them. Prevention measures include: helping the resident move, providing good nutrition and hydration, monitoring the resident's skin for signs of pressure ulcers, positioning and result. Hold the resident's wrist, count the number of beats in a minute, and recordC. beats in a minute, and record the C. Upward strokes B. Downward strokes A. Any direction is fine When shaving a male resident's neck, in which direction should you move the razor? D. Side-to-side - ANSWER- C. Upward strokes PE, handwashing, gloving, and use of hand sanitizer C. MRSA, C-Diff D. All of the above - ANSWER- A. Germ, agent, reservoir, exit portal, mode of osttransmission, entry port, and susceptible h B. P host A. Germ, agent, reservoir, exit portal, mode ROM exercises can be active, passive, or active assistive depending on the needs of the patient. A nurse requests that you take a resident's pulse at the apical site. What should you do? A. Place a stethoscope over the resident's heart, count the number of beats in a minute, and record the result. B. Place two fingers under the resident's chin on the left side, count the number of result. the D. None of the above - ANSWER- A. Place a stethoscope over the resident's heart, count the number of beats in a minute, and record the result. In order to take an apical pulse, the nursing assistant must place a stethoscope over the patient's heart and count the number of beats in a minute. A radial pulse is taken at the wrist. A carotid pulse is taken under the jaw at the side of the neck. When shaving a male resident's face, it is important to shave in the same direction as the growth of the hair to reduce skin irritation and the risk of nicks and cuts. When shaving the resident's neck, be gentle and shave in upward strokes in the direction of the hair growth. When shaving the resident's face, hold the skin taut and use downward strokes that follow the direction of the hair growth. The chain of infection includes the following: of transmission, entry port, and susceptible The chain of infection includes: the germ or microorganism, the reservoir, the exit portal, the mode of transmission, the entry point, and the susceptible host. MRSA and C-diff are types of treatment-resistant infections. The use of PPE (personal protective equipment), handwashing, gloving, and hand sanitizer are all ways to help prevent the spread of infection. Which of the following is NOT a resident's right? A. To make advanced directives B. To behave however one would like to behave C. To make choices about one's life in the care center D. To choose one's doctor - ANSWER- B. To behave however one would like to behave Although residents have many rights under the law, they do not have the right to behave however they would like to behave. Aggressive, unsafe, or discriminatory behavior is not appropriate. Residents have many rights, including: the right to be treated with dignity and respect, to access medical records, to make choices, to refuse care, to make advanced directives, to manage personal and financial affairs, to have privacy and confidentiality, and to voice grievances and have them addressed promptly (among others). Which of the following is NOT a cause of dehydration? A. Diarrhea B. Vomiting C. Constipation D. Not drinking enough fluids - ANSWER- C. Constipation Dehydration can be a dangerous condition for residents. It may be caused by diarrhea, vomiting, or poor fluid intake. Constipation does not cause dehydration. It is important to monitor a resident's fluid intake, condition, urination, and bowel movements to help prevent dehydration. When providing perineal care for a male resident with an uncircumcised penis, the nursing assistant should: A. Scrub the perineal area thoroughly and vigorously to make sure it is clean. B. Replace the foreskin after it has been pushed back to clean the head of the penis. C. Clean the anal/rectal area first and then use the same washcloth to clean the penis. D. Clean the penis starting at its base and then moving towards the tip. - ANSWER- B. Replace the foreskin after it has been pushed back to clean the head of the penis. The nursing assistant should replace the foreskin after it has been pushed back to clean the head of the penis. It is important to clean under the foreskin of the penis to remove smegma, which collects under the foreskin. Hemorrhoids are swollen and/or inflamed veins around the anus or in the lower rectum. They can be quite painful when sitting or going to the bathroom. Diarrhea is the frequent passage of liquid stools. Feces move through the intestines rapidly. This reduces the time for fluid absorption. Abdominal cramping, nausea, and vomiting may occur with Also, when bathing a resident (or providing perineal care), it is important to remember the principle of "clean to dirty." Start with "clean" areas (the head of the penis) and move to "dirty" areas (the base of the penis). Never use the same cloth to wash the rectal/anal area and then tend to the penis. If the patient ignores the urge to have a bowel movement, which of the following could happen? A. Hemorrhoids B. Incontinence C. Diarrhea D. Fecal impaction - ANSWER- D. Fecal impaction Ignoring the urge to have a bowel movement may lead to more serious health issues than simple discomfort. Fecal impaction is when a large, firm lump of feces is stuck in the rectum. The impacted stool blocks the colon and may lead to significant problems. care for Mr. Fowler. It is important to discard gloves and practice hand hygiene after every patient contact. There are also procedures where you will need to use several pairs of gloves on one patient. NEVER reuse gloves. Which of the following is NOT a sign of depression? A. Persistent sadness and feelings of worthlessness You are caring for Mrs. Tenley, a resident who has a urinary drainage bag. You empty Mrs. Tenley's bag and notice that your gloves look clean, as if you just pulled them out of the box. There is not even a spot on them. You now need to go help Mr. Fowler with a bed bath. What should you do? A. Discard the gloves, practice hand hygiene, and put on new gloves before providing care for Mr. Fowler. B. Use the same gloves for Mr. Fowler's care. No need to change them - they still seem clean. C. Use the same gloves all day as long as they look clean. D. Discard the gloves and bathe Mr. Fowler without wearing gloves. - ANSWER- A. Discard the gloves, practice hand hygiene, and put on new Which of the following should the CNA do when performing a massage? D. Pain - ANSWER- D. Pain C. Anxiety B. Take the patient outside to ensure that no one in the facility is exposed to the patient. C. Place a HEPA mask on the patient. D. Transport the patient quickly to reduce the probability that an infection will spread. - ANSWER- C. Place a HEPA mask on the patient. To prevent the spread of infection, place a HEPA mask on the patient. Moving the patient quickly or taking the patient outside will not protect other people from infection. When talking to a resident about her grandchildren, you notice that she grimaces and rubs her shoulder as she speaks to you. This could be a sign of: A. Sadness B. Fear Grimacing while rubbing or guarding an area of the body is often a non-verbal cue for pain. Be aware of patients' non-verbal expressions. A. Leave extra lotion on the resident's skin to be absorbed later after the procedure. B. Have the resident lie on his side or in prone position and provide for privacy. C. Apply cool lotion directly from the bottle onto the resident's skin. D. All of the above - ANSWER- B. Have the resident lie on his side or in prone position and provide for privacy. Massage is an excellent way to promote blood flow and relax the resident. It is also a good way for the CNA to monitor the resident's skin. When performing a massage, the CNA should have the resident lie on his side or on his stomach in the prone position to expose the back. It is important to provide for privacy during the procedure. The CNA should NOT apply cool lotion directly from the bottle; rather, the CNA should warm the lotion in her hands. The CNA should not leave additional lotion on the resident's skin after the procedure. A new resident who is Muslim enters the facility and wants to know if there is a place where he can pray quietly five times per day. As a nursing assistant, what should you do? A. Respond: "Let's talk to the nurse, social worker, and chaplain to see what we can arrange." B. Respond: "Five times a day is a lot to ask. Can't you just pray once per day?" C. Respond: "Have you thought about the role that Jesus can play in your life?" D. Respond: "I don't know," and walk away to give the resident privacy. - ANSWER- A. Respond: "Let's talk to the nurse, social worker, and chaplain to see what we can arrange." Residents have the right to take part in religious activities. Nursing assistants must help support residents' religious practices. Making judgments about the number of times a person prays, providing no support for religious practice, or trying to convert a resident are not appropriate responses. You are caring for an 85-year-old man who has stiffness and pain in his joints, and he does not like to move because of this pain. What kind of treatment might be most appropriate for his condition? A. Bed rest B. ROM exercises C. Extra sleep D. All of the above - ANSWER- B. ROM exercises It is important that healthcare providers help residents increase or maintain their highest range of motion (ROM) possible. Bed rest or additional sleep will likely reduce the patient's range of motion. In this instance, the patient should perform active range of motion exercises to maintain or increase his range of motion. The fire alarm begins to ring in the facility in which you work. You cannot see nor smell the fire and none of your patients are in immediate danger. What should you do? A. Begin to evacuate patients B. Run to find the fire and extinguish it C. Close the fire doors D. Call 911 - ANSWER- C. Close the fire doors The RACE procedure states that you should do the following during a fire: ●Rescue patients in immediate danger ●Activate the fire alarm ●Close fire doors ●Extinguish the fire Since none of the patients are in immediate danger and the fire alarm has been activated (thus activating the EMS system), you should begin to close the fire doors to contain the fire. Which type of care focuses on comfort and support for a dying person and that person's family? A. Holistic care B. Hospice care