Nurse Aide Training: Best Practices and Procedures, Exams of Nursing

Download Nurse Aide Training: Best Practices and Procedures and more Exams Nursing in PDF only on Docsity! Prometric CNA Practice Test 346 Questions and Answers 2024 A resident often carries a doll with her, treating it like her baby. One day she is wandering around crying that she can't find her baby. The nurse aide should (A) ask the resident where she last had the doll. (B) ask the activity department if they have any other dolls. (C) offer comfort to the resident and help her look for her baby. (D) let the other staff know the resident is very confused and should be watched closely. - ✔ (C) offer comfort to the resident and help her look for her baby. A nurse aide is asked to change a urinary drainage bag attached to an indwelling urinary catheter. The nurse aide has never done this before. The best response by the nurse aide is to (A) change the indwelling catheter at the same time. (B) ask another nurse aide to change the urinary drainage bag. (C) change the bag asking for help only if the nurse aide has problems. (D) ask a nurse to watch the nurse aide change the bag since it is the first time. - ✔ (D) ask a nurse to watch the nurse aide change the bag since it is the first time. Before feeding a resident, which of the following is the best reason to wash the resident's hands? (A) The resident may still touch his/her mouth or food. (B) It reduces the risk of spreading airborne diseases. (C) It improves resident morale and appetite. (D) The resident needs to keep meal routines. - ✔ (A) The resident may still touch his/her mouth or food. Which of the following is a job task performed by the nurse aide? (A) Participating in resident care planning conferences (B) Taking a telephone order from a physician (C) Giving medications to assigned residents (D) Changing sterile wound dressings - ✔ (A) Participating in resident care planning conferences Which of the following statements is true about range of motion (ROM) exercises? (A) Done just once a day (B) Help prevent strokes and paralysis (C) Require at least ten repetitions of each exercise (D) Are often performed during ADLs such as bathing or dressing - ✔ (D) Are often performed during ADLs such as bathing or dressing While the nurse aide tries to dress a resident who is confused, the resident keeps trying to grab a hairbrush. The nurse aide should (A) put the hairbrush away and out of sight. (B) give the resident the hairbrush to hold. (C) try to dress the resident more quickly. (D) restrain the resident's hand. - ✔ (B) give the resident the hairbrush to hold. A resident who is lying in bed suddenly becomes short of breath. After calling for help, the nurse aide's next action should be to (A) ask the resident to take deep breaths. (C) keep the water cool to prevent burns. (D) apply lotion, including between the toes. - ✔ (B) check the feet for skin breakdown. When feeding a resident, frequent coughing can be a sign the resident is (A) choking. (B) getting full. (C) needs to drink more fluids. (D) having difficulty swallowing. - ✔ (D) having difficulty swallowing. When a person is admitted to the nursing home, the nurse aide should expect that the resident will (A) have problems related to incontinence. (B) require a lot of assistance with personal care. (C) experience a sense of loss related to the life change. (D) adjust more quickly if admitted directly from the hospital. - ✔ (C) experience a sense of loss related to the life change. A resident gets dressed and comes out of his room wearing shoes that are from two different pairs. The nurse aide should (A) tease the resident by complimenting the resident's sense of style. (B) ask if the resident realizes that the shoes do not match. (C) remind the resident that the nurse aide can dress the resident. (D) ask if the resident lost some of his shoes. - ✔ (B) ask if the resident realizes that the shoes do not match. A resident's wife recently died. The resident is now staying in his room all the time and eating very little. The best response by the nurse aide is to (A) remind the resident to be thankful for the years he shared with his wife. (B) tell the resident that he needs to get out of his room at least once a day. (C) understand the resident is grieving and give him chances to talk. (D) avoid mentioning his wife when caring for him. - ✔ (C) understand the resident is grieving and give him chances to talk. When a resident refuses a bedbath, the nurse aide should (A) offer the resident a bribe. (B) wait awhile and then ask the resident again. (C) remind the resident that people who smell don't have friends. (D) tell the resident that nursing home policy requires daily bathing. - ✔ (B) wait awhile and then ask the resident again. When a resident is combative and trying to hit the nurse aide, it is important for the nurse aide to (A) show the resident that the nurse aide is in control. (B) call for help to make sure there are witnesses. (C) explain that if the resident is not calm a restraint may be applied. (D) step back to protect self from harm while speaking in a calm manner. - ✔ (D) step back to protect self from harm while speaking in a calm manner. During lunch in the dining room, a resident begins yelling and throws a spoon at the nurse aide. The best response by the nurse aide is to (A) remain calm and ask what is upsetting the resident. (B) begin removing all the other residents from the dining room. (C) scold the resident and ask the resident to leave the dining room immediately. (D) remove the resident's plate, fork, knife, and cup so there is nothing else to throw. - ✔ (A) remain calm and ask what is upsetting the resident. Which of the following questions asked to the resident is most likely to encourage conversation? (A) Are you feeling tired today? (B) Do you want to wear this outfit? (C) What are your favorite foods? (D) Is this water warm enough? - ✔ (C) What are your favorite foods? When trying to communicate with a resident who speaks a different language than the nurse aide, the nurse aide should (A) use pictures and gestures. (B) face the resident and speak softly when talking. (C) repeat words often if the resident does not understand. (D) assume when the resident nods his/her head that the message is understood. - ✔ (A) use pictures and gestures. While walking down the hall, a nurse aide looks into a resident's room and sees another nurse aide hitting a resident. The nurse aide is expected to (A) contact the state agency that inspects the nursing facility. (B) enter the room immediately to provide for the resident's safety. (C) wait to confront the nurse aide when he/she leaves the resident's room. (D) check the resident for any signs of injury after the nurse aide leaves the room. - A resident has an indwelling urinary catheter. While making rounds, the nurse aide notices that there is no urine in the drainage bag. The nurse aide should first (A) ask the resident to try urinating. (B) offer the resident fluid to drink. (C) check for kinks in the tubing. (D) obtain a new urinary drainage bag. - ✔ (C) check for kinks in the tubing. A resident who is incontinent of urine has an increased risk of developing (A) dementia. (B) urinary tract infections. (C) pressure sores. (D) dehydration. - ✔ (C) pressure sores. When cleansing the genital area during perineal care, the nurse aide should (A) cleanse the penis with a circular motion starting from the base and moving toward the tip. (B) replace the foreskin when pushed back to cleanse an uncircumcised penis. (C) cleanse the rectal area first, before cleansing the genital area. (D) use the same area on the washcloth for each washing and rinsing stroke for a female resident. - ✔ (B) replace the foreskin when pushed back to cleanse an uncircumcised penis. Which of the following is considered a normal age related change?‐ (A) Dementia (B) Contractures (C) Bladder holding less urine (D) Wheezing when breathing - ✔ (C) Bladder holding less urine A resident is on a bladder retraining program. The nurse aide can expect the resident to (A) have a fluid intake restriction to prevent sudden urges to urinate. (B) wear an incontinent brief in case of an accident. (C) have an indwelling urinary catheter. (D) have a schedule for toileting. - ✔ (D) have a schedule for toileting A resident who has stress incontinence (A) will have an indwelling urinary catheter. (B) should wear an incontinent brief at night. (C) may leak urine when laughing or coughing. (D) needs toileting every 1 2 hours throughout the day. - ‐ ✔ (C) may leak urine when laughing or coughing. The doctor has told the resident that his cancer is growing and that he is dying. When the resident tells the nurse aide that there is a mistake, the nurse aide should (A) understand that denial is a normal reaction. (B) remind the resident the doctor would not lie. (C) suggest the resident ask for more tests. (D) ask if the resident is afraid of dying. - ✔ (A) understand that denial is a normal reaction. A slipknot is used when securing a restraint so that (A) the restraint cannot be removed by the resident. (B) the restraint can be removed quickly when needed. (C) body alignment is maintained while wearing the restraint. (D) it can be easily observed whether the restraint is applied correctly. - ✔ (B) the restraint can be removed quickly when needed. When using personal protective equipment (PPE) the nurse aide correctly follows Standard Precautions when wearing (A) double gloves when providing perineal care to a resident. (B) a mask and gown while feeding a resident that coughs. (C) gloves to remove a resident's bedpan. (D) gloves while ambulating a resident. - ✔ (C) gloves to remove a resident's bedpan. To help prevent resident falls, the nurse aide should (A) always raise side rails when any resident is in his/her bed. (B) leave residents' beds at the lowest level when care is complete. (C) encourage residents to wear larger sized, loose fitting clothing.‐ ‐ (D) remind residents who use call lights that they need to wait patiently for staff. - ✔ (B) leave residents' beds at the lowest level when care is complete. As the nurse aide begins his/her assignment, which of the following should the nurse aide do first? (A) Collect linen supplies for the shift (C) Slurred speech (D) Irregular heartbeat - ✔ (C) Slurred speech Considering the resident's activity, which of the following sets of vital signs should be reported to the charge nurse immediately? (A) Resting: 98.6° 98 32‐ ‐ (B) After eating: 97.0° 64 24‐ ‐ (C) After walking exercise: 98.2° 98 28‐ ‐ (D) While watching television: 98.8° 72 14 - ‐ ‐ ✔ (A) Resting: 98.6° 98 32‐ ‐ Which of the following best describes how persons affected by Parkinson's disease typically walk? A. They tend to walk quickly. B. They tend to lean back when walking. C. They walk normally but with some shakiness. D. They shuffle their feet while taking small steps. - ✔ D. They shuffle their feet while taking small steps. Which of the following is considered a normal age-related change seen in elderly residents? A. Increase in appetite B. Decrease in constipation C. Decrease in taste sensation and smell D. Increase in amount of confusion experienced daily - ✔ C. Decrease in taste sensation and smell A nurse aide is assigned to a resident with Alzheimer's disease. The nurse aide notices that today the resident is restless and is pacing a lot. The resident is also observed rubbing his stomach. The nurse aide should report this change to the nurse and A. ask the resident when he had his last bowel movement. B. check if the resident is hungry or needs to go to the bathroom. C. try to keep the resident close to observe the resident throughout the shift. D. allow the resident to move around as long he does not harm other residents. - ✔ B. check if the resident is hungry or needs to go to the bathroom. Residents with Alzheimer's disease or dementia often lack the ability to explain physical needs, problems or discomfort. When the resident is in pain, the staff may observe the resident becoming more restless. A resident who has to use the bathroom may say "my tummy hurts" when the resident's mind no longer recognizes the meaning of body signs such as a full bladder. The resident's behavior may hold clues that the nurse aide should pay attention to. A resident rubbing his stomach could be a sign of a number of different things: hunger, nausea, the need to urinate or have a bowel movement. There could also be a serious health problem. A nurse aide is walking a resident using a gait belt. The resident tells the nurse aide she feels dizzy. The nurse aide should A. hold the gait belt tighter and ask the resident to rest for a minute. B. suggest the resident lean on the nurse aide for more support. C. guide the resident over to the handrail and ask to hold. D. ease the resident to the floor if a chair is not available. - ✔ D. ease the resident to the floor if a chair is not available. While receiving personal care in bed, a resident begins to have a seizure. The nurse aide should A. hold the resident down to reduce injury. B. keep the airway open and prepare to do CPR. C. call the charge nurse and remain with the resident. D. place a tongue blade between the resident's teeth. - ✔ C. call the charge nurse and remain with the resident. When moving a resident in bed, a lift or turning sheet may be used to help prevent A. atrophy. B. shearing. C. infections. D. contractures. - ✔ B. shearing. A resident has an indwelling urinary catheter. Which of the following is part of the catheter care procedure performed by the nurse aide? A. Clean the catheter, starting at the meatus and moving downward. B. Clean the catheter, starting at the end and moving towards the genitalia. C. Disconnect the drainage bag from the catheter to empty the bag fully. D. Cleanse around the meatus with alcohol swabs, wiping front to back. - ✔ A. Clean the catheter, starting at the meatus and moving downward. Which of the following is the most appropriate schedule for residents who are incontinent to receive perineal care? A. In the morning and at bedtime B. At the beginning and near the end of a shift C. Whenever the resident is soiled with urine or stool D. Every two hours when the nurse aide checks on the resident - ✔ C. Whenever the resident is soiled with urine or stool A resident whose husband died a few years ago, says, "I have got to get dinner started. My husband will be home from work soon." What is the best way for the nurse aide to respond? A. Offer to walk with the resident to the activity department's kitchen. B. Remind the resident that the nursing home prepares her meals. C. Ask the resident about her husband's favorite dinners. D. Explain gently that the resident's husband is dead. - ✔ C. Ask the resident about her husband's favorite dinners. ✔ C. Promote circulation at pressure points A nurse aide hears the charge nurse scream at a resident. The nurse aide goes to the resident to provide immediate protection of the resident. The nurse aide should also A. call the police immediately. B. ask if the nurse is feeling stressed about something. C. report the situation to the charge nurse's supervisor. D. ask if any other staff have ever observed this behavior. - ✔ C. report the situation to the charge nurse's supervisor. According to Standard Precautions, the nurse aide should wear gloves for which of the following procedures? A. Getting linen from a linen cart B. Removing soiled linen from a bed C. Performing range of motion exercises D. Transferring a resident to a showerchair - ✔ B. Removing soiled linen from a bed While helping in the dining room, the nurse aide notices a male resident in distress holding his throat. The nurse aide believes the resident may be choking. After calling for help, the nurse aide's next action should be to A. check the resident's ABCs. B. ask if the resident can talk. C. provide an abdominal thrust. D. lower the resident to the floor - ✔ B. ask if the resident can talk. The nurse aide is taking routine vital signs on a resident. The resident's temperature is 101.4º Fahrenheit. The most appropriate response by the nurse aide is to A. place a cool, wet washcloth to the resident's forehead. B. cover the resident with extra blankets. C. record and report the change at the end of the shift. D. report the temperature promptly. - ✔ D. report the temperature promptly. The nurse aide notices that a resident with dementia keeps walking over to the piano, pausing there, touching the piano, and then walking away only to return again. Which of the following is the best action for the nurse aide to take? A. Take the resident back to the resident's room. B. Distract the resident by asking about the resident's family. C. Invite the resident to sit down at the piano with the nurse aide. D. Ask the activity director to find something for the resident to do. - ✔ C. Invite the resident to sit down at the piano with the nurse aide. The nurse aide is to obtain a resident's weight. The nurse aide should A. ask if the resident remembers his/her last weight. B. ask when the resident last ate food or drank fluid. C. wait until after the resident has a bowel movement. D. check what scale is usually used for this resident. - ✔ D. check what scale is usually used for this resident. A resident who is Roman Catholic is dying. The resident comments that she has not been to confession and she worries that she will die in a state of sin. Which of the following is the best response by the nurse aide? A. "Don't you think God knows you are in a nursing home?" B. "Would you like it arranged for a priest to visit you?" C. "Sounds like you are not ready to die." D. "Have you considered praying? - ✔ B. "Would you like it arranged for a priest to visit you?" "Sundowning" is a term used to describe when residents A. take short naps throughout the day. B. show signs of Alzheimer's at a younger age. C. prefer to go to bed earlier in the evening. D. become restless and agitated late in the day. - ✔ D. become restless and agitated late in the day. Which of the following should be reported to the charge nurse immediately? A. A resident's change in appetite B. A resident's complaint of chest pain C. A resident who refuses to take a scheduled tub bath D. A resident who wanders is found napping in another resident's bed - ✔ B. A resident's complaint of chest pain Which of the following describes an important requirement when providing colostomy care? A. Use sterile technique when providing care. B. Wear gloves for Standard Precautions. C. Avoid cleansing skin near the stoma. D. Position the resident on the side. - ✔ B. Wear gloves for Standard Precautions. Which of the following describes a resident's concern that needs to be reported to the charge nurse immediately? A. A resident's complaint of not getting to activities on time. B. A resident who states a need for a new pair of elastic stockings. C. A resident with dementia who states the need to talk to the resident's son. D. A resident who has always been oriented is suddenly scared and confused. - ✔ D. A resident who has always been oriented is suddenly scared and confused. The goal when removing gloves that are soiled is to A. remove quickly since there is a risk of exposure to germs. B. Meat and eggs C. Fruits and vegetables D. Whole grains and milk products - ✔ B. Meat and eggs Eggs and meats are sources of protein. Protein is also found in beans, peas, soy products, and nuts. Protein is important to the body for growing new tissue and repairing tissue. It is important when encouraging residents' food intake that the nurse aide recognizes the importance of different nutrients. Making sure residents eat enough protein is important to the residents' health. Fruits and vegetables are excellent sources of fiber, while pasta and rice provide carbohydrates, which are essential for energy. A resident's care plan provides the nurse aide with information about A. the financial arrangements made for the resident's care. B. specific care required for the resident and the goals of care. C. facility procedures for performing different nursing care procedures. D. the nurse aide's assignments and when care is provided to each resident. - ✔ B. specific care required for the resident and the goals of care. When feeding a resident who is lying in bed, the head of the bed is raised to A. make chewing food easier. B. decrease the risk of aspiration. C. improve the resident's digestion. D. allow for better respirations between bites. - ✔ B. decrease the risk of aspiration. Which of the following is an observation often seen when a resident is impacted? A. Liquid feces seeping out of the anus B. Darkening of the resident's urine C. Many soft, formed stools D. Bad breath odor - ✔ A. Liquid feces seeping out of the anus Which of the following is the nurse aide most likely to observe in a resident who has a low blood sugar? A. Shakiness or trembling B. Thirst and dry mouth C. Sweet breath odor D. Increased urine - ✔ A. Shakiness or trembling Residents are most likely to feel the urge to have a bowel movement A. after taking a nap. B. after eating a meal. C. just before bedtime. D. during the shift change. - ✔ B. after eating a meal. Before helping a resident to stand who has been lying in bed, the nurse aide needs to A. find out what the resident plans to do for the day. B. make sure a walker is available for support in case it is needed. C. ask if the resident has taken any medication recently. D. allow time for the resident to adjust to sitting at the edge of the bed. - ✔ D. allow time for the resident to adjust to sitting at the edge of the bed. While helping the resident to get dressed, the nurse aide observes that the resident's breathing is faster. The resident says she feels tired. What should be the nurse aide's first action? A. Dress the resident quickly. B. Check the resident's vital signs. C. Stop the dressing to let the resident rest. D. Go to find a nurse to check the resident. - ✔ C. Stop the dressing to let the resident rest. The nurse aide receives resident assignments from the charge nurse at the beginning of the shift. When planning priorities it will be most important for the nurse aide to A. decide break times with other nurse aides. B. review assignments with others to check if residents are divided evenly. C. check all assigned residents to see if anyone has immediate needs. D. check what the activity department has scheduled for residents during the shift. - ✔ C. check all assigned residents to see if anyone has immediate needs. The care plan requires that the resident be ambulated 100 feet twice a day at 10 a.m. and 2 p.m. When the nurse aide arrives to walk the resident at 10 a.m., the resident refuses. Which of the following is the best response by the nurse aide? A. "Maybe you can plan to walk a little further this afternoon." B. "The doctor ordered your walking exercise. You really need to try." C. "You have the right to refuse. Do you want me to tell the nurse?" D. "Would you prefer to walk a little later?" - ✔ D. "Would you prefer to walk a little later?" Which of the following is generally experienced by a resident with low blood sugar? A. Fever A resident who is in isolation needs a temperature taken several times a day. Where is the appropriate place for the thermometer to be kept? A. At the nurses' station. B. On the isolation cart outside the resident's room. C. In the dirty utility room. D. In the resident's room. - ✔ D. In the resident's room. What is the best reason for giving frequent perineal care to residents? A. It increases comfort. B. It decreases sexual responses. C. It helps prevent skin breakdown. D. It prevents incontinence. - ✔ C. It helps prevent skin breakdown. The first step the nurse aide should take when discovering a fire is to A. check how quickly the fire is spreading. B. remove any residents near the fire. C. throw a blanket over the flames. D. pull the alarm. - ✔ B. remove any residents near the fire. To help prevent burns to residents during meals, the nurse aide should A. place a clothing protector on the resident. B. wait to serve the food until hot food is cold. C. add ice to any hot liquids, such as coffee or soup. D. let residents know which foods and beverages are hot. - ✔ D. let residents know which foods and beverages are hot. A resident tells the nurse aide about being bored. The resident says, "My days seem to last forever." What should the nurse aide do? A. Tell the resident, "I know what you mean. My days seem long too." B. Ask the charge nurse if the resident can have some medication. C. Ask about activities the resident has enjoyed in the past. D. Tell the resident to check the activity schedule. - ✔ C. Ask about activities the resident has enjoyed in the past. Why is it important to check the feet of a resident with diabetes at least once a day? A. To look for sores on the feet the resident may not feel B. To check if vision problems have resulted in foot injuries C. To trim the toenails so they do not become long or jagged D. To make sure the resident does not get a foot fungus - ✔ A. To look for sores on the feet the resident may not feel A resident's hands shake when trying to drink liquids, causing the liquids to spill. What is the best response by the nurse aide? A. Thicken the liquid so it will not spill. B. Place a clothing protector on the resident. C. Seat the resident with other residents who also spill. D. Suggest that the resident might do well with a cup with a lid. - ✔ D. Suggest that the resident might do well with a cup with a lid. A resident who has dementia is usually able to get dressed with some prompting. This morning the resident is more confused and needs more help with all activities of daily living. What should the nurse aide do? A. Tell the resident not to feel bad about needing more help today. B. Provide extra help as needed to avoid the resident becoming frustrated. C. Ask if the resident would prefer to stay in night clothes for the day. D. Check if the resident will get dressed for another nurse aide. - ✔ B. Provide extra help as needed to avoid the resident becoming frustrated. A resident, who is on bed rest, asks for a bedpan. The resident is not able to lift own hips to help with the placement of the bedpan. The best action by the nurse aide is to A. ask the nurse if the resident should have a urinary catheter. B. turn the resident onto one side to place the bedpan under the resident's hips. C. place an underpad on incontinent brief under the resident to collect the urine. D. have another nurse aide assist to lift the resident onto the bedpan. - ✔ B. turn the resident onto one side to place the bedpan under the resident's hips. A nurse aide is assisting a resident at mealtime. The resident grabs his throat and cannot speak. What should the nurse aide do first? A. Try to get the resident to take a few sips of water through a straw. B. Reach around from behind the resident to provide abdominal thrusts. C. Pat the resident's back and then reach in his mouth to remove the blockage. D. Ask the resident to take a deep breath and cough. - ✔ B. Reach around from behind the resident to provide abdominal thrusts. A resident is admitted to the nursing home for rehabilitation after a stroke. The plan is for the resident to stay only a short time, before returning home. Which of the following shows the best support of the resident's needs? While feeding a resident, the nurse aide notices that the resident is coughing a lot after each drink of fluid. What is the appropriate response by the nurse aide? A. Allow the resident more time to swallow. B. Use a straw when giving the resident fluids. C. Add a thickening product to the resident's fluids. D. Stop feeding and ask a nurse to check the resident. - ✔ D. Stop feeding and ask a nurse to check the resident. When checking the resident's urinary drainage bag, the nurse aide observes that the resident has had about 50 ccs (mls) of urine output in the last six hours. What should the nurse aide do first? A. Begin offering the resident fluids to drink every 15 minutes. B. Report the observation to the charge nurse immediately. C. Ask if the resident is having any pain when urinating. D. Check to see if the tubing is kinked or bent. - ✔ D. Check to see if the tubing is kinked or bent. When caring for a resident who is comatose, the nurse aide is expected to A. provide mouth care once a day. B. avoid changing the resident's position. C. talk to the resident while providing care. D. keep the resident's room dark and quiet. - ✔ C. talk to the resident while providing care. When a resident is not able to stand, the resident's height is usually measured by A. having coworkers hold the resident upright to allow for the measurement. B. adding the length of legs, chest, and neck/head to determine the height. C. asking the resident's height and subtracting an inch for age-related shrinkage. D. taking the measurement from head to heels while the resident is flat in bed. - ✔ D. taking the measurement from head to heels while the resident is flat in bed. A nurse aide is assigned to a table in the dining room during the residents' lunch. One of the residents who is seated at the table begins to have a seizure. The nurse has been called. The next action by the nurse aide should be to A. guide the resident from the chair to the floor. B. remove the other resident's away from the table. C. try to open the resident's mouth to check for food. D. keep the resident in the chair by holding around the resident's waist. - ✔ A. guide the resident from the chair to the floor. A resident says, "I am not going to eat this food. It is poisoned," What is the best response by the nurse aide? A. Offer to taste all the food first to prove it is not poisoned. B. Report to the charge nurse that the resident is acting crazy. C. Ask if there is something else the resident would like to eat. D. Leave the resident alone because the resident will eat when hungry enough. - ✔ C. Ask if there is something else the resident would like to eat. Which of the following is an example of disinfection? A. Washing a resident's hands after toileting B. Using a wipe to clean around a resident's stoma C. Cleaning a shower chair with a chemical cleanser D. Cleaning a resident's bath basin with soap after use - ✔ C. Cleaning a shower chair with a chemical cleanser Disinfecting is a process that involves using a chemical to kill microbes, and it is used on equipment that comes in contact with body fluids or substances--generally used in the nursing home setting on equipment that is used between residents. Which of the following is a right of nursing home residents? A. To select the staff that will provide their care B. To have designated smoking areas in the facility C. To make decisions about their care and treatment D. To have activities offered throughout the day and evening shift - ✔ C. To make decisions about their care and treatment After reporting the observation of a red area on the resident's hip, the nurse aide should expect that the A. resident will be placed on short-term bed rest. B. area will be covered with a protective dressing. C. area will need frequent massage with a moisturizing lotion. D. resident should be positioned to avoid pressure on the area. - ✔ D. resident should be positioned to avoid pressure on the area. It is most important for the nurse aide to check the temperature of the water before A. assisting the resident with mouth care. B. soaking the resident's feet for foot care. C. giving the resident a bed bath. D. washing hands. - ✔ B. soaking the resident's feet for foot care. When fire presents an immediate danger to residents, the first response should be to remove any residents from harm. The acronym of R-A-C-E is used to remind staff of the steps to follow when responding to a fire emergency. R - removal of residents from danger A - alarm (getting emergency assistance) C- confine the fire (closing doors and windows) E - extinguish (if this can be done safely) A resident with a feeding tube is scheduled for a shower. The resident's feeding tube is connected to a pump. Which of the following is the appropriate response by the nurse aide? A. Disconnect the feeding tube temporarily to give the shower. B. Protect the pump with a plastic bag before bringing into the shower room. C. Ask the charge nurse for assistance with the feeding pump. D. Give the resident a bed bath since the resident has a feeding tube. - ✔ C. Ask the charge nurse for assistance with the feeding pump. The normal appearance of urine is A. clear. B. cloudy. C. dark yellow. D. strong smelling. - ✔ A. clear. A nurse aide finds a resident who has a history of falls lying on the floor in the resident's room. The resident is crying and says, "I fell again." What should the nurse aide do first? A. Call for help while keeping the resident calm. B. Check for injuries while asking how the resident fell. C. Place a pillow under the resident's head and cover with a blanket. D. Consider if the resident is trying to get attention. - ✔ A. Call for help while keeping the resident calm. A resident who used to go to the bathroom by herself now asks for assistance to walk to the bathroom. What is the appropriate response by the nurse aide? A. Assist the resident and report the change to the charge nurse. B. Understand that these changes are just a normal part of aging. C. Update the resident's care plan and explain the change to the charge nurse. D. Encourage independence and suggest that the resident try going to the bathroom on her own. - ✔ A. Assist the resident and report the change to the charge nurse. What should a nurse aide do with a used disposable razor? A. Throw the razor away in a trash can. B. Place the razor in a sharps container immediately. C. Clean, rinse, and dry the razor so it can be used again. D. Wrap the razor in a paper towel until it can be thrown away. - ✔ B. Place the razor in a sharps container immediately. The Health Insurance Portability and Accountability Act (HIPAA) is important to the nurse aide because it A. allows residents to carry health care from the hospital to the nursing home. B. provides for insurance coverage for residents and health care workers. C. identifies protected health information that must remain confidential. D. provides accountability for care offered across health care settings. - ✔ C. identifies protected health information that must remain confidential. A resident must have assistance to walk. When leaving the resident in the resident's room, what must the nurse aide do before leaving the room? A. Turn on the resident's television. B. Make sure the resident's bedpan is within reach. C. Place the call light where the resident can reach it. D. Say to the resident, "Remember that you need help to walk." - ✔ C. Place the call light where the resident can reach it. The nurse aide is bathing a resident and notices new swelling in the resident's ankles. Which of the following is the best response by the nurse aide? A. Ask if the resident has been eating salty foods lately. B. Elevate the resident's legs and check again later. C. Report the swelling to the charge nurse. D. Avoid bathing the resident's lower legs. - ✔ C. Report the swelling to the charge nurse. A resident has a contracture of the right arm. When putting on the resident's button-front shirt, the nurse aide should A. put the shirt sleeve on the left arm first, then the right arm. B. ask which arm the resident prefers the sleeve to go on first. C. put the shirt sleeve on the right arm first, then the left arm. D. raise resident's arms up to slide both sleeves on at the same time. - ✔ C. put the shirt sleeve on the right arm first, then the left arm. When weighing a resident, it is important to make sure the A. resident's last measured weight is available. B. scale measures both pounds and kilograms. C. resident is wearing light weight clothing such as pajamas. D. scale is balanced or calibrated before helping the resident onto the scale. - A few minutes before the end of the shift, a resident calls and whispers to the nurse aide, "I had an accident. I wet myself." What should the nurse aide do? A. Explain that the next shift will assist the resident in a short time. B. Remove any wet clothing and place the resident on a dry underpad. C. Ask if the resident feels very uncomfortable. D. Provide incontinent care to the resident. - ✔ D. Provide incontinent care to the resident. A nurse aide enters a room just as a resident's wife slaps the resident. The resident does not seem upset or hurt. What should the nurse aide do? A. Leave the room and close the door to allow privacy. B. Consider if this is normal behavior for this couple. C. Report the observation to the charge nurse immediately. D. Tell the wife that she must leave the facility for the day. - ✔ C. Report the observation to the charge nurse immediately. When going to take routine vital signs, the nurse aide discovers that a minister is praying with the resident. The nurse aide should A. ask how long the minister plans to visit. B. explain politely that it is time to take vital signs. C. check if the resident is praying before interrupting. D. wait to take the vital signs after the minister has left. - ✔ D. wait to take the vital signs after the minister has left. A charge nurse asks a nurse aide to perform a task that is not part of the nurse aide's scope of practice. What should the nurse aide do? A. Consider if the task can be performed another way. B. Provide the care and perform the task as best as possible. C. Contact the ombudsman's office since resident's rights may be violated. D. Refuse to perform the task and explain it is not within the nurse aide's role. - ✔ D. Refuse to perform the task and explain it is not within the nurse aide's role. A resident with dementia says, "I need to get home. My daughter's school bus is coming soon." The nurse aide knows the resident is confused because her only daughter just turned 60. What is the best response by the nurse aide? A. "Let's go see if Bingo has started yet. You love Bingo." B. "Remember you are in a nursing home. Your daughter is all grown up." C. "Do you mean your great-granddaughter? Your daughter just turned 60." D. "What do you like to do with your daughter when she gets home from school?" - ✔ D. "What do you like to do with your daughter when she gets home from school?" The nursing home is having a Christmas party. A resident who is Jewish is not interested in going to the party. The nurse aide should A. remind the resident how much the resident enjoys parties. B. encourage the resident to go since so many other residents are attending. C. respect the resident's decision and ask what the resident would like to do. D. ask if the resident participated in any activities for the Jewish Hanukah holiday. - ✔ C. respect the resident's decision and ask what the resident would like to do. A nurse aide walks into a resident's room and finds a resident on the floor. The resident says, "I fell down and I cannot move my arm." What should be the nurse aide's next action? A. Help the resident to a sitting position on the floor. B. Ask the resident to stay still while the nurse aide calls for help. C. Ask the resident to describe the pain and how the fall happened. D. Support the injured arm by placing a pillow under the arm and shoulder. - ✔ B. Ask the resident to stay still while the nurse aide calls for help. A resident has an indwelling urinary catheter. When the resident sits in a wheelchair, where should the nurse aide place the drainage bag? A. On the floor directly next to the wheelchair, positioned well below the resident's bladder B. Tucked at the resident's side on the seat of the chair to keep the drainage bag level with the resident's bladder C. Hung from back of the wheelchair so that it is out of the resident's view and above the bladder D. Attached to the seat of the wheelchair, positioned below the level of the resident's bladder - ✔ D. Attached to the seat of the wheelchair, positioned below the level of the resident's bladder A resident who must stay in bed is at risk for developing A. dementia. B. arthritis. C. footdrop. D. Parkinson's disease. - ✔ C. footdrop. When counting a resident's pulse, the nurse aide should A. notice if the rhythm of the heart-beat is regular. B. ask if the resident takes any heart medication. C. consider the time of day when the pulse is taken. D. multiply the rate by four if counted for 30 seconds. - ✔ A. notice if the rhythm of the heart-beat is regular. A nurse aide is assigned to provide postmortem care for a resident, but has never done this procedure before. Which of the following is the most appropriate response by the nurse aide? A. Ask another nurse aide to trade assignments. B. Provide the care since the resident cannot be harmed. C. Talk to other nurse aides about how to perform the procedure. D. Discuss the nurse aide's lack of experience with the nurse. - ✔ D. Discuss the nurse aide's lack of experience with the nurse. Which action is most helpful to help decrease a resident's incontinence? A. Leaving the bedpan in place for extra time B. Putting an incontinent brief on the resident C. Answering the resident's call light quickly D. Controlling fluid intake throughout the day - ✔ C. Answering the resident's call light quickly The nurse aide's role in assisting with a bowel and bladder retraining program includes A. being consistent with carrying out the toileting schedule. B. notifying the family that the resident has been placed on the program. C. determining the type of program best suited for the resident. D. checking the resident every four hours for incontinence. - ✔ A. being consistent with carrying out the toileting schedule. A resident with advance directives has a DNR order. This means that the resident A. does not remember. B. should not be restrained. C. does not respond to instructions. D. should not be resuscitated. - ✔ D. should not be resuscitated. When a resident's husband begins telling the nurse aide how to care for his wife, the nurse aide should A. accept that the husband has always been in charge. B. explain that the nurse aide is certified and able to care for his wife. C. suggest that the husband participate in his wife's resident care conference. D. understand that the husband wants staff aware of his wife's needs. - ✔ D. understand that the husband wants staff aware of his wife's needs. The term vital signs refers to A. any important information about a resident's condition. B. the color, condition, and appearance of the skin. C. fluid intake and output, as well as bowel movements. D. temperature, pulse, and respirations. - ✔ D. temperature, pulse, and respirations. The nurse aide can help the resident have regular bowel movements by A. making sure the resident gets a lot of rest. B. providing a routine time for the resident to toilet. C. giving the resident cereal for breakfast every morning. D. keeping a bedpan within reach while the resident is in bed. - ✔ B. providing a routine time for the resident to toilet. When feeding a resident, the nurse aide notices that the resident keeps coughing after each drink of fluids. What is the appropriate response by the nurse aide? A. Give the resident more time to swallow. B. Keep the amount of fluid small by using a spoon to give fluids. C. Add thickener to the fluid and see if it helps stop the coughing. D. Stop the feeding and report the coughing to the charge nurse right away. - ✔ D. Stop the feeding and report the coughing to the charge nurse right away. A resident who was admitted today is sitting in a chair in his room. He asks for help to go to the bathroom. The nurse aide knows the resident's care plan has not been completed. To help the resident the nurse aide should A. ask the resident to use a walker while assisting the resident to the bathroom. B. get another nurse aide's help to walk the resident to the bathroom. C. position a commode chair next to the chair the resident is sitting in. D. ask the charge nurse for instructions on what assistance the resident needs. - ✔ D. ask the charge nurse for instructions on what assistance the resident needs. What is the main purpose of a restorative care program? A. Ensure the resident can return home B. Provide meaningful activities for the resident C. Help the resident improve his/her level of functioning D. Provide assistance with activities of daily living (ADLs) - ✔ C. Help the resident improve his/her level of functioning A resident is NPO because of nausea. What should the nurse aide do? A. Give the resident fluids in small amounts. B. Provide the resident with a small cup of ice chips. C. Ask if the resident can handle any fluids with the nausea. B. "You are in the nursing home. I am here to help you." C. "This is your daughter Anna. Do you remember her?" D. "Look at the time. Lunch is in 30 minutes. Are you feeling hungry?" - ✔ D. "Look at the time. Lunch is in 30 minutes. Are you feeling hungry?" A resident has returned from the hospital after a hip replacement. The nurse aide should expect that the resident will be A. dependent and need total care. B. confined to bed for several weeks. C. going to physical therapy to increase mobility. D. receiving range of motion (ROM) exercises to hip. - ✔ C. going to physical therapy to increase mobility. Rehabilitation - ✔ A program of care given by a specialist or a team of specialists to restore or improve function after an illness or injury Medicare - ✔ _____ is a health insurance program for people who are 65 years and older Bathing, skin, nail, hair care, mouth care, assistance with walking, eating, dressing, transferring, toileting. - ✔ activities of daily life (ADL'S) Ethics - ✔ have to do with the knowledge of right and wrong Criminal Laws - ✔ laws to protect individuals from people or organizations that try to harm them are As a response to reports of poor care and abuse in long-term care facilities - ✔ Why was the Omnibous Budget Reconciliation Act passed in 1987 ADLs - ✔ activities of daily living amb - ✔ ambulate bm - ✔ bowel movement c/o - ✔ complains of DNR - ✔ do not resuscitate DX,dx - ✔ diagnosis f/u, F/U - ✔ Follow up inc - ✔ incontinent I&O - ✔ Intake & Output NPO - ✔ nothing by mouth mL - ✔ milliliter prn, PRN - ✔ As necessary ROM - ✔ Rang of Motion vs, VS - ✔ Vital Signs w/c, W/C - ✔ Wheelchair Planning (nursing process) - ✔ (nursing process) In agreement with the resident, goals are set and a care plan is created to meet the residents needs. Diagnosis (nursing process) - ✔ (nursing process) The identification of health problems after looking at all of the residents' needs. Evaluation (nursing process) - ✔ (nursing process) A careful examination to see if goals were met or progress was achieved ✔ A stethoscope and a blood pressure cuff--also called a sphygmomanometer Nurse Aide Training Competency Evaluation Program - ✔ Makes the rules about training and testing nursing assistants. The state programs make sure that federal rules are followed in nursing facilities that receive payment from Medicare or Medicaid. Setting up and running the nursing assistant registry is also a part of this program. If a nursing assistant is accused of abusing a resident the facility will investigate according to its policies and procedure. If they determine abuse has occurred a report must be made to them and they will decide whether or not to mark it on their registry. A policy is - ✔ a course of action that should be taken every time a certain situation occurs A procedure is - ✔ a method or way of doing something Assisting stroke residents to eat - ✔ Place food in the resident's field of vision Use assistive devices Watch for signs of choking Place food in the unaffected/nonparalyzed side of the mouth Hand hygiene - ✔ Washing hands with either plain or antiseptic soap and water or using alcohol--based hand rubs the most important thing NA can do to prevent the spread of disease Wet hands and wrists, apply soap, lather for at least 20 seconds, clean nails Conversions - ✔ 30 mL = 30 cc = 1 oz = 1/8 cup Cyanotic - ✔ Skin that is blue or gray Military time - ✔ Midnight = 0000 1 am = 0100 1pm = 1300 OBRA: hours of training and continuing education hours for CNAs - ✔ NAs must complete at least 75 hours of training that covers topics like communication, preventing infections, safety and emergency procedures, and how to promote residents' independence and legal rights They must attend regular in-service education (a minimum of 12 hours per year) to keep their skills updated Importance of wrinkle free linen - ✔ Sheets that do not lie flat under the resident's body increase the risk of pressure ulcers because they cut off circulation Communication with visually-impaired resident - ✔ When you enter a new room with them, orient them to where things are. Describe things around you without using words like "see, look, watch" Use the face of an imaginary clock as a guide to explain the positions of objects that are in front of the person Walk slightly ahead of them if they need guidance in getting around Encourage them to use their other senses Assisting resident to walk recovering from a stroke - ✔ Always use a gait belt for safety. Stand on the weaker side. Support the weaker (involved) side. Lead with the stronger side ROM exercises - ✔ put a particular joint through its full arc of motion. The goals are to decrease or prevent contracture or atrophy, improve strength, and increase circulation. Active ROM - ✔ performed by a resident themselves without help. NA role: Encourage Active Assisted ROM - ✔ done by the resident with some assistance and support from the NA Passive ROM - ✔ used when residents are not able to move on their own. Performed by the caregiver without the resident's help Transfer Belt - ✔ Wash hands. Provide privacy. Lower Bed. Lock bed wheels. Assist the resident to sit with feet flat on the floor. Put on non-skid shoes and tie the laces. Place the belt over the resident's clothing and around the waist--not over bare skin. Tighten until it is snug but there is enough room to insert hand under belt. Make sure skin folds aren't caught under it. Position the buckle off-center for comfort Empathy - ✔ identifying with the feelings of others. Understanding their problems because of personal experience. Identify with and care about them Sympathy - ✔ sharing in the feelings and difficulties of others. Feel bad for them Objective - ✔ is based on what a person sees, hears, touches, or smells. Collected by using the senses. Also called signs. Subjective - Physical abuse - ✔ any treatment that causes harm to a person's body Psychological abuse - ✔ emotional harm caused by threatening, scaring, humiliating, intimidating, isolating, or insulting a person or treating them like a child. Includes verbal abuse--words that mistreat a person Sexual abuse - ✔ forcing a person to perform or participate in sexual acts outside of their will, including unwanted touching and exposure, porn Financial Abuse - ✔ improper or illegal use of someone's money or property Assault - ✔ threat to harm a person Battery - ✔ intentional touching of a person without their consent Domestic violence - ✔ abuse by spouses, intimate partners, or family members Workplace violence - ✔ abuse of staff by others at work (other staff, residents, or visitors False imprisonment - ✔ unlawful restraint that affects a person's freedom of movement (includes threatening restraint and keeping residents from leaving Involuntary seclusion - ✔ separation of someone from others against their will Sexual harassment - ✔ any unwelcome sexual advance or behavior Substance abuse - ✔ use of substances in a way that harms oneself or others Active neglect - ✔ purposeful failure to provide needed care, resulting in harm to a person Passive neglect - ✔ unintentional failure to provide needed care, resulting in harm to a person Negligence - ✔ the failure to act or provide the proper care for a resident, resulting in unintended injury Malpractice - ✔ when a person is injured due to professional misconduct through negligence, carelessness, or lack of skill Policies in LTC facilities - ✔ All resident information must remain confidential Plan of care must always be followed NAs should not do tasks not listed in the job description NAs must report important changes in residents to a nurse Personal problems are not discussed with residents NAs shouldn't accept gifts from residents Be on time for work Procedure - ✔ a method or way of doing things Footcare for diabetics - ✔ Check for signs of irritation or sores, promote blood circulation, prevent infection Never cut toenails or apply lotion between toes Never go barefoot and prevent build-up of moisture by wearing leather shoes Temperature sites - ✔ Digital or electronic--oral, rectal, axillary (tympanic) Ear, temporal artery Least accurate: axillary Most accurate: rectal CNA scope of practice - ✔ Defines the tasks CNA is allowed to do and how to do them correctly NAs do not: administer medications honor a request to do something not listed in the care plan or outside of scope perform procedures that require sterile technique (ex: changing sterile dressings) diagnose illnesses or perscribe treatments or medications tell the resident or family the diagnosis or treatment plan Body mechanics - ✔ the way the parts of the body work together when a person moves. Proper technique helps save energy and prevent injury CNA documentation - ✔ Because NAs spend more time with residents than other members of the care team they may observe things about residents that others haven't noticed. This is valuable information that will help in care planning. Documenting accurately is the key to care planning. A thorough written record shows an NA's observations to others. A medical chart is a legal document that is considered in court to be what actually happened. If it was not documented, it was not done. It is the only way to guarantee clear and complete communication with all members of the care team. Document AFTER care is given. Standard precautions - ✔ treating blood, body fluids (not including sweat), non-intact skin (like abrasions, pimples, or open sores), and mucous membranes as if they were infected. Should be used with all residents Only safe way to do your job HIV testing - ✔ results are confidential and cannot be shared with a person's family, friends, or employer without his consent. They can't be fired from a job because of the disease. But a healthcare worker with HIV/AIDS may be reassigned to job duties with a lower risk of transmitting the disease Feeding residents - ✔ Check the diet card and verify their identity, sit at their eye level, bed at 90 degree angle, clean their hands, put a protective barrier, identify the foods and ask what they want first, offer drink, give them full attention, talk, wipe their hand and hands, remove clothing protector and food tray, document, call bell Pressure ulcer signs - ✔ Stage 1: redness that is not relieved after 15-30 minutes Stage 2: partial skin loss--looks like a blister or shallow crater Stage 3: full skin loss--deep crater, possibly to the muscle Stage 4: full skill loss with major damage to muscle, bone, etc. Beginning signs and symptoms of HIV - ✔ symptoms similar to the flu--fever, muscle aches, cough, fatigue. As it worsens the immune system overreacts and attacks everything Hearing-impaired communication - ✔ speak clearly, slowly, and good lighting. Face them, get their attention, ask if they can hear you, don't shout, keep your voice pitch low, use short sentences and simple words, repeat using different words when needed TB and sputum collection - ✔ TB--highly contagious lung disease that includes coughing, fever, shortness of breath, fatigue and bloody sputum Sputum--thick mucus coughed up from the lungs. Sputum specimen--may help diagnose respiratory problems/illness or evaluate the effects of medication. collect in the early morning Spit it directly into the specimen container Stand behind the resident during the collection process You must wear PPE--gloves and mask--when collecting Contrature - ✔ the muscle shortens, becomes inflexible, and "freezes" in position. Causes permanent disability of the limb Ostomy guidelines - ✔ regular skin care Empty and clean the bag whenever stool is eliminated Always wear gloves and wash hands carefully Skin barriers to protect from irritation Follow diet instructions Include plenty of fluids Provide privacy Report odors to nurse Report emotional or physical adjustment problems to nurse Perseveration - ✔ repeating words, phrases, questions, or actions. Happens often with people with Alzheimer's disease and can be soothing for them. Put on and take off PPE - ✔ ON: Gown, mask, gloves OFF: gloves, mask, gown Take off gloves, untie gown, roll it away Transfer resident with weak side - ✔ Use gait belt, stand on their weaker side, lead with the strong side, place wheelchair on strong side Hypertension - ✔ blood pressure consistently 140/90 or higher. caused by atherosclerosis--hardening and narrowing of blood vessels, or kidney disease, tumors, pregnancy, medication. Can lead to heart attack, kidney disease or blindness so it has to be treated. Special diet and exercise required Canes - ✔ C-cane--used to improve balance Function grip cane--has a straight grip handle to improve grip control and provide a little more support Quad cane--four feet and a rectangular base--designed to bear more weight than other canes Gain intake should be half whoe grains - ✔ an extra sheet placed on top of the bottom sheet when the bed is made to allow caregivers to reposition the resident without causing shearing Bladder retraining - ✔ Follow the schedule carefully, keep a record of their bladder habits, offer bathroom trips regularly, answer call lights promptly, privacy, running water, positive words for all attempts Barriers to communication - ✔ Resident doesn't hear NA Resident is difficult to understand Meaning of words is not understood Slang, profanity, cliches, why?, advice, yes/no questions only, foreign language, nonverbal communication Verbal communication - ✔ involves the use of words, spoken or written Nonverbal communication - ✔ communicating without using words, like shrugging or the tone of how someone says something Deep breathing - ✔ help expand the lungs, clearing them of mucus and preventing infections. Incentive spirometers are used (requires special training) Incident reporting - ✔ confidential and not written on the medical record. Done to improve the quality of the facility and protect everyone involved. Covers falls, breaking things, mistakes in care, sexual advances, threats, injury on job, exposure to blood or body fluids. State the facts and include suggestions for change. Angina pectoris - ✔ chest pain, pressure, or discomfort Ethical behavior - ✔ honesty, protecting residents privacy and property, keep information confidential at and away from the workplace, reporting abuse, follow the care plan, report and document accurately, don't accept gifts, don't get personally involved with residents or their family members Physical restraints - ✔ a way to restrict voluntary movement. Vests, jackets, belts, mitts, rails, tray tables. Must be ordered by a doctor Rehabilitation - ✔ care that is managed by professionals to help restore a person to his highest possible level of functioning. Restorative care - ✔ usually follows rehabilitation. The goal is to keep the resident at the level achieved by rehabilitative services.