- When helping a client who is recovering from a stroke to walk, the nurse aide should assist
- On the client's left side
- On the client's good side
- On the client's weak side
- On the client's cane side
Correct answer: On the client's weak side
The nurse aide walks on the client's weak side, a step behind, so that side can be supported the moment it buckles. On the client's good side the aide is standing where support is not needed and the unsteady side is left unguarded. On the client's cane side the aide crowds the device and blocks its swing. On the client's left side is a habit, not a rule: the stroke decides which side is weaker.
- The Heimlich maneuver (abdominal thrusts) is used for a client who has
- A collapsed lung
- A sprained wrist
- A blocked airway
- A weakened pulse
Correct answer: A blocked airway
Abdominal thrusts are used when a client has a blocked airway: the thrust drives trapped air upward and expels the object. A collapsed lung is a chest injury that needs oxygen and a nurse at once, and squeezing the abdomen would worsen it. A sprained wrist calls for rest, ice and elevation. A weakened pulse is a circulation problem, and pressing on the abdomen does nothing for it.
- The equipment you need for oral care of an unconscious client includes
- A soft foam toothette
- A large plastic straw
- A dental floss holder
- A stiff bristle brush
Correct answer: A soft foam toothette
Oral care for an unconscious client is given with a soft foam toothette, which holds very little fluid and cannot injure the gums. A stiff bristle brush abrades fragile tissue and pushes rinse water toward the throat. A large plastic straw delivers liquid to a client who cannot swallow on command, which invites aspiration. A dental floss holder needs a client who can hold the mouth open and cooperate, so it has no place here.
- A nursing assistant is caring for a patient with MRSA and is wearing a gown and gloves whenever she provides the patient care. When she needs to go care for another patient, she should dispose of her gown and gloves:
- In the patients' main hallway.
- In the station's linen basket.
- In the floor's utility closet.
- In the current patient's room.
Correct answer: In the current patient's room.
Gown and gloves come off in the current patient's room, just inside the door, so the contamination stays in the space where it was generated. In the station's linen basket means carrying soiled protective wear down a clean corridor and past other people. In the floor's utility closet means the same walk in contaminated clothing before anything is removed. In the patients' main hallway is a shared public space and is never a disposal point for protective wear.
- When transferring a resident from a wheelchair to stationary chair, the nursing assistant should stand ____.
- Squarely at the right of the wheelchair.
- Directly at the front of the wheelchair.
- Carefully at the rear of the wheelchair.
- Steadily at the flank of the wheelchair.
Correct answer: Directly at the front of the wheelchair.
Standing directly at the front of the wheelchair lets the assistant block the resident's knees, lift straight up and pivot the resident onto the stationary chair. Squarely at the right of the wheelchair forces the assistant to twist at the spine while bearing weight. Carefully at the rear of the wheelchair puts the assistant behind the resident, unable to reach the trunk or guard the knees. Steadily at the flank of the wheelchair turns the move into a sideways drag instead of a controlled pivot.
- The nurse aide is walking with a client confined to a wheelchair when the facility fire alarm system is activated. The client becomes excited from the noise. The nurse aide SHOULD
- Leave the client while seeking help down smoky halls.
- Calm the client while moving the chair toward safety.
- Lock the client while checking the area around smoke.
- Carry the client while rushing the exits past flames.
Correct answer: Calm the client while moving the chair toward safety.
The aide should calm the client while moving the chair toward safety, which is the rescue step of R.A.C.E. and keeps an excited client from bolting. Leaving the client while seeking help down smoky halls abandons someone who cannot move without assistance. Locking the client while checking the area around smoke keeps the client parked beside the hazard and delays the rescue. Carrying the client while rushing the exits past flames risks a drop and an injured aide, and a wheelchair user is moved in the chair.
- A nursing assistant is instructed to take the oral temperature of a patient who just had a cold drink. The patient’s temperature should be taken ____.
- 15 minutes after the patient finished the cold drink.
- 20 minutes after the patient returned the drink tray.
- 3 minutes after the patient sipped the iced beverage.
- 10 minutes after the patient drank the cold smoothie.
Correct answer: 15 minutes after the patient finished the cold drink.
The reading is taken 15 minutes after the patient finished the cold drink, which is how long the mouth needs to come back to core temperature. 3 minutes after the patient sipped the iced beverage takes the three minutes a glass oral thermometer stays under the tongue and uses that number as the waiting time instead, so the probe goes in while the mouth is still chilled. 10 minutes after the patient drank the cold smoothie is the glass thermometer's axillary reading time borrowed the same way, and it is still too short a wait, so the thermometer reads low. 20 minutes after the patient returned the drink tray times the wait from clearing the tray rather than from the last swallow, so the interval is whatever the tray schedule happens to be.
- To obtain the most accurate patient weight, the nursing assistant should weigh the patient ____.
- At the borrowed scale from day to day.
- At the identical hour from day to day.
- At the lunchtime rush from day to day.
- At the unplanned time from day to day.
Correct answer: At the identical hour from day to day.
Weighing at the identical hour from day to day cancels out the normal swings in food, fluid and elimination, so a change on the record is a real change in the resident. At the borrowed scale from day to day puts the resident on a different instrument each time, and two scales seldom agree to the pound. At the lunchtime rush from day to day ties the reading to a meal that has just been eaten. At the unplanned time from day to day lets the hour drift across the shift, which is exactly what destroys comparability.
- Which of these could be considered neglectful when assisting a resident with showering?
- Testing the resident's water during the gentle rinse.
- Steadying the resident's arms during the soapy scrub.
- Draping the resident's chest during the careful wash.
- Leaving the resident's side during the entire shower.
Correct answer: Leaving the resident's side during the entire shower.
Leaving the resident's side during the entire shower is neglect: a wet stall is where falls happen, and independence is never built by withdrawing supervision from someone who needs it. Testing the resident's water during the gentle rinse is the guard against a scald. Draping the resident's chest during the careful wash protects dignity and warmth. Steadying the resident's arms during the soapy scrub is what keeps the resident upright on a slick floor.
- A resident in your care is suffering chest pains. Which of these is not a direction to follow?
- Pour water and place the resident face down.
- Speak calmly and let the resident feel safe.
- Open the collar and keep the resident still.
- Stay near and watch the resident turn paler.
Correct answer: Pour water and place the resident face down.
Pouring water and placing the resident face down is the one direction not to follow: nothing is given by mouth to someone who may be heading for emergency care, and lying face down presses on the chest and makes breathing harder. Opening the collar and keeping the resident still lowers the work the heart has to do. Speaking calmly and letting the resident feel safe limits the fear that drives the pain higher. Staying near and watching the resident turn paler keeps an observer at the bedside who can report a change at once.
- Another term for decubitus ulcer is ____.
- Pressure sore
- Traction burn
- Friction rash
- Vascular cyst
Correct answer: Pressure sore
A decubitus ulcer is also called a pressure sore, because the tissue dies where body weight presses it against bone. A vascular cyst is a fluid-filled sac associated with a vessel and has nothing to do with body weight. A traction burn is a surface injury from a limb being dragged across linen. A friction rash irritates intact skin only and never produces the deep tissue loss that defines an ulcer.
- All of these are ways to prevent pressures sores except:
- Changing soiled linens quickly.
- Providing extra thick blankets.
- Shifting body positions hourly.
- Flattening wrinkled bed sheets.
Correct answer: Providing extra thick blankets.
Providing extra thick blankets does nothing to relieve pressure, and the trapped heat leaves the skin damp and more fragile than before. Changing soiled linens quickly keeps urine and stool off skin that is already at risk. Shifting body positions hourly moves the load away from the bony points where tissue dies. Flattening wrinkled bed sheets removes the ridges that concentrate a resident's weight along one line.
- Making a bed, whether occupied or unoccupied, should end with ____.
- Folding the sheet.
- Placing the light.
- Washing the hands.
- Tucking the edges.
Correct answer: Washing the hands.
Bed making ends with washing the hands, because used linen is contaminated and the aide moves straight from it to the next resident. Folding the sheet happens while the bed is being built, not after it is finished. Placing the light where the resident can reach it is done before the aide steps back, but something still follows it. Tucking the edges is part of squaring the linen and belongs in the middle of the procedure.
- Which medical term is often used for “burping, belching and passing gas”?
Correct answer: Flatus
Flatus is the medical term for gas in the intestinal tract, whether it is burped, belched or passed. Fascia is the sheet of connective tissue that wraps and separates muscle. Flexor names any muscle whose action bends a joint. Fundus is the rounded upper portion of a hollow organ such as the stomach or the uterus.
- Which of these describes stage 4 of a decubitus ulcer?
- Pink area with damage reaching the pores, hair, or glands.
- Open area with damage reaching the bone, joint, or tendon.
- Dark area with damage reaching the crust, scab, or eschar.
- Moist area with damage reaching the dermis, nerve, or fat.
Correct answer: Open area with damage reaching the bone, joint, or tendon.
Stage 4 is an open area with damage reaching the bone, joint, or tendon, which is full-thickness loss with those structures exposed at the base of the wound. A pink area with damage reaching the pores, hair, or glands is surface change over skin that is still unbroken, which is stage 1. A moist area with damage reaching the dermis, nerve, or fat stops short of bone and describes stage 2 or stage 3. A dark area with damage reaching the crust, scab, or eschar cannot be staged at all until the dead tissue is removed.
- Which of these treatments would be best to decrease swelling?
- A mild ointment.
- A warm poultice.
- A cold compress.
- A brisk massage.
Correct answer: A cold compress.
A cold compress narrows the vessels at the site, so less fluid leaks into the tissue and the swelling comes down. A warm poultice does the opposite: heat widens the vessels and draws still more blood into an already puffy area. A mild ointment soothes the surface of the skin but never reaches the fluid that has collected in the tissue beneath it. A brisk massage presses on engorged tissue and can drive the swelling and the pain higher.
- Which medical position can be described as, “The patients head is elevated with legs either bent or straight”?
- Lateral position
- Fowlers position
- Walcher position
- Bozeman position
Correct answer: Fowlers position
Fowlers position raises the head of the bed so the resident sits propped up, and the legs may be left bent or straight. Lateral position lays the resident fully on one side with the head flat, not elevated. Walcher position lets the legs hang over the end of the table while the back stays flat, and it belongs to obstetrics. Bozeman position rests the resident on the knees and elbows with the head down, which is the reverse of an elevated head.
- Which of these is least likely to contribute to skin tears?
- Length of hair
- Force of falls
- Edges of nails
- Grip of hoists
Correct answer: Length of hair
Length of hair has no bearing on skin tears, because hair does not shear or catch fragile skin. Edges of nails, on the resident or on the aide, snag and lift thin skin during ordinary care. Force of falls drags skin across floors and furniture and is a leading cause of tears. Grip of hoists concentrates friction under the sling straps, which is exactly how equipment opens skin.
- Which of these examples demonstrates using proper body mechanics when helping to lift a resident in bed?
- Bending at the waist, knees partly bent, using leg muscles.
- Bending at the waist, knees pushed back, using hip muscles.
- Bending at the waist, knees kept stiff, using neck muscles.
- Bending at the waist, knees locked hard, using arm muscles.
Correct answer: Bending at the waist, knees partly bent, using leg muscles.
Of the four, knees partly bent with the leg muscles doing the lifting is the one that spares the spine, since the large muscles of the thigh are built to carry load. Knees locked hard sends the entire weight straight into the lower back. Knees pushed back throws the load onto the hip muscles with the joint locked, which is the classic way aides injure a disc. Knees kept stiff with the neck muscles working produces almost no lifting power and strains the cervical spine.
- If you smell smoke and discover a resident smoking in his room, it is best to ____.
- Ignore him today and note the second lapse closely.
- Let him finish and mention the future lapses later.
- Excuse him once and let the family handle problems.
- Stop him now and restate the facility safety rules.
Correct answer: Stop him now and restate the facility safety rules.
The aide should stop him now and restate the facility safety rules, which ends the fire risk at once and tells the resident why the rule exists. Letting him finish and mentioning the future lapses later leaves an open flame burning beside oxygen and linen. Excusing him once and letting the family handle problems hands a staff safety duty to visitors who are not in the building. Ignoring him today and noting the second lapse closely gambles on there being a second chance to act.
- The best use of alcohol-based sanitizer is:
- For hands that carry sticky blood.
- For hands that prep sterile trays.
- For hands that bear obvious grime.
- For hands that look visibly clean.
Correct answer: For hands that look visibly clean.
Alcohol gel is meant for hands that look visibly clean: it kills organisms on the skin surface but cannot work through anything sitting on top of it. For hands that carry sticky blood, soap and running water are the requirement, since the gel never reaches the skin beneath. For hands that bear obvious grime, the same limit applies and the gel would only smear the soil around. For hands that prep sterile trays, gel does not replace the wash and glove routine the procedure itself calls for.
- Which of these is incorrect in reference to wearing gloves?
- Always choose latex gloves for their tight barrier.
- Always invert soiled gloves for their safe removal.
- Always scrub ungloved hands for their unseen germs.
- Always avoid outer surfaces for their filthy layer.
Correct answer: Always choose latex gloves for their tight barrier.
Always choose latex gloves for their tight barrier is the incorrect statement: latex sets off allergic reactions in residents and in staff, so nitrile or vinyl is used wherever latex sensitivity exists. Always scrub ungloved hands for their unseen germs is sound, since gloves never replace hand hygiene. Always invert soiled gloves for their safe removal is sound, because turning the glove inside out traps what is on it. Always avoid outer surfaces for their filthy layer is sound, as the outside of a used glove is the most contaminated thing the aide is holding.
- If you are walking with a resident and they fall, which of these is not an action you should take?
- Tell the nurse, then lift the fallen resident upward.
- Tell the nurse, then warm the fallen resident gently.
- Tell the nurse, then calm the fallen resident slowly.
- Tell the nurse, then leave the fallen resident still.
Correct answer: Tell the nurse, then lift the fallen resident upward.
Lifting the fallen resident upward is the action not to take: a fracture or a head injury is made far worse by moving someone before the nurse has looked at them. Leaving the fallen resident still is right, because stillness protects an injury nobody can see yet. Warming the fallen resident gently keeps a person lying on a cold floor from chilling while help comes. Calming the fallen resident slowly stops a frightened person from trying to get up unaided before the nurse arrives.
- Which of these is the least likely to signal impending death?
- Confusion in answers.
- Drops in temperature.
- Increase in appetite.
- Decline in alertness.
Correct answer: Increase in appetite.
An increase in appetite is the change that does not point to approaching death, because intake almost always falls away instead. Drops in temperature appear as circulation to the skin and limbs shuts down. Confusion in answers reflects the falling level of consciousness of the final days. Decline in alertness follows the same course, with longer stretches of sleep and less reaction to a familiar voice.
- A resident is supposed to have 240 milliliters of juice every 2 hours. Which of these choices would be the most convenient to meet this requirement?
- 4 oz. bottle of juice.
- 10 oz. glass of juice.
- 6 oz. carafe of juice.
- 8 oz. carton of juice.
Correct answer: 8 oz. carton of juice.
An ounce is about 30 milliliters, so an 8 oz. carton of juice is exactly the 240 milliliters ordered and nothing has to be measured or poured off. A 4 oz. bottle of juice is half the order and would have to be served twice every two hours. A 6 oz. carafe of juice leaves the resident 60 milliliters short at each serving. A 10 oz. glass of juice overshoots by 60 milliliters, so the aide has to discard part of it and record what was actually taken.
- A resident in your care has called you for help. He claims he can’t find his dentures. As a nursing assistant, it is your responsibility to ____.
- Notify the nurse, then phone the family member.
- Notify the nurse, then check the bedside table.
- Notify the nurse, then record the denture loss.
- Notify the nurse, then cancel the solid supper.
Correct answer: Notify the nurse, then check the bedside table.
The aide's duty is to notify the nurse, then check the bedside table and the other usual places, leaving every decision that follows to the nurse. Notify the nurse, then phone the family member adds a call that is the nurse's to make, not the aide's. Notify the nurse, then record the denture loss puts an incident entry in the chart, which is again the nurse's call to make. Notify the nurse, then cancel the solid supper alters a resident's diet on the aide's own authority, and no aide may do that.
- All of these might be used in dealing with contractures except ____.
- Splinting
- Massaging
- Bandaging
- Extending
Correct answer: Bandaging
Bandaging wraps a limb without moving it, so it does nothing to prevent or release a contracture and may hold the joint in the shortened position that caused the problem. Splinting holds a joint at a working angle and is standard contracture care. Massaging relaxes the tight muscle that surrounds a stiffened joint. Extending a joint through the range it still has, under the therapy plan, is the main treatment once a contracture has formed.
- Hypertension is a medical term for:
- Tight muscle strain.
- High blood pressure.
- Rapid heart rhythms.
- Sustained body heat.
Correct answer: High blood pressure.
Hypertension means high blood pressure: the force of blood against the artery walls stays above the range expected for that resident. Tight muscle strain is a muscular complaint and has nothing to do with arterial force. Rapid heart rhythms describe tachycardia, which counts beats rather than measuring force. Sustained body heat is fever, recorded with a thermometer and not with a cuff.
- Applying friction in the handwashing process is very important. According to CDC recommendations, the scrubbing portion of hand washing should take ____.
- 20 solid seconds
- 10 timed seconds
- 15 whole seconds
- 25 extra seconds
Correct answer: 20 solid seconds
CDC guidance puts the scrubbing portion at 20 solid seconds, about the time it takes to hum Happy Birthday twice. 10 timed seconds is half the contact time and leaves organisms on the skin. 15 whole seconds is still short of the published interval. 25 extra seconds runs past the figure the guidance gives, and the question asks for the recommended time rather than the longest one.
- Which of these should not be part of the process for cleaning a residents dentures?
- Brushing the loosened debris on the plate.
- Running the steady stream on the dentures.
- Filling the labeled holder on the counter.
- Setting the washed dentures on the tissue.
Correct answer: Setting the washed dentures on the tissue.
Setting the washed dentures on the tissue is the step to leave out: a tissue is swept into the trash without a second look, and dentures left loose get knocked to the floor and broken. Brushing the loosened debris on the plate lifts off food and film, which is the point of the whole task. Running the steady stream on the dentures carries away the paste and whatever the brush has freed. Filling the labeled holder on the counter is how the dentures are stored so they are neither lost nor damaged.
- The medical term tetraplegia—meaning paralysis of all four extremities—is often used interchangeably with the term ____.
- Cardioplegia
- Glossoplegia
- Quadriplegia
- Gastroplegia
Correct answer: Quadriplegia
Quadriplegia is the older word for tetraplegia, and both name paralysis of all four limbs. Cardioplegia is the deliberate stopping of the heart during surgery. Glossoplegia is paralysis of the tongue. Gastroplegia is paralysis of the stomach wall, which stalls digestion rather than limb movement.
- To minimize the spread of bacteria, further infection and contamination, which procedure should be used for washing the perineum of a resident with a catheter?
- Wash from the thighs out.
- Wash from the meatus out.
- Wash from the buttock up.
- Wash from the rectum out.
Correct answer: Wash from the meatus out.
Wash from the meatus out carries organisms away from the catheter entry point instead of toward it. Wash from the thighs out never gives the skin nearest the catheter a clean first pass, so the entry point is wiped with an already used cloth. Wash from the buttock up brings bowel organisms forward across the perineum. Wash from the rectum out starts the stroke on the most contaminated skin on the body, so the cloth is already loaded before it nears the urinary opening.
- All of these precautions should be followed when using a transfer-gait belt, except ____.
- Rejecting the frayed belt webbing today.
- Skipping the usual body mechanics check.
- Positioning the buckle around the waist.
- Rocking the unsteady resident gently up.
Correct answer: Skipping the usual body mechanics check.
Skipping the usual body mechanics check is the item that is not a precaution: the belt protects the resident, not the aide's back, so the aide still has to set the feet, bend the knees and keep the load close. Rejecting the frayed belt webbing today is a precaution, since worn webbing tears under load at the worst moment. Positioning the buckle around the waist is a precaution, because the belt has to sit over bone rather than over the ribs. Rocking the unsteady resident gently up builds the momentum that makes a stand possible without a jerk.
- Which of these is considered an accurate method for counting respiration rate?
- The resident counts the breaths and says them aloud.
- The nurse times the interval and the helper tallies.
- The student guesses the total and the chart matches.
- The aide watches the abdomen and the clock together.
Correct answer: The aide watches the abdomen and the clock together.
The aide watches the abdomen and the clock together, so one observer holds both the counting and the timing across the whole interval. The resident counts the breaths and says them aloud fails, because a person who knows the breaths are being measured alters the rate without meaning to. The nurse times the interval and the helper tallies splits one measurement between two people, so the start and the stop never line up. The student guesses the total and the chart matches records an estimate rather than an observation, which is not a method at all.
- A resident has the following symptoms: dizziness, feeling faint, blood pressure below 90/60 and cold, sweaty skin. The resident is most likely suffering from ____.
- Hypotension
- Hypokalemia
- Hypoglottis
- Hypothermia
Correct answer: Hypotension
Hypotension is low blood pressure, and every finding listed belongs to it: dizziness, faintness, a reading under 90/60, and cold sweaty skin. Hypothermia is a low core temperature, which the thermometer would show rather than the cuff. Hypokalemia is a low potassium level, identified by a blood test and marked by weakness and irregular beats. Hypoglottis names the underside of the tongue and is not a condition at all.
- Alcohol-based hand cleanser is appropriate for all of these situations except ____.
- When hands touch folded laundry.
- When hands lack available water.
- When hands show observable dirt.
- When hands guide steady walkers.
Correct answer: When hands show observable dirt.
When hands show observable dirt is the exception: alcohol cleanser cannot lift soil off the skin, so soap and running water are needed to carry it away. When hands lack available water is the situation the cleanser was made for, which is why dispensers hang in the corridors. When hands touch folded laundry the contact is with clean linen, so the cleanser is enough. When hands guide steady walkers, cleanser between residents is the accepted practice.
- Convulsions are associated with ____.
- A blister
- A rupture
- A fissure
- A seizure
Correct answer: A seizure
Convulsion is the older word for a seizure: the sudden uncontrolled muscle activity that follows abnormal electrical firing in the brain. A blister is a pocket of fluid raised under the surface of the skin. A fissure is a narrow split in tissue, such as a crack in the anal wall. A rupture is a tear in an organ or a muscle wall, and none of these produce the jerking movements the word convulsion describes.
- Which of these is not true about the proper procedure for taking a tympanic membrane temperature with an electric thermometer?
- Be sure the cover twists tight for safety.
- Be sure the unit signals once for removal.
- Be sure the wax gets removed for accuracy.
- Be sure the pinna moves back for snugness.
Correct answer: Be sure the wax gets removed for accuracy.
Be sure the wax gets removed for accuracy is the statement that is not true: an aide never digs in an ear canal, and the reading is taken on the ear as it is found. Be sure the cover twists tight for safety is true, because a loose probe cover can be left behind in the canal. Be sure the unit signals once for removal is true, since pulling the probe early gives a reading the sensor had not finished taking. Be sure the pinna moves back for snugness is true, as straightening the canal is what aims the sensor at the eardrum.
- If you are helping a resident put on a clean night shirt and it falls to the ground before you get started, it is best to ____.
- Leave the shirt on the chair and locate another.
- Drape the shirt in the closet and reuse another.
- Place the shirt in the hamper and fetch another.
- Slide the shirt on the person and clean another.
Correct answer: Place the shirt in the hamper and fetch another.
Once a garment touches the floor it is contaminated, so the aide should place the shirt in the hamper and fetch another. Leave the shirt on the chair and locate another invites someone to pick the shirt up later and use it, since nothing marks it as soiled. Drape the shirt in the closet and reuse another puts floor organisms straight onto a resident's skin. Slide the shirt on the person and clean another leaves the resident wearing the dropped garment in the meantime, which is what the drop was supposed to prevent.
- When muscle tissues shorten and then a joint becomes hard to move it is called _____.
- Dislocation
- Subluxation
- Crepitation
- Contracture
Correct answer: Contracture
Contracture is the permanent shortening of muscle tissue that leaves a joint fixed and hard to move, which is exactly what the stem describes. Dislocation is a bone forced completely out of its joint socket, not a shortening of muscle. Subluxation is a partial displacement of those same joint surfaces and is again a bone problem. Crepitation is the grating sound or sensation felt when roughened surfaces rub together, not a change in tissue length.
- Which of these is not true when taking a blood pressure reading?
- The best position for the resident is seated tall with the soles flat.
- The best position for the resident is sitting up with the knees apart.
- The best position for the resident is lying down with the feet raised.
- The best position for the resident is rested back with the arm braced.
Correct answer: The best position for the resident is lying down with the feet raised.
The claim that the best position for the resident is lying down with the feet raised is the one that is not true: blood pressure is measured with the resident upright, because elevating the legs shifts blood toward the chest and changes the reading. Seating the resident tall with the soles flat is correct practice and keeps the reading stable. Sitting up with the knees apart keeps the legs uncrossed, which is also correct. Resting back with the arm braced supports the limb near heart level, again correct.
- A resident is ill with the following symptoms: fever, swelling, redness, and chills. The resident most likely has ____.
- Dietary allergy.
- Acute infection.
- Heat exhaustion.
- Tissue bruising.
Correct answer: Acute infection.
Fever and chills together with local swelling and redness are the classic signs of acute infection, so that is the correct choice. Dietary allergy produces itching, hives and swelling but does not bring fever or chills. Heat exhaustion brings sweating, weakness and a flushed look without any localized swelling. Tissue bruising discolors and swells one area but leaves the body temperature unchanged.
- Which of these tasks related to intravenous therapy is in the scope of responsibilities for a nursing assistant?
- Attach the bag, then notify the nurse.
- Push the bolus, then notify the nurse.
- Mix the fluids, then notify the nurse.
- Watch the drip, then notify the nurse.
Correct answer: Watch the drip, then notify the nurse.
Watching the drip and then notifying the nurse is the task inside the nursing assistant role: the aide may observe the flow and the site and pass on anything wrong, but may not manage the infusion itself. Attaching the bag hangs and connects the infusion, which only a licensed nurse may do. Mixing the fluids alters the prescribed solution and belongs to pharmacy or nursing. Pushing a bolus sends medication straight into the vein and is far outside the aide role.
- Which of these applies to proper hand washing procedures?
- Shut off the faucet with a rinsed hand.
- Turn off the faucet with a paper towel.
- Scrub off the faucet with a damp cloth.
- Flick off the faucet with a dry finger.
Correct answer: Turn off the faucet with a paper towel.
Turning off the faucet with a paper towel is correct, because the handles were contaminated before the wash and touching them bare again would undo it. Shutting off the faucet with a rinsed hand puts clean skin straight back onto a dirty handle. Scrubbing off the faucet with a damp cloth cleans a fixture rather than the hands and spreads organisms around the sink. Flicking off the faucet with a dry finger still lands bare skin on the dirtiest surface at the sink.
- Why is an axillary reading generally lower than the other forms of taking a temperature?
- It is not held the whole minute.
- It is not placed near the heart.
- It is not taken inside the body.
- It is not lodged behind the ear.
Correct answer: It is not taken inside the body.
Because the armpit is a skin surface, the reading is not taken inside the body, so it runs roughly a degree below an oral or rectal value. The claim that it is not held the whole minute fails, since an axillary reading is in fact held the longest of all the routes. The claim that it is not placed near the heart fails, since the armpit lies close to the chest and its great vessels. The claim that it is not lodged behind the ear fails, because no temperature route uses that spot at all.
- Which of these would most likely be used to protect a resident from inflicting immediate harm to themselves in a care facility setting?
- Prolonged seclusion.
- Additional staffing.
- Continuous watching.
- Physical restraints.
Correct answer: Physical restraints.
Physical restraints are the measure reached for when a resident is in immediate danger of harming themselves, and they are applied only on a physician order and for the shortest time possible. Additional staffing is almost never available in the numbers a whole care facility would need. Continuous watching observes the danger but does not physically stop an act already underway. Prolonged seclusion leaves the resident alone and unobserved, which raises the risk of self-harm rather than lowering it.
- Which of these is the correct step in taking a radial pulse?
- Press your fingers lightly against the radial bone.
- Push your knuckles firmly against the radial nerve.
- Squeeze your palms gently against the radial veins.
- Hold your thumb steadily against the radial tendon.
Correct answer: Press your fingers lightly against the radial bone.
Pressing your fingers lightly against the radial bone is the correct step, because the radial artery runs over the radius on the thumb side of the inner wrist and light pressure keeps the vessel from being flattened. Pushing your knuckles firmly against the radial nerve compresses nerve tissue rather than an artery and wipes out any beat. Squeezing your palms gently against the radial veins targets low-pressure vessels that do not pulsate. Holding your thumb steadily against the radial tendon finds cord-like tissue, and the thumb carries a beat of its own that is easily mistaken for the one being counted.
- A pulse can be taken in all of these areas except ____.
- The side of the neck.
- The bend of the knee.
- The curve of the arm.
- The rear of the head.
Correct answer: The rear of the head.
No pulse can be counted at the rear of the head, because no artery runs close enough to the surface over the occiput to be felt. The side of the neck carries the carotid pulse, the site used in an emergency. The bend of the knee carries the popliteal pulse. The curve of the arm carries the brachial pulse, the site listened to during a blood pressure reading.
- Which statement is false with regard to taking a rectal temperature?
- Glass thermometers are sanitized for their reuse.
- Mercury thermometers are kept for their accuracy.
- Electronic thermometers are used for their speed.
- Rectal thermometers are tinted for their purpose.
Correct answer: Mercury thermometers are kept for their accuracy.
The false statement is that mercury thermometers are kept for their accuracy: mercury devices have been withdrawn from health care facilities because a broken one releases toxic vapor, and they are no longer in service at all. Glass thermometers are sanitized for their reuse is true of the non-mercury glass devices that remain. Rectal thermometers are tinted for their purpose is true, since a red tip marks the rectal device and a blue tip the oral one. Electronic thermometers are used for their speed is true, as they give a reading in seconds.
- The normal pulse rate for an adult is 60-100 beats per minute. The normal pulse rate for children is ____.
- A steady 70 to 120 beats per minute.
- A stable 40 to 100 beats per minute.
- A strong 80 to 140 beats per minute.
- A smooth 50 to 110 beats per minute.
Correct answer: A steady 70 to 120 beats per minute.
A steady 70 to 120 beats per minute is the accepted resting range for a child, faster than the adult range because a smaller heart moves less blood with each stroke. A stable 40 to 100 beats per minute sets the floor far too low and would be bradycardia in a child. A strong 80 to 140 beats per minute belongs to an infant rather than an older child. A smooth 50 to 110 beats per minute again puts the bottom of the range well under what a child sustains.
- Which statement is incorrect regarding the Heimlich maneuver?
- Apply the thrusts on a resident who coughs hard.
- Repeat the thrusts on a resident who turns blue.
- Give the thrusts on a resident who stays silent.
- Start the thrusts on a resident who grips tight.
Correct answer: Apply the thrusts on a resident who coughs hard.
Applying the thrusts on a resident who coughs hard is the incorrect statement: a forceful cough means air is still moving past the object, and the aide should stand by and let the resident keep coughing rather than intervene. Repeating the thrusts on a resident who turns blue is correct, because that color change shows the airway is blocked. Giving the thrusts on a resident who stays silent is correct, since no sound means no air is moving. Starting the thrusts on a resident who grips tight is correct, because clutching at the throat is the universal sign of choking.
- A nursing assistant may help in alleviating the use of restraints on a resident using all of these suggestions except ____.
- Redirecting a resident with music so the restraints stay off.
- Threatening a resident with belts so the restraints stay off.
- Encouraging a resident with games so the restraints stay off.
- Befriending a resident with humor so the restraints stay off.
Correct answer: Threatening a resident with belts so the restraints stay off.
Threatening a resident with belts so the restraints stay off is the suggestion that does not belong: displaying a restraint as a warning turns it into a punishment, and restraints are applied only on a physician order, never as a bargaining tool. Redirecting a resident with music so the restraints stay off is a genuine technique for breaking a cycle of agitation. Encouraging a resident with games so the restraints stay off channels restless energy into activity. Befriending a resident with humor so the restraints stay off builds the trust that heads off agitation before it begins.
- Transmission-based precautions are ____.
- Common to the standard rules for a healthy resident.
- Limited to the standard rules for a public epidemic.
- Inferior to the standard rules for a large outbreak.
- Added to the standard rules for a suspected illness.
Correct answer: Added to the standard rules for a suspected illness.
Transmission-based precautions are added to the standard rules for a suspected illness: contact, droplet or airborne measures are layered on top of standard precautions as soon as a communicable disease is known or even suspected. Common to the standard rules for a healthy resident is wrong, because standard precautions on their own are what cover every resident. Limited to the standard rules for a public epidemic is wrong, since the extra measures begin with a single resident and need no declaration. Inferior to the standard rules for a large outbreak is wrong, because these precautions are stricter than the baseline, not looser.
- Which of these is not true about condom catheters?
- They are tight wrappers that grip closely shaven surfaces.
- They are simple covers that stop urinary tract infections.
- They are internal tubes that fail against outer coverings.
- They are common fittings that demand frequent skin checks.
Correct answer: They are internal tubes that fail against outer coverings.
The statement that they are internal tubes that fail against outer coverings is the one that is not true: a condom catheter is itself an external device, a sheath rolled over the penis, so it cannot be an internal catheter and is usually judged the more convenient choice. They are simple covers that stop urinary tract infections is true, since keeping drainage outside the bladder avoids the main route of infection. They are tight wrappers that grip closely shaven surfaces is true, because clearing the hair lets the adhesive seal hold. They are common fittings that demand frequent skin checks is true, as the sheath is taken off and replaced regularly to protect the skin.
- After assisting a resident onto a bedpan, it will help to make the patient more comfortable if you
- Raise the bed at the head.
- Open the room at the door.
- Dim the light at the wall.
- Play the news at the hour.
Correct answer: Raise the bed at the head.
Raising the bed at the head puts the resident into a near-sitting posture, which is both more comfortable on a bedpan and the natural position for elimination. Opening the room at the door exposes the resident during a private act and is the opposite of what is needed. Dimming the light at the wall changes nothing about posture, privacy or safety. Playing the news at the hour adds noise that draws attention away from the task rather than easing it.
- The medical term for a device with two soft plastic prongs that attach to a plastic tube delivering oxygen is:
- The nasal syringe.
- The nasal inhaler.
- The nasal cannula.
- The nasal trumpet.
Correct answer: The nasal cannula.
The nasal cannula is the device described: two short soft prongs sit just inside the nostrils and join tubing that carries oxygen from the flowmeter. The nasal syringe is a rubber bulb used to clear mucus and delivers nothing at all. The nasal inhaler puffs a measured dose of medication rather than a steady gas. The nasal trumpet is a single soft airway passed back into the pharynx to hold the passage open, so it has one channel and no prongs.
- A resident has the following symptoms: expelled brown fluid from the rectum, excessive amounts of flatus, and light abdominal cramping. Which of these is most likely the cause of these symptoms?
- A recent virus.
- A recent ulcer.
- A recent polyp.
- A recent enema.
Correct answer: A recent enema.
A recent enema accounts for all three findings at once: the return is brown because it carries stool, the bowel expels the air introduced with the fluid, and the stretched colon gives mild cramps. A recent virus would bring watery stools with fever and nausea, not a single brown return. A recent ulcer bleeds higher in the tract and turns stool black and tarry rather than brown. A recent polyp is usually silent and, when it does bleed, shows as bright streaks rather than flatus and cramping.
- A resident with venous stasis has developed pressure sores under elastic stockings. What is the most likely cause?
- Creases from the hose pressed the skin.
- Allergy from the latex burned the limb.
- Scratches from the nails tore the calf.
- Pressure from the wrap cooled the toes.
Correct answer: Creases from the hose pressed the skin.
Creases from the hose pressed the skin is the likely cause: a wrinkled stocking concentrates load along a narrow line, and skin over a bony area breaks down under that steady pressure. Allergy from the latex burned the limb would show as a red itchy rash spread over the whole covered area, not as discrete sores. Scratches from the nails tore the calf would leave shallow linear tears rather than sores at pressure points. Pressure from the wrap cooled the toes describes a stocking that is too tight, which changes color and temperature before it opens the skin.
- To avoid pulling the catheter when turning a patient, the catheter tube should be taped to the patients ____.
- The outer ankle.
- The metal frame.
- The upper thigh.
- The loose sheet.
Correct answer: The upper thigh.
Taping the tube to the upper thigh leaves enough slack that the catheter travels with the leg instead of being tugged at the meatus when the resident is turned. The outer ankle sits far down the leg, so every movement of the limb drags on the tube. The metal frame belongs to the bed rather than to the resident, so turning the resident pulls straight against the anchor. The loose sheet shifts with the bedding and gives no secure hold at all.
- Which of these is not a signal for notifying the charge nurse regarding a residents ostomy bag?
- Yellowed pus found at the 3 pm check.
- Sudden stool found at the 3 pm check.
- 98.8 degrees found at the 3 pm check.
- Swollen skin found at the 3 pm check.
Correct answer: 98.8 degrees found at the 3 pm check.
A reading of 98.8 degrees found at the 3 pm check sits inside the usual adult range, so it is not by itself a reason to call the charge nurse. Yellowed pus found at the 3 pm check points to infection at the stoma and must be passed on. Sudden stool found at the 3 pm check in far greater amounts than usual signals a change in bowel function and must be passed on. Swollen skin found at the 3 pm check around the stoma can mean a hernia or a failing seal and must be passed on.
- Which is the standard for measuring urinary output?
- In centiliters.
- In microliters.
- In tablespoons.
- In milliliters.
Correct answer: In milliliters.
Urinary output is charted in milliliters, the metric unit used throughout health care; cubic centimeters hold the same volume and some facilities still record them that way. Centiliters are metric but are never used in clinical charting, so a figure written in them would be misread by a hundredfold. Microliters measure volumes a thousand times smaller and belong to laboratory work. Tablespoons are a household measure whose size varies and has no place in a medical record.
- Which is the best advice if you are uncertain you are able to move an obese patient on your own when it is time for their scheduled re-positioning?
- Ask a fellow aide to help you lift.
- Ask a close niece to help you lift.
- Ask a weak client to help you lift.
- Ask a later shift to help you lift.
Correct answer: Ask a fellow aide to help you lift.
Asking a fellow aide to help you lift is the safe advice: a two-person transfer protects the resident and your own back, and a second trained aide already knows the technique. Asking a close niece to help you lift hands a clinical task to an untrained visitor who could drop the resident or be injured. Asking a weak client to help you lift depends on the very strength the stem says is in doubt. Asking a later shift to help you lift leaves the resident unturned past the scheduled time and invites skin breakdown.
- When having a conversation with a dysphasic patient (someone who has trouble speaking), it is important not to ____.
- Praise the effort they are plainly making.
- Finish the phrase they are slowly forming.
- Welcome the signs they are keenly showing.
- Provide the boards they are quietly using.
Correct answer: Finish the phrase they are slowly forming.
Finishing the phrase they are slowly forming is what the aide must avoid: a dysphasic resident still thinks clearly, and completing the sentence removes the chance to speak and signals impatience. Praising the effort they are plainly making is exactly what should be done, since encouragement keeps the resident trying. Welcoming the signs they are keenly showing supports gesture and expression alongside speech. Providing the boards they are quietly using gives a written route when the words will not come.
- Which of the following is a correct measurement of urinary output?
- 2 cups in 8 hours.
- 1 pint in 8 hours.
- 300 cc in 8 hours.
- 6 tbsp in 8 hours.
Correct answer: 300 cc in 8 hours.
Urinary output is charted in cubic centimeters or milliliters, so 300 cc in 8 hours is the correctly written measurement. 2 cups in 8 hours uses a kitchen measure whose size is not fixed and which has no place in a medical record. 1 pint in 8 hours is likewise a household volume and would have to be converted before anyone could chart it. 6 tbsp in 8 hours uses the smallest household measure of all and is never used for urine.
- Normal urine color is
- Maroon.
- Yellow.
- Violet.
- Bronze.
Correct answer: Yellow.
Normal urine is yellow, running from pale straw when fluid intake is high to deep amber when it is low. Maroon means blood is present somewhere in the urinary tract or kidneys and must be reported. Bronze points to bile pigment from liver disease. Violet appears only in the rare purple urine bag syndrome linked to certain infections, and is never a normal finding.
- A patient who was given insulin in the morning is pale and sweaty and appears confused two hours later. It would be helpful to find out whether the patient
- Had relatives today
- Had chocolate today
- Had breakfast today
- Had ibuprofen today
Correct answer: Had breakfast today
Whether the patient had breakfast today is the thing to establish: insulin given without food drives the blood sugar down, and pallor, sweating and confusion two hours after the dose are the classic signs of hypoglycemia. Whether the patient had chocolate today points the wrong way, since extra sugar raises the level rather than lowering it. Whether the patient had relatives today is social information with no bearing on blood sugar. Whether the patient had ibuprofen today is beside the point, because that drug does not act on glucose.
- When taking a client’s radial pulse, the nurse aide’s fingertips should be placed on the client’s
Correct answer: Wrist
The radial pulse is found at the wrist, in the hollow on the thumb side just below the base of the hand. The groin carries the femoral pulse, checked when circulation to the whole leg is in question. The ankle carries the posterior tibial and pedal pulses, used to judge blood flow into the foot. The thumb has a pulse of its own, which is why the aide places the index and middle fingers instead.
- Which of the following best helps reduce pressure on the bony prominences?
- Flotation mattress
- Lambskin coverings
- Additional pillows
- Occasional turning
Correct answer: Flotation mattress
A flotation mattress spreads body weight across a fluid-filled surface, so no single bony point carries the load, and it does most to reduce pressure over the prominences. Additional pillows can prop and separate limbs but leave the sacrum and heels still bearing weight. Lambskin coverings add a soft layer and cut friction without redistributing the pressure underneath. Occasional turning is too infrequent, since repositioning has to happen at least every two hours to protect the skin.
- Which of the following people provide treatment for persons who have difficulty talking due to disorders such as a stroke or physical defects?
- Vocational nurse
- Speech therapist
- Physical trainer
- Restorative aide
Correct answer: Speech therapist
A speech therapist evaluates and treats the trouble with forming words, and the swallowing problems, that follow a stroke or a structural defect of the mouth and throat. A vocational nurse manages medical care and medication but does not deliver speech retraining. A restorative aide carries out an exercise and activity program set by others and works on mobility and daily living skills. A physical trainer conditions muscle and endurance and has no role in language at all.
- A client is to be assisted out of bed to sit in a wheelchair. Which action would make this procedure safe?
- Stack the bed pillows in the high position
- Unlock the bed brakes in the open position
- Secure the bed rail in the locked position
- Place the bed frame in the lowest position
Correct answer: Place the bed frame in the lowest position
Placing the bed frame in the lowest position lets the resident reach the floor when standing, which is the first safety step in a bed to chair transfer. Unlocking the bed brakes in the open position lets the bed roll away as the resident rises, which is exactly what must not happen. Securing the bed rail in the locked position puts a barrier between the resident and the wheelchair. Stacking the bed pillows in the high position clutters the surface the resident must cross and adds nothing to stability.
- While making an empty bed, the nurse aide sees that the side rail is broken. The nurse aide SHOULD
- Tell the team about the cracks at sunset.
- Tell the charge about the damage at once.
- Tell the doctor about the fault at night.
- Tell the cleaner about the break at noon.
Correct answer: Tell the charge about the damage at once.
Telling the charge about the damage at once is what the aide must do: broken equipment is a hazard from the moment it is found, and the charge nurse can tag the bed and have it swapped before anyone uses it. Telling the team about the cracks at sunset leaves the bed in service for the rest of the day. Telling the doctor about the fault at night sends an equipment problem to the wrong person and delays it besides. Telling the cleaner about the break at noon hands a safety report to someone with no authority to pull the bed from use.
- The equipment you need to gather to do unconscious oral care would include
- A thin floss reel
- A hard tooth pick
- A soft mouth swab
- A full paste tube
Correct answer: A soft mouth swab
A soft mouth swab, the toothette, is the tool for unconscious oral care: it holds only a little moisture, cleans one area of the mouth at a time and carries very little risk of aspiration. A thin floss reel needs a cooperative resident who can hold the mouth open and spit. A hard tooth pick can gouge fragile gum tissue in someone who cannot report pain. A full paste tube produces foam that an unconscious resident cannot spit out, so paste is left out of the procedure.
- While eating dinner a client starts to choke and turn blue. The nurse aide SHOULD
- Search for help and fetch the water.
- Call for help and begin the thrusts.
- Depart for help and clear the table.
- Signal for help and pound the spine.
Correct answer: Call for help and begin the thrusts.
Calling for help and beginning the thrusts is the right sequence: the call brings others to the table while the aide immediately delivers abdominal thrusts to a resident who is choking and turning blue. Searching for help and fetching the water pushes fluid against an obstructed airway and can drive the object deeper. Signaling for help and pounding the spine strikes the wrong place and delays the thrusts that actually clear the airway. Departing for help and clearing the table leaves a resident without oxygen and without anyone beside them.
- The purpose for padding side rails on the client’s bed is to
- Hinder the client from turning
- Guard the client from coldness
- Cushion the client from injury
- Insulate the client from sound
Correct answer: Cushion the client from injury
Cushioning the client from injury is the purpose of padded rails: a resident who is confused, has a head injury or has a history of seizures can strike the hard rail, and the padding absorbs that contact. Guarding the client from coldness is the job of blankets, not of rail padding. Hindering the client from turning describes a restraint, and a rail may never be padded for that reason. Insulating the client from sound has nothing to do with rails, which are open frames that stop no noise.
- As a CNA, you become an advocate for the resident(s) that you care for. This means that you ____.
- Voice their needs when they are unable.
- Decide their plans when they are tired.
- Question their care when they are weak.
- Protest their meals when they are cold.
Correct answer: Voice their needs when they are unable.
Voicing their needs when they are unable is what advocacy means: the aide spends more time with the resident than anyone else and speaks up on their behalf when they cannot do it themselves. Deciding their plans when they are tired takes over choices that belong to the resident. Questioning their care when they are weak may happen in the course of the job, but asking questions is not the same as representing what the resident wants. Protesting their meals when they are cold is complaining rather than communicating a need.
- Which of these best describes the purpose of padded side rails?
- To limit trunk movement.
- To retain indoor warmth.
- To anchor alarm signals.
- To avoid skin breakdown.
Correct answer: To avoid skin breakdown.
Padding a side rail puts a soft layer between the resident and bare metal, and the purpose taken here is to avoid skin breakdown where an arm or a leg rests against the frame. To limit trunk movement describes a restraint, which is never a reason to pad a rail. To retain indoor warmth belongs to blankets, since an open rail frame holds no heat. To anchor alarm signals confuses the rail with a mounting point for the call device.
- A resident drinks 8 ounces of milk during lunch, but the standard measurement of documentation in the facility is cubic centimeters (cc). What value would the nursing assistant record?
Correct answer: 240 cc
One ounce is about 30 cc, so 8 ounces of milk is charted as 240 cc. 160 cc comes from allowing only 20 cc to the ounce and undercounts the intake by a third. 320 cc comes from allowing 40 cc to the ounce and overstates it by a third. 400 cc comes from allowing 50 cc to the ounce, which is nearly double the true conversion.
- A CNA is recording the 24-hour urine output of a patient with kidney issues. What 24-hour urine value would warrant a report to the nurse?
Correct answer: 600 cc
Normal 24-hour urine output for an adult runs from roughly 800 to 2000 cc, so 600 cc falls below that range and should be passed on to the nurse as a possible sign of kidney trouble or dehydration. 810 cc sits just inside the bottom of the normal range and calls for nothing on its own. 900 cc is comfortably inside the normal range. 990 cc is likewise a normal daily total and needs only to be charted.
- There is a sign that says “NPO” on your patients door. You know this means ____.
- The patient can not have visits or mail by hand.
- The patient can not have food or fluid by mouth.
- The patient can not have meat or cereal by tray.
- The patient can not have walks or trips by self.
Correct answer: The patient can not have food or fluid by mouth.
NPO is short for the Latin nil per os, nothing by mouth, so the sign means the patient can not have food or fluid by mouth and the aide offers neither a tray nor a drink. It is not a visiting rule, so it does not mean the patient can not have visits or mail by hand; contact limits are posted as isolation precautions. It is not a mobility alert, so it does not mean the patient can not have walks or trips by self; that would be a fall-risk notice. And it is not a diet change, so it does not mean only that the patient can not have meat or cereal by tray, which would describe a modified texture rather than a complete fast.
- Which of these would be inappropriate when caring for a diabetic patient?
- Washing and reporting the patient's dry blisters.
- Watching and reporting the patient's food intake.
- Serving and reporting the patient's extra snacks.
- Brushing and reporting the patient's tender gums.
Correct answer: Watching and reporting the patient's food intake.
The marked answer for this item is watching and reporting the patient's food intake. Washing and reporting the patient's dry blisters, serving and reporting the patient's extra snacks, and brushing and reporting the patient's tender gums are all routine parts of diabetic care, since broken skin, steady carbohydrate spacing and gum disease all matter in diabetes. Note that recording and reporting intake is itself standard diabetic care, so this item has been referred for expert review. The action a nurse aide must never take with a diabetic patient is soaking the feet in hot water, because neuropathy can hide a burn.
- Your patient has a low pulse, seems slightly confused, and has sweet, fruity-smelling breath. You suspect ____.
- Ketoacidosis
- Hypoglycemia
- Hypertension
- Hyponatremia
Correct answer: Hypertension
The marked answer for this item is hypertension. Hypoglycemia produces shakiness, sweating, hunger and a rapid pulse rather than a slow one, and hyponatremia produces cramping, nausea and headache, so neither fits the picture described. Be aware that a slow pulse, confusion and sweet, fruity breath are the classic picture of very high blood sugar and ketoacidosis, and the source explanation for this item describes high blood sugar rather than high blood pressure, so the item has been referred for expert review.
- You are caring for a patient with a strict dysphagia diet. Which item on the patients tray would you question?
- Milk puddings.
- Peanut butter.
- Whipped cream.
- Softened eggs.
Correct answer: Peanut butter.
Peanut butter is the tray item to question on a strict dysphagia diet: it is thick and sticky, clings to the roof of the mouth and the throat, and is very hard to clear in one swallow, which raises aspiration risk. Milk puddings are smooth and cohesive and move as a single bolus. Whipped cream is soft and dissolves without chewing. Softened eggs are moist, break apart easily and need no grinding, so all three belong on the tray.
- You should be careful when changing, as this is a common site for unintentionally discarded needles.
- A resident's cotton pants.
- A resident's linen sheets.
- A resident's disposal bin.
- A resident's bath washrag.
Correct answer: A resident's linen sheets.
Insulin syringes, lancets and other sharps are used at the bedside, so a dropped needle most often ends up in a resident's linen sheets; strip and roll the bed slowly rather than shaking it. A resident's cotton pants are removed at the bedside but are handled item by item and rarely hide a sharp. A resident's bath washrag is used at the sink or tub, where injections are not given. A resident's disposal bin is expected to hold waste and is emptied with gloved care rather than being a hidden hazard.
- The circulatory system consists of the
- Valves, venules, plasma and leukocytes
- Heart, veins, arteries and capillaries
- Spleen, thymus, tonsils and lymphatics
- Atria, chambers, septum and myocardium
Correct answer: Heart, veins, arteries and capillaries
The circulatory system is the pump plus the vessels that form one closed circuit: heart, veins, arteries and capillaries. Valves, venules, plasma and leukocytes mixes one heart structure with the contents of blood, which are carried by the system rather than forming it. Spleen, thymus, tonsils and lymphatics names the lymphatic and immune organs, a separate system. Atria, chambers, septum and myocardium lists parts of the heart alone and leaves out every vessel, so it cannot describe the whole circuit.
- A fractured hip is ____.
- The most difficult injury when a resident ages.
- The most costly injury when a resident returns.
- The most frequent injury when a resident falls.
- The most painful injury when a resident shifts.
Correct answer: The most frequent injury when a resident falls.
A fractured hip is the most frequent injury when a resident falls; among older adults a fall to the side lands on the greater trochanter and the hip gives way before other bones do. It is not the most difficult injury when a resident ages, because healing time tracks bone quality and the surgical repair rather than the site itself. It is not the most costly injury when a resident returns, since cost swings with the procedure and the length of rehabilitation. It is not the most painful injury when a resident shifts, because pain varies widely from person to person.
- If the nurse aide discovers fire in a client’s room, the FIRST thing to do is
- Trigger the alarm
- Remove the person
- Close the doorway
- Suppress the fire
Correct answer: Remove the person
Fire response follows R-A-C-E and the R comes first, so remove the person from the room before anything else; someone who cannot move without help is in immediate danger. Trigger the alarm is the A step and follows, or happens at the same moment if a second staff member is there. Close the doorway is the C step, done to contain smoke once people are out. Suppress the fire is the E step and is attempted only on a small fire while an escape route stays open.
- On what side should the patient lie for an enema?
- Flat back, legs drawn up
- Left side, knees bent up
- Easy side, hips kept low
- Right side, knee held up
Correct answer: Left side, knees bent up
An enema is given in the left Sims position: left side, knees bent up. The descending and sigmoid colon run down that side, so gravity carries the solution along the bowel instead of back out. Right side, knee held up works against that anatomy and the fluid is expelled early. Flat back, legs drawn up gives the tubing no path and makes leakage likely. Easy side, hips kept low lets comfort choose a position that anatomy has already decided.
- Which of the following is NOT considered to be a way to restrain a client?
- Sedative syrups
- Quilted mittens
- Wheelchair tray
- Pain management
Correct answer: Pain management
Pain management is not a restraint. Medication given to relieve pain treats a symptom, and a client who settles afterwards does so because the pain has eased, not because movement has been limited. Quilted mittens stop a client using the hands and are a physical restraint. A wheelchair tray the client cannot remove holds the person in the chair and is a physical restraint. Sedative syrups given to control behavior rather than to treat a diagnosed condition are a chemical restraint, and both kinds need a physician order.
- The electric shaver that the nurse aide is using to shave a client begins to spark and smoke. What should the nurse aide do FIRST?
- Borrow the razor
- Return the razor
- Rewire the razor
- Unplug the razor
Correct answer: Unplug the razor
Sparking and smoke mean a live electrical fault, so the first action is to unplug the razor and cut the current before the fault can start a fire or shock the client. Borrow the razor means taking a roommate's appliance, which spreads infection and leaves the faulty one still energized. Rewire the razor is outside a nurse aide's role and means handling a live defective device. Return the razor to its drawer hides the hazard for whoever plugs it in next.
- When taking an oral temperature, it is important to
- Place the thermometer beneath the tongue
- Place the thermometer along the underarm
- Place the thermometer inside the nostril
- Place the thermometer underneath the ear
Correct answer: Place the thermometer beneath the tongue
An oral reading comes from the sublingual pocket, so place the thermometer beneath the tongue and have the client close the lips around it, waiting fifteen minutes after anything hot or cold. Place the thermometer along the underarm gives an axillary reading, which runs about a degree lower and is a different route. Place the thermometer underneath the ear reads skin warmth rather than the tympanic membrane, so it is neither oral nor accurate. Place the thermometer inside the nostril is not a recognized site and risks injury to the mucosa.
- To lift an object using good body mechanics, the nurse aide SHOULD
- Lock elbows and twist upper spine
- Flex knees and keep back straight
- Plant feet close and pull abdomen
- Hold weight far and reach forward
Correct answer: Flex knees and keep back straight
Good body mechanics means flex knees and keep back straight, so the large thigh muscles raise the load while the spine stays in a neutral line. Lock elbows and twist upper spine puts a rotational force through the discs, and twisting under load is a leading cause of back injury. Hold weight far and reach forward moves the load away from the center of gravity and multiplies the strain on the low back. Plant feet close and pull abdomen narrows the base of support, which makes a stumble likelier rather than steadying the lift.
- When operating a manual bed, the nurse aide should remember to
- Leave the bed brakes off.
- Fold the bed cranks away.
- Hold the bed frame level.
- Tilt the bed headrest up.
Correct answer: Fold the bed cranks away.
Once the client is positioned on a manual bed, fold the bed cranks away so that no one catches a shin or a foot on a handle left standing out. Leave the bed brakes off reverses the rule, since the wheels are locked before any care begins and stay locked while it goes on. Hold the bed frame level defeats the purpose of the cranks, which exist so the head, the knees and the height can be changed as care requires. Tilt the bed headrest up is not a standing instruction either; the head is raised only when the client's condition calls for it.
- The most comfortable position for a resident with a respiratory problem is
- Prone position, the resident's belly lowered.
- Lateral position, the resident's knee folded.
- Supine position, the resident's chest upward.
- Fowler position, the resident's back upright.
Correct answer: Fowler position, the resident's back upright.
Fowler position, the resident's back upright, is the most comfortable choice for a breathing problem, because sitting up lets the diaphragm drop and the chest expand fully. Prone position, the resident's belly lowered presses the rib cage into the mattress and limits that expansion. Supine position, the resident's chest upward lets the abdominal organs push up under the diaphragm, which shortens every breath. Lateral position, the resident's knee folded suits sleeping but still leaves the chest flatter than sitting does.
- Which one of these behaviors is NOT a signal of possible combativeness?
- Clenching molars firmly shut.
- Balling fists tightly closed.
- Flicking eyes rapidly around.
- Speaking anger plainly aloud.
Correct answer: Speaking anger plainly aloud.
Speaking anger plainly aloud is not a warning of combativeness; a resident who can name the feeling in words is still in control and is asking to be heard. The warnings are non-verbal and arrive before any words do. Clenching molars firmly shut, balling fists tightly closed and flicking eyes rapidly around are all body cues that a strike may follow, and when the words and the body disagree the nurse aide believes the body.
- The primary reason for combative behavior in a resident is
- Confusion
- Rebellion
- Tiredness
- Annoyance
Correct answer: Confusion
Confusion is the primary reason a resident becomes combative: memory loss turns ordinary care into an unexplained intrusion by a stranger, and the reflex is to push, hit or kick. Annoyance describes a held grievance, which memory loss makes hard to form or carry. Rebellion describes a deliberate refusal of authority, and the behavior is not deliberate. Tiredness shortens patience and can set the stage, but it is a trigger rather than the underlying reason.
- When caring for a confused resident what should a nursing assistant do?
- Use simple directions.
- Avoid verbal guidance.
- Force unaided choices.
- Offer extra schedules.
Correct answer: Use simple directions.
A confused resident can follow one step at a time, so use simple directions in short sentences, say the resident's name and leave time for an answer. Avoid verbal guidance leaves the resident with nothing to hold on to and deepens the confusion. Force unaided choices asks for a decision the resident can no longer organize, which usually ends in refusal or distress. Offer extra schedules floods the resident with options and changes, raising agitation rather than easing it.
- Reality orientation should include
- Assigning playful nicknames nightly.
- Describing favorite pastimes loudly.
- Repeating personal names frequently.
- Inventing fanciful anecdotes gladly.
Correct answer: Repeating personal names frequently.
Reality orientation works by repeating anchors, and the strongest anchor a person has is their own given name, so repeating personal names frequently belongs in the program. Assigning playful nicknames nightly swaps that anchor for a label the resident never chose, such as Granny or Pops. Describing favorite pastimes loudly turns the conversation toward the nurse aide instead of orienting the resident. Inventing fanciful anecdotes gladly feeds the confusion rather than correcting it.
- What is an important way to help the resident feel comfortable in a long-term facility?
- Withhold visits for early adjustment.
- Allow space for personal possessions.
- Demand turnout for active recreation.
- Arrange roommates for steady company.
Correct answer: Allow space for personal possessions.
Familiar objects carry a person's history, so allow space for personal possessions: photographs, a favorite blanket, a small chair, even the resident's own soap and shampoo. Withhold visits for early adjustment does the opposite of what helps, leaving the resident feeling abandoned at the hardest moment. Demand turnout for active recreation strips out the choice that makes an activity worth joining. Arrange roommates for steady company assumes a stranger can stand in for what the resident brought from home.
- When preparing to give peri-care to an incontinent female resident with dementia, the CNA knows
- The resident may laugh, tease, and thank.
- The resident may doze, wander, and drift.
- The resident may weep, fight, and accuse.
- The resident may sweat, shiver, and pale.
Correct answer: The resident may weep, fight, and accuse.
Peri-care exposes the most private part of the body and a resident with dementia cannot always place what is happening, so the resident may weep, fight, and accuse: tears, a struggle and a complaint of assault are all common and all expected. The resident may laugh, tease, and thank treats an exposing procedure as a sociable one. The resident may doze, wander, and drift assumes dementia removes feeling, which it does not. The resident may sweat, shiver, and pale lists signs of fever or shock rather than the distress this care provokes. Describe each step before doing it and work calmly.
- Which of the following is NOT true of dementia?
- People with dementia act difficult from spite.
- People with dementia feel anxious from change.
- People with dementia lose skills from illness.
- People with dementia see phantoms from damage.
Correct answer: People with dementia act difficult from spite.
People with dementia act difficult from spite is the statement that is not true: resistance grows out of fear and confusion, and it is a symptom of the disease rather than a choice aimed at anyone. People with dementia feel anxious from change is true, which is why a steady routine settles them. People with dementia lose skills from illness is true, and grooming is among the first self-care tasks to slip away. People with dementia see phantoms from damage is true, since vivid hallucinations are common as the brain deteriorates.
- A resident with Alzheimer’s disease tells the nurse aide that she smells smoke. The nurse aide should
- Look closely for a fire
- Settle down for a sleep
- State policy for a ward
- Deny danger for a night
Correct answer: Look closely for a fire
Alzheimer's disease takes short-term memory first and leaves the senses working, so a resident who reports the smell of smoke may well be smelling smoke; look closely for a fire before doing anything else. Settle down for a sleep treats a safety report as tiredness. State policy for a ward answers the report with a rule and leaves a possible fire unchecked. Deny danger for a night dismisses what the resident sensed on the strength of the diagnosis alone.
- Some patients may exhibit some “false beliefs” not supported by facts or reality. This is known as
- Illusion
- Delirium
- Delusion
- Dementia
Correct answer: Delusion
A fixed false belief that no evidence can shift is a delusion: being followed, being poisoned, or a song carrying a private message. An illusion is a real sight or sound misread, such as a coat on a hook taken for a person. Delirium is a sudden, fluctuating confusion, usually caused by infection, medication or dehydration, and it clears once the cause is treated. Dementia is the slow, lasting loss of memory and thinking within which a delusion may appear, so it names the disease and not the belief.
- In a reality orientation program you would do all of the following EXCEPT
- Quiz the resident about their breakfasts.
- Remind the resident about their calendar.
- Question the resident about their season.
- Probe the resident about their childhood.
Correct answer: Probe the resident about their childhood.
Reality orientation anchors a person in the present, so probe the resident about their childhood is the activity that does not belong; reminiscence is valuable care, but it looks backward instead of orienting to now. Quiz the resident about their breakfasts uses smell and taste to fix the time of day. Remind the resident about their calendar reinforces the date with what hangs on the wall. Question the resident about their season ties the person to the weather and the day outside the window.
- The end of the day can bring a common behavior for residents with dementia, called
- Sundown Syndrome.
- Twilight Anxiety.
- Latent Agitation.
- Nighttime Terror.
Correct answer: Sundown Syndrome.
The restlessness, pacing and agitation that build as the light fades is called Sundown Syndrome, and it is tied to failing daylight, hunger, poor vision and the fatigue of a long day. Twilight Anxiety is not a recognized name for the pattern. Latent Agitation would describe a hidden state waiting to surface rather than behavior tied to the hour. Nighttime Terror describes an episode that wakes a person out of sleep, which is not what happens here, since the resident is awake throughout.
- All of the following are clues to aggressive behavior EXCEPT
- Restless steps
- Endless motion
- Flattened mood
- Locked jawline
Correct answer: Flattened mood
A flattened mood is not a clue to coming aggression; a resident who is withdrawn and low is turning inward rather than building toward a strike, and that calls for a different response entirely. Restless steps are pacing, one of the earliest signs that agitation is rising. Endless motion is the repetitive rocking that often runs ahead of an outburst. A locked jawline is the clenched jaw of a body braced to act. When any of those three appear, look for pain, hunger, fatigue or overstimulation and lower the stimulation.
- Which of the following can be a cause of intellectual disability?
- Chromosomes, infections, and sleepiness
- Chromosomes, infections, and clumsiness
- Chromosomes, infections, and loneliness
- Chromosomes, infections, and childbirth
Correct answer: Chromosomes, infections, and childbirth
Intellectual disability has causes at every stage of early life, so chromosomes, infections, and childbirth is the set that holds: a chromosome disorder such as Down syndrome, an infection such as meningitis or whooping cough, and a difficult delivery with oxygen deprivation or prematurity. Chromosomes, infections, and sleepiness fails because sleepiness is a symptom of many conditions and the cause of none. Chromosomes, infections, and clumsiness fails because poor coordination follows from some disorders rather than producing them. Chromosomes, infections, and loneliness fails because isolation shapes mood and behavior, not intellectual capacity.
- Residents with cognitive impairments often have difficulty sleeping. What can be helpful?
- Set a nightly routine and settle residents within fifteen minutes.
- Leave a nightly screen and lull residents within lighted bedrooms.
- Cancel a nightly stroll and relax residents within empty dayrooms.
- Delay a nightly bedtime and tire residents within noisy corridors.
Correct answer: Set a nightly routine and settle residents within fifteen minutes.
Sleep improves when the body clock is reset, so set a nightly routine and settle residents within fifteen minutes of the same hour each evening. Delay a nightly bedtime and tire residents within noisy corridors buys one night's exhaustion at the price of worse confusion the next day. Leave a nightly screen and lull residents within lighted bedrooms keeps light and sound in the room, and both delay sleep onset. Cancel a nightly stroll and relax residents within empty dayrooms removes the daytime activity that deepens sleep quality.
- If a resident becomes confused, you should
- Bind the resident inside padded restraints.
- Place the resident behind locked entrances.
- Help the resident recognize familiar items.
- Detain the resident beside quiet corridors.
Correct answer: Help the resident recognize familiar items.
When a resident becomes confused, rebuild the sense of time and place: give your own name, use the resident's name, say what day it is and what has just happened, and help the resident recognize familiar items such as photographs and belongings. Place the resident behind locked entrances is seclusion, which counts as a restraint and is not permitted. Bind the resident inside padded restraints is a physical restraint that requires a physician order and is never a response to confusion. Detain the resident beside quiet corridors parks the person until staff are free, which leaves the confusion untouched.
- A resident with dementia has wandered to another unit. What should the nurse aide say after finding the resident?
- "Move quick now, don't you see?"
- "Good grief, didn't you go far?"
- "Oh dear, haven't you gone off?"
- "Let's walk you back home, yes?"
Correct answer: "Let's walk you back home, yes?"
A resident who wanders is usually trying to reach something familiar, so the reply stays calm, friendly and joins the resident rather than correcting: "Let's walk you back home, yes?" offers company and a destination in one sentence. "Move quick now, don't you see?" makes the aide's workload the resident's problem and hurries someone who is already unsettled. "Oh dear, haven't you gone off?" mocks the wandering. "Good grief, didn't you go far?" demands an explanation the resident has no way to give.
- A 90 year-old resident tells you that his mother is coming to visit on Sunday. What is your most appropriate response?
- "Are you missing your mother tonight?"
- "Are you baking your mother biscuits?"
- "Are you doubting your mother passed?"
- "Are you troubling your mother again?"
Correct answer: "Are you missing your mother tonight?"
With a resident who is confused about the past, neither contradict nor play along; look for the feeling behind the words. "Are you missing your mother tonight?" names that feeling and invites him to talk about her. "Are you doubting your mother passed?" corrects him with a fact he will then have to grieve all over again. "Are you baking your mother biscuits?" joins the misunderstanding and builds on it. "Are you troubling your mother again?" scolds a resident who has done nothing wrong.
- While the nurse aide tries to dress a resident who is confused, the resident keeps trying to grab a hairbrush. The nurse aide should _.
- Hand the hairbrush to the resident.
- Strap the resident to the bedrails.
- Squeeze the sleeve to the shoulder.
- Return the hairbrush to the drawer.
Correct answer: Hand the hairbrush to the resident.
A confused resident who keeps reaching for an object is asking for something to hold, so hand the hairbrush to the resident; with the hands occupied by a familiar item the dressing goes more smoothly and the resident feels secure. Return the hairbrush to the drawer takes away the one thing the resident wants and invites a struggle. Strap the resident to the bedrails is a restraint, which needs a physician order and is never used for staff convenience. Squeeze the sleeve to the shoulder hurries a person who is already unsettled, and rushing usually slows the task down.
- A client with dementia has developed a fear of taking a shower. What can a nurse aide do?
- Wave a cash gift and win a shower another time.
- Cite a germ risk and urge a shower another try.
- Phone a grown son and ask a shower another way.
- Give a bed bath and offer a shower another day.
Correct answer: Give a bed bath and offer a shower another day.
Fear of the shower is real to a client with dementia and no argument will remove it, so give a bed bath and offer a shower another day; the client stays clean, the fear is not reinforced, and a calmer day may come. Cite a germ risk and urge a shower another try reasons with someone who can no longer follow the reasoning. Phone a grown son and ask a shower another way hands the aide's task to the family and still forces the issue. Wave a cash gift and win a shower another time buys compliance, which is neither honest nor lasting.
- A confused resident tells you there is a monster in the closet. The nurse aide should
- Bar the closet and warn the resident it is foolish.
- Raid the closet and assure the resident it is dead.
- Open the closet and show the resident it is vacant.
- Unlock the closet and tell the resident it is gone.
Correct answer: Open the closet and show the resident it is vacant.
A confused resident believes what they perceive, so meet it with calm reality: open the closet and show the resident it is vacant, stay beside them, and keep describing the room as it is. Bar the closet and warn the resident it is foolish shames the person and leaves the fear sitting behind a shut door. Raid the closet and assure the resident it is dead plays along with the hallucination and confirms that the monster was there. Unlock the closet and tell the resident it is gone does the same thing, since it accepts the monster and merely claims to have removed it.
- A resident with Alzheimer’s disease has a baby doll that she carries with her and cares for. When she misplaces the doll, she begins to cry. What should the nurse aide do?
- Hurry the resident as if the doll were hidden.
- Warn the resident as if the doll were plastic.
- Ignore the resident as if the doll were minor.
- Console the resident as if the doll were real.
Correct answer: Console the resident as if the doll were real.
Doll therapy works because the doll is real to the resident, so console the resident as if the doll were real: sit with her, join the search, and let a replacement appear quietly a little later. Hurry the resident as if the doll were hidden turns a loss into a frantic hunt and raises her distress. Warn the resident as if the doll were plastic corrects a belief she cannot revise and sharpens the grief. Ignore the resident as if the doll were minor leaves a grieving person alone with a loss that is genuine to her.
- The Global Deterioration Scale (GDS) helps caregivers understand how people decline when they have dementia. Of the seven stages, which stage has no sign of dementia?
- The fifth stage charted.
- The sixth stage entered.
- The second stage listed.
- The seventh stage shown.
Correct answer: The second stage listed.
On the Global Deterioration Scale the first three stages sit before dementia, so the second stage listed is the one with no sign of dementia; the person notices ordinary forgetfulness such as a mislaid key, and testing turns up nothing. The fifth stage charted brings the need for help choosing clothes and an inability to recall current facts such as the date. The sixth stage entered brings extensive help with daily living, incontinence and failure to recognize family members. The seventh stage shown brings total care, with speech and walking lost.
- While the nurse aide is giving care to Mr. T., he calls the nurse aide by the name of his son who died several years ago. The nurse aide’s BEST response is to
- Invite Mr. T to talk about his son.
- Leave Mr. T to worry about his son.
- Coax Mr. T to grieve about his son.
- Beg Mr. T to explain about his son.
Correct answer: Invite Mr. T to talk about his son.
When memory loss makes a resident mistake a caregiver for someone from the past, the person is usually thinking about that someone, so invite Mr. T to talk about his son and let him reminisce; a photograph or keepsake helps the conversation along. Leave Mr. T to worry about his son abandons him in a moment that clearly matters to him. Coax Mr. T to grieve about his son pushes him into a sorrow he did not ask to revisit and turns routine care into an intrusion. Beg Mr. T to explain about his son demands an account he cannot produce and will only distress him.
- Reality orientation therapy should include
- Cheering the resident by their early release.
- Amusing the resident by their invented tales.
- Addressing the resident by their actual name.
- Calling the resident by their jokey nickname.
Correct answer: Addressing the resident by their actual name.
Reality orientation therapy keeps a person tied to what is true, and the plainest truth a person owns is their own name, so addressing the resident by their actual name belongs in the program. Cheering the resident by their early release promises a discharge nobody can guarantee and will be asked about again tomorrow. Amusing the resident by their invented tales builds on a story rather than on reality. Calling the resident by their jokey nickname, such as Gramps, swaps the real name for a label and strips away dignity.
- When you approach a resident with dementia, how should you behave?
- With a rushed and impatient manner.
- With a relaxed and cheerful manner.
- With a timid and apologetic manner.
- With a hesitant and distant manner.
Correct answer: With a relaxed and cheerful manner.
A resident with dementia reads tone and body language long after words stop carrying meaning, so a relaxed and cheerful manner is what invites cooperation. A rushed and impatient manner tells the resident she is a burden and usually provokes resistance. A timid and apologetic manner invites the resident to take charge of the interaction. A hesitant and distant manner reads as rejection and raises fear.
- A resident is standing in the hallway holding a bag, and asks the nurse aide when the train is due. The aide should tell her
- Her obvious mistake, in a disrespectful tone of voice
- Her exact location, in a matter-of-fact tone of voice
- Her approximate departure, in a playful tone of voice
- Her bedroom assignment, in a dismissive tone of voice
Correct answer: Her exact location, in a matter-of-fact tone of voice
The aide should state her exact location, in a matter-of-fact tone of voice, because calm orientation to place gives a confused resident something real to hold on to without shaming her. Stating her obvious mistake, in a disrespectful tone of voice, humiliates the resident and raises her agitation. Stating her approximate departure, in a playful tone of voice, plays along with the belief about the train and deepens it. Stating her bedroom assignment, in a dismissive tone of voice, sends her away without answering what she actually asked.
- Which of the following is the most appropriate time to use a soft toothette?
- When cleansing the mouth of the unconscious resident
- When separating the molars of the epileptic patients
- When inspecting the irritation of the abscessed gums
- When polishing the underside of the acrylic dentures
Correct answer: When cleansing the mouth of the unconscious resident
A soft toothette is the right tool when cleansing the mouth of the unconscious resident, because it carries very little fluid and will not flood the airway of someone who cannot swallow or spit. When inspecting the irritation of the abscessed gums, a toothette relieves nothing and the finding belongs to the nurse. When separating the molars of the epileptic patients, nothing at all may be placed in the mouth, so no oral tool is defensible. When polishing the underside of the acrylic dentures, a denture brush and cleanser are needed because a toothette cannot lift the film.
- Which of the following would be an inappropriate action when providing nail care to a resident?
- Massage the lotion on a chapped resident's palm.
- Towel the dampness on a bathed resident's ankle.
- Trim the toenails on a diabetic resident's feet.
- Soak the calluses on a stiffened resident's toe.
Correct answer: Trim the toenails on a diabetic resident's feet.
To trim the toenails on a diabetic resident's feet is the action a nurse aide should not take: reduced sensation and poor circulation turn a small nick into an ulcer, so facility policy hands diabetic foot nails to the nurse or the podiatrist. To massage the lotion on a chapped resident's palm is ordinary skin care and is encouraged. To towel the dampness on a bathed resident's ankle prevents maceration and skin breakdown. To soak the calluses on a stiffened resident's toe softens the nail bed and is a routine part of nail care.
- A resident is recovering from a stroke and has weakness on their left side. They call you to help them put on a sweater. Assistance should be given ____.
- On the weaker damaged side of the resident.
- On the healthy stable side of the resident.
- On the outer rearward side of the resident.
- On the open frontward side of the resident.
Correct answer: On the weaker damaged side of the resident.
Help belongs on the weaker damaged side of the resident, which after this stroke is the left: that is the side that cannot steady the body, and it is the arm the sweater sleeve goes onto first. Working on the healthy stable side of the resident leaves the affected arm with no support at all. Working on the outer rearward side of the resident puts the aide out of sight and out of reach if balance is lost. Working on the open frontward side of the resident blocks the path the resident is trying to move along and still steadies nothing.
- It is time to bathe an Alzheimers patient who has had visitors in the room for most of the shift. Which of the following is the most appropriate action for the nursing assistant to take?
- Permit the visitors to name the bath hour.
- Leave the visitors to stay the entire day.
- Ask the visitors to step outside the door.
- Ask the charge nurse to move the visitors.
Correct answer: Ask the visitors to step outside the door.
To ask the visitors to step outside the door protects privacy and lets the bath happen at a reasonable hour, and it sits squarely inside the nurse aide's own responsibility. To permit the visitors to name the bath hour hands a care decision to people who have no part in the care plan. To leave the visitors to stay the entire day means the bath never happens, which edges toward neglect. To ask the charge nurse to move the visitors passes off a task the aide is trained and expected to handle.
- A resident is often late to physical therapy because she is very slow at feeding herself during breakfast. What is the best action for the nursing assistant to take?
- Refuse breakfast to the resident entirely.
- Rush breakfast to the resident repeatedly.
- Spoonfeed breakfast to the resident daily.
- Deliver breakfast to the resident earlier.
Correct answer: Deliver breakfast to the resident earlier.
Delivering breakfast to the resident earlier solves the real problem: it buys the extra minutes she needs to feed herself and still reach therapy on time, and it protects a skill she still has. Refusing breakfast to the resident entirely withholds a meal she is entitled to and edges toward neglect. Rushing breakfast to the resident repeatedly invites choking and turns the meal into a contest she loses. Spoonfeeding breakfast to the resident daily takes away her independence to save staff minutes, which is the opposite of restorative care.
- A resident on the DASH diet reduces his food intake and shows little interest in eating. What is the best way for a nursing assistant to handle the situation?
- Phone the resident's contracted registered dietitian tomorrow.
- Pressure the resident's weakened mealtime appetite repeatedly.
- Encourage the resident's favorite homemade outside casseroles.
- Offer the resident's prescribed nutritional supplement drinks.
Correct answer: Offer the resident's prescribed nutritional supplement drinks.
Offering the resident's prescribed nutritional supplement drinks is the right move: the supplements are already ordered, they fit within the sodium and fat limits of his plan, and handing them to him is squarely inside the nurse aide's role when intake falls. Phoning the resident's contracted registered dietitian tomorrow is a referral the nurse or physician arranges, and it does nothing for today's poor intake. Pressuring the resident's weakened mealtime appetite repeatedly seldom raises intake and usually hardens the refusal. Encouraging the resident's favorite homemade outside casseroles brings in food that no one has checked against the sodium limit his diet sets.
- Which of these may depend on facility rules when performing nail care on a resident?
- The purpose of soaking the fingers.
- The policy of cutting the toenails.
- The practice of seating the client.
- The job of reporting pale nailbeds.
Correct answer: The policy of cutting the toenails.
Whether a nurse aide may cut nails at all varies from building to building, so the policy of cutting the toenails is the piece that depends on facility rules; many places reserve toenails for the nurse or the podiatrist. The purpose of soaking the fingers is the same everywhere, because warm water softens the nail so it splits less. The practice of seating the client is a comfort and positioning choice made person by person, not a written rule. The job of reporting pale nailbeds falls on every nurse aide in every setting, since a color change there is a circulation finding the nurse must hear about.
- Which of these is an incorrect procedure for shaving a resident?
- Move the razor from the chin to the sideburns.
- Spread the towel from the collar to the chest.
- Draw the blade from the throat to the jawline.
- Stretch the skin from the earlobe to the lips.
Correct answer: Move the razor from the chin to the sideburns.
A face is shaved with the grain, which runs downward, so to move the razor from the chin to the sideburns is the incorrect procedure: it drags the blade against the beard and produces nicks and ingrown hairs. To spread the towel from the collar to the chest keeps clothing and linen dry and is correct. To draw the blade from the throat to the jawline follows the upward grain of the neck, which is how the neck is properly shaved. To stretch the skin from the earlobe to the lips flattens the surface so the blade cannot catch a fold, and that is correct technique too.
- Which of these is not a common mealtime and eating challenge that residents often face?
- Swallowing the thickened casseroles
- Manipulating the awkward silverware
- Hearing the dinnertime announcement
- Recognizing the gradual dehydration
Correct answer: Hearing the dinnertime announcement
Hearing the dinnertime announcement is not an obstacle at all: a facility doing its job tells residents when the meal is served, so the reminder is part of ordinary care rather than something the resident struggles against. Swallowing the thickened casseroles is a daily struggle for anyone with dysphagia. Manipulating the awkward silverware defeats residents whose grip, tremor or coordination has failed. Recognizing the gradual dehydration is exactly what many older residents cannot do, because the thirst signal fades with age.
- All of these are proper precautions for residents who are unable to move by themselves, except:
- The resident should be cleansed when the brief soils.
- The resident should be turned when the shift changes.
- The resident should be shifted when two hours elapse.
- The resident should be checked when the skin reddens.
Correct answer: The resident should be turned when the shift changes.
The precaution that fails is that the resident should be turned when the shift changes: one turn in eight or twelve hours loads the same skin far too long, and a pressure injury forms well inside that window. The resident should be cleansed when the brief soils, because urine and stool strip skin down quickly. The resident should be checked when the skin reddens, since a red patch that does not blanch is the first stage of a pressure injury. The resident should be shifted when two hours elapse, which is the standard repositioning interval for someone who cannot move alone.
- Which of these statements is false for the care of a resident’s dentures?
- The dentures become slippery in the soap's film.
- The dentures splinter easily in the aide's grip.
- The dentures stay wholly in the wearer's charge.
- The dentures stand overnight in the cup's water.
Correct answer: The dentures stay wholly in the wearer's charge.
The false claim is that the dentures stay wholly in the wearer's charge: many residents cannot manage their own dentures, cleaning and storage remain the facility's duty, and handing the job back to the resident is itself the negligence. The dentures splinter easily in the aide's grip, which is why they are handled over a lined sink or a folded towel. The dentures become slippery in the soap's film, so they are gripped firmly and washed in cool running water. The dentures stand overnight in the cup's water, because acrylic warps and cracks once it dries out.
- Morning care (sometimes referred to AM care) before the resident eats breakfast is important for which of these reasons?
- It drops all of the bacteria.
- It raises all of the spirits.
- It matches all of the claims.
- It brightens all of the face.
Correct answer: It matches all of the claims.
Morning care does three separate things at once, so it matches all of the claims: it clears the mouth of the flora that built up overnight, it settles the resident before the day starts, and it leaves the resident presentable at the table. To say it drops all of the bacteria names only the hygiene half of the benefit and overstates it, since brushing reduces the flora rather than removing it. To say it raises all of the spirits names only the comfort benefit. To say it brightens all of the face names only the appearance benefit. Each of the three is part of the reason, and none of them is the whole reason.
- A Hoyer Lift is primarily used for ____.
- Rolling a limp resident from the cot into a gurney.
- Easing a soapy resident from the shower into a tub.
- Guiding a tall resident from the curb into a sedan.
- Lifting a frail resident from the bed into a chair.
Correct answer: Lifting a frail resident from the bed into a chair.
The everyday job of a mechanical lift is lifting a frail resident from the bed into a chair and back again, which is why one hangs in almost every long-term care room. Rolling a limp resident from the cot into a gurney is done by sliding the resident flat across a board, not by slinging them in the air. Easing a soapy resident from the shower into a tub calls for a shower chair or a tub lift, and a wet sling is a fall waiting to happen. Guiding a tall resident from the curb into a sedan is a transfer-belt task, since the sling frame will not fit inside a car door.
- Key considerations for bathing residents include safety, privacy, and which of these?
- Darkening lighting.
- Hastening bathtime.
- Silencing visitors.
- Providing security.
Correct answer: Providing security.
Beyond safety and privacy the third key consideration is providing security: being undressed, wet and handled is frightening, and a resident who feels safe cooperates instead of fighting the bath. Darkening lighting is a personal preference and it makes a slick tub area harder to see. Hastening bathtime raises the risk of slips, chills and torn skin. Silencing visitors suits some residents while others are soothed by talk or music, so it is a preference and not a consideration that applies to everyone.
- Which of these is an important fact that is easily overlooked or forgotten by caregivers and facilities in reference to resident bathing needs?
- The differing schedules of the cultures.
- The thorough scrubbing of the underarms.
- The unstrained bending of the caregiver.
- The unchanging warmth of the washbasins.
Correct answer: The differing schedules of the cultures.
The differing schedules of the cultures is the fact that gets missed: how often a person expects to be bathed, and how, is learned at home, and a facility routine written for everyone runs straight over it. The thorough scrubbing of the underarms is basic technique that appears in every bathing procedure and is not overlooked. The unstrained bending of the caregiver is taught in orientation and is about staff injury rather than the resident's needs. The unchanging warmth of the washbasins is a safety check every aide is drilled on before a single bath is given.
- Bad breath, tooth decay, and skin breakdown in the mouth are all symptoms of ____.
- Overly soaked oral surfaces.
- Thin uneven oral toothpaste.
- Total body oral dehydration.
- Dry withered oral membranes.
Correct answer: Dry withered oral membranes.
Bad breath, decay and tissue breakdown arriving together point to dry withered oral membranes, because saliva is what rinses the mouth and buffers acid, and when it thins all three follow. Overly soaked oral surfaces are not a disease state; extra moisture does not produce decay or breakdown. Total body oral dehydration can give the same picture, but a resident can have a dry mouth while fully hydrated, so it is not the direct cause. Thin uneven oral toothpaste may allow decay to start, yet it does not account for tissue breakdown inside the mouth.
- An important, but frequently forgotten, consideration when providing hair care to residents is _____.
- Age and maturity
- Visit and tenure
- Race and culture
- Weather and heat
Correct answer: Race and culture
Hair texture, washing frequency and the products that suit a head of hair differ sharply by race and culture, and that is exactly what a facility skips when it runs one shampoo routine for everybody. Age and maturity change how much help a resident needs with hair, not what the hair itself requires. Visit and tenure describe how long a resident has been in the building and have no bearing on hair care at all. Weather and heat move dryness a little at the margin, but they say nothing about what the resident expects.
- A small, watery leakage of stool could indicate which of these conditions?
- A fecal impaction.
- A dosage reaction.
- A weakened muscle.
- A stomach illness.
Correct answer: A fecal impaction.
A small watery leak is the classic picture of a fecal impaction: hardened stool blocks the rectum and only liquid seeps past it, so the leak is a sign of blockage rather than of loose bowels. A stomach illness produces repeated loose stools in quantity, not a small seep. A dosage reaction from a laxative or antibiotic also gives volume, and it comes on with the drug rather than after days without a bowel movement. A weakened muscle allows formed stool to escape when the resident coughs or stands, which is a different leak entirely. Any of these findings goes to the nurse.
- Behaviors that may signal pain in the elderly may include all of these except _____.
- Refused social visiting.
- Broken nightly sleeping.
- Reduced mealtime eating.
- Constant lively talking.
Correct answer: Constant lively talking.
Constant lively talking is not a pain behavior: an older adult in pain generally goes quieter and pulls inward rather than becoming more talkative. Broken nightly sleeping is one of the commonest signs, because pain surfaces once the distractions of the day stop. Reduced mealtime eating points to pain too, since appetite falls away when a person hurts. Refused social visiting is the withdrawal pattern staff are taught to watch for in residents who will not say out loud that they hurt.
- Which of these is not a way to assist a resident to rest more comfortably and effectively?
- Banish the loud carts from the hallways.
- Strip the foam wedges from the mattress.
- Space the daily chores from the naptime.
- Borrow the quiet music from the dayroom.
Correct answer: Strip the foam wedges from the mattress.
To strip the foam wedges from the mattress is the one that does not help: those wedges hold the resident off a painful hip and off a reddened heel, and pulling them out trades a little comfort now for pain and skin damage later. To banish the loud carts from the hallways removes the noise that keeps residents awake. To space the daily chores from the naptime keeps the resident from being worn out and too tense to settle. To borrow the quiet music from the dayroom gives the resident something calming to rest to.
- As dementia progresses, incontinence can become an issue. How can the nurse aide assist?
- Take the resident to the toilet on restless cues.
- Guide the resident to the bathroom on stated cue.
- Keep the resident to the building on travel days.
- Switch the resident to the briefs on damp nights.
Correct answer: Take the resident to the toilet on restless cues.
The aide should take the resident to the toilet on restless cues, because a resident whose dementia has advanced stops recognizing or reporting the urge and instead fidgets, crosses the legs or pulls at clothing. To keep the resident to the building on travel days shrinks the resident's life to avoid an accident that a change of clothes would cover. To guide the resident to the bathroom on stated cue waits for a message the resident can no longer send. To switch the resident to the briefs on damp nights skips straight past a toileting schedule and speeds the loss of continence.
- When getting dressed, a client always wants to wear her favorite outfit. What is a good solution?
- Shift the outfit to the locked laundry cupboards.
- Persuade the client to select the newest blouses.
- Lecture the woman to relish the broader wardrobe.
- Ask the family to find several identical outfits.
Correct answer: Ask the family to find several identical outfits.
The workable answer is to ask the family to find several identical outfits, since duplicates let the resident wear what she recognizes every day while the aide keeps the clothes clean. To shift the outfit to the locked laundry cupboards hides her property from her and will read to her as theft. To persuade the client to select the newest blouses pushes a decision that confusion makes harder, not easier. To lecture the woman to relish the broader wardrobe argues with a preference that is one of the last things she still controls.
- A nurse aide finds a resident looking in the refrigerator at the nurses’ station at 5 a.m. The resident, who is confused, explains that he needs breakfast before he leaves for work. The best response by the nurse aide is to ____.
- Remind the resident about his past and his home.
- Warn the resident about his entry and his rules.
- Ask the resident about his job and his appetite.
- Press the resident about his sleep and his room.
Correct answer: Ask the resident about his job and his appetite.
The best response is to ask the resident about his job and his appetite: it neither argues with the belief nor feeds it, and it opens the door to redirecting him to a meal and then back to bed. To warn the resident about his entry and his rules treats a confused man as a rule-breaker and will read to him as an accusation. To remind the resident about his past and his home contradicts him head-on, which usually produces distress rather than insight. To press the resident about his sleep and his room ignores what he just said and starts a struggle over something he is not thinking about.
- A resident who has not been discharged insists she is going home. What should the nurse aide do?
- Notify the ward nurse, then buckle the resident.
- Notify the charge nurse, then calm the resident.
- Notify the night nurse, then block the resident.
- Notify the day nurse, then release the resident.
Correct answer: Notify the charge nurse, then calm the resident.
A resident leaving against medical advice is above a nurse aide's authority, so the aide should notify the charge nurse, then calm the resident and stay with her until the nurse arrives. To notify the ward nurse, then buckle the resident applies a restraint, which no aide may do and which needs an order in any case. To notify the night nurse, then block the resident turns the aide into a physical barrier and can amount to false imprisonment. To notify the day nurse, then release the resident lets an undischarged resident walk out, which no aide is authorized to permit.
- If a client has hand tremors, the nurse aide SHOULD
- Assist the client with the everyday tasks.
- Scold the client with the stern reminders.
- Relieve the client with the total service.
- Bind the client with the padded restraint.
Correct answer: Assist the client with the everyday tasks.
Tremors have no cure, so the aide should assist the client with the everyday tasks, stepping in only where the shaking actually defeats the hand and letting the client do the rest with weighted utensils and other adaptive gear. To relieve the client with the total service strips away skills the client still has and speeds the decline. To scold the client with the stern reminders is pointless, because a tremor is involuntary and cannot be willed away. To bind the client with the padded restraint is a restraint an aide may not apply, and it does nothing about the tremor.
- The role of the ombudsman is to
- Work with the nursing home to protect the rights.
- Partner with the nursing home to teach the aides.
- Merge with the nursing home to manage the chains.
- Bargain with the nursing home to fix the budgets.
Correct answer: Work with the nursing home to protect the rights.
An ombudsman is a trained advocate who will work with the nursing home to protect the rights of residents, taking up complaints about services, privacy, food or other residents when the family cannot settle them with staff. To bargain with the nursing home to fix the budgets is administration, and an ombudsman has no authority over money. To partner with the nursing home to teach the aides is a staff-development job that belongs to the educator. To merge with the nursing home to manage the chains describes an owner or operator, which is exactly what an ombudsman must not be.
- Equipment used to help the resident maintain correct body alignment includes all of the following EXCEPT
- Foot supports
- Wrist splints
- Plastic cones
- Cradle frames
Correct answer: Plastic cones
Plastic cones are not positioning equipment at all; they mark a wet floor or a hazard and have nothing to do with holding a body in alignment. Wrist splints hold a joint in a neutral position so a contracture cannot form. Foot supports keep the feet at a right angle to the leg and prevent foot drop. Cradle frames lift the weight of the sheet and blanket off the legs so the toes are not pushed out of line.
- After assisting with evening care, the nurse aide notices the client has bilateral hearing aids. The nurse aide understands that if a hearing aid is not in use, it should
- Have the earpiece turned loud.
- Have the battery switched off.
- Have the nightstand set aside.
- Have the pocket stuffed tight.
Correct answer: Have the battery switched off.
An aid that is out of use should have the battery switched off, because an idle aid left live drains the cell in a night and whistles with feedback in the drawer. To have the earpiece turned loud wastes the same battery and fills the room with squeal. To have the nightstand set aside leaves the aid where it is knocked to the floor, swept into linen or lost. To have the pocket stuffed tight sends the aid to the laundry inside the clothing, which is one of the commonest ways aids are destroyed.
- The primary goal of restorative care is
- Connect the client to a hired accountant.
- Return the client to a settled household.
- Restrict the client to a padded facility.
- Reduce the client to a helpless idleness.
Correct answer: Return the client to a settled household.
Restorative care aims to return the client to a settled household: strength, walking, speech and self-care are rebuilt so the person can live independently again rather than stay in the building. To connect the client to a hired accountant handles money matters, which is nobody's clinical goal. To restrict the client to a padded facility settles for permanent institutional comfort and gives up on function. To reduce the client to a helpless idleness is the outcome restorative care exists to prevent.
- What is the process of restoring a disabled client to the highest level of functioning possible?
- Rehabilitation
- Reconciliation
- Reorganization
- Reconstruction
Correct answer: Rehabilitation
Rehabilitation is the process that restores a disabled client to the highest level of function possible, using therapy to rebuild strength, movement, speech and daily skills after illness, surgery or injury. Reconstruction is a surgical repair of damaged tissue, not a program of retraining. Reconciliation is the settling of a disagreement or an account and names no process of care at all. Reorganization describes a change to how a facility is run and says nothing about the client's function.
- The nurse aide is making an occupied bed. Which of the following is the most restorative approach?
- Expose the resident to tumbles.
- Instruct the resident to relax.
- Encourage the resident to help.
- Order the resident to relocate.
Correct answer: Encourage the resident to help.
The restorative choice is to encourage the resident to help, because even someone confined to bed can roll, hold a rail or shift a hip during a linen change, and using that ability preserves it. To instruct the resident to relax does the whole job for a person who could have done part of it and speeds the loss of the skill. To expose the resident to tumbles describes dropping both side rails during an occupied bed change, which is a fall risk rather than an approach to care. To order the resident to relocate defeats the purpose, since the point of an occupied bed is that the resident stays in it.
- The most basic rule of body mechanics is to
- Bend from the knees and hips.
- Twist from the neck and back.
- Pull from the arms and hands.
- Tug from the elbow and wrist.
Correct answer: Bend from the knees and hips.
The most basic rule is to bend from the knees and hips, letting the large leg muscles do the work while the back stays straight and locked. To twist from the neck and back is the single commonest way aides injure themselves, because a loaded spine has no strength in rotation. To pull from the arms and hands puts the load on small muscles that tire fast and gives no stable base. To tug from the elbow and wrist offers even less leverage and invites both a dropped resident and a strained joint.
- A patient is leaving the hospital. The family has been told to give her medications bid. The wife asks what that means. The nurse aide tells her to give the medication
- At three even hours daily.
- At two spaced times daily.
- At one planned hour daily.
- At odd sharp spells daily.
Correct answer: At two spaced times daily.
The abbreviation bid means twice each day, so the medication is given at two spaced times daily, roughly twelve hours apart. At three even hours daily is what tid means and would give half again as much drug as ordered. At one planned hour daily is what a once-daily order would say and delivers half the intended amount. At odd sharp spells daily describes an as-needed order, which is a different instruction entirely and would leave the scheduled doses ungiven.
- A nursing assistant is helping a resident to walk. If the resident becomes faint and begins to fall, the assistant should
- Carry the resident to the bed and leave for help.
- Ease the resident to the floor and call for help.
- Push the resident to the wall and shout for help.
- Hoist the resident to the chair and cry for help.
Correct answer: Ease the resident to the floor and call for help.
When a walking resident goes weak the assistant should ease the resident to the floor and call for help, sliding the resident down the front of the body with one leg forward and the knees bent. To carry the resident to the bed and leave for help means lifting a dead weight alone and then abandoning a fallen resident. To hoist the resident to the chair and cry for help means holding up a full body weight, which usually ends with both people on the floor. To push the resident to the wall and shout for help leaves a fainting resident upright with nothing supporting the hips.
- A contracture (tightening, or shortening of a muscle) is caused by
- Excess of hard exercise
- Force of heavy pressure
- Lack of steady movement
- Advance of simple years
Correct answer: Lack of steady movement
A contracture comes from lack of steady movement: a joint that is never carried through its range shortens and stiffens until the limb is fixed, which is why range-of-motion work and splinting are used with anyone who cannot move themselves. Force of heavy pressure damages skin and produces a pressure injury, not a shortened muscle. Excess of hard exercise causes strain and soreness and if anything keeps a joint mobile. Advance of simple years alone does not fix a joint; immobility does, whatever the person's age.
- Goals of arthritis care include
- Easing all of the swelling.
- Halting all of the curling.
- Hardening all of the bones.
- Satisfying all of the aims.
Correct answer: Satisfying all of the aims.
Arthritis care pursues every one of these ends at once, so satisfying all of the aims is the complete answer. Easing all of the swelling is one goal on its own and names only the inflammation half of the work. Hardening all of the bones covers the strengthening goal and leaves out both inflammation and joint position. Halting all of the curling covers contracture prevention alone. Each one is part of the plan and none of them is the whole plan.
- A button hook and a sock assist are all part of what kind of nursing care?
- Preventive and hospitalization
- Occupational and physiotherapy
- Stabilization and compensation
- Restorative and rehabilitation
Correct answer: Restorative and rehabilitation
A button hook and a sock assist are adaptive devices that let a client dress without help, which places them in restorative and rehabilitation care, the branch that rebuilds function and independence after illness or injury. Preventive and hospitalization describes screening and inpatient admission and has nothing to do with adaptive equipment. Occupational and physiotherapy names two professions that may recommend such devices, but it is not the kind of nursing care the devices belong to. Stabilization and compensation describes holding a condition steady, not restoring a lost skill.
- ROM exercises will help prevent
- Contractures
- Constipation
- Incontinence
- Malnutrition
Correct answer: Contractures
Moving every joint through its full arc keeps muscle and tendon at length, so contractures — the permanent shortening that follows prolonged immobility — are what these exercises prevent. Constipation is prevented by fluid, fiber and walking, none of which a joint exercise supplies. Incontinence follows bladder or nerve damage and is unaffected by joint movement. Malnutrition reflects what the resident takes in, which exercising a joint cannot change.
- A patient has had hip surgery. Her legs should be
- Abducted
- Pronated
- Adducted
- Inverted
Correct answer: Abducted
After hip surgery the legs are held abducted, moved away from the midline by a wedge or abduction pillow, so the new joint cannot slip out of the socket. Adducted legs cross the midline and are the exact position that dislocates a hip prosthesis. Pronated describes a palm or foot rolled inward and says nothing about where the whole leg lies. Inverted turns the sole of the foot toward the midline and describes the ankle, not the hip.
- The most common cause of accidents in the home results from
Correct answer: Falls
Falls are the leading cause of home accidents and the leading cause of injury deaths in people over 65, which is why removing rugs, clutter and spills matters so much. Burns happen in kitchens but rank far below falls in frequency. A wound is the damage an accident leaves behind, not the event that causes it. Shock is a circulatory response to blood or fluid loss rather than a household accident.
- Mrs. Jones has been throwing up for several days, unable to eat or drink. You find her in bed. She is pale, lethargic, and her eyes are dull. She is likely suffering from
- Hypovolemic shock
- Myocardial injury
- Pulmonary embolus
- Bacterial illness
Correct answer: Hypovolemic shock
Days of vomiting with nothing taken in strip the circulating volume, and pallor, lethargy and dull sunken eyes are the classic picture of hypovolemic shock. Myocardial injury announces itself with chest pain and does not follow fluid loss. A pulmonary embolus brings sudden breathlessness rather than a gradual decline over several days. Bacterial illness would bring fever and rigors, which she does not have.
- While helping an 86 year-old male resident get ready for bed, he tells you that he is tired of living and has been saving his pain pills. What should you do?
- Notify the nurse and stay beside the client.
- Notify the nurse and hunt the bedside table.
- Notify the nurse and flush the stored pills.
- Notify the nurse and debate the gloomy mood.
Correct answer: Notify the nurse and stay beside the client.
All four reach the nurse, so what separates them is what the aide does next. Notify the nurse and stay beside the client is right: a man who says he is tired of living and has hoarded medication must not be left alone while help is arranged. Hunting the bedside table ransacks his belongings without his knowledge and leaves him unsupervised. Flushing the stored pills destroys what the nurse must see and count, and medication is not the aide's to handle. Debating the gloomy mood turns the aide into a counselor and still leaves him by himself.
- A patient chokes while eating and is unable to cough or speak. The first thing the nurse aide should do is
- Sweep one finger between the clamped molars
- Force rapid breaths between the bluish lips
- Slap the client between the shoulder blades
- Squeeze the chest between two clasped palms
Correct answer: Slap the client between the shoulder blades
For a choking adult who can neither cough nor speak, the sequence starts with a firm back blow, so slap the client between the shoulder blades is the first act before abdominal thrusts follow. Sweeping one finger between the clamped molars is a blind finger sweep, which drives the food deeper and risks a bite. Forcing rapid breaths between the bluish lips pushes the obstruction further down and belongs only to an unresponsive victim. Squeezing the chest between two clasped palms is a compression technique, not an airway clearance for someone still conscious.
- The fire alarm has sounded. The nurse aide should FIRST
- Locate the charge nurse and learn the source of the alarm
- Move the residents out of the hallway and close the doors
- Phone the fire station and repeat the address of the unit
- Carry the extinguisher and douse the hot spot of the room
Correct answer: Move the residents out of the hallway and close the doors
R.A.C.E. puts rescue and containment ahead of everything else, so the aide's first act is to move the residents out of the hallway and close the doors. Locating the charge nurse and learning the source of the alarm spends time asking questions while people remain exposed. Carrying the extinguisher and dousing the hot spot of the room is the last step and is attempted only once everyone is clear. Phoning the fire station and repeating the address duplicates a call the sounding alarm has already triggered.
- Factors that increase a resident’s risk of falling include
- Rubber soles, sturdy handrails, and bright lights.
- Muscle weakness, sedative drugs, and dim eyesight.
- Thick blankets, spare pillows, and hot compresses.
- Dental floss, fresh mouthwash, and smooth brushes.
Correct answer: Muscle weakness, sedative drugs, and dim eyesight.
Weak legs, drugs that sedate or lower blood pressure, and failing vision are the three best documented contributors, which is why muscle weakness, sedative drugs, and dim eyesight names real risk factors. Rubber soles, sturdy handrails, and bright lights are all protective and lower the risk rather than raise it. Thick blankets, spare pillows, and hot compresses are comfort measures with no effect on balance or gait. Dental floss, fresh mouthwash, and smooth brushes belong to oral hygiene.
- If you see a fire, your first action should be to
- Telephone the night operator.
- Evacuate the nearby patients.
- Activate the corridor buzzer.
- Carry the small extinguisher.
Correct answer: Evacuate the nearby patients.
R.A.C.E. begins with rescue, so on seeing a fire the first act is to evacuate the nearby patients out of the immediate danger. Telephoning the night operator passes word along but leaves helpless people where they are. Activating the corridor buzzer is the alarm step, which follows rescue and can be done while others are moved. Carrying the small extinguisher is the final step and is attempted only for a small fire once everyone is out.
- If a diabetic resident develops symptoms of increased thirst and urination, blurred vision, weakness, and a fruity-smelling breath, what should the CNA do?
- Report it to the nurse once the bath finishes.
- Report it to the nurse once the juices settle.
- Report it to the nurse once the signs surface.
- Report it to the nurse once the handover ends.
Correct answer: Report it to the nurse once the signs surface.
Thirst, frequent urination, blurred vision, weakness and fruity breath are signs of high blood sugar needing insulin, so report it to the nurse once the signs surface is the aide's job. Waiting until the bath finishes delays treatment while ketoacidosis builds. Waiting until the juices settle means sugar has been given to a resident whose blood sugar is already far too high. Waiting until the handover ends pushes an urgent finding to the end of the shift.
- You must be especially careful about fire if the resident is receiving _______.
- Sedative syrup
- Steroid creams
- Oxygen therapy
- Heat treatment
Correct answer: Oxygen therapy
Oxygen therapy enriches the air at the bedside, and enriched air makes any flame burn hotter and spread faster, which is why open flame and smoking are banned near it. Sedative syrup makes a resident drowsy but changes nothing about how a fire behaves. Steroid creams sit on the skin and do not alter the room air. Heat treatment can burn the skin it touches, yet it adds no fuel or oxygen to the room.
- Safety measures to prevent accidental poisoning from medications include
- Store the medicine beyond the reach of children.
- Repack the medicine inside the drawers of linen.
- Dispense the medicine near the edge of midnight.
- Describe the medicine beneath the name of candy.
Correct answer: Store the medicine beyond the reach of children.
Almost every childhood medication poisoning happens when a drug is within reach and nobody is watching, so store the medicine beyond the reach of children is the measure that prevents it. Repacking the medicine inside the drawers of linen strips it of its labeled container and hides it where nobody expects a drug. Dispensing the medicine near the edge of midnight means working in poor light, where the wrong drug or dose is easily taken. Describing the medicine beneath the name of candy teaches a child that pills are a treat.
- You’ve been asked to increase a residents muscle strength and joint mobility with “passive range of motion” exercises. The best example of this type of treatment would be ____.
- Timing the resident and watching the arm rotate in stages.
- Holding the forearm and moving the limb gently in circles.
- Loading the wrists and pushing the weights firmly in sets.
- Handing the objects and counting the lifts done in bursts.
Correct answer: Holding the forearm and moving the limb gently in circles.
Passive work means the aide supplies all of the movement while the resident supplies none, so holding the forearm and moving the limb gently in circles is the example asked for. Timing the resident and watching the arm rotate in stages leaves the resident doing the work, which makes it active. Loading the wrists and pushing the weights firmly in sets is resistive exercise against a load. Handing the objects and counting the lifts done in bursts again has the resident moving the limb without help.
- Which of these is the best example of restorative care skills?
- Use of softened, moistened, and electrical compresses.
- Use of absorbent, disposable, and waterproof garments.
- Use of adaptive, assistive, and therapeutic equipment.
- Use of watertight, sterilized, and antiseptic beakers.
Correct answer: Use of adaptive, assistive, and therapeutic equipment.
Restorative care aims at the highest independence a resident can reach, and use of adaptive, assistive, and therapeutic equipment is what makes a task the resident could not manage possible again. Use of softened, moistened, and electrical compresses is a comfort treatment for a sore area. Use of absorbent, disposable, and waterproof garments contains incontinence rather than working to restore continence. Use of watertight, sterilized, and antiseptic beakers is routine denture hygiene.
- When a resident has a rehabilitation plan of care, your role may be to ____.
- Offer the resident extra pain tablets.
- Dress the resident despite fair skill.
- Help the resident relearn lost skills.
- Rush the resident past hourly targets.
Correct answer: Help the resident relearn lost skills.
A rehabilitation plan sets out to return abilities the resident had before the illness, so help the resident relearn lost skills describes the aide's part in it. Offer the resident extra pain tablets is medication administration, which no aide may perform. Dress the resident despite fair skill takes back the very ability the plan is trying to rebuild. Rush the resident past hourly targets strips away the slow practice that recovery depends on.
- A button hook and a sock assist are part of what kind of nursing care?
- Palliative and musculoskeletal
- Developmental and occupational
- Prescriptive and instructional
- Restorative and rehabilitative
Correct answer: Restorative and rehabilitative
A button hook and a sock assist are adaptive devices that let a resident dress without a second pair of hands, which places them squarely in restorative and rehabilitative care. Developmental and occupational names growth and work programs rather than a category of self-care aids. Prescriptive and instructional describes teaching activity and is not a recognized branch of nursing care. Palliative and musculoskeletal pairs comfort care at the end of life with a body system, and neither covers dressing devices.
- When ambulating an unsteady client, it is BEST for the nurse aide to use a
- Quad cane
- Hand rail
- Gait belt
- Leg brace
Correct answer: Gait belt
A gait belt buckles around the waist and gives the aide a firm hold on the client, so an unsteady walker can be lowered safely instead of falling, and it spares the aide's back. A quad cane steadies the client but offers the aide nothing to grip. A hand rail is fixed to the wall and helps only along the stretch where it is mounted. A leg brace supports one joint and does nothing to stop a fall.
- The best way to encourage a residents independence is to ____.
- Let the guests finish the task and depart silently.
- Let the roommates share the wash and borrow towels.
- Let the client begin the care and assist afterward.
- Let the pajamas soil the sheets and change nightly.
Correct answer: Let the client begin the care and assist afterward.
Independence grows when a resident does everything they still can and the aide steps in only for the rest, so let the client begin the care and assist afterward is the best approach. Let the guests finish the task and depart silently hands the work to visitors and teaches the resident nothing. Let the roommates share the wash and borrow towels makes one resident responsible for another, which is neither safe nor their job. Let the pajamas soil the sheets and change nightly withholds help until the resident fails, and that is neglect.
- According to the principles of proper body mechanics, a nurse aide who is lifting an object should place his or her feet
- 20–26 inches, forearm length.
- 12–18 inches, shoulder width.
- 36–42 inches, ankle distance.
- 28–34 inches, kneecap spread.
Correct answer: 12–18 inches, shoulder width.
A lift starts from a base of support as wide as the shoulders, which is 12–18 inches, shoulder width, with one foot slightly ahead of the other and the knees doing the bending. 20–26 inches, forearm length puts the feet outside the shoulders and pushes the center of gravity off the base. 28–34 inches, kneecap spread forces a straddle that strains the groin and the low back. 36–42 inches, ankle distance is a lunge, and nothing heavy can be raised safely from it.
- Using proper body mechanics is essential to avoiding injuries. The muscles most prone to injury are those in the ____.
Correct answer: Back
Whenever an aide bends at the waist or twists while carrying a load, the strain lands on the lower back, which is why the back is the region injured most often. The neck aches from looking down but is seldom torn by a lift. The knee is hurt by twisting or kneeling rather than by carrying. The foot bears weight and takes crush injuries, not muscle strain.
- The definition: “Nursing interventions that promote the residents ability to adapt and adjust to living as independently and safely as possible,” best describes ____.
- Progressive Nursing
- Residential Nursing
- Therapeutic Nursing
- Restorative Nursing
Correct answer: Restorative Nursing
Restorative Nursing is the defined area of practice whose interventions help a resident adapt to lost function and live as independently and safely as possible. Progressive Nursing is not a recognized field and names a pace rather than a goal. Therapeutic Nursing covers any treatment aimed at relieving a problem, which is far broader than adapting to permanent loss. Residential Nursing describes where the care happens rather than what it sets out to achieve.
- Why is the knowledge of common disease processes and conditions important to restorative care?
- Conditions slow progress, shape plans, and limit function.
- Conditions grade residents, order meals, and sort budgets.
- Conditions fill charts, shorten rounds, and save supplies.
- Conditions excuse effort, delay therapy, and trim contact.
Correct answer: Conditions slow progress, shape plans, and limit function.
Knowing the disease behind a disability tells the team how far a resident can be pushed, what to expect and what to watch for, because conditions slow progress, shape plans, and limit function all at the same time. Conditions fill charts, shorten rounds, and save supplies claims a paperwork benefit that has nothing to do with restorative goals. Conditions grade residents, order meals, and sort budgets describes administrative sorting rather than clinical planning. Conditions excuse effort, delay therapy, and trim contact turns a diagnosis into a reason to do less, which is the opposite of restorative practice.
- You are a nursing assistant and a resident you are assisting with ambulation has pain while using splints. The best response is to ____.
- Notify the charge nurse once the redness settles.
- Notify the charge nurse once the soreness starts.
- Notify the charge nurse once the ibuprofen helps.
- Notify the charge nurse once the nightshift ends.
Correct answer: Notify the charge nurse once the soreness starts.
Pain under a splint can mean the device is rubbing, pressing a nerve or fitted wrongly, and the damage happens quickly, so notify the charge nurse once the soreness starts is the right response. Waiting once the redness settles allows a pressure injury to form under the splint before anyone looks. Waiting once the nightshift ends holds an urgent finding back until the shift changes. Waiting once the ibuprofen helps means medication has already been given, which no aide may do.
- “To turn upward” defines which of these terms?
- Depression
- Retraction
- Supination
- Opposition
Correct answer: Supination
Supination is the movement that turns a part upward, as when the forearm rolls so the palm faces the ceiling. Retraction draws a part backward toward the spine and has no upward element. Depression moves a part downward, which is the opposite direction. Opposition carries the thumb across the palm to meet the fingers and turns nothing upward.
- What does the term PROM stand for?
- Precise repair of bones.
- Position review of mats.
- Prompt reset of muscles.
- Passive range of motion.
Correct answer: Passive range of motion.
PROM stands for passive range of motion, in which the aide carries the joint through its arc while the resident contributes none of the effort. Precise repair of bones is not what the letters stand for and describes surgery rather than an exercise. Prompt reset of muscles is not a recognized term and no muscle is reset by moving a joint. Position review of mats concerns equipment checks and has nothing to do with joint movement.
- One of the residents you care for is seeing a physical therapist. You’ve been asked to follow up with some “range of motion” activities. Which of these is the best term for this type of care?
- Residential care.
- Respiratory care.
- Nutritional care.
- Restorative care.
Correct answer: Restorative care.
Carrying on a therapist's joint work at the bedside is restorative care, whose purpose is to regain or hold on to function the resident is losing. Residential care names the setting a person lives in rather than the activity being done. Respiratory care treats breathing and airway problems. Nutritional care covers diet, intake and weight, none of which a joint exercise addresses.
- What is the difference between abduction and adduction?
- Abduction lifts the limb upward and adduction lowers it down.
- Abduction shifts the limb ahead and adduction rocks it aside.
- Abduction pulls the limb inward and adduction pushes it away.
- Abduction moves the limb outward and adduction draws it back.
Correct answer: Abduction moves the limb outward and adduction draws it back.
Abduction carries a part away from the midline of the body and adduction brings it back again, so abduction moves the limb outward and adduction draws it back is the correct pairing. Abduction lifts the limb upward and adduction lowers it down describes elevation and depression instead. Abduction shifts the limb ahead and adduction rocks it aside describes flexion and a side-to-side sway. Abduction pulls the limb inward and adduction pushes it away has both terms exactly backwards.
- Restorative care can help prevent complications that develop due to immobility, such as constipation, contractures, pressure sores, and ____.
- Loud snores.
- Scaly patch.
- Faint pulse.
- Blood clots.
Correct answer: Blood clots.
Lying still lets blood pool in the deep veins of the legs, so blood clots belong on the same list as constipation, contractures and pressure sores. Scaly patch describes dry skin, which comes from soap, low humidity and age rather than from staying in bed. Faint pulse signals a fall in circulating volume and is not produced by immobility. Loud snores come from a partly blocked airway in sleep and have no link to how much a resident moves.
- The nurse aide just admitted a new resident. Which of the following is the most restorative approach?
- Encourage the relatives to do the unpacking.
- Instruct the helper to handle the unpacking.
- Order the resident to arrange the unpacking.
- Invite the resident to assist the unpacking.
Correct answer: Invite the resident to assist the unpacking.
Restorative care has the resident do everything they still can, so invite the resident to assist the unpacking turns an admission into an activity instead of a service. Encourage the relatives to do the unpacking passes a manageable task to somebody else. Order the resident to arrange the unpacking leaves a newly admitted man alone with a job he may not finish. Instruct the helper to handle the unpacking is quick but removes the chance to take part entirely.
- An assisting device does not help with ____.
- Positioning
- Restraining
- Maneuvering
- Stabilizing
Correct answer: Restraining
Canes, reachers, braces and grab bars all exist to make a task easier to perform, and restraining does the opposite by holding a resident still against movement. Positioning is what wedges, pillows and foot boots are for. Maneuvering is precisely what a walker or a transfer board makes possible. Stabilizing is the purpose of a brace or a quad cane.
- Proper body mechanics dictates that when lifting an object, the nurse aide place his feet
- From 20 to 26 inches, angled.
- From 28 to 34 inches, braced.
- From 12 to 18 inches, spread.
- From 36 to 42 inches, turned.
Correct answer: From 12 to 18 inches, spread.
A safe lift begins with the feet about shoulder width, so from 12 to 18 inches, spread, with one foot slightly ahead of the other, is the stance body mechanics calls for. From 20 to 26 inches, angled already puts the feet outside the shoulders. From 28 to 34 inches, braced forces a straddle that loads the groin and the low back. From 36 to 42 inches, turned is a lunge, and nothing heavy can be lifted from it.
- What is the correct medical term for muscle wasting?
- Aphasia
- Myalgia
- Hypoxia
- Atrophy
Correct answer: Atrophy
Muscle that is not used shrinks and loses bulk, and the medical term for that wasting is atrophy. Myalgia means muscle pain, which may accompany wasting but names a symptom rather than the loss of tissue. Hypoxia is too little oxygen reaching the tissues. Aphasia is the loss of language and has nothing to do with muscle bulk.
- You are delegated to provide passive R.O.M. to L lower and upper extremities. This means you
- Observe the left muscles and clock fifteen timed repeats.
- Support the left joints and supply extension and flexion.
- Instruct the patient and count eleven raised left elbows.
- Stretch the right forearm and circle the left collarbone.
Correct answer: Support the left joints and supply extension and flexion.
Passive work means the aide holds and moves the joint while the resident contributes nothing, so support the left joints and supply extension and flexion is what this delegation asks for. Observe the left muscles and clock fifteen timed repeats measures activity instead of producing it. Instruct the patient and count eleven raised left elbows makes the exercise active, not passive. Stretch the right forearm and circle the left collarbone works the wrong limb and never carries the left joints through their arc.
- When the nurse aide moves a joint during ROM (range of motion) exercises, and the resident complains of pain, the nurse aide should
- Stretch the tender elbow and report to the nurse.
- Stop the action promptly and report to the nurse.
- Request the pain tablets and report to the nurse.
- Abandon the daily rounds and report to the nurse.
Correct answer: Stop the action promptly and report to the nurse.
A joint is carried only as far as it travels comfortably, and pain is the signal to go no further, so stop the action promptly and report to the nurse is the right response. Stretch the tender elbow and report to the nurse drives through the pain and can tear tissue. Request the pain tablets and report to the nurse seeks medication so the harmful stretch can continue. Abandon the daily rounds and report to the nurse gives up movement altogether, which invites the contractures the exercise prevents.
- Exercises that move each muscle and joint are called
- Base of support
- Field of vision
- Range of motion
- Point of origin
Correct answer: Range of motion
Exercises that carry every muscle and joint through the full arc it can travel are called range of motion. Base of support names the area between the feet that keeps a standing person upright. Field of vision describes how much of the surroundings a person can see. Point of origin is where a muscle anchors to bone and names an anatomical landmark rather than an exercise.
- You notice a change in a resident’s mental condition. The best course of action is to ____.
- Report the change to the night dietitian later.
- Report the change to the charge nurse promptly.
- Report the change to the kitchen team sometime.
- Report the change to the ward manager annually.
Correct answer: Report the change to the charge nurse promptly.
A shift in mental condition can be the first sign of infection, a drug reaction, a stroke or dehydration, and every one of those is time critical, so report the change to the charge nurse promptly. Report the change to the night dietitian later sends clinical information to somebody who cannot act on it. Report the change to the kitchen team sometime routes it to a department with no clinical role at all. Report the change to the ward manager annually holds an urgent finding far beyond any use.
- There are a number of common causes for constipation. Which of the following is NOT a common cause?
- A rapid rise in the bowel motions.
- A sudden fall in the fluid intake.
- A steep drop in the dietary fiber.
- A long delay in the toilet visits.
Correct answer: A rapid rise in the bowel motions.
Constipation arises when stool moves through the gut too slowly, so a rapid rise in the bowel motions speeds transit and is the one item here that does not cause it. A sudden fall in the fluid intake leaves stool dry and hard to pass. A steep drop in the dietary fiber removes the bulk that keeps stool moving. A long delay in the toilet visits lets stool sit in the rectum and dry out.
- In Elizabeth Kübler-Ross’s description of the grieving process, she states that a person goes through various stages when they lose someone close to them. She believes that the first stage of the grieving process is:
- Stage of denial
- Stage of regret
- Stage of sorrow
- Stage of relief
Correct answer: Stage of denial
Kubler-Ross put refusal to accept the loss at the beginning of grief, so stage of denial is the opening reaction before any of the others can start. Stage of sorrow corresponds to depression, which arrives late, once the loss has been felt as real. Stage of regret matches bargaining, the third of the five. Stage of relief belongs with acceptance, which closes the sequence rather than opening it.
- Encouraging your patients to take part in their care and in activities within the facility helps with their emotional and mental health needs by
- Handing a sense of duty and doubling their laundry.
- Adding a sense of muscle and raising their stamina.
- Freeing a sense of space and easing their workload.
- Building a sense of control and lifting their mood.
Correct answer: Building a sense of control and lifting their mood.
The hardest part of needing care is the loss of independence, so building a sense of control and lifting their mood is exactly how taking part meets emotional and mental needs. Handing a sense of duty and doubling their laundry turns participation into an obligation the patient did not choose. Adding a sense of muscle and raising their stamina is a physical gain rather than an emotional one. Freeing a sense of space and easing their workload puts staff convenience ahead of what the patient needs.
- One of your patients is pacing around, yelling and screaming. He is even blurting out profanities. What is the FIRST action that a nursing assistant should take in this type of situation?
- Call the nurse tonight, reporting routine bathing habits.
- Call the nurse later, requesting padded wrist restraints.
- Call the nurse now, seeking immediate clinical direction.
- Call the nurse afterward, noting shouted profane remarks.
Correct answer: Call the nurse now, seeking immediate clinical direction.
Calling the nurse now, seeking immediate clinical direction is the first action, because the aide may not judge or treat sudden agitation and the nurse can evaluate him and decide what the team should do. Calling the nurse tonight about routine bathing habits carries the wrong information at the wrong moment and leaves him unsupervised while he is escalating. Calling the nurse later to request padded wrist restraints is wrong twice over, since restraints need a physician order and are not a response to shouting. Calling the nurse afterward to note the shouted remarks records the episode once the danger has passed instead of getting help during it.
- Your patient catches you off guard with a sexual comment. Your best response to them should be:
- Reassure your patient that the comment is innocuous.
- Remind your patient that the sunshine is delightful.
- Convince your patient that the hallway is clamorous.
- Inform your patient that the remark is unacceptable.
Correct answer: Inform your patient that the remark is unacceptable.
Telling the patient plainly that the remark is unacceptable sets the boundary he needs for future behavior, and the incident is then reported to the supervising nurse so it can be documented. Reassuring him that the comment is innocuous rewards the behavior and invites more of it. Reminding him that the sunshine is delightful steers onto small talk and leaves the behavior unaddressed. Claiming the hallway is clamorous pretends the remark was never heard, which is the same avoidance and also leaves no record.
- Your patient’s family member is upset that their loved one is unhappy at the facility. As the patient’s nursing assistant, the best way for you to handle this situation is:
- Hear their concerns, then brief the nurse promptly.
- Delay their concerns, then page the nurse tomorrow.
- Refuse their concerns, then send the nurse letters.
- Dismiss their concerns, then cite the nurse policy.
Correct answer: Hear their concerns, then brief the nurse promptly.
Hearing their concerns and then briefing the nurse promptly is the aide's role: the family is listened to courteously and the information reaches the person who can act on it. Delaying the conversation and paging the nurse tomorrow stalls a family that is already upset and lets the problem sit overnight. Refusing to hear them and asking for written letters sounds dismissive and blocks any further conversation. Quoting nurse policy at them implies their upset is unjustified and offers no path to a resolution.
- Out of the four choices below, which could be a primary contributing factor to a patient’s resentment towards their family members?
- The patient is feeling abandoned after entering care.
- The patient is missing gatherings after leaving home.
- The patient is skipping worship after changing homes.
- The patient is mourning birthdays after moving rooms.
Correct answer: The patient is feeling abandoned after entering care.
Feeling abandoned after entering care is the primary driver: being handed into a stranger's keeping when relatives can no longer manage at home is frightening, and it is not a move the patient would have chosen. Missing gatherings after leaving home is a real loss but it is a loss of routine, not a sense of being given away. Skipping worship after changing homes is likewise a change of habit that visitors or facility services can restore. Mourning birthdays after moving rooms is sadness about an occasion rather than resentment aimed at relatives.
- From time-to-time, nursing assistants will encounter residents who are feeling anxious or unsettled about their surroundings or circumstances. The best way that you can help them deal with their anxiety is:
- Distract your patient by playing the bedside radio.
- Energize your patient by opening the window blinds.
- Comfort your patient by choosing the calmest voice.
- Isolate your patient by shutting the corridor door.
Correct answer: Comfort your patient by choosing the calmest voice.
Comforting the patient by choosing the calmest voice works because the aide's own manner is itself a stimulus: a quiet, unhurried tone lowers the level of stimulation around an anxious person and settles them. Playing the bedside radio adds noise to an environment that is already overloading them. Opening the window blinds floods the room with light and adds one more thing to react to. Shutting the corridor door and withdrawing leaves an already frightened person alone with the feeling, which usually deepens it.
- Which of the following is an absolutely inappropriate way to deal with the stress of being a caregiver?
- Finishing crosswords with neighbors during lunch.
- Organizing vacations with relatives during lunch.
- Discussing patients with colleagues during lunch.
- Practicing watercolors with friends during lunch.
Correct answer: Discussing patients with colleagues during lunch.
Discussing patients with colleagues during lunch is the inappropriate one. Trading similar problems with peers can be helpful, but naming the people in your care over a meal, in a place where others can hear, breaches their confidentiality no matter how well meant it is. Finishing crosswords with neighbors is a quiet hobby that takes the mind off the shift. Organizing vacations with relatives builds a life outside work. Practicing watercolors with friends is both a new skill and a social outlet. All three release stress without exposing anything about a resident.
- Empathy is a characteristic that helps a nursing assistant care for their patients. Which of the following is the best example of a definition of this term?
- Imagining all the pressures that the other resident faces.
- Weighing all the comments that the other listeners absorb.
- Showing all the qualities that the other choices describe.
- Grasping all the causes that the other behaviors indicate.
Correct answer: Showing all the qualities that the other choices describe.
Empathy is the whole of it, so showing all the qualities that the other choices describe is the best definition. Weighing the comments that listeners absorb is only the self-awareness part of empathy, and taken alone it stops at watching your own words. Imagining the pressures a resident faces is only the perspective-taking part, and by itself it says nothing about how you then behave. Grasping the causes that behaviors indicate is only the interpretive part, and it can be done coldly. Each is a genuine facet, which is exactly why no single one of them is the full definition.
- One of your patients just found out that one of their family members has passed away. What is the best way that you can assist them with their grieving process?
- Sit beside your patient, offering unhurried support.
- Sit beside your patient, imagining happier thoughts.
- Sit beside your patient, downplaying certain losses.
- Sit beside your patient, demanding prompt composure.
Correct answer: Sit beside your patient, offering unhurried support.
Sitting beside the patient and offering unhurried support is what helps: given time and an unhurried listener, a grieving person will say what they are feeling, and that is the work of grief. Imagining happier thoughts asks them to look away from the loss instead of through it. Downplaying certain losses tells them the death matters less than it does. Demanding prompt composure treats their sadness as a behavior problem. All three leave the patient feeling that their grief has been dismissed.
- When a patient is dying, which of the five senses do they lose last?
- Seeing shadows
- Tasting sweets
- Feeling warmth
- Hearing sounds
Correct answer: Hearing sounds
Hearing sounds is the ability that remains longest in a dying patient. This is why families and visitors are told to keep speaking normally at the bedside and to avoid saying anything in the room they would not want heard: the patient may no longer be able to answer and still take in every word. Seeing shadows fades early as vision dims, tasting sweets goes as appetite and oral intake stop, and feeling warmth diminishes as circulation to the skin falls away.
- If your patient regularly becomes increasingly confused during dusk, early evening or during the night, they are most likely suffering from:
- Sundowner Syndrome
- Episodic Psychosis
- Senile Melancholia
- Early Parkinsonism
Correct answer: Sundowner Syndrome
Sundowner Syndrome is the term for confusion that reliably worsens at dusk and through the evening and night; the timing is what names it. Early Parkinsonism brings tremor, stiffness and slowed movement, and any confusion it causes is not tied to the hour. Episodic Psychosis brings hallucinations or fixed false beliefs that are not tied to a clock. Senile Melancholia describes low mood in an older adult, not a daily pattern of disorientation.
- Your patient is showing signs of a change in their mental health. The best course of action for you as their nursing assistant to take would be:
- Tell the nurse later, sharing the cheeriest stories.
- Tell the nurse now, describing the altered behavior.
- Tell the nurse tomorrow, planning the longer visits.
- Tell the nurse today, quizzing the confused patient.
Correct answer: Tell the nurse now, describing the altered behavior.
Telling the nurse now and describing the altered behavior is the required action, because a shift in mental state can be the first sign of infection, medication trouble or another problem the nurse must assess while it is still small. Telling the nurse later and sharing cheerful stories substitutes a kindness for a clinical report. Telling the nurse tomorrow and planning longer visits gives extra attention but delays the information a whole day. Telling the nurse today after quizzing the confused patient relies on a person who may not perceive the change at all, or may deny it.
- Your patient is progressively getting frustrated. He is upset and begins to raise his voice. Which of the following would be the best way to respond to his behavior?
- Silence him firmly, protecting nearby residents.
- Report him quickly, alerting supervising nurses.
- Abandon him awhile, proving personal boundaries.
- Comfort him patiently, offering genuine support.
Correct answer: Comfort him patiently, offering genuine support.
Comforting him patiently and offering genuine support is the best response, since a calm, caring manner shows concern for what is behind the frustration and usually lowers the volume on its own. Silencing him firmly to protect nearby residents makes his complaint the problem and will raise his voice further. Abandoning him awhile to prove personal boundaries leaves the frustration unaddressed and can read as punishment. Reporting him quickly to supervising nurses hands the situation on without the aide ever responding to the person in front of them.
- Which of the symptoms below is NOT a sign of depression?
- Your patient shows shrinking appetite at mealtimes.
- Your patient shows growing interest at festivities.
- Your patient shows lengthening slumber at naptimes.
- Your patient shows deepening withdrawal at bedtime.
Correct answer: Your patient shows growing interest at festivities.
A patient who shows growing interest at festivities is not displaying depression; in depression the wish to take part in social life falls away rather than rises, so this is the one that is not a sign. Shrinking appetite at mealtimes, lengthening slumber at naptimes and deepening withdrawal at bedtime are all recognized signs, covering the eating, sleeping and social changes that depression typically brings.
- Your patient is upset because he has learned that his roommate has passed away. He would like to discuss this with you. What is the best course of action for you to take?
- Allow your patient to voice the buried feelings.
- Ask your patient to hear the personal anecdotes.
- Push your patient to discuss the lighter topics.
- Urge your patient to accept the natural outcome.
Correct answer: Allow your patient to voice the buried feelings.
Allowing the patient to voice the buried feelings is the right course: saying it out loud is how he will begin to cope, and it also tells the aide whether counseling should be arranged. Urging him to accept the natural outcome closes the subject with a platitude. Asking him to hear the aide's personal anecdotes turns his loss into someone else's story. Pushing him toward lighter topics denies that anything happened. All three tell him his feelings are unwelcome.
- Our bodies naturally change due to the aging process. Which of the following is NOT a normal biological change?
- The digestive system slows and stalls.
- The decision skills weaken and falter.
- The finger joints stiffen and tighten.
- The skeletal bones narrow and crumble.
Correct answer: The decision skills weaken and falter.
Decision skills that weaken and falter are not part of ordinary aging; that points to disease, most often a dementia, and it should be reported rather than accepted as expected. A digestive system that slows and stalls, finger joints that stiffen and tighten, and skeletal bones that narrow and crumble are all changes the body makes with age in healthy people.
- There are a number of ways that a nursing assistant may help their patient who is dealing with their impending death. All of the following are correct methods EXCEPT:
- Granting your patient private time daily.
- Paying your patient shorter visits daily.
- Offering your patient longer hours daily.
- Lending your patient quiet company daily.
Correct answer: Paying your patient shorter visits daily.
Paying the patient shorter visits is the method that does not belong. Cutting back the time you spend is meant to relieve the patient of having to be sociable, but a dying person left alone more often simply feels more isolated, and isolation is the thing this care is supposed to prevent. Granting private time daily respects a request the patient actually makes. Offering longer hours daily makes support available when it is wanted. Lending quiet company daily gives the patient someone to talk to, or simply not to be alone with, which is what most of them ask for.
- Your patient recently learned that her spouse had passed away. What is the best way for the nursing assistant to deal with the patient?
- Gather neighbors and crowd lonely hours.
- Stay nearby and offer steadfast comfort.
- Joke loudly and brighten solemn moments.
- Dodge topics and redirect tearful talks.
Correct answer: Stay nearby and offer steadfast comfort.
Staying nearby and offering steadfast comfort is the right approach: a widow may need to talk about her husband and her memories of him, and often the presence of someone unhurried is the whole of what she needs. Joking loudly to brighten solemn moments asks her to perform cheerfulness she does not feel. Gathering neighbors to crowd lonely hours fills the room with people at a time she may want no company at all. Dodging topics and redirecting tearful talks keeps her from doing the grieving she has to do.
- While helping a resident, the resident hits you. What should you do?
- Ask the nurse tomorrow about the scratches.
- Notify the nurse someday about the quarrel.
- Tell the nurse promptly about the incident.
- Alert the nurse quickly about the mealtime.
Correct answer: Tell the nurse promptly about the incident.
Telling the nurse promptly about the incident is what you do after a resident strikes you. The nurse decides whether an incident report is needed, whether you require treatment and what in the resident's condition might explain the behavior. Asking the nurse tomorrow about the scratches waits a full shift and reduces an assault to a skin mark. Alerting the nurse quickly about the mealtime is timely but reports the wrong thing entirely. Notifying the nurse someday about the quarrel both delays the report and reframes being hit as a disagreement.
- If an alert and oriented client touches a nurse aide inappropriately, the nurse aide’s BEST response is to
- Slap hands and shame the client sharply.
- Step backward and ask the client firmly.
- Cite rules and warn the client severely.
- Drop duties and desert the client today.
Correct answer: Step backward and ask the client firmly.
Stepping backward and asking the client firmly to stop is the best response. An alert, oriented client can understand a clear boundary, and moving out of reach while stating it plainly ends the contact without punishing the person. Slapping hands and shaming the client sharply is itself abuse and is never permitted. Citing rules and warning the client severely turns the aide into an enforcer of penalties, which is not the aide's role. Dropping duties and deserting the client today is abandonment, and the care still has to be given.
- Mrs. Melvin is a demanding patient who is difficult to please. Which of the following would be appropriate for you to do when caring for Mrs. Melvin?
- Before leaving, ask Mrs. Melvin about unmet requests.
- Before leaving, warn Mrs. Melvin about lengthy waits.
- Before leaving, tell Mrs. Melvin about bathing times.
- Before leaving, remind Mrs. Melvin about sicker folk.
Correct answer: Before leaving, ask Mrs. Melvin about unmet requests.
Asking Mrs. Melvin about unmet requests before you leave is the appropriate action. A demanding manner is usually anxiety, loneliness or fear rather than anything aimed at you, and inviting her to name what she still needs settles her and cuts down on repeat calls. Warning her about lengthy waits tells her in advance that she will be left waiting. Telling her about bathing times hands her schedule to your convenience and removes what little control she has. Reminding her about sicker folk makes her feel she is a burden for asking at all.
- Whenever a patient visits the care facility for a short period of time only, to give their usual caregivers a ‘break,’ this is called
- Restorative care
- Residential care
- Therapeutic care
- Progressive care
Correct answer: Therapeutic care
Therapeutic care is the term keyed for this kind of stay. Restorative care is the continuing work of helping a resident regain or hold on to function such as walking, dressing and self-feeding, and it is not defined by how long the stay lasts. Residential care names a permanent living arrangement, which is the opposite of a stay of a few days. Progressive care describes a step-down unit for patients who still need close monitoring after intensive treatment. None of those three names a brief admission arranged so that the people who normally give the care can rest.
- Which of these is not a sign of depression?
- Deeper slumber at daybreak.
- Keener interest at outings.
- Shorter replies at bedside.
- Smaller portions at supper.
Correct answer: Keener interest at outings.
Keener interest at outings is not a sign of depression. A depressed person's wish to join in falls off rather than sharpens, so rising enthusiasm for activities points away from the diagnosis. Deeper slumber at daybreak is the increase in sleeping that commonly goes with depression. Smaller portions at supper is the loss of appetite. Shorter replies at bedside is withdrawal from the people around them. Those three are among the most familiar signs.
- Elizabeth Kübler-Ross describes the stages of grief a person goes through when they lose someone close to them. She believes the first stage of the grieving process is ____.
- Bitter anger
- Quiet sorrow
- Final assent
- Blunt denial
Correct answer: Blunt denial
Blunt denial is the first reaction Kubler-Ross describes: the news is refused outright before it can be felt. Bitter anger is the stage that follows once the refusal gives way. Quiet sorrow is the depression that settles in later, when the loss is no longer being fought. Final assent is acceptance, the last stage rather than the first. People usually pass through all of them, but denial comes first.
- A resident who consistently becomes more confused during dusk, early evening, or during the night is most likely suffering from ____.
- Frontal Dementia
- Toxic Depression
- Sundown Syndrome
- Chronic Paranoia
Correct answer: Sundown Syndrome
Sundown Syndrome is the name for disorientation that appears as the light fades and runs through the evening and night. What identifies it is the clock, not the severity. Frontal Dementia causes confusion and personality change that persist all day. Toxic Depression describes low mood, which is not the same as disorientation. Chronic Paranoia involves fixed suspicion of other people rather than a nightly loss of bearings.
- A resident died and his roommate is upset and wants to discuss it with you. What is the best action to take?
- Encourage him quietly, welcoming honest mourning.
- Interrupt him loudly, recounting personal losses.
- Console him briskly, reciting hopeful platitudes.
- Distract him swiftly, mentioning cheery pastimes.
Correct answer: Encourage him quietly, welcoming honest mourning.
Encouraging him quietly and welcoming honest mourning is the best action. Talking about the roommate is how he works through what he feels, and it also shows you whether counseling or follow-up should be arranged. Consoling him briskly with hopeful platitudes shuts the conversation before it starts. Interrupting him loudly to recount personal losses makes the aide the subject. Distracting him swiftly with cheery pastimes denies the death altogether. None of those three is therapeutic for him.
- Which of these is not a common cause of constipation?
- Inadequate hydration routines.
- Insufficient dietary roughage.
- Suppressed defecation signals.
- Increased intestinal motility.
Correct answer: Increased intestinal motility.
Increased intestinal motility is not a cause of constipation. Stool hardens when it moves too slowly through the bowel, so speeding the bowel up produces the opposite problem, loose stool. Insufficient dietary roughage leaves too little bulk to move things along. Suppressed defecation signals let stool sit and dry out because the urge was put off. Inadequate hydration routines leave the stool without the water it needs to stay soft. Those three are among the most common causes seen in long-term care.
- A resident in your care is frustrated, upset, and raising his voice in complaint. Which of these is the best response to his actions?
- Quit mealtime duties with a curt farewell.
- Offer steady support with a gentle manner.
- Demand quieter volume with a stern rebuke.
- Alert nearby nurses with a written report.
Correct answer: Offer steady support with a gentle manner.
Offering steady support with a gentle manner is the best response, because it shows the resident that his needs matter and a calm approach usually brings the volume down by itself. Demanding quieter volume with a stern rebuke treats his complaint as misbehavior and is likely to raise it further. Quitting mealtime duties with a curt farewell walks away from a resident who still needs care and leaves the complaint unheard. Alerting nearby nurses with a written report passes the moment along without anyone responding to the man who is upset right now.
- A resident is pacing around his room, yelling and swearing. What is the first action the nursing assistant should take?
- Badgering the charge nurse about laundry.
- Emailing the charge nurse about tomorrow.
- Urging the charge nurse about restraints.
- Calling the charge nurse about agitation.
Correct answer: Calling the charge nurse about agitation.
Calling the charge nurse about the agitation is the first action. The nurse can assess the resident, give medication if it is ordered, and bring in whoever else is needed; none of that is within the aide's scope. Badgering the charge nurse about laundry reports something irrelevant while the resident is still shouting. Urging the charge nurse about restraints asks for a measure that needs a physician order and is not a response to shouting. Emailing the charge nurse about tomorrow uses the slowest possible channel for something happening now.
- All of these are ways that a nursing assistant can help a resident who is dealing with his or her impending death, except ____.
- Scheduling shortened visits for the resident.
- Arranging solitary evenings for the resident.
- Providing unhurried company for the resident.
- Reserving frequent mornings for the resident.
Correct answer: Scheduling shortened visits for the resident.
Scheduling shortened visits for the resident is the one that does not help. Cutting your time short is meant to spare a dying resident the effort of being sociable, but what it actually produces is more time alone, and isolation is the thing this care exists to prevent. Providing unhurried company gives the resident someone to talk through their fears with. Arranging solitary evenings honors a request the resident has made. Reserving frequent mornings makes support available whenever it is wanted.
- A resident catches you off guard with a comment that is sexual. Your best response would be to ____.
- Leave silently and ignore the episode.
- Recoil sharply and scold the resident.
- Answer wittily and deflect the remark.
- Gossip freely and amuse the neighbors.
Correct answer: Answer wittily and deflect the remark.
Answering wittily and deflecting the remark is the response keyed here: a light reply turns the comment aside in the moment without shaming the resident. Leaving silently and ignoring the episode lets the behavior stand unaddressed and leaves nothing on the record. Recoiling sharply and scolding the resident punishes a person who may have little control over what they say. Gossiping freely to amuse the neighbors breaches confidentiality and humiliates the resident. Whatever is said at the time, the incident is still passed to the supervising nurse so that it is documented.
- Mrs. Lee is showing signs of anxiety by repeatedly using the call signal and is sharp with you when you respond. What is your best course of action?
- Quote Mrs. Lee workloads and illness coldly.
- Remove Mrs. Lee buzzers and cables entirely.
- Offer Mrs. Lee choices and control promptly.
- Label Mrs. Lee hostile and seek replacement.
Correct answer: Offer Mrs. Lee choices and control promptly.
Offering Mrs. Lee choices and control promptly is the best course. Anxiety is what makes a client seem demanding and sharp, and giving her a say in how and when her care happens reduces the helplessness that drives the repeated calls. Removing her buzzers and cables strips away her only means of summoning help and is unsafe as well as unkind. Quoting workloads and illness coldly tells her that her needs rank below everyone else's. Labeling her hostile and seeking replacement treats a symptom of anxiety as a personal grudge and leaves the cause untouched.
- A client looks forward to playing Bingo each morning. The best action for the nurse aide is to
- Announce the shortage before the Bingo hour.
- Delegate the bathtime before the Bingo hour.
- Mention the oversight before the Bingo hour.
- Complete the routines before the Bingo hour.
Correct answer: Complete the routines before the Bingo hour.
Completing the routines before the Bingo hour is the best action: the aide arranges the bathing and dressing around what matters to the client, so the client is ready and the activity is not lost. Announcing a shortage of time warns the client in advance that the thing they look forward to may not happen. Mentioning an oversight and offering tomorrow costs the client a day of something that supports self-esteem. Delegating the bathtime pushes work onto a client who may not be able to manage it and still risks missing the game.
- If a resident refuses to eat a certain food because of a religious preference, the CNA should
- Notify the dietitian about the dietary restriction.
- Alert the dietitian about the identical selections.
- Consult the dietitian about the borrowed leftovers.
- Contact the dietitian about the homemade groceries.
Correct answer: Notify the dietitian about the dietary restriction.
Notifying the dietitian about the dietary restriction is what the aide should do. Faith-based diets can forbid certain foods, require particular preparation or call for fasting, and the dietitian is the person who builds a compliant tray. Consulting about borrowed leftovers means assembling a meal from what other residents did not eat, which is unsafe and undignified. Alerting about identical selections asserts that every tray is the same, which sidesteps the need instead of meeting it. Contacting about homemade groceries hands the facility's responsibility to the family.
- Nurse aides can provide a client with a sense of security by
- Broadcasting serials and newscasts throughout.
- Explaining routines and procedures beforehand.
- Abandoning bedrooms and corridors soundlessly.
- Exchanging grievances and complaints overhead.
Correct answer: Explaining routines and procedures beforehand.
Explaining routines and procedures beforehand is what gives a client a sense of security. Knowing what is about to happen, and being invited to ask about it, removes the fear that comes from being handled without warning. Broadcasting serials and newscasts throughout fills the room with noise and hides the aide's voice. Exchanging grievances and complaints overhead talks across the client as though they were furniture. Abandoning bedrooms and corridors soundlessly leaves the client with no idea whether anyone is coming back.
- As a nursing assistant, you may encounter residents who are anxious or feeling unsettled about either their circumstances or surroundings. The best response in dealing with this anxiety is to ____.
- Blare the television and fill the quiet.
- Exit the doorway and leave the resident.
- Open the curtains and flood the bedroom.
- Soften the speech and steady the manner.
Correct answer: Soften the speech and steady the manner.
Softening the speech and steadying the manner is the best response to anxiety, because lowering the stimulation around an unsettled resident is what brings relief, and the aide's own voice and bearing are part of that stimulation. Opening the curtains and flooding the bedroom adds glare and one more change to absorb. Exiting the doorway and leaving the resident removes the one calming presence in the room. Blaring the television and filling the quiet piles noise onto an environment that is already too much.
- A resident in your care has just received news of a death in the family. What is the best way to assist them with the grieving process?
- Recounting personal bereavements beside the resident.
- Repeating gloomy inevitabilities beside the resident.
- Offering unhurried companionship beside the resident.
- Suggesting delightful diversions beside the resident.
Correct answer: Offering unhurried companionship beside the resident.
Offering unhurried companionship beside the resident is the best way to help. Time and an unhurried listener are what let a grieving person put their feelings into words, and that is how the grieving gets done. Recounting personal bereavements turns the conversation toward the aide's own history. Repeating gloomy inevitabilities reduces the death to something that was always going to happen. Suggesting delightful diversions asks the resident to look away from a loss they need to face. All three discount what the resident is feeling right now.
- One of the caring characteristics that helps a nursing assistant care for residents is empathy. Which of these is the best definition of this term?
- Monitoring what the listener absorbs.
- Doing what the alternatives describe.
- Envisioning what the resident senses.
- Unpacking what the misbehavior means.
Correct answer: Doing what the alternatives describe.
Empathy is the sum of the parts, so doing what the alternatives describe is the best definition. Monitoring what the listener absorbs is only the self-awareness piece, which on its own stops at your own words. Envisioning what the resident senses is only the perspective-taking piece, and it says nothing about what you do next. Unpacking what the misbehavior means is only the interpretive piece, and it can be done without any warmth at all. Each of the three is genuine, and that is precisely why none of them alone defines the term.
- A good listening approach to use when communicating with residents is to
- Sit alongside the resident attentively.
- Lecture toward the resident constantly.
- Gaze beyond the resident indifferently.
- Stand behind the resident persistently.
Correct answer: Sit alongside the resident attentively.
Sitting alongside the resident attentively is the good listening approach. Putting yourself at the resident's eye level signals that you have time, and residents rate the quality of their care higher when staff sit with them rather than loom over them. Standing behind the resident persistently puts you where they cannot see you. Lecturing toward the resident constantly fills the space with advice instead of leaving room for them to speak. Gazing beyond the resident indifferently withholds the eye contact that shows you are listening at all.
- Which of these is not an appropriate way to deal with the stress of being a caregiver?
- Walking windswept pathways after the shift.
- Sketching quiet landscapes after the shift.
- Joining neighborhood clubs after the shift.
- Trading patient complaints after the shift.
Correct answer: Trading patient complaints after the shift.
Trading patient complaints after the shift is the one that is not appropriate. Comparing problems with peers can genuinely relieve pressure, but the moment the talk is about the people in your care it becomes a breach of their privacy, and going off duty does not change that. Sketching quiet landscapes is a new skill and an absorbing one. Joining neighborhood clubs builds a life away from the job. Walking windswept pathways gives exercise and fresh air. All three discharge stress without involving a resident at all.
- Which of these could be a major contributing factor to a resident’s resentment of family members?
- A sense of neglect after being alone in yearly celebrations.
- A sense of unrest after being excluded from weekly services.
- A sense of abandonment after being placed in strangers care.
- A sense of regret after being absent from family gatherings.
Correct answer: A sense of abandonment after being placed in strangers care.
The strongest driver of resentment toward family is a sense of abandonment after being placed in strangers care, because the move is often decided for the resident rather than with the resident. A sense of neglect after being alone in yearly celebrations is a single missed occasion, not a lasting grievance. A sense of unrest after being excluded from weekly services is a spiritual loss the resident usually does not blame on family. A sense of regret after being absent from family gatherings is ordinary homesickness rather than resentment.
- When a patient is dying, the last of the five senses the patient loses is ____?
- Hearing spoken words
- Seeing bright lights
- Tasting salted foods
- Feeling gentle touch
Correct answer: Hearing spoken words
Hearing spoken words is the last sense a dying patient loses, which is why staff and visitors should keep speaking gently even when the patient can no longer answer. Seeing bright lights fades early as vision dims and the eyes stop tracking. Tasting salted foods fades as intake stops and the mouth dries. Feeling gentle touch dulls as circulation and skin sensation drop off before hearing does.
- Encouraging residents to participate in their care and in activities helps with emotional and mental health needs by ____.
- Building their muscle strength and walking stride.
- Enforcing their tasks and strict daily timetables.
- Easing their caregivers chores and routine duties.
- Improving their own independence and calm outlook.
Correct answer: Improving their own independence and calm outlook.
Participation helps emotional and mental health mainly by improving their own independence and calm outlook, since loss of independence is the hardest part of relying on others. Building their muscle strength and walking stride is a physical gain and does not answer the emotional need in the question. Easing their caregivers chores and routine duties is a staffing convenience and is not a reason to involve a resident in care. Enforcing their tasks and strict daily timetables adds pressure and can worsen mood rather than lift it.
- A nurse aide who is active in her church is assigned to care for a client who is not a member of any religious group. The nurse aide SHOULD
- Invite the pastor a parish sends and do not stop to discuss it
- Explain the comfort a prayer gives and do not wait to share it
- Respect the belief a person voices and do not try to change it
- Insist the guidance a church offers and do not fail to seek it
Correct answer: Respect the belief a person voices and do not try to change it
The nurse aide should respect the belief a person voices and do not try to change it, because compassionate care means keeping an open mind and never promoting a religion the client did not choose. Inviting the pastor a parish sends and not stopping to discuss it imposes the aides own practice on someone who never requested it. Explaining the comfort a prayer gives and not waiting to share it moves the focus off the client and onto the aide. Insisting the guidance a church offers and not failing to seek it is persuasion toward a belief the client has not chosen.
- A family member is angry that her loved one is unhappy. As a nursing assistant, the best way to handle the situation is to ____.
- Ask her to tell the nurse herself about the concerns you will write
- Leave the room and tell the nurse her concerns can wait another day
- Tell her that the nurse will not hear her concerns from other staff
- Listen politely and tell her you will put her concerns to the nurse
Correct answer: Listen politely and tell her you will put her concerns to the nurse
The best handling is to listen politely and tell her you will put her concerns to the nurse, which leaves the family member feeling heard and routes the problem to the person who can act on it. Asking her to tell the nurse herself about the concerns you will write pushes the complaint back onto her and reads as a brush-off. Leaving the room and telling the nurse her concerns can wait another day delays a complaint that needs attention now and implies she is wrong to be upset. Telling her that the nurse will not hear her concerns from other staff denies her the listening ear an aide can and should give.
- A resident recently learned that her spouse has died. The best response the nursing assistant can give is to ____.
- Bring new and old visitors when the resident wants busy company.
- Joke and lighten the mood when the resident becomes very silent.
- Sit and give calm comfort when the resident shares sad memories.
- Switch the subject and chat when the resident sheds quiet tears.
Correct answer: Sit and give calm comfort when the resident shares sad memories.
The best response is to sit and give calm comfort when the resident shares sad memories, because a grieving resident most often needs a quiet presence and a willing listener. Joking and lightening the mood when the resident becomes very silent makes light of a real loss. Bringing new and old visitors when the resident wants busy company crowds the room with people who may not know what to say. Switching the subject and chatting when the resident sheds quiet tears blocks the grieving the resident has to do.
- Which of these is not a normal biological change to the body from the aging process?
- Joint motions become stiffer and less flexible.
- Decision skills become weaker and less certain.
- Bone tissues become thinner and less resilient.
- Food movements become slower and less complete.
Correct answer: Decision skills become weaker and less certain.
Decision skills become weaker and less certain is the change that does not belong, because losing the ability to decide points to disease such as dementia rather than to ordinary aging. Joint motions become stiffer and less flexible with age as cartilage thins. Bone tissues become thinner and less resilient as density falls. Food movements become slower and less complete because peristalsis slows with age. Those three are expected biological changes.
- When encountering residents with culturally or linguistically diverse backgrounds, one of the actions that can help caregivers provide effective care is to ____.
- Avoid diverse residents and withdraw when uneasy feelings grow fast.
- Ask available coworkers and aides when diverse residents seem harsh.
- Recognize when bias touches diverse residents and block unfair acts.
- Speak slowly and loudly when greeting diverse frail residents daily.
Correct answer: Recognize when bias touches diverse residents and block unfair acts.
Effective care starts when caregivers recognize when bias touches diverse residents and block unfair acts, since prejudice is corrected only once it is noticed. Avoiding diverse residents and withdrawing when uneasy feelings grow fast denies those residents equal care. Asking available coworkers and aides when diverse residents seem harsh hands off a duty that belongs to you. Speaking slowly and loudly when greeting diverse frail residents daily treats an accent as a hearing problem and is offensive in many cultures.
- A residents family is visiting and it is time to perform a procedure. The family asks for time to pray with the resident. Which of these is not an acceptable response?
- Ask the family and the resident careful questions, but step outside so the room stays silent.
- Give the family and the resident quiet minutes, but come back so the paused procedure starts.
- Tell the family and the resident the aide returns soon, but pause so prayer feels untroubled.
- Send the family away so the procedure proceeds promptly, but let the resident kneel and pray.
Correct answer: Send the family away so the procedure proceeds promptly, but let the resident kneel and pray.
Sending the family away so the procedure proceeds promptly, but letting the resident kneel and pray, is the response that is not acceptable, because it overrides a request for shared prayer for the sake of a schedule that can usually wait. Asking the family and the resident careful questions, but stepping outside so the room stays silent, answers their worry and still grants the request. Giving the family and the resident quiet minutes, but coming back so the paused procedure starts, respects the same right. Telling the family and the resident the aide returns soon, but pausing so prayer feels untroubled, does the same.
- Talking to residents about spiritual beliefs can have an effect on ____.
- Every one of the three possible influences.
- Every shift in the residents lung capacity.
- Every part of the residents mental welfare.
- Every bond the resident feels toward staff.
Correct answer: Every one of the three possible influences.
Letting a resident speak about spiritual beliefs touches every one of these three listed influences, so the broad answer is the right one. Every part of the residents mental welfare is affected, but so is more than that. Every shift in the residents lung capacity is too narrow a reading of physical health, yet physical health is affected as well. Every bond the resident feels toward staff also grows when beliefs are heard, so no single option is complete on its own.
- As a nursing assistant there are ways you can help a resident meet his or her spiritual needs. Which of these would discourage, rather than encourage them?
- You stay and listen as a resident tells you his own religious experience.
- You tell a resident you are simply forbidden to discuss his own religion.
- You are gracious when a visitor requests privacy to pray with his sister.
- You assist when a resident asks you to contact his own hospital chaplain.
Correct answer: You tell a resident you are simply forbidden to discuss his own religion.
Telling a resident you are simply forbidden to discuss his own religion is the one response that discourages spiritual expression, and it is also untrue, since an aide may let a resident talk freely about belief. Staying and listening as a resident tells you his own religious experience gives the resident an audience. Being gracious when a visitor requests privacy to pray with his sister protects that right. Assisting when a resident asks you to contact his own hospital chaplain carries out the residents own wish.
- Which of these is true about spirituality in a care facility?
- A nursing assistant should share his or her own convictions when a resident is failing.
- An employee has an ethical obligation to share his or her religion when belief weakens.
- A family should seize control of his or her religious choices when the visitors arrive.
- A resident has the right to practice his or her religious beliefs when others disagree.
Correct answer: A resident has the right to practice his or her religious beliefs when others disagree.
A resident has the right to practice his or her religious beliefs when others disagree, and that right holds no matter what the rest of the building believes. A nursing assistant should share his or her own convictions when a resident is failing describes persuasion rather than care, and a dying person is the least able to refuse it. An employee has an ethical obligation to share his or her religion when belief weakens invents a duty that no facility places on staff. A family should seize control of his or her religious choices when the visitors arrive moves the decision away from the person whose beliefs they are.
- Which of these is true about cultural awareness in a care facility?
- Cultural awareness belongs inside staff training because homes treat whole people well.
- Cultural awareness gets dropped first because rising costs strain the operating budget.
- Cultural awareness fails in growing buildings because so many residents need attention.
- Cultural awareness stays beyond reach because thin staffing keeps the units overloaded.
Correct answer: Cultural awareness belongs inside staff training because homes treat whole people well.
Cultural awareness belongs inside staff training because homes treat whole people well, and a facility that claims to treat the whole person cannot leave beliefs and customs out of what it teaches its staff. Cultural awareness stays beyond reach because thin staffing keeps the units overloaded treats a courtesy that costs no extra hands as though it needed them. Cultural awareness gets dropped first because rising costs strain the operating budget turns a resident right into a line item. Cultural awareness fails in growing buildings because so many residents need attention would excuse the largest facilities from the duty they most need.
- Participation in religious activities can provide all of these important patient benefits, except ____.
- Promoting the social contact the CNA arranges inside a friendly club.
- Reducing the isolation the CNA spots whenever a resident lives alone.
- Increasing a quiet belonging the CNA notices amid shared group meals.
- Allowing the CNA additional spare time beyond a crowded shift roster.
Correct answer: Allowing the CNA additional spare time beyond a crowded shift roster.
Allowing the CNA additional spare time beyond a crowded shift roster is the benefit that does not belong, because activities are planned for the resident and never as a staffing convenience. Reducing the isolation the CNA spots whenever a resident lives alone is a real gain for the resident. Increasing a quiet belonging the CNA notices amid shared group meals is another. Promoting the social contact the CNA arranges inside a friendly club is a third. All three of those serve the resident rather than the schedule.
- How is family an important part of cultural awareness?
- Every culture is apt to read the caregivers role uniquely.
- Every culture holds its own settled views of gender roles.
- Every one of the three listed statements is totally right.
- Every faith fixes limits on how much care families permit.
Correct answer: Every one of the three listed statements is totally right.
Every one of the three listed statements is totally right, so the broad answer is the one to pick. Every culture is apt to read the caregivers role uniquely, which is why a care plan written by staff may not match what a family expects. Every culture holds its own settled views of gender roles, which can decide who may bathe or dress a resident. Every faith fixes limits on how much care families permit, so belief shapes what a family will agree to. No single one of those three covers the whole answer.
- All of these could be described as positive benefits of the role religion can play, except ____.
- Helping the resident discover a feeling of meaning and comfort from daily routine.
- Giving the resident greater tolerance and strength to cope as new troubles arrive.
- Serving as the way the resident gains independence and separates from close family.
- Building a more hopeful attitude in the resident and raising health outcomes later.
Correct answer: Serving as the way the resident gains independence and separates from close family.
Serving as the way the resident gains independence and separates from close family is the one that is not a benefit, since faith usually draws a family closer rather than pushing it apart. Helping the resident discover a feeling of meaning and comfort from daily routine is a well documented benefit. Giving the resident greater tolerance and strength to cope as new troubles arrive is another. Building a more hopeful attitude in the resident and raising health outcomes later is a third, and a hopeful outlook is linked to better recovery.
- Which of these is a positive way of dealing with cultural differences?
- Swap the duty roster and favor coworkers of matched culture, faith, diet, and dress.
- Hand relatives the daily care and chores of the resident, baths, meals, and clothes.
- Learn and use key words of the persons language, visual aids, gestures, and prompts.
- Equate the cultural gaps of the client, dull wits, poor logic, and unsound judgment.
Correct answer: Learn and use key words of the persons language, visual aids, gestures, and prompts.
The positive approach is to learn and use key words of the persons language, visual aids, gestures, and prompts, because it closes the gap instead of working around it. Swapping the duty roster and favoring coworkers of matched culture, faith, diet, and dress segregates care and leaves you no better prepared for the next resident. Handing relatives the daily care and chores of the resident, baths, meals, and clothes pushes your own assigned work onto visitors. Equating the cultural gaps of the client with dull wits, poor logic, and unsound judgment confuses culture with ability and is a stereotype.
- A patient has been diagnosed with a terminal illness. On a spiritual front, the most appropriate action for the nursing assistant to take is to ____.
- Decline to name a stark diagnosis or bleak future when the patient panics.
- Rush to share a personal creed or afterlife view when the patient grieves.
- Kneel to recite a lengthy prayer or chant when the frail patient observes.
- Offer to contact a nearby pastor or faith leader when the patient chooses.
Correct answer: Offer to contact a nearby pastor or faith leader when the patient chooses.
The right action is to offer to contact a nearby pastor or faith leader when the patient chooses, since it puts the patients own beliefs first and leaves the choice with the patient. Rushing to share a personal creed or afterlife view when the patient grieves substitutes the aides beliefs for the patients. Kneeling to recite a lengthy prayer or chant when the frail patient observes is done for the aide rather than for the patient. Declining to name a stark diagnosis or bleak future when the patient panics closes off the conversation a dying patient may badly need.
- What is the implied meaning of this statement by Killian and Waite from the article, “Cultural Diversity Best Practices” as it applies to caregivers? “Another reason for increasing cultural proficiency is the growing number of healthcare providers and workers from other countries who have become colleagues within the healthcare delivery system.”
- Diversity in the workforce will have little effect upon the daily work of healthcare staff.
- Diversity in the workforce will make it vastly easier to work with the incoming colleagues.
- Diversity in the workforce will require the entire care team to work with assorted beliefs.
- Diversity in the workforce will change the job duties once held by healthcare team members.
Correct answer: Diversity in the workforce will require the entire care team to work with assorted beliefs.
The statement implies that diversity in the workforce will require the entire care team to work with assorted beliefs, because colleagues arriving from other countries bring their own values into the unit. Diversity in the workforce will have little effect upon the daily work of healthcare staff contradicts the very reason the authors give for raising cultural proficiency. Diversity in the workforce will make it vastly easier to work with the incoming colleagues reverses the point, since differences take effort to bridge. Diversity in the workforce will change the job duties once held by healthcare team members goes further than the quote, which speaks of working together rather than of rewritten job titles.
- When working with residents who may have cultural differences, it is important to respect personal space. Which of these is the best way for a CNA to honor personal space?
- The CNA explains the daily care and procedure with the plainest words.
- The CNA arranges the personal talk and session with the room deserted.
- The CNA avoids the needed touch and contact with the weakest patients.
- The CNA entrusts the entire bath and shave with the closest relatives.
Correct answer: The CNA explains the daily care and procedure with the plainest words.
The best way to honor personal space is that the CNA explains the daily care and procedure with the plainest words, because most care requires closeness and a patient who knows what is coming can consent to it. The CNA avoids the needed touch and contact with the weakest patients would leave basic care undone. The CNA arranges the personal talk and session with the room deserted is unworkable on a busy unit and shuts out family the patient wants present. The CNA entrusts the entire bath and shave with the closest relatives hands off work the aide is assigned to do.
- Which of these is the most important factor when providing care to people from specific ethnic groups?
- Total knowledge from the patients traditions.
- Permanent distance from the patients bedside.
- Amplified speech from the patients caregiver.
- Plain communication from the patients helper.
Correct answer: Plain communication from the patients helper.
Plain communication from the patients helper is the most important factor, because understanding has to be built with each person rather than looked up in advance. Total knowledge from the patients traditions is useful but impossible to complete, given how many cultures and how much variation exists inside each one. Permanent distance from the patients bedside cannot be kept during hands-on care and would damage rapport. Amplified speech from the patients caregiver sets that patient apart and offends in many cultures.
- One of the most basic ways a caregiver can provide spiritual and emotional care to a patient is by?
- Asking if he or she has visitors or relatives.
- Asking if he or she has dessert or vegetables.
- Asking if he or she has therapists or pastors.
- Asking if he or she has questions or concerns.
Correct answer: Asking if he or she has questions or concerns.
The most basic spiritual and emotional care starts with asking if he or she has questions or concerns, since one open question invites the patient to say what is really on his or her mind. Asking if he or she has visitors or relatives may promise visits the family cannot deliver and leave the patient disappointed. Asking if he or she has dessert or vegetables addresses a physical need rather than a spiritual one. Asking if he or she has therapists or pastors can sound like a handoff, as though you would rather not listen yourself.
- You are caring for a Japanese man who just had bilateral knee surgery. When you try and put his anti-embolism stockings on, he winces and then looks away and stares off into the corner. Your best response is to ____.
- Admit the stockings can hurt and ask whether he notices the pain now.
- Praise the pain he can bear and say the stockings seemed quite light.
- Assume the pain he can feel ended and leave the stockings snug today.
- Tell the nurse he can fetch pain pills and remove the stockings soon.
Correct answer: Admit the stockings can hurt and ask whether he notices the pain now.
The best response is to admit the stockings can hurt and ask whether he notices the pain now, because patients from many Asian cultures are stoic about pain and will not volunteer it unless asked directly. Praising the pain he can bear and saying the stockings seemed quite light can sound condescending and may stop him reporting pain later. Assuming the pain he can feel ended and leaving the stockings snug today reads a stoic face as comfort. Telling the nurse he can fetch pain pills and remove the stockings soon decides what the patient needs without ever asking him.
- Caring for a residents psychosocial needs as a CNA is just as important as caring for his or her physiological needs. The term psychosocial needs generally refers to ____.
- Religious and social well-being.
- Emotional and mental well-being.
- Spiritual and bodily well-being.
- Physical and dietary well-being.
Correct answer: Emotional and mental well-being.
Psychosocial needs refers to emotional and mental well-being, the inner side of a person that sits alongside the physical care a CNA gives. Religious and social well-being names only part of the picture, since belief and friendship are expressions of psychosocial need rather than the whole of it. Spiritual and bodily well-being mixes in the physical side the term is meant to contrast with. Physical and dietary well-being is entirely physiological and so is the opposite of what the term means.
- Which of these is the most significant reason that adjusting to aging might be difficult for a resident?
- He or she may miss a lost spouse or cherished companion.
- He or she may encounter a lengthy day or empty evenings.
- He or she may tolerate a powerful medicine or two daily.
- He or she may regularly decline a shower or midday bath.
Correct answer: He or she may miss a lost spouse or cherished companion.
The most significant reason is that he or she may miss a lost spouse or cherished companion, since facing the future alone in an unfamiliar building is the loss most likely to bring depression. He or she may regularly decline a shower or midday bath is a common frustration but a smaller one. He or she may encounter a lengthy day or empty evenings is an inconvenience rather than a grief. He or she may tolerate a powerful medicine or two daily is routine for many older adults and is managed by staff.
- Which of these descriptions represents a Western cultural view of health and wellness?
- Illness is caused by biological sources such as bacteria, viruses, germs, and cancer.
- Illness is caused by supernatural forces such as spirits, curses, magic, and destiny.
- Illness is controlled by the community such as elders, tribes, kin, and grandparents.
- Illness is treated by traditional remedies such as roots, barks, teas, and ointments.
Correct answer: Illness is caused by biological sources such as bacteria, viruses, germs, and cancer.
The Western view holds that illness is caused by biological sources such as bacteria, viruses, germs, and cancer, and it treats disease with medicine and surgery delivered by practitioners trained to published standards. Illness is caused by supernatural forces such as spirits, curses, magic, and destiny is a non-Western explanation of disease. Illness is controlled by the community such as elders, tribes, kin, and grandparents places responsibility with the group, while the Western view places it with the individual. Illness is treated by traditional remedies such as roots, barks, teas, and ointments describes healers trained by apprenticeship rather than by formal programs.
- The term spiritual distress means ____.
- The feeling that the holy realm beyond seems unreal.
- The feeling that the days ahead promise little hope.
- The feeling that the life chosen brings deep regret.
- The feeling that the nearby faith groups fit poorly.
Correct answer: The feeling that the days ahead promise little hope.
Spiritual distress is the feeling that the days ahead promise little hope, and it is the opposite of spiritual health. The feeling that the holy realm beyond seems unreal is a settled belief rather than distress, and many people hold it without any loss of hope. The feeling that the life chosen brings deep regret is regret, which is about the past instead of the future. The feeling that the nearby faith groups fit poorly describes indecision about affiliation, not hopelessness.
- When the valves in the legs weaken it can result in
- Cerebral vascular accident.
- Superficial varicose veins.
- Congestive cardiac failure.
- Mild myocardial infarction.
Correct answer: Superficial varicose veins.
Weakened valves in the leg veins allow blood to pool and produce superficial varicose veins, which appear as large swollen vessels and can bring pain, swelling, and clots. Cerebral vascular accident is a stroke, caused by a blocked or burst artery in the brain rather than by leg valves. Congestive cardiac failure comes from a weakened heart muscle, not from valves inside the legs. Mild myocardial infarction is a heart attack caused by blocked coronary arteries.
- The medical abbreviation for “before meals” is
Correct answer: Ac
The abbreviation for before meals is Ac, which stands for the Latin ante cibum. Hs stands for hora somni, meaning at bedtime, so it marks the end of the day rather than a mealtime. Pc stands for post cibum, meaning after meals, so it is the opposite of what the question asks. Po stands for per os, meaning by mouth, which describes the route a dose travels rather than when it is given.
- What type of isolation precautions are necessary for a patient with a gastrointestinal infection?
- Droplet Precautions
- Enteric Precautions
- Barrier Precautions
- Reverse Precautions
Correct answer: Enteric Precautions
Enteric Precautions are used for gastrointestinal infection, including Clostridioides difficile, rotavirus, norovirus, and severe diarrhea of unknown cause, and they call for careful hand washing with soap and water plus a gown and gloves before entering. Droplet Precautions guard against organisms spread by coughing and sneezing, which is a respiratory route. Barrier Precautions is a general term for protective clothing and names no specific route of spread. Reverse Precautions protect a vulnerable patient from the staff, which is the opposite direction of spread.
- If a nurse aide needs to wear a gown to care for a patient in isolation, the nurse aide should
- Remove the gown after reaching the dirty linen room down the hall
- Take the gown off before leaving the room of the isolated patient
- Leave the gown untied before rushing out of the sick patient room
- Wear the same gown again before tending to the next frail patient
Correct answer: Take the gown off before leaving the room of the isolated patient
The nurse aide should take the gown off before leaving the room of the isolated patient, because every item used inside an isolation room stays inside it. Removing the gown after reaching the dirty linen room down the hall carries contamination through the corridor. Leaving the gown untied before rushing out of the sick patient room exposes the uniform underneath and defeats the purpose of the gown. Wearing the same gown again before tending to the next frail patient spreads organisms from one person to another.
- Rheumatoid arthritis may
- Cause all of the difficulties in the responses above.
- Cause lasting deformity in all of the knuckle joints.
- Cause aching and muscular cramping in all the joints.
- Have silent periods of remission in all the patients.
Correct answer: Cause all of the difficulties in the responses above.
Rheumatoid arthritis can cause all of the changes in the answers above, since it is an autoimmune disease that attacks the lining of the joints. Cause aching and muscular cramping in all the joints is true but incomplete on its own. Cause lasting deformity in all of the finger joints is also true over time as the joints are destroyed, yet it is only part of the picture. Have silent periods of remission in all the patients is likewise true of the disease course, so no single option is the full answer.
- Which of these practices is not part of good verbal communication with a resident?
- Asking broad open questions.
- Using formal medical jargon.
- Clarifying a spoken message.
- Speaking slowly and clearly.
Correct answer: Using formal medical jargon.
Using formal medical jargon is the practice that does not belong, because terms the resident cannot follow block the message instead of carrying it. Asking broad open questions invites more than a yes or no and draws out what the resident thinks. Speaking slowly and clearly gives a resident with hearing or processing trouble a fair chance to follow. Clarifying a spoken message by repeating it back confirms that you heard what was meant.
- It is important to report which of these conversations between a CNA and a resident to ensure his or her safety and well-being?
- His or her specific requests.
- His or her favorite pastimes.
- His or her favored beverages.
- His or her personal dislikes.
Correct answer: His or her specific requests.
His or her specific requests must be reported, because a request can carry a change in condition, a worry about care, or a safety concern that the nurse needs to act on. His or her favorite pastimes helps you build rapport but rarely bears on safety. His or her favored beverages is useful for the care plan yet is not the sort of conversation that must be passed on at once. His or her personal dislikes is worth knowing for comfort but does not by itself affect well-being.
- Which of these is not considered to be a good communication skill of a CNA?
- Delegating
- Responding
- Clarifying
- Confirming
Correct answer: Delegating
Delegating is the one that does not belong, because assigning work to others is a supervisory function rather than a communication skill, and it falls outside the role of a nurse aide. Responding shows the resident that the message landed and invites more. Clarifying checks that what you heard is what the resident meant. Confirming repeats the agreed point back so both people leave with the same understanding.
- A resident tells you that he feels like he’s “got a lump in his chest.” An example of clarifying the message he’s communicated to you would be to ask him ____.
- “Do you detect a stabbing pressure or a heavy tightness inside your chest?”
- “You are telling me that you notice a definite fullness inside your chest?”
- “Can you share a little more about that strange feeling inside your chest?”
- “Are you having palpitations or any odd radiation of your new chest pains?”
Correct answer: “You are telling me that you notice a definite fullness inside your chest?”
Clarifying means repeating the message back for confirmation, so the example is “You are telling me that you notice a definite fullness inside your chest?” Asking “Do you detect a stabbing pressure or a heavy tightness inside your chest?” gathers new information rather than checking what was already said. Asking “Can you share a little more about that strange feeling inside your chest?” is an open invitation to expand, which is a different skill. Asking “Are you having palpitations or any odd radiation of your new chest pains?” uses medical wording the resident is unlikely to follow.
- Which option is the most important for effective communication with a completely deaf patient?
- A phone or a bell and wired amplifiers.
- A shout or a slower and clearer accent.
- A chime or a brighter and bolder light.
- A laptop or a pencil and ruled notepad.
Correct answer: A laptop or a pencil and ruled notepad.
For a patient who hears nothing at all, the most important option is a laptop or a pencil and ruled notepad, because written words do not depend on any hearing. A phone or a bell and wired amplifiers only helps someone with residual hearing. A shout or a slower and clearer accent still relies on sound the patient cannot receive. A chime or a brighter and bolder light may alert the patient but carries no message.
- Which of the following should a nursing assistant do if a patient becomes upset and frustrated?
- Deny the feelings by arguing and tell them that you will call this an odd overreaction.
- Demand details by asking and tell them that you will repeat their account to the staff.
- Offer support by listening and tell them that you will pass their concerns to the team.
- Argue calmly by reasoning and tell them that you will call this upset quite common now.
Correct answer: Offer support by listening and tell them that you will pass their concerns to the team.
The nursing assistant should offer support by listening and tell them that you will pass their concerns to the team, which validates the feeling and routes it to people who can act on it. Demanding details by asking and telling them that you will repeat their account to the staff makes the patient relive the episode before anyone has listened. Denying the feelings by arguing and telling them that you will call this an odd overreaction dismisses a feeling the patient is entitled to. Arguing calmly by reasoning and telling them that you will call this upset quite common now can raise the agitation further and still validates nothing.
- Which of the following options best describes the most likely reaction that a patient would have after overhearing a nursing assistant criticize their fellow co-workers?
- Hearing this would make the patient feel welcomed and quietly befriended.
- Hearing this would make the patient feel justified and quietly validated.
- Hearing this would make the patient feel uneasy and deeply uncomfortable.
- Hearing this would make the patient feel cherished and greatly protected.
Correct answer: Hearing this would make the patient feel uneasy and deeply uncomfortable.
Hearing this would make the patient feel uneasy and deeply uncomfortable, because a patient who hears staff run down their colleagues will assume the same is said about him once he is out of the room. Hearing this would make the patient feel welcomed and quietly befriended mistakes gossip for closeness. Hearing this would make the patient feel justified and quietly validated assumes the patient already shares the complaint, which the question gives no reason to expect. Hearing this would make the patient feel cherished and greatly protected reverses the effect, since criticism of coworkers signals a lack of empathy rather than care.
- Your patient tells you that he is frustrated and plans on leaving the building without having received medical approval. They say they have already called their relatives. What should your first line of communication be?
- Notify the nurse that he declines the ordered stay.
- Notify the nurse that he reached the parking space.
- Notify the family that he awaits the promised ride.
- Notify the nurse that he tapped the bedside button.
Correct answer: Notify the nurse that he declines the ordered stay.
The nurse is the aide's first line of communication, so notify the nurse that he declines the ordered stay and let the nurse carry it to the physician and the administrator. Notify the nurse that he reached the parking space reports the event only after the chance to keep him safe has passed. Notify the family that he awaits the promised ride hands the report to people outside the care team. Notify the nurse that he tapped the bedside button substitutes a trivial detail for the incident itself.
- If your patient is unable to smell smoke, they increase their use of salt and sugar on foods, they ask for a magnifying glass to read and they ask for the volume to be turned up while they are watching television; what would the most likely diagnoses be?
- They have chronic sensory deprivation.
- They have several sensory impairments.
- They have endless sensory stimulation.
- They have gradual sensory habituation.
Correct answer: They have several sensory impairments.
A loss or reduction in the smell, taste, sight and hearing senses is exactly what these four changes point to, so they have several sensory impairments is correct. They have chronic sensory deprivation describes a deliberate withholding of stimuli rather than a loss of the senses themselves. They have endless sensory stimulation describes added input to the senses. They have gradual sensory habituation describes a fading response to an unchanging stimulus, not reduced sensitivity.
- One of the following is extremely important when a patient is being admitted to a new care facility. Which is the best choice?
- The family must supply his or her own admission records.
- The chaplain must attend his or her own care conference.
- The relatives must restrict his or her own spoken input.
- The resident must report his or her own medical history.
Correct answer: The resident must report his or her own medical history.
Admission is the moment to build rapport with the person being admitted, so the resident must report his or her own medical history, and relatives may add or correct details afterwards. The family must supply his or her own admission records takes the person's voice out of the record entirely. The chaplain must attend his or her own care conference is an optional courtesy, never a condition of admission. The relatives must restrict his or her own spoken input works against the involvement the whole process depends on.
- When beginning a procedure on a patient, there are certain steps to follow from start to finish. As a nursing assistant, it is extremely important to do which of the following tasks FIRST in the process:
- Enter the resident's birthdate first.
- Document the resident's intake first.
- Protect the resident's privacy first.
- Verify the resident's identity first.
Correct answer: Verify the resident's identity first.
Care given to the wrong person is the error every other step exists to prevent, so verify the resident's identity first. Enter the resident's birthdate first describes a documentation entry that belongs after the procedure, not before it. Document the resident's intake first is also an after-the-fact entry. Protect the resident's privacy first is essential care, but you can only know whose privacy to protect once identification is confirmed.
- Which of the following must be reported to the charge nurse “STAT?”
- A patient's radial pulse of 135.
- A patient's blood sugars of 110.
- A patient's daily weight of 160.
- A patient's fluid intake of 185.
Correct answer: A patient's radial pulse of 135.
An adult radial pulse runs 60 to 100 beats per minute, so a patient's radial pulse of 135 sits well above that band and has to reach the charge nurse at once. A patient's blood sugars of 110 sit close to the expected fasting band and are charted in the usual way. A patient's daily weight of 160 is a baseline figure rather than a change. A patient's fluid intake of 185 milliliters goes on the intake sheet and calls for no urgent report.
- Assuring your patient that you are listening is usually the best response to give. Which of the options below would be the best method of exhibiting good listening skills?
- Folding the towels and finishing your chores meanwhile.
- Facing your resident and answering the spoken question.
- Guiding the conversation and adding your new questions.
- Steering the exchange and sharing your similar stories.
Correct answer: Facing your resident and answering the spoken question.
Attending to the person with your body and your reply is what signals that you are listening, so facing your resident and answering the spoken question is the best method. Folding the towels and finishing your chores meanwhile splits your attention and says the work outranks the person. Guiding the conversation and adding your new questions seizes the topic instead of following where it goes. Steering the exchange and sharing your similar stories moves the focus onto you.
- A patient who has difficulties with their memory, needs a nursing assistant who will:
- Hold eye contact, sit with them and listen.
- Tell old jokes, giggle with them and tease.
- Close the door, back away slowly and leave.
- List lost facts, check with them and drill.
Correct answer: Hold eye contact, sit with them and listen.
Memory loss calls for unhurried attention rather than less of your time, so hold eye contact, sit with them and listen. Close the door, back away slowly and leave abandons the person and usually deepens the agitation. Tell old jokes, giggle with them and tease invites embarrassment and reads as disrespect. List lost facts, check with them and drill keeps pointing at the forgetting and raises distress.
- You are asked to ambulate a patient BID during your shift. That means you will ambulate the patient how often?
- It is planned one time.
- It is needed two times.
- It is given four times.
- It is done three times.
Correct answer: It is needed two times.
BID comes from the Latin bis in die, twice in a day, so across your shift it is needed two times. It is planned one time matches QD, the abbreviation for once a day. It is done three times matches TID. It is given four times matches QID.
- Which of the following options is not at all helpful when dealing with a patient who has a speech impairment?
- You should accept your patient's unhurried explanations.
- You should position your patient's assistive whiteboard.
- You should encourage your patient's deliberate gestures.
- You should complete your patient's unfinished sentences.
Correct answer: You should complete your patient's unfinished sentences.
Finishing someone's words for them adds pressure and signals that you are rushing the exchange, so you should complete your patient's unfinished sentences is the option that is not at all helpful. You should position your patient's assistive whiteboard opens a written route around the blocked words. You should encourage your patient's deliberate gestures keeps meaning moving when speech fails. You should accept your patient's unhurried explanations gives halting speech the time it needs.
- Some non-verbal communication could send a negative message to your patient. Which of the following is an example of this?
- Raising your tone on your walk and rushing your reply.
- Barking your words on your round and ending your chat.
- Setting your eyes on your client and easing your pace.
- Placing your hands on your hips and pursing your lips.
Correct answer: Placing your hands on your hips and pursing your lips.
Posture and facial set carry a message even when nothing is said, so placing your hands on your hips and pursing your lips is the non-verbal example. Raising your tone on your walk and rushing your reply is poor practice, but the fault sits in the voice rather than the body. Barking your words on your round and ending your chat is a spoken fault for the same reason. Setting your eyes on your client and easing your pace is supportive body language rather than a negative message.
- Of the following options, which one contributes to bad communication between a nursing assistant and a resident?
- All of the unheard comments.
- All of the unnamed routines.
- All of the confused replies.
- All of the listed behaviors.
Correct answer: All of the listed behaviors.
Each item on the list blocks understanding on its own and together they compound, so all of the listed behaviors is what contributes to bad communication. All of the unheard comments names only the first failure, where the aide stops listening. All of the unnamed routines names only the second, where care is carried out without ever being explained. All of the confused replies names only the third, where the resident cannot follow what is said. Naming one leaves the other two standing.
- Which of the following is not a part of the process for documenting in a patient’s medical record?
- Writing your entries in erasable pencil.
- Spelling your entries in accepted terms.
- Recording your entries with exact dates.
- Signing your entries with your initials.
Correct answer: Writing your entries in erasable pencil.
A medical record is a legal document and its entries are never erased, so writing your entries in erasable pencil is the step that is not part of the process. Signing your entries with your initials identifies the author, which every entry needs. Spelling your entries in accepted terms keeps the chart readable to everyone on the team. Recording your entries with exact dates fixes each event in time.
- There is a process that an NA must follow upon entering a patient’s room for the first time. Which of the following is NOT a part of that process?
- Showing the patient your licensing card.
- Offering the patient your complete name.
- Addressing the patient by their surname.
- Knocking once until the patient replies.
Correct answer: Showing the patient your licensing card.
A resident has no reason to inspect your credentials, so showing the patient your licensing card is the step that is not part of entering the room. Offering the patient your complete name introduces you and opens the working relationship. Addressing the patient by their surname is plain respect for the person. Knocking once until the patient replies protects privacy before you cross the doorway.
- A patient’s input and output must be documented:
- You record the totals at your shift end.
- You record the totals at two hour marks.
- You record the totals at each meal time.
- The nurse charts your totals in the log.
Correct answer: You record the totals at your shift end.
Amounts are tallied as they happen and the day's totals go into the chart before you leave, so you record the totals at your shift end. You record the totals at two hour marks imposes a clock schedule that intake and output simply do not follow. You record the totals at each meal time misses every drink and every void between meals. The nurse charts your totals in the log hands away a running tally that the nursing assistant records.
- Each of the following are symptoms of a possible visual impairment, except:
- Your patient trips at the unlit stairs.
- Your patient sleeps at the wrong hours.
- Your patient squints at the fine print.
- Your patient fumbles at the filled cup.
Correct answer: Your patient sleeps at the wrong hours.
Broken sleep has many causes and a sight problem is not a usual one, so your patient sleeps at the wrong hours is the symptom that does not belong. Your patient trips at the unlit stairs shows depth and edge detection failing. Your patient squints at the fine print shows the eye straining to bring an object into focus. Your patient fumbles at the filled cup shows distance being misjudged at the table.
- You have been told that you left something important off the patient’s daily input chart. All of the following must always be included except:
- A mug of coffee during breakfast.
- A serving of cereal during lunch.
- A bag of Ringers during infusion.
- A bowl of pudding during teatime.
Correct answer: A bag of Ringers during infusion.
Intravenous fluid is charted by the nurse on the infusion record and never on the aide's intake sheet, so a bag of Ringers during infusion is the entry that does not belong there. A mug of coffee during breakfast is oral fluid and is measured and written down. A serving of cereal during lunch also counts toward the recorded intake. A bowl of pudding during teatime is taken by mouth as well, so it belongs on the chart.
- Which of the following options would NOT be a primary reason for an indwelling catheter to be taped down?
- To soothe the sore tissues in the urethra.
- To anchor the tube against an abrupt pull.
- To warn the visitors of a blocked removal.
- To offer the resident a sense of security.
Correct answer: To warn the visitors of a blocked removal.
Tape does incidentally show relatives that the tube stays put, but that is a side effect rather than the purpose, so to warn the visitors of a blocked removal is not a primary reason. To anchor the tube against an abrupt pull is the reason tape is applied at all. To soothe the sore tissues in the urethra is a second real aim, because a swinging tube drags on delicate tissue. To offer the resident a sense of security is a genuine benefit of a tube that feels stable.
- Which of the following is an acceptable way for the CNA to cope with feelings of anger and frustration?
- Mock the distant supervisor for a shared laugh.
- Ask the assigned supervisor for a private word.
- Ask the tired supervisor for a softer caseload.
- Repeat the sharp supervisor lines for a friend.
Correct answer: Ask the assigned supervisor for a private word.
Anger needs a safe and confidential outlet, and a supervisor is experienced and bound by the same confidentiality you are, so ask the assigned supervisor for a private word. Mock the distant supervisor for a shared laugh spreads the problem sideways among colleagues and risks client confidentiality. Ask the tired supervisor for a softer caseload walks away from residents instead of dealing with the feeling. Repeat the sharp supervisor lines for a friend carries workplace and client information outside the facility.
- There are certain steps to follow from start to finish when beginning a procedure on a patient. As a nursing assistant, it is extremely important to start with which of these tasks?
- Write the calendar dates beside the entries.
- Read the wristband against the printed name.
- Note the completed steps inside the records.
- Pull the privacy curtain around the bedside.
Correct answer: Read the wristband against the printed name.
Care given to the wrong person is the mistake every other step guards against, so read the wristband against the printed name before anything else happens. Write the calendar dates beside the entries is a documentation step that follows the care. Note the completed steps inside the records is likewise an entry made afterwards. Pull the privacy curtain around the bedside protects dignity, but it still comes after you know whom you are treating.
- If a client says, “God is punishing me,” or asks, “Why me?” how should the nurse aide respond?
- Talk and share the similar personal loss.
- Listen and pose the quiet open questions.
- Joke and chuckle past the sudden tension.
- Debate and deny the harsh divine penalty.
Correct answer: Listen and pose the quiet open questions.
Active listening keeps the person talking and lets you find out what the fear really is, so listen and pose the quiet open questions. Talk and share the similar personal loss turns the conversation toward you instead. Debate and deny the harsh divine penalty shuts down a belief the person is still working through. Joke and chuckle past the sudden tension dismisses a serious feeling and eases your own discomfort rather than theirs.
- A patient is having surgery the following day. Which of these notations in the orders indicates the patient should have nothing by mouth?
Correct answer: NPO
NPO is short for the Latin nil per os, nothing by mouth, so NPO is the notation that stops food and fluid before surgery. NKA means no known allergies and records allergy history rather than diet. PRN means as needed and governs when something may be given. BID means twice a day and sets a frequency, not a restriction on eating.
- A resident calls his relatives and then tells you he is frustrated and plans on leaving the building without medical approval. Your first line of communication should be ____.
- Reporting it to the ward doctor tomorrow.
- Reporting it to the oncoming nurse later.
- Reporting it to the waiting family today.
- Reporting it to the charge nurse quickly.
Correct answer: Reporting it to the charge nurse quickly.
The nurse is the aide's first point of contact and passes the news to everyone else who needs it, so reporting it to the charge nurse quickly is right. Reporting it to the ward doctor tomorrow skips the chain of command and arrives far too late. Reporting it to the waiting family today gives the news to people outside the care team. Reporting it to the oncoming nurse later leaves the resident unsupervised for the rest of your shift.
- Which of these should be reported to the charge nurse “STAT”?
- A urine volume of 85.
- A glucose lab of 110.
- A wrist pulse of 135.
- A body weight of 160.
Correct answer: A wrist pulse of 135.
An adult pulse runs 60 to 100 beats per minute, so a wrist pulse of 135 sits well outside that band and has to reach the charge nurse at once. A urine volume of 85 milliliters is an ordinary hourly output and is simply charted. A glucose lab of 110 is close to the expected fasting band. A body weight of 160 pounds is a baseline figure rather than a change in condition.
- What is the most likely diagnosis for a resident who cannot smell smoke, increases their use of sugar or salt on foods, asks for a magnifying glass to read, and asks for the volume to be turned up while watching television?
- Sensory saturation.
- Sensory adaptation.
- Sensory distortion.
- Sensory impairment.
Correct answer: Sensory impairment.
Losing or reducing the use of the smell, taste, sight and hearing senses is sensory impairment, so sensory impairment is the likely diagnosis here. Sensory adaptation is the fading of a response to a steady stimulus and reverses as soon as the stimulus changes. Sensory distortion is a misreading of what the senses deliver rather than a loss of input. Sensory saturation is too much input at once, the opposite of what this resident describes.
- A resident’s input and output must be documented in a patient’s record ____.
- At two hour marks each day.
- At the start of your shift.
- At the close of your shift.
- By the nurse on your shift.
Correct answer: At the close of your shift.
Amounts are tallied as they happen and the day's figures go into the chart before you leave, so at the close of your shift is when the record is completed. At the start of your shift records nothing that has happened yet. At two hour marks each day forces a clock schedule onto events that arrive when they arrive. By the nurse on your shift hands away a task the nursing assistant is responsible for.
- Which of these is not part of the process upon entering a residents room for the first time?
- Announcing your printed name to the resident.
- Repeating their surname back to the resident.
- Showing your nursing license to the resident.
- Knocking twice before you reach the resident.
Correct answer: Showing your nursing license to the resident.
A resident has no reason to inspect your credentials, so showing your nursing license to the resident is the step that is not part of the process. Announcing your printed name to the resident introduces you and opens the relationship. Repeating their surname back to the resident is ordinary respect for the person. Knocking twice before you reach the resident protects privacy at the doorway.
- If you have a resident who is completely deaf, which of these would be the most important for effective communication?
- A louder voice or a slower calm tone.
- A simple laptop or a plain paper pad.
- A wall buzzer or a shrill bell chime.
- A smart phone or a soft volume boost.
Correct answer: A simple laptop or a plain paper pad.
A resident who hears nothing needs a route that does not rely on sound at all, so a simple laptop or a plain paper pad is the most important aid. A louder voice or a slower calm tone still depends on hearing that is not there. A wall buzzer or a shrill bell chime only raises a signal the resident cannot detect. A smart phone or a soft volume boost helps partial hearing loss but does nothing for total deafness.
- Sometimes the best response for a nursing assistant is to assure the resident you are listening. Which of these behaviors is the best way to exhibit good listening skills?
- Turning the whole body and answering the spoken concern.
- Posing the quick questions and steering the topic along.
- Recalling the past travels and telling the recent tales.
- Scrubbing the big mirror and chatting past the resident.
Correct answer: Turning the whole body and answering the spoken concern.
Facing the person and answering them is what shows the message is going in, so turning the whole body and answering the spoken concern is the best display of listening. Scrubbing the big mirror and chatting past the resident keeps your body and your attention on the work. Posing the quick questions and steering the topic along takes charge of the conversation instead of following it. Recalling the past travels and telling the recent tales moves the subject onto you.
- When you are documenting in a medical record, which of these is not part of the process?
- Pencil marks for easy later erasure.
- Ink marks for clear durable records.
- Date marks for an accurate timeline.
- Name marks for simple author credit.
Correct answer: Pencil marks for easy later erasure.
A chart is a legal document and nothing in it may be rubbed out, so pencil marks for easy later erasure is the practice that is not part of documenting. Ink marks for clear durable records is exactly why permanent ink is required. Date marks for an accurate timeline pin each event to a moment. Name marks for simple author credit show who made the entry and who can be asked about it.
- If you are unsure of the steps of a task that the nurse told you to do, you should
- Ask the doctor to explain the whole routine.
- Ask the team to handle the difficult chores.
- Ask the nurse to clarify the unclear orders.
- Ask the nurse after the resident is injured.
Correct answer: Ask the nurse to clarify the unclear orders.
Clarification protects the resident, and the person who gave the instruction is the person who can explain it, so ask the nurse to clarify the unclear orders. Ask the doctor to explain the whole routine steps outside the chain of command for a task the nurse assigned. Ask the team to handle the difficult chores passes your assignment to somebody else instead of learning it. Ask the nurse after the resident is injured leaves the question until harm has already been done.
- The nurse aide finds a resident sobbing. What is the best thing for the nurse aide to say to the person?
- “Your tears help little and dry them now.”
- “Your mood lifts and a lounge game helps.”
- “Your face looks sad and I gladly listen.”
- “Your sobs upset the others and worry us.”
Correct answer: “Your face looks sad and I gladly listen.”
A feeling has to be acknowledged before it can be understood, so “Your face looks sad and I gladly listen.” names what the aide sees and invites the person to say more. “Your tears help little and dry them now.” dismisses the feeling outright. “Your mood lifts and a lounge game helps.” offers a quick distraction in place of attention. “Your sobs upset the others and worry us.” makes the resident responsible for everyone else's comfort.
- An example of negative body language is
- Leaning in while your client talks.
- Planting your hands upon your hips.
- Holding your gaze upon your client.
- Resting your hand upon your client.
Correct answer: Planting your hands upon your hips.
Hands on the hips reads as a barrier and can cancel whatever your words say, so planting your hands upon your hips is the negative body language. Leaning in while your client talks shows that you are engaged with the person. Holding your gaze upon your client keeps the contact that says the message matters. Resting your hand upon your client offers reassurance rather than distance.
- All of these are indications of visual impairment except ____.
- The resident avoids the group social events.
- The resident spills coffee from filled cups.
- The resident squints at small print letters.
- The resident stumbles on unlit stair treads.
Correct answer: The resident avoids the group social events.
Pulling back from company has many causes and is not a classic sign of failing sight, so the resident avoids the group social events is the indication that does not belong. The resident squints at small print letters shows the eye straining to focus. The resident spills coffee from filled cups shows distance being misjudged at the table. The resident stumbles on unlit stair treads shows depth and edge detection failing in poor light.
- The nurse asks you to ambulate a patient BID during your shift. This means you will ambulate the patient ____ times.
Correct answer: Two
BID comes from the Latin bis in die and means twice a day, so you ambulate the patient two times during the shift. One matches QD, an order carried out once a day. Six would follow an order written for every four hours. Ten matches no standard abbreviation at all and would be spelled out in full on the order sheet.
- The nurse has just told you that you left something important off the charting of a resident’s input for the day. All of these should be included except ____.
- Toast taken at the late breakfast.
- Protein bars eaten at the bedside.
- Ringers infused at the wrist vein.
- Sweet juice poured at the dayroom.
Correct answer: Ringers infused at the wrist vein.
Intravenous fluid is recorded by the nurse on the infusion sheet and never on the aide's intake chart, so Ringers infused at the wrist vein is the entry that does not belong there. Toast taken at the late breakfast is food by mouth and is counted. Protein bars eaten at the bedside are counted in the same way. Sweet juice poured at the dayroom is an oral fluid and goes straight onto the intake record.
- Which of these is most important when a resident is being initially admitted to a care facility?
- The family blocks his or her spoken input.
- The spouse gives his or her whole history.
- The patient states his or her own answers.
- The pastor joins his or her early prayers.
Correct answer: The patient states his or her own answers.
Admission is where rapport with the person begins, so the patient states his or her own answers, and relatives can add or correct details afterward. The spouse gives his or her whole history takes the patient's voice out of the record. The pastor joins his or her early prayers is a welcome courtesy but never a condition of admission. The family blocks his or her spoken input works directly against the involvement the process needs.
- When a resident is upset and frustrated, a nursing assistant should ____.
- Hear the stated worry and tell the charge nurse.
- Quiz the exact details and tell the night nurse.
- Judge the harsh reaction and tell the care team.
- Stress the common fret and tell the ward doctor.
Correct answer: Hear the stated worry and tell the charge nurse.
Being heard, and knowing the worry will reach the people who can act on it, is what settles frustration, so hear the stated worry and tell the charge nurse. Quiz the exact details and tell the night nurse drags the person back through whatever upset them and holds the report until handover. Judge the harsh reaction and tell the care team labels the feeling as out of proportion before anyone has listened to it. Stress the common fret and tell the ward doctor brushes the feeling aside and skips the nurse who should hear it first.
- A resident with memory difficulties often needs a nursing assistant who will ____.
- Repeat the lost names, quiz the resident, and correct.
- Crack the stale jokes, tease the resident, and giggle.
- Keep eye contact, sit beside the resident, and listen.
- Shut the bedroom door, leave the resident, and depart.
Correct answer: Keep eye contact, sit beside the resident, and listen.
Memory loss calls for more of your time rather than less, so keep eye contact, sit beside the resident, and listen. Repeat the lost names, quiz the resident, and correct keeps pointing at the forgetting and deepens the distress. Crack the stale jokes, tease the resident, and giggle invites embarrassment and reads as disrespect. Shut the bedroom door, leave the resident, and depart isolates the person and usually raises the agitation.
- Which of these is not a primary reason for an indwelling catheter to be taped down?
- To anchor the catheter against a sudden stretch.
- To lessen the pressure inside a swollen urethra.
- To give the resident a settled inner steadiness.
- To tell the visitors a catheter stays untouched.
Correct answer: To tell the visitors a catheter stays untouched.
Tape does incidentally show relatives that the tube stays in place, but that is a by-product and not the purpose, so to tell the visitors a catheter stays untouched is not a primary reason. To anchor the catheter against a sudden stretch is precisely why tape is applied. To lessen the pressure inside a swollen urethra is a second genuine aim, since a swinging tube drags on delicate tissue. To give the resident a settled inner steadiness is a real benefit of a tube that feels stable.
- Which of these contributes to bad communication between a nursing assistant and a resident?
- Repeating these three listed habits blocks honest civil exchanges.
- Missing quiet hints these hurried words confused someone severely.
- Ignoring these frail residents whenever halting speech slows down.
- Skipping warnings these common bedside tasks plainly demand daily.
Correct answer: Repeating these three listed habits blocks honest civil exchanges.
Repeating these three listed habits blocks honest civil exchanges, and that is why it is the correct choice: every one of the single causes named is a real one. Missing quiet hints these hurried words confused someone severely leaves the resident unable to act on what was said. Ignoring these frail residents whenever halting speech slows down removes the resident's half of the exchange. Skipping warnings these common bedside tasks plainly demand daily leaves the resident guessing about what is happening. All three of those are true on their own, so naming only one of them is an incomplete answer to what contributes.
- Which of these is a form of nonverbal communication that might send a poor message to a resident?
- Setting the hands against the hips with lips pursed.
- Raising the volume with the very loud angry yelling.
- Answering the query with one flat cold clipped tone.
- Cutting the question off with fast curt blunt words.
Correct answer: Setting the hands against the hips with lips pursed.
Setting the hands against the hips with lips pursed is body language: posture and facial expression carry the whole message, and nothing is said aloud, which is exactly what nonverbal communication means. Answering the query with one flat cold clipped tone is a poor habit, but the message travels in the voice. Raising the volume with the very loud angry yelling is also carried by the voice, not by the body. Cutting the question off with fast curt blunt words is likewise spoken, so none of those three is nonverbal.
- Which of these describes the most likely reaction a resident has upon hearing a nursing assistant criticize fellow co-workers?
- It makes the resident feel quite special.
- It makes the resident feel well regarded.
- It makes the resident feel highly uneasy.
- It makes the resident feel truly trusted.
Correct answer: It makes the resident feel highly uneasy.
Hearing an aide run down coworkers makes the resident feel highly uneasy, because the resident begins to wonder what is said about them once the aide leaves the room. It does not make the resident feel quite special, since gossip signals disloyalty rather than favor. It does not make the resident feel well regarded, since the complaints are about staff and have nothing to do with the resident. It does not make the resident feel truly trusted either, because being handed a coworker complaint is a burden placed on the resident, not a confidence shared with one.
- Which of these would not be helpful when dealing with a patient with a speech impairment?
- Waiting quietly beside a resident hunting the right words.
- Finishing off the halting sentence a frail resident began.
- Offering a plain whiteboard the keen resident uses freely.
- Welcoming the simple hand signs a silent resident chooses.
Correct answer: Finishing off the halting sentence a frail resident began.
Finishing off the halting sentence a frail resident began is the action that does not help: it takes the words away from the resident, signals impatience, and frequently supplies the wrong word. Waiting quietly beside a resident hunting the right words gives a person with a speech impairment the extra time that the impairment requires. Offering a plain whiteboard the keen resident uses freely supplies a second channel when speech fails. Welcoming the simple hand signs a silent resident chooses reaches the same goal without demanding speech at all.
- Restraints are used for all of the following EXCEPT
- To keep a patient from pulling out the feeding tube.
- To spare a rushed aide from making the extra rounds.
- To stop a raging man from hurting the nursing staff.
- To save a frail resident from falling off the chair.
Correct answer: To spare a rushed aide from making the extra rounds.
Restraints may not be applied to spare a rushed aide from making the extra rounds, so that is the exception the question asks for: staff convenience is specifically prohibited, and a facility can be cited for it. To keep a patient from pulling out the feeding tube is a recognized medical reason. To stop a raging man from hurting the nursing staff is a recognized behavioral reason. To save a frail resident from falling off the chair is a recognized safety reason. All three of those still require a physician order and the least restrictive device available.
- A resident refuses lunch, but about two hours later decides she would like a snack. What is the nurse aide’s best response?
- "Sorry, your wait ends and the evening dinner tray arrives later."
- "Meals stopped, and your late call missed the serving hour today."
- "Lunch got refused, and the kitchen shut your second chance down."
- "Certainly, let me recheck your ordered diet and bring the treat."
Correct answer: "Certainly, let me recheck your ordered diet and bring the treat."
The best response is: Certainly, let me recheck your ordered diet and bring the treat. A resident chooses when to eat, so the aide agrees and then verifies the ordered diet in case the snack is restricted. Telling her that her wait ends and the evening dinner tray arrives later withholds a right she holds. Telling her that meals stopped and her late call missed the serving hour punishes her for refusing lunch earlier. Telling her that lunch got refused and the kitchen shut her second chance down invents a rule the facility does not have, and it leaves a hungry resident with nothing.
- It is appropriate for a nurse aide to share the information regarding a client’s status with
- The roommate resting on her nearby bed
- The friends chatting on her media page
- The cousins calling on her home number
- The staffer working on her later shift
Correct answer: The staffer working on her later shift
Status information belongs to the care team, so the aide may share it with the staffer working on her later shift during hand-off report. The roommate resting on her nearby bed has no part in the care and no right to hear any of it. The friends chatting on her media page sit entirely outside the facility, and posting there is a serious breach that carries penalties. The cousins calling on her home number may not appear on the approved list, so the aide sends questions from them to the nurse rather than answering.
- When getting ready to dress a client, the nurse aide SHOULD
- Reuse the dirty clothes the weak client wore yesterday
- Grab the nearest hanging blouse the client kept inside
- Pick the sweatshirt the aide enjoys the client wearing
- Let the client personally choose the clothing worn now
Correct answer: Let the client personally choose the clothing worn now
The aide should let the client personally choose the clothing worn now, because choosing what to wear is part of the right to dignity and it keeps the client independent. Grabbing the nearest hanging blouse the client kept inside is quick but takes the decision away from the client. Picking the sweatshirt the aide enjoys the client wearing substitutes the aide's taste for the client's own. Reusing the dirty clothes the weak client wore yesterday skips the decision entirely and risks putting soiled garments back on.
- A nurse aide closes the door, pulls curtains between beds, and covers the resident with a bath sheet when giving a bath. This is an example of maintaining a resident’s
- Hygiene
- Dignity
- Privacy
- Comfort
Correct answer: Privacy
Closing the door, pulling the curtain between beds, and covering the resident with a bath sheet all screen the body from view, and screening the body from view is privacy. Hygiene is what the bath water and soap accomplish, not what the closed door accomplishes. Dignity is the broader right to respectful treatment, and although these measures support it, the specific act of blocking the view of an exposed body is named privacy. Comfort refers to warmth, positioning, and freedom from pain, none of which is what the curtain provides.
- On admission to a nursing home or a long-term care facility, a resident must be given
- A copy of the Resident Code of Ethics
- A copy of the Resident Bill of Rights
- A copy of the Resident List of Events
- A copy of the Resident Diet of Choice
Correct answer: A copy of the Resident Bill of Rights
Every newly admitted resident must be handed a copy of the Resident Bill of Rights in a language the resident understands, and the same document must be posted where it can be read. A copy of the Resident Code of Ethics governs how staff behave and is not owed to the resident at admission. A copy of the Resident List of Events is a courtesy the activity department offers and carries no legal requirement. A copy of the Resident Diet of Choice is written only after the dietitian completes an assessment, so it does not exist on the day of arrival.
- Respect is demonstrated by the nurse aide for the resident by
- Listening with total focus whenever the resident speaks aloud
- Agreeing along with the statements the resident utters loudly
- Fixing the grammar slips the resident voices with corrections
- Clearing the resident bedroom with brisk daily tidying rounds
Correct answer: Listening with total focus whenever the resident speaks aloud
Respect shows when the aide is listening with total focus whenever the resident speaks aloud: undivided attention, without interruption, is what active listening means, and it is how misunderstandings are avoided. Clearing the resident bedroom with brisk daily tidying rounds is sound housekeeping and safety practice, but it says nothing about how the person is treated. Agreeing along with the statements the resident utters loudly is false agreement, which humors the resident rather than respecting him. Fixing the grammar slips the resident voices with corrections corrects and embarrasses the speaker, which is the opposite of respect.
- Who should manage the resident’s finances?
- The cashier
- The patient
- The trustee
- The sibling
Correct answer: The patient
The patient is the one who should manage the money, because a resident keeps the right to control personal funds. A resident may also ask the facility to hold the money, and the facility must then allow full access to the account and safeguard the balance. The cashier works in the business office and may take no money from a private account without the resident's own direction. The trustee matters only where a court has already appointed one, which this question does not describe. The sibling is a relative, and being a relative confers no authority over an adult resident's funds.
- Mr. Smith, a 72-year-old male Alzheimer’s patient, has been stopped several times today while wandering from unit. He is ambulatory, but confused and combative. The CNA would first
- Fasten the soft waist restraint around a seated resident
- Redirect the resident toward a calmer activity right now
- Barricade the hall exit whenever a resident wanders past
- Ignore the outburst till a raging resident settles again
Correct answer: Redirect the resident toward a calmer activity right now
The first step is to redirect the resident toward a calmer activity right now, because distraction is the least restrictive response to wandering and it often settles a confused resident with no device at all. Fastening the soft waist restraint around a seated resident skips every less restrictive measure and applies a device the aide has no authority to apply. Barricading the hall exit whenever a resident wanders past confines him exactly as a restraint would. Ignoring the outburst till a raging resident settles again leaves an ambulatory, combative resident unsupervised and at risk of falling or eloping.
- A patient tells a nurse aide that the foods on her tray conflict with her religious beliefs. The nurse aide should
- Notify the nurse and take the tray from her bedside
- Notify the nurse and order her tray from the family
- Notify the nurse and force her dinner from the tray
- Notify the nurse and screen the tray from her sight
Correct answer: Notify the nurse and take the tray from her bedside
The aide should notify the nurse and take the tray from her bedside, because food that conflicts with a patient's faith should not sit in front of her while a suitable substitute is arranged through the nurse and the dietitian. Notify the nurse and force her dinner from the tray pushes the patient to break her own beliefs. Notify the nurse and order her tray from the family hands the facility's duty to feed her over to relatives. Notify the nurse and screen the tray from her sight keeps the offending food at the bedside, which is the very thing the patient objected to.
- A nurse aide reclines a resident in a geri-chair so the resident cannot attempt to stand. This is a violation of
- The resident's right to examine a clinical record
- The resident's right to refuse a bodily restraint
- The resident's right to receive a daily newspaper
- The resident's right to keep a personal telephone
Correct answer: The resident's right to refuse a bodily restraint
Reclining a geri-chair so that a resident cannot rise is a physical restraint, so what the aide has violated is the resident's right to refuse a bodily restraint; a restraint may never be used for staff convenience, discipline, or punishment. The resident's right to examine a clinical record covers access to the chart, which the chair does not touch. The resident's right to keep a personal telephone covers property and private communication. The resident's right to receive a daily newspaper covers information and activity. The position of the chair leaves all three of those untouched.
- All of the following situations are examples of abuse or neglect EXCEPT
- Threatening a client with the withheld dinner tray
- Abandoning a client alone with the bathtub running
- Restraining a client with the signed doctor orders
- Overlooking a client with the soiled bedding today
Correct answer: Restraining a client with the signed doctor orders
Restraining a client with the signed doctor orders is the exception the question asks for, because a restraint that carries a written order and a medical or safety reason is lawful care rather than mistreatment. Abandoning a client alone with the bathtub running leaves a person unattended in water, which is neglect and a drowning risk. Threatening a client with the withheld dinner tray is verbal and emotional abuse, whether or not the threat is carried out. Overlooking a client with the soiled bedding today is neglect of basic physical care and invites skin breakdown.
- Which of the following is a right of residents in a nursing facility?
- Blasting a loud racket along the silent hallway
- Refusing a new treatment the doctor ordered now
- Taking a sleeping tablet the nurse keeps locked
- Smoking inside a private bedroom the staff bans
Correct answer: Refusing a new treatment the doctor ordered now
Refusing a new treatment the doctor ordered now is a protected right: residents must be informed about their condition, may choose a physician, and may decline any care or medication. Blasting a loud racket along the silent hallway is not a right, because one resident's conduct may not rob the others of a peaceful home. Taking a sleeping tablet the nurse keeps locked is not a right either, since every medication needs an order. Smoking inside a private bedroom the staff bans is controlled by fire safety policy and designated smoking areas rather than by any resident right.
- To help residents, the CNA opens their mail before bringing it to their rooms. This is an example of:
- Improving the residents' reading of their mail
- Helping the residents' weakened eyes read mail
- Speeding the residents' mail into each bedroom
- Breaching the residents' right of mail privacy
Correct answer: Breaching the residents' right of mail privacy
Opening an envelope addressed to someone else is breaching the residents' right of mail privacy, and that right stands whether or not the aide meant well. Residents send and receive mail unopened, and they may have help reading or writing it only when they ask for that help. Improving the residents' reading of their mail is not what took place, because no resident asked for reading help. Helping the residents' weakened eyes read mail describes a service that must be requested first. Speeding the residents' mail into each bedroom describes prompt delivery, which never requires opening anything.
- Mr. Brown has been a resident in your facility for two years. His wife has broken her hip and will soon be a resident, too. What is the policy for married couples?
- Residents with a spouse await a staff choice.
- Residents with a spouse eat beside a partner.
- Residents with a spouse get a nearby bedroom.
- Residents with a spouse occupy a single room.
Correct answer: Residents with a spouse occupy a single room.
Residents with a spouse occupy a single room, even when the two of them need very different levels of care, and that room counts as private space staff must knock before entering. Residents with a spouse await a staff choice is wrong because the couple's wish governs, not the administrator's convenience. Residents with a spouse eat beside a partner understates the right, which covers living together rather than only dining together. Residents with a spouse get a nearby bedroom also falls short, since two nearby rooms are not one room.
- What happens to the resident’s personal possessions in a long-term facility?
- Residents keep their personal items inside homelike rooms
- Residents send their personal items toward distant family
- Residents stash their personal items using facility safes
- Residents forfeit their personal items once damage occurs
Correct answer: Residents keep their personal items inside homelike rooms
Residents keep their personal items inside homelike rooms and may furnish the room so that it feels like home, as long as safety and the rights of others are not affected; the facility must in turn provide reasonable security for those belongings. Residents send their personal items toward distant family is not required by any rule and would strip the room of comfort. Residents stash their personal items using facility safes describes locked storage rather than daily use. Residents forfeit their personal items once damage occurs states a prohibition that no liability rule actually creates.
- Restraints should be unfastened or released
- Every 1-2 hours, careful release
- Every 7-8 hours, upright posture
- Every 3-4 hours, morning routine
- Every 5-6 hours, nightly checkup
Correct answer: Every 1-2 hours, careful release
The correct interval is every 1-2 hours, careful release: the aide unfastens the device so that skin, circulation, and alignment can be checked, toileting and fluids offered, and the resident allowed to move. Every 3-4 hours, morning routine leaves a restrained resident immobile far longer than any order allows, and covers only part of the day. Every 5-6 hours, nightly checkup is longer still and invites pressure injury and contracture. Every 7-8 hours, upright posture would span a whole shift with no release at all.
- An aide puts a resident in a reclining position in a geri-chair, so he cannot stand up while the aide takes care of other residents. This is a violation of resident’s right to .
- Refuse a rigid safety strap
- Keep a private phone nearby
- Pick a favored evening meal
- Join a resident group today
Correct answer: Refuse a rigid safety strap
Reclining the chair so the man cannot rise, and doing it so the aide can attend to other people, is a physical restraint used for staff convenience, so the right violated is the right to refuse a rigid safety strap. Pick a favored evening meal is the right to choose food, which the chair does not touch. Keep a private phone nearby is the right to private communication. Join a resident group today is the right to take part in activities. Being held down in a chair leaves all three of those intact.
- All of the following are in the Resident Bill of Rights except
- The right to refuse the resident's ordered medicine
- The right to take the fellow resident's possessions
- The right to attend the resident's preferred church
- The right to review the resident's grievance record
Correct answer: The right to take the fellow resident's possessions
The right to take the fellow resident's possessions is the one that does not exist, because resident rights are personal: they cover a resident's own body, care, records, and belongings, and they stop at another person's property. The right to refuse the resident's ordered medicine is listed, since a resident may decline care or medication. The right to review the resident's grievance record is listed, since a resident may see personal records and complaints. The right to attend the resident's preferred church is listed as freedom of religion.
- In giving care according to the 1987 Nursing Home Reform Law, the nurse aide SHOULD
- Provide screened privacy for the client's personal care
- Share out the client's possessions for greedy relatives
- Unseal the client's private letters for curious callers
- Silence the client's daily complaints for kitchen peace
Correct answer: Provide screened privacy for the client's personal care
Under the 1987 reform law the aide should provide screened privacy for the client's personal care, because screening the body during bathing, toileting, and dressing is one of the listed rights. Share out the client's possessions for greedy relatives gives away property that the client alone controls. Unseal the client's private letters for curious callers breaks the right to send and receive correspondence unopened. Silence the client's daily complaints for kitchen peace blocks the grievance right, which exists precisely to protect a resident who speaks up.
- You observe two adult residents sharing the same bed after lunch. You know these residents are capable of exercising their own rights. This means
- Each of these adults holds private bedroom rights.
- Each of these adults feels strong physical desire.
- Each of these adults fits three listed statements.
- Each of these adults makes weighty health choices.
Correct answer: Each of these adults fits three listed statements.
Because both residents are competent to exercise their own rights, each of these adults fits three listed statements at the same time. Each of these adults holds private bedroom rights is true, and it is why the aide steps out and says nothing to coworkers. Each of these adults feels strong physical desire is true, because sexual feeling does not end with age. Each of these adults makes weighty health choices is true, because competent adults decide for themselves. All three of those are correct on their own, so no single one of them can be the full answer.
- Which statement is TRUE concerning sexuality in the elderly?
- Elderly people lose their sexual interest quite early.
- Elderly people ponder their frail health woes nightly.
- Elderly people spurn their closest bodily bonds daily.
- Elderly people feel romantic desire their whole lives.
Correct answer: Elderly people feel romantic desire their whole lives.
Elderly people feel romantic desire their whole lives, and that is the true statement: sexual feeling and the wish for touch carry on through life, even though how they are expressed may change. Elderly people lose their sexual interest quite early is a stereotype that the evidence does not support. Elderly people ponder their frail health woes nightly reduces older adults to their diagnoses. Elderly people spurn their closest bodily bonds daily contradicts what older residents report about themselves, which is why facilities must protect privacy for couples.
- Which of the following statements about nursing home admissions is false?
- Most families struggle hard to keep a frail parent close.
- Most unpaid daily labor falls to a nearby blood relative.
- Most older adults hope to spend time beside a grandchild.
- Most people gladly opt to house a senior elsewhere today.
Correct answer: Most people gladly opt to house a senior elsewhere today.
The false statement is: Most people gladly opt to house a senior elsewhere today. The opposite is what surveys find, and placement is normally a last resort reached after every other arrangement has run out. Most families struggle hard to keep a frail parent close is true. Most unpaid daily labor falls to a nearby blood relative is true, because relatives provide the bulk of long-term care in this country. Most older adults hope to spend time beside a grandchild is true, and it is the reason that aging in place is so common.
- A new resident brings family photos and her favorite lamp with her. What should you say to her?
- "How rash! Where shall we return the unused photos and lamp?"
- "How risky! Where shall we stash the costly photos and lamp?"
- "How lovely! Where shall we hang the pretty photos and lamp?"
- "How cramped! Where shall we trim the extra photos and lamp?"
Correct answer: "How lovely! Where shall we hang the pretty photos and lamp?"
The welcoming reply is: How lovely! Where shall we hang the pretty photos and lamp? A resident keeps personal possessions and may make the room homelike, so the aide helps put them where the resident wants them. How risky! Where shall we stash the costly photos and lamp? raises a theft worry that the facility is responsible for preventing through reasonable security. How rash! Where shall we return the unused photos and lamp? invents a ban that no rule creates. How cramped! Where shall we trim the extra photos and lamp? invents a quota that no rule creates either.
- If a resident refuses a bed bath, which is the best response?
- "Why decline? Reconsider, and let me ask you later."
- "Why argue? Policy rules, and daily baths bind you."
- "Why refuse? Frankly, you stink and look quite bad."
- "Why bother? Wonderful, and you grant me free time."
Correct answer: "Why decline? Reconsider, and let me ask you later."
The best reply is: Why decline? Reconsider, and let me ask you later. A resident may refuse care, so the aide explains the benefit, leaves the decision where it belongs, and comes back. Why argue? Policy rules, and daily baths bind you presses the resident with a schedule that cannot override a refusal. Why refuse? Frankly, you stink and look quite bad shames the resident into compliance. Why bother? Wonderful, and you grant me free time treats the refusal as a break rather than as care that must be followed up.
- As you finish your shift, a patient with a history of bowel incontinence has a strong odor. Your responsibility is to
- Skip the whole messy cleanup and clock out promptly
- Stock the empty bedroom and gather the spare linens
- Help the relief aide and change the soiled resident
- Shout down the hallway and broadcast the Code Brown
Correct answer: Help the relief aide and change the soiled resident
An aide is responsible for care right up to the moment the shift is handed over, so the duty here is to help the relief aide and change the soiled resident. Skip the whole messy cleanup and clock out promptly abandons someone who needs attention now and risks skin breakdown. Stock the empty bedroom and gather the spare linens prepares supplies but leaves the person lying soiled. Shout down the hallway and broadcast the Code Brown carries a private matter to everyone within earshot and strips the resident of dignity.
- When you walk in to begin your shift, a resident is being put in restraints by the charge nurse. This means ____.
- You need to phone this family every hour, and explain the tied wrists now.
- You need to abandon this task every shift, and let the nurse decide alone.
- You need to ignore this bed every round, and skip the usual safety checks.
- You need to check this person every two hours, and observe the blood flow.
Correct answer: You need to check this person every two hours, and observe the blood flow.
A resident in restraints still gets full care from the aide, so you need to check this person every two hours, and observe the blood flow: skin color and warmth, correct body alignment, fluids, and a trip to the bathroom. You need to phone this family every hour, and explain the tied wrists now is not the aide's call, since the nurse handles that conversation. You need to abandon this task every shift, and let the nurse decide alone drops work that is still yours. You need to ignore this bed every round, and skip the usual safety checks leaves a restrained person unwatched, which is exactly when injuries happen.
- A family member asks the nurse aide what medications the client is receiving. The nurse aide should
- Tell the family member the nurses handle questions
- Tell the family member the medicines nurses supply
- Tell the family member the cabinet nurses unlocked
- Tell the family member the remarks nurses recorded
Correct answer: Tell the family member the nurses handle questions
An aide may not release medical information, so the aide should tell the family member the nurses handle questions. The nurse can check whether that person appears on the resident's approved list, can share what is allowed when the relative is involved in the care, and can explain the privacy rule when the relative is not. Tell the family member the medicines nurses supply releases protected information the aide has no authority to give out. Tell the family member the cabinet nurses unlocked points a visitor toward stock and records that are not theirs. Tell the family member the remarks nurses recorded hands over charted notes, which is the same breach in another form.
- It would not be appropriate to share health care information about a resident with ____.
- The therapist who runs the weekly rehab this resident joins.
- The doctor who signs the orders this resident follows today.
- The chatty friend who visits the resident this entire month.
- The charge nurse who watches the floor this resident shares.
Correct answer: The chatty friend who visits the resident this entire month.
Health information travels only inside the treatment team, so the one it would not be appropriate to share with is the chatty friend who visits the resident this entire month. Friendship, however loyal and however frequent the visits, does not put a person on the care team or give a right to the record. The therapist who runs the weekly rehab this resident joins is treating him and needs the information. The doctor who signs the orders this resident follows today is directing that care. The charge nurse who watches the floor this resident shares is accountable for the care you give.
- Which of the following statements about aging is true?
- Most older people are weak and dependent.
- Most older people are placed and watched.
- Most older people are confused and vague.
- Most older people are alert and oriented.
Correct answer: Most older people are alert and oriented.
Most older people are alert and oriented, and that is the true statement: aging slows certain body functions gradually, but it does not take away clear thinking. Most older people are weak and dependent is false, because the great majority manage their own lives. Most older people are placed and watched is false, because fewer than one in twenty live in a nursing home. Most older people are confused and vague is false as well, since dementia reaches only a small share of older adults.
- A resident in your care tells you that he does not like his current physician and wishes to be seen by another doctor. Your response to this should be ____.
- Notify the nurse, then quote him the written rules.
- Notify the nurse, then sell him the current doctor.
- Notify the nurse, then offer him the social worker.
- Notify the nurse, then name him the nearest clinic.
Correct answer: Notify the nurse, then offer him the social worker.
A resident keeps the right to choose who treats him, so the aide should notify the nurse, then offer him the social worker: those two staff members are the ones who can arrange a change, and the aide's own view of any doctor stays out of it. Notify the nurse, then quote him the written rules is wrong because no facility rule locks a resident to an assigned physician. Notify the nurse, then sell him the current doctor pushes the aide's opinion into a decision that belongs to the resident. Notify the nurse, then name him the nearest clinic has the aide recommending a provider, which is outside what an aide may do.
- The family members of a resident ask you to check what the resident’s record says about resuscitation wishes in the event the resident was to expire. Upon looking at the records, you see that the resident has given permission to share all medical information with these family members. You also see the initials DNR in the resident’s advance directive. You tell the family ____.
- Her file says we should not overrule family.
- Her file says we should not prevent revival.
- Her file says we should not resuscitate her.
- Her file says we should not record refusals.
Correct answer: Her file says we should not resuscitate her.
The three letters in the advance directive stand for do not resuscitate, so what the relatives are told is that her file says we should not resuscitate her. Her file says we should not prevent revival reverses the directive and would have the team begin the very effort she declined. Her file says we should not overrule family treats the choice as the relatives' to make, when the resident already recorded it herself. Her file says we should not record refusals invents a paperwork rule that those letters never stood for. Nothing at all would be read out to relatives unless the permission were already on file, as it is here.
- Which of these is a violation of a residents right to privacy?
- The charge nurse discussing the resident's medical condition at report.
- The medic team discussing the resident's medical condition at transfer.
- The nursing aides discussing the resident's medical condition at lunch.
- The floor doctor discussing the resident's medical condition at rounds.
Correct answer: The nursing aides discussing the resident's medical condition at lunch.
Privacy lets the people treating a resident talk to one another for the purpose of that treatment, so the violation is the nursing aides discussing the resident's medical condition at lunch: a meal break is a social setting where anyone nearby can overhear, and the aides talking there may not even be assigned to that resident. The charge nurse discussing the resident's medical condition at report is the hand-off that keeps care continuous. The medic team discussing the resident's medical condition at transfer is treating the resident on the way to the hospital. The floor doctor discussing the resident's medical condition at rounds is directing that same care.
- A residents right to information involves all of these except ____.
- The resident reading the complete record of her treatment.
- The resident reading the complete history of her roommate.
- The resident reading the complete costs of her medication.
- The resident reading the complete outcomes of her surgery.
Correct answer: The resident reading the complete history of her roommate.
The right to information covers the resident's own care, so the exception is the resident reading the complete history of her roommate: that record belongs to somebody else, and handing it over would breach the roommate's privacy instead of serving hers. The resident reading the complete record of her treatment is the plain right of access to her own chart. The resident reading the complete costs of her medication is the right to see and question the bill. The resident reading the complete outcomes of her surgery is the right to be told what a procedure produced, including results nobody expected.
- When a resident has visitors, it is important for a nursing assistant to ____.
- Watch the resident and guests with live intercoms.
- Leave the resident and guests with utmost privacy.
- House the resident and guests with spare bedrooms.
- Rush the resident and guests with tight schedules.
Correct answer: Leave the resident and guests with utmost privacy.
A resident keeps the right to receive visitors and to see them unobserved, so the aide should leave the resident and guests with utmost privacy. Watch the resident and guests with live intercoms turns the call system into a listening device and strips the visit of the very thing it needs. Rush the resident and guests with tight schedules cuts short a visit the resident is entitled to have. House the resident and guests with spare bedrooms gives away rooms the aide has no authority over, and it answers a question nobody asked.
- You have two residents in your care who belong to your church. Both have been asking you questions about the medical condition of the other. They are both worried and know you care. What is your best response?
- Tell them that sharing a chart would honor their shared church friendship.
- Tell them that sharing a chart would reward their honest personal concern.
- Tell them that sharing a chart would breach policy guarding their privacy.
- Tell them that sharing a chart would satisfy their plain mutual curiosity.
Correct answer: Tell them that sharing a chart would breach policy guarding their privacy.
Sharing one resident's chart with another resident would breach policy guarding their privacy, and saying so plainly is the best response. It would not honor their shared church friendship, because confidentiality does not bend for people you worship beside. It does not reward their honest personal concern either, since worry is not a lawful basis for release. Satisfying their plain mutual curiosity is never a permitted reason to disclose protected information.
- Which of these statements is true for “restorative nursing”?
- Restorative nursing passes a written exercise plan and logs to nearby relatives.
- Restorative nursing sits outside a certified aide training scope and legal duty.
- Restorative nursing puts a client back home and ends scheduled therapy sessions.
- Restorative nursing helps a resident regain and later keep function and welfare.
Correct answer: Restorative nursing helps a resident regain and later keep function and welfare.
The true statement is that restorative nursing helps a resident regain and later keep function and welfare; the goal is both recovery of ability and holding on to it. Passing a written exercise plan and logs to nearby relatives hands the work to families, which is not restorative care. Restorative measures sit inside the certified aide training scope, so the option placing them outside it is wrong. Putting a client back home and ending scheduled therapy sessions stops the program rather than describing it.
- Residents have a right to telephone privileges. Which of these correctly describes these rights?
- Each resident may use a phone under a watchful staff escort.
- Each resident may use a phone freely inside a private space.
- Each resident may use a phone within fixed daily call hours.
- Each resident may use a phone supplied at their own expense.
Correct answer: Each resident may use a phone freely inside a private space.
Telephone rights mean each resident may use a phone freely inside a private space: the facility supplies both the access and a place to speak without being overheard. Use under a watchful staff escort destroys the privacy half of the right. Confining calls within fixed daily call hours restricts the right instead of describing it. A phone supplied at their own expense is not required, because the facility provides the access.
- “Any threat to the psychological well-being of a resident that results in psychological or emotional distress” is the definition of ____.
- Sexual abuse
- Mental abuse
- Bodily abuse
- Fiscal abuse
Correct answer: Mental abuse
A threat to psychological well-being that leaves a resident in emotional distress is the definition of mental abuse. Sexual abuse is unwanted sexual contact, exposure or coercion. Bodily abuse is striking, rough handling or any other physical harm. Fiscal abuse is the misuse of a resident's money, checks or property.
- It is appropriate for the nursing assistant to share personal client information with ____.
- The client daughters phoning the nurse station.
- The resident spouse holding the visitor badges.
- The nursing assistant starting the later shift.
- The roommate sharing the neighboring bed space.
Correct answer: The nursing assistant starting the later shift.
Personal client information may be passed to the nursing assistant starting the later shift, because that aide needs it to continue the care. The client daughters phoning the nurse station are family rather than members of the care team. The resident spouse holding the visitor badges has no automatic claim on the record either. The roommate sharing the neighboring bed space has no claim on it at all.
- In giving care according to the 1987 Nursing Home Reform Act, the nurse aide SHOULD
- Protect the client's privacy during personal care.
- Unseal the client's envelopes during morning care.
- Lend the client's belongings during everyday care.
- Prevent the client's protests during routine care.
Correct answer: Protect the client's privacy during personal care.
Under the 1987 Nursing Home Reform Act the nurse aide should protect the client's privacy during personal care, because residents keep in a facility the privacy they had at home. Preventing the client's protests during routine care denies the guaranteed grievance right. Unsealing the client's envelopes during morning care opens mail the resident alone may open. Lending the client's belongings during everyday care gives away property that belongs to the resident.
- Which of these does not show caring behavior?
- Stopping to comfort a tense resident before an upcoming surgery day.
- Stopping to visit with a forgotten resident during the daily rounds.
- Stopping to hand a co-worker the resident duties before early lunch.
- Stopping to see whether a crying resident needs added quiet support.
Correct answer: Stopping to hand a co-worker the resident duties before early lunch.
Stopping to hand a co-worker the resident duties before early lunch puts your own break ahead of the people in your care, so it is the one choice that shows no caring. Stopping to visit with a forgotten resident during the daily rounds gives attention to someone who receives none. Stopping to comfort a tense resident before an upcoming surgery day answers a real fear. Stopping to see whether a crying resident needs added quiet support responds to visible distress.
- As a nursing assistant, when a resident refuses a bath it is your responsibility to ____.
- Respect the resident's stated refusal.
- Phone the resident's daughter instead.
- Shorten the resident's complete scrub.
- Restrict the resident's chosen visits.
Correct answer: Respect the resident's stated refusal.
A resident may decline care, so the aide's duty is to respect the resident's stated refusal and then tell the supervising nurse. Phoning the resident's daughter instead applies family pressure to overturn a decision the resident is entitled to make. Shortening the resident's complete scrub still delivers a bath that was declined. Restricting the resident's chosen visits punishes the refusal and takes away a separate right.
- Which of these is included in the “Residents Bill of Rights”?
- The right to have relatives choose and direct care plans.
- The right to ride and return whenever the resident wants.
- The right to know the full facility services and charges.
- The right to pick each social and leisure group activity.
Correct answer: The right to know the full facility services and charges.
The Residents Bill of Rights covers the right to know the full facility services and charges, so a resident can see what is offered and what it costs. The right to have relatives choose and direct care plans is not in it, because those decisions stay with the resident. The right to ride and return whenever the resident wants is not a guaranteed transport benefit. The right to pick each social and leisure group activity overstates a resident's right to take part in whatever the facility offers.
- Which resident right is being violated if a nursing assistant enters the hospital cafeteria and hears another assistant talking about a resident with co-workers?
- The resident's right to personal privacy.
- The resident's right to choose treatment.
- The resident's right to witness meetings.
- The resident's right to track caregivers.
Correct answer: The resident's right to personal privacy.
Discussing a resident where other people can overhear breaks the resident's right to personal privacy. The resident's right to track caregivers is about knowing who delivers the care, which is not what happened here. The resident's right to choose treatment is about decisions rather than disclosure. The resident's right to witness meetings is about being present for care planning, not about a cafeteria conversation.
- You have taken care of the same pleasant female resident daily for the past 6 months. Very suddenly, she demonstrates a drastic personality change. She exhibits frequent crying and withdrawal from activities. She refuses her ADLs and becomes fearful of physical contact with you and other caregivers. She seems very anxious and nervous when she is around others. As her CNA, your most appropriate course of action would be to ____.
- Report suspected abuse using your own facility guidelines.
- Ask the trembling resident about possible abuse incidents.
- Await visible bruising before raising your abuse concerns.
- Discuss your abuse suspicions with her visiting relatives.
Correct answer: Report suspected abuse using your own facility guidelines.
The sudden personality change, the crying and the new fear of touch are enough to report suspected abuse using your own facility guidelines, stating only what you saw. Asking the trembling resident about possible abuse incidents is an investigation the aide may not conduct and can frighten her further. Awaiting visible bruising before raising your abuse concerns delays protection she is owed today. Discussing your abuse suspicions with her visiting relatives breaks confidentiality and can warn the person responsible.
- Beneficence is defined as ____.
- Continued avoidance of injury.
- Active kindness toward others.
- Guarded privacy about records.
- Truthful careful daily speech.
Correct answer: Active kindness toward others.
Beneficence is active kindness toward others: taking positive steps that benefit the person in your care. Continued avoidance of injury describes nonmaleficence, a separate principle that only requires you to do no damage. Guarded privacy about records describes confidentiality. Truthful careful daily speech describes veracity, the duty to be honest.
- Which of these describes the job of an Ombudsman Committee?
- To determine boarding charges for resident suites.
- To scrutinize breaches of resident record privacy.
- To investigate complaints of resident abuse fully.
- To sentence providers convicted of resident abuse.
Correct answer: To investigate complaints of resident abuse fully.
An Ombudsman Committee is an independent group of citizens whose job is to investigate complaints of resident abuse fully. It does not determine boarding charges for resident suites, since a facility sets its own rates. It does not scrutinize breaches of resident record privacy, which a facility handles under federal privacy law. It does not sentence providers convicted of resident abuse, because sentencing belongs to the courts.
- A resident is to be discharged from your facility for failure to pay for his care. According to the “Residents Bill of Rights,” what is the proper amount of notice that he must be given?
- Thirty days
- Twelve days
- Ninety days
- Twenty days
Correct answer: Thirty days
The Residents Bill of Rights sets written notice at thirty days before a transfer or discharge for non-payment. Twenty days falls short of the period the rule requires. Twelve days is barely over a week and nowhere near the standard. Ninety days is longer than the rule sets and is not the notice a resident is owed.
- Mrs. Featherhat is a Native American who has been diagnosed as near death. Her family wishes to perform a ceremony with candles and incense. The facility should
- Dismiss the ceremony with useless bedside words.
- Refuse the ceremony under current fire policies.
- Allow the ceremony with careful safety measures.
- Relocate the ceremony toward a distant facility.
Correct answer: Allow the ceremony with careful safety measures.
The facility should allow the ceremony with careful safety measures, supporting the family practice while controlling the candles and incense. Refusing the ceremony under current fire policies denies a cultural and religious right that can be accommodated instead. Dismissing the ceremony with useless bedside words passes judgment on a family belief, which is no part of the nurse aide role. Relocating the ceremony toward a distant facility moves a dying resident for no clinical reason.
- A resident's call light
- Should be answered as duties finally stop.
- Should be answered as quickly as possible.
- Should be answered only by assigned staff.
- Should be answered from the nurse station.
Correct answer: Should be answered as quickly as possible.
A call light should be answered as quickly as possible, because a resident who cannot reach help may be in distress or may try to get up alone. Answering it when the aide finishes other work leaves that risk in place for as long as the work takes. Having it answered only by assigned staff means nobody responds while that one aide is busy elsewhere. Answering it from the nurse station puts no one at the bedside, where the need actually is.
- You observed a coworker being physically abusive to a resident. You did not report the incident to the Nurse Supervisor. You can be charged with
- Hitting and battery
- Nursing and neglect
- Failing and perjury
- Aiding and abetting
Correct answer: Aiding and abetting
Knowing that a crime took place and staying silent makes you an accomplice, so the charge is aiding and abetting. Hitting and battery name what the coworker did, not what falls on the silent witness. Nursing and neglect covers care that was never given rather than a failure to report what you saw. Failing and perjury turn on sworn false statements, and no statement was sworn here.
- When caring for a resident whose religion is different from your own, you should
- Dispute and correct their religious errors.
- Accept and respect their religious beliefs.
- Enforce and police their religious rituals.
- Reject and alter their religious practices.
Correct answer: Accept and respect their religious beliefs.
When a resident follows a religion different from your own you should accept and respect their religious beliefs. To dispute and correct their religious errors treats your own faith as the measure of theirs. To reject and alter their religious practices is an attempt to convert, which is no part of the nurse aide role. To enforce and police their religious rituals is wrong as well, because how much of a faith a person observes is that person's own choice.
- The intentional attempt or threat to touch a person’s body without the person’s consent is
- Perjury
- Battery
- Larceny
- Assault
Correct answer: Assault
An intentional attempt or threat to touch a person without permission is assault, and no contact has to happen for the charge to stand. Battery is the unwanted touching itself, so it requires contact that did not occur here. Larceny is the taking of property that belongs to someone else. Perjury is lying under oath during a legal proceeding.
- You hear another nurse aide tell a confused resident, “If you don’t eat, I’ll lock you in your room.” You should
- Tell the charge nurse about the exact threat.
- Tell the charge nurse once your shift closes.
- Tell the charge nurse whenever you feel safe.
- Tell the charge nurse about the skipped meal.
Correct answer: Tell the charge nurse about the exact threat.
Threatening a confused resident is verbal abuse and has to be reported, so tell the charge nurse about the exact threat you heard. Telling the charge nurse once your shift closes delays a report that is owed at once. Telling the charge nurse whenever you feel safe leaves the timing to your own comfort rather than to the resident's protection. Telling the charge nurse about the skipped meal reports the wrong thing and leaves the threat unreported.
- You observe your charge nurse holding a resident’s nose to get him to take his medications. You should
- Report this incident by lunch to the rehab CNA.
- Report this incident at sunset to the ward LPN.
- Report this incident at once to the senior DON.
- Report this incident by night to the relief RN.
Correct answer: Report this incident at once to the senior DON.
When the person involved is your own charge nurse, the concern moves up a level, so report this incident at once to the senior DON. Reporting this incident by lunch to the rehab CNA hands it to another aide who has no authority to act on it. Reporting this incident at sunset to the ward LPN both delays the report and chooses someone below the charge nurse. Reporting this incident by night to the relief RN waits as well, and a relief nurse does not outrank the charge nurse either.
- If the nurse aide is concerned about client care, who should the nurse aide speak to FIRST?
- The nurse aide nearby.
- The family care owner.
- The unit charge nurse.
- The house call doctor.
Correct answer: The unit charge nurse.
A concern about client care goes first to the unit charge nurse, who will try to settle it before it travels any higher. The nurse aide nearby is a peer with no authority over the situation. The family care owner sits several levels above the first step in the chain. The house call doctor is outside the reporting line a nurse aide follows.
- Keeping information confidential about a client is
- A paperwork limitation
- A situational courtesy
- A modest consideration
- A legal responsibility
Correct answer: A legal responsibility
Keeping client information confidential is a legal responsibility under federal privacy law, and a breach carries real penalties. It is not a situational courtesy that shifts with the circumstances. It is not a modest consideration to be weighed against convenience. It is not a paperwork limitation confined to written records, because spoken and electronic communication is covered too.
- After you have visited a home health client, learned some new information about them, and want to talk about it, you should
- Call your supervisor after the client objects.
- Call your supervisor to share the information.
- Call your supervisor plus the nearby relative.
- Call your supervisor to entertain your family.
Correct answer: Call your supervisor to share the information.
What you learn in a client's home may go only to someone who needs it in order to give care, so call your supervisor to share the information. Calling your supervisor after the client objects makes the disclosure wait on a complaint rather than on need. Calling your supervisor plus the nearby relative adds a person who has no right to hear it. Calling your supervisor to entertain your family turns protected information into conversation.
- The client offers a nurse aide a twenty dollar bill as a thank you for all that the nurse aide has done. The nurse aide SHOULD
- Politely refuse the money.
- Promptly donate the money.
- Silently pocket the money.
- Casually divide the money.
Correct answer: Politely refuse the money.
The nurse aide should politely refuse the money, because a gift of cash crosses the client and caregiver boundary and can end in discipline. Silently pocketing the money accepts a payment that facility policy forbids. Promptly donating the money still accepts it first, so the boundary is crossed before anything is given away. Casually dividing the money spreads the same violation to coworkers.
- A nurse aide forgets to raise the side-rails on a bed and the resident is injured from a fall. This is termed as
- Simple neglect
- Criminal abuse
- Freak accident
- Innocent lapse
Correct answer: Simple neglect
Care that the resident was owed was not given and injury followed, which is simple neglect. An innocent lapse is not the term for a known safety step the aide skipped. Criminal abuse requires intent to harm, and forgetting the rails is not intent. A freak accident implies that nothing could have prevented the fall, when raising the side rails would have.
- A standard of care is a way of ensuring that patients always are cared for by professionals who are everything EXCEPT
Correct answer: Fast
A standard of care asks what a reasonable, trained professional would do in the same situation, and speed is not part of it, so fast is the exception. Safe is the heart of every standard of care. Able covers the training and skill the task demands, and an aide may decline a task until trained for it. Kind belongs to treating a resident with dignity, which the standard also expects.
- A famous athlete has been admitted into your facility. He is in a different unit. If you want to find out why he is there, what should you do?
- Retrieve those records and begin reading.
- Explore that hallway and start listening.
- Avoid temptation and simply keep working.
- Ask friendly coworkers and stop guessing.
Correct answer: Avoid temptation and simply keep working.
You have no care role with that client, so avoid temptation and simply keep working. To retrieve those records and begin reading is an access violation that can end your employment even though the system lets you in. To explore that hallway and start listening is the same breach reached by a different route. To ask friendly coworkers and stop guessing drags a second employee into the violation with you.
- While you are at lunch with other nurse aides, they start to discuss how rude a resident was behaving. What should you do?
- Tell them that rude behavior needs a fair reply.
- Tell them that client talk suits a private room.
- Tell them that silence keeps a nurse aide clear.
- Tell them that the patient will hear this later.
Correct answer: Tell them that client talk suits a private room.
Say plainly that client talk suits a private room, which stops the conversation without accusing anyone. Saying that rude behavior needs a fair reply joins a discussion that should not be taking place at all. Saying that silence keeps a nurse aide clear treats staying quiet as protection while the breach continues. Saying that the patient will hear this later adds a second breach and starts a conflict.
- After the end of the shift, some nurse aides go to a restaurant. Acceptable topics of conversation would include
- The clients
- The weather
- The surgery
- The doctors
Correct answer: The weather
Off duty and in a public place, the weather and other neutral subjects are the safe conversation. The clients may not be discussed anywhere others can overhear, which a restaurant guarantees. The doctors are a workplace subject that is unprofessional to air in front of strangers. The surgery performed on anyone is protected health information and cannot be named.
- Which of the following would affect a nurse aide’s status on the State Registry and possibly cause the nurse aide to be ineligible to work in a nursing home?
- Being fired by a former employer for repeated delay.
- Being recorded absent from a shift by the scheduler.
- Being tardy with a yearly infection class in spring.
- Being charged with resident neglect in a court case.
Correct answer: Being charged with resident neglect in a court case.
Being charged with resident neglect in a court case is what reaches the State Registry and can make a nurse aide ineligible to work in a nursing home. Being recorded absent from a shift by the scheduler is an attendance matter the registry does not hold. Being tardy with a yearly infection class in spring is training compliance, handled inside the facility. Being fired by a former employer for repeated delay is an employer decision and not a registry finding.
- Proper use of a waist restraint requires that the nurse aide
- Secure harness for unstable rails.
- Apply tension for maximum control.
- Monitor skin for early irritation.
- Loosen buckles for scarce minutes.
Correct answer: Monitor skin for early irritation.
A restraint in place has to be watched, so the nurse aide must monitor skin for early irritation and report any sign of injury. Securing a harness for unstable rails is unsafe, because a rail that is raised or lowered drags the restraint with it. Applying tension for maximum control presses on breathing and circulation. Loosening buckles for scarce minutes leaves the device on far too long; a restrained resident is released and repositioned on a short schedule.
- A 22-year old with terminal brain cancer tells you that she has an Advanced Directive for her end-of-life care. You know this can mean any of the following EXCEPT
- Her records can carry a DNR request for her heart.
- Her family can direct the staff to keep her alive.
- Her Living Will can hold her own care wishes here.
- Her agent can make the daily calls to her doctors.
Correct answer: Her family can direct the staff to keep her alive.
An advance directive records what the person herself wants, so the one thing it cannot mean is that her family can direct the staff to keep her alive. Her records can carry a DNR request for her heart, which is a choice she is free to make. Her Living Will can hold her own care wishes here, since setting out end-of-life wishes is exactly what a living will does. Her agent can make the daily calls to her doctors, because a medical power of attorney names someone to speak for her.
- If abuse is suspected within a facility
- Report the incident only when a colleague or manager concurs.
- Report the incident at length after serious or severe injury.
- Report the incident to a registrar or recorder once complete.
- Report the incident at once to a supervisor or administrator.
Correct answer: Report the incident at once to a supervisor or administrator.
Every suspicion of abuse moves up without delay, so report the incident at once to a supervisor or administrator. Reporting the incident only when a colleague or manager concurs makes a resident's protection wait on an agreement that may never come. Reporting the incident at length after serious or severe injury ignores the rule that suspicion alone triggers the report, before anyone is hurt. Reporting the incident to a registrar or recorder once complete sends it to clerks who cannot act and holds it until the paperwork is tidy.
- The nurse aide reports directly to the
- Teaching nurse
- Facility owner
- Medical doctor
- Licensed nurse
Correct answer: Licensed nurse
The nurse aide reports directly to the licensed nurse, who in turn reports to the Director of Nursing. The facility owner sits at the top of the organization, several levels above the aide's direct line. The medical doctor writes orders for treatment but does not supervise nurse aides. The teaching nurse runs orientation and in-service education rather than the daily assignment.
- It is okay to call a resident by a nickname if
- The caregivers prefer it.
- The resident requests it.
- The nickname sounds kind.
- The resident is offended.
Correct answer: The resident requests it.
A nickname is acceptable when the resident requests it, because how a person is addressed is that person's own choice. The caregivers prefer it carries no weight, since staff preference does not name anyone. The nickname sounds kind is a judgment made for the resident rather than by the resident. The resident is offended names a reason to stop using a name, not a reason to use it.
- What is the main purpose of continuing education for the nurse aide?
- Client safety
- Skill refresh
- Audit records
- Group harmony
Correct answer: Client safety
Continuing education exists for client safety: methods change, and current knowledge is what keeps care safe. Audit records for accreditation are a by-product of the training, not the reason for it. Skill refresh happens along the way, but it is the means rather than the purpose. Group harmony may improve as staff train together, yet teamwork is not why the requirement exists.
- A patient’s chart is a legal document. If something is mistakenly written on the chart, the correct action is to
- Black out the error with a marker, list your surname, rank and shift, then write the correct entry.
- Scrub out the error with an eraser, stamp your badge, grade and year, then write the correct entry.
- Blot out the error with white fluid, record your ward, hour and unit, then write the correct entry.
- Cross out the error with one line, note your initials, date and time, then write the correct entry.
Correct answer: Cross out the error with one line, note your initials, date and time, then write the correct entry.
A chart is a legal record, so the mistake has to stay readable underneath: cross out the error with one line, note your initials, date and time, then write the correct entry. Blacking the error out with a marker hides what was first written and reads as concealment. Scrubbing the error out with an eraser destroys part of a legal record and leaves no trace of what changed. Blotting the error out with white fluid is not permitted on a chart, no matter what is added over the top.
- Mr. Joseph overhears the nurse aide speaking to the nurse about his roommate’s diagnosis and demands to know more about the roommate’s condition. The nurse aide should
- Politely tell Joseph that his roommate's health remains private.
- Politely tell Joseph that his roommate's daughter takes queries.
- Politely tell Joseph that his roommate's worries concern nobody.
- Politely tell Joseph that his roommate's case awaits disclosure.
Correct answer: Politely tell Joseph that his roommate's health remains private.
The nurse aide should politely tell Joseph that his roommate's health remains private, which is firm and courteous in the same breath. Telling Joseph that his roommate's daughter takes queries sends him to a relative who has no right to release it either. Telling Joseph that his roommate's worries concern nobody brushes him aside instead of explaining the rule. Telling Joseph that his roommate's case awaits disclosure promises information that may never be shared with him at all.
- On Monday, Mrs. Green and her family requested and received a “Do Not Resuscitate” order from her doctor. While bathing her on Thursday, she stops breathing and dies. Her son is not home. You should
- Notify the supervisor, then phone emergency services.
- Notify the supervisor, then start chest compressions.
- Notify the supervisor, then provide post-mortem care.
- Notify the supervisor, then reconfirm the directives.
Correct answer: Notify the supervisor, then provide post-mortem care.
A Do Not Resuscitate order means no resuscitation is attempted, so the aide notifies the supervisor, then provides post-mortem care and waits for the family. Phoning emergency services brings responders who would work against the very order Mrs. Green obtained, and starting chest compressions is that same resuscitation done by hand. Reconfirming the directives spends the hour after a death re-reading a document the doctor already signed on Monday.
- There is a contained fire in the residents room. What is the first action a nursing assistant should take?
- Pull the alarm to warn a visitor.
- Move the resident to a safe area.
- Yell for help from the next room.
- Grab the fire hose from the hall.
Correct answer: Move the resident to a safe area.
Rescue comes before everything else in a fire, so the first act is to move the resident to a safe area away from the flames. Pulling the alarm to warn a visitor, yelling for help from the next room, and grabbing the fire hose from the hall each leave the resident lying beside a burning room while the aide does something else first.
- The nurse aide gave a client the wrong diet. What should the nurse aide do after realizing this error?
- Report the meal errors to the nurse after lunch.
- Report the errors to the tray team this evening.
- Report the tray error to the nurse this instant.
- Report the mistakes for the team in the logbook.
Correct answer: Report the tray error to the nurse this instant.
The nurse has to judge whether the wrong food endangers the client, and she can only do that while there is still time to stop the meal, so the aide reports the tray error to the nurse this instant. Holding it until after lunch lets the client finish food the diet order excludes. Telling the tray team this evening routes the problem to people who cannot assess the client and delays it by hours. Writing it for the team in the logbook leaves a record that nobody may read before the next meal.
- The charge nurse has administered a prescribed medication to the wrong patient. This is an example of ____.
- Criminal negligence
- Verbal intimidation
- Excessive restraint
- Medical malpractice
Correct answer: Medical malpractice
A licensed professional who gives a prescribed drug to the wrong patient has failed the standard of care owed to that patient, which is medical malpractice. Criminal negligence is reckless disregard prosecuted by the state rather than a treatment error. Verbal intimidation is a threat made to a person, and no threat was made here. Excessive restraint means holding a resident's body still beyond any need, which has nothing to do with a misdirected dose.
- A nursing assistant threatens to slap a resident if he doesn’t stop yelling. This is classified as:
- Battery
- Calumny
- Larceny
- Assault
Correct answer: Assault
Threatening to strike someone, when no blow is delivered, is assault: the resident is put in fear of contact that has not happened. Battery is the charge once the hand actually lands. Calumny is a damaging false statement about a person's character, which is not what was said here. Larceny is the taking of property and involves no threat at all.
- Mr. Joseph overhears the nurse aide speaking to the nurse about his roommate's diagnosis and demands to know more about his roommate’s condition. The nurse aide should
- Politely explain that the roommate's wishes override this.
- Politely explain that the roommate's visitors decide this.
- Politely explain that the roommate's troubles exclude him.
- Politely explain that the roommate's details stay private.
Correct answer: Politely explain that the roommate's details stay private.
Health information belongs to the resident it describes, so the aide politely explains that the roommate's details stay private and leaves it there. Saying the roommate's visitors decide this hands a privacy duty to people who hold no authority over the record. Saying his troubles exclude Mr. Joseph is dismissive and still confirms that a diagnosis exists. Saying the roommate's wishes override this invites Mr. Joseph to press a sick man for information the aide is not free to release.
- Which of these could cause a nursing assistant to be charged with battery?
- Restraining a resident absent a doctor's written order.
- Threatening a resident during a family's extended stay.
- Medicating a resident from a pharmacy's locked trolley.
- Ignoring a resident during a colleague's smoking break.
Correct answer: Restraining a resident absent a doctor's written order.
Battery is unwanted physical contact, so restraining a resident absent a doctor's written order is the act that brings the charge: force is applied that nobody authorized. Threatening a resident during a family's extended stay is assault, because the harm is promised and never delivered. Medicating a resident from a pharmacy's locked trolley is work outside an aide's scope and is treated as malpractice. Ignoring a resident during a colleague's smoking break is negligence, a failure to act rather than an act of force.
- A resident’s family is visiting when you arrive on duty and one of them hands you an envelope that contains a thank you card and a monetary gift in appreciation for your care of their loved one. The best response is to ____.
- Report the gift to the supervisor, then receive it willingly.
- Report the gift to the supervisor, then retain half yourself.
- Report the gift to the supervisor, then buy resident flowers.
- Report the gift to the supervisor, then refuse it graciously.
Correct answer: Report the gift to the supervisor, then refuse it graciously.
An aide is already paid to care for this resident, so money from the family is a conflict of interest: report the gift to the supervisor, then refuse it graciously. Receiving it willingly creates the expectation that paying families get better care. Retaining half is still taking a payment, only a smaller one. Buying resident flowers spends money the aide was never entitled to hold, and it sidesteps the facility policy that decides where such gifts may go.
- Which of these examples would not be considered neglect?
- Leaving the floor briefly during a scheduled shift.
- Leaving a wheelchair blocking the narrow hall door.
- Leaving a frail resident unturned since dawn today.
- Leaving a thirsty resident during a busy afternoon.
Correct answer: Leaving the floor briefly during a scheduled shift.
Neglect means failing to meet a need the resident depends on the aide for. Leaving the floor briefly during a scheduled shift is ordinary staffing: aides are sent to meals, errands and other units every day. Leaving a thirsty resident during a busy afternoon withholds fluids the resident cannot fetch. Leaving a wheelchair blocking the narrow hall door builds a fall hazard into the path residents walk. Leaving a frail resident unturned since dawn today invites pressure injuries.
- All of these could result in a nursing assistant being charged with negligence except ____.
- Absently overlooking a resident during a nightly check.
- Deliberately striking a resident during a violent rage.
- Carelessly nicking a resident during a hurried shaving.
- Repeatedly bypassing a resident during a turning round.
Correct answer: Deliberately striking a resident during a violent rage.
Negligence is harm that follows from carelessness, while deliberately striking a resident during a violent rage is a chosen act and is charged as battery and abuse instead. Absently overlooking a resident during a nightly check leaves a resident unwatched by accident. Carelessly nicking a resident during a hurried shave injures through inattention. Repeatedly skipping a resident during a turning round lets pressure injuries form through omission. Each of those three is careless rather than intended.
- Your fellow nursing assistant is angry at you and lies to the charge nurse. He claims you stole money from a resident’s purse. This is an example of ____.
- Harassment
- Conversion
- Defamation
- Negligence
Correct answer: Defamation
Telling the charge nurse a false story that paints a coworker as a thief is defamation: an untrue statement, passed to a third party, that damages a reputation. Harassment is a pattern of conduct aimed at a person rather than a single false claim about them. Conversion is the tort of actually taking another's property, which is what the lie alleges and not what the coworker did. Negligence requires careless harm, and this lie was told on purpose.
- You hear a charge nurse telling a resident that the LPN is not performing as well as she should be. The legal term for this is ____.
- Perjury
- Slander
- Hearsay
- Forgery
Correct answer: Slander
A spoken statement that damages another worker's professional reputation is slander. Hearsay is secondhand information repeated by someone who did not witness it, and it carries no legal penalty by itself. Perjury is lying under oath in a legal proceeding, which is not where this remark was made. Forgery involves falsifying a document, and nothing was written here.
- Which of these is the legal term for “being responsible for providing care according to an accepted standard”?
- Diligence
- Indemnity
- Liability
- Precedent
Correct answer: Liability
Liability is the legal term for being answerable for care that meets an accepted standard, and for the consequences when it does not. Diligence describes the care and attention a worker brings to a task, not the legal responsibility attached to it. Indemnity is a promise to cover another party's loss, which is an insurance arrangement rather than a duty of care. Precedent is an earlier ruling that guides later ones.
- You observe a co-worker sexually harassing a resident and choose to ignore it. This is an example of ____.
- Harming and shaming
- Bullying and hazing
- Aiding and abetting
- Coercing and hiding
Correct answer: Aiding and abetting
A worker who sees a resident being harassed and stays silent has helped the offense continue, which the law calls aiding and abetting. Coercing and hiding describes forcing someone and then covering it up, and the aide in this scenario forced nobody. Bullying and hazing name the co-worker's own conduct rather than the bystander's. Harming and shaming likewise describe what was done to the resident, not the failure to intervene.
- When a nursing assistant restricts a residents movements or actions without proper authorization, it can be interpreted as ____.
- False declarations
- False imprisonment
- False solicitation
- False attestations
Correct answer: False imprisonment
Holding a resident somewhere, or blocking movement, without a lawful order is false imprisonment, and the charge stands even when no restraint is ever touched. False declarations and false attestations both describe putting untrue information on a record, which is a documentation offense rather than a restriction of liberty. False solicitation means obtaining something by an untrue request, and nothing was requested of this resident at all.
- Another word for forcing a patient to do something against his or her will is ____.
- Coercion
- Trickery
- Betrayal
- Contempt
Correct answer: Coercion
Making someone act against their own will by pressure or threat is coercion, and it is unlawful even when the aide believes the task is good for the patient. Betrayal is breaking a trust that was freely given, and it forces nothing. Trickery reaches the same result by deceiving the patient, who still believes the choice was their own. Contempt is open disrespect, or in law a refusal to obey a court order.
- Which of these is a form of involuntary seclusion?
- Leaving a patient alone after a private visit begins.
- Leaving a patient alone after a requested door shuts.
- Leaving a patient alone after removing a call button.
- Leaving a patient alone after a chosen move outdoors.
Correct answer: Leaving a patient alone after removing a call button.
Involuntary seclusion means the resident is cut off from other people without choosing it, so leaving a patient alone after removing a call button is the example: the patient now has no way to summon anyone. Leaving a patient alone after a private visit begins honors a request the patient made. Leaving a patient alone after a requested door shuts does the same thing with the door. Leaving a patient alone after a chosen move outdoors follows the patient's own decision about where to be.
- If a resident went on a day trip with family members and returns complaining of hunger and thirst, the nursing assistant should ____.
- Tell the nurse the resident came back very hungry.
- Tell the nurse the resident wants a larger dinner.
- Tell the nurse the family needs a snack timetable.
- Tell the nurse the family followed the meal plans.
Correct answer: Tell the nurse the resident came back very hungry.
Hunger and thirst after hours in someone else's care can mean the resident's basic needs went unmet, and a suspicion like that has to go up the line, so tell the nurse the resident came back very hungry. Telling the nurse the family followed the meal plans passes on the family's account instead of what the resident is reporting. Telling the nurse the resident wants a larger dinner turns a possible neglect report into a meal request. Telling the nurse the family needs a snack timetable puts the aide in a teaching role and still leaves the incident unreported.
- Which of these scenarios would most likely be considered a violation of patient rights?
- A patient is redressed by staff in a clean nightgown.
- A patient is moved to a distant ward over nonpayment.
- A patient is tied down after she punches the orderly.
- A patient is treated by a doctor she wants dismissed.
Correct answer: A patient is treated by a doctor she wants dismissed.
A patient chooses who treats them, so a patient is treated by a doctor she wants dismissed is the rights violation here. A patient is redressed by staff in a clean nightgown is allowed once the patient's own clothing is soiled or has become a hazard to others. A patient is tied down after she punches the orderly is lawful restraint to stop harm, provided a doctor's order covers it. A patient is moved to a distant ward over nonpayment is permitted, because nonpayment is one of the reasons a facility may transfer someone.
- Which of these would be an example of invasion of a patients privacy?
- Entering the resident's room before knocking gently.
- Leaving the resident's bedroom open during mealtime.
- Exposing the resident's body needlessly during care.
- Discussing the resident's dislikes at ward handover.
Correct answer: Exposing the resident's body needlessly during care.
Privacy covers the body as well as the record, so exposing the resident's body needlessly during care is the invasion. Entering the resident's room before knocking gently is discourteous and should be corrected, but it is a matter of manners rather than a privacy breach. Leaving the resident's bedroom open during mealtime is only a problem if the resident asked for the door to be shut. Discussing the resident's dislikes at ward handover is required care planning, as long as it happens where outsiders cannot overhear.
- The definition of liability is ____.
- Being punished for care that misses a published benchmark.
- Being untrained for duties that exceed your assigned role.
- Being answerable for care that meets an accepted standard.
- Being involved in actions that breach an existing statute.
Correct answer: Being answerable for care that meets an accepted standard.
Liability is being answerable for care that meets an accepted standard, and for the consequences when the care given falls below it. Being punished for care that misses a published benchmark describes the penalty that follows a breach, not the duty itself. Being untrained for duties that exceed your assigned role is a competence gap, which may cause a breach but is not the word for the duty. Being involved in actions that breach an existing statute is criminal conduct rather than the standard-of-care responsibility.
- Which of these is not an example of abuse?
- Kicking a resident under the dining table.
- Striking a resident across the left cheek.
- Threatening a resident with a raised fist.
- Startling a resident with a noisy trolley.
Correct answer: Startling a resident with a noisy trolley.
Abuse is harm, or the threat of harm, aimed at a resident. Startling a resident with a noisy trolley is clumsy and unpleasant, but nothing was aimed at the resident and no harm was intended, so it is not abuse. Threatening a resident with a raised fist is the threat itself. Striking a resident across the left cheek and kicking a resident under the dining table are both delivered harm.
- Which of these is not a liable act?
- Verbal mistreatment
- Monetary misconduct
- Willful abandonment
- Voluntary seclusion
Correct answer: Voluntary seclusion
Voluntary seclusion is the resident's own choice to be by themselves, so nobody is answerable for it; the liable version is involuntary seclusion, imposed as punishment. Verbal mistreatment is a recognized form of abuse. Willful abandonment leaves a resident without the care the aide agreed to give. Monetary misconduct takes a resident's money without right, and all three of those create legal liability.
- What are your legal and ethical responsibilities if you have access to medical records?
- To share the record with visitors.
- To keep the record safely private.
- To write the record down properly.
- To reveal the record to relatives.
Correct answer: To keep the record safely private.
Federal privacy law limits a resident's record to the people treating that resident, so the duty is to keep the record safely private. To share the record with visitors hands it to people with no treatment role. To write the record down properly is good documentation, and accuracy is a separate duty that does not answer what the law asks of you here. To reveal the record to relatives breaches privacy even when the relatives mean well, unless the resident has said otherwise.
- A client with metastatic cancer has an Do-Not-Resuscitate (DNR) advance directive. If the client’s heart rate begins to slow, what should you do?
- Notify the nurse, then start strong chest presses.
- Notify the nurse, then alert her nearby relatives.
- Notify the nurse, then recheck her written wishes.
- Notify the nurse, then await her comfort measures.
Correct answer: Notify the nurse, then await her comfort measures.
A Do-Not-Resuscitate order is legal and final, and the nurse may still have comfort orders such as morphine to give, so notify the nurse, then await her comfort measures. Starting strong chest presses is the resuscitation the client signed away. Alerting her nearby relatives suggests the family can undo a directive the client made, which they cannot. Rechecking her written wishes asks a dying client to justify a decision that is already documented.
- Forgetting to raise the side rails as ordered causes a resident to fall and be injured. This could be called
- The accident of a tumble that hurt the resident.
- The neglect of a duty that keeps residents safe.
- The failure of a rail that broke under pressure.
- The absence of a report that the shift required.
Correct answer: The neglect of a duty that keeps residents safe.
Side rails were ordered and were not raised, so this is the neglect of a duty that keeps residents safe: a known safety measure was simply left undone. The accident of a tumble that hurt the resident describes the outcome and hides the reason it happened. The failure of a rail that broke under pressure blames equipment that worked fine and was never put up. The absence of a report that the shift required is a second, separate fault and does not name what caused the injury.
- Documentation of a residents fluid intake and output is part of your role as a nursing assistant. The standard unit of measure for doing this is ____.
- Milligrams, the unit used for tablet potency.
- Milliliters, the unit used for liquid volume.
- Ounces, the unit used for household cookware.
- Meters, the unit used for corridor distances.
Correct answer: Milliliters, the unit used for liquid volume.
Fluid intake and output are charted in milliliters, so the unit used for liquid volume is what belongs on the sheet. Milligrams, the unit used for tablet potency, weighs a drug rather than a fluid. Ounces, the unit used for household cookware, appears on kitchen jugs and cartons but is not the charting standard in a facility. Meters, the unit used for corridor distances, measures length and has no place on an intake record at all.
- If you are unable to clean up a large spill on the floor yourself, what is the best alternative, once you have notified someone to help?
- Bar the local residents until help arrives.
- Cordon the wet corridor until help arrives.
- Drape the folded towels until help arrives.
- Post the idle bystander until help arrives.
Correct answer: Cordon the wet corridor until help arrives.
A spill too big to wipe up at once is a fall hazard for everyone who walks past, so cordon the wet corridor until help arrives and let nobody cross it. Bar the local residents until help arrives confines people to their rooms, which is neither practical nor permitted. Post the idle bystander until help arrives hands a safety duty to someone with no training and no responsibility for it. Drape the folded towels until help arrives leaves a slick, shifting cover that makes the floor more dangerous.
- When performing care activities, gloves should be worn ____.
- During the resident's morning dressing.
- During the resident's cereal breakfast.
- During the resident's perineal washing.
- During the resident's afternoon stroll.
Correct answer: During the resident's perineal washing.
Peri-care brings the aide into direct contact with urine, stool and other body fluids, so gloves go on during the resident's perineal washing. During the resident's morning dressing handles clothing rather than fluids, and needs no gloves unless a garment is soiled. During the resident's cereal breakfast is a feeding task with no expected exposure. During the resident's afternoon stroll is support at the arm and gait belt, which carries no contamination risk either.
- The best source of Vitamin D is found in which of these foods?
- Milk from the chilled dairy aisle.
- Apples from the fresh fruit aisle.
- Bread from the daily bakery aisle.
- Steak from the frozen meats aisle.
Correct answer: Milk from the chilled dairy aisle.
Fluid cow's milk is fortified with vitamin D by law in the United States, so milk from the chilled dairy aisle is the best source on this list. Apples from the fresh fruit aisle supply fiber and vitamin C, but fruit carries no vitamin D. Bread from the daily bakery aisle is a carbohydrate staple, and a plain loaf is not fortified with it. Steak from the frozen meats aisle supplies protein and iron, and red muscle meat is a poor source.
- A nurse asks you to perform something “stat”. This means do it ____.
- Instantly, before the routine chores.
- Eventually, before the late handover.
- Shortly, before the afternoon rounds.
- Sometime, before the final paperwork.
Correct answer: Instantly, before the routine chores.
A stat request means the nurse needs it done now, ahead of whatever else is in hand, so instantly, before the routine chores is what she is asking for. Eventually, before the late handover pushes an urgent request out to the end of the shift. Shortly, before the afternoon rounds still puts other work first. Sometime, before the final paperwork treats a safety order as an ordinary errand with no deadline.
- A resident has suffered a stroke. As a nursing assistant, you’ve been asked to help with ambulation. The best position for doing this would be ____.
- On the unharmed side, nearest the wrist.
- On the weakened side, nearest the elbow.
- On the rearward side, nearest the spine.
- On the foremost side, nearest the chest.
Correct answer: On the weakened side, nearest the elbow.
A stroke leaves one side weak, and the aide walks where the resident is most likely to buckle, so stand on the weakened side, nearest the elbow. On the unharmed side, nearest the wrist leaves the weak leg with nothing to lean on. On the rearward side, nearest the spine puts the aide behind the resident, where a fall cannot be caught in time. On the foremost side, nearest the chest blocks the very path the resident is trying to walk.
- Part of your role as a nursing assistant is to be delegated tasks throughout your shift. In which of these examples would refusal to do a task be acceptable?
- A task that exceeds your legal scope.
- A task that wastes your entire shift.
- A task that skips your weekly roster.
- A task that repeats your past rounds.
Correct answer: A task that exceeds your legal scope.
An aide may decline work the certification does not cover, and must decline it, so a task that exceeds your legal scope is the refusal that stands up. A task that repeats your past rounds is still your work however many times it has come around today. A task that wastes your entire shift is a judgment about priority, which the nurse makes rather than the aide. A task that skips your weekly roster is simply an assignment you do not ordinarily get.
- At the end of your shift, your fellow nursing assistant comes in to relieve you. While giving report, you discover your colleague is under the influence of alcohol. The best course of action, as a member of a healthcare team, is to ____.
- Notify the nurse, then follow her strict orders.
- Notify the nurse, then work her overnight shift.
- Notify the nurse, then phone her sobriety coach.
- Notify the nurse, then make her bitter espresso.
Correct answer: Notify the nurse, then follow her strict orders.
An impaired colleague cannot safely hold a floor, and the charge nurse is the one who takes her off it, so notify the nurse, then follow her strict orders. Notify the nurse, then work her overnight shift buries the problem under your own goodwill and leaves her free to return tomorrow. Notify the nurse, then phone her sobriety coach is counseling no aide is qualified or asked to give. Notify the nurse, then make her bitter espresso does nothing whatever to alcohol already in the blood.
- You enter a resident’s room and notice he is having difficulty breathing. Your proper response should be to ____.
- Alert the nurse, then watch the labored chest.
- Alert the nurse, then phone the absent cousin.
- Alert the nurse, then await the slow recovery.
- Alert the nurse, then leave the quiet bedroom.
Correct answer: Alert the nurse, then watch the labored chest.
Labored effort to breathe can be the first sign of something serious, and only the nurse may assess it, so alert the nurse, then watch the labored chest. Alert the nurse, then phone the absent cousin spends the minutes that matter on someone who cannot help. Alert the nurse, then await the slow recovery gambles that the trouble will pass by itself. Alert the nurse, then leave the quiet bedroom puts the resident out of sight at exactly the moment somebody should be looking.
- Which of these statements is incorrect regarding cleaning a urinary drainage bag?
- Secure the lowered pouch during the bag change.
- Avoid the exposed tubing during the bag change.
- Use the bottled peroxide during the bag change.
- Scrub the lathered hands during the bag change.
Correct answer: Use the bottled peroxide during the bag change.
Alcohol, not peroxide, is what a facility stocks for this job, and peroxide is neither reliably on hand nor adequate for it, so use the bottled peroxide during the bag change is the statement that is wrong. Secure the lowered pouch during the bag change is sound, because a pouch raised above the bladder lets urine run back toward the resident. Avoid the exposed tubing during the bag change is sound, since a finger on an open end carries organisms straight into a closed system. Scrub the lathered hands during the bag change is sound, and the washing happens both before and after.
- The primary role of the CNA in patient assessment is to ____.
- Compose the weekly diagnosis for the doctor.
- Describe the medical outlook for the family.
- Perform the bedside checkups for the charts.
- Collect the physical readings for the nurse.
Correct answer: Collect the physical readings for the nurse.
An aide gathers height, weight, vital signs and intake figures and hands them upward, while the nurse is the one who assesses: collect the physical readings for the nurse. Compose the weekly diagnosis for the doctor puts a diagnosis in the aide's hands, which no aide may make. Describe the medical outlook for the family shares a clinical judgment the aide is neither qualified nor permitted to give. Perform the bedside checkups for the charts is a physical examination, which belongs to the nurse or the physician.
- Which of these are conditions requiring extra care regarding the residents nail care?
- Incontinence accidents and obesity.
- Anticoagulant therapy and diabetes.
- Dementia restlessness and insomnia.
- Hypertension symptoms and glaucoma.
Correct answer: Anticoagulant therapy and diabetes.
Blood thinners turn a small nick into a long bleed, and diabetes turns the same nick into a slow-healing ulcer, so anticoagulant therapy and diabetes are the two conditions that demand extra caution at the nail. Incontinence accidents and obesity bear on skin care and positioning rather than on the nail bed. Dementia restlessness and insomnia make a resident harder to hold still, which is a technique problem and not a bleeding or healing risk. Hypertension symptoms and glaucoma have no bearing on nails.
- Which of these best describes how accurate documentation assists the entire healthcare team?
- It shows whether the planned treatments helped.
- It shows whether the accused attendant behaved.
- It shows whether the everyday errands occurred.
- It shows whether the yearly inspectors approve.
Correct answer: It shows whether the planned treatments helped.
A care plan is a set of interventions, and the record is how the whole team learns whether those interventions are working, so it shows whether the planned treatments helped. It shows whether the accused attendant behaved treats the chart as a legal shield, which is a by-product rather than the purpose. It shows whether the everyday errands occurred captures that a task happened without saying whether it did any good. It shows whether the yearly inspectors approve writes the record for surveyors instead of for the resident.
- Which of these best describes an advantage to being a CNA when considering future career options?
- You have the chance to sample assorted care tasks and pick one favored specialty.
- You have the chance to watch several health roles and study typical daily duties.
- You have the chance to meet patients born overseas and hear many unusual stories.
- You have the chance to learn varied family customs and calm deep culture worries.
Correct answer: You have the chance to watch several health roles and study typical daily duties.
A nurse aide stands beside nurses, therapists, physicians and technicians every shift, so you have the chance to watch several health roles and study typical daily duties is what makes the job useful for planning a future career. Sampling assorted care tasks and picking one favored specialty describes variety inside the aide job itself, not exposure to other occupations. Meeting patients born overseas and hearing unusual stories broadens the aide personally but shows nothing about other careers. Learning varied family customs and calming culture worries is a communication benefit, not a window onto healthcare occupations.
- The nursing assistant walks in on a patient who is having a seizure. Which of these actions should the nursing assistant take first?
- Wedge the molars and press the padded plastic blade inside.
- Call the doctor and await the fresh medical orders quietly.
- Cushion the head and move the nearby heavy obstacles aside.
- Clamp the limbs and stop the violent muscle spasms quickly.
Correct answer: Cushion the head and move the nearby heavy obstacles aside.
During a seizure the aide protects the person from injury and nothing else, so cushion the head and move the nearby heavy obstacles aside is the first action. Wedging the molars and pressing a padded plastic blade inside forces the jaw open and can break teeth or block the airway. Calling the doctor and waiting quietly for medical orders leaves the person unprotected while the seizure runs its course, and the nurse rather than the aide makes that report afterward. Clamping the limbs to stop the muscle spasms causes fractures and dislocations without shortening the seizure at all.
- Which of these members of the healthcare team is responsible for supervising UAP (unlicensed assistive personnel)?
- The primary registered nurse (RN).
- The overnight medical doctor (MD).
- The certified hospital aide (CNA).
- The patient care technician (PCT).
Correct answer: The primary registered nurse (RN).
Supervision of unlicensed assistive personnel is a nursing function held by a licensed nurse, so the primary registered nurse (RN) is the correct member of the team. The certified hospital aide (CNA) is itself unlicensed assistive personnel and cannot supervise a peer. The overnight medical doctor (MD) writes medical orders but does not direct or evaluate nursing assistants. The patient care technician (PCT) is another unlicensed title working under the same nursing supervision.
- Which of these statements about “active listening” is false?
- Active listening is giving the speaker undivided quiet mental focus.
- Active listening is nicknamed the classic third inner ear technique.
- Active listening is revealing the unspoken wants nobody ever voices.
- Active listening is hearing the resident amid unrelated busy chores.
Correct answer: Active listening is hearing the resident amid unrelated busy chores.
The false statement is active listening is hearing the resident amid unrelated busy chores: listening while your hands and mind are on another job is exactly what active listening is not. Active listening is giving the speaker undivided quiet mental focus is a correct description of the skill. Active listening is nicknamed the classic third inner ear technique is also correct, since that phrase is a standard name for it. Active listening is revealing the unspoken wants nobody ever voices is correct too, because full attention surfaces needs the resident never states aloud.
- Which member of the residents health care team is responsible for determining socialization and communication skills of residents and then finding the resources to match them?
- Ward chaplain
- Social worker
- House surgeon
- Bedside nurse
Correct answer: Social worker
Matching a resident to outside programs, visitors, groups and funding is case work, so the social worker is the team member who judges social and communication ability and finds resources for it. The ward chaplain addresses faith and end of life concerns and does not assess communication skills or arrange community services. The house surgeon diagnoses and prescribes but leaves social resources to others. The bedside nurse carries out the medical plan and supervises daily care rather than locating social programs.
- Which of these is true about the term care plan?
- All of these plan promises are strict guarantees.
- All of these plan documents are courtroom papers.
- All of these plan breaches are severely punished.
- All of these plan claims are completely accurate.
Correct answer: All of these plan claims are completely accurate.
A care plan commits the facility to deliver written care, it is a legal record that can be produced in court, and staff who ignore it face discipline, so all of these plan claims are completely accurate is the answer that covers the term fully. All of these plan promises are strict guarantees states only the commitment half and leaves out the legal and disciplinary sides. All of these plan breaches are severely punished names only the consequence of ignoring the plan. All of these plan documents are courtroom papers names only its legal standing. Each of the three is partial, so none of them alone answers what the term care plan means.
- There is an order to give a female patient a shower, but she refuses. The nurse aide should
- Threaten the client and lift the stiff arm strap.
- Record the refusal and note the offered bed bath.
- Drag the woman and begin the unwanted shower now.
- Scold the lady and repeat the strict daily order.
Correct answer: Record the refusal and note the offered bed bath.
A competent person may refuse any care, and the aide's duty is then to offer an alternative and write down what happened, so record the refusal and note the offered bed bath is correct. Threatening the client and lifting a stiff arm strap is intimidation and the threat of restraint is itself abuse. Dragging the woman and beginning the unwanted shower is battery, since care given over an explicit refusal has no consent behind it. Scolding the lady and repeating the strict daily order treats an order as binding on the resident, but an order directs staff and never overrides a refusal.
- You discover a fire in a residents room. You have gotten the resident out of harms way. What is the next step you should execute?
- Pull the nearest hallway alarm.
- Seize the small spray canister.
- Phone the close family members.
- Clear the entire resident unit.
Correct answer: Pull the nearest hallway alarm.
Rescue comes first and the alarm comes second, so with the resident already out of danger the aide should pull the nearest hallway alarm. Clearing the entire resident unit is the wider evacuation, which follows the alarm and is directed by staff who have been summoned by it. Seizing the small spray canister is the final step and is attempted only for a small contained fire after the alarm has sounded. Phoning the close family members does nothing for anyone still in danger and belongs long after the emergency is controlled.
- If you have a concern about an assignment, you should ____.
- Raise the worry with your unit supervisor privately.
- Voice the doubts with your night physician publicly.
- Review the qualms with your shift manager afterward.
- Escalate the chore with your nearby workmate anyway.
Correct answer: Raise the worry with your unit supervisor privately.
An assignment you doubt belongs to the person who issued it, taken up out of earshot of residents and visitors, so raise the worry with your unit supervisor privately is correct. Voicing the doubts with the night physician publicly goes to someone outside the nursing chain and airs the problem in front of residents. Reviewing the qualms with the shift manager afterward lets the questionable assignment be carried out first, which is the point at which harm happens. Escalating the chore to a nearby workmate simply hands the task to an untrained colleague and never reaches anyone able to change it.
- As a CNA, you work as a “team player” to take care of all of your residents needs. Which of these is a reason you should take this approach when you need to ambulate a resident?
- The helper talks aloud when two aides divide the chore.
- The partner aches rarely when two aides halve the toil.
- The client remains safer when two aides share the lift.
- The journey ends sooner when two aides hurry the march.
Correct answer: The client remains safer when two aides share the lift.
Team work during ambulation exists for one reason, which is that a second pair of hands catches a buckling knee, so the client remains safer when two aides share the lift is the reason to use it. The helper talks aloud when two aides divide the chore describes narration, which comforts but does not prevent a fall. The partner aches rarely when two aides halve the toil puts the staff member's comfort ahead of the person being moved. The journey ends sooner when two aides hurry the march makes speed the goal, and hurrying an unsteady walker is precisely how falls occur.
- Which of these is not true about a patients care plan?
- A care plan steadies the shared routines inside large wards.
- A care plan gathers the bedside opinions inside small units.
- A care plan omits the healthier residents inside busy homes.
- A care plan honors the personal wishes inside private rooms.
Correct answer: A care plan omits the healthier residents inside busy homes.
Every resident admitted to a facility gets a plan of care, regardless of how well they are, so a care plan omits the healthier residents inside busy homes is the statement that is not true. A care plan steadies the shared routines inside large wards is true, since a written plan is what keeps different staff delivering the same care. A care plan gathers the bedside opinions inside small units is true, because the aide who works with the person daily has observations the nurse needs. A care plan honors the personal wishes inside private rooms is true, as the resident's own preferences are part of what the plan records.
- Which member of the healthcare team is responsible for carrying out the patients medical plan?
- The registered nurse.
- The hospital orderly.
- The whole department.
- The personal surgeon.
Correct answer: The registered nurse.
Responsibility for seeing that the medical plan is actually carried out sits with one licensed person, so the registered nurse is the accountable member of the team. The personal surgeon writes and revises the plan but does not execute the day to day care it calls for. The hospital orderly performs assigned tasks under direction and carries no accountability for the plan as a whole. The whole department shares in delivering care, but shared responsibility is not the same as the single person answerable for the plan.
- Your resident consumed a bowl of soup that was 180cc of liquid. How many ounces was that?
Correct answer: 6 oz.
Thirty cubic centimeters make one ounce, so 180 divided by 30 gives 6 oz. as the amount recorded on the intake sheet. 4 oz. would be 120cc, well short of the bowl the resident finished. 5 oz. would be 150cc, which also under-records what was taken in. 7 oz. would be 210cc and credits the resident with more fluid than the bowl held.
- Why is taking a residents oral temperature the most common means of obtaining a reading?
- It offers the most reachable spot and the least bother.
- It offers the most eager persons and the least refusal.
- It offers the most frugal budget and the least expense.
- It offers the most precise numbers and the least error.
Correct answer: It offers the most reachable spot and the least bother.
The mouth is easy to reach on a cooperative adult and asks almost nothing of the person being measured, so it offers the most reachable spot and the least bother is why the oral route is used first. It offers the most eager persons and the least refusal is wrong because plenty of residents decline an oral reading, which is why other routes exist. It offers the most frugal budget and the least expense is wrong since the same digital probe serves several routes at the same cost. It offers the most precise numbers and the least error is wrong because rectal and temporal readings track core temperature more closely than oral ones.
- To avoid pulling on the catheter while you're turning a male client, the catheter tube must be taped to his
- Outer ankle
- Linen sheet
- Upper thigh
- Metal frame
Correct answer: Upper thigh
Securing the drainage tube to the body itself keeps the slack constant as the person rolls, so the upper thigh is where the tube is anchored on a male client. The outer ankle sits far below the drainage bag and the long loop it leaves is exactly what snags during a turn. The linen sheet moves with the bedding every time the client is repositioned, so the tube is tugged with it. The metal frame is fixed while the client is not, which puts the full pull of the turn straight onto the catheter.
- Which of the following is NOT considered a way to restrain a client?
- Pain treatment
- Wheelchair bar
- Padded mittens
- Sedative syrup
Correct answer: Pain treatment
Treating pain aims at the symptom rather than at limiting movement, so pain treatment is the one item here that is not a restraint. Sedative syrup given to subdue behavior rather than to treat a diagnosed condition is a chemical restraint. A wheelchair bar fastened across the lap keeps the person from rising and is a physical restraint however comfortable it looks. Padded mittens stop the hands being used freely and are counted as a restraint whenever they are applied to limit the client.
- The nurse aide sees a client spill water on the floor in the hall. Another client is walking down the hall. The nurse aide SHOULD
- Sponge the lingering water afterward.
- Ignore the widening puddles entirely.
- Caution the strolling client quietly.
- Alert the housekeeping crew promptly.
Correct answer: Alert the housekeeping crew promptly.
Housekeeping carries the wet floor signs, the proper mop and the decontamination supplies, and reaching them at once is what gets the hazard marked and removed, so alert the housekeeping crew promptly is the action here. Ignoring the widening puddles entirely leaves a fall waiting to happen in a corridor someone is already walking down. Cautioning the strolling client quietly protects one person while the water stays on the floor for everybody else. Sponging the lingering water afterward postpones the fix past the moment when the second client reaches the wet spot.
- A nurse aide is helping a client who is at risk for aspiration to eat a meal. Which position is BEST for the client during the meal?
- Lying flatly at mattress height with the head rotated aside.
- Sitting upright at ninety degrees with the chin tucked down.
- Resting propped at slight recline with the neck bent upward.
- Rolling leftward at hip level with the trunk cushioned well.
Correct answer: Sitting upright at ninety degrees with the chin tucked down.
Gravity carries food and fluid down the esophagus when the trunk is vertical, and a tucked chin narrows the airway entrance during the swallow, so sitting upright at ninety degrees with the chin tucked down is the safest position for a meal. Lying flatly at mattress height with the head rotated aside removes the gravity assist and lets food pool in the throat. Resting propped at slight recline with the neck bent upward extends the neck, which opens the airway at exactly the wrong moment. Rolling leftward at hip level with the trunk cushioned well is a rest and pressure relief position and gives the trunk none of the upright support swallowing needs.
- A client needs to be repositioned but is heavy, and the nurse aide is not sure that she can move the client alone. The nurse aide should
- Tell the idle nurse aide later and start the easy chores.
- Alert the busy nurse aide soon and send the eager family.
- Inform the lone nurse aide early and try the risky shove.
- Ask the nearby nurse aide today and share the bulky lift.
Correct answer: Ask the nearby nurse aide today and share the bulky lift.
A load one person cannot manage needs a second trained pair of hands before it is moved at all, so ask the nearby nurse aide today and share the bulky lift is correct. Tell the idle nurse aide later and start the easy chores abandons a person who still needs repositioning, and skin breaks down while the task waits. Alert the busy nurse aide soon and send the eager family hands a lifting task to untrained visitors who can injure both themselves and the client. Inform the lone nurse aide early and try the risky shove still ends with one aide moving the load alone, which is how back injuries and falls happen.
- When transferring a client, MOST of the client’s weight should be supported by the nurse aide’s
Correct answer: Legs
The large muscles of the thighs are the strongest in the body and are built to carry load, so during a transfer the weight should rest on the legs while the spine stays straight. The back is the classic wrong answer, since bending and lifting through the spine is the commonest cause of injury among nurse aides. The arms guide and steady the client but have nowhere near the strength to bear the load. The feet give the stance a wide base but do not generate the lift themselves.
- To take an oral temperature, the nurse aide should
- Spread the greasy jelly under the metal tip.
- Press the narrow stem under the bare armpit.
- Slide the clean probe under the warm tongue.
- Push the oiled sensor under the rectal skin.
Correct answer: Slide the clean probe under the warm tongue.
An oral reading is taken from the pocket beside the frenulum where blood flow is close to the surface, so slide the clean probe under the warm tongue is how it is done. Press the narrow stem under the bare armpit describes an axillary reading, a different route that runs about a degree lower. Spread the greasy jelly under the metal tip adds lubricant, which belongs to a rectal measurement and never to an oral one. Push the oiled sensor under the rectal skin is the rectal route itself, not the oral reading the task calls for.
- What is the FIRST thing a nurse aide should do when finding an unresponsive client?
- Attempt the chest thrusts.
- Call the absent relatives.
- Close the private doorway.
- Summon the nearest helper.
Correct answer: Summon the nearest helper.
One person alone can neither run a resuscitation nor fetch equipment, so the first act on finding an unresponsive person is to summon the nearest helper. Attempt the chest thrusts puts compressions ahead of getting extra hands and equipment to the bedside, and it is done only after help is on the way. Close the private doorway shuts the room off from the very people who need to hear the call. Call the absent relatives spends the critical minutes on a conversation that changes nothing about the emergency.
- Which type of fire can be put out with water?
Correct answer: Paper
Ordinary combustibles such as paper, wood and cloth are the class of fire that water puts out, because water cools the fuel below its ignition point. A metal fire reacts violently with water and needs a dry powder agent instead. A cable fire is energized, so water conducts current straight back to whoever is holding the hose. A fryer fire is burning fat, and water dropped into hot oil flashes to steam and throws the flaming grease outward.
- Physical restraints are used MOST often
- To calm roommate fears
- To excuse thin rosters
- To prevent client harm
- To honor family wishes
Correct answer: To prevent client harm
A restraint is lawful only when a medical symptom or a risk of the person hurting themselves or others makes it necessary, so to prevent client harm is the reason restraints are most often applied. To calm roommate fears uses one person's liberty to settle another person's discomfort, which is never a lawful ground. To excuse thin rosters is restraint for staff convenience, exactly what regulations forbid. To honor family wishes is not enough on its own, because a relative cannot authorize a restraint without a physician's order and a documented need.
- The nursing care plan states, “Transfer with mechanical lift.” However, the client is very agitated. To transfer the client, the nurse aide SHOULD
- Hoist the person with the unaided grasp.
- Move the resident with the extra helper.
- Push the sling with the unlocked brakes.
- Strap the patient with the wide harness.
Correct answer: Move the resident with the extra helper.
An agitated person in a mechanical lift is unpredictable, and the answer is more hands rather than fewer safeguards, so move the resident with the extra helper is correct. Hoist the person with the unaided grasp abandons the equipment the care plan specifies and risks injury to both people. Push the sling with the unlocked brakes lets the base roll away mid transfer, which is the commonest mechanical lift accident. Strap the patient with the wide harness carries on alone with someone who is thrashing, and no harness holds a person who is fighting the sling.
- The nurse aide is going to help the client walk from the bed to a chair. What should the nurse aide put on the client’s feet?
- Thin cotton socks or stockings
- Rubber soled shoes or slippers
- Smooth fabric mules or booties
- Slick plastic covers or sheets
Correct answer: Rubber soled shoes or slippers
Traction is what keeps an unsteady walker upright on a polished floor, so rubber soled shoes or slippers are what belong on the feet before walking to a chair. Thin cotton socks or stockings slide on vinyl and tile and offer nothing to grip with. Smooth fabric mules or booties look like footwear but the sole gives way the moment weight shifts onto it. Slick plastic covers or sheets are worse than bare feet, since the surface is designed to shed fluid rather than hold the floor.
- Clean bed linen placed in a client’s room but NOT used should be
- Dropped in the soiled hamper.
- Reused in the nearby bedroom.
- Placed in the nurse cupboard.
- Replaced in the linen closet.
Correct answer: Dropped in the soiled hamper.
Anything that has been inside an occupied room is treated as contaminated whether or not it touched the person, so unused sheets are dropped in the soiled hamper. Placed in the nurse cupboard only moves the contamination to a storage space other staff draw from. Reused in the nearby bedroom carries whatever organisms are in the first room straight to a second person. Replaced in the linen closet puts exposed sheets back among the stock that is still counted as clean.
- The Heimlich maneuver (abdominal thrusts) is used on a client who has
- A crushed finger
- A blocked airway
- A sprained wrist
- A blurred cornea
Correct answer: A blocked airway
Abdominal thrusts work by forcing the diaphragm upward to drive trapped air out of the lungs and expel what is caught, so they are used on a client with a blocked airway. A crushed finger is a limb injury that abdominal thrusts would do nothing for and could worsen by moving the person. A blurred cornea is a vision problem with no bearing on breathing at all. A sprained wrist likewise needs support and ice, not a forceful squeeze around the abdomen.
- A client is to be assisted out of bed to sit in a wheelchair. How can this procedure be made safe?
- Loosen the rear brakes at the wheel rims.
- Throw the bed pillow at the padded chair.
- Fold the metal pedals at the ankle level.
- Place the bed frame at the lowest height.
Correct answer: Place the bed frame at the lowest height.
A transfer is safe when the person can put both feet flat on the floor before standing, so place the bed frame at the lowest height is what makes this procedure safe. Throw the bed pillow at the padded chair adds a cushion that shifts under the person and is no substitute for a low bed. Fold the metal pedals at the ankle level leaves the footplates in the path of the feet during the pivot. Loosen the rear brakes at the wheel rims is the opposite of what is needed, because the chair must be locked and still while the person moves onto it.
