Your FREE National Nurse Aide Assessment Program (NNAAP) Practice Test 2026 – 150+ Q&A

Correct answer: About 105 degrees Fahrenheit (41 degrees Celsius)

Bath water around 105 degrees Fahrenheit is warm enough for comfort and effective cleansing without burning fragile skin. Water near 80 degrees or room temperature would chill the resident, and water near 130 degrees can scald, especially on thin elderly skin that senses heat poorly.

Correct answer: A bath blanket to cover areas not being washed

A bath blanket is essential so the aide can expose only the part being washed and keep the rest of the body covered, preventing chilling and protecting privacy. A heating pad risks burns, a cold-water basin would chill the resident, and a plastic gown does not address warmth or modesty during washing.

Correct answer: Finish the bath, then report and document the reddened area

A reddened area over a bony spot that does not fade with pressure is an early pressure injury sign, so the aide finishes care and then reports and documents it for the nurse. Massaging or firmly rubbing damaged skin can worsen the breakdown, and a tight bandage adds pressure rather than relieving it.

Correct answer: Keep the resident from getting cold and damp

Washing, rinsing, and drying each area before moving on keeps the resident from lying wet and becoming chilled, and it limits how much skin is exposed at one time. The practice is about comfort and warmth, not about using less soap, lengthening the bath, or skipping the bath blanket.

Correct answer: From front to back, away from the urinary opening

Female perineal care is performed by wiping from front to back, moving away from the urethra and toward the rectum, to keep bacteria from the anal area away from the urinary opening. Wiping back to front, scrubbing in circles, or going side to side can carry organisms toward the urethra and cause infection.

Correct answer: Retract the foreskin, clean the tip, and then return the foreskin to its natural position

For an uncircumcised male, the aide gently retracts the foreskin, cleans the exposed tip, then returns the foreskin to its normal position to prevent swelling and restricted blood flow. Cleaning only the outside leaves debris that can cause infection, leaving it retracted can cause harm, and powder under the foreskin traps moisture.

Correct answer: Provide the privacy curtain and ask the visitor to step out

Before perineal care the aide protects dignity by closing the privacy curtain and asking the visitor to step out. Privacy is a basic part of personal hygiene care. Rushing exposes the resident, a small towel does not provide real privacy, and delaying to the next shift neglects needed hygiene.

Correct answer: Cause skin breakdown and infection

Urine and stool left on the skin are irritating and, combined with moisture, lead to skin breakdown and infection, so perineal care after incontinence is essential. Such moisture does not improve circulation, strengthen the skin, or provide a safe temperature change; it damages the protective skin barrier.

Correct answer: Hangs loosely with extra slack to prevent pulling on the catheter

Catheter tubing should be secured with enough slack that movement does not pull on the catheter, which protects the urethra from trauma. Taping it to the floor contaminates it, wrapping it snugly around the leg can kink it, and keeping it under tension over the rail can tug the catheter painfully.

Correct answer: Touch the inside of the measuring container

The drainage spout must not touch the inside of the measuring container, because contact contaminates the spout and can introduce bacteria back into the closed drainage system. The spout should be opened to empty, can be cleaned, and should point down into the container, so those actions are correct rather than errors.

Correct answer: Document the observation and report it to the nurse

Cloudy, foul-smelling urine can signal a urinary tract infection, so the aide documents the finding and reports it to the nurse for evaluation. Changing fluids without reporting hides a problem, and flushing or removing the catheter is outside the nurse aide's scope and could harm the resident.

Correct answer: A serving of ice cream that melts at room temperature

Ice cream counts as fluid intake because it is liquid at room temperature, so it is recorded as part of the resident's fluid total. A scrambled egg, toast, and mashed potatoes stay solid at room temperature and are counted as food, not fluid.

Correct answer: 480 mL

The recorded intake is 480 mL: 180 mL of milk, 120 mL of coffee, and the 180 mL of soup actually consumed (240 mL served minus 60 mL left). Only the amount the resident drinks is counted, so the leftover soup is subtracted, making totals such as 300, 420, or 540 mL incorrect.

Correct answer: An exact measured amount is needed to track the resident's fluid balance

A graduated container gives an exact measured volume, which the care team needs to monitor the resident's fluid balance and detect problems such as dehydration or fluid overload. Speed, keeping urine warm, and saving supplies are not the reason; accuracy of the output record is.

Correct answer: On a flat surface at eye level

Liquid is read with the container on a flat surface at eye level so the measurement is accurate. Holding it above eye level, looking down from above, or tilting the container distorts the reading and can lead to an incorrect intake or output record.

Correct answer: Every 2 hours

A resident who cannot reposition independently should be turned at least every 2 hours to relieve pressure over bony areas and protect the skin. Turning only once per shift, every 6 hours, or only at bedtime leaves pressure on the same areas far too long and invites skin breakdown.

Correct answer: Supine position

Lying flat on the back is the supine position. Prone is lying face down, Fowler's is sitting up with the head of the bed raised, and lateral is lying on the side, so none of those describe a resident flat on the back.

Correct answer: Relieve pressure on the heels and prevent skin breakdown

Floating the heels off the mattress with support under the lower legs removes pressure from the heels, which are common pressure-injury sites, and helps prevent skin breakdown. The action does not affect snoring, leg appearance, or room temperature; its purpose is protecting the skin.

Correct answer: Behind the back, under the upper arm, and between the knees

Good side-lying alignment uses pillows behind the back for support, under the upper arm, and between the knees to keep joints aligned and prevent skin from rubbing. A single pillow at the head, pillows under the abdomen, or support only under the lower hip leaves the body poorly aligned and the skin at risk.

Correct answer: Allow fluid to drain out and prevent aspiration

Turning the head to the side lets oral care fluid drain out of the mouth so an unconscious resident, who cannot swallow or cough effectively, does not aspirate it into the lungs. The position is a safety measure, not about sleep comfort, the resident's view, or keeping the pillow clean.

Correct answer: Cannot swallow and could aspirate excess fluid

An unconscious resident cannot swallow, so only a small amount of fluid is used to avoid pooling and aspiration into the lungs. The reason is the absent swallow reflex, not normal swallowing, taste preference, or any expectation that the resident will wake up.

Correct answer: Line the sink with a towel or partly fill it with water

Lining the sink with a towel or adding some water cushions the dentures so they will not crack if dropped during cleaning. Holding them over an empty hard sink risks breakage, hot water can warp dentures, and scrubbing them dry in a paper towel does not clean them and risks dropping them.

Correct answer: A labeled cup of cool water or denture solution

Dentures are stored in a labeled cup filled with cool water or denture solution to keep them moist so they do not dry out, warp, or crack. Storing them dry can warp them, hot water can damage them, and leaving them loose on a washcloth risks loss or breakage.

Correct answer: Hold the meal and notify the nurse about the wrong tray

A resident ordered thickened liquids can choke or aspirate on thin liquids, so the aide holds the meal and notifies the nurse to correct the tray. Feeding the wrong consistency, improvising thickening, or letting the resident choose ignores the swallowing order and endangers the resident.

Correct answer: Offering small bites and allowing time to chew and swallow before the next bite

Feeding small bites and pausing for the resident to chew and swallow each one prevents choking and supports a safe, dignified meal. Overfilling the spoon and rushing, mixing foods together, or encouraging talking while chewing all raise the risk of choking and reduce dignity.

Correct answer: Choking on food and unable to breathe

Sudden inability to speak, clutching the throat, and turning blue during a meal are classic signs of choking with a blocked airway, which is an emergency requiring immediate help. These signs point to airway obstruction rather than a stroke, nausea, or simple tiredness.

Correct answer: Let the resident do what they can and assist only as needed

Supporting independence means allowing the resident to do as much of the dressing as possible and helping only with the parts they cannot manage, which preserves dignity and ability. Doing it all for them, choosing all clothing, or skipping the task removes independence and choice.

Correct answer: The weak left arm first

When dressing, the weak or affected limb goes into the clothing first and comes out last, so the aide dresses the weak left arm first. This avoids forcing the affected joint and reduces strain and pain. Dressing the strong arm first, both at once, or by convenience can injure the weak side.

Correct answer: Providing adaptive utensils and giving the resident extra time to eat

Offering adaptive utensils and allowing extra time lets the resident keep feeding himself despite the temporary injury, supporting independence and dignity. Feeding him to save time, removing the tray, or telling him to skip the meal takes away his ability and risks poor nutrition.

Correct answer: Place a nonslip mat in the tub and stay with the resident during the bath

Placing a nonslip mat in the tub and staying with the resident is the safest action because it prevents slipping and lets the aide help if the resident becomes weak or dizzy. Pre-filling with hot water risks burns, leaving the resident alone risks a fall or drowning, and having the resident stand to wash the back invites a fall.

Correct answer: Cut the toenails straight across only if allowed by facility policy and clean and dry between the toes

Proper foot care means trimming nails straight across only when policy permits and thoroughly cleaning and drying between the toes to prevent skin breakdown and fungal growth. Very hot water can burn fragile skin, leaving the toes damp promotes infection, and cutting deep into the corners can cause ingrown nails and injury.

Correct answer: Remove the bedpan, provide perineal cleansing, and dry the skin before repositioning

Removing the bedpan promptly, cleaning the perineal area, and drying the skin prevents irritation and skin breakdown while supporting comfort and dignity. Leaving the resident on the pan too long can damage skin, raising the bed fully can spill contents, and skipping cleansing leaves irritating moisture and waste on the skin.

Correct answer: Move the weaker leg forward, then the stronger leg

After advancing the cane, the resident should move the weaker leg forward, then the stronger leg. The cane is held on the stronger side, so the cane and the weaker leg move together to share the load and provide support, and the stronger leg then steps to meet them. Leading with the stronger leg, hopping, or crossing the legs removes that support and increases the risk of a fall.

Correct answer: Provide oral care and offer fluids if allowed, and report the finding to the nurse

The correct action is to provide oral care and offer fluids if allowed, and report the finding to the nurse. Dry, cracked lips and mouth can signal dehydration or poor oral hygiene, so moistening the mouth, encouraging permitted fluids, and reporting the observation help the team address the cause. Ignoring it, using drying alcohol-based mouthwash, or withholding fluids would worsen the problem.

Correct answer: The stool in the pouch is black and tarry or contains bright red blood

The finding to report is that the stool in the pouch is black and tarry or contains bright red blood, which can indicate bleeding in the digestive tract and must be brought to the nurse's attention. A pouch one-third full of soft brown stool, some gas, and a pink, moist stoma are all expected, normal observations during routine ostomy care and do not require special reporting.

Correct answer: 98.6 degrees Fahrenheit (37 degrees Celsius)

A normal resting oral temperature for an adult is about 98.6 degrees Fahrenheit, which is the standard average used as the baseline normal. A reading of 102.4 degrees signals a fever, while 94.0 and 90.5 degrees are abnormally low and would point to hypothermia, so none of those represent the expected normal.

Correct answer: 78 beats per minute

A normal resting adult pulse is roughly 60 to 100 beats per minute, so 78 beats per minute is within the normal range. A rate of 44 is below normal and should be reported, while 118 and 136 are above normal and also need to be reported to the nurse.

Correct answer: 16 breaths per minute

A normal resting respiratory rate for an adult is about 12 to 20 breaths per minute, so 16 breaths per minute is normal. A rate of 6 is dangerously slow, and rates of 30 and 38 are abnormally fast; all of those abnormal values should be reported to the nurse.

Correct answer: Within the normal range for an adult

A blood pressure of 118/76 mm Hg is within the normal adult range, which is generally below about 120/80 mm Hg. It is not severe hypertension, which would show much higher numbers, nor is it dangerously low, and the reading is a typical, easily measured value.

Correct answer: About one inch above the elbow crease, over the brachial artery

The cuff is placed about one inch above the elbow crease so the stethoscope can be positioned over the brachial artery for an accurate reading. Placing it directly on the elbow crease, around the wrist, or on the forearm misplaces the cuff and gives an inaccurate blood pressure.

Correct answer: Supported at the level of the heart

The arm should be supported at heart level so the blood pressure reading is accurate. Raising the arm above the head or holding it against the chest distorts the measurement, and letting the arm hang below heart level can falsely raise the reading.

Correct answer: Give a falsely high blood pressure reading

A cuff that is too small for the arm gives a falsely high blood pressure reading because it must be inflated more to compress the artery. It does not produce a falsely low value or leave the reading unchanged, and it would not specifically affect the ability to feel the pulse, so the aide should obtain a larger cuff.

Correct answer: Promptly report the high reading to the nurse

A blood pressure of 188/104 mm Hg is far above normal and a significant change, so the aide should promptly report it to the nurse for evaluation. Reassuring the resident without reporting, waiting until the next shift, or dismissing the reading as wrong could delay needed care for a possible serious problem.

Correct answer: On the thumb side of the inner wrist

The radial pulse is felt on the thumb side of the inner wrist, where the radial artery runs close to the skin. The neck is where the carotid pulse is felt, and the back of the knee and top of the foot are other pulse sites, so they are not used when the order is to take the radial pulse.

Correct answer: First two or three fingertips placed gently on the artery

The pulse is counted using the first two or three fingertips placed gently over the artery so the beats can be felt clearly. The thumb has its own pulse that can be mistaken for the resident's, and the palm or back of the hand cannot feel the pulse accurately.

Correct answer: Has a pulse that is irregular and needs accurate counting

An irregular pulse is counted for a full minute so that every beat is captured and the rate is accurate, since a short count could miss skipped or extra beats. The reason is not the resident's preference, a strong easy pulse, or a recent meal; it is the need to accurately count an irregular rhythm.

Correct answer: One complete rise and fall of the chest

One respiration is counted as one complete rise and fall of the chest, which is a single inhalation plus exhalation. Counting only the breath in, only the breath out, or two rises as one would give an inaccurate respiratory rate.

Correct answer: Without the resident realizing it is being counted

Respirations are counted without the resident knowing, often right after taking the pulse while still holding the wrist, because people change their breathing when they know it is being watched. Announcing the count, counting while the resident talks, or having them hold their breath all distort the natural rate.

Correct answer: The depth and rhythm of the breathing

While counting respirations, the aide also notes the depth and rhythm of the breathing, since shallow, deep, or irregular breaths are important to report. The color of clothing, when the resident last ate, and favorite activities are unrelated to the quality of the resident's breathing.

Correct answer: All blood, body fluids, secretions, and excretions

Standard precautions require treating all blood, body fluids, secretions, and excretions from every resident as potentially infectious, regardless of diagnosis. Limiting precautions to known infections, to fluids with an odor, or to isolation residents would miss hidden infections and is why standard precautions apply to everyone.

Correct answer: Whenever contact with blood, body fluids, or broken skin is likely

Standard precautions call for gloves whenever the aide may contact blood, body fluids, mucous membranes, or broken skin, no matter the resident's diagnosis. Wearing gloves only for known contagious diseases, only at shift start, or only when observed would leave the aide and residents unprotected.

Correct answer: Wear gloves and perform hand hygiene before and after contact

Standard precautions apply to every resident, so the aide wears gloves for the draining wound and performs hand hygiene before and after contact even without a known infection. Skipping gloves, wearing only a mask, or refusing to help all fail to provide safe, protective care under standard precautions.

Correct answer: Gown, mask, goggles, gloves

The correct donning order is gown first, then mask, then goggles or face shield, and gloves last so the gloves cover the gown cuffs. Putting gloves on first or out of sequence leaves gaps in protection, which is why the gown-mask-goggles-gloves order is followed.

Correct answer: The gloves

Gloves are removed first during doffing because they are the most contaminated item, having touched the resident and surfaces. Removing the gown, mask, or goggles first would risk spreading contamination from the dirty gloves to clean skin, so gloves come off before the other PPE.

Correct answer: Hand hygiene must always be performed after removing gloves

Hand hygiene must always be done after removing gloves because hands can become contaminated during glove removal or through unseen glove defects. Gloves do not replace hand washing, bare hands are not automatically clean, and the need for hand hygiene does not depend on whether the gloves visibly tore.

Correct answer: Put on a gown and gloves before entering

Contact precautions require a gown and gloves before entering, because the infection spreads through touching the resident or contaminated surfaces. A mask alone is for respiratory spread, and entering with no PPE, even briefly, or skipping it because the resident is not coughing would allow the infection to spread.

Correct answer: A fitted respirator mask such as an N95

Airborne precautions for infections like tuberculosis require a fitted respirator mask such as an N95 to filter tiny airborne particles. Clean gloves alone, a plastic apron, or no protection would not stop airborne organisms that are inhaled, so the special respirator is essential.

Correct answer: Spending time talking while wearing the required PPE

The aide can meet the isolated resident's emotional needs by spending time talking while wearing the required PPE, which provides company without spreading infection. Removing PPE breaks isolation, refusing to enter neglects the resident, and leaving the door open can let airborne or other organisms escape the room.

Correct answer: Performing hand hygiene before and after resident contact

Hand hygiene before and after every resident contact is the single most important and most heavily tested action for preventing the spread of infection. Gowns are used only when contamination is likely, room temperature does not control germs, and the privacy curtain protects dignity rather than preventing infection.

Correct answer: 20 seconds

Hands should be scrubbed with soap and water for at least 20 seconds to effectively remove germs. Two or five seconds is far too short to clean the hands properly, and a full five minutes is unnecessary for routine hand washing, so 20 seconds is the recommended minimum.

Correct answer: A clean, dry paper towel

The faucet is turned off with a clean, dry paper towel so the just-washed hands do not touch the dirty handle and become contaminated again. Using bare hands recontaminates them, the elbow on the spout is awkward and ineffective, and used gloves are contaminated, so the paper towel is the correct method.

Correct answer: Pointed downward toward the sink

The hands and fingertips are kept pointed downward toward the sink so contaminated water runs off the fingertips into the drain rather than back up the arms. Pointing the fingers up lets dirty water run toward the cleaner forearms, and holding them level or sideways does not direct the runoff away from clean skin.

Correct answer: Using a draw sheet to lift rather than slide the resident

Using a draw sheet to lift the resident instead of dragging the skin across the sheet reduces shearing and friction that damage skin and cause pressure injuries. Pulling under the arms drags the skin, keeping the head of the bed very high increases shearing on the tailbone, and wrinkled sheets create pressure points.

Correct answer: A resident who is immobile, incontinent, and has poor nutrition

A resident who is immobile, incontinent, and poorly nourished is at greatest risk for pressure injuries because constant pressure, moisture, and weak skin combine to cause breakdown. Residents who walk, reposition themselves, or stay active relieve pressure on their own and are at much lower risk.

Correct answer: Weakens the skin and makes breakdown more likely

Excess moisture from sweat or incontinence weakens and softens the skin, making it more likely to break down and form a pressure injury, so keeping the skin clean and dry protects it. Moisture does not strengthen the skin, improve circulation, or leave the skin unaffected.

Correct answer: Report and document the open area for the nurse to assess

An open sore with broken skin over a bony area is a pressure injury that the aide should report and document so the nurse can assess and treat it. A tight bandage adds pressure, rubbing broken skin worsens damage, and powder is not a treatment, so reporting and documenting is the correct response.

Correct answer: Rescue anyone in immediate danger

In the RACE fire response, R stands for Rescue, meaning to rescue or remove anyone in immediate danger first. It does not mean to run away, report to the family, or restart the alarm; rescuing endangered people is the first priority before alarming, containing, and extinguishing.

Correct answer: Contain the fire by closing doors and windows

In RACE, C stands for Contain, which means closing doors and windows to keep the fire and smoke from spreading. It does not mean calling families, cleaning spills, or continuing routine care; containing the fire helps protect residents and staff while the area is evacuated.

Correct answer: Remove the resident from immediate danger

Following RACE, the first action is Rescue, so the aide removes the resident from immediate danger before anything else. Trying to extinguish the fire first, charting, or opening windows would delay protecting the resident, who must be moved to safety as the top priority.

Correct answer: Begin abdominal thrusts (the Heimlich maneuver) and call for help

When a conscious resident has a completely blocked airway and cannot speak or cough, the aide performs abdominal thrusts, the Heimlich maneuver, and calls for help to dislodge the object. Giving water, having the resident lie down, or patting the hand would not clear the airway and would waste critical time.

Correct answer: Just above the navel and below the ribs, then thrust inward and upward

Abdominal thrusts are done by placing a fist just above the navel and below the ribs, then thrusting inward and upward to force air out and expel the object. Pressing on the breastbone is for chest compressions, and the lower back or neck are not used for abdominal thrusts.

Correct answer: Lower the resident to the floor and call for emergency help and the nurse

If a choking resident becomes unresponsive, the aide carefully lowers the resident to the floor and calls for emergency help and the nurse, since the situation has become more serious. Continuing standing thrusts on a limp resident, leaving the resident, or giving water would delay the lifesaving help now needed.

Correct answer: Position the body flat with the head slightly raised on a pillow

During postmortem care, the body is positioned flat with the head slightly raised on a pillow, which keeps a natural appearance and prevents discoloration of the face. Leaving the body sitting up, turning it face down, or lowering the head are not appropriate and would not present the body respectfully.

Correct answer: With the same respect and dignity given during life

Postmortem care is provided with the same respect and dignity the resident received in life, handling the body gently and protecting privacy. Working roughly, leaving the curtain open, or loudly discussing the death all show disrespect and ignore the dignity owed to the resident and the feelings of the family.

Correct answer: It is ordered to protect the resident's safety and less restrictive measures have failed

A restraint may be used only when it is ordered to protect the resident's safety and after less restrictive alternatives have been tried without success. Restraints are never used for staff convenience, to quiet a noisy resident, or on a casual suggestion, because they require an order and a genuine safety need.

Correct answer: Frequently checking on the resident and keeping needed items within reach

A good restraint alternative is checking on the resident often and keeping the call light, water, and personal items within reach so the resident does not need to get up alone. Tying the resident, permanently locking the wheelchair, or simply ordering the resident not to move are restrictive or unsafe and do not replace attentive care.

Correct answer: Keep the bed in the lowest position with the call light within reach

Keeping the bed in its lowest position with the call light within reach helps prevent falls by shortening the distance to the floor and letting the resident summon help. Raising all four side rails can act as a restraint and cause worse injuries, removing glasses or a walker reduces safe mobility, and a dark room increases fall risk.

Correct answer: A wet floor, clutter in the walkway, and poor lighting

A wet floor, clutter in the walkway, and poor lighting together create a high fall risk by making the resident more likely to slip, trip, and miss seeing hazards. A clear, well-lit floor, nonslip footwear with locked brakes, and a low bed with the call light nearby are safety measures that reduce falls.

Correct answer: About one degree Fahrenheit lower than an oral reading

An axillary temperature is about one degree Fahrenheit lower than an oral reading. The armpit is an external site, so it registers cooler than oral, rectal, or tympanic sites, which is why the aide records the route used. It is convenient and safe but considered the least accurate, not the most accurate.

Correct answer: No open flames, smoking, or sparks occur near the resident

The aide should make sure no open flames, smoking, or sparks occur near the resident, because oxygen makes fire burn faster and hotter. The nurse aide never changes the oxygen flow rate, and oil-based products such as petroleum jelly are avoided around oxygen; sealing windows is not required.

Correct answer: Mark the sheet at the top of the head and at the heels, then measure between the marks

The aide should mark the sheet at the top of the head and at the heels, then measure the distance between the marks. With the resident lying flat and straight, this gives an accurate height without making a weak resident stand. Estimating from the mattress or doubling a partial measurement is not accurate.

Correct answer: Gelatin and ice cream the resident ate at lunch

Gelatin and ice cream count as fluid intake because they are liquid at room (body) temperature. I&O records all liquids taken in, including foods that melt such as gelatin, ice cream, and popsicles. Solid foods like toast, applesauce, and banana are not counted, and urine is output, not intake.

Correct answer: Start urinating into the toilet, then catch urine in the container partway through

The resident should start urinating into the toilet, then catch urine in the container partway through the stream. The midstream clean-catch method discards the first portion to wash away surface bacteria, giving a cleaner sample. Collecting the first drops or a full 24-hour amount describes different procedures.

Correct answer: Report the reddened area to the nurse and avoid rubbing directly over it

The aide should report the reddened area to the nurse and avoid rubbing directly over it. Non-blanchable redness over a bony area is an early sign of a pressure injury, and massaging it can cause further skin and tissue damage. Delaying the report or applying tight bandages would worsen the problem.

Correct answer: Edema

This swelling that dents when pressed is called edema, the buildup of excess fluid in the tissues. The aide should report it because it can indicate heart, kidney, or circulation problems. Cyanosis is bluish skin, atrophy is muscle wasting, and dehydration involves too little body fluid.

Correct answer: Keep the side rail up on the far side and roll the resident toward it while working

The aide should keep the side rail up on the far side and roll the resident toward it while changing the linens, which protects the resident from falling. Soiled linens are rolled away from the body and never shaken or held against the uniform, to avoid spreading germs, and they are not placed on the floor.

Correct answer: Move nearby objects away and protect the resident from injury without restraining the movements

The aide should move nearby objects away and protect the resident from injury without restraining the movements. Holding the limbs or putting anything in the mouth can cause injury, and the aide should never leave the resident, but should call for help and stay until the seizure ends.

Correct answer: Around the resident's waist, snug enough that the aide's fingers fit underneath

The correct placement is around the resident's waist, snug enough that the aide's fingers fit underneath. A gait belt is applied over clothing at the waist; the aide should be able to slip flat fingers under it so it is secure but not so tight that it restricts breathing or pinches skin. Placing it at the chest or neck is unsafe, and leaving it loose lets it slide up and fail to support the resident during transfer or ambulation.

Correct answer: Apply them while the resident is lying down before getting up, smoothing out all wrinkles

The correct action is to apply the stockings while the resident is lying down before getting up, smoothing out all wrinkles. Putting them on before the legs become dependent and swollen keeps the legs from filling with blood, and removing wrinkles prevents pressure areas and skin breakdown. Rolling the top down creates a constricting band that can impair circulation, which defeats the purpose of the stockings.

Correct answer: At the same time of day, wearing similar clothing, with the scale balanced at zero

The correct approach is to weigh the resident at the same time of day, wearing similar clothing, with the scale balanced at zero. Consistency in time, clothing, and a zeroed scale removes variables so that changes truly reflect the resident's weight, which is important for monitoring conditions such as fluid retention. Weighing after a large meal or at random times, or skipping the zero check, produces unreliable readings.

Correct answer: Prepare the toothbrush and then let the resident brush her own teeth

Following restorative care, the nurse aide should prepare the toothbrush and then let the resident brush her own teeth, giving only the small amount of help she needs while she does the rest herself. Brushing for her, skipping the task, or telling her she cannot do it would take away abilities she still has. Helping only with the part she cannot manage keeps the resident as independent as possible.

Correct answer: Slowly and smoothly, only to the point of resistance

Passive range-of-motion exercises should be done slowly and smoothly, moving the joint only to the point of resistance and never forcing past it. Moving quickly, pushing past resistance, or using jerking bounces can tear tissue and cause pain or injury. Gentle, controlled movement keeps the joint flexible while keeping the resident safe.

Correct answer: Keep the joints flexible and prevent stiffness

The main purpose of range-of-motion exercises is to keep the joints flexible and prevent stiffness so the resident can keep moving and stay independent. They are not a way to lose weight, lower blood pressure, or replace bathing. Regular joint movement maintains mobility and helps prevent the joints from freezing in place.

Correct answer: Slightly behind and to the resident's weaker side, holding the belt

During ambulation with a gait belt, the nurse aide should walk slightly behind and to the resident's weaker side while holding the belt, so the aide can support and steady the resident if she starts to fall. Walking far ahead, not holding the belt, or facing backward in front of her would leave the resident unprotected. Staying close on the weak side with a firm grasp on the belt keeps the resident safe.

Correct answer: Reposition the resident regularly and keep the body in good alignment

To help prevent contractures, the nurse aide should reposition the resident regularly and keep the body in good alignment so joints are not held bent in one position for long periods. Leaving the resident in one position, keeping joints bent all the time, or restricting movement all encourage the joints to stiffen. Frequent position changes with proper alignment keep the joints from becoming permanently tight.

Correct answer: Over the resident's clothing at the waist

A transfer belt should be applied over the resident's clothing at the waist, which protects the skin and gives the nurse aide a secure place to grip. Placing it over bare skin can pinch or irritate, and putting it around the neck, shoulders, or thighs would be unsafe and ineffective. Positioning the belt over clothing at the waist allows a safe, comfortable hold.

Correct answer: Open the cartons, cut the food, and let the resident feed himself

To support independence, the nurse aide should open the cartons, cut the food, and let the resident feed himself, since he can eat on his own once the setup is done. Feeding him the whole meal, telling him he can no longer feed himself, or rushing him takes away an ability he still has. Providing only the help he needs lets the resident keep doing self-care at meals.

Correct answer: Contracture

The permanent shortening and tightening of a muscle and joint that leaves it fixed in one position is called a contracture, and it often results from lack of movement. A pressure ulcer is a skin breakdown, a fracture is a broken bone, and edema is swelling from fluid. Recognizing a contracture reminds the nurse aide why regular range-of-motion exercises matter for preventing it.

Correct answer: About three to five times, or as directed in the care plan

Each range-of-motion movement is usually repeated about three to five times per joint, or as directed in the resident's care plan, which keeps the joint flexible without overworking it. Doing it only once gives too little benefit, while exercising to exhaustion or doing twenty-five repetitions can strain the joint. Following the care plan's number of repetitions provides safe, effective exercise.

Correct answer: Stand by and let her transfer herself, offering help only if needed

When a resident can safely transfer on her own, the best response is to stand by and let her transfer herself, offering help only if needed, which respects her independence while keeping her safe. Doing it for her, telling her she must always wait for two staff, or insisting she stay in bed all work against the goal of self-care. Supervising while she does what she can encourages independence safely.

Correct answer: Anger

Lashing out and blaming others without cause is the anger stage of grief, where resentment about the loss is directed outward, sometimes at caregivers. Acceptance is a calm coming to terms with the loss, bargaining involves making promises for more time, and denial rejects that the loss is real. The nurse aide should stay calm, avoid taking the outburst personally, and report the resident's feelings to the nurse.

Correct answer: Acceptance

Calmly coming to terms with the loss and expressing readiness reflects the acceptance stage of grief, the final stage in the commonly taught model. Denial rejects the reality of the loss, anger directs resentment outward, and bargaining tries to trade for a better outcome. The nurse aide supports a resident in acceptance by being present, listening, and honoring the resident's wishes.

Correct answer: Sit with the resident, listen, and allow her to express her feelings

Sitting with the resident, listening, and allowing her to express her feelings gives genuine emotional support during grief. Offering cliches like everything happens for a reason, distracting her from her sadness, or minimizing the loss by pointing to other relatives all dismiss her feelings. Being a calm, accepting presence helps the resident grieve at her own pace.

Correct answer: A pattern of increased confusion and agitation in the late afternoon and evening

Sundowning is a pattern of increased confusion, restlessness, and agitation that appears in the late afternoon and evening in some residents with dementia. It is not a blood pressure change on standing, a swallowing problem, or a form of skin breakdown. Knowing what sundowning is helps the nurse aide anticipate the behavior and provide extra calm and reassurance during those hours.

Correct answer: Most stimulating activities happen earlier in the day with a calm evening routine

Scheduling stimulating activities earlier in the day and keeping the evening calm and consistent helps reduce sundowning agitation. Long afternoon naps can disrupt nighttime sleep, turning off lights at dusk increases confusing shadows, and evening caffeine worsens restlessness. A predictable, soothing evening routine supports the resident's emotional comfort.

Correct answer: Acknowledge that she misses her mother and ask what her mother was like

Validation therapy responds to the feeling behind the words, so acknowledging that she misses her mother and inviting her to talk about her honors the resident's emotions. Correcting her with the painful truth can cause her to grieve the death again, labeling her as confused increases distress, and promising her mother will come is a false reassurance. Entering the resident's emotional reality builds trust and comfort.

Correct answer: Has advanced dementia and is disoriented to time and place

Validation therapy is most appropriate for a resident with advanced dementia who is disoriented, because entering the resident's reality and acknowledging feelings reduces distress when facts can no longer be relearned. A mildly forgetful, alert resident usually benefits more from reality orientation, temporary medication confusion is a medical issue to report, and hearing loss is a communication need rather than a reason for validation. Matching the approach to the resident's level of confusion is key.

Correct answer: A resident who is mildly confused and sometimes unsure of the day or place

Reality orientation helps a mildly confused resident who is sometimes unsure of time or place by gently providing the day, date, location, and other cues. It can frustrate or distress a resident with severe dementia who can no longer process facts, it is unnecessary for a fully oriented resident, and grief is an emotional need that calls for support rather than orientation. Choosing reality orientation for mild confusion meets the resident's mental health needs.

Correct answer: Keeping a clearly visible clock and calendar in the resident's room

Keeping a visible clock and calendar provides ongoing cues about time and date, which is a core part of reality orientation for a mildly confused resident. Playing along with a past belief is validation rather than orientation, withholding the date or telling the resident to stop asking removes helpful cues, and isolating the resident in a dark room offers no support. Consistent, gentle reminders of time and place help the resident stay oriented.

Correct answer: Acknowledge the feeling and encourage the resident to do tasks she still can do

Acknowledging the resident's feelings while encouraging her to do tasks she is still able to do supports both her emotions and her self-worth. Agreeing that she is dependent reinforces hopelessness, promising staff will do everything increases her sense of uselessness, and changing the subject dismisses her feelings. Supporting dignity and a sense of purpose meets the resident's emotional and mental health needs.

Correct answer: Take the statement seriously and report it to the nurse right away

A statement suggesting the resident feels others would be better off without him is a possible warning sign of severe depression or suicidal thoughts and must be reported to the nurse right away. Dismissing the comment, keeping it secret, or waiting until end of shift could delay urgently needed help. Prompt reporting allows the resident to be assessed and kept safe.

Correct answer: Provide consistent caregivers and a predictable daily routine

Consistent caregivers and a predictable daily routine reduce anxiety and confusion for a resident with Alzheimer's disease, who feels safer when surroundings and people are familiar. Frequently changing the schedule, moving the resident's room, or leaving loud noise on increases disorientation and distress. A stable, familiar environment supports the resident's emotional and mental health.

Correct answer: Plan care so the resident has uninterrupted private time and is positioned as she requests for prayer

Arranging care so the resident has private, uninterrupted time and positioning her as she requests directly supports her religious practice, which is a core part of meeting spiritual needs. Telling her prayer is not allowed, limiting it to visiting hours, or claiming the facility cannot accommodate her practice all disregard her right to have her religious beliefs respected. The nurse aide should adjust the care routine around the resident's spiritual practices whenever possible.

Correct answer: Ask the resident and family about preferences and adapt care to honor those customs

Asking the resident and family about their preferences and adapting care to honor those customs is the heart of culturally sensitive care because it respects the individual rather than assuming everyone is alike. Treating everyone identically ignores meaningful differences, urging the resident to adopt the facility's customs disrespects her culture, and avoiding the topic prevents the aide from learning what the resident needs. Recognizing and accommodating cultural differences helps the resident feel respected and valued.

Correct answer: Support serving the culturally preferred foods and report the disrespectful comment to the nurse

Supporting the culturally preferred foods, which are appropriate for a resident on a regular diet, and reporting the disrespectful comment to the nurse upholds the resident's cultural needs and protects her dignity. Agreeing the food looks strange and telling the family to take it home shows cultural insensitivity, refusing to allow family food on a regular diet is unnecessary, and ignoring the situation allows disrespect to continue. Honoring cultural food practices and addressing insensitive behavior are both part of providing culturally appropriate care.

Correct answer: A sender, a message, and a receiver

Communication requires a sender, a message, and a receiver, so the correct choice names those three parts. The sender shares the message and the receiver takes it in and responds, which makes it a two-way exchange. A care plan, a diagnosis, or a schedule are documents or tasks, not the basic elements of the communication process.

Correct answer: How are you feeling this morning?

Asking how the resident is feeling this morning is an open-ended question because it invites a full answer in the resident's own words rather than a single yes or no. Open-ended questions help the resident share more about her thoughts and feelings. Asking whether she feels okay, wants breakfast, or has pain gone can each be answered with just yes or no, so they are closed questions.

Correct answer: Active listening

Nodding, keeping eye contact, and gently encouraging the resident to continue are signs of active listening, so that is the technique being used. Active listening shows the resident that the aide is paying full attention and values what is being said. Giving advice, changing the subject, or offering false reassurance would all interrupt or shut down the resident's sharing.

Correct answer: Arrange for a qualified interpreter or interpreter service

Arranging for a qualified interpreter or interpreter service is the best first step because it lets care information be shared accurately across the language difference. A trained interpreter prevents misunderstandings about the resident's care. Speaking louder does not bridge a language gap, asking another resident breaks privacy and may be inaccurate, and skipping the explanation leaves the resident uninformed.

Correct answer: Announce who you are when entering and explain what you are doing in words

Announcing who you are when entering the room and explaining each step in words is the correct approach because a resident who cannot see relies on hearing to know what is happening. Speaking clearly keeps the resident informed and prevents fear. Staying silent or touching first without speaking can startle the resident, and gestures or written notes cannot be seen by a blind resident.

Correct answer: Giving false reassurance

Telling the resident not to worry and that everything will be fine is giving false reassurance, which is a communication barrier. False reassurance dismisses the resident's real feelings and blocks honest sharing. An open-ended question, appropriate silence, and clarifying would each keep communication open instead of shutting it down.

Correct answer: Speak slowly in short phrases and add gestures or pointing to objects

Speaking slowly in short phrases and adding gestures or pointing to objects best supports a resident with receptive aphasia who struggles to understand words. Visual cues and simple, slow speech give the resident more ways to grasp the meaning. Speaking rapidly, ignoring the resident, or just getting louder with long sentences would make understanding harder, not easier.

Correct answer: "It sounds like you are missing your husband very much."

Saying "It sounds like you are missing your husband very much" is therapeutic communication because it reflects the resident's feeling back and shows the aide is listening and cares. Restating feelings invites the resident to share more. Telling her not to dwell on the past, pointing to the children, or changing the subject all block the resident from expressing her grief.

Correct answer: Give the resident a way to send and receive messages clearly

The main goal of tools like a TTY phone or written notes is to give a deaf resident a clear way to send and receive messages. These aids keep the resident included in communication about care and daily life. They are not meant to replace explanations, to save the aide time, or to discourage the resident from contacting staff.

Correct answer: "Can you tell me more about what you mean by that?"

Asking the resident to tell more about what she means is clarifying, a technique used to make sure the aide understands the message correctly. Clarifying keeps communication accurate and shows respect for the resident's words. Saying it makes no sense, moving on, or claiming to already know shuts down the conversation instead of clearing up the meaning.

Correct answer: Keep and use personal possessions as space allows

Keeping and using personal possessions as space allows is a protected residents' right that supports dignity and a homelike environment. Residents may retain personal items such as photos and jewelry. Requiring a family signature, banning all valuables, or making each item subject to nurse approval would improperly restrict this right.

Correct answer: Voice concerns and take part in the survey process

Voicing concerns and taking part in the survey process is a residents' right that lets residents speak freely with surveyors about the quality of their care. Residents may share grievances without fear of retaliation. A billing discount, choosing the surveyor, and blocking staff interviews are not part of this right.

Correct answer: Listens to resident concerns and helps resolve complaints about their care

Listening to resident concerns and helping resolve complaints describes the ombudsman, an independent advocate for residents in long-term care. The ombudsman works on the resident's behalf to address problems with care and quality of life. The ombudsman does not decide admissions, set facility prices, or provide nursing treatments.

Correct answer: Have grievances heard and resolved by an outside advocate

Having grievances heard and resolved by an outside advocate is the right supported when a family contacts the ombudsman. The ombudsman is an independent representative who investigates and helps settle complaints on the resident's behalf. Fixed meal times, having no roommate, and avoiding all treatment are not what the ombudsman role addresses.

Correct answer: Calmly accept the refusal and report it to the nurse

Calmly accepting the refusal and reporting it to the nurse respects the resident's right to refuse treatment while keeping the team informed. An alert resident may decline care, and the aide must not force it. Insisting he has no choice, withholding his meal, or taking him to therapy against his will all violate his rights.

Correct answer: Document and report the refusal to the nurse

Documenting and reporting the refusal to the nurse protects the resident's right to refuse while ensuring proper follow-up by the licensed staff. A resident may decline medication, and the aide must not disguise it or force it. Hiding the medication, insisting she swallow it, or labeling her uncooperative to family all violate her rights.

Correct answer: Privately remind coworkers that health information must stay confidential and report the breach if needed

Privately reminding coworkers that health information must stay confidential, and reporting the breach if needed, protects the resident's right to privacy of health information. Diagnoses may be discussed only by those involved in care and only in private. Joining the gossip, repeating it to a roommate, or posting a note all spread protected information further.

Correct answer: A nurse aide leaves a resident's lab results face-up on an unattended cart in the hallway

Leaving a resident's lab results face-up on an unattended cart violates confidentiality because unauthorized people can see protected health information. Health details must be kept where only the care team can access them. Reporting a symptom to the nurse, reviewing the care plan, and giving shift report to the next aide are all proper, need-to-know uses of information.

Correct answer: Verbal and psychological abuse that must be reported

Calling a resident demeaning names and threatening to withhold food is verbal and psychological abuse, which violates the resident's right to be free from abuse and must be reported. Such mistreatment harms the resident's dignity and well-being. It is never acceptable discipline, harmless teasing, or a minor matter to handle later.

Correct answer: Financial exploitation, which must be reported

Taking a resident's money without permission is financial exploitation, a form of abuse that violates the resident's rights and must be reported. Residents are protected from misuse of their funds and property. It is not restorative care or reality orientation, and it should never be dismissed as a normal family arrangement when the resident appears frightened.

Correct answer: Have her personal choices and beliefs respected

Honoring a resident's request to protect her daily prayer time reflects her right to have her personal choices and beliefs respected, part of dignity and self-determination. Residents may make choices about their routines and have their values supported. This right does not promise free transportation, allow refusal to pay, or guarantee a free private room.

Correct answer: Helping the resident find a private place to make the call

Helping the resident find a private place to make the call protects his right to privacy in communications, including private phone calls and visits. Residents may communicate confidentially with people such as attorneys. Listening in, banning calls during the shift, or requiring a speakerphone would all intrude on this protected right.

Correct answer: Right away, following the facility's reporting policy and chain of command

The mandated reporter duty is met by reporting right away through the facility's policy and chain of command, because suspected harm to a resident must be acted on promptly to keep the resident safe. Waiting until the end of the week, requiring a second occurrence, or investigating to gather proof first all delay protection and are not what the law requires.

Correct answer: Is protected from retaliation for making a good-faith report

A mandated reporter who reports suspected mistreatment in good faith is protected from retaliation, so fear of being punished is not a reason to stay silent. The protection holds even if the suspicion is later unproven, does not require the accused person's permission, and does not make the reporter responsible for the fallout of an honest report.

Correct answer: Durable power of attorney for health care

Naming a person to make medical decisions when the resident cannot is a durable power of attorney for health care, also called a health care proxy. A living will instead spells out the treatments the resident does or does not want, a last will and testament handles property after death, and a personal funds account form tracks the resident's money at the facility.

Correct answer: Can be changed or canceled by the resident as long as they are able to decide

An advance directive can be changed or canceled by the resident at any time while they are still able to make decisions, so the document reflects their current wishes. It does not become permanent at signing, is not controlled by the family while the resident can decide, and does not lose validity simply because the resident enters a facility; the aide reports the resident's statement to the nurse.

Correct answer: Respectfully decline because starting an IV is outside the aide's scope, and inform the nurse

Starting an IV line is a nursing task outside the nurse aide's scope of practice, so the aide respectfully declines and informs the nurse. Performing it because a nurse asked, getting the resident's okay, or passing it to another aide does not make the task legal for an aide; doing it would exceed legal boundaries and endanger the resident.

Correct answer: Tell the nurse she has not been trained on the lift and ask for training or another assignment

Telling the nurse she has not been trained and asking for training or reassignment is the responsible choice, because a nurse aide is accountable for performing only tasks she is trained and competent to do safely. Using unfamiliar equipment because it is assigned, self-teaching from a phone, or silently skipping needed care all put the resident at risk and violate the aide's ethical duty.

Correct answer: Continue reporting the concern up the chain of command or to the proper authority

When a reported concern appears unaddressed, the mandated reporter continues escalating up the chain of command or to the proper authority, because the legal duty is to ensure the resident is protected, not simply to report once. Assuming it was handled, confronting the coworker personally, or treating the duty as finished after one report all leave the resident at continued risk.

Correct answer: False imprisonment, because the resident is being restrained against his will without a proper order

This act is false imprisonment. Confining or restraining a resident against his will without consent and without a valid provider order meets the legal definition of false imprisonment, and unauthorized restraint is prohibited. A general safety concern does not justify it, so the aide must instead report the wandering to the nurse so the team can plan safe alternatives. Negligence is failing to provide reasonable care, and defamation involves harming someone's reputation with false statements, so neither term describes this conduct.

Correct answer: Subjective data

Information a resident reports about how they feel, such as pain or nausea, is subjective data because it is the resident's own description and cannot be directly seen or measured by the aide. Objective data is what the aide can observe or measure, a nursing diagnosis is made by the nurse, and a treatment order comes from the provider.

Correct answer: A reddened, open area is observed on the resident's heel

A reddened, open area observed on the heel is objective data because it can be seen and measured by the aide rather than only described by the resident. Statements about feeling dizzy, anxious, or having a sore throat are subjective data, since they are things only the resident can feel and report.

Correct answer: Incident report

A written report describing exactly what happened during an unexpected event such as a fall is an incident report, used to record the facts of accidents, injuries, or other unusual events. A care plan guides ongoing care, an advance directive states medical wishes, and a discharge summary covers a resident leaving the facility.

Correct answer: A factual, objective account of exactly what was seen and done

An incident report should contain a factual, objective account of exactly what was observed and done, recorded accurately and without blame. It documents the facts of the event so the facility can review and prevent future incidents. Opinions about fault, selective details, or guesses about the cause do not belong in the report.

Correct answer: Gives the health care team a reliable record to track the resident's condition

Accurate documentation gives the whole health care team a reliable record they can use to track changes in the resident's condition and plan care. As a team member, the aide records observations so others can act on them. It does not replace the nurse's checks, apply only at discharge, or let the aide make a diagnosis.

Correct answer: Draw a single line through the error, write the correction, and initial it

A documentation error should be corrected by drawing a single line through it so it stays readable, writing the correct information, and initialing the change. This keeps the record honest and complete. Erasing, using correction fluid, or removing pages hides the original entry and makes the legal record unreliable.

Correct answer: As soon as possible after the care is completed

Care should be charted as soon as possible after it is completed so the record is accurate and details are not forgotten. Timely, truthful documentation keeps the team informed. Waiting until the end of the shift risks errors, charting before care is done is falsification, and documenting only when reminded leaves gaps in the record.

Correct answer: The team relies on the aide's observations to keep the resident's care plan accurate and safe

The aide spends the most time with residents, so the health care team relies on the aide's recorded observations, such as intake and coughing while swallowing, to keep the care plan accurate and the resident safe. The aide does not change diet orders, and observations matter regardless of family interest or whether the resident feeds themselves.

Correct answer: Gives the health care team a complete picture of the resident's condition

Documenting both objective findings the aide can see or measure and subjective statements the resident reports gives the health care team a complete picture of the resident's condition. Together they help the team notice changes and plan care. Charting data does not let the aide choose medications, apply only to confused residents, or replace talking with the resident.

Correct answer: Record the facts of the event so the facility can review it and improve resident safety

The main purpose of an incident report is to record the facts of an unusual event so the facility can review what happened and take steps to improve resident safety. It is a quality and safety tool, not a way to punish staff, a substitute for the medical chart, or something to hide from the team.