Certified Nursing Assistant examination (CNA) Written Test Updated 2023-2024.
The correct answer is A. Standing behind him and using a transfer belt protects both the client and the aide.
When assisting a client in learning to use a walker, it is important to:
A. stand behind him and use a transfer belt.
B. put padding all the way around the top rim.
C. let him walk by himself so he gains independence.
D. let him practice using the walker on the day he is discharged.
The correct answer is B. Urinary retention refers to an inability to urinate. Retention of urine is a symptom that should be reported to the charge nurse as soon as it is noted.
Urinary retention refers to
A. a normal output of urine.
B. an inability to urinate.
C. Incontinence.
D. a large output of urine
The correct answer is A. Because of this aspect of hearing loss, the aged hear well if you lower your voice. Shouting in a high-pitched voice does not help.
Normal hearing loss in aging is usually related to the ability to hear
A. high-pitched sounds.
B. loud sounds.
C. all sounds.
D. rapid speech.
The correct answer is D. A confused patient may answer to any name or lie down in any bed.
The best way to safely identify your patient is by
A. asking his name.
B. calling his name and waiting for his response.
C. checking the bed plate.
D. checking the name tag
The correct answer is A. The nurse aide should report it to the charge nurse. Nurse aides cannot order a procedure or increase fluids. Anything unusual must be reported to the nurse in charge.
Mrs. Jones is on a bowel and bladder training program. She has not had a bowel movement for three days. What should the nurse aide do?
A. Report it to the charge nurse.
B. Give the patient an enema.
C. Offer prune juice.
D. Increase fluids.
The correct answer is C. The proper medical abbreviation for before meals is a.c.
The proper medical abbreviation for before meals is
A. p.c.
B. b.i.d.
C. a.c.
D. t.i.d.
The correct answer is B. The proper medical term for high blood pressure is hypertension
The proper medical term for high blood pressure is
A. diabetes.
B. hypertension.
C. hypotension.
D. CVA.
The correct answer is D. A mechanical soft diet is easy to chew, swallow, and digest.
A patient who has difficulty chewing or swallowing will need what type of diet?
A. clear liquid
B. low residue
C. bland
D. mechanical soft
The correct answer is C. Helping her locate her room on her own would make Ms. Lee feel better about herself.
Mrs Smith is an 81-year-old resident with Alzheimer’s disease and cannot find her room. What should the nurse aide do to help Mrs Smith feel more independent?
A. Scold her and tell her to stay in the room.
B. Ask her roommate to watch her.
C. Place a familiar object outside her room door.
D. Write the room number on a piece of paper.
The correct answer is A. Input and output are totaled once per shift as well as every 24 hours
How often should a patient’s intake and output records be totaled?
A. once each shift
B. twice a day
C. every four hours
D. every 12 hours
The correct answer is C. Failure to notice bruises or marks on the skin on admission may later cause someone to believe you were involved in abuse.
Which of the following should you observe and record when admitting a client?
A. color of the stool and amount of urine voided
B. how much the client has eaten and drunk
C. bruises, marks, rashes, or broken skin
D. insurance information
The correct answer is C. When responding to a patient on the intercom, you should give your name and position
When responding to a client on the intercom, you should
A. ask for the client’s name.
B. say, “What do you want?”
C. give your name and position and say, “May I help you?”
D. say, “The nurse will answer your call.”
The correct answer is A. You should never leave a new admit until the patient knows how to call for help
Which of the following things should you do to familiarize a new client with his or her surroundings?
A. Show the client where the call light is and how to work it.
B. Tell the client not to operate the TV.
C. Ask visitors to leave the room while you finish admitting the client.
D. Raise the side rails of the bed and raise the bed to high position
The correct answer is C. Nursing assistants are never allowed to give medications.
When arranging a patient’s room, you should do all of the following EXCEPT
A. check signal cords.
B. adjust the back and knee rests as directed.
C. administer medications.
D. check lighting.
The correct answer is A. You should always use good body mechanics when moving patients.
When assisting a client in and out of bed, the nurse aide should always
A. employ body mechanic techniques.
B. get another person to help.
C. pull the client’s feet out first, and then lift the back up.
D. put shoes on the client because the patient may slip.
The correct answer is A. It is necessary to turn the patient q2h to prevent pressure ulcers
It is important to reposition a patient during an eight-hour shift. How often should he or she be turned?
A. q2h
B. q4h
C. q1h
D. q1d
The correct answer is C. You should not bring the tray into the room until you have time to feed
Which of the following is the correct procedure for serving a meal to a client who must be fed?
A. Serve the tray along with all the other trays, and then come back to feed the client.
B. Bring the tray to the client last; feed after you have served all the other clients.
C. Bring the tray into the room when you are ready to feed the client.
D. Have the kitchen hold the tray for one hour.
The correct answer is C. The most serious problem that wrinkles in the bedclothes can cause patients is decubitus ulcers, or decubiti.
The most serious problem that wrinkles in the bedclothes can cause is
A. restlessness.
B. sleeplessness.
C. decubitus ulcers.
D. bleeding and shock.
The correct answer is B. Restorative care begins as soon as possible to prevent further complications
Restorative care begins
A. a week after admission.
B. as soon as possible.
C. when the patient wants.
D. twice a week.
The correct answer is B. You should always explain procedures first
You are told to put a client in Fowler’s position. Before changing the position of the client’s bed, you should
A. open the window.
B. explain the procedure to the client.
C. check with the client’s family.
D. remake the bed.
The correct answer is C. You have contaminated your hands and must start over
During hand washing, you accidentally touch the inside of the sink while rinsing the soap off. The next action is to
A. allow the water to run over the hands for two minutes.
B. dry the hands and turn off the faucet with the paper towel.
C. repeat the wash from the beginning.
D. none of the above
The correct answer is C. Your appearance is important. You should wear business attire
You are going on a job interview. How should you prepare to dress?
A. Wear your best jeans and T-shirt.
B. Use a lot of perfume.
C. Wear simple clothing (dress, shirt, pants, suit).
D. Wear a lot of jewelry.
The correct answer is D. Always make sure new patients can call for help
Mr. Brown, a newly admitted conscious client, has been put to bed. Before leaving him alone, the first action would be to
A. ask him if he is hungry.
B. inspect his skin.
C. complete the listing of his clothing and valuables.
D. make sure he knows how to use the call light.
The correct answer is C. Keeping your back straight forces you to use your strong leg muscles.
When lifting a heavy object, the correct method would be to bend at the
A. waist, keeping your legs straight.
B. waist, rounding your shoulders.
C. knees, keeping your back straight.
D. knees and waist.
The correct answer is D. Frequent hand washing is the first line to prevent the spread of infection
At what time(s) during a shift should a nurse aide wash his or her hands?
A. before eating
B. after using the bathroom
C. before and after patient care
D. all of the above
The correct answer is B. Always remember to consider infection control.
When assisting a client with eating, one of the first things the nurse aide should do is
A. cut the food into bite-size pieces.
B. wash his or her hands and the client’s hands.
C. butter the client’s bread.
D. provide the client with privacy
The correct answer is C. A new cast may cut off circulation. This is the only choice that reminds you to check for circulatory impairment.
A patient has a new cast on his right arm. While caring for him, it is important to first observe for
A. pulse above the cast.
B. color and hardness of the cast.
C. warmth and color of fingers.
D. signs of crumbling at the cast end.
The correct answer is C. Rehabilitation should always be part of the care plan.
Encouraging a client to take part in activities of daily living (ADLs) such as bathing, combing hair, and feeding is
A. done only when time permits.
B. the family’s responsibility.
C. necessary for rehabilitation.
D. a violation of client rights
The correct answer is A. Make sure to follow agency policy
In caring for a confused elderly man, it is important to remember to
A. keep the bed rails up except when you are at the bedside.
B. close the door to the room so that he does not disturb other patients.
C. keep the room dark and quiet at all times to keep him from becoming upset.
D. remind him each morning to shower and shave independently
The correct answer is D. Before assisting a patient into a wheelchair, check to see if the wheels of the chair are locked.
Before assisting a client into a wheelchair, the first action would be to check if the
A. client is adequately covered.
B. floor is slippery.
C. door to the room is closed.
D. wheels of the chair are locked
The correct answer is C. You must assist the patient from the weak side
You are transferring a resident from the bed to the wheelchair. The patient has a weak left side. You should stand
A. on the right side.
B. in front of the patient.
C. on the left side.
D. behind the patient.
The correct answer is D. Always check for vital signs; the patient may have fainted.
While making rounds at 4:00am, a nurse aide finds a patient lying on the floor. What should she or he do first?
A. Call 911/000.
B. Perform CPR.
C. Call for another nurse aide.
D. Assess the patient’s vital signs
The correct answer is A. You must stay behind the chair to control it, but it should go on and come off an elevator backward to prevent the wheels from falling into the door opening.
When moving a wheelchair onto an elevator, you should stay
A. behind the chair, pulling it toward you.
B. behind the chair, pushing it away from you.
C. in front of the client to observe his or her condition.
D. to the side and hold the door open.
The correct answer is B. Raising the bag above the bladder level can lead to backflow of the urine, with its bacteria, into the bladder
The Foley bag must be kept lower than the client’s bladder so that
A. urine will not leak out, soiling the bed.
B. urine will not return to the bladder, causing infection.
C. the bag will be hidden and the client will not be embarrassed.
D. the client will be more comfortable in bed
The correct answer is B. Always report abnormal conditions
Mr Jones is a diabetic. For his afternoon tea, the kitchen has sent a carton of chocolate ice cream. Your first action should be to
A. substitute diet cola for the ice cream.
B. hold the nourishment and report to the charge nurse.
C. ask the secretary to notify the kitchen of an error.
D. ask Mrs. Black if she likes ice cream.
The correct answer is D. All of the choices listed are correct
When assisting a client who is using the bedside commode, it is important to
A. leave the call light within reach.
B. place toilet tissue close by.
C. return to check on the client periodically.
D. all of the above
The correct answer is A. The patient must be positioned every two hours to prevent skin breakdown due to poor circulation.
Ensuring adequate circulation to tissues is a major factor in preventing skin breakdown. This can be accomplished by doing all of the following EXCEPT
A. positioning the patient every two hours.
B. using mechanical aids.
C. giving backrubs.
D. performing active or passive ROM exercises.
The correct answer is C. The purpose of cold applications is usually to prevent or reduce swelling
The purpose of cold applications is usually to
A. speed the flow of blood to the area.
B. prevent heat exhaustion.
C. prevent or reduce swelling.
D. prevent the formation of scar tissue.
The correct answer is A. A hot water bottle applied by itself is dry heat.
The hot water bottle is an example of a
A. local dry heat application.
B. generalized dry heat application.
C. local moist heat application.
D. generalized moist heat application.
The correct answer is B. Placing the patient on the left side allows better entry into the colon
Clients receiving an enema are usually placed
A. on the right side.
B. on the left side.
C. flat on the back.
D. in a semi-sitting position
The correct answer is B. The clean-catch specimen requires cleaning the perineum.
A female client’s perineal area should be cleansed before which specimen is collected?
A. 24-hour urine specimen
B. midstream clean-catch urine specimen
C. pediatric routine urine specimen
D. routine urine specimen
The correct answer is D. The other sites are rarely used by the nursing assistant.
The most common site for counting the pulse is the
A. carotid artery.
B. femoral artery.
C. brachial artery.
D. radial artery.
The correct answer is B. Telling the patient you are watching her breathing will cause her to change her breathing pattern slightly.
The correct answer is B. Telling the patient you are watching her breathing will cause her to change her breathing pattern slightly
When counting respiration’s, you should
A. wait until after the client has exercised.
B. not tell the patient what you are going to do.
C. count five respirations and then check your watch.
D. have the client count respirations while you take her pulse
The correct answer is A. A nurse aide is responsible for the other options, but he or she never inserts a catheter.
With catheterized patients, which of the following is NOT the nurse aide’s responsibility?
A. inserting the catheter
B. preventing infection
C. checking to make sure the catheter is draining properly
D. recording output
The correct answer is C. An incident report becomes a permanent part of the legal record. Make sure the facts are clear
When giving information to the charge nurse for an incident report, you should
A. write in the client’s chart that an incident occurred.
B. keep the report in your personal file.
C. state the facts clearly.
D. give your opinions as to the cause of the incident
The correct answer is A. OBRA stands for the “Omnibus Budget and Reform Act.”
All long-term-care nurse aides must be competency evaluated and must complete a distinct educational course. These requirements are set by
A. OBRA.
B. OSHA.
C. CDC.
D. FDA.
The correct answer is B. Never rearrange the furniture in a blind patient’s room after the patient settles into it. This can cause falls.
A resident is blind. It is important NOT to
A. leave the door completely opened.
B. rearrange the furniture.
C. announce yourself before entering the room.
D. explain the location of food on the plate, using the face of the clock to assist.
The correct answer is D. The family members should expect and be allowed private time during visits
When family members visit a client, the visitors should
A. stay in the day room.
B. stay a short while so as not to tire the client.
C. be expected to help with care.
D. be allowed privacy with the client.
The correct answer is D. Telling the patient that someone is always there will make him feel safe. Explaining how to use the call system will also help patients feel safe.
A new resident asks you, “If I need help or get sick during the night, who is going to be here?” You should say,
A. “Don’t worry, you’re not going to get sick.”
B. “Just yell, and someone will hear you.”
C. “Ask your roommate to ring the call bell.”
D. “There are people here all night to help you.”
The correct answer is D. All of the choices given are rights of the resident.
Which of the following is considered a client’s right?
A. having curtains pulled during personal care
B. having personal information kept confidential
C. receiving and sending private mail
D. all of the above
The correct answer is D. It is normal for a person to have moments of sadness, and it is important for the patient to know you care.
Mrs. Wilkes often cries while she is receiving her P.M. care. What should you do?
A. Tell her to stop crying.
B. Ignore her and continue with her care.
C. Tell her jokes to make her laugh.
D. Tell her that it’s all right to cry and you’re there for her if she wants to talk.
The correct answer is D. Dentures are very expensive—holding firmly and using cool water prevents them from warping, and padding the sink will prevent breakage if dropped.
When providing denture care, the nurse aide must
A. wash them with hot water.
B. hold them firmly under cool running water.
C. place a towel in the sink.
D. both choices B and C
The correct answer is C. As long-term-care providers, nursing assistants must respect the resident’s right to sexuality. However, engaging in public fondling is inappropriate and may infringe upon other residents’ rights.
Sexuality in long-term-care clients may include all of the following EXCEPT
A. needing private time with a partner.
B. caring about one’s physical appearance.
C. engaging in public fondling.
D. desiring sexual interaction.
Mrs. Wilkes is scheduled for a partial bed bath. This means you must wash her
A. face, neck, ears, arms, and hands.
B. face, underarms, hands, and buttocks.
C. face, hands, underarms, and legs.
D. face, hands, underarms, buttocks, and genitals
Mrs. Wilkes is scheduled for a partial bed bath. This means you must wash her
A. face, neck, ears, arms, and hands.
B. face, underarms, hands, and buttocks.
C. face, hands, underarms, and legs.
D. face, hands, underarms, buttocks, and genitals
The correct answer is A. You want to positively reinforce the resident’s appropriate behavior, so smiling and rewarding her good behavior is the best action.
A goal for an extended care facility (ECF) resident is that she not swear at the nurses or aides. When she calls you by your name instead of swearing at you, your appropriate action is to
A. smile and give the appropriate reward.
B. continue whatever task that is being done.
C. tease the resident about not swearing.
D. tell all of the staff that she didn’t swear.
The correct answer is B. Do not startle the resident, as this may agitate her. Speak as you enter the room.
An agitated resident must be turned every two hours all night long. The first action of the nurse aide when waking up this resident is to
A. turn on the light.
B. speak quietly and calmly.
C. touch her shoulder.
D. shout her name.
The correct answer is B. Consideration of cultural or religious beliefs is important to all patients
If a client objects to a certain food for religious or cultural reasons, the appropriate action would be to
A. tell him to wait for the next meal.
B. offer to substitute something different for him.
C. call the dietitian the next day.
D. tell him he needs to eat what is on his tray.
The correct answer is C. The other answers do not address the resident’s right to practice her religion.
A client’s religion forbids eating pork. Bacon is being served for breakfast. The most appropriate response is to
A. encourage the client to eat it because she needs protein.
B. tell the client it is all right because her doctor ordered the diet.
C. call the kitchen for a tray without bacon.
D. tell the client that restrictions are not as important as her health.
The correct answer is C. Listening to someone shows that you are very interested in what he or she is saying.
Which type of communication can often be most powerful?
A. written
B. verbal
C. silent
D. tactile
The correct answer is B. This is an example of verbal abuse.using the walker on the day he is discharged.
Your patient refuses to let you bathe her. You tell her that if she doesn’t let you wash her, she will not get lunch and will not go to game night. This is an example of
A. discipline.
B. verbal abuse.
C. mental abuse.
D. physical abuse.
When a resident refuses to take blood pressure from CNA.
report this to nurse
A CNA may share a resident’s medical information with which of the following.
Only other members of the health care team
To the best communicate with a resident who has a hearing impairment, the CNA should.
Use short sentences and simple words
If a CNA suspects that a residents is being abused she should.
Report it to the nurse immediately
An ombudsman is a person who…
Is a legal advocate for resident and helps protect their rights
To best respond to a resident with Alzheimers disease who is repeating a question over and over again
Answer questions each time they are asked, using the same wording
With regard to a resident’s toenails, a nursing assistant should
Never cut them
When providing personal care the CNA should.
Provide privacy for the resident
Generally the last sense to leave a dying person is the sense of..
HEaring
Which temperature site is considered the most accurate?
Rectal
How should a standard bedpan be positioned
Wider end aligned with resident’s buttocks
A resident tells a CNA that she is scare of dying. How should CNA respond
Listen quietly and ask questions when appropriate
To prevent DEHYDRATION, CNA should…
Offer fresh water and other fluids often
When giving perineal care to a female
Wipe from front to back
If a CNA sees a resident masturbating
Provide Privacy for the resident
In what order should range of motion exercise be done?
The arms and legs should be exercised first
A nursing assistant must wear gloves when..
Performing oral care
TO best communicate with a resident who has vision impairment
Identify herself when she enters the room
The first sign of skin breakdown is..
Discoloration
The following statement is true of normal aging process and late adulthood ( 65 years and older(
People become incontinent
Clean bed linens promote
Proper rest and sleep
Abdominal thrusts help
remove blockage from airway
A way to prevent unintended weight loss in residents
Honoring food likes and dislikes
A way to use proper body mechanics while working (can)
Bending knees while lifting
To promote a resident’s independence dignity during bowel or bladder retraining
Provide privacy for elimination
A resident tells a can that he wants to wear his gray sweater
Tell him “OK” and assist him in getting dressed
A CNA should wash her hands
Before and after a personal care procedure
How should soiled bed linens be handled?
By carrying them away from the CNA’s body
Purpose of the Health Insurance Portability and Accountability Act (HIPPA)
To keep protected health information private and secure
One safety device that helps transfer resident is called a
Transfer belt
As which side is body temperature most often take?
Rectum (rectal)
Encourage a resident’s independence and self care because doing this
promotes body function
A restraint can be applied
Only with a doctor order
A CNA can show she is listening carefully to a resident by
focusing on the resident and giving feedback
How many milliliters equal one ounce?
30
With catheters it is important for a CNA to remember that
The drainage bag should be kept lower than the hips of the bladder
When assisting a resident who has had a stroke
Lead with the stronger side when transferring
Which stage would a dying resident be if he insists that a mistake was made on his blood test and he’s not really dying
Denial
The process of helping to restore a person to the highest level of functioning is called
Rehabilitation
A can hears other can’s discussing a resident what should she do
suggest to the cna’s that this isn’t the place to have this discussion
An oral temperature should not be taken on a resident who has eaten or had fluids
in the last 10-20 minutes
How many feet does a quad cane have?
1 foot
A can can assist residents with their spiritual needs by..
Listening to residents talk about their beliefs
Th best way for a CNA to respond to a combative resident is to
Not take it personally
When a resident has a right sided weakened, how should clothing be applied first?
On the right side
When an resident offers a git to a can
politely refused the gift
According to OBRA, can must complete at least how many hour of training
75 hours of training and must pass a competency evaluation before they can be employed
Call lights should be place
Within the residents reach
How long should cans use friction when lathering and washing their hands
5 seconds
The Occupations Safety and Health Adminstration (OSHA) is a federal government agency that protect workers from
Hazards on the job
What is one important reason why the bed should remain wrinkle free?
to help keep the skin healthy and prevent pressure sores
What is the term for a device that replaces a missing body part?
prosthesis
To convert four ounces of water to mL the nurse assistant should multiply four by
30
Which of the following health care setting is for people who will die in six months?
hospice
Which of the following abbreviation means, nothing by mouth
NPO
Exercises that put each joint through its full arc of motion are called:
range of motion
What is the medical term of high blood pressure?
hypertension
what is a task that is outside the scope of practice for an NA?
inserting tubes into a resident’s body
Standard Precautions should be practiced
on every single person in your care
Which kind of care helps restore a resident to the highest level of functioning possible
rehabilitation
When getting ready to make a bed, the aide should place the clean linens on
a. in the bathroom
b. Chair or table beside the bed
c. Roommate’s bed
d. The floor
B. chair or table beside the bed
The only purpose for using a restraint is to
a. keep the client quiet
b. make nurses job easier
c. calm a verbally abusive client
d. ensure safety of others
d. ensure safety of others
Articles contaminated with blood or body fluids should be disposed of in the
a. trash
b. soiled utility room
c. biohazard container
d. soiled linen basket
c. biohazard container
To avoid pulling the indwelling urethral catheter when turning a client, the catheter tubing SHOULD be secured to the client’s
a. upper thigh
b. bed sheet
c. bed frame
d. hip
a. upper thigh
When collecting a 24 hour urine sample for a client, the nurse aide should request that the client
a. avoid red meat
b. drink 2 L of water
c. take a bath or shower before starting the urine collection
d. discard the first voided urine
d. discard the first voided urine
When ambulating the client, the nurse aide should
a. ask the nurse for help
b. be sure the client is wearing non-skid footwear
c. ask a family member for assistance
walk in front of the client and show the client the way
b. be sure the client is wearing non-skid footwear
Which of the following is the best personal protective equipment item for the nurse aide to wear when handling infectious waste that could splash or spray?
a. shoe covers
b. mask
c. goggles
d. Face shield
d. face shield
Which of the following would be an appropriate response for the nurse aide to make if a client expresses anger during care?
a. “Why are you so mean today?”
b. “You should not say such mean things to people.”
c. “You seem upset, would you like to talk about it?”
d. “I’ll come back when your bad mood is over.”
c. “You seem upset, would you like to talk about it?”
The nurse aide has raised the height of the client’s bed to provide care, but the nurse aide forgot to bring the needed supplies. What should the nurse aide do NEXT?
a. instruct client to lay still
b. lower the bed and place the call light within reach
c. Ask roommate to watch the client & get the supplies
d. quickly get the supplies
b. lower the bed and place the call light within reach
A client requests that the nurse aide call the client’s spiritual advisor. The nurse aide should:
a. call the spiritual advisor for the client
b. ask why they want the advisor called
c. tell the client that this is not part of the nurse aide’s job
d. tell the client that the aide will inform the nurse of the request
d. tell the client that the ide will inform the nurse of the request
A client wakes up during the night and asks for something to eat. The nurse aide should:
a. tell the client nothing is available at night
b. tell the client eating is not allowed at night
c. check clients diet before offering food
d. explain that breakfast is in 3 hours
c. check clients diet before offering nourishment
The nurse aide is preparing to bathe a client. What should the nurse aide do first?
a. test water temperature
b. help client undress
c. close door and windows
d. tell client what the nurse aide is going to do
d. tell client what the nurse aide is going to do
When making a bed that is occupied by a client, the nurse aide should:
a. leave the bed in the lowest position
b. make the toe pleat
c. leave the bottom sheet untucked
d. place soiled linens on the floor
b. make the toe pleat
Frequent turning and repositioning of the client helps prevent:
a. cyanosis
b. indigestion
c. coronary disease
d. pressure injuries
d. pressure injuries
When applying elastic stockings to the client, it would be BEST for the nurse aide to position the client:
a. lying down in bed
b. dangling the legs from the edge of the bed
c. standing at the side of the bed
d. sitting in a wheelchair
a. lying down in bed
The nurse aide is in the employee dining room. A group of nurse aides are eating lunch together and begin discussing how rude a certain client was acting. The aide should:
a. join in the convo
b. suggest that this is not the place to discuss a client
c. stay quiet
d. return to the unit and tell the client what was said
b. suggest that this is not the place to discuss a client
The client’s signaling device should be placed:
a. on the bed
b. within the client’s reach
c. on the client’s right side
d. over the rail
b. within the client’s reach
When helping a client who is recovering from a stroke to walk, the nurse aide should assist:
a. on the client’s strong side
b. on the client’s weak side
c. from behind the client
d. with a wheelchair
b. on the client’s weak side
A client who is confused begins to cry and scream out for the client’s parent. What should the nurse aide do next?
a. place the client in a geriatric chair
b. restrain the client to his bed
c. talk to the client in a calm voice about familiar things
d. leave the client alone in his room until he calms down
c. talk to the client in a calm voice about familiar things
Which of the following actions would be best for the nurse aide to take to show respect to the spiritual needs of a client?
a. escorting the client to religious services
b. discussing the nurse aide’s religion with the client
c. assisting the client to read the client’s religious materials
d. requesting that the facility’s spiritual advisor visits the client
c. assisting the client to read the client’s religious materials
While the nurse aide is providing care to the client, the client calls the nurse aide by the name of the client’s deceased child. The aide’s best response would be to:
a. quickly finish providing care and leave the client alone
b. pretend to be the client’s child
c. ignore the client because they are confused
d. ask the client about their favorite memories of their child
d. ask the client about their favorite memories of their child
When providing care for a client receiving oxygen therapy, the nurse aide should:
a. check ears for pressure points
b. tape cracks in oxygen tubing
c. let the nurse know that the aide cannot care for the client
d. change the flow rate if the client is short of breath
a. check ears for pressure points
A client falls and suffers a deep cut on the forehead. What should the nurse aide do next?
a. take the client out to the hospital
b. help the client back to the bed
c. take the client into the bathroom to was out the cut
d. stay with the client and call for help
d. stay with the client and call for help
The client has been sad and depressed since being admitted into the facility yesterday. What would be the best thing for the nurse aide to do for the client?
a. arrange for the client’s spiritual advisor to visit
b. turn on the TV in the client’s room and leave the client alone
c. introduce the client to other clients and staff members
d. Force the client to take part in facility activities
c. introduce the client to other clients and staff members
The nurse aide is asked by a confused client “what day is it?” The nurse aide should:
a. explain that memory loss is natural and the date is not important
b. point to the date on a calendar and say the date
c. ignore the request
d. provide the date and test the client later
b. point to the date on a calendar and say the date
Which of the following is most important for the prevention of skin breakdown in the client?
a. air drying the client’s skin
b. rubbing lotion on the client’s skin
c. ambulating the client once a day
d. repositioning the client every 2 hours
d. repositioning the client every two hours
When caring for a client who is dying, the nurse aide should:
a. only allow 1 visitor in the room at a time
b. keep the room dark at all times
c. pay special attention to fluid intake and mouth care
d. wear gloves when providing personal care
c. pay special attention to fluid intake and mouth care
To best communicate with a client who has total hearing loss, the nurse aide should:
a. smile frequently and speak loudly
b. smile often and talk rapidly
c. avoid eye contact
d. write out the information
d. write out the information
When a client who is weak and unable to move without assistance is positioned in a chair, the nurse aide should
a. check the client every 5 minutes
b. make sure the client’s water pitcher is full
c. protect the client with a seat belt
d. place the signaling device within the client’s reach
d. place the signaling device within the client’s reach
What would be the best way for the nurse aide to promote client independence when bathing a client who had a stroke?
a. give the client a complete bath only when the client requests it
b. encourage the client to do as much as possible and assist as needed
c. Leave the client alone and assume the client will do as much as the client can
d. Limit the client to washing the client’s hands
b. encourage the client to do as much as possible and assist as needed
Which of the following methods is the correct way to remove a dirty isolation gown?
(A) Pull the gown over the head
(B) Let the gown drop to the floor and step out of the gown
(C) Roll the gown dirty side in and away from the body
(D) Pull the gown off by the sleeve and shake the gown out
C. roll the gown dirty side in and away from the body
The health care team member who assists the client with the performance of activities of daily living is the:
(A) social worker.
(B) occupational therapist.
(C) speech therapist.
(D) case manager.
b. occupational therapist
What does “ambulate with assistance” mean?
a. walk with the client twice a day
b. client may use a wheelchair
c. have the client use a cane for walking
d. the client can walk with the nurse aide providing help
d. the client can walk with the nurse aide providing help
When transferring a client, most of the client’s weight should be supported by the nurse aide’s:
A. legs
b. back
c. shoulders
d. wrists
a. legs
When changing a soiled dressing, the nurse aide should wash their hands:
a. before the procedure
b. before & after the procedure
c. after the procedure
d. before, after, & during the procedure
d. before, after, & during the procedure
The nurse aide must wear gloves when
a. transferring a client
b. dressing a client
c. providing mouth care
d. weighing a client
c. providing mouth care
When assisting a client who has right-sided weakness to transfer from a wheelchair, the aide should support the client’s:
a. left side
b. right side
c. front side
d. back side
b. right side
The nurse aide can help prevent pressure injuries in the client by
a. repositioning the client every 4 hours
b. massaging reddened areas
c. keeping linens clean, dry, and wrinkle-free
d. using perfumed soap to clean the client’s skin
c. keeping linens clean, dry, and wrinkle-free
If an aide discovers a small fire in a client’s room, the aide should first:
a. remove the client from any danger
b. extinguish the fire
c. contain the fire
d. sound the alarm
a. remove the client from any danger
When the client has memory loss or confusion, the aide should
a. reassure the client that forgetting information is expected with age
b. speak loudly to the client
c. ignore the client’s statements that are not accurate
d. give the client simple step-by-step instructions
d. give the client simple step-by-step instructions
What does the abbreviation ADL mean?
a. Ad Lib
b. As Doctor Likes
c. Activities of Daily Living
d. After Daylight
c. Activities of Daily Living
Which of the following actions SHOULD the nurse aide take to communicate with a client who has hearing loss?
(A) Face the client when speaking
(B) Repeat statements twice every time (C) Shout so that the client can hear you
(D) Use a high-pitched voice
A. face the client when speaking
What is the first area of a client’s body that the aide should wash when providing a bed bath?
a. legs
b. face
c. arms
d. chest
b. face
When a nurse provides the aide confidential information about a client, the aide should
a. share it with other clients
b. keep the information private
c. tell other staff
d. tell the client’s family
b. keep the information private
Before entering a client’s room, the aide should first:
a. turn lights on
b. identify self
c. knock on the door
d. call the client by the client’s name
c. knock on the door
Mouth care for a client who is unconscious must be done every:
a. 2 hours
b. 4 hours
c. 6 hours
d. 8 hours
a. 2 hours
The nurse aide should place the client’s soiled bedsheets:
a. on the bedside table
b. on the floor of the soiled utility room
c. in a biohazard bag
d. in the soiled linen container
d. in the soiled linen container
Before taking oral temperature of a client who has just finished a cold drink, the nurse should wait:
a. 20 minutes
b. 25-35 minutes
c. 45-55 minutes
d. at least 1 hour
a. 20 minutes
To prevent dehydration of the client, the nurse aide should:
a. offer fluids frequently while the client is awake
b. wake the client hourly during the night to offer fluids
c. give the client salty foods to increase thirst
d, feed the client salty foods to increase thirst
a. offer fluids frequently while the client is awake
When preparing to take a meal tray into the client’s room, what is the most important action for the nurse aide to take?
a. check that the client’s name is displayed on the tray card
b. make sure the client’s favorite foods are present
c. determine if enough fluids have been ordered
d. keep all foods covered until eaten
a. check that the client’s name is displayed on the tray card
Which of the following equipment should the nurse aide have available when caring for a client’s beard?
a. basin, mirror, nail file, and towel
b. towel, gloves, razor, shaving cream
c. shaving cream, razor, gloves, comb
d. razor, shaving cream, towels, and orange stick
b. towel, gloves, razor, shaving cream
To find out what type of diet the client should be receiving, it would be best for the nurse aide to check:
a. with the kitchen staff
b. on the client’s room bulletin board
c. in the client’s care plan
d. with the client’s family
c. in the client’s care plan
What should the nurse aide do when a client with Alzheimer’s disease seems depressed and quiet?
a. talk when the client is silent
b. observe the client for non-verbal cues
c. change subjects until the client begins to discuss something
d. tell the client not to worry
b. observe the client for non-verbal cues
Which of the following actions by the nurse aide can best demonstrate active listening skills?
a. changing the subject frequently
b. responding when appropriate
c. correcting the client’s mistakes
d. directing the conversation
b. responding when appropriate
The nurse aide should understand that a back massage:
a. causes muscle spasms
b. increases blood pressure
c. promotes circulation
d. increases the heart rate
c. promotes circulation
When assisting with dressing a client who has left-sided weakness, what part of a sweater should be put on first?
a. both sleeves
b. left sleeve
c. client’s choice
d. right sleeve
b. left sleeve
A client with arthritis reports difficulty when cutting the food. What should the nurse aide do to encourage the client’s independence in eating?
a. cut the food and feed the client
b. insist that the client eat the meal without help
c. Assist the client in cutting the food and encourage the client to use the special eating utensils
d. ask the dietary department to puree the client’s food
c. assist the client in cutting the food and encourage the client to use the special eating utensils
The nurse aide is assisting a coworker in obtaining a quad cane for a client. How many legs should the nurse aide understand that a quad cane has?
a. 1
b. 2
c. 3
d. 4
d. 4
Once a client has been pronounced dead, the responsibility of the nurse aide is to:
a. make sure the body is clean
b. call the family
c. leave the room
d. give spiritual care
a. make sure the body is clean
A client drinks 240 mL of soup, 120 mL of coffee, and 90 mL of juice for lunch. The client’s total liquid intake for lunch is:
a. 360 mL
b. 450 mL
c. 480 mL
d. 520 mL
b. 450 mL
The client’s call light should always be placed:
a. on the bed
b. within the client’s reach
c. on the client’s right side
d. over the side rail
b. within the client’s reach
Which of the following items is used in the prevention and treatment of bedsores or pressure sores?
a. rubber sheet
b. air mattress
c. emesis basin
d. restraint
b. air mattress
When caring for a dying client, the nurse aide should:
a. keep the client’s room dark and quiet
b. allow the client to express his feelings
c. change the subject if client talks about death
d. contact the client’s minister, priest, or rabbi
b. allow the client to express his feelings
After giving a client a back rub the nurse aide should always note:
a. the last time the client had a back rub
b. any change in the client’s skin
c. client’s weight
d. amount of lotion used
b. any change in the client’s skin
Reality orientation vs Validation therapy
A resident keeps calling you by his daughter’s name (different approaches based on technique)
REALITY ORIENTATION – keep reminding resident of your name and who you are
VALIDATION THERAPY — ask him about his daughter
Shock position
Head down with feet elevated. You can elevate the feet by putting several pillows under their legs
Normal RECTAL temperature
98.6 – 100.6 degrees F (lubricate and hold in place for 1-2 minutes, insert 1 inch into the rectum and resident must be in SIMS position – which is left side lying )
Shoulder ROM exercises
Flexion & extension; abduction & adduction; internal & external rotation
Possible HIPAA violations
Taking a picture of resident or family & visitors / not closing door during tasks / not pulling the privacy curtain, not asking visitors to leave when needing to perform a task
Precautions for removing a meal tray or specimen from an isolation room
Must double bag when removing tray or specimen
BID / TID / QID
BID = twice a day / TID = three times a day / QID = four times a day
Where & how restraints secured
Secured to the movable part of the bed and are secured with an easy release knot
When passing ice water, what is the procedure?
You may not touch the inside of the water pitcher or glass; in between resident rooms be sure that ice scoop is place in the side pocket of the ice chest
Cold dry ice application preparation
Cold dry ice applications must be covered with some type of cotton cloth (i.e. pillow case
Dysphagia
Difficulty swallowing
Dysphasia
Difficulty speaking
Aphasia
Absent or difficult speech
Dyspnea
Difficulty breathing
If your resident drinks poison
You need to put on the signal light and call for the nurse
Recreation therapy
Used with residents with dementia or AD — can help increase the resident’s alertness
Orientation therapy
Helping the resident with person (who they are & who you are) / where they are / what day of the week and date or season etc.
How you will identify your resident before performing a task
Use their ID band and a 2nd identifier
Anti-Embolus hose are applied
With the resident laying in bed
Where are you standing during the application of Anti-Embolus hose?
You are standing at the foot of the bed, in good body alignment with your feet spread apart (use shoulders are your guideline about 12-18 inches) to improve your balance
Reason to use Anti-Embolus hose
They will increase circulation and help to prevent blood clots
AM care includes
Prepare for morning (Breakfast), assist with elimination, chance & clean incontinent person, wash face & hands (shower), oral hygiene, dress person, brush hair and position person for breakfast, make bed and straighten their room
PM care includes
Preparing for sleep, assist with elimination, clean & change incontinent person, help with washing face & hands, oral hygiene, back massage, undress and help with pajamas, straighten bed & unit
Position of mechanical lift sling
Needs to be under shoulders, butt and thighs
Doctor visiting your resident and he gives you a medical order
Explain that you will go get the nurse for him; that you are not allowed to take medical orders
The resident or patient
Determines the water temperature of a tepid bath used to reduce fevers
Most important step in hand washing
Friction
How do you stock (or put away) the new supplies in the utility room
You must move the old supplies to the front of the cabinet and put the new supplies in the back
Elbow ROM
Extension and Flexion
Your resident is playing bingo and a family member calls and asks to speak with her, what is your responsibility?
You go to the resident and tell them they have a phone call. You will assist resident to their room and close the door so they can have a private conversation.
NPO
Resident is not allowed anything by mouth. This resident does not receive any water (glass or pitcher) at the bedside.
Perineal Care
Always clean from cleanest to dirtiest (front to back) and to protect yourself and the resident from skin, body fluids & infection. You must follow Standard Precautions and Bloodborne Pathogen Standards.
“Security devices or Restrictive devices” are
Restraints
Standard Precautions are also called
Universal Precautions is the old term
What is included in Standard Precautions
Hand hygiene, no fake nails, no long nails and PPE when it applies
When removing a mask which tie is removed first?
The bottom or lower tie is removed first
Part of your job will require you teaching or reinforcing the nurse’s instructions. How would you teach a resident to safely lift a heavy box?
It is easier to push a heavy box rather than pull it toward you. You must demonstrate how to lift using your legs and shoulders but NEVER the back. Carry heavy objects close to your body rather than holding them away from the body.
Resident with a hip arthroplasy has to use what type of bedpan?
Fracture bedpan
Therapeutic foot soak or therapeutic bath temperature
Nurse needs to tell you the water temperature HOWEVER it is always to be resident’s COMFORT
Gait belt application
Around the waist, buckle to the side and the tail tucked in the back. Use an under-handed grip when using the gait belt
How can you respect the resident’s right to privacy?
Always close door, window curtains and privacy curtains during procedures with the proper draping of covers during the procedure (meaning you only expose the body part that you are working on)
Stages of Dying
Denial, Anger, Bargaining, Depression and Acceptance
Bland diet
Used for residents that have stomach issues to help prevent irritation
Diabetic diet
Need to eat at the same time and each meal has a controlled balance of fats, proteins and limited carbs & concentrated sweets (sugar)
Diet for residents with swallowing issues
Dysphagia diet
Mechanical soft diet
For resident’s with chewing issues: meat is ground up to require less chewing
1 ounce =
30mL
Intake
includes all liquids (any thing that melts at room temperature), IV’s & tube feedings
I & O recorded in medical record
On the flow chart
Vital signs are recorded in the medical record
On the graphic sheet
Nourishment
Must be delivered to resident immediately upon their arrival on the nursing unit
Pericare
Remember to always change gloves before pericare during bath procedure and water & washcloth prior to pericare.
Wearing gloves protects you from contact with skin, body fluids and possible infections.
Disinfection v.s. Sterilization
Disinfection kills pathogens and sterilization kills ALL microbes meaning pathogens & non pathogens. You DISINFECT a room, wheelchair, OBT and your hands. You STERILIZE surgical equipment.
Upon discharge, you are assignment to clean the resident’s room
You will DISINFECT the room
PPE sequence
ON — mask, goggles, gown & gloves / OFF — gloves, gown, googles and mask
How often are anti-embolic hose removed?
Remove every 8 hours and at bedtime
Lab specimens require
Being placed in biohazard bag, labeled and contain a requisition
24 hour urine
Discard the 1st specimen, collect all urine for the next 24 hours (keep on ice) and save the last voided specimen. If interrupted, the test must be restarted
Clean catch / mid stream urine
Requires peri care prior to asking resident to start voiding and collect urine in the middle of the stream. It will be a STERILE specimen container
Clean catch / mid stream are used to diagnose
UTI
Random urine specimen
No special container and can be collected at any time during the day or night– you need 4 ounces or 120mL
Specimen checking for occult blood
Occult means looking for hidden blood that can not be seen by the naked eye
Stool specimen
1-2 tablespoons taken from 2 separate areas of the middle of the stool and never from the edges
Sputum specimen
1-2 teaspoons, best collected first thing in the morning — sputum coughed up from the bronchus not from the back of the throat — NO MOUTHWASH prior to the collect of a sputum specimen
Hygiene water temperature
Bath temperature 110-115 degrees F / Pericare temperature 105-109 degrees F / Tub bath is 105 degrees F
Therapeutic baths / soaks / tub baths / shower chairs
Be sure to disinfect before and after use
Occupied bed
Bed made with a person remaining in bed, you must keep the person in good body alignment during the bed making procedure
Restraints
Can only be ordered by the doctor for a “medical reason” and must be the LEAST RESTRICTIVE
Major possible complication of restraints
Strangulation or entrapment
How often do you need to check someone in restraints
Every 15 minutes or more often as the nurse directs / observe skin color, temperature, warmth and ask if any numbness or tingling / IF a restraint belt goes around the waist, you must check to be sure that the resident is not having any difficulty breathing
Vest restraint
V crosses in the front of the patient
Jacket restraints
Opening goes in the back
How often will restraints be removed
Every 2 hours for a minimum of 10 minutes
Orientation of a new resident to the room
You are allowed to check the new resident’s vital signs for the nurse and explain the room, equipment, bathroom and meal / shower procedures. REMEMBER the call light is the most important piece of equipment that the resident needs to know how to use — you will also label all their personal items including clothes
Your responsibility for a discharging resident
Pack all their belongings, shower and dress resident for going home, take resident & belongings to the designated area for discharges. You will assist the resident into the car, secure seat belt and put all belongings into the car.
NEXT, you will come back and remove all linen from the bed, collect all towels, bedpans etc and remove from the room. YOU WILL DISINFECT the room if it is your responsibility to clean the room and prepare for the next resident. YOU WILL MAKE A CLOSED BED
Emptying colostomy pouches
Either in the bedpan or have the resident sit on the toilet, open the clip at the bottom and drain the stool into the toilet.
Best time to shower a resident with an ostomy?
First thing in the morning before breakfast (if the nurse just put on a new pouch, you need to wait 1-2 hours before showering)
How frequently are ostomy pouches changed?
Every 3 – 7 days or as needed if they leak
Type of stool from ostomy
Colostomy has formed stool / Ileostomy has constant liquid stool
Indwelling foley catheter
Drainage bag must always be kept lower than the resident’s bladder and hung from the bed frame & NEVER the side rail.
Where can you NEVER dispose of an ostomy pouch
Never flush down the toilet, if you put a dirty / used pouch in the garbage, you must immediately remove from the resident’s room
Where is the CATHETER secured?
To the upper inner thigh
Where is DRAINAGE TUBING secured?
To the bottom sheet
Transfer to bedside commode — your responsibility
To close room door, window curtains, privacy curtain before transfer. Once transferred, the resident will need their call signal within reach. IF ALERT, you will check on them every 5 minutes
IF DEMENTIA or AD, you need to check the care plan to see if they can be left alone on the commode —
BEST PRACTICE, you need to stay outside the privacy curtain to be available if they try to get up
Male resident uses a urinal
You need to instruct the resident they can place the urinal on the bed siderail but NEVER on the over bed table, night stand or on the floor. Be sure resident has the call light and instruct them to call you when they are finished.
Soak
When a body part is immersed in water
Aquathermia pad
Dry heat application that needs to be covered with a soft cotton cloth (pillow case)
Hot & Cold applications
You MUST check the skin every 5 minutes and they must be removed after 15-20 minutes
Abnormal vital signs
Must be report to the RN immediately
Compresses
Soft cotton cloth that are usually used with WET applications
Resident asks you what you got for his blood pressure reading
The resident has the right to know HOWEVER you can NEVER explain what the reading means. You need to tell them you will send RN to explain results.
Subjective data
Resident reports to you and are considered symptoms
You are allowed to obtain valuable information from resident and family
Such as bathing preference, favorite clothes or food but you are NEVER allowed to gather health history information
Objective data
Things you can observe through your senses (see, hear, smell etc) and are considered signs
Incident report
Anything unusual that occurs (i.e. falls, cuts/bruises / missing items)
Gait belt is considered a protective device
Used during “safe” transfers
POW
Put on weak when dressing
TOS
Take off strong when undressing
Ambulating a resident with weakness
You use your gait belt and stand to the side and slightly behind the WEAK SIDE
What hand is a cane held in?
On the strong side
Chairs from home
Must have arm rests to make it easier for residents to sit down & stand up — must be non tip
When using an ambulation device (walker or cane) what moves first?
The ambulation device followed by the weak side and then the strong side
Orthostatic hypotension
Drop in blood pressure from changing positions too quickly
Dangling
Sitting the resident on the side of the bed (procedure is to elevate the HOB first and then assist resident to the side of the bed) MUST CHECK to observe resident for symptoms of orthostatic hypotension
To pull a resident up in bed
Use the draw sheet as an assistive device to prevent friction & shearing
When pulling a resident up in bed where is the pillow placed?
At the head of the bed so that the resident’s head can’t accidentally come in contact with the head board
How is a resident in a wheelchair taken out of their room?
You pull the wheelchair BACKWARDS out the door so that you can check for any hall traffic
How do you push a wheelchair in the hallway?
You will always push the wheelchair forward so that the resident can “see” where they are going
Number of people required to operate a mechanical lift
A minimum of 2 people
PROM
The CNA does all of the ROM exercises
AAROM
The CNA assists the resident with ROM exercises
AROM
The resident is independent with exercises
Braces
Support a body part, you are responsible for being taught how to properly put on the brace, when to take it off and to CHECK the SKIN under the brace for any reddness or sores
Sundowning
When anxiety and confusion increases when the sun starts to go down
Resistance to hygiene or tasks with a dementia resident
Never push a resident, come back later and try again always using a very calm approach and gentle voice
Catastrophic reactions
Reaction typically extreme and due to over stimulation – needs very calm approach and remove from whatever is causing the over stimulation
When you are trying to assess if they understand or are oriented
Observe them during recreational activities (resident needs to follow directions and procedure steps to participate in a recreational activity)
Vital Signs – area for pulse checks
Carotid artery for CPR pulse / brachial artery for BP / radial artery thumb side for pulse
Normal adult pulse rate
60-100 bpm
Normal adult respiratory rate
12-20 per minute
Normal adult BP
120/80mmHg (**remember the correct BP designation will always include mmHg)
Hypotension
90/60mmHg
Hypertension (HTN)
140/90mmHg
Normal ORAL temperature
97.6 – 99.6 degrees F (hold in place 2-3 minutes)
Fever
Temperature should be check every 4 hours or as the nurse directs. You are allowed to give fluids as the nurse directs and cool (tepid) sponge baths in an attempt to lower the fever. All medication must be given by RN
Tepid bath for fever reduction
Expose 1 limb at a time, pat with cool wash cloth for 5 minutes, place cool cloths under both axilla, groin and forehead. DO NOT RUB AS THAT GENERATES HEAT AND WE ARE TRYING TO LOWER THE TEMPERATURE
Daily weight
Weigh at same time of day, same scale, in pajamas and after resident has voided
Height
48 inches = 4 feet / 60 inches = 5 feet / 72 inches = 6 feet
RACE
During a fire, you RESCUE, ALARM, CONFINE OR CONTAIN and EXTINGUISH
PASS
When using a fire extinguisher, PULL THE PIN, AIM AT THE BASE OF THE FIRE, SQUEEZE THE HANDLE AND SPRAY
Adult CPR ratio
30:2 (30 compressions to 2 breaths)
Sequence for CPR
COMPRESSION, AIRWAY, BREATHING and early DEFIBRILLATION
Frayed or bad electrical cords (think call light!!)
The equipment must be removed and replaced with working equipment. In the instances of a call light, do not leave the call light in the room & you can not leave the resident without a call light so you need to contact nurse / maintenence based on policy to bring a working call light to the resident’s room
Who’s responsibility is it to clean up spills?
EVERYONE’s because wet floors causes falls
You find a chemical bottle left by housekeeping in a resident’s room
Immediately remove it (NEVER LEAVE IT IN THERE) and take it to the nurse
Chemical bottles without labels
You are never to use any chemical without a label / if a label is present check the MSDS for information about the chemical
To open an airway
Head tilt – chin lift
Fall prevention
Clothes fit properly(no long pants dragging on the floor), non skid shoes and no throw rugs on floor. Answer call lights promptly and use gait belts and assistive devices correctly
Patient rights — know them and observe them with all residents at all times.
- Right to information (test results) , 2. right to quality of life (calling a resident by their title unless the resident asks you to call them something else THE RESIDENT decides what you call them), 3. right to exercise citizenship rights (i.e. voting), 4. right to freedom of choice (picking clothes, refusing treatments), 5. right to be free from all forms of abuse, 6. the right to have mail be private, 7. the right to have visitors, 8. the right to see clergy, 9. the right to privacy in all forms (close doors, window curtains, privacy curtain, only having body parts exposed when performing a task) 10.the right to private phone calls 11. the right to have all procedures explained to them (in the language they understand) 12. the right to refuse
How to read a graduate
When reading a graduate, you must read the MOST accurate side, (each graduate has ounces on 1 side and mL on the other side)……IF the MOST accurate side is OUNCES, you will need to calculate ounces into mL by multiply the number of ounces x 30
When delivering meal trays, how will you verify correct resident?
Check ID band & check name on diet card
Best position to make it easier to breathe
Semi Fowlers
Information allowed on resident / patient ID bands
Resident name, physician, date of birth, or medical record number NEVER on an ID band — emergency contact name & number, diagnosis or room number
What should you do to the stop the bleeding from a nick during shaving?
Apply pressure over the area where the nick is
Why wear gloves when shaving?
In case you nick a resident during shaving, there will be no blood contact. YOU MUST report whenever you nick or cut a resident during shaving
Resident is on anti-coagulant
You must use an electric shaver
Dressing a resident
Allow choice when picking out clothes and ENCOURAGE independence during dressing. We are not there to do everything for a resident and make them dependent on us…..we are there to keep them as independent as possible
Topical ointments
When you apply barrier cream to resident’s skin this is considered a “topical” because it goes ON TOP of the skin
“kneading” during a back massage
Is part of a back massage when you pick up the tissue between thumb and fingers
Equipment & position used for oral hygiene on an unconscious resident
Use a toothette and resident positioned onto their side
Frequency of oral hygiene for a resident NPO
Every 2 hours at least
Bed linens are soaked with liquid BM
You must roll linen away from you and your uniform and place in a LEAK PROOF bag
Sitz bath
Resident’s perineal / rectal area is place in warm water
Sitz bath observations
Because of the warm water, you must observe resident for being lightheaded or dizziness
Wandering with AD resident
Allow resident to wander in a safe secure environment
Stretchers are moved
Feet first, side rails raised and resident never left alone on a stretcher
Short lines on centigrade thermometer
0.1 degree
Apical pulse
Apex of heart, below left nipple (only pulse that needs to be heard – it can not be felt)
Short lines on Fahrenheit thermometer
0.2 degree
Long lines
1 degree
Before starting CPR
Assess for: No response, no pulse and no breathing
Weighing a resident in a wheelchair
After you obtain weight YOU MUST deduct the weight of the wheelchair in order to obtain an accurate weight
Assisting with a burn
Apply cool cloths & NEVER ICE to a burn. Do not attempt to removed clothes stuck to burn areas. Apply blankets to keep person warm (victim may be going into shock following a major burn) NEVER APPLY BUTTER or other old wive’s tails to a burn. Do not use warm or hot clothes as this allows the burn to continue to expand deeper into tissue)
OBRA required resident room temperature
To the resident’s comfort – 71-81 degrees F, if the resident is cold and the temperature of their room is outside of the acceptable range, you must NOTIFY THE NURSE
HIPAA
You must keep all information confidential & private
Residents with limited English
You must have non verbal methods to communicate
Isolation meal trays
Must be double bagged and taken to the dietary kitchen
Resident is being abused by family but asks you to keep the secret
Explain that you can not keep this secret and report abuse to the nurse
Warm soaks
the warm increases blood flow
Contamination of a stool specimen
If there is any urine in the stool specimen it can not be sent to the lab. You need to retrieve a new specimen
Rehabilitation focus
Focuses on abilities
Vital signs in the elderly
Are typically slightly lower than normal adult ranges
Signs & symptoms of Hypoglycemia
Fatigue, weakness, dizziness, hands shaky, skin cold & clammy, sweating, confusion, pulse rapid, respiration rapid & shallow
Signs & symptoms of Hyperglycemia
Hunger, excessive thirst and urination, unexplained weight loss, dry mouth, face flushed (red) sweet breath odor
Contaminated bed linen
Always rolled away from you, wear gloves and placed in an appropriate linen bag (if dripping with urine or diarrhea — leak proof bag)
Tachypnea
Respiration rate greater than 20 per minute for an adult
You take the last pair of gloves out of the box in the bathroom
It is your responsibility to replace with a new box of gloves
Can you write a letter for a resident
YES, you should also address the envelope correctly and mail for the resident
Air mattress applied to bed
ON TOP of the mattress with linen placed over the air mattress
Resident wants to call his attorney
He has the right to call his attorney at any time
Isolation cart
If you are stocking the cart for the 1st time, be sure that there are gloves, goggles, gown & masks. If you use the last of any item, it is your responsibility to restock the car
Non medicated lotions
Are applied to help keep skin hydrated (never apply lotions between toes)
Your resident refuses to eat
You MUST offer a substitution
Observations when your resident has a cold dry application (ice bag)
You must observe skin color – if you observe any cyanosis, numbness or tingling — you must report to RN immediately
When going into an isolation room to obtain a specimen
You will need to label (or tag) the specimen container BEFORE entering the isolation room
Validation therapy
A resident wants to cook — in validation therapy you will ask WHAT the resident wants to cook (do not let her cook)
When assisting a client in learning how to use a cane, the nurse aide stands
a. approximately two feet directly behind the
client.
b. about one foot from the client’s weak side.
c. about one foot from the client’s strong side.
d. slightly behind the client on the client’s weak
side.
d. slightly behind the client on the client’s weak
side.
When working with a client who has urinary
retention, the nurse aide can expect that the
client will
a. urinate large volumes.
b. be unable to urinate.
c. urinate frequently.
d. be incontinent of urine.
b. be unable to urinate.
Aging-related hearing changes result in older
clients gradually losing their ability to hear
a. high-pitched sounds.
b. low-pitched sounds.
c. slow sounds.
d. rapid sounds.
a. high-pitched sounds.
The best way to safely identify your patient is by
a. asking his name.
b. calling his name and waiting for his
response.
c. checking the bed plate.
d. checking the name tag.
d. checking the name tag.
A client is on a bowel and bladder training
program and has not had a bowel movement in
three days. The nurse aide should
a. report it to the charge nurse.
b. give the client an enema.
c. offer the client prune juice.
d. encourage the client to drink more fluids.
a. report it to the charge nurse.
The proper medical abbreviation for before
meals is
a. p.c.
b. b.i.d.
c. a.c.
d. t.i.d.
c. a.c.
A client diagnosed with hypertension will most
likely have a history of
a. low blood pressure.
b. high blood pressure.
c. low blood sugar.
d. high blood sugar.
b. high blood pressure.
A patient who has difficulty chewing or
swallowing will need what type of diet?
a. clear liquid
b. low residue
c. bland
d. mechanical soft
d. mechanical soft
An elderly resident with Alzheimer’s disease
cannot find her room. How can the nurse aide
help the client feel more independent?
a. Tell her to stay in the room.
b. Have her roommate secretly watch her.
c. Place a familiar object on the client’s door.
d. Write the room number on a piece of paper.
c. Place a familiar object on the client’s door.
How often should a patient’s intake and output
records be totaled?
a. once each shift
b. twice a day
c. every four hours
d. every 12 hours
a. once each shift
Which of the following should the nursing
assistant observe and record when admitting a
client?
a. freckles
b. wrinkles
c. short nails
d. bruises
d. bruises
When responding to a client on the intercom,
the nursing assistant should say
a. “Hello, who is calling, please?”
b. “What is it that you want?”
c. “This is [nursing assistant name and position], can I help you?”
d. “Please hold; I’ll have the nurse answer your
call.”
c. “This is [nursing assistant name and position], can I help you?”
Which of the following things should the nurse
aide do to familiarize new clients with their
surroundings?
a. Demonstrate the location and use of the call
light.
b. Explain that the TV is not to be used.
c. Instruct family to leave the room after the
aide is finished with the admission.
d. Raise the bed to the high position and raise
the safety rails.
a. Demonstrate the location and use of the call
light.
When arranging a client’s room, the nursing
assistant should do all of the following
EXCEPT
a. checking the placement of the call bell.
b. adjusting the back rest as directed.
c. administering the client’s medications.
d. adjusting the lighting as appropriate.
c. administering the client’s medications.
When assisting a client out of bed, the nurse
aide should always
a. employ body mechanic techniques.
b. get another nurse aide to assist.
c. raise the bed to its maximum height.
d. lower all safety rails.
a. employ body mechanic techniques.
How often should clients be repositioned
during an eight-hour shift?
a. qlh
b. q2h
c. q3h
d. q4h
b. q2h
Which of the following is the correct procedure
for serving a meal to a client who must be fed?
a. Serve the tray along with all the other trays,
and then come back to feed the client.
b. Bring the tray to the client last; feed after
you have served all the other clients.
c. Bring the tray into the room when you are
ready to feed the client.
d. Have the kitchen hold the tray for one hour.
c. Bring the tray into the room when you are
ready to feed the client.
The most serious problem that wrinkles in the
bedclothes can cause is
a. restlessness.
b. sleeplessness.
c. decubitus ulcers.
d. bleeding and shock.
c. decubitus ulcers.
Restorative care begins
a. as soon as possible.
b. when the client is ready.
c. when the client is discharged.
d. when the client is diagnosed as terminally ill.
a. as soon as possible.
Before placing a client in Fowler’s position, the
nurse aide should
a. open the window.
b. explain the procedure to the client.
c. check with the client’s family.
d. remake the bed.
b. explain the procedure to the client.
During hand washing, the nurse aide
accidentally touches the inside of the sink while
rinsing the soap off. The next action is to
a. allow the water to run over the hands for
two minutes.
b. dry the hands and turn off the faucet with
the paper towel.
c. repeat the wash from the beginning.
d. repeat washing, but for half the time.
c. repeat the wash from the beginning.
How should a nurse aide dress for a job
interview?
a. wearing a clean t-shirt and casual slacks
b. wearing a nurse aide uniform
c. wearing a business suit, dress, or pants and
dress shirt
d. wearing formal attire
c. wearing a business suit, dress, or pants and
dress shirt
An ambulatory client is newly admitted. Before
leaving the client alone, the nurse aide should
a. ask if the client is hungry.
b. inspect the client’s skin.
c. assess the client’s intake and output.
d. make sure the client knows how to use the
call bell.
d. make sure the client knows how to use the
call bell.
When lifting a heavy object, the correct method
would be to bend at the
a. waist, keeping your legs straight.
b. waist, rounding your shoulders.
c. knees, keeping your back straight.
d. knees and waist.
c. knees, keeping your back straight.
When should nurse aides wash their hands?
a. after eating
b. before using the bathroom
c. after client care
d. before cleaning a bedpan
c. after client care
When assisting a client with eating, one of the
first things the nurse aide should do is
a. cut the food into bite-size pieces.
b. wash his own hands and the client’s hands.
c. butter the client’s bread.
d. provide the client with privacy.
b. wash his own hands and the client’s hands.
A patient has a new cast on her right arm.
While caring for her, it is important to first
observe for
a. pulse above the cast.
b. color and hardness of the cast.
c. warmth and color of fingers.
d. signs of crumbling at the cast end.
c. warmth and color of fingers.
Encouraging a client to take part in activities of
daily living (ADLs) such as bathing, combing
hair, and feeding is
a. done only when time permits.
b. the family’s responsibility.
c. necessary for rehabilitation.
d. a violation of client rights.
c. necessary for rehabilitation.
In caring for a confused elderly man, it is
important to remember to
a. keep the bedrails up except when you are at
the bedside.
b. close the door to the room so that he does
not disturb other patients.
c: keep the room dark and quiet at all times to
keep the patient from becoming upset,
d. remind him each morning to shower and
shave independently.
a. keep the bedrails up except when you are at
the bedside.
Before assisting a client into a wheelchair, the
first action would be to check if the
a. client is adequately covered.
b. floor is slippery.
c. door to the room is closed.
d. wheels of the chair are locked.
d. wheels of the chair are locked.
A client has a weak left side. When transferring
the client from the bed to the wheelchair, the
nurse aide should stand
a. on the right side.
b. in front of the client.
c. on the left side.
d. behind the client.
c. on the left side.
While making rounds at 5:30 A.M., a nurse aide
finds a patient lying on the floor. What should
the nurse aide do first?
a. Call 911.
b. Perform CPR.
c. Call for help.
d. Assess the client’s pulse and respirations.
d. Assess the client’s pulse and respirations.
When moving a wheelchair onto an elevator,
the nurse aide should stay
a. behind the chair and pull it toward the aide.
b. behind the chair and push it away from the
aide.
c. in front of the client to observe the client’s
condition.
d. at the side of the wheelchair while opening
the door.
a. behind the chair and pull it toward the aide.
The Foley bag must be kept lower than the
client’s bladder so that
a. urine will not leak out, soiling the bed.
b. urine will not return to the bladder, causing
infection.
c. the bag will be hidden and the client will not
be embarrassed.
d. the client will be more comfortable in bed.
b. urine will not return to the bladder, causing
infection.
As an afternoon snack, the kitchen sent a
diabetic client a container of chocolate ice
cream. The nursing assistant should first
a. substitute diet soda for the ice cream.
b. hold the afternoon snack and report to the
charge nurse.
c. call the kitchen and report the error.
d. allow the client to have half of the ice cream.
b. hold the afternoon snack and report to the
charge nurse.
When assisting a client who is using the
commode, it is important to
a. leave the call light within reach.
b. lock the door to promote privacy.
c. stand next to the client until the client is
finished.
d. restrain the client to prevent a fall.
a. leave the call light within reach.
Ensuring adequate circulation to tissues is a
major factor in preventing skin breakdown.
This can be accomplished by doing all of the
following EXCEPT
a. positioning the patient every four hours.
b. using mechanical aids.
c. giving backrubs.
d. performing active or passive ROM exercises.card
a. positioning the patient every four hours.
The purpose of cold applications is usually to
a. speed the flow of blood to the area.
b. prevent heat exhaustion.
c. prevent or reduce swelling.
d. prevent the formation of scar tissue.
c. prevent or reduce swelling.
The hot water bottle is an example of a
a. local dry heat application.
b. generalized dry heat application.
c. local moist heat application.
d. generalized moist heat application.
a. local dry heat application.
Clients receiving an enema are usually placed
a. on the right side.
b. on the left side.
c. flat on the back.
d. in a semisitting position.
b. on the left side.
A female client’s perineal area should be
cleansed before which specimen is collected?
a. 24-hour urine specimen
b. midstream clean-catch urine specimen
c. pediatric routine urine specimen
d. routine urine specimens
b. midstream clean-catch urine specimen
The most common site for counting the pulse
is the
a. carotid artery.
b. femoral artery.
c. brachial artery.
d. radial artery.
d. radial artery.
When counting respirations, the nurse aide
should
a. wait until after the client has exercised.
b. not tell the patient what he is going to do.
c. count five respirations and then check his
watch.
d. have the client count respirations while the
aide takes her pulse
b. not tell the patient what he is going to do.
Which of the following is NOT the nurse aide’s
responsibility when caring for clients who have
urinary catheters?
a. inserting the catheter
b. ensuring that the catheter drains properly
c. preventing infection
d. recording urinary output
a. inserting the catheter
When giving information to the charge nurse
for an incident report, the nurse aide should
a. write in the client’s chart that an incident
occurred.
b. keep the report in her personal file.
c. state the facts clearly.
d. give her opinions as to the cause of the
incident
c. state the facts clearly.
All long-term-care nurse aides must be
competency evaluated and must complete a
distinct educational course. These requirements
are set by
a. OBRA.
b. OSHA.
c. CDC.
d. FDA.
a. OBRA.
A resident is blind. It is important not to
a. leave the door completely opened.
b. rearrange the furniture.
c. announce yourself before entering the room.
d. explain the location of food on the plate,
using the face of the clock to assist.
b. rearrange the furniture.
When family members visit a client, the visitors
should
a. stay in the day room.
b. stay a short while so as not to tire the client.
c.,be expected to help with care.
d. be allowed privacy with the client
d. be allowed privacy with the client
A resident asks, “If I need help during the
night, who will be there?” The nursing assistant
should respond,
a. “Don’t worry, you’ll be okay.”
b. “Just yell; someone will hear you.”
c. “Your roommate will probably ring the call
bell.”
d. “There are people here all night to help you.”
d. “There are people here all night to help you.”
Which of the following is a client’s right?
a. having personal information kept
confidential
b. obtaining private duty staff if desired
c. knowing what is wrong with the client’s
roommate
d. treating the staff any way he or she pleases
a. having personal information kept
confidential
A resident often cries while she is receiving her
P.M. care. What should the nurse aide do?
a. Tell her to stop crying.
b. Ignore her and continue with her carq.
c. Tell her jokes to make her laugh.
d. Tell her that it’s all right to cry, and that the
aide is there for her if she wants to talk.
d. Tell her that it’s all right to cry, and that the
aide is there for her if she wants to talk.
When providing denture care, the nurse aide
must
a. wash them in boiling water.
b. hold them under warm running water.
c. dunk them in and out of cool water.
d. place them on a towel in the sink with cool
water.
d. place them on a towel in the sink with cool
water.
Sexuality in long-term-care clients may include
all of the following EXCEPT
a. needing private time with a partner.
b. caring about one’s physical appearance.
c. engaging in public fondling.
d. desiring sexual interaction
c. engaging in public fondling.
A client is scheduled for a partial bed bath. This
means that the nurse aide must wash the
client’s
a. face, neck, ears, arms, and hands.
b. face, axillae, hands, and buttocks.
c. face, hands, axillae, and legs.
d. face, hands, axillae, genitals, and buttocks.
d. face, hands, axillae, genitals, and buttocks.
An agitated resident must be turned every two
hours all night long. The first action of the
nurse aide when waking up this resident is to
a. turn on the light.
b. speak quietly and calmly.
c. touch her shoulder.
d. shout her name.
b. speak quietly and calmly.
If a client objects to certain food for religious
or cultural reasons, the appropriate action
would be to
a. tell him to wait for the next meal.
b. offer to substitute something different for
him.
c. call the dietician the next day.
d. tell him he needs to eat what is on his tray.
b. offer to substitute something different for
him.
The client’s religion forbids eating pork. Bacon
is being served for breakfast. The most
appropriate response is to
a. encourage the client to eat it because she
needs protein.
b. tell the client it is all right since her doctor
ordered the diet.
c. call the kitchen for a tray without bacon.
d. tell the client that restrictions are not as
important as her health.
c. call the kitchen for a tray without bacon.
Which type of communication can often be
most powerful?
a. written
b. verbal
c. silent
d. tactile
c. silent
A client refuses to allow the nurse aide to bathe
her. The nurse aide tells the client that she will
not be allowed to eat lunch or go to bingo if she
does not have her bath. This is an example of
a. rehabilitation.
b. discipline.
c. verbal abuse.
d. physical abuse.
c. verbal abuse.
On entering a room, an aide notices that the
client is not breathing. The aide’s first action
should be to
a. call for help.
b. lay the client down on his back.
c. give four quick breaths.
d. give 8-10 abdominal thrusts.
a. call for help.
A client’s dentures are lost. The first action
should be to
a. notify the administrator.
b. look for them.
c. notify the doctor.
d. notify the charge nurse.
d. notify the charge nurse.
Nursing assistants are responsible for
a. planning client care.
b. doing tasks assigned by the charge nurse.
c. performing without ever asking for help.
d. comparing assignments with coworkers.
b. doing tasks assigned by the charge nurse.
A patient turns on the call light when he needs
to urinate. The appropriate action is to
a. ignore the light, since he is not the aide’s
own client.
b. announce on the intercom that there are two
patients ahead of him.
c. answer the call light and get the urinal.
d. answer the call light when the aide has the
time.
c. answer the call light and get the urinal.
A client is on CMR and in the prone position.
The nurse aide finds the client vomiting bright
red blood. The nurse aide should first
a. clean up the vomit.
b. place the client in the side-lying position.
c. provide the client with an emesis basin.
d. call the charge nurse.
b. place the client in the side-lying position.
When performing catheter care, the nurse aide
should wash the catheter
a. toward the meatus.
b. with Betadine soap.
c. away from the meatus.
d. with alcohol.
c. away from the meatus.
A nurse aide who applies restraints on a client
without directions from the charge nurse may
be accused of
a. slander.
b battery.
c. false imprisonment.
d. negligence.
c. false imprisonment.
H.S. care is care that is given
a. before meals.
b. before bedtime.
c. after meals.
d. upon awakening.
b. before bedtime.
The best food choices for a geriatric client with
no teeth would include
a. hamburger, french fries, corn, and ice cream.
b. baked chicken, dressing, green beans, and
coconut macaroons.
c. spare ribs, macaroni and cheese, coleslaw,
and fruit cocktail.
d. baked fish, whipped potatoes, spinach
souffle, and tapioca.
d. baked fish, whipped potatoes, spinach
souffle, and tapioca.
A client’s family wants to talk about the client’s
impending death, but the client does not want
to talk about it. The family should be
encouraged to
a. carry on the conversation away from the
client.
b. talk freely in front of the client in order to
help the client to accept it.
c. wait until the client dies to talk about it.
d. force the client to talk about it with them.
a. carry on the conversation away from the
client.
A nurse aide notices that a water pitcher has
spilled onto the floor. The best action for the
aide to perform is to
a. wipe it up immediately.
b. cover it with a towel.
c. notify the charge nurse.
d. contact housekeeping.
a. wipe it up immediately.
Upon entering a room, the nurse aide notices
that a patient is not breathing. The aide’s first
action is to
a. call for help.
b. lay the patient down on his back.
c. give four quick breaths.
d. give ten abdominal thrusts.
a. call for help.
When should postmortem caer be performed?
a. after the family views the body
b. Immediately after doctor pronounces
c. when rigor mortis sets in.
d.after boyd goes to teh morgue.
b. Immediately after doctor pronounces
The purpose of correctly positioning the client is to:a. prevent skin breakdown.
b. maintian function of joints and muscles
c. increase comfort.
d. All of the above
d. All of the above
A surgical bed should be left in what position?
highest position
A female resident’s husband has asked for some
time alone with his wife in her room. What
should the nurse aide do?
(A) Let the husband visit but listen outside the
door.
(B) Let the husband visit and leave the door
open.
(C) Tell the husband not to disturb his wife.
(D) Let the husband visit in private.
(D) Let the husband visit in private.
A resident needs range of motion (ROM)
exercises every day. When the nurse aide tries to
help her do the exercises, the resident says she
will not do them. She says that they are too hard.
What is the nurse aide’s best response?
(A) “Try harder and the exercises will be easier.”
(B) “I understand, but try working slowly and
resting often.”
(C) “The doctor ordered the exercises because
they are important.”
(D) “Think of something good during the
exercises and maybe they won’t be so
hard.”
(B) “I understand, but try working slowly and
resting often.”
A nurse aide enters a room to check on a resident
who is in restraints. The nurse aide finds that the
resident has gotten out of the restraint and is
partly out of the bed. What should the nurse
aide do?
(A) Call for help to get the resident back into bed
and put the restraint back on.
(B) Put the restraint back on tightly so that the
resident cannot move.
(C) Leave the restraint off and report the
problem to the charge nurse.
(D) Put a different type of restraint on the
resident.
hard.”
(A) Call for help to get the resident back into bed
and put the restraint back on.
A resident does not want to wear her dentures.
She says she has a sore in her mouth. The nurse
aide should
(A) tell her to leave her dentures out for a few
days.
(B) have the resident rinse her mouth with salt
water.
(C) tell her that she will feel better if she wears
the dentures.
(D) leave the dentures out and ask the nurse to
check the resident’s mouth.
(D) leave the dentures out and ask the nurse to
check the resident’s mouth.
After a resident has died, the nurse aide is often
assigned to do which of the following?
(A) Prepare the resident’s body.
(B) Call the resident’s family.
(C) Call the resident’s doctor.
(D) Call the undertaker.
(A) Prepare the resident’s body.
A resident complains that he cannot fall asleep.
What can the nurse aide do first to help him
relax?
(A) Move him to the day room.
(B) Give the resident a back rub.
(C) Give the resident a sleeping pill.
(D) Report the resident’s complaint to the charge
nurse.
(B) Give the resident a back rub.
A resident is to start range of motion (ROM)
exercises. When performing ROM exercises on a
resident, what does the nurse aide do to each
joint?
(A) Stretch it until it hurts.
(B) Rotate it in both directions until it hurts.
(C) Bend it to a 90-degree angle while
supporting the limb.
(D) Move it to its fullest range or until the
resident feels discomfort.
(D) Move it to its fullest range or until the
resident feels discomfort.
A sign on the resident’s door says NPO. What
does this sign tell the nurse aide about the
resident?
(A) The resident is receiving AM care.
(B) The resident is receiving oxygen therapy.
(C) The resident is not to be given any solid
food.
(D) The resident is not to be given anything by
mouth.
(D) The resident is not to be given anything by
mouth.
A resident is smoking a cigarette in the smoking
area on the outside porch of the nursing home.
The resident keeps dropping the cigarette in his
lap. What should the nurse aide do first?
(A) Stay with the resident until he is finished
smoking.
(B) Tell the resident that he must be more
careful.
(C) Check on the resident every few minutes.
(D) Go and report it to the charge nurse.
(A) Stay with the resident until he is finished
smoking.
A nurse aide is assigned to care for a resident
who asks her to stay with her because she thinks
she is dying. What should the nurse aide do?
(A) Scold the resident for talking that way.
(B) Ask the resident why she feels this way.
(C) Tell the resident, “That isn’t true.”
(D) Ignore the resident’s behavior.
(B) Ask the resident why she feels this way.
A resident is able to dress himself, but he is very
slow. What should the nurse aide do to assist this
resident to get to breakfast on time?
(A) Dress the resident.
(B) Tell the resident to hurry.
(C) Start the resident dressing earlier.
(D) Warn the resident he is going to miss
breakfast.
(C) Start the resident dressing earlier.
A nurse aide is caring for a resident on bedrest.
The resident is not able to turn herself. What is
the longest time that the nurse aide is allowed to
leave the resident in one position?
(A) 1 hour
(B) 2 hours
(C) 3 hours
(D) 4 hours
(B) 2 hours
A resident’s care plan calls for the resident to
ambulate 50 feet twice a day. The resident tells
the nurse aide that she is unable to do it now.
What should the nurse aide do?
(A) Ask the resident to be more helpful.
(B) Ask the charge nurse to change the care
plan.
(C) Tell the resident that she can skip her walk
today.
(D) Allow the resident to choose a better time to
ambulate.
(D) Allow the resident to choose a better time to
ambulate.
A nurse aide notices that a resident has very dry
skin on the feet. How should the nurse aide care
for the resident’s feet?
(A) Raise them on a pillow.
(B) Wash and dry them only.
(C) Keep socks on them at all times.
(D) Apply lotion after washing and drying the
feet.
(D) Apply lotion after washing and drying the
feet.
An elderly resident is normally alert, but today
she is slightly confused. What should the nurse
aide do?
(A) Say, “It is not like you to act like this.”
(B) Report the confusion to the charge nurse.
(C) Not worry because all old people get
confused sometimes.
(D) Ignore the confusion because the resident
may only be trying to get extra attention.
(B) Report the confusion to the charge nurse.
A nurse aide has found a fire in a resident’s waste
can. What should the nurse aide do first?
(A) Pull the fire alarm.
(B) Pour water on the fire.
(C) Move residents out of immediate danger.
(D) Use the fire extinguisher to put out the fire.
(C) Move residents out of immediate danger.
What is the first thing a nurse aide should do after
receiving the resident assignments for the shift?
(A) Start giving care to the first resident on the
assignment.
(B) Make rounds and see each resident briefly.
(C) Ask another nurse aide what to do first.
(D) Find out when the lunch break is.
(B) Make rounds and see each resident briefly.
A nurse aide is walking with a resident. The
resident says that she is going to faint. What
should the nurse aide do?
(A) Open a window to give the resident air.
(B) Walk the resident to her room quickly.
(C) Assist the resident to sit slowly on the floor.
(D) Hold the resident on her feet until she feels better.
(C) Assist the resident to sit slowly on the floor.
A resident is upset after a family visit. The
resident tells the nurse aide not to allow the
family to visit again. Which of the following is
the nurse aide’s best response?
(A) “OK, I will tell them not to visit.”
(B) “I will inform the receptionist immediately.”
(C) “Can you tell me why you are so upset?”
(D) “You will feel differently about it
tomorrow.
(C) “Can you tell me why you are so upset?”
A nurse aide is feeding a resident a pureed diet.
How should the nurse aide feed the resident?
(A) By feeding all of one food at a time.
(B) By giving portions from each food on the
tray.
(C) By mixing the food together to make feeding
easier.
(D) Any way the nurse aide wishes because
pureed food has no taste.
(B) By giving portions from each food on the
tray.
A resident is on oxygen. He tells the nurse aide
that he is not getting enough oxygen through the
tubing. What should the nurse aide do first?
(A) Turn up the oxygen.
(B) Turn off the oxygen.
(C) Check the tubing.
(D) Tell the patient to breathe faster to get more
oxygen.
(C) Check the tubing.
Which of the following is a true statement about
the elderly?
(A) They have no sex drive.
(B) They prefer to be alone.
(C) They often have problems with vision.
(D) They are not concerned about privacy.
(C) They often have problems with vision.
A resident refuses to have a bath and to shave
every day. He has not bathed for a week. What
should the nurse aide do?
(A) Force the resident to take a bath and shave
every day.
(B) Ask the charge nurse for assistance with the
problem.
(C) Leave the resident alone as he will want a
bath some day.
(D) Tell the resident’s family that the resident
has not bathed in a week.
ambulate.
(B) Ask the charge nurse for assistance with the
problem.
A resident usually dresses himself for breakfast.
Today the nurse aide finds him in pajamas at
10:00 am. What should the nurse aide do?
(A) Nothing
(B) Dress the resident
(C) Ask him “Is there anything wrong today?”
(D) Tell him “I don’t have time to dress you.”
(C) Ask him “Is there anything wrong today?”
A nurse aide finds a male resident in bed with a
female resident who is confused. What should
the nurse aide do?
(A) Scold the male resident.
(B) Report this to the charge nurse.
(C) Close the door and the privacy curtains.
(D) Put a “Do Not Disturb” sign on the door.¨
(B) Report this to the charge nurse.
A resident with poor vision was admitted to the
unit. What should the nurse aide do to ensure the
resident’s safety?
(A) Arrange the furniture against the walls.
(B) Tell the resident to walk around the room by
herself.
(C) Remove all furniture, except the bed and
chair, from the room.
(D) Help the resident become familiar with the
location of the furniture in the room..
ambulate.
(D) Help the resident become familiar with the
location of the furniture in the room..
ambulate.
A nurse aide finds clean linen lying on the floor
near the linen cart. What should the nurse aide
do?
(A) Discard the linen in the soiled linen hamper.
(B) Place the linen on the clean linen cart and
cover the cart.
(C) Place the linen in a resident’s room for
immediate use.
(D) Leave the linen on the floor for
housekeeping staff to remove.
(A) Discard the linen in the soiled linen hamper.
A resident cannot walk by herself. What must
the nurse aide do before leaving her room?
(A) Give her a bedpan.
(B) Tell her to shout if she needs help.
(C) Put the call light where she can reach it.
(D) Let another nurse aide know that she is in
her room.
(C) Put the call light where she can reach it.
A resident has trouble finding her room. What
could the nurse aide do to help this resident?
(A) Speak sharply to her whenever she goes to
the wrong room.
(B) Assign another resident to watch her.
(C) Make a special sign for her door.
(D) Keep her in her room.
(C) Make a special sign for her door.
A resident dies during the night. At breakfast,
another resident who was his friend, begins to
talk to the nurse aide about the death. What
should the nurse aide do?
(A) Distract the resident by talking about the
news of the day.
(B) Tell the resident to find someone else to talk
to.
(C) Find out who told the resident about the
death.
(D) Allow the resident to talk about the death.
(D) Allow the resident to talk about the death.
A resident is lying on the floor having a seizure
when the nurse aide walks into the room. What
should the nurse aide do first?
(A) Restrain the residents arms.
(B) Put a screen around the resident for privacy.
(C) Place a padded tongue blade between her
teeth.
(D) Move any objects which could injure the resident and support her head.
(D) Move any objects which could injure the resident and support her head.
A resident was given a stuffed animal as a gift.
The resident wants to keep the stuffed animal
with her much of the time. What should the
nurse aide do?
(A) Explain that adults do not hold stuffed
animals.
(B) Ask her relatives to take the stuffed animal
home.
(C) Let her hold the stuffed animal whenever she
wants to.
(D) Suggest that she keep the stuffed animal on
the windowsill.
(C) Let her hold the stuffed animal whenever she
wants to.
A resident is dehydrated. The nurse aide’s
assignment says “Force fluids.” What should the
nurse aide do?
(A) Decrease the resident’s fluid intake.
(B) Increase the resident’s fluid intake.
(C) Give liquids with meals only.
(D) Measure output.
(B) Increase the resident’s fluid intake.
A nurse aide wants to get a resident involved in
her own care. Which of these statements would
best encourage the resident’s involvement?
(A) “Stop feeling sorry for yourself.”
(B) “It’s time for us to eat our breakfast.”
(C) “I want to brush your hair right now.”
(D) “Do you want to take your bath now or after
breakfast?”
(D) “Do you want to take your bath now or after
breakfast?”
A resident has an indwelling catheter. As the
nurse aide cares for him, which of these should
the nurse aide report to the charge nurse
immediately?
(A) The resident complains of pain and burning.
(B) The urine in the collection bag is clear and
light yellow in color.
(C) The resident tells the nurse aide that he hates
to have a catheter.
(D) The urine in the collection bag is hanging
below the level of the bladder.
(A) The resident complains of pain and burning.
What is the best source of information about the
care a nurse aide needs to give a resident?
(A) The resident’s family
(B) The resident’s roommate
(C) The resident’s plan of care
(D) Other nurse aides on the unit
(C) The resident’s plan of care
A resident tells the nurse aide that her hearing aid
is not working. What should the nurse aide do
first?
(A) Turn up the volume.
(B) Change the battery.
(C) Tell the charge nurse.
(D) Check to see that the hearing aid is turned
on.
(D) Check to see that the hearing aid is turned
on.
While making rounds at 3:00 A.M., a nurse aide
hears a resident crying softly. How should the
nurse aide respond?
(A) Tell the resident that everything will be
better in the morning.
(B) Tell the resident that everything is fine and
to cheer up.
(C) Pretend not to notice that the resident is
crying.
(D) Ask the resident what is wrong.
(D) Ask the resident what is wrong.
A resident is being discharged from the nursing
home. He tells the nurse aide that he feels
worried about the change. What is the nurse
aide’s most helpful response?
(A) Encourage the resident to talk about his
feelings.
(B) Tell the resident not to worry as things will
work out fine.
(C) Tell the resident that he should be happy to
leave the nursing home.
(D) Suggest to the resident that his worries will
go away if he ignores them.
(A) Encourage the resident to talk about his
feelings.
A nurse aide is called away from a resident’s
beside. When the nurse aide returns, the resident
screams, “I’m too old and too sick to be left
alone.” How should the nurse aide respond?
(A) “You’re fine. Don’t carry on so.”
(B) “I understand, but I have other things to do.”
(C) “Why don’t you just forget it and rest
awhile?”
(D) “I’m sorry I had to leave. Can I help you
now?”
(D) “I’m sorry I had to leave. Can I help you
now?”
A nurse aide is cleaning a resident’s closet. He
finds moldy food and throws it away. The
resident shouts, “Leave my food alone.” What is
the best response by the nurse aide?
(A) “Why are you saving this food? Do you get
hungry between meals?”
(B) “You should eat all your meals, so that you
are not hungry later on.”
(C) “Hiding food is against health laws.”
(D) “This moldy food smells awful.”
(A) “Why are you saving this food? Do you get
hungry between meals?”
A nurse aide observes that a new resident is upset
and frightened while getting ready for bed. The
resident tells the nurse aide that a dark room
frightens her. What is the nurse aide’s best
response?
(A) “Darkness can’t hurt you.”
(B) “As old as you are, you should not be
afraid.”
(C) “You will soon get used to sleeping in the
dark.”
(D) “I will leave the door open so the light can
come in.”
(D) “I will leave the door open so the light can
come in.”
A nurse aide is assisting a resident with lunch.
The resident grabs his throat and cannot speak.
What should the nurse aide do first?
(A) Offer the resident a drink.
(B) Perform the Heimlich maneuver.
(C) Place the resident on the floor and elevate
his feet.
(D) Keep the resident warm by putting a blanket
on him.
(B) Perform the Heimlich maneuver.
A nurse aide realizes from the assignment sheet,
that a resident has not has a bowel movement for
more than 3 days. What should the nurse aide do?
(A) Ignore the problem.
(B) Give the resident an enema.
(C) Report the finding to the charge nurse.
(D) Sit the resident on the toilet until he has a
bowel movement.
(C) Report the finding to the charge nurse.
A resident has had a stroke and has weakness on
her right side. Where should the nurse aide stand
when helping the resident walk?
(A) On the resident’s right side
(B) On the resident’s left side
(C) In front of the resident
(D) Behind the resident
(A) On the resident’s right side
A resident is grieving over the recent death of her
husband. How can the nurse aide best offer
support to the resident?
(A) Leave the resident alone as much as
possible.
(B) Encourage the resident to express her
feelings.
(C) Change the subject when the resident speaks
about her husband.
(D) Tell the resident about the nurse aide’s own
experiences with death.
(B) Encourage the resident to express her
feelings.
A nurse aide is assigned to care for a resident
who has wandered over to another unit. What is
the nurse aide’s most helpful response, when the
nurse aide brings the resident back?
(A) “Let me walk with you.”
(B) “How did you get over here?”
(C) “Don’t you know where you belong?”
(D) “Don’t you realize I have a lot to do?”
(A) “Let me walk with you.”
A resident has a cold and is using tissues for his
nose. There are used tissues on the resident’s
bed, floor, and bedside stand. What should the
nurse aide do to control the spread of infection?
(A) Report the resident’s behavior to the resident
council.
(B) Ask the resident to throw his used tissues in
the toilet.
(C) Pick up the used tissues in the resident’s
room once a day.
(D) Attach a paper bag to the resident’s bed and
ask him to put the used tissues in it.
(D) Attach a paper bag to the resident’s bed and
ask him to put the used tissues in it.
A resident tells a nurse aide he is going to kill
himself. What should the nurse aide do?
(A) Nothing, because people who threaten
suicide usually do not kill themselves.
(B) Call the resident’s family and ask them to
come and sit with him.
(C) Tell the resident that things are not as bad as
they seem.
(D) Stay with the resident and call for help.
(D) Stay with the resident and call for help.
A nurse aide sees the charge nurse swallow
medication that belongs to a resident. What
should the nurse aide do?
(A) Ignore the incident because the charge nurse
might get the nurse aide fired.
(B) Tell the resident’s family that the charge
nurse is stealing medication.
(C) Report the incident to the administrator or
nursing supervisor.
(D) Suggest the nurse get help immediately.
(C) Report the incident to the administrator or
nursing supervisor.
Which of the following should the nursing
assistant observe and record when admitting a
client?
a. freckles
b. wrinkles
c. short nails
d. bruises
d. bruises
When responding to a client on the intercom,
the nursing assistant should say
a. “Hello, who is calling, please?”
b. “What is it that you want?”
c. “This is [nursing assistant name and
position], can I help you?”
d. “Please hold; I’ll have the nurse answer your
call.”
c. “This is [nursing assistant name and
position], can I help you?”
When arranging a client’s room, the nursing
assistant should do all of the following
EXCEPT
a. checking the placement of the call bell.
b. adjusting the back rest as directed.
c. administering the client’s medications.
d. adjusting the lighting as appropriate.
c. administering the client’s medications.
When assisting a client out of bed, the nurse
aide should always
a. employ body mechanic techniques.
b. get another nurse aide to assist.
c. raise the bed to its maximum height.
d. lower all safety rails.
a. employ body mechanic techniques.
How often should clients be repositioned
during an eight-hour shift?
a. qlh
b. q2h
c. q3h
d. q4h
b. q2h
Which of the following is the correct procedure
for serving a meal to a client who must be fed?
a. Serve the tray along with all the other trays,
and then come back to feed the client.
b. Bring the tray to the client last; feed after
you have served all the other clients.
c. Bring the tray into the room when you are
ready to feed the client.
d. Have the kitchen hold the tray for one hour.
c. Bring the tray into the room when you are ready to feed the client.
What is one important reason why the bed should remain wrinkle-free?
to help keep the skin healthy and prevent pressure sores
What is the term for a device that replaces a missing body pat?
prosthesis
To convert four ounces of water to milliters (ml or mL), the nurse assistant should multiply four by:
30
Which of the following healthcare settings is for people who will die in six months?
hospice
Which of the following abbreviations means “nothing by mouth”?
NPO
Exercises that put each joint through its full arc of motion are called:
range of motion
What is the medical term for high blood pressure?
hypertension
What is a task that is outside the scope of practice for an NA?
inserting tubes into a resident’s body
Standard Precautions should be practiced
on every single person in your care
Which kind of care helps restore a resident to the highest level of functioning possible?
rehabilitation
If an activity is not listed on the care plan, what is the responsibility of a NA?
The NA should not perform the activity if it is not listed on the care plan.
Restraints can be applied:
only with a doctor’s orders
Generally, the last sense to leave a dying person is the sense of
hearing
What is a normal range of a blood pressure?
varies 119/75 is an example
Incontinence may be caused by:
nervous system diseases
Standing with the legs shoulder-width apart is using
good body mechanics
Aftr an amputation, a resident may experience phantom sensation. Phantom sensation is
pain or sensation caused by remaining nerve endings
How should a fracture pan be positioned?
with the handle toward the foot of the bed
What does palliative care involve?
pain relief and comfort
Nursing assistants do not usually perform procedures that require
sterile technique
Insulin reaction can be caused by
too little food
Which of the following is a requirement of OBRA?
nursing assistants must have at least 75 hours of training
What is a good way for a nursing assistant to care for a mentally ill resident?
support the resident and his or her family and friends
When should sheets be changed?
whenever they are soiled, wrinkled, or damp
What does the chain of command do?
describes the line of authority
What is a good way for a nursing assistant to respond to inappropriate sexual behavior?
take the resident to a private area
What should a nursing assistant do if she suspects a resident is being abused?
she should report it to the nurse immediately and let him/her handle it from there
What is one good way a nursing assistant can assist residents with normal changes of aging related to the urinary system?
offer frequent trips to the bathroom
Which of the following is true of Transmission-Based Precautions?
they are practiced in addition to Standard Precautions
What can nursing assistants do in regards to IVs?
Nursing assistants will observe the IV site for problems
Passive range of motion exercises are done
when a resident cannot move on her own
Which of the following is used when documenting the amount of fluid a resident drinks?
milliters
When encountering a fire, a nursing assistant should first
remove resident from danger
What is a common “cliche”?
It will all work out in the end.
What member of the care team might help a resident learn to use adaptive devices for eating or dressing?
occupational therapist
A way to prevent aspiration during oral care of unconscious residents include:
using as little liquid as possible when giving oral care
Providing privacy while giving care is a patient’s
legal right
What is something a nursing assistant needs to observe and report regarding the musculoskeletal system:
white, shiny, red, or warm areas over a joint
What is one way a nursing assistant can promote a resident’s independence?
allowing a resident to do a task by himself no matter how long it takes hime
To treat a minor burn, a nursing assistant should
use cool, clean water
For a nursing assitant, confidentiality means
keeping private things private
When leaving a resident’s room, a nursing assistant should
restock supplies and leave the call light within reach
What should a nursing assistant do each time a patient is repositioned?
should check residents’skin each time they are repositioned
Which is the most essential nutrient for life?
water
Which sense is usually last to leave the body when a person is dying?
hearing
What is a function of the nervous system?
senses and interprets information from outside the body
During a seizure an NA should
keep the resident safe
The ability to think logically and quickly is called
cognition
How can a nursing assistant help residents with their spirtual needs?
learn about resident’s beliefs and listen carefully
If a resident with Alzheimer’s disease has problems with dressing, the nursing assistant should:
lay out clothes in the order they should be put on
What is a type of advance directive:
Durable Power of Attorney for Health Care
Which type of urine speciment does not include the first and last urine in the sample?
clean catch
___________is maintaining equal intake and output.
fluid balance
How should a resident with chronic obstructive pulmonary disease (COPD) be positioned?
sitting upright
The first sign of skin breakdown is
pale, white, reddened, or purple skin
The single most important thing you can do to prevent the spread of disease is to
wash your hands
Which temperature site is generally considered to be the most accurate?
rectal
What may influence a food preference?
religion
A _ is the permanent and painful stiffening of a joint and muscle.
contracture
Diabetes can lead to what complications:
impaired wound healing
Where should the call light be placed when a nursing assistant leaves a resident’s room?
within the resident’s reach
Why should a nursing assistant be concerned if he notices that areas of a resident’s skin have become pale, white, or a reddened color?
it could be the beginning of a pressure sore
We have an expert-written solution to this problem!
What can an overbed table be used for?
placement of meals
Pressure sores can lead to:
life-threatening infections
If a resident starts to fall, the best thing an NA can do is to:
widen her stance and bring the resident’s body close to her
Ten ounces is equal to __ milliliters (mL)
300
An attitude that is helpful in hospice work is
respect privacy and independence
If a resident with Alzheimer’s disease shows violent behavior, the nursing assistant should
remove triggers
In which of the following procedures must a nursing assistant always wear gloves?
shaving
What thermometer is used to take a temperature from the ear?
tympanic thermometer
HIV can be transmitted
to a fetus by an infected mother
When assisting a resident with a standard bedpan, where should the wider end of the bedpan be placed?
in alignment with the resident’s buttocks
The artificial opening in the abdomen of a resident with an ostomy is called a
stoma
Which is true about nursing assistants and catheters?
NAs observe and report regarding catheters
Which of the following statements is true of pain?
pain is a different experience for each person
What is a guideline for good skin care?
check the resident’s skin daily and report changes
When a resident has left-sided weakness, which sleeve should be put on first?
left sleeve
With whom may a nursing assistant share a resident’s medical information?
other staff members involved in the resident’s care
How many rubber-tipped feet does a quad can have?
four
If a nursing assistant sees a letter for the resident at the front desk, she should
take the opened letter to the resident’s room
Where should the nursing assistant stand when helping a resident who is recovering from a stroke to walk?
on the resident’s weaker side
When communicating with a resident who is visually-impaired, the nursing assistant should
tell the resident what the nursing assistant is doing while careing for him
A nursing assistant should wear gloves when
giving perineal care to a resident
In order to communicate with a resident who is hearing-impaired, the nursing assistant should
face the resident directly when speaking
Before helping a resident eat, how should the nursing assistant position the resident?
sitting as upright as possible
When speaking with residents, nursing assistants should
use simple, non-medical terms
To prevent falls, a nursing assistant should
keep walkways free of clutter
Which position is a resident in if he is lying on his stomach?
prone position
When assisting a patient with dentures, a nursing assistant should
clean dentures should be returned to the resident or stored in a denture cup that is labeled
When providing perineal care for a female resident, the nursing assistant should
wipe from front to back
When observing catheters, a nursing assistant should be sure that
the drainage bag is kept lower than the hips or bladder
Which member of the care team diagnoses disease and prescribes treatment?
physician (MD)
A resident’s proteced health information (PIH) may be shared with:
only those who need the information for care or processing of records
What is an example of physical abuse?
pinching a resident
What is the correct conversion of 4:10p.m. to military time?
1610 hours
Joking with a resident’s roommate about the resident’s incontinence is what type of abuse?
phychological abuse
What is the correct conversion of 1900 hours to standard time?
7:00p.m.
When should a nursing assistant identify a resident?
befrore helping with feeding
What is an example of a normal change of aging?
weaker muscles
When using a transfer belt, the NA should:
place it over a resident’s clothing