2026/2027 Mosby’s Essentials For Nursing Assistants
Workbook 7th Edition
Answer Key Complete Solution
GRADE A+
1. A 78-year-old resident recovering from a hip replacement tries to rise from bed without
assistance, complaining of sharp, sudden pain in the operated leg. The leg appears
shortened and externally rotated, and the resident is unable to move it without severe
discomfort. What should the nursing assistant do first to ensure the resident’s safety and
prevent further injury?
A. Keep the resident still, support the leg carefully, and notify the nurse immediately
B. Encourage the resident to stand slowly to test mobility
C. Apply a cold compress to reduce pain before movement
D. Attempt to straighten the leg gently to relieve discomfort
Correct Answer: A
Rationale: Sudden leg shortening with external rotation is a classic sign of hip dislocation after
surgery. Any attempt to move the leg could worsen the injury, potentially causing additional soft
tissue damage or fracture. The safest course of action is to support the leg in its current position
and immediately notify the nurse so that proper assessment and medical intervention can occur,
ensuring the resident’s safety and preventing complications such as nerve or vascular injury.
2. While walking in the hallway, a resident suddenly becomes pale, sweaty, and complains
of a crushing pressure in the chest that radiates to the jaw and left arm. The resident looks
anxious and is clutching their chest. What is the priority action the nursing assistant should
take immediately?
A. Assist the resident to a safe seated or lying position and notify the nurse immediately
B. Encourage the resident to continue walking slowly to the nurse’s station
C. Offer the resident water to calm them down
D. Encourage slow, deep breathing while walking
Correct Answer: A
Rationale: These symptoms are classic signs of an acute myocardial infarction (heart attack).
Prompt positioning in a seated or lying position reduces strain on the heart and prevents collapse.
Immediate notification to the nurse allows for urgent intervention, including administration of
oxygen, medications, and activation of emergency response if necessary. Delaying action could
lead to cardiac arrest or permanent heart damage.
,3. A resident with type 2 diabetes consumes only half of breakfast. One hour later, the
resident becomes sweaty, shaky, and confused after receiving insulin. What should the
nursing assistant do first if within scope of practice?
A. Provide a fast-acting carbohydrate, such as juice or glucose gel, and notify the nurse
immediately
B. Administer additional insulin to stabilize blood sugar
C. Encourage the resident to rest quietly and monitor symptoms
D. Document the incident and wait until the next blood glucose measurement
Correct Answer: A
Rationale: The resident’s symptoms indicate hypoglycemia, a potentially life-threatening
condition that can quickly progress to seizures, unconsciousness, or death. Immediate
administration of fast-acting carbohydrates raises blood glucose rapidly, stabilizing the resident’s
condition. Notifying the nurse ensures proper monitoring, potential adjustment of insulin dosage,
and prevents recurrence, maintaining the resident’s safety and overall health.
4. During oral care, a nursing assistant observes thick white patches on a resident’s tongue
and inner cheeks that cannot be wiped away, accompanied by mild soreness and difficulty
swallowing. What should the assistant do?
A. Scrub the patches vigorously to remove them
B. Report the findings to the nurse immediately for evaluation
C. Ignore the patches as they are likely harmless
D. Use mouthwash independently to cleanse the area
Correct Answer: B
Rationale: Non-removable white patches may indicate oral thrush, particularly in
immunocompromised residents or those on antibiotics. Early recognition and reporting to the
nurse are crucial to prevent progression of infection, reduce discomfort, and ensure timely
antifungal treatment. Ignoring or attempting aggressive cleaning could damage mucous
membranes and worsen the condition.
5. A resident with dementia becomes verbally aggressive and tries to strike the nursing
assistant during morning care. The resident appears anxious and resists assistance. What is
the most appropriate first action?
A. Step back calmly, speak softly, and attempt care later when the resident is calmer
B. Restrain the resident immediately to prevent harm
C. Scold the resident for inappropriate behavior
D. Force the resident to comply with care tasks
Correct Answer: A
Rationale: Aggression in residents with dementia is often triggered by fear, confusion, or
inability to communicate needs. Remaining calm and stepping back minimizes risk of injury,
maintains the resident’s dignity, and prevents escalation. Restraints or verbal scolding can
,increase agitation and lead to further behavioral issues, making patience and strategic delay the
safest approach.
6. While assisting a resident with swallowing difficulties (dysphagia) during lunch, the
resident starts coughing violently, appears fatigued, and has trouble clearing their airway.
What is the first action the nursing assistant should take?
A. Continue feeding slowly to complete the meal
B. Stop feeding immediately, maintain an upright position, and notify the nurse
C. Offer thin liquids to soothe the throat
D. Encourage the resident to lean back and rest
Correct Answer: B
Rationale: Coughing and fatigue during eating indicate aspiration risk, which could lead to
choking or aspiration pneumonia. The nursing assistant must stop feeding, ensure the resident is
upright to maintain airway patency, and report the incident to the nurse for further assessment.
Continuing to feed or offering liquids could worsen the situation and compromise the resident’s
safety.
7. During perineal care, the nursing assistant notices redness and small open areas on a
resident’s skin in the sacral area. What is the correct first action?
A. Apply lotion and continue care as usual
B. Report the findings to the nurse immediately
C. Skip cleaning the area during future care
D. Apply strong antiseptics independently
Correct Answer: B
Rationale: Early detection of skin breakdown prevents progression to pressure injuries or
infection. Reporting to the nurse allows for assessment, implementation of protective measures,
and treatment planning. Ignoring or treating independently could worsen the injury and
compromise resident safety.
8. A resident receiving anticoagulant therapy experiences a persistent nosebleed that does
not stop with light pressure. What should the nursing assistant do first?
A. Tilt the head backward to stop the bleeding
B. Apply firm pressure to the nostrils while leaning the resident slightly forward and notify the
nurse immediately
C. Ignore the bleeding as it will likely stop on its own
D. Insert tissue deeply into the nostrils to absorb the blood
Correct Answer: B
Rationale: Correct positioning and firm pressure help control bleeding while preventing
aspiration. Residents on anticoagulants are at high risk of excessive bleeding, making timely
reporting to the nurse essential for medical evaluation and safety.
, 9. A resident says, “I don’t want to live anymore,” during conversation in the dayroom.
What is the nursing assistant’s immediate responsibility?
A. Report the statement immediately to the nurse
B. Offer reassurance and comfort only
C. Ignore the comment
D. Attempt counseling independently
Correct Answer: A
Rationale: Suicidal statements are medical emergencies. Prompt reporting allows for mental
health assessment, safety interventions, and monitoring to prevent self-harm. Nursing assistants
should never attempt counseling independently as it may delay appropriate care.
10. A resident complains of redness and mild discomfort under the foreskin. How should
the nursing assistant perform hygiene safely?
A. Gently retract the foreskin, clean from tip to base, and return the foreskin to its normal
position
B. Leave the foreskin retracted to prevent irritation
C. Apply strong antiseptics independently
D. Skip cleaning to avoid discomfort
Correct Answer: A
Rationale: Proper foreskin hygiene prevents infections such as balanitis and maintains comfort.
Returning the foreskin prevents constriction or swelling and ensures skin integrity. Improper
cleaning or leaving the foreskin retracted can lead to complications.
11. A resident feels dizzy upon standing, and blood pressure readings are significantly low.
What is the first action the nursing assistant should take?
A. Document the readings and continue routine care
B. Assist the resident to a lying position and notify the nurse immediately
C. Encourage the resident to drink fluids only
D. Ignore the symptom as it may resolve spontaneously
Correct Answer: B
Rationale: Symptomatic hypotension increases the risk of falls, fainting, and injury. Immediate
repositioning prevents accidents and reporting to the nurse ensures further assessment and
intervention.
12. A resident’s oxygen tubing becomes disconnected, and they appear anxious and short of
breath. What is the immediate action?
A. Calm the resident and reattach the tubing securely
B. Remove oxygen until the nurse arrives
C. Leave the resident and call for help
D. Increase oxygen flow without checking equipment
Workbook 7th Edition
Answer Key Complete Solution
GRADE A+
1. A 78-year-old resident recovering from a hip replacement tries to rise from bed without
assistance, complaining of sharp, sudden pain in the operated leg. The leg appears
shortened and externally rotated, and the resident is unable to move it without severe
discomfort. What should the nursing assistant do first to ensure the resident’s safety and
prevent further injury?
A. Keep the resident still, support the leg carefully, and notify the nurse immediately
B. Encourage the resident to stand slowly to test mobility
C. Apply a cold compress to reduce pain before movement
D. Attempt to straighten the leg gently to relieve discomfort
Correct Answer: A
Rationale: Sudden leg shortening with external rotation is a classic sign of hip dislocation after
surgery. Any attempt to move the leg could worsen the injury, potentially causing additional soft
tissue damage or fracture. The safest course of action is to support the leg in its current position
and immediately notify the nurse so that proper assessment and medical intervention can occur,
ensuring the resident’s safety and preventing complications such as nerve or vascular injury.
2. While walking in the hallway, a resident suddenly becomes pale, sweaty, and complains
of a crushing pressure in the chest that radiates to the jaw and left arm. The resident looks
anxious and is clutching their chest. What is the priority action the nursing assistant should
take immediately?
A. Assist the resident to a safe seated or lying position and notify the nurse immediately
B. Encourage the resident to continue walking slowly to the nurse’s station
C. Offer the resident water to calm them down
D. Encourage slow, deep breathing while walking
Correct Answer: A
Rationale: These symptoms are classic signs of an acute myocardial infarction (heart attack).
Prompt positioning in a seated or lying position reduces strain on the heart and prevents collapse.
Immediate notification to the nurse allows for urgent intervention, including administration of
oxygen, medications, and activation of emergency response if necessary. Delaying action could
lead to cardiac arrest or permanent heart damage.
,3. A resident with type 2 diabetes consumes only half of breakfast. One hour later, the
resident becomes sweaty, shaky, and confused after receiving insulin. What should the
nursing assistant do first if within scope of practice?
A. Provide a fast-acting carbohydrate, such as juice or glucose gel, and notify the nurse
immediately
B. Administer additional insulin to stabilize blood sugar
C. Encourage the resident to rest quietly and monitor symptoms
D. Document the incident and wait until the next blood glucose measurement
Correct Answer: A
Rationale: The resident’s symptoms indicate hypoglycemia, a potentially life-threatening
condition that can quickly progress to seizures, unconsciousness, or death. Immediate
administration of fast-acting carbohydrates raises blood glucose rapidly, stabilizing the resident’s
condition. Notifying the nurse ensures proper monitoring, potential adjustment of insulin dosage,
and prevents recurrence, maintaining the resident’s safety and overall health.
4. During oral care, a nursing assistant observes thick white patches on a resident’s tongue
and inner cheeks that cannot be wiped away, accompanied by mild soreness and difficulty
swallowing. What should the assistant do?
A. Scrub the patches vigorously to remove them
B. Report the findings to the nurse immediately for evaluation
C. Ignore the patches as they are likely harmless
D. Use mouthwash independently to cleanse the area
Correct Answer: B
Rationale: Non-removable white patches may indicate oral thrush, particularly in
immunocompromised residents or those on antibiotics. Early recognition and reporting to the
nurse are crucial to prevent progression of infection, reduce discomfort, and ensure timely
antifungal treatment. Ignoring or attempting aggressive cleaning could damage mucous
membranes and worsen the condition.
5. A resident with dementia becomes verbally aggressive and tries to strike the nursing
assistant during morning care. The resident appears anxious and resists assistance. What is
the most appropriate first action?
A. Step back calmly, speak softly, and attempt care later when the resident is calmer
B. Restrain the resident immediately to prevent harm
C. Scold the resident for inappropriate behavior
D. Force the resident to comply with care tasks
Correct Answer: A
Rationale: Aggression in residents with dementia is often triggered by fear, confusion, or
inability to communicate needs. Remaining calm and stepping back minimizes risk of injury,
maintains the resident’s dignity, and prevents escalation. Restraints or verbal scolding can
,increase agitation and lead to further behavioral issues, making patience and strategic delay the
safest approach.
6. While assisting a resident with swallowing difficulties (dysphagia) during lunch, the
resident starts coughing violently, appears fatigued, and has trouble clearing their airway.
What is the first action the nursing assistant should take?
A. Continue feeding slowly to complete the meal
B. Stop feeding immediately, maintain an upright position, and notify the nurse
C. Offer thin liquids to soothe the throat
D. Encourage the resident to lean back and rest
Correct Answer: B
Rationale: Coughing and fatigue during eating indicate aspiration risk, which could lead to
choking or aspiration pneumonia. The nursing assistant must stop feeding, ensure the resident is
upright to maintain airway patency, and report the incident to the nurse for further assessment.
Continuing to feed or offering liquids could worsen the situation and compromise the resident’s
safety.
7. During perineal care, the nursing assistant notices redness and small open areas on a
resident’s skin in the sacral area. What is the correct first action?
A. Apply lotion and continue care as usual
B. Report the findings to the nurse immediately
C. Skip cleaning the area during future care
D. Apply strong antiseptics independently
Correct Answer: B
Rationale: Early detection of skin breakdown prevents progression to pressure injuries or
infection. Reporting to the nurse allows for assessment, implementation of protective measures,
and treatment planning. Ignoring or treating independently could worsen the injury and
compromise resident safety.
8. A resident receiving anticoagulant therapy experiences a persistent nosebleed that does
not stop with light pressure. What should the nursing assistant do first?
A. Tilt the head backward to stop the bleeding
B. Apply firm pressure to the nostrils while leaning the resident slightly forward and notify the
nurse immediately
C. Ignore the bleeding as it will likely stop on its own
D. Insert tissue deeply into the nostrils to absorb the blood
Correct Answer: B
Rationale: Correct positioning and firm pressure help control bleeding while preventing
aspiration. Residents on anticoagulants are at high risk of excessive bleeding, making timely
reporting to the nurse essential for medical evaluation and safety.
, 9. A resident says, “I don’t want to live anymore,” during conversation in the dayroom.
What is the nursing assistant’s immediate responsibility?
A. Report the statement immediately to the nurse
B. Offer reassurance and comfort only
C. Ignore the comment
D. Attempt counseling independently
Correct Answer: A
Rationale: Suicidal statements are medical emergencies. Prompt reporting allows for mental
health assessment, safety interventions, and monitoring to prevent self-harm. Nursing assistants
should never attempt counseling independently as it may delay appropriate care.
10. A resident complains of redness and mild discomfort under the foreskin. How should
the nursing assistant perform hygiene safely?
A. Gently retract the foreskin, clean from tip to base, and return the foreskin to its normal
position
B. Leave the foreskin retracted to prevent irritation
C. Apply strong antiseptics independently
D. Skip cleaning to avoid discomfort
Correct Answer: A
Rationale: Proper foreskin hygiene prevents infections such as balanitis and maintains comfort.
Returning the foreskin prevents constriction or swelling and ensures skin integrity. Improper
cleaning or leaving the foreskin retracted can lead to complications.
11. A resident feels dizzy upon standing, and blood pressure readings are significantly low.
What is the first action the nursing assistant should take?
A. Document the readings and continue routine care
B. Assist the resident to a lying position and notify the nurse immediately
C. Encourage the resident to drink fluids only
D. Ignore the symptom as it may resolve spontaneously
Correct Answer: B
Rationale: Symptomatic hypotension increases the risk of falls, fainting, and injury. Immediate
repositioning prevents accidents and reporting to the nurse ensures further assessment and
intervention.
12. A resident’s oxygen tubing becomes disconnected, and they appear anxious and short of
breath. What is the immediate action?
A. Calm the resident and reattach the tubing securely
B. Remove oxygen until the nurse arrives
C. Leave the resident and call for help
D. Increase oxygen flow without checking equipment
