NUR MISC Certified Nursing Assistant
Examination EXAM with Questions and
Answers/Plus a Rationale Updated 2026 A+/Instant
Download PDF
EXAM COVERAGE
1. Resident Rights and Legal/Ethical Responsibilities
2. Communication and Interpersonal Skills
3. Infection Control and Safety
4. Personal Care Skills
5. Basic Nursing Skills and Restorative Care
6. Mental Health and Social Service Needs
7. Care of Cognitively Impaired Residents
8. Basic Anatomy and Physiology
9. Emergency Procedures and Triage
1. A resident with late-stage dementia exhibits aggressive behavior during care. Which approach
best demonstrates person-centered care?
A. Applying physical restraints to protect the nursing assistant from harm.
B. Determining the underlying trigger for the aggression and adjusting the care approach
accordingly.
C. Speaking firmly to the resident to establish authority and stop the behavior.
, D. Ignoring the resident until they calm down to avoid reinforcing the behavior.
Answer: B
CORRECT ANSWER : B
Rationale: Aggression in dementia is frequently a form of communication for unmet needs (pain,
fear, discomfort). Option B addresses the root cause, whereas restraints (A) violate rights, firm
tone (C) escalates agitation, and ignoring (D) neglects safety.
2. A resident on a bladder retraining program has been continent for two days. Today, they
experience a sudden episode of incontinence. What is the priority action?
A. Restart the bladder training program from day one.
B. Assess the resident for symptoms of a urinary tract infection (UTI) or other physical
change.
C. Limit the resident's fluid intake to prevent further accidents.
D. Document the event as a failure of the training program.
Answer: B
CORRECT ANSWER : B
Rationale: A sudden change in urinary status, especially in the elderly, is a hallmark indicator of
a UTI or other acute clinical change. Options A and D are premature, and restricting fluids (C)
is medically contraindicated and dangerous.
3. A nurse aide observes a coworker neglecting to perform hand hygiene after assisting a resident
with toileting. What is the appropriate response?
A. Report the coworker to the facility administrator immediately.
B. Politely remind the coworker of the hand hygiene policy and report the pattern if it
continues.
C. Ignore the incident, as it is the coworker's responsibility to manage their own practice.
D. Clean the resident’s room yourself to ensure the environment is safe.
Answer: B
CORRECT ANSWER : B
, Rationale: Professional accountability requires peer-to-peer feedback to uphold safety
standards. Immediate administrative reporting (A) may be excessive for a first instance, while
ignoring (C) or taking over tasks (D) fails to correct the underlying infection control risk.
4. You are assisting a resident with a transfer using a mechanical lift. The resident is fearful and
grasping the lift frame tightly. How should you proceed?
A. Tell the resident to stop grabbing and force the lift movement.
B. Stop, reassure the resident, and involve a second staff member to stabilize the resident
during the transfer.
C. Use your strength to pull the resident’s hands away so the lift can be completed.
D. Decide that the resident is too difficult to transfer and leave them in bed.
Answer: B
CORRECT ANSWER : B
Rationale: Resident safety and emotional wellbeing are paramount during transfers. Involving a
second person (B) ensures stability and reduces fear, whereas forcing (A, C) risks injury and
trauma, and abandoning the resident (D) is a failure of duty.
5. A resident has a blood pressure reading of 180/105 mmHg, which is significantly higher than
their baseline. What is the correct protocol?
A. Retake the blood pressure in 30 minutes to see if it decreases.
B. Notify the charge nurse immediately and document the finding accurately.
C. Tell the resident that their blood pressure is high and that they should be worried.
D. Ignore the reading, as it is likely due to the resident being agitated during the process.
Answer: B
CORRECT ANSWER : B
Rationale: Significant deviations from baseline vital signs require immediate clinical assessment
by a nurse. Delaying reporting (A) or dismissing the data (D) places the resident at risk for
cardiac or neurological events; informing the resident (C) causes unnecessary alarm.
6. When cleaning a resident's dentures, which technique prevents accidental damage?
A. Soaking them in hot water for at least one hour.
, B. Placing a washcloth in the sink basin to cushion them if dropped.
C. Using a stiff-bristled brush with household bleach for sterilization.
D. Keeping them dry on the bedside table overnight.
Answer: B
CORRECT ANSWER : B
Rationale: Dentures are fragile and expensive; a cushioned surface in the sink prevents
breakage during cleaning. Hot water (A) can warp them, bleach (C) damages material, and
drying (D) can cause them to lose their shape.
7. A resident with dysphagia is eating lunch and begins to cough forcefully. What is the priority
intervention?
A. Immediately perform the Heimlich maneuver.
B. Encourage the resident to continue coughing to clear the airway.
C. Give the resident a large glass of water to wash down the food.
D. Lay the resident flat in their bed.
Answer: B
CORRECT ANSWER : B
Rationale: Forceful coughing indicates the resident is still moving air; intervention is only
required if they cannot breathe, talk, or cough. Water (C) and lying flat (D) increase aspiration
risk, and Heimlich (A) is for a total obstruction.
8. When caring for a resident with a diagnosis of stage 2 pressure injury, what is the core nursing
responsibility?
A. Applying an antibiotic ointment you found in the supply closet.
B. Following the specific wound care order and documenting the wound's status.
C. Keeping the resident in bed at all times to prevent pressure.
D. Scrubbing the wound area daily to ensure it remains clean.
Answer: B
Examination EXAM with Questions and
Answers/Plus a Rationale Updated 2026 A+/Instant
Download PDF
EXAM COVERAGE
1. Resident Rights and Legal/Ethical Responsibilities
2. Communication and Interpersonal Skills
3. Infection Control and Safety
4. Personal Care Skills
5. Basic Nursing Skills and Restorative Care
6. Mental Health and Social Service Needs
7. Care of Cognitively Impaired Residents
8. Basic Anatomy and Physiology
9. Emergency Procedures and Triage
1. A resident with late-stage dementia exhibits aggressive behavior during care. Which approach
best demonstrates person-centered care?
A. Applying physical restraints to protect the nursing assistant from harm.
B. Determining the underlying trigger for the aggression and adjusting the care approach
accordingly.
C. Speaking firmly to the resident to establish authority and stop the behavior.
, D. Ignoring the resident until they calm down to avoid reinforcing the behavior.
Answer: B
CORRECT ANSWER : B
Rationale: Aggression in dementia is frequently a form of communication for unmet needs (pain,
fear, discomfort). Option B addresses the root cause, whereas restraints (A) violate rights, firm
tone (C) escalates agitation, and ignoring (D) neglects safety.
2. A resident on a bladder retraining program has been continent for two days. Today, they
experience a sudden episode of incontinence. What is the priority action?
A. Restart the bladder training program from day one.
B. Assess the resident for symptoms of a urinary tract infection (UTI) or other physical
change.
C. Limit the resident's fluid intake to prevent further accidents.
D. Document the event as a failure of the training program.
Answer: B
CORRECT ANSWER : B
Rationale: A sudden change in urinary status, especially in the elderly, is a hallmark indicator of
a UTI or other acute clinical change. Options A and D are premature, and restricting fluids (C)
is medically contraindicated and dangerous.
3. A nurse aide observes a coworker neglecting to perform hand hygiene after assisting a resident
with toileting. What is the appropriate response?
A. Report the coworker to the facility administrator immediately.
B. Politely remind the coworker of the hand hygiene policy and report the pattern if it
continues.
C. Ignore the incident, as it is the coworker's responsibility to manage their own practice.
D. Clean the resident’s room yourself to ensure the environment is safe.
Answer: B
CORRECT ANSWER : B
, Rationale: Professional accountability requires peer-to-peer feedback to uphold safety
standards. Immediate administrative reporting (A) may be excessive for a first instance, while
ignoring (C) or taking over tasks (D) fails to correct the underlying infection control risk.
4. You are assisting a resident with a transfer using a mechanical lift. The resident is fearful and
grasping the lift frame tightly. How should you proceed?
A. Tell the resident to stop grabbing and force the lift movement.
B. Stop, reassure the resident, and involve a second staff member to stabilize the resident
during the transfer.
C. Use your strength to pull the resident’s hands away so the lift can be completed.
D. Decide that the resident is too difficult to transfer and leave them in bed.
Answer: B
CORRECT ANSWER : B
Rationale: Resident safety and emotional wellbeing are paramount during transfers. Involving a
second person (B) ensures stability and reduces fear, whereas forcing (A, C) risks injury and
trauma, and abandoning the resident (D) is a failure of duty.
5. A resident has a blood pressure reading of 180/105 mmHg, which is significantly higher than
their baseline. What is the correct protocol?
A. Retake the blood pressure in 30 minutes to see if it decreases.
B. Notify the charge nurse immediately and document the finding accurately.
C. Tell the resident that their blood pressure is high and that they should be worried.
D. Ignore the reading, as it is likely due to the resident being agitated during the process.
Answer: B
CORRECT ANSWER : B
Rationale: Significant deviations from baseline vital signs require immediate clinical assessment
by a nurse. Delaying reporting (A) or dismissing the data (D) places the resident at risk for
cardiac or neurological events; informing the resident (C) causes unnecessary alarm.
6. When cleaning a resident's dentures, which technique prevents accidental damage?
A. Soaking them in hot water for at least one hour.
, B. Placing a washcloth in the sink basin to cushion them if dropped.
C. Using a stiff-bristled brush with household bleach for sterilization.
D. Keeping them dry on the bedside table overnight.
Answer: B
CORRECT ANSWER : B
Rationale: Dentures are fragile and expensive; a cushioned surface in the sink prevents
breakage during cleaning. Hot water (A) can warp them, bleach (C) damages material, and
drying (D) can cause them to lose their shape.
7. A resident with dysphagia is eating lunch and begins to cough forcefully. What is the priority
intervention?
A. Immediately perform the Heimlich maneuver.
B. Encourage the resident to continue coughing to clear the airway.
C. Give the resident a large glass of water to wash down the food.
D. Lay the resident flat in their bed.
Answer: B
CORRECT ANSWER : B
Rationale: Forceful coughing indicates the resident is still moving air; intervention is only
required if they cannot breathe, talk, or cough. Water (C) and lying flat (D) increase aspiration
risk, and Heimlich (A) is for a total obstruction.
8. When caring for a resident with a diagnosis of stage 2 pressure injury, what is the core nursing
responsibility?
A. Applying an antibiotic ointment you found in the supply closet.
B. Following the specific wound care order and documenting the wound's status.
C. Keeping the resident in bed at all times to prevent pressure.
D. Scrubbing the wound area daily to ensure it remains clean.
Answer: B
