, Question 1
A nurse aide is caring for a resident with Clostridioides difficile infection.
Which action best breaks the chain of infection at the mode of transmission?
A. Wearing a mask when within 3 feet of the resident
B. Using an alcohol-based hand rub after removing gloves
C. Using soap and water for hand hygiene after glove removal
D. Placing the resident in a negative-pressure room
Correct Answer: C - Using soap and water for hand hygiene after
glove removal
RATIONALE
C. difficile spores are resistant to alcohol; mechanical removal with
soap and water is required after glove removal, directly interrupting
contact transmission. Masks and negative-pressure rooms address
airborne/droplet precautions, not contact. Alcohol rub is ineffective
against C. difficile spores.
Question 2
A resident's morning vital signs are: T 38.9°C (102°F), P 118, R 26, BP 88/54.
Which finding should the nurse aide report FIRST to the nurse?
A. Temperature of 38.9°C
B. Pulse of 118
C. Respirations of 26
D. Blood pressure of 88/54
Correct Answer: D - Blood pressure of 88/54
RATIONALE
A BP of 88/54 indicates hypotension with potential for hypoperfusion
and shock, the most immediately life-threatening finding. While fever
and tachycardia are abnormal, hypotension takes priority for urgent
reporting. Respirations of 26 are elevated but less acutely dangerous
than hypotension.
Page 2
, Question 3
A resident who is NPO is found to have a full water pitcher at the bedside.
What is the nurse aide's most appropriate action?
A. Leave the pitcher in case the order changes
B. Remove the pitcher and document the NPO status
C. Offer small sips of water to prevent thirst
D. Ask the roommate to monitor the resident
Correct Answer: B - Remove the pitcher and document the NPO
status
RATIONALE
NPO means nothing by mouth; leaving or offering fluids violates the
order and could cause harm (e.g., aspiration before surgery).
Removing the pitcher and documenting reinforces safety and
communicates status. Delegating monitoring to a roommate is
inappropriate and unsafe.
Question 4
Which technique best protects the nurse aide's lumbar spine when repositioning
a dependent resident up in bed?
A. Twist at the waist while pulling the resident upward
B. Raise the bed to elbow height and use a draw sheet with a coworker
C. Bend at the waist and lift with the arms extended
D. Reach across the bed to pull the resident toward you
Correct Answer: B - Raise the bed to elbow height and use a draw
sheet with a coworker
RATIONALE
Raising the bed to a safe working height and using a draw sheet with
assistance reduces force and maintains neutral spine alignment,
minimizing injury. Twisting, bending at the waist, and reaching across
the bed increase shear and compressive forces on the lumbar spine.
Page 3
, Question 5
A resident with dysphagia is prescribed thickened liquids. Which action by the
nurse aide indicates correct understanding of aspiration prevention?
A. Thinning the liquid with water if it is too thick
B. Positioning the resident supine during meals
C. Ensuring the resident is upright at 90 degrees during and after meals
D. Encouraging the resident to drink quickly to finish the meal
Correct Answer: C - Ensuring the resident is upright at 90
degrees during and after meals
RATIONALE
An upright position at 90 degrees uses gravity to keep the bolus
moving downward and reduces aspiration risk. Thinning liquids,
supine positioning, and rapid drinking all increase the likelihood of
aspiration in dysphagia.
Question 6
A nurse aide observes a resident's urine is dark amber and has a strong odor.
Which finding should be reported to the nurse as a priority?
A. The resident drank 8 oz of water at breakfast
B. The resident reports burning on urination
C. The resident's roommate also has dark urine
D. The resident prefers to use a bedpan
Correct Answer: B - The resident reports burning on urination
RATIONALE
Dysuria with dark, malodorous urine suggests a urinary tract infection,
which requires prompt reporting and possible treatment. Fluid intake,
roommate status, and toileting preference are relevant but do not
indicate an acute infection needing immediate attention.
Page 4
A nurse aide is caring for a resident with Clostridioides difficile infection.
Which action best breaks the chain of infection at the mode of transmission?
A. Wearing a mask when within 3 feet of the resident
B. Using an alcohol-based hand rub after removing gloves
C. Using soap and water for hand hygiene after glove removal
D. Placing the resident in a negative-pressure room
Correct Answer: C - Using soap and water for hand hygiene after
glove removal
RATIONALE
C. difficile spores are resistant to alcohol; mechanical removal with
soap and water is required after glove removal, directly interrupting
contact transmission. Masks and negative-pressure rooms address
airborne/droplet precautions, not contact. Alcohol rub is ineffective
against C. difficile spores.
Question 2
A resident's morning vital signs are: T 38.9°C (102°F), P 118, R 26, BP 88/54.
Which finding should the nurse aide report FIRST to the nurse?
A. Temperature of 38.9°C
B. Pulse of 118
C. Respirations of 26
D. Blood pressure of 88/54
Correct Answer: D - Blood pressure of 88/54
RATIONALE
A BP of 88/54 indicates hypotension with potential for hypoperfusion
and shock, the most immediately life-threatening finding. While fever
and tachycardia are abnormal, hypotension takes priority for urgent
reporting. Respirations of 26 are elevated but less acutely dangerous
than hypotension.
Page 2
, Question 3
A resident who is NPO is found to have a full water pitcher at the bedside.
What is the nurse aide's most appropriate action?
A. Leave the pitcher in case the order changes
B. Remove the pitcher and document the NPO status
C. Offer small sips of water to prevent thirst
D. Ask the roommate to monitor the resident
Correct Answer: B - Remove the pitcher and document the NPO
status
RATIONALE
NPO means nothing by mouth; leaving or offering fluids violates the
order and could cause harm (e.g., aspiration before surgery).
Removing the pitcher and documenting reinforces safety and
communicates status. Delegating monitoring to a roommate is
inappropriate and unsafe.
Question 4
Which technique best protects the nurse aide's lumbar spine when repositioning
a dependent resident up in bed?
A. Twist at the waist while pulling the resident upward
B. Raise the bed to elbow height and use a draw sheet with a coworker
C. Bend at the waist and lift with the arms extended
D. Reach across the bed to pull the resident toward you
Correct Answer: B - Raise the bed to elbow height and use a draw
sheet with a coworker
RATIONALE
Raising the bed to a safe working height and using a draw sheet with
assistance reduces force and maintains neutral spine alignment,
minimizing injury. Twisting, bending at the waist, and reaching across
the bed increase shear and compressive forces on the lumbar spine.
Page 3
, Question 5
A resident with dysphagia is prescribed thickened liquids. Which action by the
nurse aide indicates correct understanding of aspiration prevention?
A. Thinning the liquid with water if it is too thick
B. Positioning the resident supine during meals
C. Ensuring the resident is upright at 90 degrees during and after meals
D. Encouraging the resident to drink quickly to finish the meal
Correct Answer: C - Ensuring the resident is upright at 90
degrees during and after meals
RATIONALE
An upright position at 90 degrees uses gravity to keep the bolus
moving downward and reduces aspiration risk. Thinning liquids,
supine positioning, and rapid drinking all increase the likelihood of
aspiration in dysphagia.
Question 6
A nurse aide observes a resident's urine is dark amber and has a strong odor.
Which finding should be reported to the nurse as a priority?
A. The resident drank 8 oz of water at breakfast
B. The resident reports burning on urination
C. The resident's roommate also has dark urine
D. The resident prefers to use a bedpan
Correct Answer: B - The resident reports burning on urination
RATIONALE
Dysuria with dark, malodorous urine suggests a urinary tract infection,
which requires prompt reporting and possible treatment. Fluid intake,
roommate status, and toileting preference are relevant but do not
indicate an acute infection needing immediate attention.
Page 4
