The Ultimate |CNA| Mastery Guide: Your Path to Success in the Nursing Assistant Certification Exam *Q&A* (100% Correct) 2025/2026 |VERIFIED|

The Ultimate |CNA| Mastery Guide: Your Path to Success in the Nursing Assistant Certification Exam *Q&A* (100% Correct) 2025/2026 |VERIFIED| What is the primary responsibility of a Certified Nursing Assistant (CNA) when assisting a patient with feeding? The CNA should ensure the patient is positioned comfortably, assist with cutting or preparing food if necessary, and monitor the patient's swallowing to prevent choking. How should a CNA respond if a patient begins to complain about shortness of breath during a routine procedure? The CNA should immediately stop the procedure, notify the nurse or physician, and assist the patient in a position that eases their breathing, such as sitting upright. What is the correct technique for hand washing to prevent the spread of infection? Wet hands, apply soap, rub hands together for at least 20 seconds, rinse thoroughly, and dry with a clean paper towel or air dryer. How should a CNA address a patient who refuses to take prescribed medications? The CNA should report the refusal to the nurse, ensure the patient understands the importance of the medication, and respect the patient's autonomy. What is the most effective way for a CNA to assist a resident with mobility limitations while preventing falls? The CNA should use assistive devices like walkers or canes, maintain a steady gait, and always offer support while walking. What are the appropriate steps for repositioning a bedridden patient? 1 The CNA should explain the procedure to the patient, use proper body mechanics, ensure the patient is in a comfortable and safe position, and reposition at least every two hours to prevent bedsores. What is the purpose of using standard precautions in patient care? Standard precautions prevent the spread of infections by treating all blood, body fluids, non intact skin, and mucous membranes as potentially infectious. What should a CNA do if they notice a patient has developed a pressure ulcer? The CNA should notify the nurse immediately, document the ulcer's location and appearance, and ensure proper repositioning techniques are followed to prevent further damage. How can a CNA ensure patient dignity when providing personal care? The CNA should maintain the patient’s privacy, use proper draping, communicate respectfully, and encourage the patient to be as independent as possible during personal care. What is the proper procedure for taking a patient's temperature orally? The CNA should ensure the thermometer is clean, place it under the patient’s tongue, ask the patient to close their mouth, and wait for the thermometer to beep before removing it. Why is it important for a CNA to monitor a patient’s vital signs regularly? Monitoring vital signs helps detect changes in the patient's condition early, providing important data for healthcare providers to make timely medical decisions. What should a CNA do if a patient is found unresponsive? The CNA should check for breathing, immediately call for help, and initiate CPR if necessary while following proper protocols. What is the correct technique for assisting a patient with ambulation? The CNA should ensure the patient is wearing non-slip shoes, offer assistance with a gait belt if needed, and provide support while maintaining the patient’s balance. 2 What is the best way to assist a patient with a colostomy bag? The CNA should ensure proper hygiene when emptying or changing the colostomy bag, maintain the patient's privacy, and check the bag for leaks or odors regularly. How should a CNA assist a patient in taking a bath or shower? The CNA should ensure the water temperature is comfortable, offer assistance as needed while respecting the patient’s privacy, and ensure safety to prevent slips or falls. What are the signs of dehydration that a CNA should look out for? Dry mouth, decreased urine output, dark-colored urine, dizziness, and confusion are signs of dehydration that require immediate attention. What is the best practice when transferring a patient from a bed to a wheelchair? The CNA should use proper body mechanics, ensure the wheelchair is locked, and provide support to the patient to prevent falls or injury during the transfer. How should a CNA handle a situation where a patient exhibits signs of confusion or agitation? The CNA should remain calm, use clear and simple communication, ensure the patient’s environment is safe, and notify the nurse of any significant behavioral changes. What is the importance of proper documentation in nursing assistant care? Documentation ensures that the patient's care is accurately recorded, allows for communication between healthcare providers, and is legally required for patient safety and accountability. What steps should a CNA take to prevent a patient from choking while eating? The CNA should ensure the patient is seated upright, encourage small bites, assist with chewing if needed, and monitor the patient closely during meals. What should a CNA do if a patient complains of pain? 3 The CNA should listen attentively, report the complaint to the nurse, assist the patient with comfort measures, and follow any prescribed pain management protocol. How can a CNA help reduce a patient’s risk of developing blood clots in the legs? The CNA should encourage frequent leg exercises, assist with ambulation as appropriate, and ensure the patient is wearing compression stockings if ordered. What should a CNA do when assisting a patient with incontinence care? The CNA should maintain the patient’s dignity, use proper hygiene techniques, and monitor for any signs of skin breakdown. What is the proper procedure for measuring a patient's blood pressure? The CNA should ensure the cuff is placed at the correct position on the arm, inflate it to the correct pressure, and listen for the systolic and diastolic readings using a stethoscope. How should a CNA handle a situation where a patient is upset or anxious? The CNA should offer reassurance, listen to the patient's concerns, stay calm, and notify the nurse if the situation requires further intervention. What is the appropriate response if a patient is found with a high fever? The CNA should notify the nurse immediately, document the temperature, and assist with comfort measures such as adjusting room temperature or offering fluids if appropriate. How should a CNA assist a patient with oral hygiene? The CNA should ensure the patient is in a comfortable position, use a soft toothbrush or sponge, and offer assistance with flossing if necessary. What should a CNA do if a patient is experiencing a seizure? The CNA should stay calm, protect the patient from injury by removing nearby hazards, and place a soft object under the head while notifying the nurse and documenting the event. 4 What should a CNA do if a patient begins to vomit while lying in bed? The CNA should turn the patient’s head to the side to prevent aspiration, provide comfort, and notify the nurse of the vomiting episode. How can a CNA help maintain a patient's privacy and confidentiality? The CNA should close curtains or doors during personal care, avoid discussing patient details outside of the care setting, and follow healthcare facility privacy policies. What is the proper technique for measuring a patient's pulse? The CNA should place their fingers on the patient’s wrist or neck, count the beats for 60 seconds, and document the result. What should a CNA do if a patient expresses feelings of depression or hopelessness? The CNA should listen empathetically, reassure the patient, and report these feelings to the nurse for further assessment and care. What are the signs that a patient may be at risk for a fall? Weakness, unsteady gait, confusion, medications that cause dizziness, and environmental hazards like clutter or wet floors are all risk factors for falls. What is the correct way to assist a patient in using a bedpan? The CNA should ensure the patient is in a comfortable position, provide privacy, and assist with cleaning the area afterward while maintaining patient dignity. How can a CNA ensure proper skin care for a patient at risk of pressure ulcers? The CNA should regularly reposition the patient, keep the skin clean and dry, use pressure relieving devices, and monitor for signs of skin breakdown. How should a CNA respond if a patient is experiencing excessive bleeding? The CNA should apply pressure to the wound, notify the nurse immediately, and monitor the patient for signs of shock while ensuring safety and comfort. 5 What is the role of a CNA in end-of-life care? The CNA should provide comfort and dignity, assist with hygiene, offer emotional support, and respect the patient's and family's wishes while maintaining communication with the healthcare team. Persons who perform delegated tasks under the supervision of licensed nurses are assistants The goal of the health team is to Provide quality care Nursing A federal health insurance program providing benefits for older persons and some younger people with certain disabilities is Medicare Nursing assistants work under the direction of Licensed nurses An illness for which there is no reasonable expectation of recovery is Your role in the survey process includes which of the following? Provides care to persons at home Home health agency A terminal illness Helping keep the agency clean Provides complex care while the person recovers from illness or surgery before returning home Hospital Serves people who do not need hospital care but need complex equipment and care measures Sub-acute facility Serves people who are dying Hospice Restraining a resident without a doctor's order is a violation of OBRA 6 What is considered a violation of privacy? Leaving the resident without bed covers Separating the person from others against his or her will is Who is able to exercise rights for an incompentent resident? Involuntary seclusion Legal representative Which requires nursing assistant training and competency evaluation? Reconciliation Act (OBRA) of 1987 An ombudsman... Promotes the resident's needs and interests Omnibus Budget When a resident is given certain drugs that affect his mood, behavior or mental function, it may deny his right to Freedom from restraints A person has the right to be free from involuntary seclusion. An example of involuntary seclusion would be: Forcing the person to remain in his/her room during breakfast You are responsible for the care you give. To provide quality care: Before entering a person's room, you should: Maintain good work ethics Knock on the door and wait to be asked in This is an official record of persons who have completed a nursing assistant training and competency evaluation program. Nursing assistant registry What state law regulates nursing practice? The state's nurse practice act Nursing assistants can have their certification denied, revoked, or suspended for patient or resident Neglecting a 7 The nurse tells you to perform a procedure. Which of the following may put you at risk of losing your certification or license? Ensuring you do whatever the nurse tells you to do Which of these areas of study is not included in a training program for nursing assistants? Phlebotomy (drawing blood) OBRA requires that re-training and a new competency evaluation test must be taken if you have not worked as a certified nursing assistant for 24 months Your work as a nursing assistant is supervised by A licensed nurse You are alone in the nurses' station and you answer the phone. Dr. Smith begins to give you verbal orders. You should Politely give you name and title and ask the doctor to wait while you get the nurse When you read a job description, you should not take a job if it requires you to your training limits As a nursing assistant, you Are responsible for your own actions Function beyond The nurse is delegating a task to you. Which of the following involves the communication step? The nurse explains the steps of the task You have been delegated several tasks. What should you do? the tasks. Which of the following is a task that can be delegated to you? Ask the nurse to help you prioritize Turn and re-position a person The nurse delegates a task to you and then watches you complete that task. Why might the nurse observe you? The nurse is accountable to make sure you are competent 8 The nurse provides corrective feedback on a task that you did not complete well. Which of the following responses is the most appropriate? Suggest ways that you can improve. ...means having the necessary ability, knowledge, or skill to perform a task safely and successfully. Competent Being responsible for one's actions and the actions of others who perform delegated tasks is being Accountable ...is the duty or obligation to perform some act or function. Responsibility To ____ means to authorize another person to perform a nursing task in a certain situation. Delegate A ____ is nursing care or a nursing procedure, activity, or work that can be delegated to nursing assistants when it does not require an RN's professional judgment. Nursing Task Planning involves Setting priorities and goals During which step of the nursing process is care given? The assignment sheet is used to Implementation Communicate delegated measures and tasks to you Identify which component is not part of the nursing process The nursing process Is used in all health care settings Which of these is an example of objective data? Objective Data Temperature reading on the thermometer Nurses will measure if goals in the planning steps are met during Evaluation 9 A nursing diagnosis Describes a health problem that can be treated by nursing measures Your role in the nursing process involves Reporting observations If you are unsure of a vital sign measurement, you must Promptly ask the nurse to take it again You are measuring vital signs on a patient. What do you report to the nurse at once? that is changed from the prior measurement The normal body temperature range for the rectal site is Rectal temperatures are taken when 98.6° F to 100.6° F The oral site cannot be used Which pulse site is used for children under the age of 2 years? Which is correct when counting respirations? The apical site Any vital sign Count each rise and fall of the chest as one respiration. What is the normal respiratory rate for a newborn? 35 respirations per minute A person with a systolic pressure that remains above 140 mm Hg or a diastolic pressure that remains above 90 mm Hg has Hypertension The period of heart muscle relaxation is Diastole How long should you count for an apical pulse? This instrument is vibrated to test hearing one minute Tuning fork 10 The lithotomy position is used to examine The vagina You are preparing a person for an exam. Which is correct? feelings The person is weighed before an exam. Which is correct? You need to be sensitive to the person's The person voids before being weighed A person is confused. He resists your efforts to prepare him for an exam. Which is correct? exam may need to be tried at another time A laryngeal mirror is used to examine the Mouth, teeth, and throat Which health team members can perform physical examinations? Doctors and many RNs You are going to assist with a physical exam. You can do which of the following? The Collect supplies and equipment Collect supplies and equipment Provide a bath blanket After the exam, you need to do which of the following? Negligence by an RN is Malpractice Discard disposable items. On your day off, you bring a patient your favorite cookies. This is A person's picture is taken without permission. This is Boundary crossing Invasion of privacy A person is tied in a chair to prevent the person from wandering. This is False imprisonment 11 A rule of conduct made by a government body is A law These are laws that deal with relationships between people If you suspect that a resident is being abused, you must Standards of care come from which of the following? Laws Civil laws Report your concerns to the nurse What should the nursing assistant do if he finds a co-worker drinking alcohol at work? behavior to the nurse Touching a person's body without his or her consent is battery Report the To function at your best, you must be physically and mentally healthy. Which of the following is an unhealthy habit? Eat foods high in fats and salt Looking at things from another's point of view is Empathy You are talking about a patient while at lunch. Which is correct? right to privacy and confidentiality Unprofessional appearance involves the following You have violated the person's Wear a lot of jewelry and bright nail polish. You are ill and cannot come to work. Which is correct? Confidentiality means Follow the agency's attendance policy Trusting others with personal and private information You are resigning from a job. Which is correct? Giving a 2-week notice is good practice. 12 Dealing with stress is important. Stress affects The whole person When leaving the unit for breaks or lunch, you should Adults need about _________ hours of sleep daily Which statement about ergonomics is correct? Tell the nurse 7 - 8 It involves changing the task, work station, equipment, and tools to help reduce stress on the worker's body Which of the following is a rule for body mechanics? Face your work area Risk factors for work-related musculo-skeletal disorders (MSDs) include which of the following? Performing the same motion continuously or frequently Which of the following will likely lead to back disorders? The back-lying position is the Supine position A person is positioned in a chair. Which is correct? back Most older persons do not tolerate this position Twisting while lifting The back and buttocks are against the chair Prone position A semi - sitting position; the head of the bed is raised between 46 and 60 degrees Regular position changes and good alignment Promote comfort and well-being A pillow is positioned against the person's back in the Semi-Fowler's position fowler's 13 The person's unit Is a private area. You help control noise by Answering phones and call lights promptly To provide full visual privacy, you must care is given. Pull the privacy curtain completely around the bed when Which of the following is an OBRA requirement for resident rooms? Full visual privacy is provided You are concerned that the gap between the top of the mattress and the head-board on a patient's bed may be an entrapment risk. What should you do? Tell the nurse at once Keeping the person's room clean, neat, safe, and comfortable is the responsibility of involved in the person's care The nursing staff cannot control which factor that affects comfort? Beds are kept at the lowest horizontal position to Illness Everyone Let the person get out of bed with ease What items are never placed on an over the bed table? A person that weighs 600 pounds will need Bedpans, urinals, and soiled linens A bariatric bed This type of bed is ready for a person arriving by stretcher. Which is correct when handling linens? A surgical bed Collect linens in the order of use. This type of bed is made for a person who will be up most of the day A closed bed 14 After making a closed bed, do the following Decontaminate your hands A clean, neat, wrinkle-free bed does which of the following? In nursing centers, a complete linen change is usually done: person's bath day Linens are always changed Increases the person's comfort. Once or twice per week, on the When wet, damp, soiled, or very wrinkled Which spreads microorganisms? Clean linens are placed Shaking linens On a clean surface or barrier Oral hygiene Prevents mouth odor and infection You are assisting a resident with a tub bath. Which is correct? when getting into and out of the tub. Which is a rule for bathing? Have the person use grab bars Cover the person for warmth and privacy Which statement about giving perineal care is correct? Hardened plaque on teeth is Profuse sweating is Tartar Diaphoresis Pat dry after rinsing A thin film that sticks to teeth, it contains saliva, microbes, and other substances is Plaque 15 The infestation of the body with lice is Pediculosis corporis Hair loss is Alopecia Which statement about shampooing the person's hair is correct? on the person's condition, safety factors, and personal choice You assist a resident with shaving his face. Which is correct? once Being in or on a host Infestation _ is an excessive amount of dry, white flakes from the scalp A drug that prevents or slows down blood clotting is an The shampoo method depends Report nicks or cuts to the nurse at Dandruff Anticoagulant Excessive body hair Pediculosis is aslo called... Hirsutism Lice A chronic condition in which a person cannot sleep or stay asleep all night is Distraction means to Persons with dementia Change the person's center of attention Insomnia Are allowed to wander at night in a safe and supervised setting Which promotes comfort? Which measure promotes sleep? Keeping the bed linens tight and wrinkle-free Following the person's bedtime routines 16 Pain that is felt in a part of the body that is no longer there is Phantom pain A resident tells you that she wants someone to read the Bible to her before she goes to sleep. What should you do? Tell the nurse about her request Which statement about anxiety is correct? During sleep The person is uneasy and tense There are no voluntary arm or leg movements Which of the following will promote sleep? Following bedtime rituals A written or electronic account of a person's condition and response to treatment and care is the Medical record A Kardex is A card file used to summarize information What should the person do before you collect a sputum specimen? mouth with water Which is correct when recording on a patient's or resident's chart? concisely Anterior means At or toward the front of the body or body part Which means inflammation of a joint? Shortened forms of words or phrases are Arthritis Abbreviations Have the person rinse their Communicate clearly and 17 The prefix "ab" means Away from Dysphagia means Difficulty swallowing What does EMR stand for? electronic medical record A microbe that is harmful and causes infection is A pathogen A person is on contact precautions. The person must stay in her room. Which is correct? person with respect, kindness, and dignity The process of becoming unclean is An infection in a body part is Contamination A local infection An infection that develops in a person cared for in any setting where health care is given is healthcare-associated infection Protection against a certain disease is The process of cleaning Immunity Removes organic matter Treat the A An item contaminated with blood, body fluids, secretions, or excretions that may be dangerous or harmful is Biohazardous waste Masks prevent the spread of microbes from Isolation Precautions are based on Respiratory secretions Clean and dirty 18 Painful or difficult urination is Dysuria Frequent urination at night is Nocturia The loss of urine in response to a sudden, urgent need to void is called You assist a person with the bedpan. Which is correct? Urge incontinence Return when the person signals. Knock before entering. The healthy adult produces ___________ml of urine a day. UTI means urinary tract infection Urine flows from the kidney to the bladder via: the ureters 1500 When a person has dementia, what measures may help keep the person clean and dry? for signs that the person may need to void, such as pulling at clothing If a man is unable to stand and place a urinal to void, you should Observe Place and hold the urinal for him Hematuria means Blood in the urine The type of catheter that drains the bladder and then is removed is called a Straight catheter. A straight catheter drains the bladder and then is removed. Foley, condom, and suprapubic catheters are left in place Where is the catheter secured? The inner thigh Secure the catheter to the inner thigh. Or secure it to the man's abdomen. This prevents excess catheter movement and friction at the insertion site. 19 Which statement about catheters is true? during, and after surgery. They are used to keep the bladder empty before, Catheters create a risk for UTIs. However, they are used to promote comfort and to keep the bladder empty before, during, and after surgery. They do not treat the cause of incontinence. When giving catheter care, which measure should you question? to front. Dry the perineal area from back When giving catheter care, hold the catheter at the meatus and clean the catheter from the meatus down at least 4 inches. You will need to retract the foreskin of an uncircumcised male. After rinsing the catheter, the perineal area should be dried from front to back. Which statement about urine drainage systems is true? The urinary system is sterile. A closed drainage system is used for indwelling catheters. The urinary system is sterile. Standard drainage bags usually hold at least 2000 mL (milliliters) of urine. The drainage bags stay lower than bladder level. When is the leg bag emptied? When it is half full Leg bags fill faster than standard drainage bags. Check leg bags often. Empty the leg bag if it is becoming half full. When emptying a urine drainage bag, which step do you do first? Place a paper towel on the floor. Place a paper towel on the floor, and place the graduate on the paper towel under the drainage bag. Open the clamp and let the urine drain into the graduate. Clean the end of the drain with an antiseptic wipe, close the clamp, and measure the urine. When are condom catheters changed? Daily Condom catheters are changed daily after perineal care. Which measure can cause a UTI? drainage bag Allowing urine to flow back into the bladder when moving the 20 You can decrease the risk of UTI by keeping the drain from touching other surfaces, using a clean, separate graduate for each person, using a clean area of the washcloth for each stroke during catheter care, and by preventing urine from flowing back into the bladder. A patient has a catheter. When the person is in bed, you attach the drainage bag to The bed frame The semi-solid mass of waste products in the colon that is expelled through the anus is called Feces. Feces refers to the semi-solid mass of waste products in the colon that is expelled through the anus. Gas or air passed through the anus is flatus. The partially digested food and fluids in the stomach are called chyme. Peristalsis is the alternating contraction and relaxation of intestinal muscles. The person is placed in which position when an enema is administered? Sims' Place the person in Sims' position or in a left side-lying position. Prone, supine, and Trendelenberg positions are not as effective for enema administration. When bleeding is present in the stomach or small intestine, stools appear Black. Stools are normally brown. Bleeding in the stomach and small intestine causes black or tarry stools. Bleeding in the lower colon and rectum causes red-colored stools. Diseases and infection can cause clay colored or white, pale, orange-colored, or green-colored stools. A common cause of constipation is Inactivity. Common causes of constipation include inactivity, low-fiber diet, decreased fluid intake, and ignoring the urge to have a BM When performing digital removal of an impaction, the person should be monitored frequently for Bradycardia. Checking for and removing impactions are very dangerous. The vagus nerve can be stimulated. Stimulation of the vagus nerve slows the heart rate. The heart rate can slow to unsafe levels in some persons Which is a sign of dehydration? Thirst 21 The person has pale or flushed skin, dry skin, and a coated tongue. Urine is dark and scant in amount (oliguria). Thirst, weakness, dizziness, and confusion also occur. Which statement about C. difficile is true? infected person. Contact precautions are required when caring for an The microbe is found in feces. A person becomes infected by touching items or surfaces contaminated with feces and when touching his or her mouth or mucous membranes. Contact precautions are required. Alcohol-based hand rubs are not as effective against C. difficile as soap and water. When caring for persons with C. difficile, wash your hands with soap and water. Gas or air passed through the anus is called Flatus. Gas and air are normally in the stomach and intestines. They are expelled through the mouth (burping, belching, and eructating) and anus. Gas or air passed through the anus is called flatus. Flatulence is the excessive formation of gas or air in the stomach and intestines. Which measure should you question on the care plan of a person who is undergoing bowel training? Decreased fluids The care plan includes a high-fiber diet, increased fluids, warm fluids, activity, and privacy. The type of enema that may be ordered when the bowel does not need a complete cleansing is Small-volume. The doctor orders a tap water, saline, or soapsuds enema when the bowel needs to be cleaned of feces and flautus. Small-volume enemas are ordered for constipation of when the bowel does not need a complete cleansing. The values, beliefs, and customs of a group passed from one generation to the next is Which action promotes a person's dignity? Culture Covering the person for privacy during care The following statements relate to basic needs. Which is correct? needs People normally meet their own 22 Body language includes Hand movements and gestures Communication that uses the written or spoken word is Direct questions are used to Verbal communication Focus on specific information The lowest level basic care needs are Physical needs What is the concept that considers the whole person? Holism Which of the following would be considered a barrier to communication? Rooting reflex Giving your opinion Newborns have certain reflexes. Which reflex is necessary for feeding? (It guides the baby's mouth to the nipple.) Toilet training is a major developmental task for Which statement about school-age children is correct? skip, hop, and ride a two-wheeled bike. Toddlers They are very active. They can swim, jump, At what stage should children receive factual sex education? Which is a developmental task of adolescence? Late childhood Accepting changes in the body and appearance Which is a developmental task of middle adulthood? Adjusting to aging parents Adjusting to retirement and reduced income is a developmental task of The Moro reflex occurs when the baby is startled by a loud noise Late adulthood 23 Middle Adulthood is 40-65 relates to changes in mental, emotional, and social function Development A mechanical device attached to the person's body that he or she cannot remove easily and that restricts freedom of movement is A restraint Which is a safety measure for using a restraint? Checking the person at least every 15 minutes OBRA requires informed consent for restraints. Which is correct? consent, his or her legal representative does so Which statement about restraint use is correct? If the person cannot give Restraints are used only as a last resort Which is required for restraint use? Which is a restraint alternative? A doctor's order The person wanders in a safe area. The person who is restrained must be observed every Restraints are used 15 minutes Only to treat a medical symptom or for the immediate physical safety of the person or others Every two hours the person in restraints is re-positioned and basic needs met. Identify which of the following would be one of those needs elimination needs Unnecessary restraint is false imprisonment 24 When logrolling a person, you must Turn the person as a unit, in alignment, with one motion When delegated the dangling procedure, you need the following information from the nurse and the care plan The amount of help the person needs When moving a person up in bed, be sure to support the person's Head Which of the following would mean that the under-pad is not safe to use as an assistive device? is disposable and is made of thin material that tears easily. __ occurs when skin sticks to a surface and muscles slide in the direction the body is moving. shearing _ is to put weight on one's legs. weight bearing __ is the person's ability to perform the activities of daily living. Functional Status How a person moves to and from a lying position, turns from side to side, and re-positions in bed or other furniture is ___ Bed mobility The rubbing of one surface against another is Friction You are helping a patient transfer from the bed to the chair. Which is correct? It Help the person to dangle. Make sure his feet touch the floor Which statement about mechanical lifts is correct? Always follow the manufacturer's instructions You are transferring a patient from the wheelchair to the toilet. Which is correct? the person if the grab bars by the toilet are not secure Do not transfer 25 You need to transfer a resident to a stretcher. Which is correct? Use a friction-reducing device To prevent injuries during a stand-pivot transfer, you need to width apart A full sling supports The entire body Keep your feet at least shoulder When a person is transferring to a chair or a wheelchair, help the person out of bed on strong side What is the most important safety measure to consider when performing a pivot transfer? on the wheelchair and bed Muscle atrophy is A decrease in size or a wasting away of muscle tissue A resident is on strict bedrest. Which is correct? Bed cradles are used to Good body alignment is important Keep the weight of top linens off the feet. Which statement about range-of-motion (ROM) exercises is correct? His or her Brakes The joint is moved slowly, smoothly, and gently. Moving a body part away from the mid-line of the body is A person uses crutches to walk. Which action promotes safety? f its the person with crutches. Braces are used for which of the following reasons? Abduction A physical therapist measures and Prevent or correct deformations 26 A patient wears an ankle brace. When you remove the brace, you notice a reddened area on the ankle bone. What should you do? Report your observation to the nurse. Which statement about recreational activities in nursing centers is correct? are important for physical and mental well-being. Recreational activities When performing range of motion exercises for the shoulder, the correct term for moving the arm away from the body is abduction Most older people Live in their own homes Retirement usually means The person has reduced income Changes in the integumentary system occur with aging. Which statement is correct? easily damaged Aging requires certain dietary changes. Which is correct? constipation and bone changes Changes in the circulatory system occur with aging. Which statement is correct? may occur in many body parts __ is the study of the aging process. Another word for shrink is ___ __ is the care of aging people gerontology atrophy Geriatrics The leading cause of injury to the elderly is: The skin is Older persons need foods that prevent Poor circulation Falls 27 Older people have difficulty seeing: Blue and green colors Older men may have difficulty urinating because the: Prostate gland enlarges Constipation is a common problem in older persons because of Which is a cause of poor circulation in order persons? Decreased peristalsis Narrowed arteries Older people often complain about how food tastes. This is because number The older person's ability to sense pain is: Chest thrusts are most effective for Decreased Very obese person Taste buds decrease in You notice a frayed electrical cord on a resident's bed. What should you do? at once Which is a fire prevention measure? Report it to the nurse Supervise the smoking of patients and residents who cannot protect themselves. You must check the MSDS Before using a hazardous substance Which practice promotes safety where oxygen is used? room Errors in care are reported At once Removing smoking materials from the You are dealing with an agitated person. You should do which of the following? free Keep your hands 28 Hemipledia means paralysis on one side of the body Use at least _______ identifiers. The R in RACE stands for Most falls occur in rescue 2 Patient and resident rooms and bathrooms To protect persons from harm, you need to To prevent falls Answer call lights promptly Always lower the bed to the lowest position when you are done giving care Which measure will help prevent falls? The call light is always within the person's reach Which statement about transfer/gait belts is correct? They help prevent falls and other injuries. If you find a person on the floor, what should your next action be? with the person and call for the nurse. Fall risk wrist band is usually what color? A bed or chair alarm Yellow Do not move the person. Stay Makes a sound or has a recorded message to alert staff the person is attempting to get up unassisted The most common type of permanent dementia is Alzheimer's disease The most common mental health disorder in older persons is Depression 29 Catastrophic reactions involve Extreme responses Increased signs, symptoms, and behaviors of AD during hours of darkness is Which statement about AD is correct? The person with AD Symptoms worsen over many years. Sundowning Must be kept free from abuse, mistreatment, and neglect How many stages of Alzheimer's Disease are there? 3 Identify which item is not a common causes of agitation or aggression in the resident with dementia. following a routine How do AD special care units differ from other areas of a care facility? locked Entrances and exits may be When you wish to communicate with a person who has AD or other dementias, you should eye contact to get the person's attention You care for several persons with AD. Why must you report behavior changes to the nurse? may signal other illnesses or injuries. Make They A resident has problems finding her room, the bathroom, the dining room, and so on. Which of the following might help her? Picture signs A patient has AD. To gain the person's attention, you need to: Approach the person from the front A resident has AD. The person's care plan should include which of the following measures to promote sleep? Follow the person's bedtime rituals. 30 A resident has AD. She tends to wander and is sometimes combative. Her son asks you to restrain her. Which is correct Restraints require a doctor's order. A resident has AD. His wife visits daily. They like to touch, hold hands, and kiss. Which action is correct? Providing privacy Which of the following occurs early in AD? Tinnitus is Problems managing money Ringing, roaring, hissing, or buzzing in the ears Age-related macular degeneration is a disease that When caring for the blind person, do the following Otitis media is common in Infants and children Which statement about hearing aids is correct? Blurs central vision Identify yourself when you enter the room They make sounds louder. To communicate with the person with a hearing loss, you should slowly. Dysarthria means Difficult or poor speech With expressive aphasia, the person Speak clearly, distinctly, and Has difficulty sending out thoughts To communicate with the speech-impaired person, do the following your full attention Cataract is an eye disorder in which The lens becomes cloudy Listen and give the person 31 The major symptoms of Ménière's disease are ear A person has severe hearing loss. Which is correct? Tinnitus, hearing loss, vertigo, and pressure in the Awareness of surroundings requires hearing. A patient is speech-impaired. When communicating with the person, you should ask the person to: Write down key words or the message A resident has a hearing aid. Which is correct? When not in use, the hearing aid is turned off A resident has glaucoma. What do you know about the person's sight? the side. Which statement about multiple sclerosis is correct? The person cannot see to A person's risk increases if a family member has MS. Amyotrophic lateral sclerosis (ALS) Affects muscles of speech, chewing, and swallowing A man suffered a head injury 3 weeks ago. The person is unconscious and unaware of his surroundings. He has sleep-wake cycles and periods of being alert. This describes a Vegetative state Autonomic hyperreflexia is treated by person sit uprigh An open fracture is also called a surgical replacement of a joint. Another name for quadriplegia Raising the head of the bed 45 degrees or having the compound fracture arthroplasty Tetraplegia 32 Stroke occurs when which of the following happens? Warning signs of stroke include which of the following? Warning signs of stroke last a few minutes. This is called: Functions lost as a result of stroke depend on: Bleeding in the brain or a blood clot Weakness of 1 side of the body A transient ischemic attack The area of brain damage Which of the following are common with Parkinson's disease? expression Slow movement and mask-like A resident has MS. The person's care plan includes the following. Which should you question? Perform all ADL for the person. A resident has amyotrophic lateral sclerosis (ALS). Which is correct? that control voluntary muscles. Congenital means To be born with Which occurs with hypertension? ALS attacks the nerve cells The resting blood pressure is too high The coronary arteries are in the Heart The major complications of coronary artery disease (CAD) are irregular heartbeat, and sudden death Cardiac rehabilitation includes the following Exercise training Angina, myocardial infarction, 33 Which is a bacterial infection in the lungs spread by airborne droplets with coughing, sneezing, speaking, singing, or laughing? Tuberculosis An inflammation and infection of lung tissue is ___ Pauses in breathing that occur during sleep is An excessive loss of blood in a short time is pneumonia sleep apnea Hemorrhage __ is another name for dysrhythmia. Hypertension is dangerous because it: Angina occurs when: arrhythmia Can damage other organs The heart needs more oxygen The right side of the heart cannot pump blood normally. Signs and symptoms include: feet and ankles COPD interferes with: O2 and CO2 exchange Which statement about asthma is correct? Wheezing and cough are common The most common symptom of gastro-esophageal reflux disease (GERD) is Risk factors for GERD include the following Alcohol use A person is vomiting. Which of the following measures is needed? and the Bloodborne Pathogen Standard Swollen Heartburn Follow Standard Precautions 34 Many people have small pouches in their colons. Each pouch is called a Diverticulum Which person is at greatest risk for gallstones? weight Hepatitis is inflammation of the Liver Which statement about type 1 diabetes is correct? Which is a cause of hypoglycemia? A woman over the age of 60 years who is over It must be controlled to prevent complications. Missing a meal Aspirated vomitus Can obstruct an airway A person with cirrhosis will need good skin care because of Hepatitis B, C, and D are spread by: Persons with diabetes need Contaminated blood Good foot care What type of diabetes is more common in older persons? The loss of appetite is Anorexia Itching Type 2 The process of removing waste products from the blood in patients in renal failure: The breathing of fluid, food, vomitus, or an object into the lungs is Which foods are high in vitamin C? Citrus fruits, tomatoes, and green vegetables Hemodialysis Aspiration 35 Which is allowed on a sodium-controlled diet? How much water does an adult need daily to survive? A resident has an order for NPO. This means that You are feeding a person. Which is correct? Steamed fruits and vegetables 1500 mL The person cannot eat or drink anything. Sit down facing the person A very low body temperature is: Hypothermia Which of the following measures prevents the spread of microbes when providing drinking water? Make sure the water pitcher is labeled with the person's name and room and bed number. A tube inserted into the stomach through a surgically created opening is A gastrostomy tube Giving a patient nourishment with Total Parenteral Nutrition (TPN) means the patient is receiving the nourishmen Directly into their bloodstream A patient is receiving enteral nutrition through a gastrostomy tube. To prevent regurgitation, the person is positioned in Fowler's or semi-Fowler's position Giving nutrients through a catheter inserted into a vein is Parenteral nutrition The alarm is sounding on an IV infusion pump. What should you do? Which health team members are responsible for intravenous (IV) therapy? What is the IV flow rate? Tell the nurse right away. RNs The number of drops per minute or milliliters per hour 36 You notice that the IV flow rate is too fast. What should you do? A patient complains of pain at the IV site. What should you do? According to Maslow's theory of basic needs Tell the nurse Tell the nurse Lower-level needs must be met before higher-level needs. A vague, uneasy feeling that occurs in response to stress is Anxiety A person is intensely afraid of a situation that has no real danger. The person avoids the situation. The person has a Phobia Compulsion Before leaving the house, a person always checks exactly 10 times to make sure the stove is turned off. This is a A woman was mugged while running in the park. She relives the event frequently during the day. The person is having Flashbacks The person with this disorder has severe mood swings. Bipolar disorder You are caring for an 80-year-old nursing center resident. You notice that the person is not motivated to perform grooming activities. The person complains of not sleeping and of headaches. These are signs and symptoms of Depression Anorexia nervosa and bulimia nervosa occur mainly in Teenage girls and young women A person you are caring for threatens suicide. Which is correct? with the person. Call for the nurse at once. Stay 37 A defect of the spinal column in which the vertebrae do not form properly is Spina bifida Which statement about spina bifida occulta is correct? The spinal cord and nerves are normal A condition in which cerebrospinal fluid collects in and around the brain is A disability that occurs before 22 years of age is That which is passed down from parents to children is The uncontrolled contractions of skeletal muscles is Developmental disability Inherited spastic An abnormality present at birth that can involve body structure or function is a Hydrocephalus birth defect ___ involves severe limits in intellectual function and adaptive behavior occurring before age 18. intelletual disability Any lost, absent, or impaired physical or mental function is a The lack or absence of breathing is Bloody sputum is hemoptysis The amount of oxygen given is the Apnea Flow rate A reduced amount of oxygen in the blood is Very deep and rapid respirations are hypoxemia Kussmaul respirations disability 38 The ________________________ is sitting up and leaning over the table to breathe. position The collapse of a portion of the lung is atelectasis bluish color to the skin, lips, mucous membrane, and nail beds. cyanosis Orthopenic An ____________ is a sensitivity to a substance that causes the body to react with signs and symptoms allergy A surgically created opening into the trachea Tracheostomy An alarm sounds on a ventilator. What is the first thing you should do? is connected to the ventilator. A resident has a tracheostomy. Which measure will help prevent aspiration? dressings do not have loose gauze or lint What should you do if a person's airway comes out? Call for the nurse When performing suctioning on an adult, a suctioning cycle is no longer than Blood in the pleural space is Hemothorax Check if the person's tube Making sure that 10 to 15 seconds Because a person with an endotracheal tube(ET) cannot speak, it is important to call light in reach Petrolatum gauze is kept at the bedside of a person with a chest tube to Always keep the Cover the insertion site if the chest tube comes out 39 Using a machine to move air in and out of the lungs is Rehabilitation starts when Mechanical ventilation The person first seeks health care Rehabilitation focuses on The whole person A patient does not feel that he is making progress. The person is angry. How can you help? understand the person's feelings. Offer support by not being judgmental. You promote the person's quality of life by Try to Providing privacy when the person is practicing new skills You are feeling frustrated by a person's slow progress with rehabilitation. What should you do? Discuss your feelings with the nurse. A nursing assistant with special training in restorative nursing and rehabilitation skills is a restorative aide The process of restoring the disabled person to the highest possible level of physical, psychological, social, and economic functioning is rehabilitation Care that helps people regain their health, strength, and independence is restorative nursing You are admitting a person with dementia. The person wants to leave. Which is correct? health team helps the person feel safe and welcome. The You are admitting a person. While you are taking vital signs, the person complains of severe abdominal pain. What should you do? Call for the nurse 40 A patient wishes to leave the hospital without the doctor's permission. What should you do? Notify the nurse at once When taking a person's weight, the first step in using any scale is to 1 inch = ___________ cm 2.54 Identify the task that is not part of assisting with an admission 1 kg = _____ pounds 2.2 pounds A person is being discharged, as the nursing assistant you will be belongings Sexuality develops when Sexuality involves A baby's sex is known The whole person A person attracted to both sexes is Bisexual A man believes he is a female in a man's body. The person is The inability of the male to have an erection is Sexual activity and expression of sexuality Impotence Zero the scale Complete the nursing assessment Gathering the person's Transsexual May involve hand-holding, touching, and embracing A patient touches you inappropriately. What should you do? talk to the nurse. Politely ask the person to stop and 41 Diabetes, spinal cord injuries, and MS may cause Impotence Long Term Care Centers Designed for persons who cannot care for themselves: Medical, nursing, dietary, recreational, rehabilitative, and social services are provided Residents Persons in long-term care centers; Center is their permanent or temporary home; Most residents are older and have chronic diseases, poor nurtrition, or poor health; Some residents are disabled from birth defects, accidents, or diseases; Alert, oriented residents Resident knows who & where they are, the year, and time of day. They have physical problems. Disability level affects the amount of care required. Some require complete care, others need help with daily activities Confused & disoriented residents Resident is mildly to severely confused & disoriented. Some simply have trouble remembering where the dining room is, the month, or year. Others are more confused & disoriented--they do not know who or where they are. Sometimes the problem is short term. For others it is permanent and becomes worse Complete care residents Residents who are disabled, confused, and disoriented. They cannot meet their own needs or tell you what they need. They need to be kept clean, safe, and comfortable Short-term residents/Respite Care Residents who need to recover from surgery, fractures, or illnesses and regain strength & mobility to return to their former living situations. Home care-giver is given a rest. Life-long Residents Residents with birth defects & childhood injuries & diseases can cause disabilities such as mental retardation & Down syndrome. Person has limited function in at least 3 ares: self-care, understanding, or expressing language, learning, mobility, self-direction, independent living, & f inancial support. Person needs lifelong assistance, support and special services. Developmental Disability A disability occurring before 22 years of age; May be a physical impairment, intellectual impairment, or both 42 Residents with problems coping or adjusting to stress affecting behavioral Mentally ill residents and function. Terminally ill residents Residents who are going to die from terminal illness (cancer, AIDS, liver/heart/kidney/respiratory disease. Nursing Team Nursing Process RN's, LPN's (LVN's), & Nursing Assistant's 1) Assessment - Collects information. 2) Nursing Diagnosis - Describes health problems. 3) Planning - Setting priorities and goals. 4) Implementation - Carries out the plan (goals). 5) Evaluation - Measures if the goals of the planning step were met. Medicare Medicaid A federal health insurance program for persons 65 yrs of age or older A health care payment program sponsored by federal & state governments OBRA-Residents Rights Right to all his or her information records; Right to refuse treatment; Right to privacy & confidentiality; Right to personal choice; Right to voice concerns, questions, & complaints about care; Right to not have to work for care, care items, or other things or privileges; Right to form & take part in resident & family groups; Right to keep and use personal items; Right to be free from all abuse, mistreatment, & neglect; Right to be free of restraint; Right to a quality of life that promotes dignity & self esteem; Promotes physical, psychological, and mental well-being for quality of life Quality of Life Activities Nursing center provides activity programs that allow personal choice. They must promote physical, intellectual, social, spiritual, & emotional well being. Religious services promote spirtual health Quality of Life Environment Nursing centers environment must promote quality of life by being clean, safe & as home-like as possible. OBRA Requirements for Dignity & Privacy 1. Courteous & Dignified Interactions (right tone of voice, good eye contact, stand or sit close, use proper name & title, gain attention before interacting with resident, use touch IF person approves, respect social status, listen with interest, DO NOT yell, 43 scold, or embarrass resident) 2. Courteous & Dignified Care (grooming, dressing, clothing is personal choice, promote independence & dignity in dining, respect private space & property, assist with walking, transfers, bathing & hygiene preferences) 3. Privacy & Self-Determination (avoid exposure & embarrassment, keep person properly draped at all times, use curtains & screens during all care & procedures, knock before entering, close bathroom door when person uses it) 4. Maintain Personal Choice & Independence (Person smokes in allowed areas, takes part in activities according to interests, involved in scheduling activities & care, gives input to care plan about preferences & independence, involved in room or roommate change) OBRA Requirements (all 50 states) Nursing Assistant training and competency evaluation program must be completed to work in nursing centers and hospital long-term care units. OBRA Training Program Requires at least 75 hours of instruction (16 hrs are supervised practical training); includes knowledge & skills needed to give basic nursing care; takes place in a laboratory or clinical setting OBRA Competency Evaluation After training program you take a written test that has multiple choice questions and a skills test that is performing certain skills learned in training program. OBRA allows at least 3 attempts to successfully complete the evaluation OBRA Nursing Assistant Registry An official record or listing of persons who have successfully completed a competency evaluation; Each state must have a nursing assistant registry; all information stays in registry for at least 5 years OBRA other requirements & provisions Retraining & new competency evaluation program are required for NA who have not worked for 2 consecutive years. It does not matter how long you worked, it is how long you did NOT work: Requires new competency evaluation OR Both retraining & new competency evaluation; Nursing agencies must provide 12 hrs of educational programs to NA's every year Delegation RN's can delegate tasks to LPNs/LVNs, & NA's (Right Task, Right Circumstances, Right Person, Right Directions & Communication, Right Supervision) Refusing a Task Have the right to refuse when: Task is beyond legal limits of your role, Is not in your job description, You were not prepared to perform the task, Task could harm the person, Person's condition has changed, You do not know how to use the supplies or equipment, directions are unethical, 44 illegal, or against agency policy, directions are unclear or incomplete, nurse is not available for supervision Ethical Aspects Knowing difference between right & wrong conduct; behaves and acts in the right way and does not harm anyone; not being prejudiced or biased Good Work Ethics Caring, Dependable, Considerate, Cheerful, Empathetic, Trustworthy, Respectful, Courteous, Conscientious, Honest, Cooperative, Enthusiastic, Self-aware 5 Steps of Nursing Process Evalualtion Assessment Assessment, Nursing diagnosis, Planning, Implementation, & Involves collecting information about the person; Nursing history is taken from family's health history, info from doctor, test results, & past medical records Signs Symptoms Objective data that is seen, heard, felt, or smelled (you can feel a pulse, see urine) Subjective data is things a person tells you about that you cannot observe through your senses (you cannot see pain, fear, or nausea) Nursing Evaluation Involves measuring if goals in planning step were met: progress is evaluated; changes in nursing diagnoses, goals & care plan may result; NA has keep role as NA's observations are used for this step Safety & Security Needs Feeling safe from harm, danger, & fear; People feel safe and more secure if they know told what is or going to happen (Tell them - Why it is needed, who will do it, how it will be done, what sensations or feelings to expect) Dealing with Behavior Issues Recognize frustrating & frightening situations; Treat person with dignity & respect; Answer questions clearly and thoroughly and have nurse answer questions you cannot answer; Keep person informed about what you are going to do and when; Do NOT keep person waiting, answer signal lights promptly; explain reason fo