Best Practices for Certified Nursing Assistants (CNAs) in Residential Care | Exams Medicine | Docsity (2024)

Download Best Practices for Certified Nursing Assistants (CNAs) in Residential Care and more Exams Medicine in PDF only on Docsity! CNA Practice Exam #10 Questions And Answers. 1. Which of the following is NOT part of standard precautions? - \A. Using PPE B. Removing organic material before disinfection or sterilization procedures C. Placing the resident in a single room D. Hand hygiene C Standard precautions are part of the Centers for Disease Control and Prevention's (CDC's) guidelines to reduce the risk of spreading pathogens from blood, body fluids, open wounds, and mucous membranes. CNAs should practice standard precautions whenever they give care to residents. These include using PPE (personal protective equipment), practicing hand hygiene, and removing organic material (such as blood) from items before disinfecting or sterilizing them. Placing a resident in a single room is not part of standard precautions; this action is part of airborne precautions, which are designed to protect people from infections transmitted through respiratory droplets. 2. Which of the following is NOT part of oral care for an unconscious person? - \A. Use a toothbrush to clean the resident's teeth B. Protect the resident from aspiration C. Assume the resident can hear you D. Avoid inserting fingers inside the resident's mouth A A CNA should never use a toothbrush to clean an unconscious resident's teeth because the CNA could accidently hurt the resident. Instead, the CNA should check the center's policy and use the approved tool (usually a sponge swab). An unconscious resident may be able to hear the healthcare provider, so the CNA should explain the procedure and speak to the resident throughout the procedure. The CNA should not insert fingers inside the resident's mouth, as the resident could bite down and injure the CNA during the procedure. To protect the resident from aspiration (breathing food, fluid, or vomitus into the lungs), the CNA should position the person to one side with their head to the side to allow fluid to drain from the mouth. 3. Which of the following is the correct temperature for a resident's bath? - \A. 130 Degrees Fahrenheit B. 110 Degrees Fahrenheit C. 120 Degrees Fahrenheit D. 100 Degrees Fahrenheit B Before giving a resident a bath, the CNA must always check the water temperature to ensure that the water is not too hot or too cold. A temperature of 100 degrees Fahrenheit is tepid and will be too cold for a bath. Water that is 120 degrees Fahrenheit and above will scald (burn) people. A temperature of 110 degrees Fahrenheit is appropriate for bathing. 4. Which of the following is NOT part of the recording responsibilities of a CNA? - \A. Always erase mistakes completely B. Always record the date and time of every observation C. Always identify the resident D. Always use ink A Medical records are legal documents. You should never write in pencil, erase mistakes, nor use liquid paper to correct mistakes. Instead, use pen for recording and put a single line through the mistake. Then, date and initial the line, and re-write the entry. Be sure to always identify the resident, note the date and time of the observation, and record only what you observed or performed. 5. Restorative nursing care helps the patient with all of the following except: - \A. Improves the mobility of the resident. B. Improves the communication practices of the resident. C. Improves the cognitive functioning of the resident. The nursing assistant provides no treatment to the resident, and does not speak to or acknowledge her in any way. B. The nursing assistant threatens to hit the resident. C. The nursing assistant locks the wheels of the resident's wheelchair, so that the resident "won't get into trouble." D. The nursing assistant slaps the resident for "talking back." A Neglect is the failure to provide a resident with the care or services needed to avoid physical harm or mental anguish. Failing to provide treatment and ignoring a resident demonstrates neglect. Threatening to hit a resident is assault and a form of verbal abuse. Slapping a resident is battery and a form of physical abuse. Locking the wheels of a resident's wheelchair is false imprisonment and a form of physical abuse. 11. When giving a resident a bed bath, which of the following should the nursing assistant perform first? - \A. Wash around the resident's eyes B. Put on gloves C. Lower the head of the bed D. Provide for privacy D When bathing a resident, it is important to provide privacy before beginning the bed bath. Bathing can be a stressful or embarrassing activity for residents. Pulling the curtain, covering areas not being bathed, and remaining professional will help maintain the resident's privacy. 12. Which of the following is a strategy for preventing decubitus ulcers? - \A. Inspect the resident's skin during routine care and report concerns at once. B. Position the resident according to the care plan. C. Keep linens dry and wrinkle free. D. All of the above D Preventing pressure ulcers (decubitus ulcers) is much easier than treating them. Prevention measures include: helping the resident move, providing good nutrition and hydration, monitoring the resident's skin for signs of pressure ulcers, positioning and turning the resident according to the care plan, using pillows and pads, good skin care, proper bathing, and cleaning an incontinent patient promptly. 13. Which of the following is true about a patient with diabetes? - \A. All patients must take insulin. B. A patient with hypoglycemia has high blood sugar, which is a potentially dangerous medical condition. C. A small cut on the foot of the patient is a potentially dangerous situation. D. All of the above C Patients with diabetes can get infections more easily in their feet than other patients. A small cut on the foot of a patient with diabetes could lead to an infection and (ultimately) an amputation. It is important that nursing assistants pay close attention to the feet of a patient with diabetes. Not all patients with diabetes take insulin. It is important to monitor the blood sugar of patients with diabetes. Both high blood sugar (hyperglycemia) and low blood sugar (hypoglycemia) can be very dangerous for a patient with diabetes. A nursing assistant should call the nurse immediately if a patient with diabetes has hyperglycemia or hypoglycemia. 14. Asepsis means: - \A. The absence of all microorganisms B. The body's overwhelming and life-threatening response to infection C. The absence of disease-causing germs D. A communication disorder resulting from damage to the brain C Asepsis means the absence of disease-causing microorganisms. Surgical asepsis is defined as the absence of all microorganisms. Aphasia is a communication disorder resulting from damage to the brain. Sepsis is the body's overwhelming and life- threatening response to an infection. 15. Which of the following tasks can a nursing assistant legally perform? - \A. Inserting a urinary catheter B. Wound care C. Giving a patient medication D. Taking a patient's blood pressure D A nursing assistant may not perform any sterile procedures; therefore, they cannot legally administer wound care or catheter insertion. Moreover, nursing assistants may not give patients medication. A nursing assistant is able to take a patient's blood pressure. 16. A nursing assistant may legally: - \A. Mentor other CNAs B. Teach other CNAs C. Supervise other CNAs D. None of the above D A nursing assistant may not legally supervise, teach, or mentor other nursing assistants. These tasks are part of the role of the nurse. A nursing assistant should help other nursing assistants perform tasks, such as: positioning and transferring, feeding, and bathing residents when asked. However, all legal supervision, teaching, and mentoring of nursing assistants falls to the nurse. 17. You are caring for a 90-year-old, frail resident named Mr. Jenkins. Mr. Jenkins suffers from dementia, and he sometimes gets confused at night. He occasionally thinks that his mother is calling him in for dinner when it gets dark. What physical problem places Mr. Jenkins at risk for falls? - \A. His confusion at night B. His dementia C. His frailness D. All of the above B Although residents have many rights under the law, they do not have the right to behave however they would like to behave. Aggressive, unsafe, or discriminatory behavior is not appropriate. Residents have many rights, including: the right to be treated with dignity and respect, to access medical records, to make choices, to refuse care, to make advanced directives, to manage personal and financial affairs, to have privacy and confidentiality, and to voice grievances and have them addressed promptly (among others). 23. Which of the following is NOT a cause of dehydration? - \A. Diarrhea B. Vomiting C. Constipation D. Not drinking enough fluids C Dehydration can be a dangerous condition for residents. It may be caused by diarrhea, vomiting, or poor fluid intake. Constipation does not cause dehydration. It is important to monitor a resident's fluid intake, condition, urination, and bowel movements to help prevent dehydration. 24. When providing perineal care for a male resident with an uncircumcised penis, the nursing assistant should: - \A. Scrub the perineal area thoroughly and vigorously to make sure it is clean. B. Replace the foreskin after it has been pushed back to clean the head of the penis. C. Clean the anal/rectal area first and then use the same washcloth to clean the penis. D. Clean the penis starting at its base and then moving towards the tip. B The nursing assistant should replace the foreskin after it has been pushed back to clean the head of the penis. It is important to clean under the foreskin of the penis to remove smegm*, which collects under the foreskin. Also, when bathing a resident (or providing perineal care), it is important to remember the principle of "clean to dirty." Start with "clean" areas (the head of the penis) and move to "dirty" areas (the base of the penis). Never use the same cloth to wash the rectal/anal area and then tend to the penis. 25. If the patient ignores the urge to have a bowel movement, which of the following could happen? - \A. Hemorrhoids B. Incontinence C. Diarrhea D. Fecal impaction D Ignoring the urge to have a bowel movement may lead to more serious health issues than simple discomfort. Fecal impaction is when a large, firm lump of feces is stuck in the rectum. The impacted stool blocks the colon and may lead to significant problems. Hemorrhoids are swollen and/or inflamed veins around the anus or in the lower rectum. They can be quite painful when sitting or going to the bathroom. Diarrhea is the frequent passage of liquid stools. Feces move through the intestines rapidly. This reduces the time for fluid absorption. Abdominal cramping, nausea, and vomiting may occur with diarrhea. Incontinence is the loss of control over one's bladder or bowel functions. 26. You are caring for Mrs. Tenley, a resident who has a urinary drainage bag. You empty Mrs. Tenley's bag and notice that your gloves look clean, as if you just pulled them out of the box. There is not even a spot on them. You now need to go help Mr. Fowler with a bed bath. What should you do? - \A. Discard the gloves, practice hand hygiene, and put on new gloves before providing care for Mr. Fowler. B. Use the same gloves for Mr. Fowler's care. No need to change them - they still seem clean. C. Use the same gloves all day as long as they look clean. D. Discard the gloves and bathe Mr. Fowler without wearing gloves. A It is important to discard gloves and practice hand hygiene after every patient contact. There are also procedures where you will need to use several pairs of gloves on one patient. NEVER reuse gloves. 27. Which of the following is NOT a sign of depression? - \A. Persistent sadness and feelings of worthlessness B. Progressive short-term memory loss C. Eating too much or too little D. Sleeping too much or too little B Some of the signs or symptoms of depression can be contradictory (depending on the person). Some people sleep too much or too little. Some people may eat too much or too little. Some have chronic pain, or may feel anxious, irritable, or indifferent. Many depressed people have persistent feelings of sadness, hopelessness, or worthlessness. Progressive short-term memory loss may be a sign of dementia. It is not a sign of depression. 28. Which of the following is a risk factor for falls? - \A. Care equipment, such as IV poles and tubes B. Poor judgment C. Urinary or fecal incontinence D. All of the above D There are many risk factors for falls, including environmental factors like care equipment, bed height, throw rugs, slippery floors, poor lighting, and the improper use of wheelchairs, crutches, walkers, and canes. Additionally, patients may have a variety of issues that increase the probability of falls, including: balance problems, low or high BP, confusion, depression, side effects from medication, elimination needs (incontinence), foot problems, joint pain, muscle weakness, vision problems, and poorly fitting shoes. 29. A nurse just changed a bandage on a patient's wound and has asked you to dispose of the used bandage. How should you go about doing this? - \A. Wear gloves and place the used bandage in a special "hazardous waste" container. B. Throw the used bandage in the trash. D. All of the above B It is important that healthcare providers help residents increase or maintain their highest range of motion (ROM) possible. Bed rest or additional sleep will likely reduce the patient's range of motion. In this instance, the patient should perform active range of motion exercises to maintain or increase his range of motion. 35. The fire alarm begins to ring in the facility in which you work. You cannot see nor smell the fire and none of your patients are in immediate danger. What should you do? - \A. Begin to evacuate patients B. Run to find the fire and extinguish it C. Close the fire doors D. Call 911 C The RACE procedure states that you should do the following during a fire: • Rescue patients in immediate danger • Activate the fire alarm • Close fire doors • Extinguish the fire Since none of the patients are in immediate danger and the fire alarm has been activated (thus activating the EMS system), you should begin to close the fire doors to contain the fire. 36. Which type of care focuses on comfort and support for a dying person and that person's family? - \A. Holistic care B. Hospice care C. Restorative care D. Rehabilitative care B Hospice care focuses on the comfort and support of a patient and her family when the patient has less than six months to live (and has chosen hospice care). Hospice care emphasizes ensuring a patient's quality of life, rather than attempting to find a cure. Rehabilitative and restorative care are designed to help a patient improve or maintain her level of functioning. Holistic care describes the care of the whole person (clinical, emotional, spiritual, social, and physical). 37. Which of the following is true about high-performing healthcare teams? - \A. They have zero tolerance for mistakes. B. Each team member does his job without interfering with others' responsibilities. C. The doctor is the strong central leader directing the team. D. They collaborate and communicate effectively to serve the needs of patients. 37. D High-performing healthcare teams collaborate and communicate to serve the needs of patients. High-performing healthcare teams must learn from mistakes to improve care, and they must be open to helping one another. Healthcare is a "team sport." Although the doctor is an important member of the healthcare team, the doctor needs the input, collaboration, and expertise of all the team members. 38. In Maslow's hierarchy of needs, which of the following needs is at the bottom of the pyramid? - \A. Self-actualization B. Love and belonging C. Self-esteem D. Physical needs A Maslow's hierarchy of needs starts at the top of the pyramid with the most important and immediate needs for life: • Level 1 - Physical needs (air, food, water) • Level 2 - Safety and security • Level 3 - Love and belonging • Level 4 - Self-esteem • Level 5 (the lowest-priority level) - Self-actualization This does not mean that self-actualization is not important; it just means that people must meet their physical needs (level 1) in order to live long before they need to meet their need for self-actualization (level 5). 39. The most common reason for inappropriate behavior in residential nursing care is: - \A. An interpersonal disagreement B. A cognitive problem C. A physical problem D. A drug problem B The most common reason for inappropriate behavior in residential nursing care is a cognitive (or thinking) problem, such as dementia or Alzheimer's disease. Though infrequent, there are times when drug interactions, interpersonal disagreements, or physical issues may trigger inappropriate behavior. 40. Which of the following is an open-ended question? - \A. "What time would you like to get up tomorrow morning?" B. "On a scale of 1-10, with 1 being no pain and 10 being the most pain you can imagine, how much does it hurt?" C. "Do you like cookies?" D. "What was your childhood like?" D The question: "What was your childhood like?" is an example of an open-ended question. It provides many options as to how a person chooses to answer, and it is a good way to start a conversation. Use open-ended questions when you have time to speak with a resident and learn a little more about the resident's life. 41. The nursing assistant leaves a patient's room for a 20-minute break, does not tell her colleagues, and leaves the bed rails down on the resident's bed. The care plan states that the bed rails should be raised for this resident. Five minutes later, the patient falls out of bed and breaks his hip. Who is responsible for this? - \A. The nursing home is responsible. B. The nursing assistant is personally responsible. C. Clinical nurse specialist C Many patients who have had a stroke lose some of their speaking and communication skills. A speech-language pathologist evaluates speech and language, and helps to treat patients with speech, voice, hearing, communication, and swallowing disorders. An audiologist tests patients' hearing, prescribes hearing aids, and helps patients with hearing loss. A clinical nurse specialist provides nursing care and has areas of specialization (wound care, geriatrics, rehabilitation, etc.). A clinical laboratory technologist undertakes complicated lab testing of body fluids in order to help with diagnoses and treatment plans. 47. The Resident's Bill of Rights is posted near the front entrance to the facility. What does this document contain? - \A. The ethical principles of healthcare B. Key financial information about billing for Medicare and Medicaid C. The moral imperatives of healthcare providers D. An outline of the legal rights of residents D The Resident's Bill of Rights must be posted publicly in healthcare facilities. This essential document contains the legal rights of patients. 48. Which is the proper order of operations to perform when using a fire extinguisher to put out a fire? - \A. Pull the pin, aim the extinguisher at the base of the fire, squeeze the trigger, and sweep the extinguisher from side-to-side to completely cover the fire. B. Sweep the extinguisher from side-to-side to completely cover the fire, pull the pin, aim the extinguisher at the base of the fire, and squeeze the trigger. C. Squeeze the trigger, pull the pin, aim the extinguisher at the base of the fire, and sweep the extinguisher from side-to-side to completely cover the fire. D. Aim the extinguisher at the base of the fire, pull the pin, squeeze the trigger, and sweep the extinguisher from side-to-side to completely cover the fire. A When using a fire extinguisher to put out a fire, use the PASS method to remember the proper order: • Pull the pin • Aim at the base, or bottom, of the fire or flame • Squeeze the trigger while holding the extinguisher upright • Sweep or move the spray from side-to-side to completely cover the fire 49. Which of the following practices opens up a line of communication with a resident? - \A. Interrupting the resident with a story about your social media page when the person is telling you something personal about her life. B. Sitting at the resident's eye level - when the resident is seated - to show that you are listening. C. Responding with answers like: "I am sure everything will be fine," or "Just be happy, that is all you can do." D. Checking the time of the clock on the wall when the person is speaking. B Much communication is non-verbal. You can show a person that you are listening by sitting at eye level (if they are sitting) and listening closely to what they say. This opens up a line of communication. Checking the time on the clock, interrupting the person with your own personal story, and responding with canned answers like, "I am sure everything will be fine," or "Just be happy, that is all you can do," are all ways to shut down communication. 50. Contractures are: - \A. A normal part of the aging process B. The result of too much physical activity C. An unfortunate and untreatable condition D. The result of too little physical activity D Contractures are muscles or tendons that abnormally shorten due to disease or too little physical activity. Contractures are not a normal part of the aging process. They can be prevented and treated. 51. When taking a resident's blood pressure, the first sound you hear is at 136. The last sound you hear is at 82. How should you document this reading? - \A. 82/136 B. High C. Low D. 136/82 D The first number in a blood pressure measurement is the systolic pressure, which is the force of the blood moving through the arteries when the heart beats. This is the top number in a blood pressure reading. The second number is the force of blood moving through the arteries when the heart is at rest. This is the diastolic pressure. It is the bottom number in a blood pressure reading. Although this blood pressure reading is high (a normal BP for an adult is less than 120/80), you should record the actual blood pressure reading, not a generalization. 52. When caring for a patient's dentures, which of the following statements is false? - \A. When cleaning dentures, place a towel in the bottom of the sink. B. Dentures are expensive and difficult to replace. C. Dentures must be cleaned at least once per day. D. Always carry dentures in your hand when you go to the bathroom to clean them. D Dentures are expensive and difficult to replace if they are broken. Never carry dentures. 53. What is the purpose of reporting? - \A. To ensure that your legal responsibilities are fulfilled. B. To ensure that the nurse is aware of the patient's condition and needs in order to best inform care for the patient. C. To ensure that you pass off information to someone who is responsible for the patient. D. To ensure that you follow the facility's protocols and procedures. B Follow the patient's exercise plan. A Patients with dementia or Alzheimer's disease may become agitated at night (see sundowning or sundowner's syndrome). Consequently, it is important to help promote sleep; discourage napping; keep a regular and soothing bedtime routine; use nightlights to help reduce anxiety or confusion; create a quiet atmosphere and help patients be active during the day (including exercise) so that they are tired at night. 59. Which of the following is true about the ombudsman? - \A. The ombudsman is at the facility to catch healthcare providers engaging in negligent or abusive behaviors. B. The ombudsman protects the health, safety, rights, and welfare of residents. C. The ombudsman is an employee of the facility. D. All of the above B The ombudsman protects the health, safety, rights, and welfare of residents. The ombudsman is not an employee of the facility and is not there to catch healthcare providers doing something wrong. However, the ombudsman will help manage difficult situations, monitor nursing center care, and represent the residents' interests. The name, address, and phone number of the ombudsman must be posted publicly in the nursing home. 60. What is elopement? - \A. Wandering in the nursing home B. Forgetting where you are C. Falling in love D. Leaving the nursing center without staff knowledge D Elopement occurs when a resident leaves the nursing center without staff knowledge. People with Alzheimer's disease or dementia may wander and not find their way back. They have poor judgment and could hurt themselves. Elopement is dangerous! It is important that nursing centers follow appropriate guidelines to prevent elopement (locked doors or wings, use of proper identification, keeping a close watch on residents with dementia or Alzheimer's disease, etc.). 61. A nursing assistant is going to help Mr. Fowles with a bath. She knocks on the door and waits a moment. Suddenly, Mr. Fowles looks up at her, curses at her, and throws a shoe at her. What should the nursing assistant do? - \A. Scream at Mr. Fowles and tell him, "No one speaks to me like that!" B. Shut the door and ignore Mr. Fowles, as he does not deserve care if he is being disrespectful. C. Immediately tell the nurse. D. Pick up the shoe and throw it back at Mr. Fowles. C Wild and inappropriate behavior must be reported to the nurse immediately, as this could be a sign that the resident has a medical condition. It is not appropriate to scream or throw things at residents ─ this is abuse. It is also not appropriate to shut the door and ignore the resident ─ this is neglect. 62. The best way for nursing assistants to manage the effects of poor or inappropriate behavior in a healthcare setting is to: - \A. Restrain the patients B. Prevent the behavior C. Medicate the patients D. Control the patients B The best way to manage the effects of poor or inappropriate behavior is to prevent the behavior in the first place by offering proactive care and practicing good communication with everyone in the facility. Patients have the right to personal choices, so controlling them violates their rights. Restraints and medication should not be used to control patients unless they are an immediate danger to themselves or others. This is a last resort that can only be ordered by a doctor. 63. You are working with Mr. Neal and have recently begun weighing him each day. Yesterday, Mr. Neal weighed 175 pounds. Today, he weighs 194 pounds. You redo the weight measurement, and it still reads 194 pounds. What is the most likely cause of this weight gain? - \A. Mr. Neal has been eating lots of junk food over the past 24 hours. B. The measurements were inaccurate on both days. C. Mr. Neal has gained excess fluid in the past 24 hours. D. Mr. Neal was thirsty and drank a lot of water before the weigh-in. C Mr. Neal's weight gain indicates that he is retaining fluid, which is likely caused by edema. It is not possible to gain 19 pounds in one day from eating too much junk food. Nor is it likely that the measurements were wrong on both days, or that Mr. Neal drank 19 pounds of water prior to the weigh-in. 64. You have a patient who has a history of falls. Which of the following safety measures will help keep him from falling out of his bed? - \A. A low bed B. Padded briefs C. A gym mat on the floor D. Monitoring the patient D Close monitoring of the patient is the best option for fall prevention in this case. A low bed, a gym mat on the floor, and padded briefs may help reduce an injury from a fall out of bed, but these methods will not prevent the fall. 65. Which of the following is a mistake of commission? - \A. A nursing assistant transfers the wrong resident to radiology for an x-ray. B. A nursing assistant does not report a resident's rectal bleeding. C. A nursing assistant forgets to take a resident's vital signs. D. All of the above A A mistake of commission occurs when someone does the wrong thing. In this case, taking the wrong resident to radiology for an x-ray is a mistake of commission. A mistake of omission is a mistake when a person does not do what she is supposed to do. Forgetting to take vital signs and failing to report rectal bleeding are mistakes of omission.