Certified Nursing Assistants
Certified Nursing Assistants are crucial members of any health care team. They are continuously working under the direction of a nurse. (RN or LPN/LVN) CNAs also provide hands on nursing care to patients, residents, clients and customers in various health care settings. CNAs usually provide assistance with self-care, such as bathing, dressing, eating, toileting and oral care to patients who are unable to complete these tasks on their own. CNAs are often often the staff member, who will read the patient’s vital signs, weigh the patients and they measure the patient’s height.
CNA exams are normally taken in two parts. There is a written component and a hands-on skills component. The written component of the test is typically in a multiple-choice format and will evaluate the CNAs knowledge of the subjects that all CNAs are expected to know.
Anyone writing a CNA exam must have a high school diploma or GED.
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- Question 1 of 20
When a nursing assistant is assisting a patient, which of the following needs to be reported to the staff nurse right away?CorrectIncorrect
Anyone with diabetes is at a greater risk for infection because their wound will not heal as quickly as someone without diabetes. Due to this, any kind of cut, irritation of the skin or abrasion needs to be reported right away to the nurse. In answer A, if a patient is in need of more supplies the nursing assistant needs to help with this (such as more towels and soap for help with the additional perineal cleaning). With answer C, it’s up to the nursing assistant to change out the bedding, and for answer D it is perfectly fine to wash the patient’s hair if they request it and it doesn’t go against current orders or medical needs of the patient.
- Question 2 of 20
When a nursing assistant is bathing a patient, they discover that there is a new area on the person’s heel that is both warm and red. Upon finding this new area on the body, what should the nursing assistant do?CorrectIncorrect
It’s possible the area of the foot that’s both warm and red is a pressure sore starting to develop. The nursing assistant needs to finish the bath and completely dry off the patient before telling the nurse. For answer A, lotion should never be applied to the area before informing a nurse. The area of concern might require different assistance and the lotion may simply make matters worse (or increase the chance of skin damage). Answer B should not take place as the patient needs to finish the bath. Answer D shouldn’t happen because the nursing assistant needs to not only avoid using lotion initially but massaging it into the skin shouldn’t happen either as it may damage the skin further.
- Question 3 of 20
While providing HS oral care for a patient who uses dentures, what kind of actions should a nursing assistant take?CorrectIncorrect
Dentures should always be cleaned with cool to tepid water, and then placed into a denture with either denture cleaning solution or cool to tepid water in it. Answer B does not work as the teeth should never be placed in a washcloth as it may develop bacteria. Answer C should it not good, as hot water should never be used. Hot water may damage the dentures (and if the patient needs the teeth right away it can burn their mouth. Answer D doesn’t clean the teeth, opens the teeth up for bacterial growth. It may also be accidentally thrown away by a cleaning crew or other nursing assistant.
- Question 4 of 20
While providing AM care for a patient who recently suffered a stroke and now has weakness in their right side, what should a nursing assistant do when dressing the patient first?CorrectIncorrect
When a nursing assistant is dressing a patient who is weak or suffers from paralysis on one particular side, this should be the area that is undressed last and then clothed first. With answer A, the answer is backward. With answer B, there is no need to remove all of the clothing prior to dressing, unless the patient has soiled himself or herself. For answer D, again there is no need to remove the clothing from the upper portion of the body first. This can happen after addressing the lower half of the body.
- Question 5 of 20
Of the following, which should the nursing assistant report to the nurse?CorrectIncorrect
It is important for the nursing assistant to report on these changes because the urine is cloudy. Cloudy urine may be a sign of other health issues. Urine should be between clear and a light yellow. Each of the three other answers is all generally normal, as urine that is clear yellow is safe. Additionally, requesting for assistance to make it to the bathroom is perfectly fine.
- Question 6 of 20
At breakfast time, a nursing assistant is helping a patient who suffers from diabetes. The patient is scheduled to have heart surgery later on in the day. Which of the following breakfast trays is right for the patient to consume?CorrectIncorrect
The patient is going to fall under the Nothing by mouth category and should not consume any kind of food prior to surgery (including beverages and liquids). Answer B is a representation of a clear liquid diet, although this still would not be the right diet for someone going into surgery. Answer A is not an adequate diet for someone who suffers from diabetes, which is why it should be avoided. So outside of D, none of the diets is right for a person who is going to have surgery later in the day.
- Question 7 of 20
A patient requests to be placed in a semi-Fowler position. What is a semi-Fowler position?CorrectIncorrect
The semi-Fowler position is where the head position of the bed is raised up to between 30 and 45 degrees. Answer A is known as a prone position. Answer B is known as a supine position. Answer D is known as the high-Fowler position.
- Question 8 of 20
A patient has started to suffer from diarrhea. They are also telling the nursing assistant of feeling lightheaded when standing. Generally, the patient has no problem moving around on his or her own (including going to the bathroom). When this is brought to the attention of the nursing assistant, what should they do?CorrectIncorrect
The very first thing a nursing assistant needs to do when this is brought to their attention provides the patient with a means for calling help. If a patient is no suffering from light-headedness it means they may be at a greater risk of falling. As the patient’s safety is a top priority it is important to offer this first. Having a patient move up and down in order to get their blood pumping throughout the body is not necessary and may prove unnecessary (it is important to have the nurse look in on the patient). Having the patient layback down may be needed, but it isn’t the first task an assistant should take.
- Question 9 of 20
A patient who is currently in comatose has been immobile for the last several works. Due to this, the patient is at risk for possible muscle atrophy and contractures. What should a nursing assistant do during their AM rounds in order to provide the best care for the patient?CorrectIncorrect
When a patient is suffering from muscle atrophy and contracture it means their muscles are becoming weaker and shortening, which reduces their range of motion. Both of these conditions often lead to immobility, so performing passive range of motion exercises is important (unless they have different medical guidelines from the doctor). For answer B, active range of motion exercises should be performed by residents who are independent. A comatose resident likely will not be able to carry out these actions. For choice C, a patient can still take a full bath, and answer D should not be performed as if oral care is administered while laying down the patient’s face should be turned to avoid aspiration.
- Question 10 of 20
When providing HS care, the nursing assistant discovers a resident has a new pedal edema and onset bilateral ankle. What’s the first action that should be taken by the nursing assistant?CorrectIncorrect
Any sudden and new onset edema may mean a deterioration of a medical condition. Spotting edemas in patients should be expected, a new one needs to be looked over by the nurse, in which case it needs to be reported right away. The feet should not be massaged as it can break the skin. Selection B can be helpful but it is best to figure out what is going on with the patient first. Option D may be harmful to the patient as it is not yet determined what is causing the problem.
- Question 11 of 20
When performing hourly rounds post-surgery, a patient complains of pain in their right calf. What should the nursing assistant do?CorrectIncorrect
When there is calf pain (especially when in just one leg), it may be a sign of DVT post surgery. Due to this, it must be reported right away. Performing active range of motion might be appropriate, but it’s important to determine the cause of the problem first. Selection B should not happen as massaging the leg might put the patient at a greater risk of pulmonary embolism. Selection C of having the patient walk around might be helpful, but again it’s important for the nurse to help diagnose the situation first.
- Question 12 of 20
If a nursing assistant uses a gait belt to assist a patient, where should the nursing assistant stand?CorrectIncorrect
When using a gait belt the nursing assistant needs to stand to the side and slightly behind the patient while holding onto the belt (using both hands). In all of the other options, the nursing assistant doesn’t have enough direct control over both the belt and the patient while still being able to walk themselves.
- Question 13 of 20
When planning the daily schedule for an older patient with little mobility, the individual has a physical therapy session at 10 A.M. and an occupational therapy session at 2 P.M. What schedule should the nursing assistant set up?CorrectIncorrect
Older patients generally need more time in between activities in order to rest. Providing two hours between care and therapy sessions will allow for this. Option B provides the two-hour window, with two hours before the first session and two hours after the final session. Every other option has at least one one-hour break in between sessions and offered care, which is not enough unless there are other needs that need to be addressed.
- Question 14 of 20
A patient who doesn’t have any pressure sores but is at risk of them from their immobility is receiving care from a nursing assistant. How often should the nursing assistant reposition the patient?CorrectIncorrect
Even if the patient is not currently demonstrating bedsores, individuals who are immobile need to be moved at least once every two hours to avoid pressure sores from happening. Answer A is not correct as perineal care is likely offered less frequently. Option B isn’t right as a patient may not realize they are developing the bedsores. And option D should be avoided altogether.
- Question 15 of 20
When offering A.M. care, one of the older patients currently suffering from cognitive changes tells a nursing assistant they do not want to pick out what they are going to wear because it will take too long. Instead, they want the nursing assistant to pick for them. What would be the best response from the nursing assistant?CorrectIncorrect
It is important to keep the patient active and engaged. Picking out clothing gives the patient some control over their situation, so it is better if they do it. However, they are still growing in their comfort level, so offering to help is the best course of action. The other options do not promote emotional support and do not help the patient build confidence. It is necessary to provide both an emotionally supportive response and help keep the patient feel as independent as possible.
- Question 16 of 20
Of the following, which is not an age-related expected change?CorrectIncorrect
As a person ages, they will experience reduced circulation, not improved circulation. Everything else is a common age-related change a person may end up experiencing.
- Question 17 of 20
What is an example of a physiological need?CorrectIncorrect
A physiological need is considered one of the most basic needs the body has. This includes food, water, shelter, sexual release, and sleep. Family is an example of a social need. Having a job is an example of a safety need. Personal status is an example of an esteem need.
- Question 18 of 20
A nursing assistant is helping a new patient. While assisting, the patient comments on how much they hate being in the facility, that they don’t have friends and that they just don’t know what’s going on. What should the nursing assistant say?CorrectIncorrect
It is important to acknowledge the patient’s feelings and not blow it off. It is necessary to offer suggestions as to how they can interact with other members of the community. Answer A, B, and C are all inappropriate as none of the answers offer support or possible suggestions as to how they might cope with the new surroundings. It is necessary to both acknowledge how a patient is feeling while also offering helpful suggestions on how to make it better.
- Question 19 of 20
When a nursing assistant is conducting range of motion exercises on a patient’s shoulder, they take hold of the patient’s arm and move it away from the middle of their body while also paying extra careful attention to not place additional stress on the joint. Which of the following forms of motion is this an example of?CorrectIncorrect
This is a form of abduction. Abduction occurs when a limb is moved away from the centerline of the body. Option A, Flexion is known as the bending of a limb at the joint. Option C, Adduction, is when the limb is moved towards the centerline of the body (not away from it). Option D, or extension, is when the limb is straightened out at the joint.
- Question 20 of 20
When a nursing assistant is offering perineal cleaning and care for a female patient that currently has an indwelling urinary catheter, which of the following techniques should be utilized?CorrectIncorrect
It is important for the nursing assistant to always begin by cleaning the perineum from the front to the back. They should never clean from the back to the front as this may increase the chance of a urinary tract infection. Prior to cleaning the tubing of the catheter, the nursing assistant needs to check and ensure the catheter is properly secured to the patient’s leg. This will prevent the catheter from dislodging during cleaning. Choice B is not correct, as it is necessary to clean everything, including the catheter. Not cleaning the area opens the patient up to possible infections. Option C is not accurate as even though the patient has an indwelling catheter, it is still necessary to clean off all the equipment and the perineum as well. Failure to clean the perineum may open up the possibility of infection. Option D has the correct order, but the correct technique is not used. A nursing assistant should never clean the patient (especially female patients) from the back to the front as it can push bacteria into the vaginal area and lead to infections. The cleaning of the catheter material is correct though, as it is important to wash from the area nearest the patient away. This also helps prevent the spread of bacteria into the vaginal area.