CNA Practice Exams

Question 1

When assisting a client in learning how to use a cane, the nurse aid stands….

1. approximately two feet directly behind the client.
2. about one foot from the client’s weak side.
3. about one foot from the client’s strong side.
4. slightly behind the client on the client’s weak side.

Answer 1

Answer: 4

Standing slightly behind the client at her weak side better enables the nurse aide to prevent falls. Choices 1 and 2 are incorrect because these distances are too far to safely catch the client if she falls or to support her. Choice 3 is incorrect because if the nurse aide is placed there, the client may collapse on her weak side.

Question 2

When working with a client who has urinary retention, the nurse aide should expect that the client will…

1. urinate large volumes.
2. be unable to urinate.
3. urinate frequently.
4. be incontinent of urine.

Answer 2

Answer: 2

Urinary retention means that the client cannot urinate. The problem should be reported to the nurse as soon as possible. Choice 1 is incorrect; urinating in large volumes, also called polyuria, is indicative of a medical problem such as diabetes mellitus. Choice 3 is incorrect; urinating too frequently means that the client may have a problem such as a urinary tract infection. Choice 4 is incorrect; urinary incontinence is the accidental release of urine. It may happen in small amounts when someone coughs or sneezes, or regularly if someone has a medical problem. While choices 1, 3, and 4 are not correct answers, these problems should be reported to the nurse as soon as possible.

Question 3

Aging-related hearing changes result in older clients gradually losing their abiity to hear…

1. high-pitched sounds.
2. low-pitched sounds.
3. sound levels.
4. faint sounds.

Answer 3

Answer: 1

Age-related hearing loss, also called presbycusis, results in older persons gradually losing their abilit to hear high-pitched sounds. Choice 2 is incorrect; the ability to hear low-pitched sounds may mean that the client has otosclerosis, which is usually related to abnormal bone growth in the bones of the inner ear. Choices 3 and 4 are incorrect; a reduction in sound level and the inability to hear faint sounds can indicate hearing loss due to problems such as an ear infection or impacted cerumen (too much ear wax).

Question 4

The best way to safely identify your patient is by…

1. asking his name.
2. calling his name and waiting for his response.
3. checking the bed plate.
4. checking the name tag.

Answer 4

Answer: 4

Checking a client’s name tag is the safest way of assuring that you have the correct client. If you ask a client his name, and he is confused or has difficulty hearing, he may give you the wrong name. A confused client may also be lying in the wrong bed.

Question 5

A client is on a bowel and bladder training program and has not had a bowel movement in three days. The nurse aide should…

1. report it to the charge nurse.
2. give the client an enema.
3. offer the client prune juice.
4. encourage the client to drink more fluids.

Answer 5

Answer: 1

The nurse aide should report this problem because nurse aides cannot perform any of the interventions on their own. Nurse aides cannot give clients enemas without being instructed to do so by the nurse. They also cannot encourage drinking more fluids or give prune juice as a treatment on their own (and prune juice would be insufficient for this client).

Question 6

The proper medical abbreviation for before meals is…

1. p.c.
2. b.i.d.
3. a.c.
4. t.i.d.

Answer 6

Answer: 3

The proper medical abbreviation for before meals is a.c., p.c. is the proper medical abbreviation for after meals, b.i.d. is the proper medical abbreviation for twice a day, and t.i.d. is the proper medical abbreviation for three times a day.

Question 7

A client diagnosed with hypertension will most likely have a history of…

1. low blood pressure.
2. high blood pressure.
3. low blood sugar.
4. high blood sugar.

Answer 7

Answer: 2

Hypertension is the medical term for high blood pressure, so the client will most likely have this problem in his history, although it may now be controlled with medication. The medical term for low blood pressure is hypotension. The medical term for low blood sugar is hypoglycemia. The medical terms for high blood sugar is hyperglycemia.

Question 8

A patient who has difficulty chewing or swallowing will need what type of diet?

1. clear liquid.
2. low residue.
3. pureed.
4. mechanical soft.

Answer 8

Answer: 4

A mechanical soft diet is prescribed for clients who need a diet that is easy to chew, swallow, and digest. Choice 1 is incorrect; a clear liquid diet is usually prescribed for clients before medical tests, for clients who have nausea and vomitting or an acute illness, or for clients who have experienced trauma or surgery. Choice 2 is incorret; a low residue diet is prescribed for clients to reduce the frequency and volume of their stools. Choice 3 is incorrect; a pureed diet is prescribed for clients who have poor dentition, who are very frail, or who are in end-stage disease.

Question 9

An elderly resident with Alzheimer’s disease cannot find her room. How can the nurse aide help the client feel more independent?

1. tell her to stay in her room.
2. have her roommate secretly watch her.
3. place a familiar object on the client’s door.
4. write a room number on a piece of paper.

Answer 9

Answer: 3

A familiar object can enable a client to find her room on her own, helping her feel more independent. Telling a client to stay in her room is restrictive and may be a violation of her rights. Choice 2 is incorrect because asking a roommate to do something for another client is inappropriate-it puts undue strain on the roommate and can create an unsafe environment for the client and the roommate. Choice 4 is incorrect because the client may lose the piece of paper or may be too confused at times to know what the number means.

Question 10

How often should a patient’s intake and output records be totaled?

1. Once each shift
2. Twice a day
3. Every four hours
4. Every 12 hours

Answer 10

Answer: 1

Intake and output are usually recorded every shift, as well as every 24 hours. Most agencies run on 8-hour shifts, not 12-hour shifts. When clients need more frequent observation of intake and output, they are usualy ill enough to need hourly observations and may thus be in the critical care unit.

Question 11

Which of the following should the nursing assistant observe and record when admitting a client?

1. Freckles
2. Wrinkles
3. Short nails
4. Bruises

Answer 11

Answer: 4

Brusing may be due to accidents, abuse, medications, or illnesses, and should be recorded and reported. Freckles and wrinkles are normal skin variations and do not require recording or reporting. Short nails are not problematic; however, long nails may result in the client scratching and injuring herself.

Question 12

When responding to a client on the intercom, the nursing assistant should say…

1. “Hello, who is calling, please?”
2. “What is it that you want?”
3. “This is [nursing assistant name and position], can I help you?”
4. “Please hold; I’ll have the nurse answer your call.”

Answer 12

Answer: 3

Always give your name and position when answering the call bell, and politely ask the client what she wants. Choices 1 and 2 are incorrect; these questions may come across as the nurse aide acting in a rude manner and should be avoided. Choice 4 is incorrect because it is the nurse aide’s responsibility to answer call bells promptly and appropriately.

Question 13

Which of the following things should the nurse aide do to familiarize new clients with their surroundings?

1. Demonstrate the location and use of the call light.
2. Explain that the TV is not to be used.
3. Instruct family to leave the room after the aide is finished with the admission.
4. Raise the bed to the high position and raise the safetly rails.

Answer 13

Answer: 1

The nurse aide should make sure that the client knows how to call for help. Unless otherwise noted, the TV is there for the client to use, and unless otherwise stated, there is no reason to ask the family to leave the room once the client is admitted. Choice 4 is incorrect, because raising the bed to the highest position creates a dangerous situation if the client is left alone.

Question 14

When arranging a client’s room, the nursing assistant should do all of the following EXCEPT…

1. checking the placement of the call bell.
2. adjusting the back rest as directed.
3. administering the client’s medications.
4. adjusting the lighting as approriate.

Answer 14

Answer: 3

Nursing assistants are not allowed to administer medications. The nursing assistant should check to make sure that the call bell is within the client’s reach, adjust the back rest as directed, and adjust the room lighting for comfort and visibility.

Question 15

When assisting a client out of bed, the nurse aide should always…

1. employ body mechanic techniques.
2. get another nurse aide to assist.
3. raise the bed to its maximum height.
4. lower all safety rails.

Answer 15

Answer: 1

Nurse aides should always use proper body mechanics when moving clients. The nurse aide obtains the assistance of another nurse only when it is required. Raising the bed to the maximum height when assisting a client out of bed increases the risk of the client’s falling out of the bed and injuring herself. Raised side rails can be used by the client for balance and assist her out of the bed.

Question 16

How often should clients be repositioned during an eight-hour shift?

1. q1h
2. q2h
3. q3h
4. q4h

Answer 16

Answer: 2

Clients should be turned every two hours to prevent decubiti. Choice 1 is incorrect; unless there is a reason, during a client every hour is too frequent and disruptive to the client’s rest. Choice 3 and 4 are incorrect; turning the client every three or four hours is not frequent enough to prevent decubiti.

Question 17

Which of the following is the correct procedure for serving a meal to a client who must be fed?

1. Serve the tray along with all the other trays, and then come back to feed the client.
2. Bring the tray to the client first, and feed the client before serving the other clients.
3. Bring the tray into the room when you are ready to feed the client.
4. Have the kitchen hold the tray for one hour.

Answer 17

Answer: 3

An aide should not bring the tray into the room until he was time to feed the client. Choice 1 is incorrect, because the client may attempt to feed herself and may choke on the food. Choice 2 is incorrect, because it takes time to feed a client and thus the other clients will be waiting too long to recieve their food. Choice 4 is incorrect, because the food will not be palatable after sitting around for an hour.

Question 18

The most serious problem that wrinkles in the bedclothes can cause is…

1. restlessness.
2. sleeplessness.
3. decubitus ulcers.
4. bleeding and shock.

Answer 18

Answer: 3

The most serious problems that wrinkles in the bedclothes can cause is decubitus ulcers, also called decubiti. Restlessness and sleeplessness are problematic and may cause health issues, but they are not the most serious problems. Bleeding and shock are not common complications of wrinkled bed clothing.

Question 19

Restorative care begins…

1. as soon as possible.
2. when the client is ready.
3. when the client is discharged.
4. when the client is diagnosed as terminally ill.

Answer 19

Answer: 1

Restorative care begins as early as possible to prevent further disability. Choice 2 is incorrect; the planning stage of restorative care can begin before the client is ready. Choice 3 is incorrect; there will not be enough time to successfully carry out restorative care if one waits until discharge. Restorative care is not used for terminal clients/ End of life care may be more appropriate.

Question 20

Before placing a client in Fowler’s position, the nurse aide should…

1. turn the client onto her abdomen.
2. explain the procedure to the client.
3. flatten the entire bed.
4. remake the bed with new linens.

Answer 20

Answer: 2

Caregivers should always explain procedures first. Turning a client on her abdomen is using the prone position. The Fowler’s position requires the nurse aide to raise the head of the bed 45 to 60 degrees. Remaking the bed is unnecessary to place a client in Fowler’s position.

Question 21

During the handwashing, the nurse aide accidently touches the inside of the sink while rinsing the soap off. The next action is to…

1. allow the water to run over the hands for two minutes.
2. dry the hands and turn off the faucet with the paper towel.
3. repeat the wash from the beginning.
4. repeat the washing, but for half the time.

Answer 21

Answer: 3

The aide has contaminated her hands and must rewash her hands. She must completely start over. Plain water will not remove bacteria, and the full time required to remove the contamination from the sink.

Question 22

How should a nurse aide dress for a job interview?

1. wearing a clean t-shirt and casual slacks.
2. wearing a nurse aide uniform.
3. wearing a business suit, dress, or pants and dress shirt.
4. wearing formal attire.

Answer 22

Answer: 3

First impressions are critical, so nurse aides should wear business attire. Choice 1 is incorrect, because the nurse aide should present himself as a well-groomed professional. Choice 2 is incorrect, because wearing a uniform outside of the workplace may be disallowed in some facilities because it can be contaminated. Choice 4 is incorrect, because wearing formal attire is overdressing and not businesslike.

Question 23

An ambulatory client is newly admitted. Before leaving the client alone, the nurse aide should…

1. ask if the client is hungry.
2. inspect the client’s skin.
3. assess the client’s intake and output.
4. make sure the client knows how to use the call bell.

Answer 23

Answer: 4

New clients should always know how to call for help before being left alone. Choice 1 is incorrect; the client may not be allowed to have food due to upcoming testing or surgery. Choice 2 is incorrect; it is the nurse’s role to inspect the client’s skin at the time of admission. Choice 3 is incorrect; the client was just admitted and thus will not have an intake or output yet.

Question 24

When lifting a heavy object, the correct method would be to bend at the…

1. waist, keeping your legs straight.
2. waist, rounding your shoulders.
3. knees, keeping your back straight.
4. knees and waist.

Answer 24

Answer: 3

Keeping the back straight forces the body to use strong leg muscles. Bending at the waist with legs straight can cause back injury, and bending at the waist with rounded shoulders can cause back injury.

Question 25

When should nurse aides wash their hands? 1. Before eating 2. Before using the bathroom 3. After client care 4. Before cleaning a bedpan

Answer 25

Answer: 3 ## Footnote Nurse aides should wash their hands after client care to prevent cross-contamination. Nurse aides should wash their hands after eating, after using the bathroom, and after cleaning a bedpan.

Question 26

When assisting a client with eating, one of the first things the nurse aide should do is... 1. cut the food into bite-size pieces. 2. wash his own hands and the client's hands. 3. butter the client's bread. 4. provide the client with privacy.

Answer 26

Answer: 2 ## Footnote Nurse aides must always remember to consider infection control first before anything else. Eventually, food should be cut into 1/3-size bites to prevent choking. Choice 3 is incorrect, because the nurse aide should first ask the client if he wants butter on his bread. Choice 4 is incorrect because the client may want to eat with others to socialize.

Question 27

A patient has a new cast on her right arm. While caring for her, it is important to first observe for... 1. pulse above the cast. 2. color and hardness of the cast. 3. warmth and color of fingers. 4. signs of crumbling at the cast end.

Answer 27

Answer: 3 ## Footnote A new cast may cut off circulation, and checking the pulse below the cast helps to make sure that this has not happened. The pulse above the cast willl not help detect cast tightness. A new cast will be damp and should not be touched with fingertips to prevent pitting the cast. Crumbling should not be an issue with a new cast.

Question 28

Encouraging a client to take part in activities of daily living (ADLs) such as bathing, combing hair, and feeding is... 1. done only when time permits. 2. the family's responsibility. 3. necessary for rehabilitation. 4. a violation of client rights.

Answer 28

Answer: 3 ## Footnote Rehabilitation should always be part of the care plan. and encouraging a client to take part in ADLs is an expected role of the nurse aide. This is the nurse aide's responsibility (however, the family can assist the client if they desire to do so and there are no contraindications). Considerate and respectful care is a basic right of all clients.

Question 29

In caring for a confused elderly man, it is important to remember to... 1. keep the bedrails up expect when you are at the bedside. 2. close the door to the room so that he does not disturb other patients. 3. keep the room dark and quiet at all times to keep the patient from becoming upset. 4. remind him each morning to shower and shave independently.

Answer 29

Answer: 1 ## Footnote The nurse aide should always make sure to follow agency policy. Closing the door causes client isolation, and keeping the room dark and quiet at all times can cause sensory deprivation, which can increase confusion. A confused client needs assistance with bathing and shaving to avoid injury.

Question 30

Before assisting a client into a wheelchair, the first action would be to check if the... 1. client is adequately covered. 2. floor is slippery. 3. door to the room is closed. 4. wheels of the chair are locked.

Answer 30

Answer: 4 ## Footnote Before assisting a patient in a wheelchair, check to see if the wheels of the chair are locked. Making sure the client is covered is important, but not the first action. The nurse should check the floor before entering the room to avoid self-injury, and the door should be open in case the call bell falls out of reach and the nurse aide needs to call for help.

Question 31

A client has a weak left side. When transferring the client from the bed to the wheelchair, the nurse aide should stand... 1. on the right side. 2. in front of the client. 3. on the left side. 4. behind the client.

Answer 31

Answer: 3 ## Footnote Assist the client at the client's weak side to prevent falls. Choice 1 is incorrect; the nurse aide should stand at the client's weak side, not strong one. Choice 2 is incorrect; this is done for clients who do not have one-sided weakness. Choice 4 is incorrect because the client may slide and fall.

Question 32

While making rounds at 5:30 a.m., a nurse aide finds a patient lying on the floor. What should the nurse aide do first? 1. Call 911. 2. Perform CPR. 3. Call for help. 4. Assess the client's pulse and respirations.

Answer 32

Answer: 4 ## Footnote The nurse aide should assess pulse and breathing first. The client may have fainted. The nurse aide should check pulse and respiration status before calling for help or preforming CPR.

Question 33

When moving a wheelchair onto an elevator, the nurse aide should stay... 1. behind the chair and pull it toward the aide. 2. behind the chair and push it away from the aide. 3. in front of the client to observe the client's condition. 4. at the side of the wheelchair while opening the door.

Answer 33

Answer: 1 ## Footnote The nurse aide must stay behind the chair to control it and move it backward to prevent the wheels from falling into the door opening. The nurse aide needs to remain near the client and in control of the wheelchair.

Question 34

The Foley bag must be kept lower than the client's bladder so that... 1. urine will not leak out, soiling the bed. 2. urine will not return to the bladder, causing infection. 3. the bag will be hidden and the client will not be embarrassed. 4. the client will be more comfortable in bed.

Answer 34

Answer: 2 ## Footnote Raising the bag above the bladder level can lead to backflow of urine and can cause bacteria to flow to the bladder. The Foley system is a closed system and should not leak, and the bag can be hidden at almost any height. Preventing backflow doess avoid discomfort, but this is secondary.

Question 35

As an afternoon snack, the kitchen sent a diabetic client a container of chocolate ice cream. The nurse aide should first... 1. substitute diet soda for the ice cream. 2. hold the afternoon snack and report to the charge nurse. 3. call the kitchen and report the error. 4. allow the client to have half of the ice cream.

Answer 35

Answer: 2 ## Footnote The nursing assistant should report this error to the charge nurse, who in turn will contact the kitchen to obtain the correct nourishment. The nurse aide cannot substitute food for a client with diabetes, and diet cola has no calories and is thus not a substitute for a healthy snack. It is the nurse's role to call the kitchen. Choice 4 is incorrect, because ice cream contains sugar and fat, and a diabetic snack needs to be carefully calculated into their overall diet.

Question 36

When assisting a client who is using the commode, it is important to... 1. leave the call light within reach. 2. lock the door to promote privacy. 3. stand next to the client until the client is finished. 4. restrain the client to prevent a fall.

Answer 36

Answer: 1 ## Footnote The client should always have access to a means to help when needed. A locked door slows access to the client in the event of an emergency. Standing next to the client deprives the client of privacy. Restraining a client without an order or consent can be considered unlawful imprisonment.

Question 37

Ensurinng adequate circulation to tissues is a major factor in preventing skin breakdown. This can be accomplished by doing all of the following EXCEPT... 1. positioning the patient every four hours. 2. using mechanical aids. 3. giving backrubs. 4. performing active or passive ROM exercises.

Answer 37

Answer: 1 ## Footnote The patient must be positioned every two hours to prevent skin breakdown due to poor circulation. Certain mechanical aides are created for the purpose of preventing skin breakdown; backrubs prevent skin breadown by stimulating circulation; and range of motion exercise improves circulation and joint mobility, thus decreasing skin breakdown.

Question 38

The purpose of cold applications is usually to... 1. speed the flow of blood to the area. 2. prevent heat exhaustion. 3. prevent or reduce swelling. 4. prevent the formation of scar tissue.

Answer 38

Answer: 3 ## Footnote The purpose of cold applications is usually to prevent and reduce swelling. Warm applications speed the flow of blood to an area. Cold applications are not used to prevent heat exhaustain and will not prevent scar formation.

Question 39

The hot water bottle is an example of a... 1. local dry heat application. 2. generalized dry heat application. 3. local moist heat application. 4. generalized moist heat application.

Answer 39

Answer: 1 ## Footnote A hot water bottle applied by itself is local dry heat. A hot water bottle is too small for generalized application.

Question 40

Clients recieving an enema are usually placed... 1. on the right side. 2. on the left side. 3. flat on back. 4. in a semisitting position.

Answer 40

Answer: 2 ## Footnote Placing the patient on the left side allows better entry into the colon. Placing a client on the right side or on the back makes entry into the color more difficult. A semisitting position is unstable and causes the client to fall.

Question 41

A female client's perineal area should be cleansed before which specimen is collected? 1. 24-hour urine specimen. 2. midstream clean-catch urine specimen. 3. pediatic routine urine specimen. 4. routine urine specimen.

Answer 41

Answer: 2 ## Footnote The clean-catch specimen requires cleaning the perinem. A 24-hour urine specimen and a routine urine specimen do not require prior cleaning, regardless of age.

Question 42

The most common site for counting the pulse is the... 1. carotid artery. 2. femoral artery. 3. brachial artery. 4. radial artery.

Answer 42

Answer: 4 ## Footnote The carotid artery, femoral artery, and brachial artery are not used routinely to count a client's pulse.

Question 43

When counting respirations, the nurse aide should... 1. wait until after the client has exercised. 2. not tell the patient what he is going to do. 3. count five respirations and then check his watch. 4. have the client count respirations while the aide takes her pulse.

Answer 43

Answer: 2 ## Footnote Telling the patient that the aide is watching her breathing will cause to patient to slightly changer her breathing pattern. Choice 1 is incorrect, because exercise will temporarily increase the client's respirations. Choice 3 is incorrect because respirations are counted over 30 or 60 seconds. Choice 4 is incorrect because clients cannot count their own respirations.

Question 44

Which of the following is NOT the nurse aide's responsibility when caring for clients who have urinary catheters? 1. Inserting the catheter 2. Ensuring that the catheter drains properly 3. Preventing infection 4. Recording urinary output

Answer 44

Answer: 1 ## Footnote Nurse aides are not responsible for catheter insertion. Nurse aides should ensure that the catheter drains properly, take proper precautions to prevent infection, and record the urinary output when a client has a catheter.

Question 45

When giving information to the charge nurse for an incident report, the nurse aide should... 1. write in the client's chart that an incident has occurred. 2. keep the report in her personal file. 3. state the facts clearly. 4. give her opinions as to the cause of the incident.

Answer 45

Answer: 3 ## Footnote An incident report becomes a permanent part of the legal record. Make sure the facts are clear. The nurse, not the aide, documents incident reports. The incident report becomes a hospital record, not a personal record. Incident reports require facts, not opinions.

Question 46

All long-term nurse aides must be competency evaluated and must complete a distinct educational course. These requirements are set by... 1. OBRA'87. 2. OSHA. 3. CDC. 4. FDA.

Answer 46

Answer: 1 ## Footnote OBRA' 87 stands for Omnibus Budget Reconciliations Act of 1987. OSHA stands for Occupational Safety and Health Administration. CDC stands for Centers for Disease Control and Prevention. FDA stands for the Food and Drug Administration.

Question 47

A resident is blind. It is important not to... 1. leave the door completely closed. 2. rearrange the furniture. 3. announce yourself before entering the room. 4. explain the location of food on the plate, using the face of the clock to assist.

Answer 47

Answer: 2 ## Footnote Never rearrange furniture in a blind patient's room after the patient settles into it. This can cause falls. Choice 1 is incorrect; clients who are visually impaired require the same respect and privacy as those who can see clearly. Choice 3 is incorrect; announcing yourself allows the client to know that you have entered the room. Choice 4 is incorrect; explaining the location of food on the plate helps the visually impaired client to be more independent by feeding himself.

Question 48

When family members visit a client, the visitors should... 1. stay in the day room. 2. stay a short while so as not to tire the client. 3. be expected to help with care. 4. be allowed privacy with the client.

Answer 48

Answer: 4 ## Footnote The family members should expect and be allowed private time with their loved one. Visitors should be allowed to visit directly with the client, and as long as possible, wherever appropriate. Family visitation is important to the healing and well-being of the client. Family may help with care if they wish, but should not be require to do so.

Question 49

A resident asks, "If I need help during the night, who will be there?" The nursing assistant should respond,... 1. "Don't worry, you'll be okay." 2. "Just yell; someone will hear you." 3. "Your roommate will probably ring the call bell." 4. "There are people here all night to help you."

Answer 49

Answer: 4 ## Footnote To make clients feel safe, assure them that help is always there, if needed. Telling a worried client not to worry is not helpful and can be disrespectful. Telling a client to yell for help and saying that a roommate will probably ring the bell is not helpful or reassuring.

Question 50

Which of the following is a client'r right? 1. Having personal information kept confidental 2. Obtaining private duty staff if desired 3. Knowing what is wrong with the client's roommate 4. Treating the staff any way he or she pleases

Answer 50

Answer: 1 ## Footnote Clients have the right to confidentiality. This means that all clients have the right to confidentiality, which includes roommates. While clients are allowed to obtain private duty staff, it is not a client right. Clients do not have a right to treat the staff with disrespect.

Question 51

A resident often cries while she is recieving her p.m. care. What should the nurse aide do? 1. Tell her to stop crying 2. Ignore her and continue with her care 3. Tell her jokes to make her laugh 4. Tell her that it's all right to cry, and that the aide is there for her if she wants to talk

Answer 51

Answer: 4 ## Footnote It is normal for a person to have moments of sadness, and it is important for the patient to know that the nurse aide cares. The nurse aide should also report this to the nurse in case the crying is the result of something more serious, such as depression. It is inappropriate to tell a client to stop crying, but at the same time, the nurse aide should not ignore clients and their needs. Humor can sometimes help, but will probably not help in cases where sadness seems frequent.

Question 52

When providing denture care, the nurse aide must... 1. wash them in boiling water. 2. hold them under warm running water. 3. dunk them in and out of cool water. 4. place them on a towel in the sink with cool water.

Answer 52

Answer: 4 ## Footnote Dentures are expensive. The towel prevents breakage if dropped, and the cool water prevents warping. Choice 1 is incorrect; hot wat can damage dentures. Use lukewarm water. Choice 2 is incorrect because holding them under running water runs the risk of dropping and breaking them. Choice 3 is incorrect; dentures need to be carefully cleaned to remove debris and old denture adhesive.

Question 53

Sexuality in long-term clients may include all of the following EXCEPT... 1. needing private time with a partner. 2. caring about one's physical appearance. 3. engaging in pulbic fondling. 4. desiring sexual interaction.

Answer 53

Answer: 3 ## Footnote As long-term care providers, nursing assistants must respect the resident's right to sexuality. However, engaging in public fondling is inappropriate and may infringe on other resident's rights. Private time with a partner is appropriate for meeting sexual needs, and one's personal appearance and self-esteem are related to their feelings of comfortable sexuality. Desire sexual interaction is a healthy human desire, even in older adults.

Question 54

A client is scheduled for a partial bed bath. This means that the nurse aide must wash the client's... 1. face, neck, ears, arms, and hands. 2. face, axillae, hands, and buttocks. 3. face, hands, axillae, and legs. 4. face, hands, axillae, genitals, and buttocks.

Answer 54

Answer: 4 ## Footnote Partiel bed baths are generally given before breakfast due to incontinence to help the client feel comfortalbe and clean. Partial bed baths should include the genital and buttocks area since they are usually given because of incontinence.

Question 55

A goal for an extended care facility (ECF) resident is that she not swear at the nurses or aides. When she call an aide by his name, the appropriate action is to... 1. smile and give the appropriate reward. 2. continue whatever task that is being done. 3. tease the resident about not swearing. 4. tell all of the staff that she didn't swear.

Answer 55

Answer: 1 ## Footnote The nurse aide should positively reinforce the resident's appropriate behavior, so smiling and rewarding her good behavior is the best action. Ignoring positive behavior does not help the patient to continue it, and teasing is not appropriate. The nurse aide should report to the nurse that the client has episodes of not swearing so that the nurse knows that plan is working.

Question 56

An agitated resident must be turned every two hours all night long. The first action of the nurse aide when waking this resident is to... 1. turn on the light. 2. speak quietly and calmly. 3. touch her shoulder. 4. shout her name.

Answer 56

Answer: 2 ## Footnote Do not startle the resident, as this may agitate her. The aide should speak quietly as he enters the room. Suddenly turning on the light may startle the resident and increase her agitation, and an agitated client may interpret touch as a threat and lash out at the aide. Shouting can further agitate the client because it may make you appear to be aggressive.

Question 57

If a client objects to certain food for religious or cultural reasons, the appropriate action would be to... 1. tell him to wait for the next meal. 2. offer to substitute something different for him. 3. call the dietician the next day. 4. tell him he needs to eat what is on his tray.

Answer 57

Answer: 2 ## Footnote Consideration of cultural or religious beliefs is important to all patients. Clients should not be made to wait for their food for any reason, and the dietician should be called that day by the nurse to report the client's religious preferences. Clients should not be forced to do something that is against their religion.

Question 58

The client's religion forbids eating pork. Bacon is being served for breakfast. The most appropriate response is to... 1. encourage the client to eat it because she needs protein. 2. tell the client it is all right since her doctor ordered the diet. 3. call the kitchen for a tray without bacon. 4. tell the client that restrictions are not as important as her health.

Answer 58

Answer: 3 ## Footnote The other answer choices do not address the resident's right to practice her religion. Religious preferences need to be considered in client care, even by physicians. Bacon is a pork product and thus inappropriate to serve to this client. Healthy alternatives can be found for dietary needs.

Question 59

Which type of communication can often be most powerful? 1. written 2. verbal 3. silent 4. tactile

Answer 59

Answer: 3 ## Footnote Listening to someone shows that you are very interested in what he or she is saying.

Question 60

A client refuses to allow the nurse aide to bathe her. The nurse aide tells the client that she will not be allowed to eat lunch to go to bingo if she does not have her bath. This is an example of... 1. rehabilitation. 2. discipline. 3. verbal abuse. 4. physical abuse.

Answer 60

Answer: 3 ## Footnote Threatening to withhold activities and food is verbally abusive. Choice 1 is incorrect because this is an inappropriate restriction that can hinder rehabilitation. Choice 2 is incorrect because threats are not discipline. Choice 4 is incorrect because this is abusive behavior; however, there is no physical contact, thus this is not physical abuse.

Question 61

One entering a room, an aide notices that the client is not breathing. The aide's first action should be to... 1. call for help. 2. lay the client down on his back. 3. give four quick breaths. 4. give 8-10 abdominal thrusts.

Answer 61

Answer: 1 ## Footnote Always call for help first in an emergency. The aide should call for help first, before he takes any physical action. Abdominal thrusts are not used until the rescuer verifies that the client's airway is blocked.

Question 62

A client's dentures are lost. The first action should be to... 1. notify the adminstrator. 2. look for them. 3. notify the doctor. 4. notify the charge nurse.

Answer 62

Answer: 4 ## Footnote The first step for any lost belongings is always to notify the charge nurse. The nurse should report their loss before looking for them. The nurse aide does not report directly to the administrator or to the physician.

Question 63

Nursing assistants are responsible for... 1. planning client care. 2. doing tasks assigned by the charge nurse. 3. performing without ever asking for help. 4. comparing assignments with coworkers.

Answer 63

Answer: 2 ## Footnote Nursing assistants work under the supervision of practical and registered nurses and perform tasks assigned to them. Choice 1 is incorrect; nurse aides can participate in planning client care, but they are not responsible for it. Choice 3 is incorrect; personnel should ask for help when needed, including nurse aides. Choice 4 is incorrect; nurse aides should focus on their own assignments and not be concerned about the assignments of others.

Question 64

A patient turns on the call light when he needs to urinate. The appropriate action is to... 1. ignore the light, since he is not the aide's own client. 2. announce on the intercom that there are two patients ahead of him. 3. answer the call light and get the urinal. 4. answer the call light when the aide has the time.

Answer 64

Answer: 3 ## Footnote A nurse aide should answer any call light as soon as possible. Choice 1 is incorrect; nurse aides are responsible to answer call lights for all clients, when in a position to do so. Choice 2 is incorrect; clients should not be made to feel that they need to wait in line for care; the nurse aide should answer the call light as soon as possible to assure that there is not an emergency.

Question 65

A client is on CMR and in the prone position. The nurse aide finds the client vomitting bright red blood. The nurse aide should first... 1. clean up the vomit. 2. place the client in the side-lying position. 3. provide the client with an emesis basin. 4. call the charge nurse.

Answer 65

Answer: 2 ## Footnote Placing the client in a side-lying position prevents aspiration of the vomitus. Choice 1 is incorrect; while the nurse aide does need to clean the client, this is not the priority. Choice 3 is incorrect; the client is lying down and thus cannot use an emesis basin. Choice 4 is incorrect; the nurse aide should call the charge nurse after he places the client on her side.

Question 66

When performing catheter care, the nurse aide should wash the catheter... 1. towards the meatus. 2. with Betadine soap. 3. away from the meatus. 4. with alchohol.

Answer 66

Answer: 3 ## Footnote You should follow the clean-to-dirty priniciple, which the meatus considered cleaner than the catheter tubing. Choice 1 is incorrect; washing towards the meatus drags bacteria up the catheter into the meatus, possibly causing infection. Choice 2 in incorrect; soap and water should be used in catheter care. Choice 4 is incorrect; alcohol can cause irritation of the urinary mucosa.

Question 67

A nurse aide who applies restraints on a client without directions from the charge nurse may be accused of... 1. slander. 2. battery. 3. false imprisonment. 4. negligence.

Answer 67

Answer: 3 ## Footnote Applying restraints without an order or without consent can be considered false imprisonment. Choice 1 is incorrect because slander is transient, usually verbal, defamation of character. Choice 2 is incorrect because battery is unlawful physical contact. Choice 4 is incorrect because negligence is failure to exercise reasonable care.

Question 68

H.S. care is care that is given... 1. before meals. 2. before bedtime. 3. after meals. 4. upon awakening.

Answer 68

Answer: B ## Footnote H.S. is the medical abbreviation for hours of sleep. Choice 1 is incorrect; the medical abbreviation for before meals is a.c. Choice 3 is incorrect; the medical abbreviation for after meals is p.c. Choice 4 is incorrect; while not commonly used, o.m. means on morning.

Question 69

The best foods for a geriatric client with no teeth would include... 1. hamburger, french fries, corn, and ice cream. 2. baked chicken, dressing, green beans, and coconut macaroons. 3. spare ribs, macaroni and cheese, coleslaw, and fruit cocktail. 4. baked fish, whipped potatoes, spinach souffle, and tapioca.

Answer 69

Answer: 4 ## Footnote Of the choices listed, only choice 4 contains a soft diet. Choices 1, 2, and 3 all contain foods difficult to eat without teeth.

Question 70

A client's family wants to talk about the client's impending death, but the client does not want to talk about it. The family should be encouraged to... 1. carry on the conversation away from the client. 2. talk freely in front of the client in order to help the client to accept it. 3. wait until the client dies to talk about it. 4. force the client to talk about it with them.

Answer 70

Answer: 1 ## Footnote If the client does not want to talk about death, the family should be allowed to talk privately, away from the client. Choices 2 and 4 are incorrect because the client's wishes should be respected and clients should not be forced to talk about something they do not want to talk about. Choice 3 is incorrect; the family should be able to verbalize their feelings now and not have to wait.

Question 71

When should postmortem care be performed? 1. after the family views the body 2. immediatley after the doctor pronounces the patient dead 3. when rigor mortis sets in 4. after the body goes into the morgue

Answer 71

Answer: 2 ## Footnote Postmortem care needs to be done before rigor mortis sets in so that the patient's appearance can be maintained. Once rigor mortis sets in, the body will be difficult to position. Postmortem care should occur before the family comes to view the body to remove any bodily fluids and treatment remnants. In some facilities, the funeral director completes postmortem care; however it is initiated on the medical unit.

Question 72

A walker may be used if the client can... 1. support some weight. 2. use her hands wells. 3. balance without help. 4. walk independently.

Answer 72

Answer: 1 ## Footnote A resident must be able to support some weight before using a walker. Hand strength alone is not adequate for walker usage, and though balance is important, the patient must first be able to support some weight. If the person can walk independently, she does not need a walker.

Question 73

A cane should be used on... 1. the affected (weak) side of the body. 2. the unaffected (strong) side of the body. 3. the side with the strongest arm. 4. the weak side one day, and the strong side the next day.

Answer 73

Answer: 2 ## Footnote If the cane is not used on the strong side, the resident may fall. Switching sides will not strengthen the weak side, and the client may fall when the cane is used on the weak side. Choice 3 is incorrect because though arm strength is important, it is not as important as leg strength.

Question 74

A nurse aide is collecting linens for a bed change and drops a sheet on the floor. What should the nurse aide do? 1. Ignore it and leave it on the floor. 2. Place it pack on the linen cart. 3. Discard it in the soiled linen hamper. 4. Use it anyway.

Answer 74

Answer: 3 ## Footnote To prevent contamination and spread of microorganisms, the sheet should be put in the soiled linen hamper. Linens acts a fomites, and this linen has been contaminated and cannot be used until it is washed. Leaving bed linens on the floor creates a fall hazard.

Question 75

When applying a cold treatment to a patient, it is important to observe the patient closely for signs of... 1. redness. 2. dizziness. 3. fainting. 4. cyanosis.

Answer 75

Answer: 4 ## Footnote Cyanosis is an indication of poor circulation, which could lead to tissue death. The nurse aide should stop the treatment and report it to the charge nurse. Redness would be an issue with hot treatment, not with cold treatment. Cold packs should not result in dizziness or fainting.

Question 76

The purpose of correctly positioning the client is to... 1. prevent skin breakdown. 2. maintain function of joints and muscles. 3. increase comfort. 4. all of the above.

Answer 76

Answer: 4 ## Footnote Correctly positioning a patient should prevent skin break- down, increase comfort, and maintain the function of the joints and muscles.

Question 77

A surgical bed should be left in what position? 1. Fowler's position 2. lowest horizontal position 3. semi-Fowler's position 4. level with the stretcher

Answer 77

Answer: 4 ## Footnote The bed should be level with the stretcher. This makes the transfer safe. Choice 1 is incorrect; in Fowler's position, the head of the bed is raised between 45 and 60 degrees, making transfer from the stretcher difficult and unsafe. Choice 2 is incorrect; the lowest position will not be level with the stretcher, making transfer unsafe. Choice 3 is incorrect; in semi-Fowler's position, the head of the bed is raised between 30 and 45 degrees, making transfer from the stretcher difficult and unsafe.

Question 78

The preferred way to remove a bedpan from a client who is unable to lift her buttocks is to... 1. use a mechanical lifting device. 2. have another nursing assistant lift the client. 3. turn the client to the side while holding the pan. 4. slowly slide the pan from under the client.

Answer 78

Answer: 3 ## Footnote Turning the resident is the easiest method, it is important to hold the pan to prevent spilling the contents. Choice 1 is incorrect; mechanical lifts are used for people who are very heavy or who are unable to assist in transfer. Choice 2 is incorrect; having another aide assist in lifting the patient is a possible way, but not the preferred way since that help may not be available when needed and you do not want the client to sit on the bedpan any longer when necessary. Choice 4 is incorrect; slowly siding the pan from under the client risks the possibility of spilling the contents onto the bed.

Question 79

After shaving a patient with a safety razor, the nurse aide should... 1. cover it before discarding. 2. wrap in a paper towel and drop it into the trash can. 3. dispose of it in a sharps container. 4. place it in the patient's drawer for reuse.

Answer 79

Answer: 3 ## Footnote Sharps containers are puncture resistant. They are used to prevent contact with bloodborne pathogens. Sharps should never be tossed into the trash. They may cause injury, and there is concern of serious infection. Safety razors are for one-time use.

Question 80

When a client complains that his dentures are hurting, the appropriate action is to... 1. encourage him to wear the dentures more often. 2. report the complaint to the charge nurse. 3. report the complaint to the physician. 4. put the dentures on the bedside table.

Answer 80

Answer: 2 ## Footnote Always bring such complaints to the charge nurse. Choice 1 is incorrect; poorly fitting dentures are painful and can cause injury to the mouth. Choice 3 is incorrect; the nurse aide reports directly to the nurse; not the physician. Choice 4 is incorrect; dentures are kept safely in a denture cup, labled with the client's name. Leaving them on the table risks both contamination and damage.

Question 81

A nurse aide notices that a water pitcher has spilled onto the floor. The best action for the aide to perform is to... 1. wipe it up immediately. 2. cover it up with a towel 3. notify the charge nurse. 4. contact housekeeping.

Answer 81

Answer: 1 ## Footnote Take care of spills immediately, or a patient may be injured while waiting for housekeeping. It is not necessary to notify the charge nurse for this, and leaving the spill to find the charge nurse or housekeeping increases the chance of someone falling on it. Covering it with a towel could create a fall hazard.

Question 82

Upon entering a room, the nurse aide notices that a patient is not breathing. The aide's first action is to... 1. call for help. 2. lay the patient down on his back. 3. give four quick breaths. 4. give ten abdominal thrusts.

Answer 82

Answer: 1 ## Footnote Call for help to activate the facility's emergency medical services. Early activation increases the client's chances for survival. Choice 2 is a correct action, but not the first action. Choices 3 and 4 are incorrect; check the airway before giving rescue breaths and do not start thrusts until you verify the person's airway is obstructed.

Question 83

A patient is on bed rest, wearing anti-embolitic stockings. How often should the stockings be removed? 1. never 2. q2h 3. at least twice a day 4. q6h

Answer 83

Answer: 3 ## Footnote To allow normal blood flow to the lower extremities, the stockings should be removed twice a day. Anti-embolism stockings are removed every 8 to 12 hours to allow for adequate circulation. They prevent blood from pooling in the lower extremeties, and therefore should not be removed too often.

Question 84

Pressure ulcers (decubitus ulcers) can be prevented by... 1. changing the client's position every two hours. 2. placing a gel or foam pad on top of the mattress. 3. increasing the client's consumption of vitamin C. 4. both a and b.

Answer 84

Answer: 4 ## Footnote Chaning positions frequently and using a gel or foam pad are both key. There is no data to suggest that vitamin C prevents pressure ulcers.

Question 85

The first step in getting a client up to walk is to... 1. sit the client on the side of the bed. 2. put the client's slippers on. 3. check the activity order. 4. tell the client that he will be getting up.

Answer 85

Answer: 3 Always make sure the resident is allowed to get up first. The nurse does sit the client on the side of the bed before standing, put the client's slippers on before standing, and tell the client that he will be getting up, but not before checking the activity order.

Question 86

A client's vital signs are as follows: 118/80-98.8-80-30. Which finding should be reported at once? 1. blood pressure 2. temperature 3. pulse 4. respiration

Answer 86

Answer: 4 The respiratory rate of the client is elevated. The blood pressure, temperature, and pulse are within normal limits.

Question 87

All of the following can cause an inaccurate oral temperature reading EXCEPT... 1. drinking a cup of tea ten minutes before the reading. 2. using an electronic thermometer. 3. failing to shake down a glass thermometer. 4. vigorous exercise prior to the reading.

Answer 87

Answer: 2 Electronic thermometers are commonly used for assessing temperature. Drinking hot liquids, failing to shake down a glass thermometer, and exercising vigoroysly prior to an oral temperature reading cause an inaccurate reading.

Question 88

Diastolic blood pressure is determined by... 1. listening for the first clear sound. 2. listening for the last clear sound. 3. substracting the lower number from the top. 4. adding the top and bottom numbers.

Answer 88

Answer: 2 The diastolic blood pressure occurs when the heart muscle relaxes. It is the bottom number of the reading and is the last sound heard before silence. The systolic blood pressure occurs when the heart muscle contracts, and the difference between the systolic and diastolic pressure is the pulse pressure. There is no reason to add the systolic and diastolic pressures.

Question 89

All of the following are correct when measuring blood pressure, EXCEPT... 1. do not assess blood pressure in an arm with an IV running. 2. do not take the blood pressure in the same arm as where a person had a mastectomy. 3. use the biggest cuff possible to get an accurate reading. 4. make sure the room is quiet so you can hear before taking blood pressures.

Answer 89

Answer: 3 Always use a cuff that fits. If the cuff is too large, you will get a reading that is too low. Choice 1 is incorrect; inflating the cuff may cause pain at the IV site and may cause the IV catheter to dislodge. Choice 2 is incorrect; some people who have mastectomies also have axillary (armpit) lymph nodes removed, which disrupts fluid flow in the arm and can lead to inaccurate blood pressure reading. Choice 4 is incorrect; blood pressure may be difficult to hear, and thus the room should be quiet.

Question 90

The first step in performing any procedure is to... 1. explain the procedure. 2. gather the equipment. 3. perform proper handwashing. 4. provide privacy.

Answer 90

Answer: 3 Infection control (handwashing) is always the first step in a procedure. Explaining the procedure is important and assuring privacy is important, but you should wash your hands before approaching the client. Wash your hands before touching equipment to avoid contamination.

Question 91

Which of the following best destroys all bacteria? 1. soaking in alcohol 2. washing with bleach 3. sterilizing 4. scrubbing in hot water

Answer 91

Answer: 3 Sterilization is the most thorough method of destroying bacteria. Antiseptics, such as alcohol, are used to prevent pathogens from spreading and may kill them. Disinfectants, such as bleach, can kill bacteria, but are too stand to use on the skin. Sanitation, including scrubbing in hot water, removes pathogens to prevent them from spreading.

Question 92

In the event of a fire in a client's room, the nurse aide should first... 1. notify the charge nurse. 2. turn on a fire alarm. 3. get the client to a safe place. 4. use a fire extinguisher.

Answer 92

Answer: 3 Always get the client to safety first. Do not use time to notify the nurse. Turn on the alarm after getting the client to safety. You can use the fire extinguisher in the event of a small fire, but do so after getting the client to safety.

Question 93

Safe use of oxygen therapy includes... 1. always setting the flow meter at 2-3 liters per minute. 2. using wool blankets only. 3. cleansing the nasal prongs each shift with alcohol. 4. posting a "no smoking" sign on the door.

Answer 93

Answer: 4 Smoking in bed brings all three elements of a fire together: linens for fuel, heat from the cigarette, and oxygen from the air. Choice 1 is incorrect, because the flow is determined by the physician. Choice 2 is incorrect, because wool can cause sparks. Choice 3 is incorrect, because alcohol causes drying.

Question 94

During CPR, the client should be lying... 1. flat on a hard surface. 2. with head and shoulders elevated. 3. with feet raised on a pillow. 4. flat on the bed to prevent injuries.

Answer 94

Answer: 1 The client should be lying flat on a hard surface to assure adequate compression and blood flow. The head and shoulders should be level with the rest of the body, and the feet should be level with the rest of the body. A bed mattress is too soft for effective chest compressions.

Question 95

A procedure manual is a... 1. written set of instructions on how to perform procedures. 2. set of directions needed to complete a nurse aide's job description. 3. book of directions for administering medications. 4. book listing the procedures a nurse aide has been assigned to do.

Answer 95

Answer: 1 A procedure manual is a written set of instructions on how to perform procedures. A job description contains the general tasks, or function, and responsibilities of that position. The procedure of administering medications would probably be found in the procedure manual, but the procedure manual would contain other procedures. The nurse aide assignments will most likely be created by the charge nurse.

Question 96

If a client cannot speak English, the nures aide should... 1. have the family interpret. 2. ask the charge nurse to arrange for an interpreter. 3. call the doctor to talk to the client. 4. tell the client that she cannot answer the question.

Answer 96

Answer: 2 It is mandatory to provide a certified interpreter to clients not fluent in English. Choice 1 is incorrect; using a family member to interpret sacrifices confidentiality. Choice 3 is incorrect; this is not appropriate for either translation or the nurse aide role. Choice 4 is incorrect; clients have a right to have their questions answered as quickly as possible.

Question 97

The accepted way to identify a client is to... 1. check the bed name and number. 2. check the identification band. 3. ask the client's name. 4. call the client by name.

Answer 97

Answer: 2 An identification band is the only definitive way to identify the patient. A confused patient may answer to any name or may not know his name. A confused client may also be in the wrong bed.

Question 98

Which of the following best describes nail care? 1. Nail care is not needed for the elderly. 2. Use scissors for all nail care. 3. All clients need nail care. 4. Check with the charge nurse for nail care instructions.

Answer 98

Answer: 3 All residents need nail care, and nail care is part of the nurse aide role. The nursing assistant should be able to obtain information needed from the care plan. Nails are cut with nail clippers.

Question 99

When performing perineal care on a male client, always... 1. clean the scrotum first. 2. retract the foreskin if uncircumcised. 3. clean from front to back. 4. hold the penis at a 90-degree angle.

Answer 99

Answer: 2 Material may build up under the foreskin in uncircumcised males unless the foreskin is retracted for cleaning. Choices 1, c, and d are incorrect. You should wash the penis before the scrotum, move from the tip of the penis to the base, and hold the penis slightly away from the body.

Question 100

Back rubs aid in all of the following EXCEPT... 1. improving posture. 2. improving circulation. 3. increasing one-to-one interaction. 4. relaxing the client.

Answer 100

Answer: 1 Back rubs are not used to improve posture. They improve circulation, give the nurse aide some time to talk to the client, and help to relax the client.

Question 101

A client's elbows are dry and red. The nurse aide should... 1. report this to the charge nurse. 2. apply lotion to the elbows. 3. appy elbow protectors. 4. perform range of motion exercises.

Answer 101

Answer: 1 Report this to the charge nurse, since there are many reasons for redness. The redness and dryness may not be due to dry skin or friction rubbing. Range of motion may cause additional problems, depending on the cause of redness and dryness.

Question 102

A decubitus ulcer can be caused by all of the following EXCEPT... 1. poor nutrition. 2. pressure on the skin. 3. poor circulation. 4. cotton clothing.

Answer 102

Answer: 4 Poor circulation, poor nutrition, and pressure on the skin all can cause decibitus ulcer. Poor circulation is a risk factor for pressure ulcers because the skin is deprived of nutrients and oxygen. Poor nutrition is a risk factor for pressure ulcers. Pressure deprives the skin of blood flow and thus nutrients and oxygen, causing cells to die.

Question 103

The nursing assistant shampoos a client's hair to improve all of the following EXCEPT... 1. circulation to the client's scalp. 2. the client's general appearance. 3. the client's sense of well-being. 4. the rate of the client's hair growth.

Answer 103

Answer: 4 Shampooing can improve circulation to the client's scalp, the client's appearance, and the client's sense of well-being, but not hair growth rate.

Question 104

When removing a soiled gown from a client who has an IV, the best action is to... 1. remove the opposite arm from the gown first. 2. have the nurse remove the IV needle. 3. disconnect the bag and tubing. 4. slip the gown over the IV solution bag.

Answer 104

Answer: 1 Remove the sleeve from the arm without tubing first. The IV catheter is not removed for clothing changes, and the IV is not disconnected by the nurse aide.

Question 105

If a client does not eat all the food on his tray, the first thing an aide should do is... 1. notify the charge nurse. 2. ask the client why he has not finished. 3. remove the tray. 4. urge the client to eat all of the food.

Answer 105

Answer: 2 The patient may not be eating due to personal dislike of the food. Asking first allows the nurse aide to request a replacement if the problem is simple. Notifying the charge nurse is not the first thing the nurse aide should do. You should remove the tray after trying to find out why the client will not eat. The client may simply need more seasoning. Do not force clients to eat.

Question 106

The client states that a mistake was made: There is salt on her tray, although the doctor has ordered a low-salt diet. The nurse aide shoud... 1. explain this means no salt when preparing food. 2. tell the client not to use the salt. 3. check the diet order with the charge nurse. 4. call the kitchen for a new tray.

Answer 106

Answer: 3 Any diet question must be answered before the resident eats. The nurse aide should not conduct dietary teaching, and should always check the diet order with the nurse first.

Question 107

Which of the following provides identification of clients in long-term care facilities? 1. identification bracelet 2. photograph 3. identification bracelet and photograph 4. calling clients by name

Answer 107

Answer: 3 Both identification bracelets and photographys are used for identification purposes in long-term facilities. Confused clients may not know their own names.

Question 108

Before transferring a client from the bed to a wheelchair, the nurse aide should sit her on the edge of the bed for a few minutes to... 1. rearrange her gown or clothing. 2. prevent orthostatic hypotension. 3. position and secure the wheelchair. 4. rest and remove the transfer belt.

Answer 108

Answer: 2 *Orthostatic hypotension* is the light-headed feeling we all get when we rise too quickly. The gown or clothing is rearranged once the client is in the wheelchair, and the wheelchair should be positioned and secured before moving the client. The transfer belt is not removed before moving the client.

Question 109

The client's religion forbids eating meat. Beef stew is being served for lunch. The nurse aide should... 1. tell the client to eat it because she needs protein. 2. tell the client it is all right since her doctor ordered the diet. 3. ask the nurse to call the kitchen. 4. tell the client that religious restrictions are not as important as her health.

Answer 109

Answer: 3 The other answers doe not address the resident's right to practice religion or her right to choice. Religious restrictions are to be respected by healthcare providers.

Question 110

It is important to remember that dying patients... 1. have the same needs for care as other patients. 2. need to be by themselves in a quiet room. 3. do not need to be consulted regarding their care. 4. are usually in pain.

Answer 110

Answer: 1 Not all dying patients have the same problems, but they have all the same care needs as anyone else. Choice 2 is incorrect; many dying patients want companionship in their final hours. Choice 3 is incorrect; dying patients should be consulted regarding their care needs. Choice 4 is incorrect; not all dying patients are in pain.

Question 111

Dying patients and their families... 1. always pass through the five stages of dyng in order. 2. always accept death before it occurs. 3. may go back and forth among the five stages. 4. must go through all stages of dying before they die.

Answer 111

Answer: 3 Because each dying resident has unique emotional needs, each person will go through the stages at different times and in a different order. We now know that people experience loss differently and that they may not experience all the stages, nor may they experience them in order. Many people do not accept death before it occurs.

Question 112

Which of the following is an early sign of dementia in an elderly client? 1. refusing to eat a meal 2. not knowing who she is 3. fequent urination 4. complaining of headaches

Answer 112

Answer: 2 Memory loss is a sign of dementia. Refusal to eat is not a sign of dementia, but difficulty cooking a meal is an ealy sign. Headaches and frequent urination are not signs of dementia.

Question 113

Clients with Alzheimer's disease may have all of the following characterisitics EXCEPT... 1. physical wasting away. 2. memory loss. 3. wandering. 4. irritability.

Answer 113

Answer: 1 Clients with Alzheimer's disease should not have signs of physical wasting away, unless they have not been cared for. This may be a sign of neglect. Memory loss, wandering, and irrability are characteristics of Alzheimer's disease.

Question 114

When a client turns on the call light every few minutes, the appropriate response is to... 1. ask the client not to call so often. 2. stop by the room more often. 3. place the call light out of reach. 4. tell the client how busy the staff is.

Answer 114

Answer: 2 Patients who use their call bell frequently are usually afraid they will be ignored if they don't often call. Stopping in frequently reassures them. The client should always have access to the call bell. Asking the client to no call so often is inappropriate, and telling the client the staff is busy can increase her fear that her needs will not be met.

Question 115

The doctor writes an order for "do not resuscitate" (DNR). What does this mean? 1. Put the client on a machine if she stops breathing. 2. The client needs to be kept alive. 3. CPR will not be performed. 4. Start CPR immediately if the client stops breathing.

Answer 115

Answer: 3 "Do not resuscitate" means that no attempts will be made to resusciate the patient. Ventilators will not be used if there is a DNR order and the patient will not be kept alive artificially. CPR should not be initiated.

Question 116

How a client reacts to illness and disability is most dependent on his... 1. age and stage of life. 2. spouse's support. 3. income and level of education. 4. support system and life history.

Answer 116

Answer: 4 A person's total environment always affects everything that person does and thinks. Age and stage of life do affect a client's reactions, but they are not the most critical factors. A patient's overall support system plays a stronger role than just the spouse's support. Income and level of education do affect a client's reactions, but they are not the most critical factors.

Question 117

A client with dementia makes sexual advances towards another client who has dementia. The nurse aide should... 1. allow it; OBRA'87 states that all clients must be allowed to fulfill sexual needs. 2. ask them to keep their sexual activity in a private place. 3. ignore it so as not to embarrass them. 4. tell the charge nurse, since a client with dementia is unable to give consent.

Answer 117

Answer: 4 Clients with demential are not able to give consent; therefore, the nurse aide has a responsibility to protect clients from sexual advances. Choice 1 is incorrect; while OBRA'87 does state that clients must be allowed to fulfill their sexual needs, clients with dementia cannot legally consent to sexual activity. Choices 2 and 3 are incorrect; this is inappropriate sexual activity because clients with dementia cannot legally consent to sexual activity.

Question 118

A client hits a nurse aide during lunch. The appropriate response is to... 1. call the charge nurse for help. 2. continue to feed her. 3. apply a restraint. 4. yell at her to stop hitting.

Answer 118

Answer: 1 Obtaining assistance is the only correct way to deal with abuse by a resident. This is abusive behavior, and it should not be ignored. Choice 3 is incorrect, because restraints require physicians's orders. Choice 4 is incorrect; yelling at patients is also abusive.

Question 119

A resident is confined to her bed. What might keep her from getting pressure sores? 1. a plastic draw sheet 2. a foot board 3. body lotion 4. an air mattress

Answer 119

Answer: 4 An air mattress relieves pressure. Air pressure alteration reduces pressure against the body to prevent circulation impairment. Choice 1 is incorrect; a plastic dray sheet can irritate delicate skin by holding moisture against the skin. Choice 2 is incorrect; a foot board is helpful, but alone will not prevent pressure sores. Choice 3 is incorrect; lotion and massage are helpful, but will not prevent pressure sores alone.

Question 120

If the client is in traction, the nurse aide should never... 1. monitor affect skin temperature. 2. give a total bed bath. 3. change the position of the weights. 4. monitor distal pulses.

Answer 120

Answer: 3 Position of weights in traction is ordered by the physician. Therefore, the nursing assistant should never change the position of the weights without an order. The skin temperature should be monitored because coolness can indicate decreased circulation. Total bed baths are not contraindicated because of traction. Distal pulses should be monitored in clients with traction to check for adequate circulation.

Question 121

Security for a client's dentures includes... 1. keeping them in a tissue in a dresser drawer. 2. placing them in a labeled denture cup. 3. insisting the resident wear the dentures. 4. placing an identifying mark on the dentures.

Answer 121

Answer: 2 Every resident with dentures must have a labeled denture cup to ensure security of costly dentures. Residents should not be forced to wear their dentures, and markers and pens should not be used on dentures.

Question 122

If family members bring new clothes in for an ECF resident, the nurse aide should... 1. put them in the resident's dresser drawers. 2. label them with the resident's name. 3. ask the family to remove an equal number of old clothes. 4. make sure the charge nurse sees the clothes.

Answer 122

Answer: 2 All residents have the right to their own personal possessions. Labels allow the aide to better provide protection. Choice 1 is incorrect; the nurse aide should label the clothing before placing them in the resident's dresser. Choice 3 is incorrect; the resident is entitled to keep her personal possessions. Choice 4 is incorrect; the nurse aide can label and store clothing without consulting the nurse.

Question 123

The charge nurse intructs the nurse aide to clean an ECF resident's closet. The nurse aide should... 1. ask the family to do it. 2. get another nurse aide to do it. 3. enlist help from the client. 4. have the client do it.

Answer 123

Answer: 3 The client has a legal right to decide what to keep and what to throw away, but may need assistance in the cleaning process. The family is not required to clean the resident's closets, and the nurse aide should not pass off her responsibilties to another nurse aide. ECF clients are not usually well enough to clean their closets, nor should they be expected to clean them.

Question 124

Before dressing an ECF resident, the nurse aide should... 1. check the order. 2. choose the client's clothes. 3. close the door. 4. report to the charge nurse.

Answer 124

Answer: 3 A nurse aide should always close the door to promote privacy. Except for unusual circumstances, there are no orders for how a client should be dressed, and dressing does not require reporting to the charge nurse. The client has the right to choose her own clothing.

Question 125

Confidentiality refers to... 1. never sharing client information. 2. the client's right to privacy. 3. not documenting information in the client's chart. 4. the client's right to have insurance.

Answer 125

Answer: 2 Confidentially refers to the client's right to privacy. Choice 1 is incorrect; client information is shared with the rest of the healhcare team of the client's hospital or ECF unit. Choice 3 is incorrect; chart documentation is important to promote communication and to provide a lasing document of the client's hospitalization or ECF stay. Choice 3 is incorrect; clients do not have a right to insurance.

Question 126

During A.M. care, the nurse aide nicks a resident while shaving him. What should she do first? 1. Report it to the charge nurse. 2. Do nothing. 3. Appy pressure to stop the bleeding. 4. Place a bandage on it.

Answer 126

Answer: 3 The first step is to stop bleeding in order to ensure the patient's comfort. Choice 1 is incorrect; the nurse aide should report this to the charge nurse, but it is not the priority. Choice 2 is incorrect; doing nothing can cause excessive bleeding in clients who have bleeding tendencies, such as those who are taking anti-clotting medications, and may also lead to infection. Choice 4 is incorrect; bleeding should be stopped first.

Question 127

Maintaining good interpersonal relationships depends on... 1. agreeing with the crowd. 2. communicating clearly with others. 3. following orders without question. 4. avoiding contact after work hours.

Answer 127

Answer: 2 Clear communication is critical to good interpersonal relationships, while contact avoidance can damage them, One can disagree and still maintain good interpersonal relationships. Following orders without questioning can lead to resentment and doing things improperly if the orders are not correct.

Question 128

If a nursing assistant does not know how to complete an assignment, he should... 1. ask another nursing assistant. 2. ask the client for his preference. 3. contact the charge nurse for help. 4. utilize a policy manual.

Answer 128

Answer: 3 Asking for help from a supervisor is a critical component to career growth. Choice 1 is incorrect; the other nursing assistant may also not know how to complete the assignment. Choice 2 is incorrect; nurse aides should not ask clients for assistance with understanding assignments. Choice 4 is incorrect; policy manuals contain policies, not assignment procedures.

Question 129

Reporting what the client tells you is an example of... 1. subjective observation. 2. objective observation. 3. primary observation. 4. secondary observation.

Answer 129

Answer: 1 Subjective observation comes from what the client tells you. Objective observation comes from what you see, hear, feel, or smell. Primary observation relates to what should be considered first. Secondary observation relates to what is considered after primary observation.

Question 130

Incontinence means that the patient is... 1. unable to make decisions. 2. unable to speak. 3. experiencing a disorder that comes with aging. 4. in need of medical attention.

Answer 130

Answer: 4 Incontinence is generally due to a medical problem. It is important to adhere to a bowel/bladder training program. *Aboulia* is the term for the inability to make decisions. *Aphasic* is the term for the inability to speak. *Gero* and *geri* are used in terms that relate to aging.

Question 131

Failure to raise the side rails on the bed of a confused client is an act of... 1. malpractice. 2. negligence. 3. overt commission. 4. breaking a criminal law.

Answer 131

Answer: B Negligence is an unintentional act of injury. It is breech of civil law, not criminal law. Malpractice is negligent treatment of a patient by a professional. Overt commission means openly acting on something, such as deliberately injuring a patient.

Question 132

During a job interview, it is important to tell the interviewer about... 1. qualifications. 2. childcare needs. 3. scheduling problems. 4. salary expectations.

Answer 132

Answer: 1 You need to sell yourself during the interview. Ask about benefits and your personal needs after you get the job. Do not discuss scheduling problems until after you have been offered the position, and do not discuss salary expectations until after you have been offered the position or at least until the interviewer has discussed it with you.

Question 133

When a nurse aide cannot work due to illness, the nurse aide should... 1. arrange for someone to cover his or her shift. 2. contact the supervisor as soon as possible. 3. call the charge nurse one hour before the shift begins. 4. wait until the charge nurse calls to find out where the aide is.

Answer 133

Answer: B Contact a supervisor as soon as possible, so that a replacement can be found in a timely manner. Choice 1 is incorrect; the nurse aide is not responsible to cover his or her shift. Choice 3 is incorrect; calling one hour before the shift begins decreases the change that someone else can be found to cover it. Choice 4 is incorrect; waiting for the charge nurse to call you is not responsible behavior and may result in disciplinary action.

Question 134

What is the main goal of OBRA'87? 1. to provide a safe environment for residents of extended-care and hospice facilities. 2. to provide prompt payment of care costs of residents covered by Medicare and Medicaid. 3. to make sure that healthcare providers meet the requirements nationwide by passing a competency and skill test to provide quality care. 4. to shorten the hospital stay of patients who can be attended at home by a nurse aide.

Answer 134

Answer: 3 All healthcare providers must be responsible for their actions. OBRA'87 does not cover hospice facilities, oversee payment of care costs, or act to shorten hospital stays.

Question 135

The client asks to see a priest. The nurse aide shoud... 1. ask the charge nurse to call a priest. 2. tell the client to see if a priest walks by his or her door. 3. call the doctor. 4. tell the client to call herself.

Answer 135

Answer: 1 It is the client's right to have clergy available as requested. The client should not have to rely on chance to see a clergy person, nor should she have to contact the clergy person herself. It is not the physician's duty to call the priest in this case.

Question 136

When caring for a client who has just been placed on NPO, the nurse aide should first... 1. encourage the client not to think about food or water. 2. encourage the client to eat and drink. 3. remove the water pitcher and all items of food and drink. 4. give the client meticulous mouth care.

Answer 136

Answer: 3 NPO means nothing by mouth, so removing all food and water will reduce temptations. Encouraging someone not to think about something typically results in her thinking about it. The client had just been placed on NPO and thus mouth care is not required at this time.

Question 137

If a nurse aide sees another employee hit a client, the nurse aide should... 1. tell the employee to stop. 2. keep an eye out to see if it happens again. 3. tell another nurse aide. 4. report it to the charge nurse immediately.

Answer 137

Answer: 4 Tell the charge nurse immediately when you suspect abuse. You are legally obligated to report it, and you want to do so as soon as possible to prevent further abuse. The nurse aide should not directly confront an abusive employee, nor should she wait to see if it will happen agian, as that can result in another client being injured. Answer 3 is also incorrect; another nurse aide cannot do anything to help, so you should tell the charge nurse.

Question 138

Which statement about mouth care for unconscious residents is correct? 1. Unconscious residents may be able to hear you speaking to them during mouth care. 2. Unconscious residents can both swallow and spit. 3. Unconscious residents do not need to be observed for mouth sores. 4. Unconscious residents have very moist gum tissue.

Answer 138

Answer: 1 The last sense to leave is hearing; speak with kindness and be aware of what you say. Unconscious residents cannot swallow and spit, which means mouth care must be carried out carefully to prevent aspiration. The mouth and lips of an unconscious patient can easily become dry and sore, thus they need frequent mouth care and observation for sores.

Question 139

A hearing-impaired client has the right to all of the following EXCEPT... 1. written notes. 2. an interpreter. 3. assistance with hearing aids. 4. purchase of the most expensive hearing aid.

Answer 139

Answer: 4 The client has the right to assistance with hearing aids, but there is no right that pertains to getting expensive options. A hearing imparied client may need written notes to understand procedures and directions or an interpreter, especially if the client uses sign language.

Question 140

When documenting a client's vital signs, the nurse aide makes a mistake. The nurse aide should... 1. cover the mistake with heavy black marker. 2. cover the mistake with correction fluid. 3. make a single live over it, write "error" and initial it. 4. ignore it.

Answer 140

Answer: 3 Charting errors are corrected by using a single black line through the error, marking it with the word "error," and initialing it. The client's chart is a legal document, and covering the error with a heavy black marker or correction fluid is unacceptable.

Question 141

Inactivity and immobility may cause all of the following EXCEPT... 1. pressure ulcers. 2. permanent contractures. 3. increased intestinal peristalsis. 4. secretions remaining in the lungs.

Answer 141

Answer: 3 Intestinal peristalsis decreases with inactivity and immobility. Pressure ulcers are the most common complication of immobility. Contractures occurs when a joint is left in the same position for a long time, and decreased fillings of the lungs from immobility allows fluid and mucous to build up in the lungs.

Question 142

The nurse aide know that the term "up ad lib" means the client... 1. is not permitted out of bed. 2. is independent with balanced periods of rest and activity. 3. is out of bed at mealtime only. 4. will need assistance for all activities of daily living.

Answer 142

Answer: 2 "Up ad lib" is an activity order suggesting the client can perform ADLs independently with periods of rest as needed. "Completel bed rest (CBR)" means that the client is not permitted out of bed. Clients allowed out of bed for mealtime only usually have an order that specifies this. "Ambulate with assistance" is the term usually used for clients who need assistance with activities.

Question 143

When lifting a patient, it is important to use good body mechanics. The nurse aide should... 1. keep the patient at arm's length. 2. bend at the knees. 3. twist at the waist. 4. move the patient rapidly.

Answer 143

Answer: 2 It is important to use the large muscles in the legs and thighs to prevent back injury. Keeping the patient at arm's length risks the patient falling and the nurse aide hurting his back, and twisting at the waist can cause back strain. Moving the patient rapidly can causes injury to both the patient and the nurse aide.

Question 144

A common sign of approaching death is... 1. increased appetite. 2. normal or elevated vital signs. 3. severe, unceasing pain. 4. decreased body functions.

Answer 144

Answer: 4 As circulation slows, body functions decrease. Appetite and vital signs decrease when death approaches. Not all dying patients are in severe, unceasing pain.

Question 145

Tuberculosis is a disease of the... 1. throat. 2. colon. 3. lungs. 4. kidneys.

Answer 145

Answer: 3 Tuberculosis most commonly affects the lungs. A person with tuberculosis in the lungs can spread it to others through droplets in respiratory secretions. Tuberculosis does not usually affect the throat or colon. While it may spread to the kidneys, it is primarily a lung disorder.

Question 146

The nursing assistant notes that a client's respiratory rate is zero. The nursing assistant should... 1. resume the client's normal care. 2. wait ten minutes and check the client's respirations again. 3. inform the client's family that the client is dead. 4. contact the charge nurse immediatley.

Answer 146

Answer: 4 Respiratory rate of zero may signal approaching death; contact the nurse immediately. Choice 1 is incorrect; a respiratory rate of zero means that the client is not breathing, and this should be reported immediately. Choice 2 is incorrect; the client will die if there is no immediate intervention- ten minutes is too long to wait. Choice 3 is incorrect; it is not the nurse aide's responsibility to notify the family when there is a death.

Question 147

After a client dies, the client's spouse wishes to share his emotions. The nurse aide should... 1. listen and try to provide comfort. 2. change the subject. 3. tell the spouse to contact a counselor. 4. send him to the charge nurse.

Answer 147

Answer: 1 Caring for the family is part of the job, and thus the nurse aide should comfort the spouse. Nurse aides do not need to call the charge nurse; they can use their therapeutic communication skills to communicate with family and relatives of dying clients. If the client wants to share his emotions, the nurse aide should be a good listener and not change the subject.

Question 148

An example of a special device to help prevent contractures is a(n): 1. handroll. 2. doppler. 3. air mattress. 4. manometer.

Answer 148

Answer: 1 A handroll is placed in the palm of the hand to prevent the hands and fingers from contracting into a flexed position. A doppler is a type of measuring device, such as an ultrasound or blood pressure device. An air mattress is used to prevent pressure ulcers. A manometer is an instrument used of measuring the pressure of gases and vapors.

Question 149

Falsely stating that a coworker took a client's money is an example of... 1. negligence. 2. assault. 3. defemation. 4. hoarding.

Answer 149

Answer: 3 *Defamation* is harming a person's reputation by words that you say (slander) or write (libel). *Negligence* is a failure to exercise reasonable care; it is an unintentional wrong. *Assault* is threatening a person or attempting to touch a person without their consent. *Hoarding* is the accumulation of food and other items.

Question 150

Hemiplegia refers to... 1. paralysis on one side of the body. 2. paralysis of both legs. 3. paralysis of both arms. 4. paralysis of all four extremities.

Answer 150

Answer: 1 *Hemiplegia* refers to paralysis of one side of the body. *Paraplegia* refers to paralysis of the legs or lower body. *Cruciate paralysis* is paralysis of an upper extremity. *Quadriplegia* refers to paralysis of all four extremities.

Question 151

The most accurate method of measure body temperature is... 1. rectal. 2. oral. 3. axial. 4. feeling the forehead.

Answer 151

Answer: 1 The rectal temperature method is considered the most accurate, as the thermometer is in direct contact with membranes. An oral temperature reading can be affected by many factors, including the client's drinking hot or cold fluids just before the readings. The axillary temperature can be affected if the patient just washer under her arms or applied deodorant. Feeling the forehead is an inaccurate way to measure temperature; however, there are temporal thermometers that are swept across the head to measure temperature.

Question 152

Which of the following sets of vital signs should be reported immediately? 1. T-98.6, P-60, R-14, BP-120/60 2. T-102.4, P-100, R-32, BP-180/100 3. T-99.6, P-80, R-16, BP-132/70 4. T-97.6, P-82, R-20, BP-110/60

Answer 152

Answer: 2 A temperature of 102.4^oF is elevated. The patient's pulse indicates tachycardia, which is a fast pulse, and the patient's blood pressure is high, indicating hypertension. Choice 1 is incorrect; these vital signs are within the normal limits. Choice 3 is incorrect; the temperature is at the high end of normal, as is the systolic blood pressure. These do need to be reported, but not immediately. Choice 4 is inccorect; these vital signs are within normal limits.

Question 153

A client consumed 180 cc of tea, 60 cc of soup, and 120 cc of ice cream. What is her total fluid intake? 1. 180 cc 2. 240 cc 3. 360 cc 4. 400 cc

Answer 153

Answer: 3 Ice cream is a fluid, so the client's total intake is 360 cc. Fluid intake is as follows: 180 cc (tea) plus 60 cc (soup) plus 120 cc (ice cream) equals 360 cc. Choices 1, 2, and 4 are incorrect because the numbers do not add up to 360 cc.

Question 154

A client is placed on a strict I&O after surgery. The nurse aide should... 1. keep the client NPO. 2. record the client's entire solid food intake. 3. record the client's fluid intake only. 4. record the client's fluid intake and urine output.

Answer 154

Answer: 4 I&O refers to fluid intake and urinary output, as well as other outputs, including drainage. Choice 1 is incorrect; the nurse aide cannot place a client on NPO without an order. Choice 2 is incorrect; soild food intake is not included in the I&O. Choice 3 is incorrect; this is only partially correct since fluids are output would be measured.

Question 155

Which of the following would be included in a client's output record? 1. urine, food, and IV solutions 2. urine, emesis, and bleeding 3. liquids taking in during the shift 4. bowel movements only

Answer 155

Answer: 2 Urine, emesis, and bleeding are all considered output. Choice 1 is incorrect; food eaten is not included in I&O and IV solutions are included in the intake. Choice 3 is incorrect; liquids are part of intake. Choice 4 is incorrect; bowel movements are included if liquid, but not the only inclusion in output.

Question 156

Which of the following is an intake-and-output problem that the nurse aide must report? 1. The client state the he is not hungry. 2. The client requests a bedpan. 3. The client has not voided in eight hours. 4. The client's eight-hour output is 600 cc.

Answer 156

Answer: 3 Failure to void (urinate) may indicate kidney failure. The normal adult urinary output is 1,500 cc per day, or approximately 500 cc per eight-hour shift. While a client's stating he is not hungry is important to note, this is not an I&O problem. A client's request for a bedpan is not typically reported.

Question 157

A client's water pitcher holds 500 cc. The pitcher is full at the beginning of the shift, and empty halfway through the shift. The nurse refills it, and the client drinks half of the pitcher by the end of the shift. The total water intake for this client at the end of the shift is... 1. 250 cc. 2. 500 cc. 3. 750 cc. 4. 1,000 cc.

Answer 157

Answer: 3 A full pitcher at 500 cc, plus a half pitch, plus a half pitcher at 250 cc equal 750 cc of water. 250 cc would be one half of the water pitcher. 500 cc would be a full water pitcher. 1,000 cc would be two full water pitchers.

Question 158

The nurse aide finds a damaged piece of equipment. The nurse aide should... 1. dispose of it immediately. 2. use it until new equipment arrives. 3. report it immediately. 4. repair it herself and then use it.

Answer 158

Answer: 3 Immediately reporting equipment damage can prevent an accident. It is not the nurse aide's role to repair equipment. Most equipment is costly and repairable, and thus should not be thrown away unless the nurse aide is told to so so. Using faulty equipment is hazardous and can result in injury.

Question 159

After caring for a confused client, the nurse aide fails to pull up the safety rails, and the client falls out of the bed and fractures a hip. This is called... 1. abuse. 2. negligence. 3. battery. 4. assault.

Answer 159

Answer: 2 *Negligence* is an unintentional wrong. *Abuse* is an intentional act that causes harm to another person. *Battery* is the infliction of injury. *Assault* is threatening a person or attempting to touch a person without his consent.

Question 160

A nursing assistant is giving foot care to a resident. What should he NOT do? 1. Remove corns. 2. Soak the resident's feet in warm water. 3. Check for skin breakdown. 4. Clean under the toenails using a orangewood stick.

Answer 160

Answer: 1 Only a podiatrist or a nurse can remove corns. Choice 2 is incorrect; soaking the feet may help to soften corns. Choice 3 is incorrect; the nurse aide should check the skin for signs of breakdown when performing foot care. Choice 4 is incorrect; an orangewood stick is used to clean underneath a person's toes.

Question 161

When restraints are in use, the nurse aide should report all of the following EXCEPT? 1. the type of device being used 2. the time the restraint was released 3. unusual observations about the client's skin 4. the aide's experience with restraints

Answer 161

Answer: 4 The aide's experience is not part of the client's record. There are different types of restraints, and thus the nurse aide should document the type used for the client. Restraints are removed every two hours to allow for repositioning, and can sometimes cause bruising and other complications. Both pieces of information should be recorded.

Question 162

The pulse located in the neck is called the... 1. apical pulse. 2. femoral pulse. 3. radial pulse. 4. carotid pulse.

Answer 162

Answer: 4 The *carotid pulse* is located in the neck. The *apical pulse* is located on the chest, over the apex of the heart. The *femoral pulse* is located in the groin area. The *radial pulse* is located on the inside of the wrist.

Question 163

A client complains of numbness on one side of the body. The client's grip is weak and speech is slurred. The nurse aide should... 1. call the doctor because the client had a CVA. 2. check the blood pressure to verify it is a CVA. 3. check the client later to see if it may be a CVA. 4. report it to the charge nurse immediately because it may be a CVA.

Answer 163

Answer: 4 These are all signs of a possible CVA (stroke), and the nurse aide should report this to the charge nurse immediately to prevent further damage to the client. Choice 1 is incorrect; the client may be having a CVA, but is not the nurse aide's role to call the physician. Choice 2 is incorrect; a CVA needs immediate medical attention, thus the nurse aide should not waste time taking the client's blood pressure. Choice 3 is incorrect; a CVA requires immediate attention, and thus the nurse aide needs to report these signs immediately.

Question 164

When providing perineal care to a female patient, it is important to wash from the front to the back to avoid spreading bacteria found in the resident's... 1. pancreas. 2. vulvus. 3. meatus. 4. rectum.

Answer 164

Answer: 4 Bacteria from the rectum can cause urinary tract infections. The pancreas is an internal organ located in the abdomen. Poper perineal care is used to prevent contaminating the vulvus or meatus with bacteria.

Question 165

The order "vital signs q.i.d." means to record vital signs... 1. four times a day. 2. twice per day. 3. morning and evening. 4. once per shift.

Answer 165

Answer: 1 Q.i.d. means four times a day. B.i.d. means twice a day. Q.a.m. and q.p.m. mean every morning and evening. Qshift means once per shift.

Question 166

The nurse aide notices that a client has an open red area on her coccyn that is draining. The nurse aide should... 1. wash the area with soap and water and apply alcohol. 2. ask another nursing assistant to look at it and give his opinion. 3. check it again at the same time the next day. 4. tell the charge nurse so she can check it.

Answer 166

Answer: 4 An opening in the skin prediposes the client to infection and must be checked by the nurse. The nurse aide should not touch the area before telling the nurse, and alcohol would cause pain on an open wound. The wound may get worse if the nurse aide waits another day.

Question 167

A nursing assistant is ambulating a client in the hallway. Suddenly, the client complains of chest pain and shortness of breath. The nurse aide should first... 1. walk the client to the client's bed immediately. 2. get the sphygmomanometer and take the client's blood pressures. 3. stay with the client and call for help. 4. help the client to the floor and go find a phone to call 911.

Answer 167

Answer: 3 Do not leave the client in an emergency. Chest pain and dizziness may signal a myocardial infarction (heart attack). Choice 1 is incorrect; the client may be having a heart attack (myocardial infarction) and should not continue to ambulate. The nurse aide should not leave the client, so all other choices are incorrect.

Question 168

A client finishes drinking a glass of cold water just as the nurse aide arrives to take the client's rectal temperature. The nurse aide should... 1. wait 15 minutes before taking the temperature. 2. give the client some warm water to counter the effect of the cold water. 3. report this to the charge nurse. 4. take the client's rectal temperature as planned.

Answer 168

Answer: 4 Take the client's rectal temperature as planned, because the cool water would affect the oral, not rectal reading. Choice 1 is incorrect, because waiting 15 minutes after a client drinks cold water is for oral temperatures. Choice 2 is not necessary, since the nurse aide is taking a rectal temperature. Choice 3 is incorrect; there is no need to report this to the charge nurse.

Question 169

Which of the following observations should be reported immediately? 1. T-98.2, P-88, R-20 2. yellow-colored urine 3. bluish tint to lips and skin 4. skin that is warm and dry to the touch

Answer 169

Answer: 3 Bluish discoloration (cyanosis) indicates low oxygen level in the body. The condition can be life threatening. T-98.2, P-88, R-20 are normal vital signs. Yellow is a normal color for urine. The skin should be warm and dry to the touch.

Question 170

Microorganisms can be spread by direct and indirect contact. An example of *indirect contact* is... 1. bathing the patient. 2. using contaminated blood. 3. touching objects or dirty instruments. 4. breathing dust particles in the air.

Answer 170

Answer: 3 Objects such as bed linens, dishes, and dirty instruments harbor microorganisms. Bathing a patient, using contaminated blood, and breathing dust particles are all examples of direct contact.

Question 171

Which statement about handwashing is correct? 1. The faucet is clean and may be touched when washing hands. 2. Wash at least two inches above the wrist. 3. Hands can be washed in any temperature of water. 4. Hand sanitizers are never substitutes for handwashing.

Answer 171

Answer: 2 Hands should be washed at least two inches above the wrist. Choice 1 is incorrect; the faucet is most likely contaminated by dirty hands. Choice 3 is incorrect; hands should be washed in warm water. Choice 4 is incorrect; according to the CDC, hand sanitizers can be used for routine hand decontamination.

Question 172

The nursing assistant finds a client lying on the floor. The nursing assistant should first... 1. run out of the room and get help. 2. help her up into a chair. 3. gently shake her and ask if she is okay. 4. call 911.

Answer 172

Answer: 3 Shaking and shouting helps determine if the client is conscious and oriented. Choice 1 is incorrect; the nurse aide should not leave the client. Choice 2 is incorrect; the client may be unconscious or not breathing. Choice 3 is incorrect; the nurse aide should first check the client, and then summon help. Calling 911 is not typical in an inpatient facility.

Question 173

Which statement about use of fire extinguishers is correct? 1. Any fire extinguisher can be used on any fire. 2. Each fire extinguisher should be used for the correct type of fire. 3. Nurse aides are not responsible for using fire extinguishers. 4. Fire extinguishers should not be used for small fires.

Answer 173

Answer: 2 Different extinguishers are used on various types of fires. Choice 1 is incorrect; fires are classified as A (fueled by ordinary material), B (fueled by a petroleum product), or C (an electrical fire), and only ABC fire extinguishers can be used for all three. Choice 3 is incorrect; nurse aides are responsible for using fire extinguishers correctly. Choice 4 is incorrect; fire extinguishers are used for fires of all sizes.

Question 174

A client begins to choke during feeding. The client is conscious but unable to speak or cough. The nurse aide should... 1. shake the client and ask if the client is okay. 2. call the physician. 3. administer abdominal thrusts. 4. sweep one finger in the client's mouth to check for obstruction.

Answer 174

Answer: 3 Abdominal thrusts can dislodge the obstruction. Choice 1 is incorrect; the nurse aide witnessed the client choke during feeding and noted the client is unable to speak; therefore, the nurse aide knows the client is not okay and cannot respond to her. Choice 2 is incorrect; it is not the nurse aide's role to call a physician. Choice 4 is incorrect; sweeping the mouth may push the oject further into the airway.

Question 175

The nurse aide should tell the licensed nurse of a patient with _________ does not finish the food on his tray. 1. stroke 2. cancer 3. diabetes 4. Alzheimer's disease

Answer 175

Answer: 3 A diabetic's blood sugar is contolled by diet and medication. Any food not eaten will affect the blood sugar level. Missing part of one meal should not create problems for the client in situations 1, 2, or 4. However, this should be reported at the end of the shift.

Question 176

Which of the following tasks is NOT within the job description of the nurse aide? 1. providing the resident with ROM 2. shaving the resident 3. applying a sterile dressing to an open wound 4. recording vital signs

Answer 176

Answer: 3 Only a licensed RN or LPN may perform sterile procedures. Nurse aides can perform range of motion exercises, as well as shave clients and record vital signs.

Question 177

Giving good oral care to a client includes all of the following except... 1. wearing gloves. 2. handling and storing dentures carefully. 3. using dental floss. 4. removing oxygen before brushing.

Answer 177

Answer: 4 Oxygen does not interfere with oral hygiene. Gloves should be worn when performing oral care; dentures should be handled and stored correctly; and dental floss should be used when appropriate.

Question 178

To prevent infection in a client with an indwelling catheter, the nurse aide should... 1. keep the drainage bag higher than the bladder. 2. do perineal care from front to back as needed. 3. let the tubing make a U loop below the bed. 4. do perineal care every other night.

Answer 178

Answer: 2 Always wipe from front to back to prevent rectal germs from entering the vagina or urinary tract. Keeping the drainage bag higher than the bladder can cause urine to back flow into the bladder, increasing the chance of infection. A U loop may also cause backflow to the bladder, increasing the risk for infection. Perineal care is performed at least daily.

Question 179

A client is on a clear fluid diet. The client's lunch tray may consist of... 1. tea, broth, and gelatin. 2. coffee, milk, and soup. 3. milk, soup, and ice cream. 4. coffee, broth, and crackers.

Answer 179

Answer: 1 Clear fluids are see-through. Milk, ice cream, coffee, and crackers are not clear fluids.

Question 180

Which statement about injuries to clients and staff members is correct? 1. Injuries should be treated and reported on incident report. 2. Injuries to staff can be ignored if they are minor. 3. Injuries should be reported only if they are major. 4. Injuries should be treated but do not need to be reported.

Answer 180

Answer: 1 Minor and major injuries must be documented. Injuries to staff should never be ignored and should always be treated and reported.

Question 181

Lying on a job application is an example of... 1. tort. 2. malpractice. 3. fraud. 4. negligence.

Answer 181

Answer: 3 *Fraud* denotes deception. A *tort* is a wrong that involves a breach of a civil duty. The Joint Commission defines *malpractice* as "improper or unethical conduct or unreasonable lack of skill by a holder of a professional or offical position." The Joint Commission define *negligence* as "failure to use such care as a reasonably prudent and careful person would use under similar circumstances."

Question 182

While shaving a client, the nurse aide accidently nicks the client. The nurse aide should... 1. put alcohol on the nick. 2. report it to the charge nurse. 3. report it to the physician. 4. ignore it, since it is just a nick.

Answer 182

Answer: 2 Report it to the charge nurse; a nick can become infected, and all injuries must be reported immediately. Alcohol may sting, and nurse aides cannot apply alcohol without an order. The nurse aide does not report to the physician.

Question 183

When witnessing another aide hitting an irritable client, the nurse aide should... 1. tell the aide to stop. 2. observe the aide for a few days. 3. report it to the charge nurse. 4. ignore it; the client is irritable.

Answer 183

Answer: 3 Abuse must be reported immediately. The nurse aide should not directly confront an abusive staff member, and waiting for a few days can risk the abuser injuring another client. Clients should never be hit, regardless of their behavior.

Question 184

When clients are in a healthcare institution, they can expect their treatment to conform to the... 1. Infection Control Manual. 2. Patient's Bill of Rights. 3. Policy and Procedure Manual. 4. Physician's Code of Ethics.

Answer 184

Answer: 2 The Patient's Bill of Rights is a written statement that includes the rights clients are entitled to when recieving healthcare. The Infection Control Manual and Policy and Procedure Manual do not address client treatment. The Physician Code of Ethics applies only to physicians.

Question 185

A conversation about a client in the hospital's elevator violates the... 1. client's right to privacy. 2. client's right to medical care. 3. client's right to review his records. 4. client's right to ask questions.

Answer 185

Answer: 1 Conversations regarding a client should never take place in a public area such as an elevator. This violates the client's rights to privacy. This situation does not violate the client's right to receive medical care, to review his records, or to ask questions.

Question 186

A client constantly makes sexual remarks to staff. When discussing this at a team meeting, the administration decides to instruct staff to call the client by name and tell the client,... 1. "You are making me blush." 2. "Your comments are not acceptable." 3. "You are quite a character." 4. "You should be ashamed of yourself."

Answer 186

Answer: 2 The staff must tell the client that the behavior is inappropriate. Choice 1 is incorrect; this comment may increase the negative behavior if the client is trying to get a reaction from staff. Choice 3 is incorrect; this comment condones the behavior. Choice 4 is incorrect; this comment belittles the client.

Question 187

Which of the five senses would best detect a rash? 1. sight 2. smell 3. touch 4. hearing

Answer 187

Answer: 1 Rashes are best detected by observation. Smell may be useful only if the rash is giving off an odor. Touch is only useful if the rash has a definite texture. Hearing is not useful in detecting a rash.

Question 188

The best way a nurse aide can clean an infant's eyes is with a(n)... 1. cotton swab lubricated with petroleum jelly. 2. moist cotton ball, wiping from the inner to the outer corner. 3. alcohol wipe, using circular motions. 4. hot towel, wiping from the outer to the inner corner.

Answer 188

Answer: 2 Infant's eyes are cleaned from inner to outer to prevent the spread of infection. A moist cotton ball is soft and will not injure the eye. Petroleum jelly is not a cleaning agent. Alcohol is not used to clean the eyes, and it can cause chemical damage to them. A hot towel can burn the delicate eyes, and wiping from outer to inner can increase the risk for infection.

Question 189

A client who is hard of hearing repeatedly turns her light on. When responding to this client's call light, the nurse aide should... 1. listen carefully to determine her needs. 2. talk loudly over the intercom so that she can hear. 3. train her to use the call light less often. 4. tell the charge nurse that the client is attention seeking.

Answer 189

Answer: 1 Listening builds trust, and continuous call bell ringing may have an underlying reason, such as loneliness. Choice 2 is incorrect; a hearing-impaired person may not be able to understand the nurse aide over the call bell system, thus the nurse aide should respond in person. Choice 3 is incorrect; a client must have a way to communicate with staff at all times. Choice 4 is incorrect; the nurse aide should listen to the client to determine the client's needs.

Question 190

Another employee asks the nurse aide what is wrong with a newly admitted client. What should the nurse aide do? 1. Tell the employee, since information can be shared with coworkers. 2. Discuss the situation with the charge nurse before talking to the other employee. 3. Wait until break time to discuss the client with the other employees. 4. Tell the other employees that aides are not allowed to talk about the clients.

Answer 190

Answer: 4 The Patient's Bill of Rights assures that client's confidential information is shared only when necessary for care. The nurse aide should not discuss the client at any time with another employee, unless it is directly related to client care. Information is only shared with the immediate healthcare team as needed. The nurse aide should understand client confidentiality.

Question 191

Most hospital stays are... 1. one week. 2. a few days. 3. two days. 4. as long as necessary.

Answer 191

Answer: 4 Many hospital stays vary based on the patient's specific diagnosis and procedures. There is no one average hospital stay; the average length depends on the diagnosis.

Question 192

When caring for a female client, how should the nurse aide address her? 1. "Ma'am" 2. "Miss" 3. by her first name 4. by her surname

Answer 192

Answer: 4 Clients should be addressed by their surnames (e.g. Mrs. Smith). This shows that the aide respects the client's dignity. "Ma'am" is a term used by military, not by hospital personnell, and "miss" may be viewed as condescending. Using a client's first name may be viewed as a sign of disrespect and should not be done unless requested by the client.

Question 193

A client is on a low-sodium diet. The nurse aide notes that the client received bacon the the breakfast tray. The nurse aide should... 1. remove the bacon from the tray. 2. instruct the client not to eat the bacon. 3. take the breakfast tray to the charge nurse. 4. take the breakfast tray back to the dietician.

Answer 193

Answer: 3 The client should not have the bacon. The charge nurse is responsible for contacting the dietician about the error. Choice 1 is incorrect; the client should not have the bacon, but there may be other inappropriate items on the tray. Choice 2 is incorrect; the client may eat it anyway. Choice 4 is incorrect; it is not the nurse aide's role to confer directly with the dietician.

Question 194

While providing personal care for a client, the nurse aide should... 1. uncover the client completely so that she can work quickly. 2. uncover only the area she is working on. 3. keep the client completely covered and work under the covers. 4. leave the curtain open at all times.

Answer 194

Answer: 2 Covering the areas of the body that the nurse aide is not working on will allow privacy and keep the body warm. Keeping the client uncovered deprives the client of her dignity, an also can cause discomfort from her being cold. Working under the covers makes care difficult and disallows the nurse aide to observe problems, such as skin redness. The curtain should remain closed, because the client has the right to privacy.

Question 195

When providing morning (A.M.) care for the client, the nurse aide should... 1. let the client do as much as he is able to do. 2. do everything for the client so it is done correctly. 3. care only for clients who are the same sex. 4. work as quickly as possible.

Answer 195

Answer: 1 Encouraging independence allows clients to feel self-worth by participating in their own care. Choice 2 is incorrect; the nurse aide should foster independence and allow the client to do as much as possible, even if not done correctly. Choice 3 is incorrect; in general, nurse aides cae for clients of both genders; however some cultures require that care be given by persons of the same gender. Choice 4 is incorrect; care should not be rushed.

Question 196

A client with left-sided weakness should be taught to... 1. put his right arm into his shirt first. 2. put his left arm into his shirt fisrt. 3. put both arms in the shirt at the same time. 4. wear a hospital gown to make dressing easier.

Answer 196

Answer: 2 The client should put the weak arm in the shirt first. Putting the strong arm in first will make it difficult to finish putting on the shirt. It will be too difficult for the client to put both arms into the shirt at the same time. Clients should be encouraged to wear their own clothing to enhance self-esteem and normality.

Question 197

It is important not to shake linens to prevent the spread of what type of microorganisms? 1. bacteria 2. fungi 3. rickettsiae 4. fomites

Answer 197

Answer: 4 Fomites are in or on some hospital equipment. Bacteria, fungi, and ricketsiae may be on fomites.

Question 198

If a client objects to certain foods for religious or cultural reasons, the nurse aide should... 1. tell him to consult with his doctor. 2. offer to get something different for him. 3. tell him he will have to speak to the dietician tomorrow. 4. tell him he will be given a tube feeling if he won't eat.

Answer 198

Answer: 2 Consideration of cultural or religious beliefs is important to all clients. It is not usually necessary to call the physician for cultural preferences. However, if it becomes necessary, this should be handled by the nurse. The client is entitled to have a preferred food right away. However, the nurse aide should inform the nurse of the cultural preference so that the nurse can contact the dietician regarding future meals. Telling a client he will get a tube feeding if he will not eat is abusive behavior and may constitue assault because it is a threat.

Question 199

A terminally ill resident refuses to bath and throws a water basin across the room. Which stage of dying does this behavior represent? 1. denial 2. anger 3. bargaining 4. acceptance

Answer 199

Answer: 2 The client is in the anger stage of dying, and the nurse aide should acknowledge the client's anger and allow him to talk about it. During denial, the resident will not believe that he is dying. During bargaining the resident hopes that he can somehow postpone death. During acceptance, the resident comes to terms with his mortality.

Question 200

A terminally ill resident begs, "Please just let me live long enought to see my granddaughter." Which stage of dying does this behavior represent? 1. denial 2. anger 3. bargaining 4. acceptance

Answer 200

Answer: 3 In bargaining, clients "want to make a deal" with someone who may be able to control their fate. The nurse should offer realistic support. During denial, the resident will not believe that he is dying. During anger, the client can be difficult and may act out his anger toward the staff. During acceptance, the resident comes to terms with his mortality.

Question 201

An important think the nurse aide can do for a dying client is to... 1. leave her alone to allow for privacy. 2. give physical and emotional support. 3. encourage her to believe that a miracle may occur. 4. force her to eat three meals a day to keep up her strength.

Answer 201

Answer: 2 Physical and emotional support are both vital to terminal clients. Choice 1 is incorrect; the dying client may not want to be alone. Choice 3 is incorrect; fasle hope is inappropriate. Choice 4 is incorrect; dying clients often lose their appetites and should not be forced to eat.

Question 202

What is most important to show the client in his new room? 1. the televison remote control 2. how to lower and raise the bed 3. the location of the call bell and how to use it 4. where to store personal belongings

Answer 202

Answer: 3 Providing a means to call a nurse is important to avoid injury and meet the client's needs. Choices 1, 2, and 4 are important, but not the most important things for the client to know.

Question 203

The older adult likes to feel positive about herself by sharing past achievements and experiences. The best way the nurse aide can encourage this is by... 1. pairing the older adult with another talkative resident. 2. encouraging frequent rest periods to save energy for socializing. 3. listerning to the older adult's past experiences. 4. telling the older adult that the aides are too busy to listen to her stories.

Answer 203

Answer: 3 Listening tells clients you are interested in what they have to say. Choice 1 is incorrect; this is helpful for socialization, but may not be the best way to promote positive feelings. Choice 2 is incorrect; this is helpful, but secondary. Choice 4 is incorrect; this in inappropriate, as nurse aides should listen to their clients.

Question 204

When caring for a client who is anxious, the nurse aide should do all of the following EXCEPT... 1. remain calm. 2. make the client stay still. 3. provide a quiet atmosphere. 4. use simple, easy to understand words.

Answer 204

Answer: 2 Forcing an anxious client to stay still may increase the client's anxiety level. You being calm will help the client to become calm, and a quiet environment assists in decreasing anxiety. Anxiety decreases cognition (thinking ability); therefore the nurse aide should speak in a calm, clear, easy-to-understand manner.

Question 205

A client asks the nurse aide if she could have a few minutes to pray before her bath. The best response by the nurse aide would be to... 1. tell her that her bath comes first. 2. allow her some private time to pray. 3. tell her to wait until clergy visits. 4. start bathing her.

Answer 205

Answer: 2 Respecting a client's spiritual needs is an important aspect of the client's care. A client's right to religious beliefs should be respected. Unless specifically requested, clients do not need clergy to pray. Choice 4 ignores both the client's religious beliefs and the client's right to be heard.

Question 206

During orientation to a new job, a nursing assistant realizes that the work shift ends at 3:30 P.M. and not 3:00 P.M. as previously thought. The nursing assistant's child needs to be picked up every day at 3:15 P.M. The nursing assistant should... 1. discuss this with the charge nurse as soon as possible. 2. ask another nursing assistant to cover after 3:00 P.M. 3. leave early, as no one is likely to notice. 4. come in 15 minutes earlier in the morning.

Answer 206

Answer: 1 Being honest and up front with your supervisor is the best approach. Choice 2 is incorrect; a nurse aide cannot ask another nurse aide to cover her work time. Choice 3 is incorrect; this is being dishonest and honesty is a critical quality for healthcare workers. Choice 4 is incorrect; the nurse aide cannot set own her hours; this requires making arrangements with the charge nurse or other appropriate personnel.

Question 207

The best definition of a certified nursing assistant is... 1. graduate nurse who is registered and licensed by the state to practice nursing. 2. licensed person who provides education about special diets. 3. person who transcribes the physician's orders for patient care. 4. person who is certified to give care under the direct supervision of a registered or licensed practical nurse.

Answer 207

Answer: 4 This is the only definition of a certified nursing assistant. The nursing assistant is always under the direct supervision of a licensed nurse. Choice 1 refers to a licensed nurse. Choice 2 refers to a licensed dietician. Choice 3 refers to a medical transcriber.

Question 208

When the nurse aide shows genuine interest and concern for the client, this is an example of... 1. honesty. 2. caring. 3. teamwork. 4. accuracy.

Answer 208

Answer: 2 Nursing is caring. It is an attitude of interest and concern. *Honesty* is being truthful in one's words and actions. *Teamwork* is the ability to work well with others as a team. *Accuracy* is one's ability to do things correctly.

Question 209

When giving a bed bath, the nurse aide should... 1. put the bed in the low position. 2. cover the resident with a bath blanket. 3. wash the perineal area from back to front. 4. place dirty towels and linens on the floor.

Answer 209

Answer: 2 Privacy and warmth are in accordance with the Patient's Bill of Rights. Choice 1 is incorrect; when giving a bed bath, the nurse aide should place the bed in a high position to avoid injuring her back through constant bending. Choice 3 is incorrect; the perineal area is washed from front to back. Choice 4 is incorrect; dirty towels and linens are placed in the appropriate receptacle.

Question 210

An indwelling catheter drains the bladder of... 1. feces. 2. emesis. 3. urine. 4. blood.

Answer 210

Answer: 3 A catheter inserted in the bladder drains urine from the body.

Question 211

The charge nurse asks the nurse aide to place a client in the Fowler's position after the client eats breakfast. How should the aide position the client? 1. lying with the head of the bed elevated at a 45- to 60-degree angle 2. lying on the side with the knee and thigh drawn upward toward the chest 3. lying flat on her side 4. lying fat on her abdomen

Question 212

How many stages of death were identified by Dr. Elizabeth Kubler-Ross? 1. four 2. five 3. eight 4. two

Question 213

A cane should be used on... 1. the affected side. 2. the unaffected side. 3. either side, depending on how the client feels. 4. the weak side one day and the strong side the next.

Question 214

All of the following factors contribute to lack of appetite EXCEPT... 1. decreased activity. 2. bad denures. 3. increased exercise. 4. decreased saliva.

Question 215

Atrophy is... 1. contracture. 2. orthotic. 3. muscle wasting. 4. a fracture.

Question 216

The nurse aide, a member of the healthcare team, can participate in many aspects of the nursing process, except for... 1. collecting data. 2. planning the care. 3. making observations. 4. carrying out selected interventions.

Question 217

When using crutches, the client's weight must rest on the... 1. armpit. 2. knees. 3. hand rests. 4. shoulders.

Question 218

How often should a client be repositioned if he cannot move himself? 1. every hour 2. every two hours 3. every three hours 4. every four hours

Question 219

A client who had a CVA is going through a self-care/grooming program. The main goal of this program is for the client to... 1. be discharged sooner. 2. gain independence. 3. learn to accept his disability. 4. improve his body image.

Question 220

The goal of bladder training is to... 1. gain voluntary control of urination. 2. stop using a catheter. 3. prevent skin problems caused by incontinence. 4. prevent urinary tract infections from indwelling catheters.

Question 221

A resident sometime chokes while eating. The nursing assistant should... 1. instruct his roommate to watch him eat. 2. feed him to prevent problems. 3. use the Heimlich manuever between bites. 4. observe him while he eats.

Question 222

If a client complains of a burning, tingling area on her skin, the aide should first... 1. rub the area well with lotion. 2. report the complaint to the licensed nurse. 3. keep an eye on the area for a few days. 4. use cornstarch on the area.

Question 223

When changing a pillowcase, a nurse aide should not hold the pillow under his chin because this would... 1. tear the pillowcase. 2. drop the pillowcase. 3. dampen the pillowcase. 4. spread bacteria.

Question 224

A nonsterile dressing is one that is... 1. wet. 2. dry. 3. clean. 4. new.

Question 225

When asked to clean a resident's eye, the nurse aide should... 1. clean it from the outer corner to the inner corner. 2. clean it with hydrogen peroxide. 3. use a clean surface of cloth each time he wipes. 4. clean the eye with exudates first.

Question 226

One nurse aide is assigned vital signs, while another is assigned bathing. This is an example of which type of nursing? 1. primary 2. patient-centered 3. team 4. modular

Question 227

Gloves must be worn when... 1. providing pericare. 2. making beds. 3. washing a resident's hair. 4. feeding a patient.

Question 228

While the nurse aide was caring for a client for four hours, the client asked to be taken to the bathroom every 15 minutes. The nurse aide's best action is... 1. leaving the client on a padded bedpan. 2. placing the client in bed with a waterproof underpad. 3. giving the client some time to rest. 4. discussing this with the charge nurse.

Question 229

An elderly resident becomes confused and begins to wander. The nurse aide should... 1. restrain her to prevent injuries. 2. orient her to time and place. 3. tell her family about the behavior. 4. report her behavior to the charge nurse.

Question 230

The Hoyer lift is used for all of the following purposes EXCEPT... 1. preventing injuries to healthcare workers. 2. supporting ambulatory clients. 3. moving clients who are heavy. 4. moving clients who are weak.

Question 231

When performing active range-of-motion exercises for a resident, the nurse aide should... 1. move the joints until the resident feels pain. 2. keep the body exposed to prevent overheating. 3. have the client do as much as she can. 4. minimize proper body mechanics.

Question 232

Using a broad base of support means... 1. keeping the feet comfortably apart. 2. keeping knees locked in place. 3. holding objects away from the body. 4. holding feet and hands as far from the body as possible.

Question 233

If a client is in traction, the nursing assistant should NOT... 1. give a complete bed bath. 2. monitor affected skin. 3. change the position of the weights. 4. monitor all possible distal pulses.

Question 235

Dangling a client's leg over the side of the bed is done to... 1. make sure she is able to sit up first. 2. give her time to put on her shoes. 3. prevent decubitus ulcers. 4. prevent orthostatic hypotension.

Question 236

Walking with a client is safest if done with a... 1. transfer belt. 2. wheelchair a few steps behind him. 3. Hoyer lift. 4. nurse or doctor ready for emergencies.

Question 237

When having a client sit up and dangle his legs before walking, the nurse aide should observe for all of the following EXCEPT... 1. cheerfulness. 2. sudden paleness. 3. excessive sweating. 4. increased respirations.

Question 238

When the nurse aide is transferring a client from the bed to the wheelchair, she should always... 1. unlock the brakes on the wheelchair. 2. lock the brakes on the wheelchair first. 3. use a Hoyer lift. 4. put socks on the client first.

Question 239

Before any transfer, the nurse aide should do all of the following EXCEPT... 1. have the nurse's approval. 2. know the proper procedure. 3. use a transfer belt if needed. 4. check with the client's physician.

Question 240

The pulse located in the wrist is called the... 1. carotid pulse. 2. apical pulse. 3. femoral pulse. 4. radial pulse.

Question 241

A patient is scheduled for an EKG/ECG. This stands for... 1. electroencephalogram. 2. electrocardiogram. 3. electroconvulsive therapy. 4. electromyogram.

Question 242

Which of the following sets of vitals should be reported immediately? 1. T-98.2, P-122, R-20, BP-84/40 2. T-99.0, P-72, R-16, BR-134/82 3. T-98.8, P-66, R-14, BP-100/62 4. T-98.6, P-90, R-18, BP-120/70

Question 243

A piece of linen that is placed beneath the client from shoulders to thighs is called... 1. an underpad. 2. a spread. 3. a drawsheet. 4. a sheet.

Question 244

Which bedmaking procedure is used when the client remains in bed? 1. occupied bedmaking procedure 2. unoccupied bedmaking procedure 3. circle bedmaking procedure 4. procedure using only fitted sheets

Question 245

Which complication may happen if a post-op client does not take in adequate fluids? 1. constipation 2. blood clots 3. infection 4. foot drop

Question 246

Which type of client is most likely to have problems as a result of poor nail care? 1. a cancer client 2. a diabetic client 3. a stroke client 4. a developmentally disabled client

Question 247

When performing mouth care for a client with right-sided weakness, the nurse aide should... 1. pay special attention to the left side of her mouth. 2. let her do as much of it as she can. 3. do the mouth care for her. 4. tell her to do it herself.

Question 248

A trochanter roll is used to... 1. keep the arm straight. 2. keep the patient on the side. 3. keep the hip in alignment. 4. keep the leg flexed.

Question 249

A resident with a paralyzed left arm may be able to feed herself if she uses a(n): 1. plate guard. 2. arm brace. 3. sling. 4. bib.

Question 250

Which statement about residents with developmental disabilities is generally correct? 1. They should be treated like children. 2. They cannot walk or talk. 3. They learn at a slower pace. 4. They are suspicious of new people.

Question 251

A diabetic client has had her leg ampulated. Her need for sexuality will... 1. be more important for a while. 2. be less important for a while. 3. disappear forever. 4. be unaffected.

Question 252

Client's with Alzheimer's disease may show which of the following symptoms? 1. high fever accompanied by chills 2. clear memory of the recent and distant past 3. chest pains and difficulty breathing 4. physical and mental decline

Question 253

If a client is upset and is yelling, the nurse aide should respond by... 1. saying sternly, "Quiet down!" 2. offering to call her doctor. 3. shutting her door for privacy. 4. calmly sitting down with the client and listening.

Question 254

A common sign of depression is... 1. attending activities daily. 2. laughing and smiling. 3. decreased appetite. 4. socializing with friends.

Question 255

A client who has just been told she is dying asks the nurse aide to help her make a list of things she wants to do before she dies. The nurse aide should... 1. tell her to wait for her family to help her. 2. tell her that the list is not necessary. 3. help her make the list. 4. tell her not to worry because she has plenty of time.

Question 256

To assist a client with his psychological needs, the nurse aide should... 1. be a good listener and show empathy. 2. assure the client that everything will be okay. 3. maintain the client's confidentiality. 4. encourage the client to talk to his roommate.

Question 257

A Catholic client refuses to eat meat on Fridays. Her luch one Friday consists of a roast beef sandwiche and a salad. The nurse aide should first... 1. tell the client to eat only the salad. 2. offer to get her a meatless lunch. 3. ask family members to bring in something else. 4. request that a priest come and speak with her.

Question 258

A nurse aide enters a room and finds a patient having sex with his wife. What should the nurse aide do? 1. Ask him to stop. 2. Step out of the room quietly and close the door. 3. Report it to the charge nurse. 4. Discuss it with another nurse aide.

Question 259

A young, permanently handicapped resident tends to be very quiet and act as if nothing matters. The nurse aide can best show respect for her by... 1. including her in the plan for care. 2. serving her dinner first. 3. calling her by her first name. 4. doing the client's care for her.

Question 260

An example of using body language while communicating is... 1. using gestures and facial expressions. 2. writing the message on paper. 3. sharing your feelings and concerns. 4. offering your advice and opinions.

Question 261

A nurse aide smiles and nods her head while sitting with a client. This type of nonverbal communication best demonstrates... 1. encouragement for the client to continue talking. 2. displeasure at having to listen to the client. 3. agreement with everything that the client says. 4. lack of available work for the nurse aide.

Question 262

Barriers to effective communication include... 1. reflection. 2. clarification. 3. assuming. 4. listening.

Question 263

A client's best friend asks the nurse aide what is wrong with the client. The nurse aide's best response is... 1. "I'm sorry, I'm not allowed to discuss him with you." 2. "You really should ask the charge nurse for that information." 3. "I'll tell you, but keep it confidential." 4. "I'm really not sure what is wrong with him."

Question 264

A client who is alert and oriented refuses his bath. The best response from the nurse aide is... 1. "You must take a bath every day, even if you don't want to." 2. "I doubt your roommate would appreciate the smell." 3. "Can you tell me why you don't feel like bathing today?" 4. "Is there something wrong with taking a bath?"

Question 265

An example of false imprisonment is... 1. using restraints without a doctor's order or the client's consent. 2. closing the door to the client's room. 3. treating the client differently because of his religious beliefs. 4. refusing to answer a call light that rings frequently.

Question 266

Another nurse aide is not providing adequate care for the residents. The nurse aide who notices this should... 1. keep a list of activities not performed. 2. tell the other staff members. 3. complete the inadequate care himself. 4. report this to the charge nurse immediately.

Question 267

A nurse aide notes a bright red rash on a client.This type of observation is termed... 1. subjective. 2. objective. 3. primary. 4. secondary.

Question 268

A former union leader was the victim of an industrial accident and is now a resident. To maintain the resident's dignity, the nurse aide may suggest that the client... 1. read industrial magazines. 2. serve on the resident council. 3. watch business-oriented movies. 4. relax and play bingo.

Question 269

A client's daught wants to help with her mother's care. The nurse aide should... 1. allow her to do whatever care she wants to do. 2. tell her she cannot perform any care for her mother. 3. let her do the bathing and dressing only. 4. have her do whatever the nurse agrees to.

Question 270

It is important to remember that a client in the last stage of a terminal illness should... 1. be left alone to grieve. 2. be offered care to meet her physical and emotional needs. 3. be cared for only by relatives and close friends. 4. not be offered any choices about her care.

Question 271

Allowing clients to dress in their personal clothing... 1. decreases clothing costs. 2. improves client well-being. 3. makes it easier to dress clients. 4. enhances infection control.

Question 272

A young, postoperative client has his door closed, and the nurse aide needs to check his vital signs. The nurse aide should... 1.