Certified Nursing Assistant State Exam Questions and Answers 2024( A+ GRADED 100% VERIFIED).

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• Pages 16
• Category Exam Elaboration
• School / University University of Illinois at Urbana-Champaign
• Course Nursing
• Course Level Phd level
• Year 2024
• Keywords Reality orientation vs Validation therapy A resident keeps calling you by his daughter's name (different approaches based on technique) - ANSWER REALITY ORIENTATION - keep reminding resident of your name and who you are VALIDATION THERAPY -- ask him about his daughter Shock position - ANSWER Head down with feet elevated. You can elevate the feet by putting several pillows under their legs Normal RECTAL temperature - ANSWER 98.6 - 100.6 degrees F (lubricate and hold in place for 1-2 minutes, insert 1 inch into the rectum and resident must be in SIMS position - which is left side lying ) Shoulder ROM exercises - ANSWER Flexion & extension; abduction & adduction; internal & external rotation Possible HIPAA violations - ANSWER Taking a picture of resident or family & visitors / not closing door during tasks / not pulling the privacy curtain, not asking visitors to leave when needing to perform a task Precautions for removing a meal tray or specimen from an isolation room - ANSWER Must double bag when removing tray or specimen BID / TID / QID - ANSWER BID = twice a day / TID = three times a day / QID = four times a day Where & how restraints secured - ANSWER Secured to the movable part of the bed and are secured with an easy release knot When passing ice water, what is the procedure? - ANSWER You may not touch the inside of the water pitcher or glass; in between resident rooms be sure that ice scoop is place in the side pocket of the ice chest Cold dry ice application preparation - ANSWER Cold dry ice applications must be covered with some type of cotton cloth (i.e. pillow case Dysphagia - ANSWER Difficulty swallowing Dysphasia - ANSWER Difficulty speaking Aphasia - ANSWER Absent or difficult speech Dyspnea - ANSWER Difficulty breathing If your resident drinks poison - ANSWER You need to put on the signal light and call for the nurse Recreation therapy - ANSWER Used with residents with dementia or AD -- can help increase the resident's alertness Orientation therapy - ANSWER Helping the resident with person (who they are & who you are) / where they are / what day of the week and date or season etc. How you will identify your resident before performing a task - ANSWER Use their ID band and a 2nd identifier Anti-Embolus hose are applied - ANSWER With the resident laying in bed Where are you standing during the application of Anti-Embolus hose? - ANSWER You are standing at the foot of the bed, in good body alignment with your feet spread apart (use shoulders are your guideline about 12-18 inches) to improve your balance Reason to use Anti-Embolus hose - ANSWER They will increase circulation and help to prevent blood clots AM care includes - ANSWER Prepare for morning (Breakfast), assist with elimination, chance & clean incontinent person, wash face & hands (shower), oral hygiene, dress person, brush hair and position person for breakfast, make bed and straighten their room PM care includes - ANSWER Preparing for sleep, assist with elimination, clean & change incontinent person, help with washing face & hands, oral hygiene, back massage, undress and help with pajamas, straighten bed & unit Position of mechanical lift sling - ANSWER Needs to be under shoulders, butt and thighs Doctor visiting your resident and he gives you a medical order - ANSWER Explain that you will go get the nurse for him; that you are not allowed to take medical orders The resident or patient - ANSWER Determines the water temperature of a tepid bath used to reduce fevers Most important step in hand washing - ANSWER Friction How do you stock (or put away) the new supplies in the utility room - ANSWER You must move the old supplies to the front of the cabinet and put the new supplies in the back Elbow ROM - ANSWER Extension and Flexion Your resident is playing bingo and a family member calls and asks to speak with her, what is your responsibility? - ANSWER You go to the resident and tell them they have a phone call. You will assist resident to their room and close the door so they can have a private conversation. NPO - ANSWER Resident is not allowed anything by mouth. This resident does not receive any water (glass or pitcher) at the bedside. Perineal Care - ANSWER Always clean from cleanest to dirtiest (front to back) and to protect yourself and the resident from skin, body fluids & infection. You must follow Standard Precautions and Bloodborne Pathogen Standards. "Security devices or Restrictive devices" are Restraints - ANSWER Standard Precautions are also called Universal Precautions is the old term What is included in Standard Precautions - ANSWER Hand hygiene, no fake nails, no long nails and PPE when it applies When removing a mask which tie is removed first? - ANSWER The bottom or lower tie is removed first Part of your job will require you teaching or reinforcing the nurse's instructions. How would you teach a resident to safely lift a heavy box? - ANSWER It is easier to push a heavy box rather than pull it toward you. You must demonstrate how to lift using your legs and shoulders but NEVER the back. Carry heavy objects close to your body rather than holding them away from the body. Resident with a hip arthroplasy has to use what type of bedpan? - ANSWER Fracture bedpan Therapeutic foot soak or therapeutic bath temperature - ANSWER Nurse needs to tell you the water temperature HOWEVER it is always to be resident's COMFORT Gait belt application - ANSWER Around the waist, buckle to the side and the tail tucked in the back. Use an under-handed grip when using the gait belt How can you respect the resident's right to privacy? - ANSWER Always close door, window curtains and privacy curtains during procedures with the proper draping of covers during the procedure (meaning you only expose the body part that you are working on) Stages of Dying - ANSWER Denial, Anger, Bargaining, Depression and Acceptance Bland diet - ANSWER Used for residents that have stomach issues to help prevent irritation Diabetic diet - ANSWER Need to eat at the same time and each meal has a controlled balance of fats, proteins and limited carbs & concentrated sweets (sugar) Diet for residents with swallowing issues - ANSWER Dysphagia diet Mechanical soft diet - ANSWER For resident's with chewing issues: meat is ground up to require less chewing 1 ounce = - ANSWER 30mL Intake - ANSWER includes all liquids (any thing that melts at room temperature), IV's & tube feedings I & O recorded in medical record - ANSWER On the flow chart Vital signs are recorded in the medical record - ANSWER On the graphic sheet Nourishment - ANSWER Must be delivered to resident immediately upon their arrival on the nursing unit Pericare - ANSWER Remember to always change gloves before pericare during bath procedure and water & washcloth prior to pericare. Wearing gloves protects you from contact with skin, body fluids and possible infections. Disinfection v.s. Sterilization - ANSWER Disinfection kills pathogens and sterilization kills ALL microbes meaning pathogens & non pathogens. You DISINFECT a room, wheelchair, OBT and your hands. You STERILIZE surgical equipment. Upon discharge, you are assignment to clean the resident's room - ANSWER You will DISINFECT the room PPE sequence - ANSWER ON -- mask, goggles, gown & gloves / OFF -- gloves, gown, googles and mask How often are anti-embolic hose removed? - ANSWER Remove every 8 hours and at bedtime Lab specimens require - ANSWER Being placed in biohazard bag, labeled and contain a requisition 24 hour urine - ANSWER Discard the 1st specimen, collect all urine for the next 24 hours (keep on ice) and save the last voided specimen. If interrupted, the test must be restarted Clean catch / mid stream urine - ANSWER Requires peri care prior to asking resident to start voiding and collect urine in the middle of the stream. It will be a STERILE specimen container Clean catch / mid stream are used to diagnose - ANSWER UTI Random urine specimen - ANSWER No special container and can be collected at any time during the day or night-- you need 4 ounces or 120mL Specimen checking for occult blood - ANSWER Occult means looking for hidden blood that can not be seen by the naked eye Stool specimen - ANSWER 1-2 tablespoons taken from 2 separate areas of the middle of the stool and never from the edges Sputum specimen - ANSWER 1-2 teaspoons, best collected first thing in the morning -- sputum coughed up from the bronchus not from the back of the throat -- NO MOUTHWASH prior to the collect of a sputum specimen Hygiene water temperature - ANSWER Bath temperature 110-115 degrees F / Pericare temperature 105-109 degrees F / Tub bath is 105 degrees F Therapeutic baths / soaks / tub baths / shower chairs - ANSWER Be sure to disinfect before and after use Occupied bed - ANSWER Bed made with a person remaining in bed, you must keep the person in good body alignment during the bed making procedure Restraints - ANSWER Can only be ordered by the doctor for a "medical reason" and must be the LEAST RESTRICTIVE Major possible complication of restraints - ANSWER Strangulation or entrapment How often do you need to check someone in restraints - ANSWER Every 15 minutes or more often as the nurse directs / observe skin color, temperature, warmth and ask if any numbness or tingling / IF a restraint belt goes around the waist, you must check to be sure that the resident is not having any difficulty breathing Vest restraint - ANSWER V crosses in the front of the patient Jacket restraints - ANSWER Opening goes in the back How often will restraints be removed - ANSWER Every 2 hours for a minimum of 10 minutes Orientation of a new resident to the room - ANSWER You are allowed to check the new resident's vital signs for the nurse and explain the room, equipment, bathroom and meal / shower procedures. REMEMBER the call light is the most important piece of equipment that the resident needs to know how to use -- you will also label all their personal items including clothes Your responsibility for a discharging resident - ANSWER Pack all their belongings, shower and dress resident for going home, take resident & belongings to the designated area for discharges. You will assist the resident into the car, secure seat belt and put all belongings into the car. NEXT, you will come back and remove all linen from the bed, collect all towels, bedpans etc and remove from the room. YOU WILL DISINFECT the room if it is your responsibility to clean the room and prepare for the next resident. YOU WILL MAKE A CLOSED BED Emptying colostomy pouches - ANSWER Either in the bedpan or have the resident sit on the toilet, open the clip at the bottom and drain the stool into the toilet. Best time to shower a resident with an ostomy? - ANSWER First thing in the morning before breakfast (if the nurse just put on a new pouch, you need to wait 1-2 hours before showering) How frequently are ostomy pouches changed? - ANSWER Every 3 - 7 days or as needed if they leak Type of stool from ostomy - ANSWER Colostomy has formed stool / Ileostomy has constant liquid stool Indwelling foley catheter - ANSWER Drainage bag must always be kept lower than the resident's bladder and hung from the bed frame & NEVER the side rail. Where can you NEVER dispose of an ostomy pouch - ANSWER Never flush down the toilet, if you put a dirty / used pouch in the garbage, you must immediately remove from the resident's room Where is the CATHETER secured? - ANSWER To the upper inner thigh Where is DRAINAGE TUBING secured? - ANSWER To the bottom sheet Transfer to bedside commode -- your responsibility - ANSWER To close room door, window curtains, privacy curtain before transfer. Once transferred, the resident will need their call signal within reach. IF ALERT, you will check on them every 5 minutes IF DEMENTIA or AD, you need to check the care plan to see if they can be left alone on the commode -- - ANSWER BEST PRACTICE, you need to stay outside the privacy curtain to be available if they try to get up Male resident uses a urinal - ANSWER You need to instruct the resident they can place the urinal on the bed siderail but NEVER on the over bed table, night stand or on the floor. Be sure resident has the call light and instruct them to call you when they are finished. Soak - ANSWER When a body part is immersed in water Aquathermia pad - ANSWER Dry heat application that needs to be covered with a soft cotton cloth (pillow case) Hot & Cold applications - ANSWER You MUST check the skin every 5 minutes and they must be removed after 15-20 minutes Abnormal vital signs - ANSWER Must be report to the RN immediately Compresses - ANSWER Soft cotton cloth that are usually used with WET applications Resident asks you what you got for his blood pressure reading - ANSWER The resident has the right to know HOWEVER you can NEVER explain what the reading means. You need to tell them you will send RN to explain results. Subjective data - ANSWER Resident reports to you and are considered symptoms You are allowed to obtain valuable information from resident and family - ANSWER Such as bathing preference, favorite clothes or food but you are NEVER allowed to gather health history information Objective data - ANSWER Things you can observe through your senses (see, hear, smell etc) and are considered signs Incident report - ANSWER Anything unusual that occurs (i.e. falls, cuts/bruises / missing items) Gait belt is considered a protective device - ANSWER Used during "safe" transfers POW - ANSWER Put on weak when dressing TOS - ANSWER Take off strong when undressing Ambulating a resident with weakness - ANSWER You use your gait belt and stand to the side and slightly behind the WEAK SIDE What hand is a cane held in? - ANSWER On the strong side Chairs from home - ANSWER Must have arm rests to make it easier for residents to sit down & stand up -- must be non tip When using an ambulation device (walker or cane) what moves first? - ANSWER The ambulation device followed by the weak side and then the strong side Orthostatic hypotension - ANSWER Drop in blood pressure from changing positions too quickly Dangling - ANSWER Sitting the resident on the side of the bed (procedure is to elevate the HOB first and then assist resident to the side of the bed) MUST CHECK to observe resident for symptoms of orthostatic hypotension To pull a resident up in bed - ANSWER Use the draw sheet as an assistive device to prevent friction & shearing When pulling a resident up in bed where is the pillow placed? - ANSWER At the head of the bed so that the resident's head can't accidentally come in contact with the head board How is a resident in a wheelchair taken out of their room? - ANSWER You pull the wheelchair BACKWARDS out the door so that you can check for any hall traffic How do you push a wheelchair in the hallway? - ANSWER You will always push the wheelchair forward so that the resident can "see" where they are going Number of people required to operate a mechanical lift - ANSWER A minimum of 2 people PROM - ANSWER The CNA does all of the ROM exercises AAROM - ANSWER The CNA assists the resident with ROM exercises AROM - ANSWER The resident is independent with exercises Braces - ANSWER Support a body part, you are responsible for being taught how to properly put on the brace, when to take it off and to CHECK the SKIN under the brace for any reddness or sores Sundowning - ANSWER When anxiety and confusion increases when the sun starts to go down Resistance to hygiene or tasks with a dementia resident - ANSWER Never push a resident, come back later and try again always using a very calm approach and gentle voice Catastrophic reactions - ANSWER Reaction typically extreme and due to over stimulation - needs very calm approach and remove from whatever is causing the over stimulation When you are trying to assess if they understand or are oriented - ANSWER Observe them during recreational activities (resident needs to follow directions and procedure steps to participate in a recreational activity) Vital Signs - area for pulse checks - ANSWER Carotid artery for CPR pulse / brachial artery for BP / radial artery thumb side for pulse Normal adult pulse rate - ANSWER 60-100 bpm Normal adult respiratory rate - ANSWER 12-20 per minute Normal adult BP - ANSWER 120/80mmHg (**remember the correct BP designation will always include mmHg) Hypotension - ANSWER 90/60mmHg Hypertension (HTN) - ANSWER 140/90mmHg Normal ORAL temperature - ANSWER 97.6 - 99.6 degrees F (hold in place 2-3 minutes) Fever - ANSWER Temperature should be check every 4 hours or as the nurse directs. You are allowed to give fluids as the nurse directs and cool (tepid) sponge baths in an attempt to lower the fever. All medication must be given by RN Tepid bath for fever reduction - ANSWER Expose 1 limb at a time, pat with cool wash cloth for 5 minutes, place cool cloths under both axilla, groin and forehead. DO NOT RUB AS THAT GENERATES HEAT AND WE ARE TRYING TO LOWER THE TEMPERATURE Daily weight - ANSWER Weigh at same time of day, same scale, in pajamas and after resident has voided Height - ANSWER 48 inches = 4 feet / 60 inches = 5 feet / 72 inches = 6 feet RACE - ANSWER During a fire, you RESCUE, ALARM, CONFINE OR CONTAIN and EXTINGUISH PASS - ANSWER When using a fire extinguisher, PULL THE PIN, AIM AT THE BASE OF THE FIRE, SQUEEZE THE HANDLE AND SPRAY Adult CPR ratio - ANSWER 30:2 (30 compressions to 2 breaths) Sequence for CPR - ANSWER COMPRESSION, AIRWAY, BREATHING and early DEFIBRILLATION Frayed or bad electrical cords (think call light!!) - ANSWER The equipment must be removed and replaced with working equipment. In the instances of a call light, do not leave the call light in the room & you can not leave the resident without a call light so you need to contact nurse / maintenence based on policy to bring a working call light to the resident's room Who's responsibility is it to clean up spills? - ANSWER EVERYONE's because wet floors causes falls You find a chemical bottle left by housekeeping in a resident's room - ANSWER Immediately remove it (NEVER LEAVE IT IN THERE) and take it to the nurse Chemical bottles without labels - ANSWER You are never to use any chemical without a label / if a label is present check the MSDS for information about the chemical To open an airway - ANSWER Head tilt - chin lift Fall prevention - ANSWER Clothes fit properly(no long pants dragging on the floor), non skid shoes and no throw rugs on floor. Answer call lights promptly and use gait belts and assistive devices correctly Patient rights -- know them and observe them with all residents at all times. - ANSWER 1. Right to information (test results) , 2. right to quality of life (calling a resident by their title unless the resident asks you to call them something else THE RESIDENT decides what you call them), 3. right to exercise citizenship rights (i.e. voting), 4. right to freedom of choice (picking clothes, refusing treatments), 5. right to be free from all forms of abuse, 6. the right to have mail be private, 7. the right to have visitors, 8. the right to see clergy, 9. the right to privacy in all forms (close doors, window curtains, privacy curtain, only having body parts exposed when performing a task) 10.the right to private phone calls 11. the right to have all procedures explained to them (in the language they understand) 12. the right to refuse How to read a graduate - ANSWER When reading a graduate, you must read the MOST accurate side, (each graduate has ounces on 1 side and mL on the other side)......IF the MOST accurate side is OUNCES, you will need to calculate ounces into mL by multiply the number of ounces x 30 When delivering meal trays, how will you verify correct resident? - ANSWER Check ID band & check name on diet card Best position to make it easier to breathe - ANSWER Semi Fowlers Information allowed on resident / patient ID bands - ANSWER Resident name, physician, date of birth, or medical record number NEVER on an ID band -- emergency contact name & number, diagnosis or room number What should you do to the stop the bleeding from a nick during shaving? - ANSWER Apply pressure over the area where the nick is Why wear gloves when shaving? - ANSWER In case you nick a resident during shaving, there will be no blood contact. YOU MUST report whenever you nick or cut a resident during shaving Resident is on anti-coagulant - ANSWER You must use an electric shaver Dressing a resident - ANSWER Allow choice when picking out clothes and ENCOURAGE independence during dressing. We are not there to do everything for a resident and make them dependent on us.....we are there to keep them as independent as possible Topical ointments - ANSWER When you apply barrier cream to resident's skin this is considered a "topical" because it goes ON TOP of the skin "kneading" during a back massage - ANSWER Is part of a back massage when you pick up the tissue between thumb and fingers Equipment & position used for oral hygiene on an unconscious resident - ANSWER Use a toothette and resident positioned onto their side Frequency of oral hygiene for a resident NPO - ANSWER Every 2 hours at least Bed linens are soaked with liquid BM - ANSWER You must roll linen away from you and your uniform and place in a LEAK PROOF bag Sitz bath - ANSWER Resident's perineal / rectal area is place in warm water Sitz bath observations - ANSWER Because of the warm water, you must observe resident for being lightheaded or dizziness Wandering with AD resident - ANSWER Allow resident to wander in a safe secure environment Stretchers are moved - ANSWER Feet first, side rails raised and resident never left alone on a stretcher Short lines on centigrade thermometer - ANSWER 0.1 degree Apical pulse - ANSWER Apex of heart, below left nipple (only pulse that needs to be heard - it can not be felt) Short lines on Fahrenheit thermometer - ANSWER 0.2 degree Long lines - ANSWER 1 degree Before starting CPR - ANSWER Assess for: No response, no pulse and no breathing Weighing a resident in a wheelchair - ANSWER After you obtain weight YOU MUST deduct the weight of the wheelchair in order to obtain an accurate weight Assisting with a burn - ANSWER Apply cool cloths & NEVER ICE to a burn. Do not attempt to removed clothes stuck to burn areas. Apply blankets to keep person warm (victim may be going into shock following a major burn) NEVER APPLY BUTTER or other old wive's tails to a burn. Do not use warm or hot clothes as this allows the burn to continue to expand deeper into tissue) OBRA required resident room temperature - ANSWER To the resident's comfort - 71-81 degrees F, if the resident is cold and the temperature of their room is outside of the acceptable range, you must NOTIFY THE NURSE HIPAA - ANSWER You must keep all information confidential & private Residents with limited English - ANSWER You must have non verbal methods to communicate Isolation meal trays - ANSWER Must be double bagged and taken to the dietary kitchen Resident is being abused by family but asks you to keep the secret - ANSWER Explain that you can not keep this secret and report abuse to the nurse Warm soaks - ANSWER the warm increases blood flow Contamination of a stool specimen - ANSWER If there is any urine in the stool specimen it can not be sent to the lab. You need to retrieve a new specimen Rehabilitation focus - ANSWER Focuses on abilities Vital signs in the elderly - ANSWER Are typically slightly lower than normal adult ranges Signs & symptoms of Hypoglycemia - ANSWER Fatigue, weakness, dizziness, hands shaky, skin cold & clammy, sweating, confusion, pulse rapid, respiration rapid & shallow Signs & symptoms of Hyperglycemia - ANSWER Hunger, excessive thirst and urination, unexplained weight loss, dry mouth, face flushed (red) sweet breath odor Contaminated bed linen - ANSWER Always rolled away from you, wear gloves and placed in an appropriate linen bag (if dripping with urine or diarrhea -- leak proof bag) Tachypnea - ANSWER Respiration rate greater than 20 per minute for an adult You take the last pair of gloves out of the box in the bathroom - ANSWER It is your responsibility to replace with a new box of gloves Can you write a letter for a resident - ANSWER YES, you should also address the envelope correctly and mail for the resident Air mattress applied to bed - ANSWER ON TOP of the mattress with linen placed over the air mattress Resident wants to call his attorney - ANSWER He has the right to call his attorney at any time Isolation cart - ANSWER If you are stocking the cart for the 1st time, be sure that there are gloves, goggles, gown & masks. If you use the last of any item, it is your responsibility to restock the car Non medicated lotions - ANSWER Are applied to help keep skin hydrated (never apply lotions between toes) Your resident refuses to eat - ANSWER You MUST offer a substitution Observations when your resident has a cold dry application (ice bag) - ANSWER You must observe skin color - if you observe any cyanosis, numbness or tingling -- you must report to RN immediately When going into an isolation room to obtain a specimen - ANSWER You will need to label (or tag) the specimen container BEFORE entering the isolation room Validation therapy - ANSWER A resident wants to cook -- in validation therapy you will ask WHAT the resident wants to cook (do not let her cook)