CNA Basic Nursing Skills Practice Test – 2

This is our 2nd basic nursing skill practice test. Basic nursing skills practice test is a great way to assess your knowledge of the material before taking the certification exam. The practice test consists of 60 questions that cover a range of topics, from vital signs to communication. It is important to take the practice test seriously and to time yourself so that you are familiar with the testing process.

This is a timed quiz. You will be given 60 seconds per question. Are you ready?

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Various factors will change pulse rate. An increased pulse rate can be caused by

Correct! Wrong!

The heart rate is lowest when the person is at rest or not engaging in physical activity. The heart rate increases when there is a need for more oxygen. Exercise always triggers a faster pulse. Other factors that raise the heart rate include pain, anxiety, stress, or too much thyroid medication.

For most residents, the range of normal respiration is

Correct! Wrong!

The normal breath rate for adults is 12 – 20 times a minute. When measuring a client's respiratory rate, start when the client is at rest. A single breath comprises one inhalation followed by one exhalation. Count breaths for 60 seconds when taking a respiratory rate.

Which of these is not true about condom catheters?

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Condom catheters are external catheters and often described as more convenient than internal catheters. All of the other options are facts about their use.

Which of the following is true regarding the use of side rails on a bed?

Correct! Wrong!

Bed rails can be a safety risk for some clients, who might be injured while trying to get out of bed. Clients can also become trapped or strangled in bed rails. Using bed rails without permission can be seen as an attempt to restrain the client. Always follow the care plan regarding the use of bed rails.

Which is the best advice if you are uncertain you are able to move an obese patient on your own when it is time for their scheduled re-positioning?

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Always ask another nursing aide to help if a resident is too heavy and you are not sure if you can manage on your own. You do not want to risk injury to the patient or yourself. The same applies to family members. The patient is not able to move himself/herself, so this option is not appropriate in this scenario.

Signs of poor circulation include

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Poor circulation is the result of another medical condition. Peripheral artery disease (PAis a narrowing of the blood vessels in the arms, legs, head, or stomach, resulting in impaired blood circulation. Without a good blood supply, the skin becomes pale and cool to the touch. Edema develops when extra fluid cannot be returned to the heart. Other symptoms of PAD include numbness, tingling, pain, and muscle cramps. Other causes of poor circulation are diabetes, obesity, and varicose veins.

Strokes are seen in the elderly. A stroke occurs when

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A stroke occurs when the blood supply to the brain is cut off, so oxygen cannot reach the brain cells. Strokes are caused by blood clots in the arteries of the brain or a burst blood vessel in the brain.

A resident is NPO for tests. The nurse aide should

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NPO is a common medical term that means the client cannot eat or drink anything, including water or ice chips. A doctor may order a patient to be NPO before surgery or certain lab work. If a client is ill or has a gastrointestinal condition, the doctor may write an order to be NPO until the cause is known. The nurse aide can provide mouth care for a client who is NPO. Placing an "NPO" sign over the client's bed will remind all staff members not to give the client anything to eat or drink.

What can the nurse aide give a resident who has an order for NPO?

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NPO is a common medical term that means the client cannot eat or drink anything, including water or ice chips. A doctor may order a patient to be NPO before surgery or certain lab work. If a client is ill or has a gastrointestinal condition, the doctor may write an order to be NPO until the cause is known. The nurse aide can provide mouth care for a client who is NPO. Placing an "NPO" sign over the client's bed will remind all staff members not to give the client anything to eat or drink.

Which of the following is a proper way to correct an error in charting?

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There are strict guidelines on how to correct a charting error. Never erase or cover the error. Draw a single line through the error so that the entry is still visible. Add the date and your initials. Continue with the correct entry. There can be serious consequences for you and your facility if proper protocols for error correction are not followed.

A nursing assistant is instructed to take the oral temperature of a patient who just had a cold drink. The patient’s temperature should be taken

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A delay of 15 minutes should be enough time for the oral cavity to return to a more accurate body temperature.

Who supervises the work of a nurse aide?

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The work of a nurse aide is overseen by a registered nurse (RN) or a licensed practical or vocational nurse (LPN/LVN). The scope of practice for an RN or LPN/LVN includes having responsibility for staff who provide daily, hands-on care for clients. Open communication between the nurse aide and the supervisor makes for excellent client care.

Headaches, nausea, and pain are considered

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Symptoms are the client's experience of how he or she feels. Pain, nausea, and anxiety are things that only the client can perceive and report. They may contribute to the signs that others can see, such as a higher heart rate, change of skin color, or unusual behavior, but the symptoms begin with the client.

Elderly residents sometimes appear stooped over and seem to have lost height. This is due to

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Osteoporosis in the spinal column can lead to a gradual loss of height and a stooped posture. The loss of calcium in the vertebrae of the spine can cause fractures and back pain, although most of the fractures are tiny and painless. Both older men and women can get osteoporosis.

If the resident is smoking and the nurse aide needs to take an oral temperature, what should the nurse aide do?

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Before taking an oral temperature, determine if the client has smoked or has had anything hot or cold to drink in the last 15 minutes. If so, wait a full 15 minutes before taking the temperature to obtain an accurate measurement.

Diabetes mellitus makes a resident more prone to develop

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Diabetics have high blood sugar levels, which can weaken the immune system, the body's defense system against infections. In diabetes, infections most commonly occur in the urinary tract and skin. Furthermore, diabetics often have nerve damage; they can develop foot infections without realizing it.

Constipation and indigestion can result from

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About 75% of elderly people have slowed peristalsis (muscular contractions that move food through the intestines) because there are fewer nerves to control the gut. As a result, food does not move in an even pattern. This can cause constipation and indigestion. Any pathogens in the digestive tract have a chance to multiply, which may lead to enteric infections.

A nurse aide is going to take Mr. Heath’s vital signs. What should the nurse aide do to reduce Mr. Heath's anxiety and get him to cooperate?

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Before providing any care, the nurse aide must follow all the standard steps in preparation. Gather everything needed so you won't have to leave the client's room once you begin. Always wash your hands both before and after each client interaction. After confirming the client's ID, explain the procedures to the client, even for routine tasks such as taking vital signs. Allow the client to ask questions before proceeding.

A bedsore or decubitus ulcer is caused by

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One of the primary responsibilities of a nurse aide is to monitor the client's skin for any signs of breakdown that could develop into bedsores (also known as decubitus ulcers or pressure sores). During baths, dressing, or position changes, inspect the skin for redness, pallor, warmth, or bruising. Reposition at least every two hours, protecting areas that rub together, as well as the bony prominences. Massages to the back and buttocks can promote circulation. Range-of-motion exercises are also helpful. Always report any signs of breakdown to the nurse.

The thinning of the fatty layer under the skin could cause a resident to

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The natural aging process causes many changes in the skin. The outer layer of skin becomes thin and appears pale and clear. Blood vessels become fragile, leading to bruising and bleeding under the skin. The fat layer also thins, so there is less padding, which increases the risk of injury and pressure sores. Rubbing or pulling on the skin can produce skin tears.

A hospice specializes in the care of people who are

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Hospice care is specialized care for clients who are terminally ill. The care includes the family and caregivers. It does not attempt to cure the client. Hospice care is intended to improve the quality of life for everyone involved, by taking care of their physical, emotional, and spiritual needs.

The nurse aide notices on the flow sheet that a resident has not had a bowel movement for five days. The nurse aide should

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Although each person has a unique pattern of bowel movements, the normal number is 3 to 14 times a week. If the client has had a sudden change in bowel habits or is experiencing symptoms of constipation such as bloating, pain, or nausea, the cause should be investigated. Adding fiber and fluids to the diet can help prevent constipation.

The plan that starts on the resident’s admission and assists when the resident goes home is called

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A good discharge plan allows for continuity of the care that begins on admission. It anticipates possible issues or barriers that the client or the client's family may encounter, and services that will be needed after discharge. All team members can contribute to the plan, based on their interactions with the client.

A sitting or semi-sitting position with the head of the bed elevated is called

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Fowler's position is the standard way to position a client to improve oxygenation. There are several types of Fowler's position. In high Fowler's, the client sits upright in bed at a 90-degree angle to allow the chest to expand. The semi-Fowler's position raises the head of the bed to 45–60 degrees. This position is used for drainage and comfort after surgery.

Why should heat NOT be applied to a diabetic resident’s feet?

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Diabetics often have neuropathy (nerve damage) and may be unable to detect if their feet are injured. The diabetic may be unable to feel temperatures, so extreme care must be taken to protect the feet from both heat and cold. Diabetics should always wear socks and shoes to prevent cuts or injuries to their feet.

If you smell smoke and discover a resident smoking in his room, it is best to

Correct! Wrong!

The resident needs to stop and to know you will not allow his behavior to continue. He also may need to be reminded of the policies and hazards. The other options are not the proper way to immediately deal with the situation.

Which of these should not be part of the process for cleaning a residents dentures?

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Placing dentures on a tissue could lead to dentures being knocked off and damaged or a housekeeper removing the tissue and, inadvertently, throwing the dentures in the trash. The other options are extremely important to the washing process.

What is the purpose of the chain of command in a long-term care facility?

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Every staff member has a role in providing excellent client care. With good communication, each person can work within their scope of practice and allow others with different authority to handle appropriate tasks. In a long-term care facility, the CNA reports to the registered nurse (RN) or licensed vocational nurse (LVN), who in turn reports to the Director of Nursing. The facility's Administrator and Medical Director may be the persons with the most responsibility.

A diabetic resident asks the nurse aide to cut her toenails. The nurse aide should

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Diabetics often have neuropathy (nerve damage) and may be unable to tell if their feet are injured. Even trimming toenails can cause an injury. Diabetics need expert care from a podiatrist or a qualified foot care professional. You can be held liable if the client develops an infection after you cut her toenails.

When muscle tissues shorten and then a joint becomes hard to move it is called

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Contracture is the shortening of muscle tissue making stretching difficult. A rupture is when something bursts open. A twitch is a sudden, jerking movement. A perforation is an opening.

A CNA is recording the 24-hour urine output of a patient with kidney issues. What 24-hour urine value would warrant a report to the nurse?

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The normal 24-hour urine output for a patient should between 800 and 2000 cc. 600 cc of urine in 24 hours could indicate a complication and should be reported.

A nurse aide is assigned to a stroke patient with a diagnosis of aphasia. The nurse aide knows that

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When a client has suffered a stroke or some other head injury, the speech center of the brain can be damaged, resulting in aphasia. Chief signs of aphasia include difficulty finding appropriate words when speaking, trouble understanding speech, and difficulty with reading and writing.

Which of these best describes the purpose of padded side rails?

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Padded side rails are to protect the resident from injury. The other answers are incorrect.

All of the following statements about type 2 diabetes are true EXCEPT

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More than 34 million Americans have diabetes (about 1 in 10), and approximately 90-95% of them have type 2 diabetes. Type 2 diabetes is the most common form of diabetes, usually occurring in adults over age 45 who are obese and inactive. It is a chronic disease that requires ongoing medical management. Although there is no cure, it can be controlled with lifestyle changes such as diet and exercise. Medications, or possibly insulin, can also be helpful in keeping blood sugar levels at optimal levels.

There are two kinds of restraints

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There are two categories of restraints that are meant to protect the client or others. Physical restraints are devices that are designed to restrict movement. Examples are vests, hand mitts, belts, lap trays, or bed rails. Chemical restraints are medications given to control behavior such as yelling or combative behavior. All restraints require a physician's order.

Which of the following is a major reason for urinary incontinence in the elderly?

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As part of the aging process, a client may experience urinary incontinence because of weakness of the muscle that keeps the urine in until the client can get to the toilet. Another possible reason is that the bladder itself doesn't contract to expel all the urine. Bladder infections and prostate problems can also contribute to incontinence. Diseases such as Alzheimer's or multiple sclerosis can also be causes.

When lifting a heavy object, which muscle groups should you use?

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When lifting a client or a heavy object, use your legs to position yourself to support the load. Keep your back straight and locked; do not turn or twist. Do not attempt to lift by bending forward. Bend your hips and knees to squat down. Keep the load close to your body and straighten your legs as you lift. If you have any doubts, ask a co-worker for assistance.

A nursing assistant is caring for a patient with MRSA and is wearing a gown and gloves whenever she provides the patient care. When she needs to go care for another patient, she should dispose of her gown and gloves:

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Taking the gown and gloves off in the patients room before leaving to care for another patient helps reduce the spread of infection to staff and other patients.

The loss of the ability to express oneself is known as

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When a client has suffered a stroke or some other head injury, the speech center of the brain can be damaged, resulting in aphasia. Chief signs of aphasia include difficulty finding appropriate words when speaking, trouble understanding speech, and difficulty with reading and writing.

The exchange of oxygen and carbon dioxide takes place

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The lungs are the main organs of the respiratory system. They take in oxygen during inhalation and release carbon dioxide during exhalation. These gases are exchanged in the tiny air sacs of the lungs, called alveoli.

Making a bed, whether occupied or unoccupied, should end with

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Hands should be washed after making the bed. The other options are part of the process but not the last step.

A resident in your care has called you for help. He claims he can’t find his dentures. As a nursing assistant, it is your responsibility to

Correct! Wrong!

The supervising nurse should be notified. He or she will determine the appropriate documentation of the incident. It is not a nursing assistants role to contact the family members or make a decision that the resident should stop eating.

A Foley catheter is used

Correct! Wrong!

A Foley catheter is a sterile tube that is placed into the bladder to drain urine. It is held in place by a balloon that is inflated after being inserted. When a client has an indwelling Foley catheter, you should check that the tubing is open so that the urine can flow from the bladder. After each position change or whenever the client returns to the bed or chair after being up, ensure that the tubing is not kinked or closed. The bag should be lower than the bladder to prevent backflow.

The nurse aide knows to wear which of the following when performing care for clients?

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The nurse aide is considered a health care professional and should dress accordingly. Each facility has a dress code policy regarding the type of uniform to wear. Clothing must be clean and free from stains, tears, or wrinkles. Shoes must be closed toe with non-skid soles. Appropriate grooming is always necessary. To prevent a nurse aide from injuring a client while giving care, the nurse aide's jewelry is usually limited to a watch and a wedding ring. A name tag is part of the standard uniform.

Many elderly residents lose their appetite because of

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As people age, loss of appetite can be normal. But there are also specific reasons that the ability to enjoy food declines. With fewer taste buds, flavors are harder to detect; more seasoning or appealing aromas may be helpful. People who are depressed or socially isolated often don't feel like eating. Meals that are colorful, beautifully prepared, and nutritious at senior centers or other places can help elderly people look forward to eating. Other causes of loss of appetite include dental problems and side effects of medications.

When lifting, the nurse aide should have his or her feet separated in the standing position to

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When feet are placed about a shoulder width apart, a comfortable and wide base of support is established. With a wide base of support, you are less likely to lose your balance. To turn, use your feet, not your back. Do not twist your back or torso while lifting.

When transferring a resident from a wheelchair to stationary chair, the nursing assistant should stand

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Standing in front of the wheelchair is the most ergonomic way for the nursing assistant to pivot a resident into a stationary chair. The other options are not as effective for allowing this.

The medical term for a device with two soft plastic prongs that attach to a plastic tube delivering oxygen is:

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A nasal cannula is the device that goes into the nose and helps deliver oxygen. The other options are all incorrect.

Which of these examples demonstrates using proper body mechanics when helping to lift a resident in bed?

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Keeping knees flexed and using leg muscles to lift are the best options to avoid injury. The other options are not using body mechanics properly and increase the likelihood for injury.

When dry, hard stool fills the rectum and will not pass, it is called

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Fecal impactions commonly occur in people who suffer with chronic constipation. A fecal impaction is a mass of dry, hard stool in the colon or rectum. The client is unable to pass it without assistance. The stool may need to be removed manually by inserting a gloved finger into the rectum. Enemas and laxatives may also be tried.

A Hepatitis B vaccination protects the person receiving it against a disease that affects

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Hepatitis B is a serious, contagious infection caused by the hepatitis B virus (HBV). Most commonly spread by exposure to body fluids, it can cause both acute and chronic disease. Many agencies and facilities require employees to receive the HBV vaccination series to protect themselves and others.

To minimize the spread of bacteria, further infection and contamination, which procedure should be used for washing the perineum of a resident with a catheter?

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Washing from the meatus out is correct because it avoids further spread of contamination. Peroxide is not a cleanser and the other two options are in the opposite direction they should be in.

Wasting or a decrease in the size of a muscle is called

Correct! Wrong!

Muscle atrophy is a loss of muscle mass. The main cause of atrophy is lack of physical activity, which may be due to injury or disease. After an injury such as a herniated disc or a broken leg, the muscles are often immobile or painful to move. Diseases which lead to atrophy include multiple sclerosis, anorexia nervosa, and AIDS.

The best way for a nurse aide to gather information about the safety and well-being of a resident is

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As the primary staff member for providing hands-on care for a resident, the nurse aide is able to observe the resident's current condition accurately. Flow sheets provide information about the resident over time, but the nurse aide is able to assess the situation in real time.

To count respirations, one respiration includes

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The normal respiratory rate for adults is 12 – 18 breaths per minute. To get an accurate respiratory rate, choose a time when the client is at rest. Observe the client for one minute while counting. Each rise and fall of the chest represents one respiration. While counting, note if the client is having trouble breathing or taking full inhalations. If so, notify the nurse.

A resident with venous stasis has developed pressure sores under elastic stockings. What is the most likely cause?

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Wrinkles in stockings or bed sheets are a common cause of pressure sores. While the other options may cause different symptoms, pressure sores develop when there is an article pressing against the body for a period of time.

If you are walking with a resident and they fall, which of these is not an action you should take?

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Helping the resident off the floor and into the nearest chair is not an immediate action to take. A serious injury might become worse if the resident is moved. The other actions are all necessary in the process of dealing with a resident who has fallen.

Which medical position can be described as, “The patients head is elevated with legs either bent or straight”?

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In Fowlers position the head is elevated. In Trendelenbergs position the head is lower than the feet. In Sims position the resident is lying on one side. In Roses position the head is over the end of a table.

Which of these is the correct step in taking a radial pulse?

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Taking a radial pulse requires fingers placed on the inside of the wrist against the radial bone. The count is for 60 seconds. The other options are incorrect.

The best use of alcohol-based sanitizer is:

Correct! Wrong!

Alcohol-based sanitizers are best used for hands that are not visibly soiled. Soap and water are used when soiling is visible. The other options are not appropriate times to use alcohol-based sanitizer.

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