Activities of Daily Living — CNA practice questions

A resident with severe arthritis in both hands becomes frustrated trying to button her blouse each morning. The BEST suggestion for the nurse aide to bring to the nurse is:

1. That staff dress her completely from now on so she is not frustrated each morning
2. That she wear a hospital gown instead of her own clothing while her hands are painful
3. That she be offered adaptive clothing such as tops with hook-and-loop closures
4. That she stay in her nightgown until the arthritis in her hands improves

Answer: C — That she be offered adaptive clothing such as tops with hook-and-loop closures

C) Correct — adaptive clothing preserves independence and dignity while removing the task the resident cannot manage. A) is doing FOR rather than WITH and erodes remaining ability. B) strips personal identity and is not a substitute for street clothes in long-term care. D) is a plausible-sounding delay but leaves her undressed and less engaged, and chronic arthritis will not simply resolve.

Perineal care for a female resident requires you to wipe:

1. Front to back and top to bottom, with a clean cloth surface each stroke
2. Back to front, so the urethral area is cleaned only after the rectal area
3. In a circular motion outward, using the same cloth surface throughout
4. Side to side across the perineum, rinsing the cloth in the basin between strokes

Answer: A — Front to back and top to bottom, with a clean cloth surface each stroke

A) Correct — wiping front to back and using a fresh area of the cloth for every stroke keeps rectal organisms away from the urethra, which is the main way perineal care prevents urinary tract infection. B) Back to front drags rectal flora onto the urethra. C) A circular motion with the same cloth surface reuses contaminated cloth. D) Side to side crosses between the rectal and urethral areas, and rinsing in the basin contaminates the water.

When providing oral care to an UNCONSCIOUS resident, the safest position is:

1. Supine and flat, with the head supported on a pillow so the mouth stays open
2. Sitting fully upright at 90 degrees, the position used for a resident who is alert
3. Side-lying with the head turned to the side so the fluid drains out of the mouth
4. Head lower than the feet so gravity keeps fluid away from the back of the throat

Answer: C — Side-lying with the head turned to the side so the fluid drains out of the mouth

A) Lying flat lets fluid pool at the back of the throat and be aspirated. B) An unconscious resident cannot maintain an upright posture safely. C) Correct - side-lying with the head turned lets water and secretions run out of the mouth instead of into the airway, and only small amounts of fluid and a padded tongue blade are used. D) A head-down tilt increases the risk of aspiration.

A resident who is frequently incontinent is placed on a toileting schedule. The MAIN purpose of the schedule is to:

1. Reduce how much the resident drinks during the day so there is less urine for staff to manage
2. Offer toileting at planned intervals so the resident stays dry and continent as long as possible
3. Demonstrate that the resident no longer needs any staff assistance with toileting
4. Allow staff to change briefs less often, especially during the overnight hours

Answer: B — Offer toileting at planned intervals so the resident stays dry and continent as long as possible

B) Correct — scheduled toileting anticipates need rather than reacting to accidents, preserving continence, skin integrity and dignity. A) is a harmful misconception; restricting fluids causes dehydration and concentrated, irritating urine. C) misstates the goal, which is support rather than proof of independence. D) is staff convenience, not a resident-centered purpose.

While cleaning a resident's dentures at the sink, the nurse aide should:

1. Soak the dentures briefly in very hot water to loosen debris and disinfect the acrylic surface
2. Line the sink with a towel or fill it with water first, and hold the dentures low over the basin
3. Scrub them with an abrasive household cleanser to remove stubborn stains and tobacco stains
4. Store them dry, wrapped in a tissue on the overbed table where the resident can reach them

Answer: B — Line the sink with a towel or fill it with water first, and hold the dentures low over the basin

B) Correct - a lined or water-filled sink cushions the dentures if they slip, and breakage during cleaning is the most common denture mishap; holding them low over the basin shortens the fall. A) confuses hot with clean; hot water warps denture material. C) abrasive cleanser scratches the surface and damages the fit. D) storing them dry dries and warps them and invites accidental disposal - they belong in a labeled container with cool water or solution.

When dressing a resident with right-side weakness, dress which side first?

1. The left arm first, since the stronger side slides into a sleeve more easily
2. Either side, as long as the resident is seated and supported
3. The right, weak side goes into the garment first and comes out last
4. The upper body first, then the lower body, regardless of side

Answer: C — The right, weak side goes into the garment first and comes out last

A) Dressing the strong left arm first forces the weak arm through a sleeve that is already stretched taut, which strains the shoulder. B) The order is not optional; a hemiplegic shoulder is easily injured. C) Correct - the weak side goes in first while the garment is loose and comes out last, which protects the affected joint and lets the resident help with the strong side. D) Upper versus lower body is not the principle being tested; the weak-side rule applies to each garment.

When performing perineal care for a female resident, the nurse aide should wipe:

1. From the rectum forward toward the urethra, so the most soiled area is cleaned first and last-rinsed
2. Back and forth several times with the same area of the cloth to be sure all soil is lifted away
3. From side to side across the labia with gentle strokes to avoid irritating the delicate tissue
4. From front to back, using a clean area of the washcloth for each stroke

Answer: D — From front to back, using a clean area of the washcloth for each stroke

D) Correct - wiping front to back with a clean cloth surface on every stroke keeps rectal organisms away from the urethra and lowers urinary tract infection risk. A) is a direction reversal that drags rectal bacteria toward the urethra. B) reuses contaminated cloth, spreading organisms. C) sounds gentle but does not follow the clean-to-dirty direction that prevents contamination.

After a meal, a resident on aspiration precautions should remain upright for at least:

1. 5 minutes, just long enough for the aide to clear the meal tray away
2. 10 minutes, about the time it takes to finish after-meal oral care
3. 30 minutes, and longer when the resident's care plan specifies more
4. 2 hours, keeping the resident seated until the next scheduled repositioning

Answer: C — 30 minutes, and longer when the resident's care plan specifies more

C) Correct — remaining upright for at least 30 minutes after eating lets the stomach begin to empty and reduces the chance that food or fluid refluxes and is aspirated. A) 5 minutes is far too brief and reflects the aide's schedule rather than the resident's safety. B) 10 minutes is still well short of the accepted minimum, even though oral care is appropriate after the meal. D) 2 hours exceeds what is required, and holding a resident upright that long risks pressure injury and fatigue.

A nurse aide is giving a complete bed bath to a resident. Which action BEST protects the resident's skin and dignity during the procedure?

1. Uncover the entire body at the start so the whole bath can be finished quickly
2. Expose and wash one body part at a time, keeping the rest of the resident covered
3. Use very hot water so that the resident does not become chilled during the bath
4. Wash from the feet upward toward the face, using the same section of the washcloth throughout

Answer: B — Expose and wash one body part at a time, keeping the rest of the resident covered

B) Correct — exposing only the area being washed preserves warmth, privacy and dignity, which is the controlling principle of bed bathing. A) tempts because speed reduces chilling time, but full exposure violates privacy and cools the resident faster. C) confuses 'warm' with 'hot'; water above a comfortable warm range burns fragile older skin. D) reverses the correct direction — wash from cleanest (face) to dirtiest (perineum) and change washcloth areas frequently.

When giving a back rub, you should:

1. Apply firm, sustained pressure over reddened areas to stimulate blood flow to the skin
2. Use long, smooth strokes; avoid massaging over bony prominences or reddened areas
3. Use lotion straight from the cabinet so it feels cooling and refreshing on warm skin
4. Continue the massage for at least half an hour so the muscles fully relax before sleep

Answer: B — Use long, smooth strokes; avoid massaging over bony prominences or reddened areas

A) Massaging reddened skin over bone increases tissue damage. B) Correct. C) Cold lotion is uncomfortable; warm it in your hands first. D) A back rub of a few minutes is sufficient.

ADLs?

Activities of Daily Living: bathing, dressing, toileting, transferring, continence, eating. CNAs assist with all of these as needed.