Basic Nursing Skills — CNA practice questions

When measuring height of a resident who cannot stand, you may:

1. Measure supine in bed, head to heel, with the resident lying in a straight line
2. Estimate the height by eye and note in the chart that the figure is approximate
3. Use the height the resident reported at their last admission to another facility
4. Skip the measurement and ask the nurse to assess the resident's height instead

Answer: A — Measure supine in bed, head to heel, with the resident lying in a straight line

A) Correct. B) An eyeball estimate is not a measurement, even if labeled as one. C) Old reported heights are unreliable and adults lose height over time. D) Measuring height is within the aide's scope and should not be handed off.

When using a fire extinguisher under the PASS method, where should the nurse aide aim the nozzle?

1. At the top of the flames
2. At the wall behind the fire
3. At the smoke above the fire
4. At the base of the fire, where the fuel is burning

Answer: D — At the base of the fire, where the fuel is burning

D) Correct — aiming at the base puts the extinguishing agent on the burning fuel, which is what actually stops the fire. A) is the most common misconception; spraying the visible flame tips accomplishes almost nothing. C) treats smoke as the fire, but smoke is a byproduct and cannot be extinguished. B) wastes the extinguisher's short discharge time on a surface that is not fueling the fire.

Standard precautions are used with which residents?

1. Only residents with a known infection listed on the care plan
2. Only residents on transmission-based precautions
3. Only residents whose blood or body fluids are visibly soiled
4. Every resident, every time, regardless of diagnosis

Answer: D — Every resident, every time, regardless of diagnosis

D) Correct — standard precautions assume the blood and body fluids of every resident may be infectious, because many infections are unknown or not yet diagnosed. A) tempts because care plans do flag known infections, but waiting for a diagnosis leaves the aide exposed to undiagnosed carriers. B) confuses standard precautions with the extra layer of transmission-based precautions added on top of them. C) is a common misconception; body fluids are treated as infectious whether or not soiling is visible.

A resident tells the nurse aide, "My chest feels tight and I can't catch my breath." The aide should FIRST:

1. Tell the resident it is probably indigestion from lunch
2. Stay with the resident and get the nurse right away
3. Take a full set of vital signs and chart them before saying anything
4. Have the resident lie flat and rest

Answer: B — Stay with the resident and get the nurse right away

B) Correct — chest tightness with shortness of breath is a potential emergency, and the aide's role is to stay with the resident and get the nurse immediately. A) interprets and diagnoses, which is outside the aide's scope and may delay life-saving care. C) tempts because vital signs are useful, but obtaining and charting them before alerting anyone wastes critical time. D) is wrong for a resident struggling to breathe, who is usually more comfortable upright.

A resident's urinal contains 12 ounces of urine and he also vomited 4 ounces. Using 30 mL per ounce, what total output should be recorded?

1. 160 mL
2. 360 mL
3. 480 mL
4. 800 mL

Answer: C — 480 mL

C) Correct — 12 plus 4 equals 16 ounces, and 16 times 30 mL equals 480 mL; emesis is output and is included. B) counts only the urine and omits the vomit, the classic omission error. A) comes from multiplying by 10 instead of 30. D) uses 50 mL per ounce, an incorrect conversion factor.

Approximately how often should a urinary drainage bag be emptied?

1. Only when it is completely full, so the closed drainage system is opened as seldom as possible
2. Every shift and whenever it is about 2/3 full, using the bag's drain spout
3. Once a week when the tubing and collection bag are changed by the nurse
4. Only when the resident notices it is full and asks to have it emptied

Answer: B — Every shift and whenever it is about 2/3 full, using the bag's drain spout

A) Waiting until the bag is full risks overflow and backflow of urine toward the bladder. B) Correct - regular emptying keeps the bag below bladder level effective, allows accurate output recording, and keeps the closed system intact because the spout, not the tubing, is opened. C) Weekly emptying is far too infrequent; the bag would overflow. D) Many residents cannot see or report on the bag; emptying is the aide's responsibility.

Which information is MOST important for the nurse aide to include in the end-of-shift report?

1. Personal opinions about which residents are difficult so the next shift knows what to expect
2. Changes in residents' conditions, intake and output, and care not yet completed
3. Details of a conversation about a resident that was overheard in the hallway during the shift
4. A summary of the aide's own workload and how many assignments were completed on time

Answer: B — Changes in residents' conditions, intake and output, and care not yet completed

B) Correct — report exists so the oncoming staff know what changed, what the numbers were, and what still needs doing. A) is unprofessional and biases the next shift against a resident. C) passes along unverified information and may breach confidentiality. D) tempts because workload feels report-worthy, but it tells the next aide nothing about the residents' needs.

Which is the BEST practice when a male resident uses a urinal in bed?

1. Leave the urinal in place between uses so it is handy and the resident does not have to wait for help
2. Empty, rinse and store the urinal after each use, recording the output if intake and output is ordered
3. Empty it once per shift to reduce interruptions and to allow a single accurate total to be recorded
4. Place the covered urinal on the overbed table within easy reach of the resident's stronger hand

Answer: B — Empty, rinse and store the urinal after each use, recording the output if intake and output is ordered

B) Correct - emptying and rinsing right away controls odor and skin exposure, keeps the urinal out of the bed, and lets output be measured accurately when it has been ordered. A) leaving a full urinal against the skin causes irritation and spills. C) once a shift allows urine to sit and makes accurate measurement of separate voids impossible. D) the overbed table holds meals and personal items and must never hold elimination equipment.

Hand-washing should last at least:

1. 5 sec, a quick rinse between residents in the same room
2. 10 sec, about the time needed to work the soap into a lather
3. 20 seconds of vigorous lathering over all surfaces of the hands
4. 60 sec, matching the longer scrub used before sterile procedures

Answer: C — 20 seconds of vigorous lathering over all surfaces of the hands

C) Correct — at least 20 seconds of vigorous lathering that covers the palms, backs of the hands, between the fingers, and under the nails is the accepted standard. A) 5 seconds does not allow soap and friction to lift and rinse away organisms. B) 10 seconds may produce lather but ends before the mechanical action has done its work. D) 60 seconds is longer than routine handwashing requires; that length belongs to a surgical scrub.

A newly admitted resident arrives on the unit. Which task is within the nurse aide's role during admission?

1. Completing the initial head-to-toe skin assessment and staging any wounds that are found
2. Explaining the medication schedule to the family so they know when to visit around doses
3. Measuring height, weight and vital signs and inventorying the resident's belongings
4. Deciding which room and roommate the new resident will be assigned to on the unit

Answer: C — Measuring height, weight and vital signs and inventorying the resident's belongings

C) Correct — baseline measurements and a belongings inventory are standard aide admission duties. A) assessing and staging wounds is a licensed nurse function; the aide observes and reports what is seen. B) medication teaching is outside the aide's scope. D) room assignment is an administrative and nursing decision.

Resident falls — first action?

Stay with resident. Call for help. Don't move. Take vitals. Look for injury. Notify nurse. Document. Do NOT lift alone.

Hand washing technique?

Wet → soap → lather 20 sec → rinse fingertips DOWN → dry with paper towel → use towel to turn off faucet + open door. Don't touch sink.

What is the universal sign of choking, and what does an aide do for a conscious choking adult?

Hands clutching the throat. If the person cannot speak, cough, or breathe, give abdominal thrusts and call for help.

What are standard precautions?

Treating all blood, body fluids, secretions, excretions except sweat, non-intact skin, and mucous membranes as potentially infectious for every resident.