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Which of the following actions is correct when giving a client a bath?
Clean the perineal area by gently wiping with the washcloth from back to front.
Ensure any areas not being currently washed are covered by a sheet or towel.
Make the client give themselves their own bath, even if they perform it poorly.
Lotion the client’s feet after bathing and be sure to get in between the toes.
Question 1 Explanation:
In order to maintain privacy and keep a client warm, it is important to cover areas that are not being bathed. When cleaning the perineal area, wipe front to back. Have the client assist with ADLs, but support them. Do not lotion between toes because it predisposes them to fungal infections.
Which of the following procedures cannot be performed by a nursing assistant?
Reporting a soiled dressing to the nurse.
Inserting a Foley catheter.
Performing oral care on an unconscious patient.
Assisting the client to the bathroom.
Question 2 Explanation:
Inserting an indwelling urinary catheter requires sterile technique, which is not a component of nursing assistant skills.
A client who suffered a left-sided stroke one year ago has unresolved aphasia. The nurse knows that the term aphasia means:
that the client is confused.
that the client is unable to void.
that the client is unable to understand and process language.
that the client is unable to speak.
Question 3 Explanation:
The term “aphasia” means that the client is unable to speak, or may have difficulty finding words at times.
A patient who is immobile may experience which of the following feelings?
Question 4 Explanation:
This patient may feel sad due to the limitation of their illness.
The Omnibus Budget and Reconciliation Act (OBRA) requires all nursing homes to do what for their clients?
Help residents write wills and choose power of attorneys.
Help residents reach their highest level of psychological and mental functioning.
Help residents perform ADLs and avoid neglect.
Help residents to transfer to other nursing homes if they want.
Question 5 Explanation:
OBRA requires facilities to help their residents achieve their highest points of physical, psychological, and mental functioning, as well as make choices about their lives.
Range-of-motion exercises are most important for which type of patient to perform?
A patient with a pulled leg muscle.
A patient who has hypertension.
A patient with hemiplegia.
A patient with depression.
Question 6 Explanation:
The patient with hemiplegia should participate in range-of-motion exercises in order to maintain joint function and avoid blood clots. Hemiplegia is a form of paralysis that affects one side of the body, often just one arm and one leg, but at times extending partially to the torso.
Which of the following is an example of a nursing assistant’s desired characteristic of reliability?
The nursing assistant lets the nurse know when a patient states he is in pain.
The nursing assistant monitors a patient’s vital signs.
The nursing assistant completes a task designated by the nurse in a timely manner.
The nursing assistant clocks in fifteen minutes after her shift began.
Question 7 Explanation:
Completing tasks as asked indicates reliability. Monitoring vital signs is good, but too general. Communication and tardiness are separate concepts from reliability.
The term grievance refers to which aspect included in the Patient Bill of Rights?
There is no lifetime monetary limit on essential care.
Patients are not allowed to call doctors at home.
Patients have access to their health information at all times.
Patients have the right to file a complaint without fear or penalty.
Question 8 Explanation:
The ability to file a grievance in a nursing home or other nursing care facility is considered a legal right as defined by the Patient Bill of Rights.
Which of the following diseases does not require airborne precautions?
Question 9 Explanation:
MRSA is a disease transmitted by skin-to-skin contact. It does not require airborne or droplet precautions.
The nursing assistant cares for a patient with hepatitis C. The nursing assistant knows that the patient could have come in contact with this disease in which of the following ways?
IV drug use.
Dirty toilet seat.
Dirty eating utensils.
Question 10 Explanation:
IV drug use is one of the many ways that it is possible to contract the hepatitis C virus.
The nursing assistant cares for a client who is depressed. One day, the client states “I can’t go on any longer. I have made a plan to kill myself. I don’t know if I would follow through with it, but it seems much better than living this life any longer.” Which of the following is the correct action?
Report the situation to the physician.
Ask the patient, “Can you tell me more about your feelings?”
Report the situation to the nurse in charge.
Reassure the patient by saying, “It’s not that bad. You’ll feel better tomorrow.”
Question 11 Explanation:
This patient is no longer just depressed; they are suicidal. Having a plan puts them at increased risk, and they need to be reported to the nurse for their own safety.
When recording data on a legal form, it is considered correct to write with which of the following?
A black or a blue pen.
A blue pen.
A black pen.
A red pen.
Question 12 Explanation:
Legal documentation must be composed with a black or a blue pen in order to be valid.
The nursing assistant takes the blood pressure of a patient known for “running low.” To her surprise, the reading is 155 over 85. Which of the following factors might be directly responsible?
The patient denies skipping any medication.
The patient is stressed.
The blood pressure cuff is too tight.
The patient is lying in bed.
Question 13 Explanation:
The blood pressure cuff size is a direct influence on the reading. The blood pressure will read higher with a tight cuff and lower with a cuff that is too large.
What is the difference between Sims position and left lateral position?
In Sims position, a pillow is placed between the patient’s knees to prevent them from touching.
In lateral position, the patient’s head is elevated to 15 degrees on two pillows.
In lateral position, the patient’s undermost arm is positioned laterally and parallel to the patient’s back.
In Sims position, the patient’s undermost arm is positioned laterally and parallel to the patient’s back.
Question 14 Explanation:
This correctly describes how Sims position is different than left lateral position. A pillow is placed between the knees in both positions listed.
When assisting the resident to transfer from the bed to a chair, the nursing assistant knows it is necessary to do all of the following EXCEPT:
Assist the resident to put on a robe and nonskid slippers.
Encourage the resident to pivot themselves with minimal assistance.
Place the chair on the resident’s strong side.
Place the bed in the lowest position and lock the wheels.
Question 15 Explanation:
Residents should be fully assisted and supervised when turning in order to prevent falls.
When applying a jacket restraint to a patient, it is most important to:
Check that the patient is not able to hit any other patients nearby.
Check that the patient can fully expand their chest for breathing.
Use a half-bow knot to secure each tie around the bed frame.
Use a square knot to fasten the vest ties together behind the chair.
Question 16 Explanation:
Breathing is always priority number one for patients. After that, concentrate on how to apply the vest properly.
Choose the observation that should be reported to the nurse STAT.
Temperature of 98.9 degrees F.
A pulse of 72.
32 respirations per minute.
Blood pressure of 102 over 75.
Question 17 Explanation:
The number of respirations is slightly too fast to be considered normal and could be considered a respiratory problem.
Which of the following best describes the concept of empathy?
A nursing assistant asks a patient whether they would like to take a walk or watch a movie.
A nursing assistant speaks with a dietician about alterations to the patient’s meal tray.
A nursing assistant speaks with a patient about their recent diagnosis of cancer.
A nursing assistant asks the nurse when she may take a meal break.
Question 18 Explanation:
Speaking with a patient about a recent, potentially devastating diagnosis, shows a willingness to discuss feelings and issues that may be difficult to talk about.
Another term that is similar to the word convulsion is:
Question 19 Explanation:
Convulsions are also sometimes known as seizures.
Which of the following bedtime snacks should a patient choose in order to increase their intake of vitamin D?
A warm glass of milk.
Question 20 Explanation:
Milk and other dairy products are usually fortified with vitamin D. This is the best snack to increase intake.
Diabetes is a disease of which primary body system?
Question 21 Explanation:
Diabetes is a disease process that occurs due to a disease of the endocrine system and subsequently affects all other systems.
Which of the following is the leading cause of accidental death in those 85 years of age and older?
Question 22 Explanation:
Falls are the number one cause of accidental death in this age group. Work hard to prevent them!
All of the following factors may interfere with elimination EXCEPT:
Question 23 Explanation:
Family stress does not typically interfere with elimination. Aging, medications, and infection do have a direct effect on elimination.
During a bath, the three most important things for the resident are:
Safety, security, and privacy.
Safety, warmth, and cleanliness.
Comfort, rest, and security.
Privacy, rest, and warmth.
Question 24 Explanation:
Safety, security, and privacy are most important to the resident during a bed bath.
A nursing assistant arrives at work. Three hours into the shift, she feels chilled and takes her temperature. The read-out is 101.0 degrees F. The correct action is to:
Continue working, but wear a mask.
Report herself to the nursing supervisor and be dismissed home.
Continue working, but wash hands every fifteen minutes.
Leave immediately for home.
Question 25 Explanation:
As a nursing assistant, you can’t just leave your patients without transferring their care elsewhere. The nursing supervisor can assist with this process if you are too sick to do so yourself. A fever means that you are an infection risk to residents.
A nursing assistant happens to witness a patient fall and is asked to document what happened. Which of the following statements is written correctly for legal documentation?
“The patient tripped over bedsheets because housekeeping left them on the floor all day.”
“The patient slipped and slid down the side of the bed to the floor, landing on their sacrum.”
“The patient fell because they ignored me when I told them to stay in bed.”
“The patient fell because the nurse forgot to lock the wheels of the bed again.”
Question 26 Explanation:
This statement is the only correct documentation because it reflects events as they happened and does not assign blame.
Which of the following disorders are said to be irreversible?
Question 27 Explanation:
Emphysema is the only truly irreversible disease listed. Asthma may be “outgrown” after childhood, and chicken pox is an acute, short-lived illness. Hypertension may be “cured” with diet, exercise, and medication.
The abbreviation Rx indicates:
A type of wound.
An acute illness.
Question 28 Explanation:
The abbreviation Rx stands for ‘treatment’ or ‘prescription.’
The nursing assistant cares for a diabetic client. Which of the following symptoms in this client should be immediately reported?
Refusal to eat dessert.
A bowel movement.
Question 29 Explanation:
Emesis (vomiting) in the diabetic client can indicate a potential for blood sugar imbalance. This should be reported to the nurse for further assessment.
It would be inappropriate to utilize an alcohol-based hand sanitizer in which of the following situations?
The nursing assistant’s hands are visibly soiled.
The nursing assistant has just left the patient’s room.
The nursing assistant is about to enter the patient’s room.
The nursing assistant helps a patient to the bathroom while wearing gloves.
Question 30 Explanation:
Visibly soiled hands require scrubbing, soap, and water to clean.
The nursing assistant knows that urine is normally:
Dark in color and foul-smelling.
Clear, dark yellow.
Clear, pale yellow.
Question 31 Explanation:
Clear, pale yellow urine indicates a well-hydrated patient.
The nursing assistant is helping a male patient to use the urinal. She pulls the curtain around the bed for privacy before saying:
“If you do not fill it completely, I will empty it later.”
“If you need any more assistance, please ring the bell.”
“Please ring me when you are finished and I will empty it for you.”
“Please let me know later how many mL.”
Question 32 Explanation:
The nursing assistant cannot ask the patient to measure his own urine, or delay in emptying it. Once the patient is finished, he should ring the bell so that she can measure it and empty it herself.
A patient is undergoing bowel training. The nursing assistant knows that bowel training:
is used for people with colostomies to ensure a regular pattern.
is a normal part of a healthy digestive tract.
is a technique for going to the bathroom without pushing.
is not used anymore.
Question 33 Explanation:
Bowel training is used with ostomy patients to ensure a regular elimination pattern.
The nursing assistant would suspect that one of her patients is having a problem with swallowing if she notices which of the following?
Completing a meal over the course of fifteen minutes.
Chewing very slowly.
Pocketing of food.
Question 34 Explanation:
A patient who pockets food may be having a difficult time swallowing.
When caring for a patient, the nursing assistant notices that the patient is bleeding around an IV site. Which of the following is the most appropriate action to take?
Clamp the IV catheter and tell the nurse.
Tell the nurse when she happens to see her.
Report it to the patient’s nurse immediately.
Report it to the nursing supervisor.
Question 35 Explanation:
This should be reported to the patient’s nurse immediately.
Rectal temperatures are usually taken on patients who are:
Question 36 Explanation:
Unconscious patients cannot close their mouths around an oral thermometer. Any of the other patient types would be resistant and/or fearful to a rectal thermometer.
A typical blood pressure around the upper arm should NOT be taken when the patient:
complains that “this is the fifth time today.”
has IV catheters in both the left and right arms.
has heart failure.
has had lymph nodes removed around the axilla of the left arm.
Question 37 Explanation:
If the patient has IV catheters in both arms, a blood pressure cuff will impede their intravenous flow.
Which of the following is an example of nonverbal communication?
Minimizing facial expression.
Question 38 Explanation:
Hand gestures are an example of nonverbal communication.
Which of the following is an example of emotional lability?
The patient gets upset after a long day and blames it on tiredness.
The patient gets upset when he learns he has been diagnosed with cancer.
The patient gets upset when he does not receive a plate in his favorite color.
The patient gets upset after telling the nurse immediately prior how happy he is.
Question 39 Explanation:
Switching quickly from happy to sad, or mad to peaceful, is the definition of emotional lability.
The nursing assistant speaks with the nursing facility’s ombudsman. The role of this position is to:
care for patients as if they were their own family.
make residents as happy as possible.
assist residents to set up insurance and policy claims.
investigate residents’ complaints and bring them to the attention of the correct authorities.
Question 40 Explanation:
The ombudsman’s job is to ensure that residents’ complaints are heard.
An eighty-five year-old resident at a longterm care facility is signing up for an afternoon activity. The resident asks the nursing assistant which choice she thinks is best. Which of the following should the nursing assistant suggest?
Tai chi and meditation.
Question 41 Explanation:
Tai chi is excellent for balance and would help the patient to decrease her risk of falls. Meditation may increase happiness and decrease any depression. Watching TV encourages stasis, not movement, and the rest are perhaps too active.
The nursing assistant knows that the term “pulse deficit” refers to:
the difference between the systolic and diastolic blood pressure.
an absence of the pulse.
the difference between the apical and radial pulse.
a strong pulse.
Question 42 Explanation:
The apical pulse is assessed through a stethoscope placed over the heart, while the radial pulse is typically taken by applying finger pressure to the inner wrist and counting the number of heartbeats. The difference between the two pulse rates is called the pulse deficit.
A nursing assistant watches a nurse teach a client about heart failure. The client has many questions and seems more confused rather than less. Which of the following strategies is best in regard to teaching?
Give the client a DVD to watch about heart failure.
Have the client repeat back what the nurse has said.
Give the client a brochure about heart failure.
Encourage the client to form more of a discussion with the nurse in order to understand better.
Question 43 Explanation:
The more involved a client is in learning, the more they will remember and understand.
The nursing assistant cares for a client with AIDS. The nursing assistant knows that AIDS patients require what type of precautions?
Question 44 Explanation:
AIDS patients require standard precautions. Gloves must be worn at all times when handling blood or other body fluids.
When the nursing assistant brings the client his tray for lunch, the client repeats questions twice before remembering the answer. The nursing assistant knows that the client had a fall two days ago. Which of the following actions is correct?
Assess the client’s head for bruising.
Take the client’s temperature.
Report it to the nurse immediately.
Assume the client is forgetful.
Question 45 Explanation:
Memory loss after a fall can indicate a concussion. Report it to the nurse immediately.
A resident is having difficulty chewing regular meals at dinner. Which of the following diets might be suggested to order for next time?
Question 46 Explanation:
A soft diet should be tried before a pureed diet for this patient.
A patient says that her visitor is unable to come during visitor hours and asks if she could be accommodated. The nursing assistant:
reviews the issue with the patient’s nurse before answering.
says, “Of course! That would be fine.”
reviews the issue with the charge nurse before answering.
says, “I’m sorry, that’s not our policy here.”
Question 47 Explanation:
It is appropriate to review this with the charge nurse of the unit before answering yes or no.
Before assisting the nurse to administer an enema to a bedridden client, the nursing assistant should most importantly:
review the procedure and what’s going to happen.
open the window.
reassure the client that it won’t hurt much.
gather all materials needed.
Question 48 Explanation:
It is important for the resident to know what’s going to happen and what to expect.
When making the patient’s bed, the nursing assistant knows it is most important to:
change the pillow cover every four hours.
use linen that has only been in the client’s room.
inspect the sheets for softness.
straighten the sheets to reduce wrinkle formation.
Question 49 Explanation:
Wrinkles and creases in the sheets can contribute to bed sores.
Rehabilitation care after any injury should begin when?
When the patient enters a rehab program.
One week into recovery.
As soon as possible.
When the doctor says so.
Question 50 Explanation:
Rehabilitation should begin as soon as possible in order to get the most recovery.
A nursing assistant who suspects a resident is being abused by someone in the facility should report it to:
the charge nurse.
the nurse caring for the client.
a fellow nurse’s aide.
Question 51 Explanation:
Reporting it to the charge nurse will ensure that it is handled properly.
A nursing assistant cares for a resident who has a cast on the left arm. While receiving a bed bath, the nursing assistant notices that the fingers on the client’s left hand are cold. Which of the following actions should the nursing assistant take next?
Tell the nurse immediately.
Feel the client’s fingers on the other hand.
Ask the client if it hurts.
Give the client gloves.
Question 52 Explanation:
First, check the fingers on the other hand. The client may have overall decreased circulation. If the fingers on the other hand are warm, however, the cast may need to be adjusted.
A client in the hospital announces that he is leaving this minute and that no one can stop him. The nursing assistant should:
tell the patient to wait and see if he likes the care more as he feels better.
tell the patient to wait so that she can get the nurse because he has to sign a form.
warn the patient that it’s better to follow the doctor’s recommendations.
tell the patient that he can’t leave.
Question 53 Explanation:
Clients who want to leave AMA (against medical advice) may do so, but they need to sign an AMA form or their insurance will often not pay for treatment.
A patient with a respiratory illness complains of thick, sticky secretions that are hard to cough up. The nursing assistant knows to suggest which of the following?
Drink plenty of fluids.
Turn and cough every hour.
Go outside and breathe the fresh air.
Question 54 Explanation:
Drinking fluids will help to lubricate the secretions so that the patient can cough them up easier.
A patient has a fever and describes feeling very uncomfortable. Which of the following recommendations is best for the nursing assistant to provide?
Give the patient a backrub.
Administer Tylenol 500mg PO.
Give the patient a cool washcloth to be placed on the forehead.
Suggest the patient sit outside in the fresh air.
Question 55 Explanation:
A cool washcloth can make a patient with a fever feel better. The nursing assistant may not administer medications.
The nursing assistant overhears the nurse say to the patient that he has a “bulging tympanic membrane.” What does this most likely mean?
The patient is in pain.
The patient has a viral illness.
The patient has an ear infection.
The patient should clean his ears more frequently.
Question 56 Explanation:
The tympanic membrane is more commonly known as the eardrum. A bulging, tympanic membrane typically indicates an ear infection, not necessarily a viral illness.
A patient who has recently been paralyzed below the waist due to a motorcycle accident refuses his medications from the nurse. The patient then refuses to say anything. What is the nursing assistant’s best response?
Say, “You seem upset.”
Ignore the client’s temper tantrum.
Say, “Why did you refuse your medication?”
Say, “Don’t worry, things will seem better tomorrow.”
Question 57 Explanation:
Reflective statements are an important therapeutic tool.
A 52-year-old homeless man has just been admitted to the ER with a core body temperature of 90.2 degrees F. The doctor diagnoses the man with hypothermia. The nursing assistant knows that the organ most under stress from the low body temperature is the:
Question 58 Explanation:
The heart may fail or go into an arrhythmia from the drop in body temperature.
The nursing assistant receives her assignment for the shift and notices that she does not have a nurse assigned to her group. What action should she take next?
Offer to team up with another nursing assistant to give medications.
Begin gathering medications she must give.
Loudly complain about the situation.
Alert the charge nurse to the situation.
Question 59 Explanation:
Medications may not be given by a nursing assistant. Alert the charge nurse to ensure that there is a nurse provided for each client in the assignment.
A nursing assistant begins caring for a client during a bed bath and notes he has a reddened, intact area on his coccyx. Which of the following correctly describes this condition?
Ulceration stage 1.
Ulceration stage 2.
Ulceration stage 3.
Ulceration stage 4.
Question 60 Explanation:
This is a stage 1 ulceration, or bed sore, and should be reported to the nurse.
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