Basic Nursing Skills 1 — Questions and Answers

Question 1: When transferring a patient from bed to wheelchair, what is the most important safety consideration?

Making sure the wheelchair is positioned parallel to the bed
Ensuring the wheelchair brakes are locked and footrests are moved aside (Correct answer)
Having the patient wear non-slip socks
Adjusting the bed to its highest position

Correct answer: Ensuring the wheelchair brakes are locked and footrests are moved aside

The most critical safety consideration when transferring a patient from bed to wheelchair is to ensure the wheelchair brakes are locked and the footrests are moved out of the way. Locked brakes prevent the wheelchair from moving during the transfer, eliminating a major fall risk. Moving footrests prevents tripping hazards and allows for proper patient positioning, ensuring a safe transfer.

Question 2: A patient's oral temperature reading is 102.6°F. What should the CNA do first?

Immediately give the patient a cold drink
Retake the temperature to confirm the reading (Correct answer)
Apply cooling blankets without reporting
Document the temperature and continue with other tasks

Correct answer: Retake the temperature to confirm the reading

A significantly elevated temperature like 102.6°F is an abnormal finding that requires verification. Retaking the temperature ensures accuracy and rules out equipment malfunction or improper technique before reporting to the nurse or initiating interventions. This prevents unnecessary alarm or interventions based on a potentially false reading.

Question 3: When measuring a patient's blood pressure, the cuff should cover what percentage of the upper arm?

25-50% of the upper arm
50-75% of the upper arm
75-80% of the upper arm (Correct answer)
85-90% of the upper arm

Correct answer: 75-80% of the upper arm

For an accurate blood pressure reading, the cuff bladder should encircle 75-80% of the arm's circumference. If the cuff is too small, the reading will be falsely high; if too large, it will be falsely low. Proper cuff size is crucial for obtaining reliable vital sign measurements.

Question 4: A resident in a long-term care facility has been sitting in their wheelchair for 3 hours. What should the CNA do?

Leave the resident as they appear comfortable
Reposition the resident or help them change positions (Correct answer)
Add extra cushions to the wheelchair
Wait until the next scheduled activity

Correct answer: Reposition the resident or help them change positions

Prolonged sitting in one position, even if the resident appears comfortable, increases the risk of pressure injuries (bedsores). CNAs are responsible for repositioning residents at least every two hours to promote circulation and prevent skin breakdown. This proactive measure is essential for resident comfort and skin integrity.

Question 5: When providing perineal care for a female patient, the CNA should clean:

From back to front using circular motions
From front to back using a clean area of the washcloth for each stroke (Correct answer)
From side to side across the perineal area
The entire area with the same section of washcloth

Correct answer: From front to back using a clean area of the washcloth for each stroke

Cleaning from front to back (urethra to anus) prevents the transfer of bacteria from the anal area to the urethra, which can cause urinary tract infections (UTIs). Using a clean section of the washcloth for each stroke further minimizes the spread of microorganisms. This technique is crucial for maintaining hygiene and preventing infection.

Question 6: A patient complains of chest pain. What is the CNA's immediate priority?

Give the patient water and encourage deep breathing
Have the patient lie flat and elevate their legs
Help the patient to a comfortable position and call for the nurse immediately (Correct answer)
Take vital signs first, then report to the nurse

Correct answer: Help the patient to a comfortable position and call for the nurse immediately

Chest pain is a critical symptom that could indicate a life-threatening condition like a heart attack. The CNA's immediate priority is to ensure the patient's comfort and safety, then promptly report this urgent symptom to the nurse. The nurse will then assess the patient and determine the appropriate medical interventions.

Question 7: When making an occupied bed, what should the CNA do to maintain the patient's dignity?

Work as quickly as possible to minimize discomfort
Keep the patient covered and expose only the area being worked on (Correct answer)
Ask family members to leave the room completely
Explain that dignity isn't important during care procedures

Correct answer: Keep the patient covered and expose only the area being worked on

Maintaining a patient's dignity and privacy is a fundamental aspect of person-centered care, especially during personal care procedures like bed making. Keeping the patient covered and exposing only necessary areas respects their modesty and promotes a sense of comfort and security. This practice builds trust and upholds ethical care standards.

Question 8: A patient using a walker should be instructed to:

Step into the walker, then move the walker forward
Move the walker forward, then step into it (Correct answer)
Move the walker and step simultaneously
Lean heavily on the walker for support

Correct answer: Move the walker forward, then step into it

The correct technique for using a walker involves moving the walker forward first, then stepping into it with the weaker leg, followed by the stronger leg. This sequence provides a stable base of support before the patient shifts their weight. It ensures balance and prevents falls during ambulation.

Question 9: When collecting a urine specimen from a patient with a urinary catheter, the CNA should:

Empty the drainage bag and collect from the bag
Disconnect the catheter from the drainage tube
Use the sterile port on the catheter tubing with a sterile syringe (Correct answer)
Have the patient try to urinate into a specimen cup

Correct answer: Use the sterile port on the catheter tubing with a sterile syringe

To collect a sterile urine specimen from a urinary catheter, the CNA must use the designated sterile port on the catheter tubing. Collecting from the drainage bag is not sterile, and disconnecting the catheter introduces a high risk of infection. This method ensures the specimen is free from external contamination, allowing for accurate diagnostic testing.

Question 10: A patient is choking and cannot speak or cough. What should the CNA do first?

Give 5 back blows between the shoulder blades
Perform abdominal thrusts (Heimlich maneuver) (Correct answer)
Try to remove the object with fingers
Give small sips of water to help wash it down

Correct answer: Perform abdominal thrusts (Heimlich maneuver)

When a patient is choking and cannot speak or cough, it indicates a complete airway obstruction, which is a medical emergency. The immediate and most effective intervention is to perform abdominal thrusts (Heimlich maneuver) to dislodge the object. This action is critical to restore breathing and prevent severe complications.

Question 11: When documenting a patient's intake, which measurement should be recorded for a coffee cup that was half full?

120 mL (Correct answer)
150 mL
200 mL
240 mL

Correct answer: 120 mL

In healthcare, a standard coffee cup is typically estimated to hold 240 mL (8 ounces) when full. Therefore, if a coffee cup was half full, the intake would be half of 240 mL, which is 120 mL. Accurate measurement of fluid intake is crucial for monitoring a patient's hydration status and fluid balance.

Question 12: A patient with diabetes appears sweaty, shaky, and confused. What should the CNA suspect and do?

High blood sugar - give insulin immediately
Low blood sugar - give a quick-acting carbohydrate if the patient can swallow safely (Correct answer)
Heart attack - have the patient lie down flat
Stroke - check for facial drooping

Correct answer: Low blood sugar - give a quick-acting carbohydrate if the patient can swallow safely

The symptoms of being sweaty, shaky, and confused are classic signs of hypoglycemia (low blood sugar), which is a medical emergency for diabetic patients. If the patient is conscious and can safely swallow, giving a quick-acting carbohydrate like juice or glucose tablets can rapidly raise blood sugar levels. This immediate intervention can prevent severe complications, but the nurse must be notified promptly.

Question 13: When assisting a patient with range-of-motion exercises, the CNA should:

Move joints quickly to complete exercises efficiently
Push joints beyond their comfortable range to improve flexibility
Support the joint above and below while moving slowly and smoothly (Correct answer)
Focus only on large joints like shoulders and hips

Correct answer: Support the joint above and below while moving slowly and smoothly

When performing range-of-motion exercises, it is crucial to support the joint both above and below to prevent injury and provide stability. Movements should be slow, smooth, and within the patient's comfortable range, never forcing the joint beyond its natural limits. This technique ensures patient safety and therapeutic effectiveness.

Question 14: A patient is receiving oxygen therapy via nasal cannula. The CNA notices the patient's lips and nail beds appear blue. What should be done first?

Increase the oxygen flow rate immediately
Check that the nasal cannula is properly positioned and notify the nurse (Correct answer)
Have the patient take deep breaths and cough
Document the observation and continue monitoring

Correct answer: Check that the nasal cannula is properly positioned and notify the nurse

Blue lips and nail beds (cyanosis) indicate hypoxemia, meaning the patient is not receiving enough oxygen. The CNA's first action should be to ensure the oxygen delivery device (nasal cannula) is correctly positioned and functioning. After checking the equipment, the nurse must be notified immediately as this is a critical change in the patient's condition requiring prompt assessment and intervention.

Question 15: When providing mouth care for an unconscious patient, the CNA should:

Position the patient flat on their back
Use a large amount of liquid to thoroughly rinse the mouth
Turn the patient's head to the side and use minimal liquid (Correct answer)
Skip mouth care since the patient cannot eat

Correct answer: Turn the patient's head to the side and use minimal liquid

When providing mouth care for an unconscious patient, the primary concern is preventing aspiration (inhaling fluid into the lungs). Turning the patient's head to the side allows gravity to drain fluids out of the mouth, and using minimal liquid reduces the risk of choking or aspiration. This technique ensures safety while maintaining oral hygiene.

Question 16: A patient asks the CNA about their medical diagnosis and treatment plan. How should the CNA respond?

Provide detailed information since the patient has a right to know
Tell the patient not to worry about medical details
Refer the patient to their nurse or doctor for medical information (Correct answer)
Give general information but avoid specific details

Correct answer: Refer the patient to their nurse or doctor for medical information

CNAs are not authorized or qualified to discuss a patient's medical diagnosis, prognosis, or treatment plan. This information is complex and requires the expertise of a licensed nurse or doctor. The CNA's role is to refer such questions to the appropriate healthcare professional, respecting the scope of practice and ensuring accurate communication.

Basic Nursing Skills 1

When transferring a patient from bed to wheelchair, what is the most important safety consideration?