CNA Basic Nursing Skills 21 2 — Questions and Answers
Question 1: During a cardiac arrest, what is the correct compression-to-ventilation ratio for adult CPR according to AHA guidelines?
- 15 compressions to 2 breaths
- 30 compressions to 2 breaths (Correct answer)
- 30 compressions to 1 breath
- 20 compressions to 2 breaths
Correct answer: 30 compressions to 2 breaths
The AHA adult CPR ratio is 30 chest compressions to 2 rescue breaths, minimizing interruptions to compressions.
The 30:2 ratio minimizes interruptions to compressions, which maintain coronary and cerebral perfusion. Chest compressions should be at least 2 inches deep, at a rate of 100-120 per minute, allowing full chest recoil. Rescue breaths are given over 1 second each. If the rescuer is untrained in or unable to give breaths, hands-only CPR (compressions only) is still effective and recommended.
Question 2: What should the CNA do when encountering an unresponsive resident?
- Begin CPR immediately without calling for help
- Check for responsiveness by tapping the shoulder and shouting, activate the emergency response system, and begin CPR if there is no pulse or breathing (Correct answer)
- Wait until the resident wakes on their own
- Call the resident's family before contacting the nurse
Correct answer: Check for responsiveness by tapping the shoulder and shouting, activate the emergency response system, and begin CPR if there is no pulse or breathing
The response sequence is: check for responsiveness, activate emergency response (call for help), and begin CPR if no pulse/breathing are detected.
When a resident is found unresponsive, the CNA taps the shoulder and shouts 'Are you okay?' If there is no response, the call system is activated immediately. The CNA checks for breathing and pulse (carotid, up to 10 seconds). If absent, CPR is begun. Activating the emergency response brings the nurse, crash cart, and AED to the scene — help that is critical for survival.
Question 3: An AED is brought to the scene of a cardiac arrest. What is the CNA's responsibility when an AED is present?
- Continue CPR until the nurse arrives and ignore the AED
- Attach and use the AED as soon as possible and follow its voice prompts (Correct answer)
- Only allow physicians to use the AED
- Wait to use the AED until two nurses are present
Correct answer: Attach and use the AED as soon as possible and follow its voice prompts
AEDs are designed for use by bystanders and first responders. Their rapid application significantly improves cardiac arrest survival rates and CNAs trained in CPR are expected to use them.
Every minute of delay in defibrillation reduces survival from ventricular fibrillation by approximately 10%. AEDs provide voice and visual instructions that guide the user step by step. The CNA should attach the AED pads to the bare chest as directed, ensure no one is touching the resident during analysis and shock delivery, and resume CPR immediately after each shock. Using an AED is within the CNA's scope during an emergency.
Question 4: A resident has fallen and is unconscious. Before moving them, the CNA should first:
- Move them to a more comfortable position
- Assess for responsiveness, breathing, and call for help without moving the resident until assessed for spinal injury (Correct answer)
- Place a pillow under their head
- Check their pulse and then move them to the bed
Correct answer: Assess for responsiveness, breathing, and call for help without moving the resident until assessed for spinal injury
An unconscious fall victim should not be moved until assessed for potential spinal injury; calling for help and assessing without moving protects against worsening a possible spinal cord injury.
Falls with loss of consciousness carry the risk of spinal injury, especially in elderly residents with osteoporosis or prior neck/back disease. Moving the resident before ruling out spinal injury can convert an incomplete injury to a complete one, causing permanent paralysis. The CNA activates the emergency response, maintains the resident in place, and follows nursing and emergency instructions for safe movement using spinal precautions if needed.
Question 5: During a fire emergency, what does the acronym RACE stand for?
- Rescue, Announce, Contain, Extinguish (Correct answer)
- Remove, Assess, Call, Evacuate
- Respond, Alert, Close, Exit
- Run, Alert, Check, Evacuate
Correct answer: Rescue, Announce, Contain, Extinguish
RACE — Rescue (move residents from immediate danger), Announce/Alarm (activate the fire alarm), Contain (close doors and windows), Extinguish (use fire extinguisher if safe) — is the standard fire response protocol.
RACE is a universal fire safety protocol in healthcare settings. Rescue means moving residents from the immediate area of the fire. Announce means activating the fire alarm and calling 911. Contain means closing doors and windows to slow fire spread. Extinguish means using a fire extinguisher on small, contained fires only if safe to do so. Resident safety and evacuation always take priority over attempting to fight the fire.
Question 6: A resident has a suspected fracture after a fall. How should the CNA manage the injured limb?
- Gently straighten the limb to reduce pain
- Move the limb through its normal range of motion to assess mobility
- Immobilize the limb in the position found and notify the nurse immediately (Correct answer)
- Apply a tight bandage and have the resident walk to test for injury
Correct answer: Immobilize the limb in the position found and notify the nurse immediately
Suspected fractures should be immobilized in the position found. Moving or manipulating a fractured limb can cause additional tissue damage, pain, or nerve injury.
Moving a fractured limb can displace bone fragments, injure adjacent blood vessels and nerves, increase bleeding, and worsen pain. The CNA immobilizes the limb as found (not straightened), reassures the resident, prevents weight bearing, and immediately notifies the nurse. The nurse will arrange for X-rays and physician assessment. If there is obvious deformity, swelling, or the resident cannot move the limb, fracture should be assumed.
CNA Basic Nursing Skills 21 2
During a cardiac arrest, what is the correct compression-to-ventilation ratio for adult CPR according to AHA guidelines?