CNA Basic Nursing Skills 4 2 — Questions and Answers
Question 1: When transferring a resident from a bed to a wheelchair, what should the CNA do first?
- Slide the resident to the edge of the bed immediately
- Lock the wheelchair brakes and position it at a 45-degree angle to the bed (Correct answer)
- Lift the resident under the arms
- Ask the resident to stand up quickly to avoid a fall
Correct answer: Lock the wheelchair brakes and position it at a 45-degree angle to the bed
Locking the wheelchair brakes and positioning it correctly at a 45-degree angle to the bed is the first safety step before initiating a transfer.
A safe transfer begins with proper preparation: the wheelchair is positioned at a 45-degree angle to the bed on the resident's stronger side, brakes are locked, and footrests are raised. The CNA then assists the resident to a sitting position at the edge of the bed, checks for dizziness (orthostatic hypotension), and uses a gait belt if indicated. Skipping preparation steps dramatically increases fall risk.
Question 2: The purpose of a gait belt during a transfer is to:
- Restrict the resident's movement
- Provide a firm grip for the CNA to safely assist the resident (Correct answer)
- Eliminate the need for the resident to bear weight
- Hold the resident's clothes in place
Correct answer: Provide a firm grip for the CNA to safely assist the resident
A gait belt gives the CNA a secure grip around the resident's waist, enabling safer guiding and support during transfers and ambulation.
Gait belts (also called transfer belts) are applied snugly around the resident's waist — typically allowing two fingers to fit underneath. They allow the CNA to maintain a firm, controlled grip during transfers without grabbing clothing or limbs, which could cause injury. They are especially important for residents with limited strength, balance issues, or a fall history.
Question 3: When repositioning a resident in bed to a lateral (side-lying) position, what should be placed between the resident's knees?
- A rolled towel under the lower knee only
- Nothing; leg contact helps maintain position
- A pillow or foam pad (Correct answer)
- A folded blanket under the entire leg
Correct answer: A pillow or foam pad
Placing a pillow or foam pad between the knees prevents bony prominences from pressing against each other, reducing pressure injury risk.
In a lateral position, the medial aspects of the knees and ankles are bony prominences that press against each other. Without padding, this contact creates pressure and friction, leading to skin breakdown. A pillow or foam pad between the knees redistributes this pressure. Pillows may also be used behind the back and under the upper arm to maintain proper alignment.
Question 4: What is the recommended body mechanics principle for CNAs when lifting or transferring residents?
- Bend at the waist and keep legs straight
- Keep the load as far from the body as possible
- Bend at the knees and keep the back straight, using leg muscles to lift (Correct answer)
- Twist the torso to reposition the resident quickly
Correct answer: Bend at the knees and keep the back straight, using leg muscles to lift
Bending at the knees with a straight back and using leg muscles protects the CNA's spine and reduces the risk of back injury.
Proper body mechanics are essential for CNA safety. The spine should remain neutral (not flexed or twisted) during lifting. The CNA should stand close to the resident, use a wide base of support, bend at the hips and knees, tighten the abdominal muscles, and lift with the leg muscles. Twisting while lifting is a primary cause of back injury in healthcare workers.
Question 5: A resident is able to bear weight on one leg but not the other. Where should the CNA position themselves during a stand-pivot transfer?
- Directly behind the resident
- On the resident's stronger side
- On the resident's weaker side (Correct answer)
- Anywhere that is comfortable for the CNA
Correct answer: On the resident's weaker side
The CNA stands on the resident's weaker side to provide support where the resident has the least ability to protect themselves.
During transfers, the CNA positions on the resident's weaker side to guide, support, and protect that limb. This placement prevents the weak limb from buckling unsupported and allows the CNA to block the knee if needed. The gait belt should be used, and the CNA instructs the resident to push up from the bed using their stronger arm and leg.
Question 6: After placing a resident in a wheelchair, what should the CNA do before leaving the resident?
- Unlock the brakes so the resident can move independently
- Ensure the resident's feet are on the footrests and the call light is within reach (Correct answer)
- Raise the wheelchair footrests to the highest position
- Document the transfer in the medical record immediately
Correct answer: Ensure the resident's feet are on the footrests and the call light is within reach
Ensuring feet are safely on footrests prevents foot injury from dragging, and a reachable call light allows the resident to summon help if needed.
After completing a wheelchair transfer, the CNA lowers the footrests so the resident's feet rest on them — preventing the feet from dragging on the floor when the wheelchair is moved. The call light must be within the resident's reach before the CNA leaves the room. Brakes may be left unlocked if the resident is able to safely manage the wheelchair, but safety depends on the individual care plan.
CNA Basic Nursing Skills 4 2
When transferring a resident from a bed to a wheelchair, what should the CNA do first?