CNA Basic Nursing Skills 7 2 — Questions and Answers
Question 1: A resident on oxygen therapy has nasal cannula prongs that have become displaced. What should the CNA do?
- Reposition the cannula prongs in the nostrils and adjust the tubing for comfort (Correct answer)
- Remove the cannula entirely and notify the nurse to reapply it
- Increase the oxygen flow rate to compensate
- Leave it in place and document it at the end of the shift
Correct answer: Reposition the cannula prongs in the nostrils and adjust the tubing for comfort
The CNA should reposition the nasal cannula to ensure the resident continues to receive prescribed oxygen, then assess for comfort and check that the flow rate is unchanged.
Maintaining an open and properly positioned nasal cannula is part of the CNA's observation and care responsibilities. If the cannula is dislodged, repositioning it is appropriate. The CNA should NOT change the flow rate, which is a nursing function. Any observations about increased respiratory distress, low oxygen saturation on the monitor, or skin irritation from the cannula should be reported to the nurse.
Question 2: What is the CNA's primary responsibility regarding oxygen therapy?
- Adjusting oxygen flow rates as needed based on the resident's comfort
- Observing the resident for respiratory distress and reporting abnormalities to the nurse (Correct answer)
- Setting up and calibrating oxygen concentrators
- Deciding when to discontinue oxygen therapy
Correct answer: Observing the resident for respiratory distress and reporting abnormalities to the nurse
CNAs observe residents on oxygen therapy for signs of respiratory distress and report changes, but do NOT adjust flow rates or discontinue therapy.
Oxygen therapy is a medical treatment ordered and monitored by licensed staff. CNAs ensure the equipment is properly positioned, observe the resident for respiratory changes (rate, effort, color, restlessness), report abnormal pulse oximetry readings if monitoring is in place, and ensure the oxygen source has adequate supply. Changing flow rates or settings is outside the CNA's scope of practice.
Question 3: What should the CNA do if a resident on oxygen becomes severely short of breath and cyanotic (blue lips)?
- Increase the oxygen flow rate immediately
- Elevate the head of the bed and call for the nurse immediately (Correct answer)
- Give the resident a paper bag to breathe into
- Tell the resident to slow their breathing and relax
Correct answer: Elevate the head of the bed and call for the nurse immediately
Elevating the head of the bed facilitates breathing and calling the nurse immediately is the correct emergency response to acute respiratory distress.
Cyanosis (blue discoloration of lips, fingernails, or skin) indicates oxygen deprivation and is a medical emergency. The CNA positions the resident to maximize breathing (High Fowler's or Fowler's position) and immediately activates the emergency call system for the nurse. Increasing oxygen flow is outside scope and could be harmful without assessment. Stay with the resident until help arrives.
Question 4: Why is smoking prohibited in areas where oxygen is in use?
- Smoke activates fire alarms unnecessarily
- Oxygen is highly flammable and smoking creates a serious fire and explosion hazard (Correct answer)
- Smoking reduces the oxygen concentration in the room
- Hospital regulations prohibit smoking in any shared space
Correct answer: Oxygen is highly flammable and smoking creates a serious fire and explosion hazard
Oxygen supports combustion; a spark or flame near an oxygen source can cause rapid ignition and explosion, creating a life-threatening fire hazard.
Oxygen itself does not burn, but it dramatically accelerates combustion. Materials that would normally ignite slowly or not at all can burn rapidly or explosively in an oxygen-enriched environment. Cigarettes, candles, electric sparks, and open flames must be strictly prohibited in areas where oxygen concentrators, tanks, or tubing are present. CNAs must educate residents and visitors about this hazard and enforce the restriction.
Question 5: When observing a resident's respirations, which finding should be reported immediately?
- Respiratory rate of 16 breaths per minute
- Regular breathing without audible sounds
- Respiratory rate of 8 breaths per minute with shallow depth (Correct answer)
- The resident takes a deep breath while sleeping
Correct answer: Respiratory rate of 8 breaths per minute with shallow depth
A rate of 8 breaths per minute (bradypnea) with shallow depth indicates inadequate ventilation and requires immediate nursing assessment.
Bradypnea with shallow respirations suggests severely reduced tidal volume, which may lead to hypoxia and carbon dioxide retention. This can occur with medication overdose, neurological conditions, or respiratory failure. The CNA should immediately notify the nurse and remain with the resident. In a CPR-trained environment, the CNA should be prepared to initiate emergency procedures if the resident stops breathing.
Question 6: A resident is using a pulse oximeter. What does the reading measure?
- Blood glucose levels
- The percentage of hemoglobin saturated with oxygen in the blood (Correct answer)
- Respiratory rate automatically
- Blood pressure
Correct answer: The percentage of hemoglobin saturated with oxygen in the blood
A pulse oximeter measures the oxygen saturation (SpO2) of hemoglobin in peripheral blood, providing a non-invasive indicator of oxygenation.
Pulse oximetry is a non-invasive method of monitoring oxygen saturation. A normal reading is typically 95-100%. Values below 90% are clinically significant and require prompt reporting. Factors that can affect accuracy include poor peripheral circulation, nail polish, cold extremities, and motion artifact. The CNA reports abnormal SpO2 readings to the nurse along with the resident's clinical presentation.
CNA Basic Nursing Skills 7 2
A resident on oxygen therapy has nasal cannula prongs that have become displaced.
What should the CNA do?