CNA Basic Nursing Skills 9 2 — Questions and Answers
Question 1: What does the CNA's role regarding medications primarily involve?
- Administering oral medications to residents as part of routine care
- Crushing medications and mixing them with food without nursing authorization
- Observing and reporting side effects of medications and assisting residents in taking them in some states under specific delegation (Correct answer)
- Preparing and drawing up injectable medications
Correct answer: Observing and reporting side effects of medications and assisting residents in taking them in some states under specific delegation
CNAs primarily observe for side effects and report changes. In some states and under specific delegation and training, CNAs may assist with medication administration for oral medications.
Medication administration is primarily a nursing function. In many states, CNAs with additional Certified Medication Aide (CMA) training and under specific delegation can administer certain medications. Without this training and delegation, the CNA's role is limited to observing for and reporting medication side effects, noting if a resident refuses medication, and supporting the resident in taking their medication (handing a cup of water, for example) — not independent administration.
Question 2: A resident on a diuretic medication suddenly has very low blood pressure. What should the CNA do?
- Give the resident extra salt with meals
- Have the resident stand up slowly and walk it off
- Keep the resident lying or sitting safely and report to the nurse immediately (Correct answer)
- Wait to see if the blood pressure improves before notifying anyone
Correct answer: Keep the resident lying or sitting safely and report to the nurse immediately
Hypotension, especially in a resident on diuretics, is a serious finding. Keeping the resident safe and notifying the nurse ensures timely clinical assessment.
Diuretics increase urinary output and can cause dehydration and electrolyte imbalances leading to hypotension. A sudden drop in blood pressure can cause falls and syncope. The CNA should ensure the resident is in a safe position (lying or seated), apply fall precautions, and immediately notify the nurse. The nurse will assess and may contact the physician about medication adjustment or IV fluid replacement.
Question 3: Which observation suggests a resident may be experiencing a side effect from an anticoagulant (blood thinner)?
- Increased appetite and energy
- Unexplained bruising, prolonged bleeding from a small cut, or blood in urine or stool (Correct answer)
- Improved skin color and circulation
- Decreased blood pressure
Correct answer: Unexplained bruising, prolonged bleeding from a small cut, or blood in urine or stool
Anticoagulants reduce blood clotting ability; side effects include unusual or excessive bruising and prolonged bleeding, which must be reported promptly.
Common anticoagulants include warfarin (Coumadin), heparin, and newer agents like apixaban (Eliquis). Side effects include bruising easily, prolonged bleeding from small wounds, blood in urine (hematuria), dark tarry stools (melena indicating GI bleeding), or spontaneous nosebleeds. Any of these findings should be reported immediately as they may indicate the medication dosage needs adjustment.
Question 4: A resident reports nausea shortly after taking a new medication. The CNA should:
- Tell the resident it is normal and will pass
- Give the resident antacids from the medication cart
- Report the nausea to the nurse as a possible medication side effect (Correct answer)
- Have the resident skip the next dose
Correct answer: Report the nausea to the nurse as a possible medication side effect
New-onset nausea following a new medication is a potential side effect that requires nursing evaluation and possible physician notification.
Nausea is a common side effect of many medications, including antibiotics, analgesics, and cardiac medications. While it may seem minor, it can indicate GI intolerance or a more serious adverse reaction. The nurse will assess whether the nausea is drug-related, whether the medication should be taken with food, or whether the prescriber needs to be notified about a dosage or medication change. Never advise residents to skip doses.
Question 5: What should the CNA do if they discover a resident's medication was not picked up from the medication cart by the nurse?
- Administer it themselves so the resident does not miss a dose
- Report the missed medication to the nurse immediately (Correct answer)
- Discard it to prevent confusion
- Administer it at the next scheduled time without telling anyone
Correct answer: Report the missed medication to the nurse immediately
A missed medication dose is a clinical safety issue that must be reported to the licensed nurse for assessment and appropriate follow-up.
Missing a medication dose can have significant consequences depending on the drug — anticoagulants, antibiotics, cardiac medications, and blood pressure drugs all require consistent dosing. The CNA's role is to report the observation to the nurse, who will document it as a medication variance, assess the resident, determine whether a catch-up dose is needed, and notify the physician if required by policy.
Question 6: A resident who takes a beta-blocker medication has a resting heart rate of 48 beats per minute. What should the CNA do?
- Begin CPR
- Reassure the resident that this is expected with the medication
- Report the finding to the nurse for assessment, as this is below the normal range (Correct answer)
- Ask the resident if they want to stop taking the medication
Correct answer: Report the finding to the nurse for assessment, as this is below the normal range
A heart rate of 48 bpm is bradycardia and falls below the normal range of 60-100 bpm. Beta-blockers can slow the heart rate, but 48 bpm warrants nursing assessment.
Beta-blockers are prescribed to slow the heart rate and reduce blood pressure in cardiac conditions. However, a rate of 48 bpm may indicate the dose is too high or that the resident is developing complications. The nurse will assess the resident for symptoms (dizziness, fatigue, syncope) and may contact the physician. CPR is only initiated if the patient is unresponsive and has no pulse.
CNA Basic Nursing Skills 9 2
What does the CNA's role regarding medications primarily involve?