CNA Basic Restorative Services 1 — Questions and Answers

Question 1: A contracture (tightening, or shortening of a muscle) is caused by

old age
lack of movement of the muscle (Correct answer)
pressure on the muscle
too much exercise

Correct answer: lack of movement of the muscle

A contracture is the permanent shortening of a muscle or joint, often resulting from prolonged immobility or lack of movement. When muscles and joints are not regularly moved through their full range of motion, the connective tissues can stiffen and shorten, leading to a fixed, often painful, position. Regular range of motion exercises are crucial in preventing contractures.

Question 2: Proper body mechanics dictates that when lifting an object, the nurse aide place his feet

it doesn’t matter
3ft-5ft apart
12in – 18in apart (Correct answer)
6in-12in apart

Correct answer: 12in – 18in apart

Proper body mechanics for lifting involves maintaining a wide base of support to ensure stability and balance. Placing feet 12 to 18 inches apart, roughly shoulder-width, helps distribute weight evenly and provides a strong foundation. This stance allows the lifter to use their powerful leg muscles, rather than their back, to lift safely and prevent injury.

Question 3: A patient is leaving the hospital. The family has been told to give her medications bid. The wife asks what that means. The nurse aide tells her to give the medication

three times a day.
once a day.
only when needed.
twice a day. (Correct answer)

Correct answer: twice a day.

The medical abbreviation 'bid' stands for 'bis in die,' which is Latin for 'twice a day.' This instruction indicates that a medication or treatment should be administered two times within a 24-hour period. It is crucial for CNAs to understand these abbreviations to accurately relay information and ensure proper patient care.

Question 4: Mr. Johnson has just returned from surgery. Which of the following things do you do?

Notify family about the surgery results.
Turn, cough, and deep breathe, leg exercises (Correct answer)
Check vital signs every 4 hours.
Immediately give medication to control nausea

Correct answer: Turn, cough, and deep breathe, leg exercises

After surgery, patients are at risk for complications like pneumonia (due to shallow breathing) and blood clots (due to immobility). Turning, coughing, and deep breathing exercises help expand the lungs and prevent fluid buildup, while leg exercises promote circulation and reduce the risk of deep vein thrombosis. These actions are vital for post-operative recovery and fall within the CNA's scope of practice under nurse supervision.

Question 5: A patient has had hip surgery. Her legs should be

abducted (Correct answer)
adducted
elevated
in the most comfortable position for the patient

Correct answer: abducted

After hip surgery, especially total hip replacement, it is crucial to prevent adduction (moving the leg toward the midline) and internal rotation to avoid dislocating the new hip joint. Abduction, or keeping the legs spread apart, often with an abductor pillow, helps maintain proper alignment and stability of the hip. This position prevents the femoral head from popping out of the acetabulum.

Question 6: A nursing assistant is helping a resident to walk. If the resident becomes faint and begins to fall, the assistant should

Hold the resident up and continue walking
Ease the resident to the floor and call for help (Correct answer)
Carry the resident back to bed and then go for help
Hold the resident up and call for help

Correct answer: Ease the resident to the floor and call for help

If a resident begins to fall, the safest action is to ease them gently to the floor, controlling the fall as much as possible, to minimize injury to both the resident and the aide. Attempting to hold them up completely can result in injury to both parties due to the sudden shift in weight. Once safely on the floor, the aide should call for help and assess the resident for injuries before attempting to move them.

Question 7: What is the process of restoring a disabled client to the highest level of functioning possible?

Retention
Rehabilitation (Correct answer)
Responsibility
Reincarnation

Correct answer: Rehabilitation

Rehabilitation is the process of helping a person recover, improve, or regain skills and independence lost due to illness, injury, or disability. The goal is to restore the individual to the highest possible level of functioning and quality of life. This often involves a multidisciplinary approach including physical, occupational, and speech therapy.

Question 8: Exercises that move each muscle and joint are called

adduction
range of motion (Correct answer)
abduction
rotation

Correct answer: range of motion

Range of motion (ROM) exercises involve moving a joint through its full extent of movement to maintain or improve flexibility and prevent stiffness and contractures. These exercises can be active (performed by the patient), active-assistive (patient assists), or passive (performed entirely by the caregiver). Regular ROM helps preserve joint health and mobility.

Question 9: Goals of arthritis care include

strengthening bones and muscles.
decreasing inflammation and preserving joints.
preventing contractures.
all of the above. (Correct answer)

Correct answer: all of the above.

Comprehensive arthritis care aims to manage symptoms and improve quality of life by addressing multiple aspects of the condition. This includes decreasing inflammation and preserving joint function to reduce pain and damage, preventing contractures through movement and positioning, and strengthening surrounding bones and muscles to support affected joints. Therefore, all listed options are crucial goals.

Question 10: The nurse aide documents that about 45 minutes after the resident is put to bed for an afternoon nap, the resident urinates in bed. To help with bladder training, the nurse aide should

remind the resident that it is important to cooperate with bladder training
take the resident to the bathroom right before going to bed (Correct answer)
report to the registered nurse that the resident will not succeed in bladder training
take the resident to the bathroom after about 30 minutes of being in bed for the nap

Correct answer: take the resident to the bathroom right before going to bed

Bladder training involves establishing a predictable voiding schedule to help residents regain bladder control. If a resident consistently urinates in bed 45 minutes after being put to bed, taking them to the bathroom *before* that time, specifically right before going to bed, can help them void successfully and prevent incontinence. This proactive approach reinforces the training and helps the resident achieve continence.

Question 11: What can you do to allow a helpless resident some independence when he must be fed?

Feed the resident lying down
Ask which foods the resident would like to eat first (Correct answer)
Always stand to feed the resident
Feed the resident with a fork

Correct answer: Ask which foods the resident would like to eat first

Even when a resident requires assistance with feeding, offering choices, such as which food to eat first, promotes their independence and dignity. This allows them to exert some control over their meal, fostering a sense of autonomy despite their physical limitations. It respects their preferences and encourages participation in their care.

Question 12: The primary goal of restorative care is

return the resident to a normal life at home (Correct answer)
do everything for the resident
take care of the resident’s personal business
keep the resident comfortable in the nursing home

Correct answer: return the resident to a normal life at home

The primary goal of restorative care is to help residents regain their highest possible level of physical, mental, and psychosocial functioning. This often means working towards returning them to their home environment and enabling them to live as independently as possible. It focuses on rehabilitation and maximizing their capabilities, rather than just maintaining comfort in the facility.

Question 13: ROM exercises will help prevent

Pressure sores
Depression
Obesity
Contractures (Correct answer)

Correct answer: Contractures

Range of motion (ROM) exercises are crucial for preventing contractures, which are the permanent shortening of muscles and tendons, leading to stiffness and limited joint movement. By regularly moving joints through their full range, ROM exercises maintain flexibility, improve circulation, and prevent the tissues from becoming rigid and fixed. This helps preserve mobility and function.

Question 14: You are delegated to provide passive R.O.M. to L lower and upper extremities. This means you

Watch how many times she moves left lower and upper extremities in 15 minutes
Extend Rt. Arm over the Left side of the body
Support each joint and provide extension and flexion movements on the Left side of the body (Correct answer)
Have patient raise left arm and leg ten times

Correct answer: Support each joint and provide extension and flexion movements on the Left side of the body

Passive Range of Motion (PROM) means the caregiver moves the patient's joints through their full range of motion without the patient's assistance. 'L lower and upper extremities' specifies the left arm and leg. Supporting each joint and performing flexion and extension movements ensures the exercises are done safely and effectively to maintain joint mobility and prevent contractures.

Question 15: The nurse aide just admitted a new resident. Which of the following is the most restorative approach?

encourage the resident to participate in unpacking (Correct answer)
tell him he’ll need to unpack for himself
unpack all of his clothes and put them away for him
encourage a family member to unpack for him

Correct answer: encourage the resident to participate in unpacking

A restorative approach focuses on promoting independence and self-care. Encouraging a new resident to participate in unpacking their belongings, even if it's just directing where things go, helps them feel more in control, fosters a sense of ownership over their new space, and utilizes their existing abilities. This promotes dignity and helps them adjust to their new environment.

Question 16: When the nurse aide moves a joint during ROM (range of motion) exercises, and the resident complains of pain, the nurse aide should

stop the movement at the point the pain occurs and report to the nurse (Correct answer)
ask the nurse to give pain medication so the exercises can continue
stop giving the resident any ROM exercises
push past the point where the pain occurs to see if it still hurts

Correct answer: stop the movement at the point the pain occurs and report to the nurse

When performing ROM exercises, pain is a critical indicator that the movement should be stopped immediately to prevent injury or further discomfort. The nurse aide should never push past the point of pain. Reporting the pain to the nurse is essential for assessment and to determine if the exercise plan needs adjustment or if there's an underlying medical issue.

Question 17: Pressure sores can often be prevented if the client is

turned or repositioned every two hours (Correct answer)
dressed in loosely fitting clothing.
positioned with a pillow under the head.
placed in an incontinence brief.

Correct answer: turned or repositioned every two hours

Pressure sores (also known as decubitus ulcers or bedsores) develop when sustained pressure on the skin reduces blood flow, leading to tissue damage. Regularly turning or repositioning a client, typically every two hours, relieves this pressure, allowing blood to circulate and preventing skin breakdown. This is a fundamental and highly effective preventative measure.

Question 18: The role of the ombudsman is to

control the nursing home budget
prepare classes that nurse aides take to learn about client hygiene
run a group of nursing homes
work with the nursing home to protect clients’ rights (Correct answer)

Correct answer: work with the nursing home to protect clients’ rights

An ombudsman is an advocate for residents in long-term care facilities. Their primary role is to investigate and resolve complaints made by or on behalf of residents, ensuring that residents' rights are protected and that they receive proper care. They act as a liaison between residents, families, and the facility, working to improve quality of life and care.

Question 19: The nurse aide is making an occupied bed. Which of the following is the most restorative approach?

do everything for the resident
encourage the resident to help (Correct answer)
lower both side rails
tell the resident to get out of bed

Correct answer: encourage the resident to help

Encouraging the resident to help with tasks like making an occupied bed promotes their independence and self-esteem, which is central to restorative care. This approach helps maintain their physical abilities and sense of control, rather than fostering dependency. Doing everything for them or telling them to get out of bed are not restorative or respectful approaches.

Question 20: Equipment used to help the resident maintain correct body alignment includes all of the following EXCEPT

splints
cones (Correct answer)
bed cradles
foot supports

Correct answer: cones

Splints, bed cradles, and foot supports are all devices specifically designed to help maintain correct body alignment, prevent deformities, and support limbs. Cones, however, are not typically used for maintaining body alignment in this context. They might be used for other purposes, but not for the primary goal of alignment support.

Question 21: When ambulating an unsteady client, it is BEST for the nurse aide to use a

walker.
quad cane.
gait belt. (Correct answer)
wheelchair

Correct answer: gait belt.

A gait belt provides a secure way for the nurse aide to assist an unsteady client, offering a firm grip point without pulling on clothing or skin. It allows the aide to support the client's balance and prevent falls effectively. Walkers, quad canes, and wheelchairs are assistive devices for the client, but the gait belt is the best tool for the aide to physically assist an unsteady client during ambulation.

Question 22: The most basic rule of body mechanics is to

bend from the knees and hips (Correct answer)
never use a lift belt
twist as you lift
keep the arms flexed

Correct answer: bend from the knees and hips

Bending from the knees and hips, rather than the waist, keeps the back straight and uses the stronger leg muscles to lift. This fundamental principle of body mechanics minimizes strain on the back and reduces the risk of injury for the nurse aide. Twisting while lifting or keeping arms flexed are incorrect and unsafe practices.

Question 23: After assisting with evening care, the nurse aide notices the client has bilateral hearing aids. The nurse aide understands that if a hearing aid is not in use, it should

be left on the client’s bedside table.
be placed in the client’s pocket.
be left turned on.
have the battery disengaged. (Correct answer)

Correct answer: have the battery disengaged.

Disengaging the battery or turning off a hearing aid when not in use conserves battery life and prevents whistling or feedback noises. This practice ensures the device is ready for use when needed and prolongs the life of the battery. Leaving it on or in a pocket can drain the battery unnecessarily.

Question 24: If a client has hand tremors, the nurse aide SHOULD

tell the client to stop shaking and to control the tremors.
assist the client with the activity of daily living as needed (Correct answer)
restrain the hand that has the tremor.
do everything for the client to avoid embarrassment.

Correct answer: assist the client with the activity of daily living as needed

Clients with hand tremors may struggle with fine motor tasks but can often perform them with some assistance. The nurse aide should provide support as needed, allowing the client to maintain as much independence as possible. Doing everything for them or restraining them would be disempowering and inappropriate.

Question 25: A button hook and a sock assist are all part of what kind of nursing care?

Activities of daily living
Disability and reactivity
Prosthetic mobility
Restorative and rehabilitation (Correct answer)

Correct answer: Restorative and rehabilitation

A button hook and sock assist are adaptive devices designed to help individuals perform activities of daily living (ADLs) despite physical limitations. Their use is a key component of restorative and rehabilitation nursing care, aiming to restore or maintain a resident's independence and functional abilities. This type of care focuses on helping residents regain skills or adapt to new ways of performing tasks.

CNA Basic Restorative Services 1

A contracture (tightening, or shortening of a muscle) is caused by