CNA Personal Care Skills 4 2 — Questions and Answers
Question 1: When providing perineal care to a female resident, the CNA should cleanse:
- From back to front to remove the most contamination first
- In circular motions around the perineal area
- From front to back using a clean area of cloth for each stroke (Correct answer)
- Using the same cloth section for the entire perineal area
Correct answer: From front to back using a clean area of cloth for each stroke
Front-to-back cleansing prevents the introduction of rectal bacteria into the urinary tract, reducing infection risk.
Female perineal care must always proceed front to back — from the urethra toward the anus — to prevent fecal bacteria from contaminating the urinary tract and causing UTIs. A fresh portion of cloth or new wipe should be used for each stroke to avoid recontamination. This principle applies during routine care, catheter care, and after bowel or bladder incontinence episodes.
Question 2: Before assisting a resident with oral hygiene, the CNA should:
- Apply toothpaste without asking the resident for preferences
- Explain the procedure, gather supplies, provide privacy, and apply gloves (Correct answer)
- Perform oral care while the resident is lying flat in bed
- Skip gloves since this is not a body fluid contact situation
Correct answer: Explain the procedure, gather supplies, provide privacy, and apply gloves
Explaining the procedure, ensuring privacy, gathering supplies, and applying gloves are all required preparation steps for oral hygiene.
Before any personal care procedure, the CNA must explain what will be done and obtain permission, gather all needed supplies, ensure privacy, and apply gloves since oral care involves contact with saliva. Residents should be positioned upright at least 30-45 degrees to prevent aspiration.
Question 3: When assisting a hemiplegic resident with dressing, the correct technique is:
- Dress the stronger side first and undress the weaker side first
- Dress the weaker (affected) side first and undress the stronger side first (Correct answer)
- Always start with the upper body regardless of which side is affected
- Ask the resident to manage dressing independently to encourage rehabilitation
Correct answer: Dress the weaker (affected) side first and undress the stronger side first
Dressing the weaker side first requires less manipulation of the affected limb, while undressing the stronger side first allows easier removal.
When dressing a resident with hemiplegia, dressing the weaker or affected side first minimizes manipulation of the affected limb and allows the garment to be in place before maneuvering the stronger arm through. When undressing, the stronger side comes out first, again allowing easier manipulation of the affected side last. This technique reduces discomfort and prevents injury.
Question 4: To prevent pressure ulcers during bathing, the CNA should:
- Scrub bony prominences vigorously to stimulate circulation
- Pat skin dry gently, especially skin folds and bony prominences (Correct answer)
- Apply thick lotion between skin folds to keep skin moist
- Use hot water to open pores and improve circulation
Correct answer: Pat skin dry gently, especially skin folds and bony prominences
Gently patting skin dry, especially over bony prominences and skin folds, prevents friction injury and maintains skin integrity.
Bony prominences such as the sacrum, heels, hips, and elbows are at high risk for pressure ulcers. During bathing, the CNA should use gentle non-irritating motions over these areas. After washing, pat skin completely dry especially in skin folds where moisture causes maceration. Lotion should not be applied between moist skin folds, which can worsen maceration. Hot water can damage fragile elderly skin.
Question 5: When trimming a resident's fingernails, the CNA should:
- Cut nails in a curved shape, cutting deeply into corners
- Cut nails straight across and file any sharp edges smooth (Correct answer)
- Soak nails first only for diabetic residents
- Use scissors rather than nail clippers for better control
Correct answer: Cut nails straight across and file any sharp edges smooth
Cutting nails straight across prevents ingrown nails, and filing smooths sharp edges that could scratch or injure.
Fingernails should be trimmed straight across and filed smooth to prevent scratches. Soaking nails before trimming is appropriate for all residents to soften nails. For diabetic residents, nail cutting requires special care and may require a nurse or podiatrist, as cuts or nicks can lead to serious infections due to impaired healing and circulation.
Question 6: The correct water temperature for a resident's bath or shower should be:
- As hot as the resident prefers to ensure comfort
- Checked by the CNA with a thermometer or wrist, 105-110 degrees F (Correct answer)
- Room temperature to prevent burns in all residents
- Determined by turning on hot water first and adjusting down
Correct answer: Checked by the CNA with a thermometer or wrist, 105-110 degrees F
Water temperature should be tested before use and maintained between 105-110 degrees F to prevent burns, especially in residents with decreased sensation.
Elderly residents are at high risk for scalding burns due to decreased temperature sensation, thinner skin, and slower reaction times. The CNA must always test water temperature before the resident is exposed, using a thermometer or the inner wrist. The resident's preference should be accommodated within safe limits, but the CNA may not allow water that is unsafe even if the resident requests it.
CNA Personal Care Skills 4 2
When providing perineal care to a female resident, the CNA should cleanse: