CNA Practice Test - Basic Nursing Skills #2 1 2 — Questions and Answers

Question 1: A resident is in a semi-Fowler's position. The head of the bed is elevated to approximately:

0 to 15 degrees
30 to 45 degrees (Correct answer)
60 to 75 degrees
90 degrees

Correct answer: 30 to 45 degrees

Semi-Fowler's position elevates the head of the bed to 30-45 degrees, which is commonly used for residents with respiratory issues, tube feedings, or to prevent aspiration.

The four main Fowler's positions are defined by head-of-bed elevation: Low Fowler's (15-30 degrees), Semi-Fowler's (30-45 degrees), Fowler's (45-60 degrees), and High Fowler's (60-90 degrees). Semi-Fowler's is one of the most commonly used positions in nursing homes because it promotes breathing comfort, reduces aspiration risk during feeding, and relieves pressure on the sacrum. It is used for residents who have difficulty breathing, are receiving tube feedings, or are recovering from abdominal surgery. A small pillow under the knees can prevent the resident from sliding down. CNAs should ensure residents in Fowler's positions are repositioned regularly to prevent pressure injury development at the sacrum and heels.

Question 2: The medical term for difficulty swallowing is:

Aphasia
Dysphagia (Correct answer)
Aphagia
Dysphasia

Correct answer: Dysphagia

Dysphagia is the medical term for difficulty swallowing, which is common in residents who have had a stroke, Parkinson's disease, or head and neck cancer.

Dysphagia (difficulty swallowing) is a common problem in long-term care, particularly in residents with neurological conditions (stroke, Parkinson's disease, ALS, multiple sclerosis), structural abnormalities, or head and neck cancer. It increases the risk of aspiration (food or liquid entering the airway) and aspiration pneumonia — a leading cause of death in nursing home residents. Signs of dysphagia include: coughing or choking during meals, a wet or gurgly voice after eating, pocketing food in the cheeks, prolonged meal times, drooling, and unexplained weight loss. The speech-language pathologist (SLP) evaluates swallowing and recommends diet texture modifications. The CNA must follow the prescribed diet texture and positioning orders exactly.

Question 3: A resident with a urinary catheter complains of burning and urgency. The catheter bag shows cloudy, dark urine with a strong odor. The CNA should:

Increase the resident's fluid intake and check back in an hour
Report the findings to the charge nurse immediately, as these may indicate a catheter-associated urinary tract infection (CAUTI) (Correct answer)
Empty the catheter bag and assume the problem will resolve
Reposition the catheter tubing and continue routine care

Correct answer: Report the findings to the charge nurse immediately, as these may indicate a catheter-associated urinary tract infection (CAUTI)

Cloudy, dark, malodorous urine combined with burning and urgency in a catheterized resident are signs of a possible CAUTI requiring immediate nursing assessment.

Catheter-associated urinary tract infections (CAUTIs) are the most common healthcare-associated infections in long-term care. Signs and symptoms include: cloudy, dark, or bloody urine, strong or foul odor, fever, burning or suprapubic discomfort (in residents who can report it), increased confusion in residents with dementia, and general malaise. Prevention measures the CNA can perform include: maintaining a closed catheter drainage system, keeping the drainage bag below the level of the bladder at all times, securing the catheter to prevent tugging, performing meatal care during perineal care, ensuring adequate hydration, and using aseptic technique when handling the catheter. Any suspected CAUTI must be reported immediately; delay in treatment can lead to urosepsis, a life-threatening complication.

Question 4: When measuring and recording urinary output, the CNA should measure output:

Approximately, estimating to the nearest 100 mL
Precisely, using a graduated measuring container and recording in milliliters (mL) (Correct answer)
Only when the physician specifically orders exact measurements
After averaging two readings together for accuracy

Correct answer: Precisely, using a graduated measuring container and recording in milliliters (mL)

Urinary output must be measured precisely using a graduated container and recorded in milliliters to provide accurate information for the medical team.

Precise measurement of urinary output is essential for monitoring fluid balance (intake and output or I&O). Accurate I&O is critical for residents with heart failure, renal disease, edema, dehydration, or those receiving IV fluids. The CNA uses a calibrated graduated container (hat or urinal) and holds it at eye level to read the meniscus accurately. Output is recorded in milliliters (mL) or cubic centimeters (cc) on the I&O flowsheet or in the electronic health record. Normal adult urinary output is approximately 30 mL/hour or 720-1800 mL per day. The CNA should report to the nurse: output less than 30 mL/hour, no urine output for 4+ hours, output that significantly exceeds or falls below intake, or any change in the color, clarity, or odor of urine.

Question 5: Which of the following is the correct procedure for applying an elastic (Ace) bandage to a resident's leg?

Start at the thigh and wrap downward toward the foot
Start at the foot and wrap upward toward the knee, overlapping each turn by one-half to two-thirds the width of the bandage (Correct answer)
Wrap as tightly as possible to prevent swelling
Apply at the knee and wrap in both directions simultaneously

Correct answer: Start at the foot and wrap upward toward the knee, overlapping each turn by one-half to two-thirds the width of the bandage

Elastic bandages should always be applied from distal (foot) to proximal (knee/thigh), which promotes venous return and prevents blood from pooling in the extremity.

Elastic bandages (Ace bandages) are applied from distal to proximal (foot up toward the knee or thigh) because this directs venous blood return upward toward the heart and prevents blood and fluid from pooling below the bandage. Begin at the ball of the foot, wrapping the foot in a figure-eight pattern, then spiraling up the leg with each turn overlapping the previous by one-half to two-thirds. The bandage should be snug but not constrictive — you should be able to slide two fingers under it. After application, check for: adequate circulation (warm skin temperature, normal color, capillary refill less than 3 seconds), sensation, and movement. Report any complaints of numbness, tingling, increased pain, or coolness or discoloration distal to the bandage.

Question 6: The purpose of performing post-mortem care (care after death) is to:

Conduct an investigation into the cause of death
Prepare the body with dignity and respect, preserving its appearance before viewing by family and transfer to the funeral home (Correct answer)
Administer final medications as ordered
Obtain tissue samples for laboratory analysis

Correct answer: Prepare the body with dignity and respect, preserving its appearance before viewing by family and transfer to the funeral home

Post-mortem care involves preparing the deceased resident's body with dignity and respect to preserve its appearance for family viewing and transfer to the funeral home.

Post-mortem care (also called last offices) is performed after the physician or nurse has pronounced death. The purpose is to prepare the body respectfully and in accordance with any cultural or religious preferences documented in the care plan or expressed by the family. Steps typically include: cleansing the body, closing the eyes (gently taped if needed), closing the mouth (dentures may be reinserted), removing tubes and equipment unless an autopsy is required, positioning the body in good alignment, changing soiled linens, applying identification tags, and documenting the time and procedure. The CNA should treat the deceased with the same dignity they would a living resident. Family members may wish to be present, which should be facilitated if requested.

CNA Practice Test - Basic Nursing Skills #2 1 2

A resident is in a semi-Fowler's position.
The head of the bed is elevated to approximately: