Basic Nursing Skills 14 Flashcards

A CNA is performing passive range-of-motion exercises on a resident's shoulder when the resident suddenly grimaces and reports sharp pain at 90 degrees of abduction. What is the most appropriate immediate action?

Answer: Stop the movement at the point of pain, support the extremity, and report to the nurse

When a resident reports sharp pain during ROM exercises, the CNA must immediately stop at that point, support the limb to prevent further injury, and report to the nurse before continuing. Continuing past pain, applying overpressure, or delaying notification could cause serious harm such as a rotator cuff tear or joint injury.

When measuring urinary output for a resident on strict intake and output, the CNA notices the urine in the collection hat has an unusual dark amber color with a strong odor and visible sediment. What is the correct sequence of actions?

Answer: Measure and record the output, then report the abnormal characteristics to the nurse

The CNA must always measure and accurately record all output as part of strict I&O, then report abnormal observations (color, odor, sediment) to the nurse for further assessment. Discarding urine wastes critical diagnostic information. CNAs are expected to observe and report — withholding the measurement until the nurse arrives could cause a delay in care.

A resident with a stage II pressure injury on the sacrum requires a dressing change per the nurse's instructions. The CNA removes the old dressing and observes that the wound edges appear slightly macerated and the periwound skin is pale and wrinkled. What does this finding most likely indicate, and who must address it?

Answer: Excess moisture beneath the dressing; the CNA should report this finding to the nurse before applying a new dressing

Macerated, pale, wrinkled periwound skin is a classic sign of excessive moisture under the dressing, which can extend tissue damage. This is an abnormal finding that must be reported to the nurse before proceeding, as the dressing type or frequency may need to be changed. CNAs do not independently modify wound care plans, apply alcohol near wounds, or perform debridement.

A CNA is ambulating a post-surgical resident using a gait belt when the resident suddenly becomes pale, diaphoretic, and states 'I feel like I'm going to faint.' The hallway has no chairs immediately available. What is the correct technique to protect the resident?

Answer: Widen the CNA's stance, slide the resident down the CNA's leg to the floor in a controlled descent, and call for help

When a resident is about to faint during ambulation, the priority is preventing an uncontrolled fall. The CNA should widen their base of support, use the gait belt to guide the resident in a controlled slide down the CNA's leg to the floor, then call for help. Leaving the resident alone to get a wheelchair risks an unprotected fall. Lowering the head while standing is impractical and dangerous. Continuing ambulation ignores a medical emergency.

While performing a complete bed bath on a cognitively intact resident, the CNA notices multiple small, round bruises in various stages of healing on the resident's upper arms and inner thighs. The resident becomes quiet and avoids eye contact when asked about them. What is the CNA's most critical obligation?

Answer: Complete the bath professionally, then immediately report the observations and the resident's behavioral response to the nurse or supervisor

Patterned bruising in various stages of healing, particularly in unusual locations, is a red flag for abuse or neglect. The CNA's mandatory obligation is to report observations — including the resident's behavioral cues — to the nurse or supervisor immediately. CNAs should not conduct investigations, document directly in the medical chart independently, use personal devices to photograph residents (a HIPAA and policy violation), or confront suspected abusers, which could escalate danger.

A CNA is assigned to feed a resident with dysphagia who is ordered a nectar-thick liquid diet. During the meal, the resident coughs repeatedly after each sip and begins producing a wet, gurgling vocal quality. What is the priority intervention?

Answer: Stop feeding immediately, sit the resident upright, and notify the nurse of the signs of aspiration

Repeated coughing and a wet/gurgly voice after swallowing are classic clinical signs of aspiration — material is entering the airway rather than the esophagus. The CNA must stop feeding immediately, ensure the resident is fully upright, and notify the nurse urgently. Changing consistency without nurse authorization, encouraging throat clearing and continuing, or tilting the head back (which worsens aspiration risk) are all unsafe and outside the CNA's independent scope.