Practice Questions

The following are practice questions, to help you prepare for certification testing. Answers, along with explanation, follow the questions. Topics covered on the test include:

  • Personal care and basic nursing skills
  • Restorative services
  • Infection control
  • Mental and social needs
  • Cognitive impairment
  • Resident's rights
  • Safety and emergencies
  • Communication and interpersonal skills
  • Role and responsibilities of the CNA

Directions
A brief description of a resident is followed by ten questions related to that resident. Each question has four possible answers. Read each question and all answer choices carefully. Choose the one best answer.

Mrs. Alice Carter had a CVA (stroke), is paralyzed on her right side, and has difficulty with speech (aphasia). She is 73 years old.

1. When Mrs. Carter had a CVA (stroke), it was the result of decreased oxygen to her:

  • heart 
  • hands 
  • brain 
  • feet

2. You make Mrs. Carter's occupied bed. You should:

  • get her into a chair to make it easier for you 
  • make the bed any way you want 
  • change the sheets with Mrs. Carter in the bed 
  • put a toe pleat at the foot of the bed

3. Mrs. Carter's bed should be clean, neat, and free of wrinkles because:

  • her family will be happy 
  • it will help prevent skin breakdown 
  • it will look nicer 
  • that's what the nurse told you to do

4. You will do range of motion (ROM) with Mrs. Carter. You should begin at the:

  • hip 
  • shoulder 
  • foot 
  • fingers

5. You can spread pathogens from Mrs. Carter to her roommate by:

  • letting them share supplies 
  • holding contaminated items away from your uniform 
  • washing your hands frequently 
  • cleaning shared equipment between use

6. Mrs. Carter's daughter complains about her mother's care. She is angry. You should:

  • forget it - what she thinks doesn't matter 
  • tell her to leave before she upsets Mrs. Carter 
  • leave the room - it is not your problem 
  • listen and kindly tell her you will get the nurse

7. Mrs. Carter's roommate is cognitively impaired. A term used to describe impairment of mental function is:

  • edema 
  • dementia 
  • hypertension 
  • dehydration

8. You respect Mrs. Carter's right to confidentiality by:

  • asking her which activities she would like to attend 
  • reporting possible abuse 
  • never discussing her information publicly 
  • closing the door, curtains, and drapes before giving care

9. The fire alarm sounds. The FIRST thing you do is:

  • call for help 
  • move the residents to safety 
  • close doors and windows 
  • use the fire extinguisher

10. You are responsible for documentation which is:

  • a written account of a resident's care and condition 
  • a report to the nurse 
  • a verbal account of a resident's care and condition 
  • only necessary if there is a change in the resident's condition

Mrs. Della Dewey is in PHASE TWO of Alzheimer's disease. She has arthritis in her right knee and hip. She is 74 years old.

11. Because Mrs. Dewey is in phase two of Alzheimer's disease, she:

  • needs assistance with ADLs
  • is independent with ADLs
  • is dependent for all ADLs
  • can not recognize family, staff, or self

12. You assist Mrs. Dewey to get into her chair. You should place the chair:

  • on her affected side 
  • on her unaffected side
  • in front of her
  • across the room because she needs to walk

13. You make Mrs. Dewey's unoccupied bed. To leave it open, you:

  • fanfold the top linen to the foot of the bed with the top edge closest to the center of the bed
  • do not put on the top linen
  • fanfold the top linen to the side of the bed
  • fanfold the top linen to the foot of the bed with the top edge closest to the foot of the bed

14. You assist Mrs. Dewey to walk. You should:

  • stand in front of her and hold her hands
  • stand behind her in case she falls
  • stand to the side and slightly behind her
  • hold her under the arm for balance

15. The MOST IMPORTANT way you protect Mrs. Dewey from infection is by:

  • cleaning her room 
  • washing your hands 
  • keeping other residents away from her 
  • wearing gloves whenever you touch her

16. As you approach her, Mrs. Dewey begins kicking and tries to hit you. You should:

  • leave the room and do not provide care for her 
  • grab her wrists and hold her arms down 
  • give her medication
  • provide for her safety and report to the nurse immediately 

17. You use reality orientation with Mrs. Dewey. You:

  • remind her of person, place, and time 
  • let her talk about past experiences 
  • acknowledge her feelings 
  • ignore her questions

18. When Mrs. Dewey is dressing, you should:

  • choose her clothes for her 
  • let her wear whatever she wants even if it looks bad 
  • give her a choice of two outfits
  • ask her family to pick her outfits

19. Mrs. Dewey is very agitated. The nurse tells you to apply a protective device (restraint). You should:

  • apply the device according to manufacturer's guidelines
  • fasten the ties in a double knot 
  • apply the device as tightly as possible 
  • refuse to restrain the resident and report the nurse for abuse

20. Mrs. Dewey is trying to tell you something but it doesn't make sense. You should:

  • ignore her 
  • watch her facial expressions and body language 
  • get the nurse
  • nod your head and pretend to understand

ANSWERS

1. C - Cerebrovascular accident (CVA, stroke) is a decreased blood flow to the brain resulting in brain injury. Symptoms include headache, dizziness, weakness or paralysis of an extremity or one side of the body, inability to talk, incontinence.
a. A decrease of oxygen to the heart can result in a heart attack (myocardial infarction).
b. A decrease of oxygen to the hands or feet can cause cyanosis, a bluish tinge to the skin and nail beds.
d. A decrease of oxygen to the hands or feet may cause cyanosis, a bluish tinge to the skin and nail beds.

2. C - An occupied bed is made when a resident is unable to get out of bed. To make an occupied bed, change the sheets while the resident is in the bed.
a. The resident should never be inconvenienced in order to make the CNA's job easier.
b. The CNA must provide care according to the resident's comprehensive care plan and according to the direction of the nurse.
d . A toe pleat is made at the foot of the unoccupied bed. If the bed is occupied, top linens should be loosened over the resident's feet.

3. B - The resident needs a clean, neat, wrinkle-free bed to prevent skin breakdown and skin irritation, and for comfort and dignity.
a. Procedures are performed for the benefit and well-being of the resident. Most families are pleased when the resident's needs are identified and met but that is not the primary reason for performing the procedure correctly.
c. Procedures are performed for the benefit and well-being of the resident. The resident's room may look nicer if the bed is made properly but that is not the primary reason for performing the procedure correctly.
d. The CNA should perform procedures as directed by the nurse but should also understand why a procedure must be done a certain way.

4. B - Range of motion (ROM) exercises are exercises that move each joint in the resident's body to the fullest extent possible without causing pain. Begin at the shoulder, then exercise the elbow, wrist and fingers, hip, knee, ankle and toes.
a. If you start at the hip, you would be moving pathogens from the hip up toward the face.
c. If you start at the foot, you would be moving pathogens from the foot up toward the face.
d. If you start at the hands, you would be moving pathogens from the hands up toward the face.

5. A - You may spread pathogens by letting roommates share supplies including bedpans, basins, tissue, etc. Each resident should have his own supplies.
b. Holding contaminated items away from your uniform reduces the number of pathogens on your uniform and minimizes the spread of infection.
c. Washing your hands correctly and frequently is the best way to reduce the spread of infection.
d. All common use equipment such as wheel chairs, lifts, showers, bathtubs, etc. must be cleaned between use by different residents to reduce the spread of pathogens.

6. D - Listen to family member's suggestions, complaints, and comments and direct the family to the nurse. The resident's family may feel anger about losing control and responsibility for the care of the resident. They may feel that they are being replaced. Their anger may be directed toward staff. Acknowledging the family's feelings by patiently listening, often defuses the anger.
a. The family is an extension of the resident and a valuable part of the health care team. Part of your responsibility is to help the family develop trust in you and the facility. How the family feels directly effects the resident.
b. The resident has a right to visit with family without interruption. Therefore, you may not tell a visitor to leave.
c. The family should always be treated with the same respect as the resident. It is disrespectful to walk away and ignore the concerns of the family.

7. B - Cognitive impairment is a temporary or permanent change within the brain which affects a person's ability to think, reason, and learn. Dementia is a general term used to describe a group of symptoms related to a decline in thinking skills.
a. Edema is swelling of joints, tissue, and organs.
c. Hypertension is another word for high blood pressure.
d. Dehydration is a condition in which fluid output is greater than fluid intake.

8. C - The resident has the right to confidentiality. Personal information, medical records, written and telephone communications, medical treatment, personal care, behavior, and meetings with family are not discussed with anyone but appropriate staff in a private place.
a. You respect the resident's right to choose by allowing the resident to select activities.
b. You respect the resident's right to be free of abuse by reporting any suspected abuse to the nurse immediately.
d. You respect the resident's right to privacy by closing doors, curtains, and drapes before giving care.

9. B - Remember RACE: Remove residents from the area of immediate danger; activate the fire alarm; close the doors and windows to contain the fire; extinguish small fires with a fire extinguisher if possible. Always remove residents from the area of immediate danger before doing anything else.
a. In all other emergency situations, the first thing you do is call for help.
c. Close the doors and windows is the third letter in the word RACE.
d. Extinguisher is the fourth letter in the word RACE.

10. A - Documentation is the written account of a resident's condition. Documentation may include charts, worksheets, and facility records. Documentation should include what you observe and care you perform.
b. Reporting means verbally informing the person in authority (the nurse) about resident care and what has been observed.
c. Reporting means verbally informing the person in authority (the nurse) about resident care and what has been observed.
d. All care you give and all observations you make should be documented.

11. A - In phase two of Alzheimer's disease, residents need assistance with ADLs. Alzheimer's disease is a disease of the brain affecting memory, judgment, ability to think, and eventually, all physical functions.
b. Residents in phase one of Alzheimer's disease are independent with ADLs.
c. Residents in phase three are of Alzheimer's disease dependent for all ADLs.
d. Residents in phase three are of Alzheimer's disease unable to recognize family, staff, and self.

12. B - Place the chair on the resident's unaffected side (strong side). The unaffected side supports weight.
a. Placing the chair on the resident's affected side (weak side) may put undue stress on that side and result in pain, loss of balance, and possible injury for the resident.
c. The chair should be braced firmly against the side of the bed which helps stabilize the chair and is the shortest distance for the resident to turn.
d. If the resident needs to ambulate (walk), the care plan will reflect that need. The CNA does not determine the resident's need to walk.

13. A - When making an unoccupied open bed, the top linen should be fanfolded to the foot of the bed with the top edge closest to the center of the bed. If the resident gets into the bed, he must be able to reach the edge of the top linen to cover himself.
b. If top linen is not put on the bed, the resident will be unable to cover himself.
c. Fanfolding the top linen to the side of the bed allows the resident to get into the bed from one side only. Fanfolding linens to the bottom of the bed allows the resident to get into the bed from either side.
d. If the top edge of the linen is closest to the foot of the bed, the resident will have difficulty covering himself.

14. C - When walking with a resident, you should stand to the side and slightly behind the resident. This position allows you to clearly see in front of the resident, allows you to guide the resident toward a clear path, and puts you in a position to assist the resident if he begins to fall.
a. Standing in front of the resident limits your ability to clearly see the path and any obstacles that may be present. Holding both of the resident's hands may cause imbalance.
b. Standing behind the resident limits your ability to clearly see the path and any obstacles that may be present.
d. Never attempt to move or stabilize a resident by holding her under the arm. If the resident begins to lose balance or fall, you may cause serious injury to the resident's shoulder and arm.

15. B - Handwashing is the best way to prevent the spread of infection.
a. The CNA must clean up spills immediately to insure resident safety and clean the overbed table after performing procedures but housekeeping is responsible for keeping the resident room clean and sanitary.
c. Residents have basic psychosocial needs including the need for social interaction. Keeping a resident away from others violates the resident's right to have access to visitors.
d. Gloves should be worn whenever there is a possibility of coming into contact with body fluids.

16. D - Remain calm, provide for the resident's safety, and report to the nurse immediately. Difficult behavior may result from too much stimulation, change in routine or environment, physical pain or discomfort, reactions to medications, or fatigue.
a. Refusing to provide care for the resident is neglect.
b. Any action or thing that restricts the resident's movement is considered restraint. It is unsafe for the resident and the nursing assistant to try to physically restrain the resident.
c. CNAs are not allowed to give medication or determine if medication is necessary.

17. A - Reality orientation helps the resident remain aware of who they are, where they are, and a sense of time.
b. Talking about past experiences is reminiscing.
c. Validation therapy helps residents improve dignity and self-worth by having their feelings and memories acknowledged.
d. Ignoring a resident may be considered psychological abuse.

18. C - Offer the resident a choice of two outfits to be certain that the resident is dressed properly. Residents with dementia need assistance when dressing.
a. The resident has a right to choose clothing and the resident's self-esteem is improved when choice is offered.
b. A resident with dementia may be unable to select appropriate clothing or become overwhelmed with many choices. Being certain the resident is dressed appropriately preserves the resident's dignity.
d. The resident's family is not responsible for selecting the resident's clothing on a daily basis.

19. A - A protective device (restraint or safety device) must be applied according to manufacturer's guidelines for safety and legal reasons.
b. Devices with ties should be secured with a quick release knot for safety.
c. The device must be checked for proper fit and comfort by placing the open hand flat between the resident and the restraint.
d. A protective device may be used only with a doctor's order. The CNA should follow the direction of the nurse in charge.

20. B - To communicate with a confused resident, watch the resident's facial expressions and body language for indications of needs, feelings, and moods. Understand that all behavior has meaning.
a. By ignoring the resident's attempt to communicate or by pretending to understand, important information can be lost.
c. The CNA has the obligation to attempt to understand the resident's communications.
d. The resident may become agitated and lose trust and confidence in the CNA if the nursing assistant makes no effort to understand what the resident wants or needs.