CNA Final Review Flashcards
What is another term for nursing assistant?
Nurse’s Aide
What can a CNA do to help a resident who can’t fall asleep?
Offer a snack, give a backrub
What is tuberculosis and how does it spread?
A disease that affects the lungs and is spread through droplets
How does Covid spread?
Covid is airborne, and can also be spread through droplets
What is the medical word for fainting or passing out?
Syncope
What is the medical word for a bloody nose?
Epistaxis
What does perseveration refer to?
Inappropriate and constant repetition of an act or phrase
What is an orthotic?
A brace or splint used to support the body
What are social determinants of health?
The 5 conditions in the environment that influence quality of life:
Economic stability
Access to education
Access to healthcare
Safe neighborhoods
A social community with friends
What do you do if you suspect one of your patients doesn’t have one of the 5 social determinants of health?
Let the Nurse know
What does combative mean in a medical context?
Refers to a patient who is angry and won’t cooperate
What is apnea?
Without breathing; sleep apnea is a condition where people stop breathing temporarily in their sleep
When you hear the systolic immediately while taking blood pressure what is the problem?
The blood pressure is high, and you didn’t inflate the cuff high enough
Fill in the blank: Apnea literally means _______.
Without breathing
What is adaptive equipment?
Any tool or device used to help with ADLs
What are the range of motion rules?
Stop if there is resistance or the person complains of pain, follow the care plan, support the joint; usually involves 3 to 5 repetitions
What is the armpit temperature called?
Axillary; it usually runs one degree lower than an oral temperature
What are the shaving guidelines?
Shave with the hair growth: down on the face and up on the neck
What is important to know about cold packs?
Used to decrease pain and prevent swelling; applied with a barrier, checked after 5 minutes, removed after 20 minutes; can cause an injury similar to a burn if left on too long
What is a sharps container for?
To dispose of anything that might be sharp, like needles, razors, or lab tubes
What is c-diff?
Clostridium difficile - an intestinal infection causing severe diarrhea and is very contagious; requires contact precautions and actual handwashing as it is immune to hand sanitizer
What is misappropriation?
Taking something that isn’t yours, usually from work; examples include bringing home a box of gloves or charging a personal item on the company credit card
Who is affected by a resident dying?
Everyone involved, including the staff; counseling help is available if staff members need it
How do you care for a dying patient?
Take care of their physical needs, turn and do oral care every 2 hours, give a bed bath as needed; if they stop breathing, get the nurse to verify there isn’t a heartbeat
What is a draw sheet?
A flat sheet that goes across the middle of the bed; also called a lift sheet or a turn sheet, depending on its use
What is delegation?
Authorizing someone else to do a task on your behalf; the nurse delegates direct patient care to the CNA
What are the 5 rights of delegation?
The right person, right task, right circumstance, right direction, and right supervision
What is sexual harassment?
Unwelcome sexual advances or remarks; should be reported to a supervisor or human resources
How do you help with a bedpan?
Position a bedpan with the thinner edge at the person’s back, sit the person up (Fowler’s), give them the call light and provide privacy
What is the type of bedpan called that is used for a patient who has had hip surgery?
Fracture Pan
What is a low sodium diet?
Also called NAS (no added salt), the person on this diet should eat foods low in salt and cannot add any additional salt to their food; usually used for people with high blood pressure or kidney disease
What does the affected side mean?
Weak side
If a patient wants to leave the facility against medical advice (AMA) what does that mean?
They want to leave without being discharged and against the wishes of their doctor
What should you do if a patient wants to leave AMA?
Tell the Nurse
What does flexed or flexion mean?
When a joint is bent or when the angle of a joint is decreased, the opposite of extension
What does disoriented mean?
Associated with confusion; a person who is disoriented may not know the date or time, where they are, or even who they are
What is a bowel program?
Also called bowel training; the purpose is to help an incontinent patient regain control of their bowel function by providing BRP or a commode at regularly scheduled times
What does alignment mean?
Keeping the body straight or having good posture
What is a developmental disability?
Having a physical or mental impairment that becomes apparent shortly after birth or during childhood and delays, limits, or prevents the progression of normal development
What is battery?
Offensive touching or use of force on a person without their consent
What is flatus or flatulence?
This is the medical term for gas (farts)
What is restorative care?
Another term for rehabilitation; helping a person return to his highest level of physical, emotional, or economic function
What is a medical record?
A legal document where a patient’s information is kept and care is recorded
What is a minimum data set?
A federal form filled out on nursing home residents about the degree of assistance or skilled care they need
Define restraint.
Anything that restricts a person’s freedom of movement; it can be physical or chemical (a medication)
Define unbecoming.
inappropriate
What is normal growth and development for an infant?
Infancy is from birth to 1 year; infants learn to smile, laugh, and say simple words; they progress from drinking milk to eating solids
What is normal growth and development for a toddler?
Toddlerhood is from age 1 to age 3; toddlers become physically coordinated, able to run and jump; they become toilet trained and have a vocabulary that can express emotions; they are self-centered, have trouble following rules, and have separation anxiety when separated from a parent
What is normal growth and development for a preschooler?
Preschool is from age 3 to 5; preschoolers dress themselves, have a good imagination, and ask questions; they begin to notice the difference between genders and understand the difference between right and wrong
What is normal growth and development for a school age child?
School age is from 5 to 12 years; characterized by growth spurts, developing gender identity, and wanting approval from peers and adults; they will develop morals, logical thinking, and the ability to understand other people’s perspectives
What should you do if you discover a coworker stealing from a resident?
This is financial abuse; treat the same as any abuse and report it to your supervisor and Adult Protective Services
What is palliative care?
Care with a goal of relieving pain, symptoms, and emotional and physical stress but not curing disease; often part of hospice care, but can be found in other places as well
What is included in vital signs?
Temperature, pulse, respirations, and blood pressure
What is the normal range for blood pressure?
90-140 over 60-90
What do you do if a vital sign is out of range?
Repeat it and then report it to the nurse
Give examples of acute diseases or conditions.
Broken bones, the flu or a cold, heart attack, chicken pox, appendicitis
What is foot drop?
When the foot droops or bends abnormally from injury or atrophy; treatment includes keeping the foot in proper alignment by using a board (foot board) for the feet to rest against, or using a brace designed to prevent it
What is a common symptom of congestive heart failure?
Edema (swelling) in the feet
How should you use a gait belt?
Apply it over clothes and hold onto it with an underhand grip
What GI condition can result in stomach pain and the leaking of small amounts of thin watery stool?
Fecal impaction
How should you clean a stoma?
Wipe the stoma gently, clean the skin around it with mild soap and water, and ensure ostomy appliances fit closely
What is validation therapy?
Communicating that a resident’s opinions and feelings are acknowledged, respected, and heard, regardless of agreement
What should you do when a resident with dementia talks about their past?
Allow them to express their reality and ask questions that encourage sharing
What is it called if you touch a patient without their consent?
Physical abuse or battery
What is the primary job of the respiratory system?
To supply oxygen and remove carbon dioxide
Oxygenated blood is carried by?
Arteries
Oxygen is considered a _______.
life sustaining treatment
How is hepatitis A transmitted?
Fecal-oral transmission, often from unwashed hands of food preparation workers
When your patient is on oxygen what should you not let them do?
smoke
What should you check when a patient is on oxygen?
Flow rate and signs of irritation or pressure from the nasal cannula
What should you ensure if the oxygen is supplied by a tank?
The tank has enough oxygen and is positioned securely
What is the most common form of dementia?
Alzheimer’s
What are common symptoms of dementia?
Short term memory loss, pacing, wandering, sundowning
When brushing out tangled hair where should you start?
At the ends, or tips, of the hair
Is pain subjective or objective?
Subjective
What should always be done with a patient’s report of pain?
always reported to the nurse
What is the best position for a resident at mealtime?
Seated upright in a comfortable position, at eye level with the caregiver
If someone appears to be choking and they are coughing what should you do?
Encourage them to continue coughing
When your Parkinson’s patient who is very shaky
Take them out but stay with them
Which body system is affected by Parkinson’s?
The nervous system
What are signs of anemia (low red blood count)?
Dizziness, Fatigue, Pale skin
Parkinson’s is considered?
A progressive disease; medications may slow it down but there is no cure
What is defamation?
Slander; communicating a false statement that implies a negative image about a person or business
What is an interdisciplinary team?
A group of healthcare providers from many disciplines (Dr, Nurse) who work together to ensure a patient’s needs are being met
What is the competency evaluation?
The tests you take to become certified as a CNA; written test (75%), Skills test (Pass or Fail)
How long do you have to take it (competency evaluation) after you complete your CNA course?
Within a Year
After feeding a patient who is on aspiration precautions or after a feeding tube has been given you should..
Keep the head of the bed up 30-45 degrees; even if the patient doesn’t want their head up
Communicable or contagious means..
A disease can spread or be transmitted from one person to another
If a resident has a contagious disease should they have a roommate?
No; although residents with non-contagious diseases frequently share a room, roommates who share a room should use their own personal care items
What information should a CNA obtain on a new admit?
All vital signs, height and weight
What is the proper process for using a walker?
The person should set the walker 10-18 inches in front of them, then step toward it
What should the average fluid output be for a healthy adult?
At least 1500 mLs; low urine output (oliguria, less than 500 mLs) should be reported to the nurse
What is PVD?
Peripheral Vascular Disease; chronic disease with poor circulation in the extremities
What is COPD?
Chronic Obstructive Pulmonary Disease; usually caused by smoking (SOB need O2); sitting with the head of the bed up
When taking a blood pressure what should you consider when choosing an arm to use?
Never use an arm with an IV, cast, shunt; never take a blood pressure on the same side as a mastectomy
What is phantom pain?
Pain that the patient perceives in a body part that has been amputated
What is an artificial body part called?
A prosthetic or a prosthesis
What are complications of immobility?
Atrophy (skinny), contractures (shortens), pneumonia, blood clots
What is the difference between a safety razor and a straight razor?
A straight razor is old-fashioned - like a knife with a handle; a safety razor is like a disposable razor
When is it appropriate to flirt with a patient or resident?
Never
How can the elderly prevent loss of bone and muscle strength?
Exercise, especially weight bearing
What assistance can you give a resident with their mail?
Deliver mail to them; you can offer help but don’t open it unless they want help
What should you check when delivering a patient tray?
Check for correct name and diet
For liquid or fluid intake what should you count?
Anything that is liquid at room temperature
What is projection?
Blaming someone else for your own uncomfortable or unacceptable actions or feelings
What is an ileostomy?
When the entire large colon is removed and the end of the small intestine is brought to the surface of the abdomen in a stoma; liquid stool, prone to dehydration
What is a plate guard or a plate rim?
A device that clips onto the edge of a plate; food can be scooped against the rim so it doesn’t fall off the edge of the plate
What should you do if a resident has blood in their urine?
Report it to the nurse; let her see it if possible
How do you operate a fire extinguisher?
The acronym PASS: P - Pull the pin; A - Aim at the base of the fire; S - Squeeze the handle; S - Spray
How should you document the valuables residents bring to the nursing home with them?
General terms, don’t make assumptions; use words like white, metal, and blue instead of gold, diamond, gem
What is the most common injury for CNAs in the workplace?
Back injury
What is required before hot or cold treatments can be used?
A doctor’s order
What should you do if a resident refuses necessary treatment?
Report it to the nurse
Are residents allowed to have personal items?
Yes; they should be labeled or marked with the resident’s name
Who should be responsible to keep the facility clean?
Everyone on the healthcare team
What is dialysis?
A process commonly used for patients in kidney failure; it cleans the blood
What is an incident report?
A form filled out any time there is an accident or injury that tells the details of what happened; a CNA can fill it out or add comments to one filed by the nurse
If you have to evacuate the facility because of an emergency how do you know what to do?
The facility has evacuation plans, usually found at the nurses station
What is the CNAs responsibility if they are assisting in a procedure that involves a sterile field?
Never touch anything in the sterile field; also never reach across it
What is a suffix and/or prefix?
A prefix always comes at the beginning of a word and usually indicates location, time, number, or status; a suffix always comes at the end of a word and usually indicates the procedure, condition, disorder, or disease
When should you wear gloves?
If it is warm, wet, and not yours
If your patient asks you a question about their disease..
Direct their questions to the nurse
What is a normal result of aging for the nervous system?
Slower reflexes and reaction time
What happens when the urinary system ages?
Kidney function decreases; the person is at a higher risk for urinary tract infections
What are your body’s specific defense mechanisms?
Antibodies developed by having an illness or being immunized
What are your body’s nonspecific defense mechanisms?
Intact skin, coughing, sneezing, tears, white blood cells
When you transfer a resident from a bed to their chair where should they put their hands?
They should push up from the bed if they are able, and/or place their hands on your arms
If the resident has a weak side how should you transfer them?
Use a gait belt and do a pivot transfer; the resident pivots on their strong side
Common symptoms of anxiety are..
Hyperventilation, feeling dizzy, dry mouth, insomnia, nausea
If you see something spilled in the hall should you clean it up or wait for housekeeping?
Any safety hazard should be dealt with immediately by the person who discovers it first
What should you do if a feeding pump is beeping?
Tell the nurse; don’t ever silence it without saying something
What causes varicose veins?
The veins in the legs lose elasticity and the valves become weak, allowing blood to pool in them
What should you worry about if you are shaving a resident who is on oxygen?
Don’t use the electric razor; never take off or turn off the oxygen unless you check with the nurse first; work around it
What is an important thing to remember when caring for a blind resident?
Always introduce yourself and give your title when you enter their room
What is a bedside commode?
A portable rolling toilet with a bucket that needs to be emptied and cleaned after use
What is dyspnea?
Shortness of breath, painful or difficult breathing
What is dysuria?
Painful urination
What is the most likely cause of cloudy vision in the elderly?
Cataracts
What is the best thing to do for an Alzheimer’s patient who likes to wander?
Provide a safe place for them to wander in or take them for a walk
What is the best way to approach an Alzheimer’s or dementia patient?
Speak calmly; use their name and simple words and directions; have a quiet environment and a consistent routine
Where should you discard a used razor?
sharps container
What is partial weight bearing?
The patient can put weight on their good leg but they cannot put weight on their bad leg
When using a tub for baths what should you remember?
Sanitize it between residents
An Alzheimer’s patient doesn’t recognize her son a good response would be..
Isn’t it nice your son is here to visit!
When your patient with dementia is getting sick but can’t tell you what might you notice first?
A change in behavior
How might this dementia patient indicate pain?
Groaning, grunting, grimacing, folding over
If your patient is crying what should you do?
Spend time with them; try to build a good rapport by showing sympathy and concern
What is HIPAA?
The Health Insurance Portability and Accountability Act
What does HIPAA cover/protect?
It’s about protecting patient information; it covers when and how information can be shared, and how records are stored and disposed of
If a patient is receiving anticoagulants (blood thinners) can you shave them?
Not with a blade; you should use an electric razor
What body system is most affected by multiple sclerosis?
The nervous system; it causes increasing muscle weakness and fatigue, occurs more frequently in younger people
Do the elderly have sexual needs and what can the CNA do?
Yes, they do (basic physical need); the CNA should provide privacy
What is a common symptom of depression?
Low levels of energy
What is ombudsman?
The patient’s representative; they investigate problems, complaints, and grievances
List tips for caring for dentures safely.
Lukewarm water; line the sink with a paper towel and fill with water; hold firmly in 1 hand while brushing with the other; store in water; transport in a denture cup
What should you report to the next shift when they take over for you?
Any problems the residents had, or anything out of the ordinary that happened
If the resident is found climbing out of bed in the middle of the night what is the most likely reason?
They need to use the bathroom
What is osteoporosis?
Excessive loss of bone tissue; frequent bone fractures
Are ice cream and popsicles counted as liquids?
Yes, anything that is liquid at room temperature is counted as a liquid
What would be the best way to transfer a resident who has both legs amputated?
Get plenty of help and use a mechanical lift
What observations could be noted about urine?
Amount, color, clarity, presence of sediment or blood
When was OBRA (Omnibus Budget Reconciliation Act) passed?
1987
How can you reduce communication errors?
Get feedback; ask the resident if they understand
If a resident falls and you think they might be injured (especially a hip injury) what should you do?
Don’t move them; stay with them; keep them in the same position and send someone to get the nurse
Why do the elderly fall so often?
They have poor balance and are often confused, so they don’t recognize a dangerous situation
Which disease makes the patient more likely to fall?
Parkinson’s disease; the muscles have tremors and are rigid
Which systems are kidneys part of?
The urinary system
What are some guidelines for the nurses station phone?
Never use it for a personal call; never take doctor’s orders - the nurse has to do that
If you are feeding a patient who has had a stroke what should you be aware of?
The food should be placed in the unaffected side of the mouth (their good side)
What is an MI?
A myocardial infarction; heart attack
What are signs and symptoms of an MI?
Chest pain or pressure, sweating, shortness of breath, nausea/vomiting, arm/neck/back pain
How is HIV most commonly spread?
Through unprotected sexual contact
What important step should you take every time you leave a resident?
Give them their call light; make sure it is on their strong side
What is leukemia?
Cancer of the white blood cells
Where would be the safest place to leave a hearing aid when taking the resident to a shower?
In the resident’s room
What is the last stage of an illness before death?
The terminal stage
If a patient has supplemental feedings what is the CNA’s responsibility?
Offer it to the resident frequently
How often should catheter care be provided?
Every day and prn
What is systole or systolic?
When the heart is contracting; the top number of a blood pressure (the first sound you hear)
What is diastole or diastolic?
When the heart is relaxed; the bottom number of a blood pressure (the last sound you hear)
What should you do if you find a syringe with a needle on the floor?
Put it in the sharps container just the way it is; do not recap the needle
What does bedfast mean?
It is the same as bedrest; the person cannot get up
What would you do to help a patient with hand tremors?
Assist with feeding, especially hot liquids
If a resident is in bed on their side how would they be positioned?
Legs flexed (bent) at the knees with a pillow between them, a pillow behind their back, and one between their arms
What is the main cause of emphysema?
Smoking
When should a sputum sample be collected?
First thing in the morning
What are some signs and symptoms of Parkinson’s disease?
Tremors, muscle stiffness, general weakness, shuffling, stooped posture, freezing, repetitive hand motions
What can increase an older person’s risk for constipation?
Medications and immobility; give fluids and encourage exercise to alleviate or help with constipation
What does the abbreviation NPO stand for?
Nothing by mouth
What is peristalsis?
The wave-like muscle movement that moves the food through the intestines
What is a trochanter roll?
A pillow or rolled towel placed along the outside of the hip and upper leg of a patient in bed to keep their leg from turning out
What is the drug therapy for cancer called?
Chemotherapy
What can you do for a patient who is in respiratory distress (having trouble breathing)?
Elevate the head of the bed, check to make sure the oxygen is working
How should you remove dentures?
Upper - pull down and out; lower - pull up and forward
What does it mean to ambulate a resident with assistance?
To help them walk
What would be more likely to make a resident fall a non-skid rug or a highly polished floor?
A highly polished floor
If you are feeding a resident when should you offer fluids?
Frequently
What should you do if a resident’s family offers you a tip?
Refuse politely, explain that CNAs are not allowed to take tips
What is included in the circulatory system?
Heart, blood vessels (veins and arteries)
What care do you give a patient who has had hip surgery?
Keep the legs apart using an abduction pillow; don’t let the resident cross their legs or bend the hip more than 90 degrees
Residents’ personal items?
Should be labeled according to the facility’s policies
What are general rules to follow with side rails?
If you are turning a resident toward the side for any reason, have the side rail up on the side they are turning towards; if you leave a full rail up, it is considered a restraint
When positioning a resident in a wheelchair?
The spine should be straight
If the patient has a gastrostomy (feeding) tube how should they be positioned?
With the head of the bed up at 45 degrees
Where does a CNA usually take a pulse?
The radial artery (wrist)
What is a normal pulse?
60-100
Where do you take a tympanic temperature?
in the ear
When should a new rash be reported?
immediately
What is a bed cradle used for?
Used to protect the feet; it is a metal frame that holds the sheets off the person’s feet and keeps them from getting bed sores on their toes
What is the result when there is not enough blood flow to the heart?
Chest Pain
If your patient is on dialysis how would you take a blood pressure?
Don’t take it on the arm used for dialysis; take it on the other arm
For wheelchair safety what should you be aware of?
Back the wheelchair down ramps; brakes are locked
What is an in-house transfer?
Transferring a resident from one room to another in the same facility
When you are walking a patient who has a Foley catheter what should you do with the bag?
Keep it below the level of the bladder
Define dementia.
A progressive deterioration of mental abilities
What does communication require?
A sender, a message, and a receiver
What are common symptoms of dehydration?
Dry mouth, dark concentrated urine, constipation
What is the name of the table that goes over the patient’s bed often used to place meals on?
overbed table
Should you soak fingernails before or after you cut them?
before
What is sundowning and when does it occur?
When the patient gets more confused in the evening
What should you use to shave a person who is on oxygen?
A regular safety razor; not an electric shaver
What level of Maslow’s Hierarchy of needs encourages patients to be the best they can be?
Self-actualization (the top level)
What are the levels of Maslow’s Hierarchy of needs and which has to be met first?
Physical (first), safety and security, love and belonging, self-esteem, self-actualization
Which level of need would not be met if you don’t answer a call light?
Security
What is another name for a soft diet?
Mechanical; used for patients who have difficulty chewing, swallowing, or who have mouth pain
What is dysphagia and how do we help a patient with dysphagia eat?
Difficulty swallowing; we should position them in Fowler’s and feed them with a mechanical soft diet
What is dysphasia?
Dysphasia is difficulty communicating; difficulties speaking and understanding speech
With normal aging most people..
Stay generally active, are in good health
What is the name of the membrane found in your nose and mouth?
Mucous membrane
If a patient is ambulatory which scale would you use to weigh them?
The standing/upright scale
What does disinfecting do?
Kills most of the pathogens or germs by using a chemical that is too strong to be used on the skin
If your patient is on oxygen and a family member begins smoking what should you do?
Ask them to put it out immediately
How should disinfectants be stored?
Locked up
What is the first thing you should do as you prepare to transfer a patient?
Consider their abilities and limitations
Define delusions.
A false personal belief that is maintained in spite of obvious proof to the contrary (believing you are someone else)
Define hallucination.
Perceiving something with your senses that is not real
How do you label a specimen you have collected before you send it to the lab?
Include the date, the patient’s name, and date and time it was collected, and the type of test ordered; sometimes also a doctor’s name and the initials of those who gathered it
Define osteoarthritis.
A wear and tear joint disease more common in the elderly
What is the problem and what should you do if your patient develops a soft spot or redness on her heel?
A pressure ulcer is starting; elevate the heels off of the mattress and report it to the nurse
If your patient has a feeding tube what is an important thing for you to do?
Watch for kinks in the tubing; report choking or vomiting immediately; provide oral hygiene; be very careful when repositioning the patient
What can you do when you are ambulating a resident to prevent them from falling?
Use a gait belt
Define aphasia.
A condition where the patient cannot communicate (stroke); they may not be able to speak or understand what is being said to them
How do we care for the feet of a diabetic?
Breathe, rinse, and dry thoroughly; check for broken, cracked, or damaged skin; clipping toenails is allowed if the facility permits
When your patient is wearing oxygen and also had electrical equipment what should you worry about?
Turn equipment off before unplugging it to prevent sparks; make sure there are no damaged cords, and if there is then get them replaced fast and let the nurse know
Define geriatrics.
The branch of medicine that focuses on caring for people later in life
How do you collect a 24 hour urine sample?
Have the patient urinate and don’t save it, mark the time; for the next 24 hours save all the urine in one container and keep it in the fridge; at the end of the 24 hours have the patient urinate one more time, label it and deliver it to the lab
How do you collect a stool sample?
Using a clean container and a small stick, scoop the stool into the container from a collecting device; deliver it to the lab as soon as possible
Alcohol?
Is a carcinogen according to several health organizations
What does it mean if something is sterilized and how is it usually done?
Sterilized means the absence of any microbes; usually done in an autoclave using steam
What is a chemical disinfection?
When an object is cleaned with a strong chemical that removes most but not all pathogens
What should you do if your patient’s disease can be transmitted through droplets?
Wear a Mask
How can you prevent your patient from being burned?
Warn them if there are hot liquids on their trays
How can HIV (AIDS) or HBV (hepatitis B) be transmitted?
Through blood and bodily fluid; contact with a dirty needle or syringe or sexual intercourse
Where do you find the rules for each facility?
In their policy book
Faucets are?
Dirty, unclean, full of bacteria
Who is the most susceptible to disease?
The elderly, the young, and anyone already sick
What are characteristics of a good CNA?
Dependable, caring, sensitive, mature, good ethics, positive, knowledgeable
What is the purpose of white blood cells?
They are your body’s natural defense against disease; they fight infection
What is Huntington’s disease (chorea)?
A hereditary disease that appears in midlife; causes irreversible and progressive loss of muscle control and loss of mental abilities
What is a care plan?
A specific plan for each resident listing goals and needs written by the nurse; found at the nurses station usually in the patient’s chart
What should you worry about if your patient has a cast?
Always check for feeling and warmth of the fingers below the cast
To maintain the best stability how should you leave the wheels on a wheelchair?
Facing Foreward
Define microorganism.
A living thing that cannot be seen with the naked eye (bacteria, virus, fungus)
What is the best way to prevent contamination?
Hand washing; the next best way is wearing gloves
Define antisepsis.
A practice that kills microorganisms or stops them from growing
Why are we finding so many diseases now that do not respond to antibiotics?
Antibiotics have been inappropriately used or overused and it causes bacteria to grow resistant to them
How do we add moisture to the patient’s oxygen?
The oxygen flows through a container of water called a humidifier; high enough for the oxygen to bubble as it passes through
What can someone have if they are on a clear liquid diet?
Only liquids that you can see through (water, broth, jello, tea, coffee)
What is included in a full liquid diet?
Anything that is liquid (milk, ice cream, pudding, soup); also anything from a clear liquid diet
What treatment should be provided immediately for a laceration?
Direct pressure to stop the bleeding
In residents with poor circulation is their skin temperature usually warmer or cooler than normal?
Cooler
List something patients can do if they have edema (swelling) in their feet or legs.
Elevate their feet and avoid constrictive clothing
What organization requires ongoing training about blood-borne pathogens and hazardous waste?
OSHA (Occupational Safety and Health Administration)
What should you do first if you make an error?
Tell the supervisor
What is post mortem care?
Care of the body after death
What skill will CNAs most often be ordered to provide after surgery?
Frequent vital signs
What are 2 main purposes of monitoring a patient’s weight?
See if they are retaining fluid and assess nutritional status
What is the opening of a colostomy called?
Stoma
If a patient is masturbating in a public area what should you do?
Move them to their room or a more private area to respect their right of privacy
Why is being empathetic better than being sympathetic?
Sympathy shows pity whereas empathy shows understanding
What is the purpose of range of motion?
To keep joints mobile and prevent contractures
How do you measure a resident’s height if they can’t stand and have contractures so they can’t lie straight?
Use a tape measure and follow the curves of their body
What is the difference between active and passive range of motion?
Passive - CNA does it; Active - Patient does it
How many hours does a CNA have to work every 2 years to recertify?
200 hours
List the main signs and symptoms of diabetics.
Polyuria (increased urine), polydipsia (increased thirst), polyphagia (increased hunger)
What is the difference between subjective and objective information?
Subjective - What the resident says (symptom); Objective - Facts that can be observed (sign)
What should you do if you are walking a patient who starts to fall?
Assist her to lie down, tell the nurse, look for abnormal signs and symptoms
List several ways you can best talk to a patient who is hearing impaired.
Slowly, clearly, distinctly, low pitch, face-to-face
Give an example of a chronic disease.
Cancer, Parkinson’s, dementia, Alzheimer’s, diabetes
What are the 5 stages of grieving?
Denial, anger, bargaining, depression, acceptance
What could it mean if a Foley bag has no urine in it the entire shift?
Catheter has fallen out, kidney failure, kinked, under patient’s leg
Why do diabetics have a high risk of foot sores?
Decreased circulation and sensation
What are defense mechanisms used for?
To block unpleasant feelings or anxiety, to avoid conflict
Define reality orientation.
Helping a patient gain as much reality as possible; call them by name, tell them the date, time of day, etc.
What is the difference between acute and chronic disease?
Acute - Sudden, treatable; Chronic - Gradual, long term
What organization/legislation sets the rules on nurse’s aide training and certification?
OBRA (1987)
What patients usually have sitz baths ordered?
Postpartum patients and patients who have had rectal surgery
What term means to retain fluid in the tissues?
Edema
What is a nosocomial infection?
An infection acquired in healthcare facilities or hospitals (HAI)
Define aspiration.
Fluid or particles entering the lung instead of going down the GI tract; coughing or choking
What does lethargic mean?
A lowered level of consciousness including drowsiness, indifference, and reduced level of activity
What is another way to describe diabetics?
Hyperglycemia
What situations could cause aspirations if you aren’t careful?
Providing oral care to an unconscious person; feeding a resident too fast
What is the immediate care for a resident who is vomiting?
Turn their head to the side to prevent aspiration
Why is it important for intake and output to be even?
To avoid fluid imbalance
What is included in output besides urine?
Liquid stool, emesis, blood/wound drainage, sweat, saliva
Define pathogen.
A microbe that is harmful and causes infection, sometimes commonly referred to as a germ
What is the goal of rehabilitation?
To help a patient do as much as possible, as well as possible, for as long as possible
What is the main reason for straining urine?
To check for kidney stones
What should be documented as output for incontinent patients?
The number of times they wet the bed
List the times excellent oral care would be needed.
Patient is unconscious, on oxygen, on tube feedings, frequent vomiting
What term is a written document that gives another person the right to make decisions for you if you are unable?
Power of attorney
What causes dehydration?
More output than intake; frequently caused by vomiting or diarrhea or heavy sweating
Define hospice.
Care of terminally ill (less than 6 months to live)
Why should you NOT slide a patient across the sheets?
It causes friction, shearing, and skin tears
What else causes friction and shearing?
Leaving the head of the bed up too high for too long allowing the resident to slide down the bed
What is the ratio of breaths to compressions in infant CPR if you are doing it alone?
30 compressions, 2 breaths
Why is it important to weigh patients with congestive heart failure every morning?
They can retain fluid which causes weight gain
Define standard or universal precaution.
Deciding what PPE to use based on risk of exposure; infection control precautions used for all patients to reduce the spread of infection
List the risks of prolonged bed rest.
Pneumonia, bed sores, contractures, weakness
Why shouldn’t leftover cleansers be stored in an empty glass jar?
You can’t tell what they are without a proper label so they are a potential hazard
Why can’t bleaches and cleansers be mixed together to store?
They can give off a dangerous gas
A patient ate turkey, potatoes, gravy, jello, mashed carrots, juice, cake, and ice cream - what 3 items are counted as intake for I and O?
Jello, juice, ice cream
What pressure is the point where the first sound of the blood pressure is heard?
Systolic pressure
What should you do if a patient can’t eat some foods for religious reasons?
Tell the nurse or dietician; make sure they get other options
What letter in the alphabet is the abbreviation for the word “with”?
C
What position should a patient be put in if he is going into shock?
Trendelenburg
What system should you use for telling a blind person what is on their plate?
The clock method
What key step can be taken to ensure accurate weights are taken on patients?
Balance the scale first, weigh at the same time every day, weigh on the same scale, in the same amount of clothing
Why is it better for residents to get dressed instead of wearing pajamas all day?
It helps them feel better about themselves
Do patients with dementia do better in a structured environment that changes a lot?
Structured, safe, unchanging environment
List factors that can affect vital signs.
Time of the day, eating/drinking, smoking, medications/stress, gender/weight
What is the 2nd most common cause of accidents in the elderly?
burns
If a patient has a weak right side what side is dressed first?
The right (weak) side, also called the affected side
If you don’t know how to perform a task what book at the facility will tell you how?
Policy and procedure manual
On admission to a facility what do you do if a patient says they already know their weight
To verify for accuracy; we want to use the same scale that will be used throughout their stay
What is a sitz bath?
A method for soaking the perineal area to clean wounds, promote healing, decrease pain, and improve circulation
Define TED hose and explain their purpose?
They are elastic stockings to improve circulation in the legs; they prevent blood clots and edema
What should you do if your patient is diabetic and when you go to check on him he is very lethargic?
Check his blood sugar and notify the nurse
How should you respond to a suicidal patient?
ALWAYS take the threat seriously and tell the nurse
How often should immobile patients be repositioned?
every 1-2 hours
What does R.A.C.E stand for?
R - rescue or remove; A - alarm or activate; C - confine or contain; E - extinguish or evacuate
What measurement is usually used to record intake and output?
Cubic centimeters (cc) or milliliters (mLs)
What direction should you shave on a man’s face?
In the direction that the hair grows (down on the cheek, up on the neck)
How often should a shave be offered?
Daily
How do you fix charting errors?
Cross out the error with a single line and initial the mistake
How often should restraints be removed and repositioned?
Every 1-2 hours (check on the patient every 15 minutes)
What is the first step you should take if you suspect that someone is choking?
ask, “are you choking”
How many CC’s or mLs are in an ounce?
30
How do you treat someone having a seizure?
Support their head so they don’t injure themselves; clear the area; be there to support them after
Why should females be wiped and cleaned from front to back?
To avoid UTIs
What program uses both state and federal money to help pay for care needed?
Medicaid
When should respirations be counted?
When the patient is unaware that you are taking them
If you suspect patient abuse what should you do?
Tell the RN or supervisor; report to APS
What is the normal range for temperature?
98-99
How to take a rectal temp?
Use a red thermometer, lubricate it, insert 1 inch or less, don’t let go of the thermometer, provide peri-care after
Which patients should be offered HS snacks?
All patients, unless they are NPO
Why is cutting toenails not usually included in routine nail care?
Not all patients can have it done; it must be ordered separately; not all facilities allow CNAs to clip toenails
What should you do first if you make an error when caring for a patient?
Tell the nurse
What is the most common accident for the elderly?
falls
What chamber of the heart receives the blood that is returning from the body?
Right Atrium
List key steps that should be taken for good body mechanics.
Never twist your body; keep feet 12 inches (shoulder width) apart; lift with legs not back; hold object close; get help
What if you need to move something that is very heavy?
Do not attempt to lift it; try to push or pull the object
List ways to avoid pressure sores.
Reposition (2 hrs); pad bony areas with pillows; good skin care; good nutrition
Why should residents be encouraged to do as much for themselves as possible?
They’ll feel more self-reliant; it keeps them active; it is good for their self-esteem
If you are feeding a blind person what should you remember?
Always tell them what you are feeding them
What time is it if it is 2015 in military time?
8:15 P.M.
Do ALL elderly patients get dementia?
No, only about 15%; however, this makes up most of the people you take care of
What is the purpose of SDS sheets?
They tell about chemicals or hazardous materials; what to do if they are swallowed or spilled
What does MSDS stand for?
Material Safety Data Sheet; the new acronym for SDS (safety data sheet)
What term means paralyzed from the waist down?
Paraplegia
When should TED hose be applied?
Before getting out of bed in the morning, or when feet are elevated before swelling begins
Define negligence.
Not providing the care that a patient needs or not performing it safely
What is CVA?
Cerebrovascular accident or stroke
How often should an elderly patient’s hair be shampooed?
At least once a week
What is an open ended question?
Any questions that require more than a yes or no answer
Where should restraints be tied when the person is in bed?
On the bed frame; never on the side rails; using a quick release knot
What instrument do you need to take an apical pulse?
A stethoscope (and a clock with a second hand)
What part of the body usually has poor circulation in diabetic patients?
Feet
Pulses are located over what type of blood vessel?
Artery
What liquid is most important for patients to drink enough of?
Water; it helps with elimination of waste
What is the position called when the resident is flat on their back?
Supine
How can you best help a blind resident walk?
Allow them to hold your arm
Where is the radial pulse taken?
The wrist, using 2 fingers; never your thumb because it has its own pulse
Define log rolling and explain why it is done.
Moving the patient while keeping the body in alignment; used for patients with neck, back, or hip injury; you need 2 people, move the patient on the count of 3 with a draw sheet; the patient should cross their arms and have a pillow in between their legs
What type of seizure causes the person to fall asleep suddenly?
Narcolepsy
What is the best way to prevent contractures?
Range of Movement
What is the purpose of the Heimlich maneuver?
Choking and has no air exchange; thumb side up against the abdomen just above the navel; you would recognize when a person needs this
What should you say if a patient wants to tell you a secret?
You can tell me anything you want, but I can’t keep it a secret if the nurse needs to know
How often should oral care be provided for patients who are unconscious?
Every 2 hours
What often causes falls in the home?
Throw rugs and poor vision with a cluttered environment
What term means for muscles to shrink
Atrophy
What is a written statement about the life-saving measures a patient wants to be taken?
A living will, often used in conjunction with a POLST form
What is a mini stroke called?
Transient ischemic attack
What temperature should bath water be?
100-105 degrees or warm to the touch
What is the ratio of compression to breaths in 1 man adult CPR?
30 compressions and 2 breaths
What nutrient is needed for tissue to grow and repair?
Protein
What nutrient do we get the most of our energy from?
Carbs
What is included in non-verbal communication?
Body language, gestures, facial expressions
What type of seizure has tonic-clonic contractions?
Grand Mal
How long should you wait to take a temperature if the patient has had anything to eat or drink?
15 to 30 minutes
Where is the apical pulse taken?
The chest, over the heart
What does the abbreviation QID mean?
4 times a day
What position is it when the patient is lying flat on their stomach?
Prone
What is the least accurate way to measure temperature?
Axillary
What letter of the alphabet is the abbreviation for the word without?
S
What is always required before restraints can be used?
Doctor’s order
What should be done first in the case of a fire?
Rescue the patient and remove the patient from danger
What pressure is the point where the last sound of the blood pressure is heard?
Diastolic pressure
What should you do if you find a patient masturbating in his room?
Close the door and leave the room and give him his privacy
What procedure should be performed if a victim is not breathing and has no heartbeat?
CPR (cardiopulmonary resuscitation)
What position should unconscious patients be in during oral care?
Lateral (side-laying)
What should the aide do if she finds a piece of broken equipment?
Tell the supervisor or RN; don’t use it until it is fixed
What program in the government is managed by the Social Security Administration and pays for health care for the elderly?
Medicare
When should linens that are wet or soiled be changed?
Immediately
When a patient is dying what is the last sense to leave?
Hearing
If you are angry with a patient who should you talk to?
The supervisor and RN (not coworkers or the patient’s family)
What does QS stand for?
Quantity sufficient
What does the abbreviation HS stand for?
Hour of sleep or bedtime
How often does a CNA certification need to be renewed?
Every 2 years
What utensil should be used when feeding patients?
A spoon
What is the #1 way to prevent the spread of infection?
Hand Washing
Everything in an isolation room is considered to be…
Contaminated - everything should be single use and disposed into a biohazard container; laundry and trash should be double bagged
What is the most important step in good communication?
Listening
List patient rights.
Privacy, confidentiality, respect, care, free from abuse, have visitors, visit in private + more
What should you do if you find leftover medications in your patient’s room?
Tell the nurse, do not give them to the patient
What term means the buildup of plaque and fat in the arteries?
Atherosclerosis
When is it ok to call a resident by their first name?
When the resident requests it
What type of seizure causes brief periods of inattention and staring into space?
Petit Mal
How can you best treat bleeding or hemorrhaging?
Apply direct pressure
How many ounces are in 1 cup?
8
Should canes be used on the patient’s weak or strong side?
Strong
Is dry heat or wet heat more intense and potentially dangerous?
Wet - a hot washcloth is more intense than a hot pack
If the patient has a weak right side what side is undressed first?
The left (strong) side, also called the unaffected side
List rules for handling linens.
Don’t shake, don’t put them on the floor, don’t return clean/unused ones to the closet, stack in order of use and flip
What should the average intake be for a healthy adult?
1500 to 2000 CC’s (mLs)
What can you do to decrease the risk of drying the skin of elderly patients?
Use less soap, use lotion, don’t bathe everyday
List 3 times using restraints would be appropriate.
Resident safety, safety of others, pulling out tubes
What is the term for being paralyzed from the neck down?
Quadriplegia
Who acts as the case manager for home care patients?
The RN
What body parts are included in the partial bed bath?
Face, hands, axillary, back, peri area
What is the purpose of bladder training?
To help the patient gain control of their bladder once the catheter is removed
List requirements for caring for a patient in traction.
Keep weights off the floor, keep the patient in good body alignment, avoid bumping them or traction equipment
What is the danger of using hot packs on the legs of people with edema?
Bad burns since sensation is often decreased; more swelling
Define hemiplegia.
Paralysis on one side of the body (right or left)
What is an inventory list?
A list of all the patient’s belongings
