CNA Written Exam – NNAAP Nurse Aide Assessment — Questions and Answers

Question 1: What is the correct technique for measuring oral temperature with a digital thermometer?

Place under the tongue in the front of the mouth
Place under the tongue in the posterior sublingual pocket (Correct answer)
Place between the cheek and gum
Have the patient hold it with their lips only

Correct answer: Place under the tongue in the posterior sublingual pocket

For an accurate oral temperature reading, the tip of the thermometer must be placed in the posterior sublingual pocket, which is a heat-rich area under the tongue. This position allows the thermometer bulb to be in direct contact with the mucous membranes, reflecting core body temperature effectively. Placing it elsewhere can lead to inaccurate readings.

Question 2: Which abbreviation on a medication order means 'twice daily'?

QID
QD
BID (Correct answer)
TID

Correct answer: BID

BID (bis in die) means twice daily; QD = once daily, TID = three times daily, QID = four times daily.

Question 3: After inserting an NG tube, the most reliable method to verify placement is:

Auscultating air insufflation over the stomach
Observing the patient for coughing or choking
Confirming placement with an X-ray (Correct answer)
Aspirating gastric contents and checking pH

Correct answer: Confirming placement with an X-ray

Radiographic confirmation (X-ray) is the gold standard for verifying NG tube placement before initiating feedings or medications.

Question 4: When making an occupied bed, what should the CNA do to maintain the patient's dignity?

Keep the patient covered and expose only the area being worked on (Correct answer)
Ask family members to leave the room completely
Explain that dignity isn't important during care procedures
Work as quickly as possible to minimize discomfort

Correct answer: Keep the patient covered and expose only the area being worked on

Maintaining a patient's dignity and privacy is a fundamental aspect of person-centered care, especially during personal care procedures like bed making. Keeping the patient covered and exposing only necessary areas respects their modesty and promotes a sense of comfort and security. This practice builds trust and upholds ethical care standards.

Question 5: The nurse is assessing a patient for fluid overload. Which finding supports this assessment?

Sunken eyes and dry mouth
Decreased blood pressure
Peripheral edema and crackles in the lungs (Correct answer)
Poor skin turgor and dark urine

Correct answer: Peripheral edema and crackles in the lungs

Peripheral edema and pulmonary crackles (from fluid accumulation in lung interstitium) are hallmark signs of fluid overload (hypervolemia).

Question 6: What is the minimum time required for proper hand washing with soap and water per CDC guidelines?

30 seconds
10 seconds
15 seconds
20 seconds (Correct answer)

Correct answer: 20 seconds

CDC guidelines recommend scrubbing hands with soap and water for at least 20 seconds to effectively remove microorganisms.

Question 7: Which nursing intervention helps prevent foot drop in an immobile patient?

Using a footboard or high-top sneakers to maintain dorsiflexion (Correct answer)
Elevating legs above heart level
Applying anti-embolic stockings
Performing heel massage every 2 hours

Correct answer: Using a footboard or high-top sneakers to maintain dorsiflexion

A footboard or high-top sneakers maintain the foot in dorsiflexion, preventing the plantar flexion contracture known as foot drop in immobile patients.

Question 8: The nurse is measuring a wound. She finds it is 3 cm long, 2 cm wide, and 1 cm deep. How should this be documented?

Area = 3 cm
3×2×1 cm (Correct answer)
6 cm²
3×2 cm

Correct answer: 3×2×1 cm

Wound measurements are documented as length × width × depth in centimeters to provide a complete three-dimensional assessment.

Question 9: Which type of enema is primarily used to stimulate peristalsis and evacuate the bowel before a procedure?

Retention enema
Barium enema
Oil retention enema
Cleansing enema (Correct answer)

Correct answer: Cleansing enema

A cleansing enema instills a large volume of solution to stimulate peristalsis and mechanically evacuate stool from the colon.

Question 10: The nurse is transferring a patient from bed to wheelchair. To protect their own back, the nurse should:

Use a wide base of support and bend at the hips and knees (Correct answer)
Lift with arms extended and back straight but bent forward
Keep feet together and reach forward during the lift
Twist at the waist while lifting the patient

Correct answer: Use a wide base of support and bend at the hips and knees

Safe body mechanics require a wide base of support, bending at hips and knees (not the waist), keeping the load close to the body to protect the nurse's spine.

Question 11: When collecting a urine specimen from a patient with a urinary catheter, the CNA should:

Disconnect the catheter from the drainage tube
Use the sterile port on the catheter tubing with a sterile syringe (Correct answer)
Empty the drainage bag and collect from the bag
Have the patient try to urinate into a specimen cup

Correct answer: Use the sterile port on the catheter tubing with a sterile syringe

To collect a sterile urine specimen from a urinary catheter, the CNA must use the designated sterile port on the catheter tubing. Collecting from the drainage bag is not sterile, and disconnecting the catheter introduces a high risk of infection. This method ensures the specimen is free from external contamination, allowing for accurate diagnostic testing.

Question 12: The nurse discovers a medication error after administration. The priority action is to:

Do nothing if the patient appears unharmed
Assess the patient and notify the provider immediately (Correct answer)
Document the error and continue the shift
Notify the pharmacy and wait

Correct answer: Assess the patient and notify the provider immediately

After a medication error, the priority is patient assessment and immediate notification of the provider so appropriate interventions can be ordered.

Question 13: Signs and symptoms of dehydration include all of the following EXCEPT:

Increased skin turgor loss
Decreased urine output
Dry mucous membranes
Bounding pulse (Correct answer)

Correct answer: Bounding pulse

Dehydration causes a weak, thready pulse due to reduced circulating volume — a bounding pulse is associated with fluid overload, not dehydration.

Question 14: What is the normal color of urine in a well-hydrated adult?

Light orange
Clear and colorless
Pale yellow to amber (Correct answer)
Dark amber or brown

Correct answer: Pale yellow to amber

Normal, adequately hydrated urine ranges from pale yellow to amber due to the pigment urochrome.

Question 15: A medication has a narrow therapeutic index. This means:

The drug has few side effects
The drug is inexpensive and widely available
The medication can be given by any route
The difference between therapeutic and toxic doses is small (Correct answer)

Correct answer: The difference between therapeutic and toxic doses is small

A narrow therapeutic index means the therapeutic dose is close to the toxic dose, requiring careful monitoring.

Question 16: Which sign indicates the patient may be experiencing refeeding syndrome after starting nutritional support?

Hyperphosphatemia and hyperkalemia
Hypophosphatemia, hypokalemia, and hypomagnesemia (Correct answer)
Hypernatremia and elevated albumin
Weight gain and improved skin turgor

Correct answer: Hypophosphatemia, hypokalemia, and hypomagnesemia

Refeeding syndrome causes electrolyte shifts (hypophosphatemia, hypokalemia, hypomagnesemia) as glucose and insulin drive minerals into cells during rapid nutritional repletion.

Question 17: Dark, tarry (melena) stools are most commonly associated with:

Upper gastrointestinal bleeding (Correct answer)
Excess dietary fiber intake
Normal bowel function
Lower gastrointestinal bleeding

Correct answer: Upper gastrointestinal bleeding

Melena results from digested blood and typically indicates bleeding in the upper GI tract (esophagus, stomach, or proximal small intestine).

Question 18: When using a gait belt to assist a patient to ambulate, it should be placed:

Around the patient's hips
Around the patient's thighs
Around the patient's chest
Around the patient's waist, over clothing (Correct answer)

Correct answer: Around the patient's waist, over clothing

A gait belt is secured snugly around the patient's waist (over clothing) to provide a secure grip for the nurse during ambulation assistance.

Question 19: The nurse notes a wound has yellow, thick, foul-smelling drainage. This type of drainage is called:

Purulent (Correct answer)
Sanguineous
Serous
Serosanguineous

Correct answer: Purulent

Purulent drainage is thick, opaque, yellow, green, or brown, and indicates infection or the presence of microorganisms.

Question 20: Which position should be avoided to prevent sacral pressure injuries?

Semi-Fowler's at 30 degrees
Prone positioning
Elevating the head of bed greater than 30 degrees (Correct answer)
Lateral positioning at 30 degrees

Correct answer: Elevating the head of bed greater than 30 degrees

Elevating the head of bed greater than 30 degrees increases shear and friction on the sacrum, promoting pressure injury development.

Question 21: A patient's pulse rate is 48 beats per minute. What should the CNA do?

Have the patient exercise to increase the heart rate
Take the pulse again in one hour
Retake the pulse and report the finding to the nurse immediately (Correct answer)
Document the finding and continue routine care

Correct answer: Retake the pulse and report the finding to the nurse immediately

A pulse rate of 48 beats per minute is significantly below the normal adult range of 60-100 bpm, indicating bradycardia. This finding could signal a serious underlying medical condition, requiring prompt attention. Therefore, the CNA should first retake the pulse to confirm the accuracy of the reading, and then immediately report this critical finding to the nurse for further assessment and intervention.

Question 22: What is the primary goal of a pressure-relieving mattress overlay in wound care?

Redistribute pressure to prevent new pressure injuries (Correct answer)
Absorb wound exudate
Maintain wound moisture
Provide warmth to promote circulation

Correct answer: Redistribute pressure to prevent new pressure injuries

Pressure-relieving mattress overlays (foam, air, gel) redistribute body weight to reduce prolonged pressure on bony prominences and prevent pressure injury formation.

Question 23: When feeding a patient who has difficulty swallowing, what position should they be in?

Upright at 90 degrees or as upright as possible (Correct answer)
Lying on their side (lateral position)
Semi-Fowler's position at 30 degrees
Flat on their back (supine)

Correct answer: Upright at 90 degrees or as upright as possible

When feeding a patient with difficulty swallowing, positioning them upright at 90 degrees or as close as possible is crucial. This position utilizes gravity to assist food and liquids in moving down the esophagus, significantly reducing the risk of aspiration. Aspiration, where food or liquid enters the lungs, can lead to serious complications like pneumonia.

Question 24: A patient has not had a bowel movement in 4 days and reports straining without results. This best describes:

Fecal incontinence
Diarrhea
Constipation (Correct answer)
Flatulence

Correct answer: Constipation

Constipation is characterized by infrequent, difficult passage of stool, often accompanied by straining and a feeling of incomplete evacuation.

Question 25: Which wound drainage is described as thin, watery, and blood-tinged?

Serous
Sanguineous
Purulent
Serosanguineous (Correct answer)

Correct answer: Serosanguineous

Serosanguineous drainage is a mix of serous (clear/watery) and sanguineous (bloody) drainage, appearing pink or light red.

Question 26: Standard precautions apply to:

Only patients in contact isolation
All patients regardless of diagnosis or infection status (Correct answer)
Only bodily fluids that are visibly bloody
Only patients with known infections

Correct answer: All patients regardless of diagnosis or infection status

Standard precautions apply to all patients in all healthcare settings regardless of their known infection status, treating all blood and body fluids as potentially infectious.

Question 27: Which lab value best reflects a patient's long-term nutritional status and protein synthesis?

Serum albumin (Correct answer)
Blood glucose
Hemoglobin
Serum creatinine

Correct answer: Serum albumin

Serum albumin reflects long-term protein status (half-life ~20 days); levels below 3.5 g/dL indicate malnutrition or poor protein synthesis.

Question 28: The Z-track technique is used for which type of injection?

Subcutaneous
Intramuscular (Correct answer)
Intravenous
Intradermal

Correct answer: Intramuscular

The Z-track technique is used for intramuscular injections to prevent medication from leaking into subcutaneous tissue and causing irritation.

Question 29: Which thermometer site provides the most accurate core body temperature in an adult?

Tympanic
Rectal (Correct answer)
Oral
Axillary

Correct answer: Rectal

Rectal temperature is closest to core body temperature and is the most accurate method for adults.

Question 30: When measuring a patient's blood pressure, the cuff should cover what percentage of the upper arm?

85-90% of the upper arm
50-75% of the upper arm
25-50% of the upper arm
75-80% of the upper arm (Correct answer)

Correct answer: 75-80% of the upper arm

For an accurate blood pressure reading, the cuff bladder should encircle 75-80% of the arm's circumference. If the cuff is too small, the reading will be falsely high; if too large, it will be falsely low. Proper cuff size is crucial for obtaining reliable vital sign measurements.

Question 31: What is the priority nursing action when caring for a patient with an indwelling urinary catheter to prevent infection?

Change the catheter every 24 hours
Maintain a closed drainage system (Correct answer)
Keep the drainage bag above bladder level
Irrigate the catheter every shift

Correct answer: Maintain a closed drainage system

Maintaining a closed, sterile drainage system is the most important intervention to prevent catheter-associated urinary tract infections (CAUTIs).

Question 32: Which position is most appropriate when placing a patient on a bedpan?

Supine with legs extended
Left lateral Sims' position
Semi-Fowler's or elevated head-of-bed position (Correct answer)
Prone position

Correct answer: Semi-Fowler's or elevated head-of-bed position

Elevating the head of the bed to semi-Fowler's position mimics the natural sitting position for defecation and reduces straining.

Question 33: A patient is choking and cannot speak or cough. What should the CNA do first?

Give 5 back blows between the shoulder blades
Perform abdominal thrusts (Heimlich maneuver) (Correct answer)
Try to remove the object with fingers
Give small sips of water to help wash it down

Correct answer: Perform abdominal thrusts (Heimlich maneuver)

When a patient is choking and cannot speak or cough, it indicates a complete airway obstruction, which is a medical emergency. The immediate and most effective intervention is to perform abdominal thrusts (Heimlich maneuver) to dislodge the object. This action is critical to restore breathing and prevent severe complications.

Question 34: What is the proper method for measuring urine output from a urinary catheter?

Use the markings on the drainage bag for measurement
Empty the drainage bag completely and measure the total (Correct answer)
Measure only the urine produced in the last hour
Estimate the amount by looking at the drainage bag

Correct answer: Empty the drainage bag completely and measure the total

To accurately measure urine output from a urinary catheter, the entire contents of the drainage bag should be emptied into a graduated cylinder and measured. Estimating or only measuring partial amounts would lead to inaccurate intake and output records, which are vital for monitoring a patient's fluid balance and kidney function.

Question 35: A nurse is caring for a patient in restraints. How often should restraints be assessed and released?

Every 2 hours (Correct answer)
Every 30 minutes
Once per shift
Every 4 hours

Correct answer: Every 2 hours

Patients in restraints must be assessed at least every 2 hours; restraints should be released, skin checked, ROM performed, and needs addressed at each check.

Question 36: A patient on a clear liquid diet may have:

Milk, ice cream, and pudding
Gelatin, broth, apple juice, and popsicles (Correct answer)
Mashed potatoes and pureed fruits
Soft bread and scrambled eggs

Correct answer: Gelatin, broth, apple juice, and popsicles

Clear liquid diets include transparent or translucent liquids such as broth, gelatin, apple juice, and popsicles — nothing that is opaque.

Question 37: Which dietary teaching point is most important for a patient with newly diagnosed type 2 diabetes?

Eliminate all carbohydrates from the diet
Avoid all fats and oils
Increase protein intake to 50% of total calories
Distribute carbohydrate intake evenly throughout the day (Correct answer)

Correct answer: Distribute carbohydrate intake evenly throughout the day

Consistent carbohydrate distribution throughout the day helps maintain stable blood glucose levels in patients with type 2 diabetes.

Question 38: A patient suddenly reports a strong urge to defecate. The nurse's first action should be to:

Assist the patient to the commode or bathroom promptly (Correct answer)
Apply a brief for incontinence management
Document the report and continue current care
Administer a PRN laxative as ordered

Correct answer: Assist the patient to the commode or bathroom promptly

Prompt assistance to the toilet or commode respects patient dignity, prevents incontinence, and maintains bowel continence.

Question 39: How should a CNA respond if they make an error in documentation?

Start over with a completely new documentation form
Draw a single line through the error, write 'error' and initial it, then write the correct information (Correct answer)
Erase the error completely and write the correct information
Use correction fluid to cover the mistake

Correct answer: Draw a single line through the error, write 'error' and initial it, then write the correct information

When an error is made in documentation, the correct procedure is to draw a single line through the incorrect entry, write "error" above or next to it, and initial it. This method ensures that the original information remains legible for legal and historical purposes, maintaining the integrity of the medical record. It prevents any appearance of tampering, which erasing or using correction fluid would create.

Question 40: An intradermal injection is administered at which angle?

5–15 degrees (Correct answer)
30–45 degrees
90 degrees
60 degrees

Correct answer: 5–15 degrees

Intradermal injections are given at a 5–15 degree angle to deposit medication just under the epidermis, creating a wheal.

Question 41: Which type of wound healing occurs when wound edges are approximated and there is minimal tissue loss?

Quaternary intention
Secondary intention
Tertiary intention
Primary intention (Correct answer)

Correct answer: Primary intention

Primary intention healing occurs when wound edges are brought together (e.g., surgical incision) with minimal tissue loss and scarring.

Question 42: A patient receiving enteral tube feedings develops abdominal distension, nausea, and high gastric residual volumes. The nurse should:

Continue feeding and recheck in 4 hours
Hold the feeding and notify the provider (Correct answer)
Switch to a different formula immediately
Increase the feeding rate to meet nutritional goals

Correct answer: Hold the feeding and notify the provider

High gastric residual volumes with abdominal distension and nausea suggest intolerance or aspiration risk; tube feedings should be held and the provider notified.

Question 43: When collecting a clean-catch midstream urine specimen from a female patient, the nurse should instruct the patient to:

Cleanse the urethral area front to back, then collect midstream urine (Correct answer)
Void directly into the specimen cup without preparation
Collect the last portion of the urine stream
Collect all urine from the beginning of urination

Correct answer: Cleanse the urethral area front to back, then collect midstream urine

Cleansing front to back prevents contamination with perineal flora, and collecting midstream urine reduces urethral meatal contamination.

Question 44: Wound healing by secondary intention is characterized by:

Granulation tissue formation filling a large wound (Correct answer)
Healing without any scarring
Immediate wound closure with sutures
Delayed primary closure after infection resolves

Correct answer: Granulation tissue formation filling a large wound

Secondary intention healing occurs when wounds are left open and heal through granulation tissue formation, contraction, and epithelialization.

Question 45: What is the most important consideration when providing personal care to maintain patient dignity?

Completing the care as quickly as possible
Providing privacy and explaining what you're doing (Correct answer)
Talking continuously to distract the patient
Having family members help with the care

Correct answer: Providing privacy and explaining what you're doing

Maintaining patient dignity during personal care is paramount, as these tasks are often intimate and vulnerable. Providing privacy, such as closing curtains or doors, respects their personal space and body. Additionally, explaining each step of the care helps the patient feel informed, reduces anxiety, and allows them to maintain a sense of control, thereby preserving their dignity.

Question 46: A patient is on neutropenic precautions. The nurse should:

Place patient in negative-pressure room with N95 mask required
Place patient in positive-pressure room and restrict fresh fruits and flowers (Correct answer)
Use standard precautions and encourage ambulation in hallways
Apply contact precautions and restrict visitation

Correct answer: Place patient in positive-pressure room and restrict fresh fruits and flowers

Neutropenic (protective) isolation uses a positive-pressure room, restricts items that harbor bacteria/fungi (fresh flowers, plants, uncooked foods), and limits exposure to pathogens.

Question 47: What does a widened pulse pressure (>40 mmHg) most commonly indicate?

Dehydration
Hypothyroidism
Anemia
Aortic regurgitation or increased intracranial pressure (Correct answer)

Correct answer: Aortic regurgitation or increased intracranial pressure

A widened pulse pressure can indicate aortic regurgitation, elevated intracranial pressure, or other hemodynamic changes.

Question 48: Which site is most commonly used to assess an adult's pulse?

Radial artery (Correct answer)
Brachial artery
Popliteal artery
Femoral artery

Correct answer: Radial artery

The radial artery at the wrist is the most accessible and commonly used site for routine pulse assessment in adults.

Question 49: Which solution is most appropriate for routine wound irrigation?

Hydrogen peroxide
Full-strength povidone-iodine
Normal saline (0.9% NaCl) (Correct answer)
70% isopropyl alcohol

Correct answer: Normal saline (0.9% NaCl)

Normal saline is isotonic and non-cytotoxic, making it the safest and most recommended solution for routine wound irrigation.

Question 50: Before administering a cleansing enema, the nurse should verify that the solution temperature is approximately:

Body temperature (98.6°F / 37°C)
Room temperature (72°F / 22°C)
Refrigerator temperature (40°F / 4.4°C)
Warm but comfortable (105°F / 40.5°C) (Correct answer)

Correct answer: Warm but comfortable (105°F / 40.5°C)

Enema solution should be approximately 105–110°F (40.5–43.3°C) — warm enough to stimulate peristalsis without causing mucosal injury.

Question 51: A patient asks the CNA about their medical diagnosis and treatment plan. How should the CNA respond?

Give general information but avoid specific details
Provide detailed information since the patient has a right to know
Refer the patient to their nurse or doctor for medical information (Correct answer)
Tell the patient not to worry about medical details

Correct answer: Refer the patient to their nurse or doctor for medical information

CNAs are not authorized or qualified to discuss a patient's medical diagnosis, prognosis, or treatment plan. This information is complex and requires the expertise of a licensed nurse or doctor. The CNA's role is to refer such questions to the appropriate healthcare professional, respecting the scope of practice and ensuring accurate communication.

Question 52: Which factor can cause a falsely low pulse oximetry reading?

Elevated hemoglobin
High ambient temperature
Hyperventilation
Peripheral vasoconstriction (Correct answer)

Correct answer: Peripheral vasoconstriction

Peripheral vasoconstriction reduces blood flow to the fingertip, resulting in a falsely low SpO2 reading.

Question 53: Which patient requires the most urgent repositioning?

An immobile patient with non-blanchable redness over the sacrum (Correct answer)
A patient in lateral position with a pillow between knees
A patient sitting in a chair for 30 minutes
A mobile patient who has been in bed for 1 hour

Correct answer: An immobile patient with non-blanchable redness over the sacrum

Non-blanchable redness over a bony prominence (Stage 1 pressure injury) indicates early tissue ischemia; the patient must be repositioned immediately to restore circulation.

Question 54: Which food is highest in potassium and beneficial for a patient with hypokalemia?

White bread
White rice
Bananas and oranges (Correct answer)
Cream cheese

Correct answer: Bananas and oranges

Bananas, oranges, potatoes, and leafy greens are high in potassium and should be encouraged in patients with hypokalemia.

Question 55: What is the correct way to use a mechanical lift to transfer a patient?

Two people should operate the lift, with one controlling the lift and one guiding the patient (Correct answer)
The patient should help by pushing off with their feet
One person can safely operate the lift alone
The patient should be lifted as quickly as possible

Correct answer: Two people should operate the lift, with one controlling the lift and one guiding the patient

Operating a mechanical lift safely requires the coordinated effort of two people to ensure both patient and staff safety. One person should be dedicated to controlling the lift's mechanics, while the second person focuses on guiding and supporting the patient. This team approach provides optimal stability, prevents accidental injury, and ensures the patient is properly positioned throughout the entire transfer process.

Question 56: Which bed position is used for a patient who is receiving tube feedings to reduce aspiration risk?

Trendelenburg
Supine (flat)
Left lateral
Semi-Fowler's to High Fowler's (30–45 degrees) (Correct answer)

Correct answer: Semi-Fowler's to High Fowler's (30–45 degrees)

Elevating the head of bed 30–45 degrees during and after tube feedings reduces the risk of aspiration by using gravity to keep gastric contents down.

Question 57: The nurse uses SBAR to communicate a patient concern. SBAR stands for:

Situation, Background, Assessment, Recommendation (Correct answer)
Status, Brief, Assessment, Review
Safety, Background, Action, Response
Subjective, Background, Analysis, Resolution

Correct answer: Situation, Background, Assessment, Recommendation

SBAR (Situation, Background, Assessment, Recommendation) is a standardized communication framework used in healthcare to convey critical patient information concisely.

Question 58: A patient has a serum sodium level of 128 mEq/L. The nurse recognizes this as:

Hyponatremia (Correct answer)
Hyperkalemia
Hypokalemia
Hypernatremia

Correct answer: Hyponatremia

Normal serum sodium is 135–145 mEq/L; a level of 128 mEq/L is below normal, indicating hyponatremia.

Question 59: When making an occupied bed, what is the most important safety consideration?

Working quickly to minimize patient discomfort
Removing all pillows to make the process easier
Keeping the bed in the lowest position throughout
Raising the bed rails on the side opposite to where you're working (Correct answer)

Correct answer: Raising the bed rails on the side opposite to where you're working

When making an occupied bed, patient safety is paramount. Raising the bed rails on the side opposite to where the CNA is working prevents the patient from rolling out of bed and falling. This crucial safety measure ensures the patient remains secure while the CNA is focused on the task.

Question 60: Fall prevention interventions for a high-risk patient include all of the following EXCEPT:

Keeping the bed in lowest position
Keeping all four side rails raised at all times (Correct answer)
Ensuring the call light is within reach
Placing a fall-risk armband on the patient

Correct answer: Keeping all four side rails raised at all times

Raising all four side rails is considered a restraint and is not a standard fall prevention measure; standard practice is to raise 2–3 rails as a reminder barrier.

Question 61: What is the normal adult resting heart rate range?

120–140 bpm
40–60 bpm
100–120 bpm
60–100 bpm (Correct answer)

Correct answer: 60–100 bpm

A normal adult resting heart rate is 60–100 beats per minute.

Question 62: Which type of isolation is used for a patient with active pulmonary tuberculosis?

Protective isolation
Airborne precautions (Correct answer)
Contact precautions
Droplet precautions

Correct answer: Airborne precautions

Active pulmonary TB is transmitted by airborne droplet nuclei (<5 microns) and requires airborne precautions including a negative-pressure room and N95 respirator.

Question 63: What is the normal range for adult respiratory rate?

30-40 breaths per minute
12-20 breaths per minute (Correct answer)
20-30 breaths per minute
8-12 breaths per minute

Correct answer: 12-20 breaths per minute

The normal respiratory rate for a healthy adult at rest typically ranges from 12 to 20 breaths per minute. Rates outside this range, either too slow (bradypnea) or too fast (tachypnea), can indicate underlying health issues and should be reported to the nurse for further assessment.

Question 64: The three components of the chain of infection that nurses most directly control are:

Environment, agent virulence, and host defenses
Portal of exit, mode of transmission, and portal of entry (Correct answer)
Incubation period, infectious dose, and transmission route
Infectious agent, reservoir, and host susceptibility

Correct answer: Portal of exit, mode of transmission, and portal of entry

Nurses break the chain of infection primarily by controlling the portal of exit (source control), mode of transmission (hand hygiene, PPE), and portal of entry (aseptic technique).

Question 65: A nurse is removing PPE after leaving an isolation room. What is removed last?

Gown
Mask or respirator (Correct answer)
Eye protection
Gloves

Correct answer: Mask or respirator

When doffing PPE, gloves are removed first, then gown, then eye protection, and the mask/respirator is removed last to minimize face contamination.

Question 66: The urinary catheter drainage bag must be positioned:

Above the bladder to promote drainage
At the same level as the bladder
On the bed at waist level
Below the bladder level and off the floor (Correct answer)

Correct answer: Below the bladder level and off the floor

Positioning the drainage bag below the bladder uses gravity to promote urine flow, while keeping it off the floor prevents contamination.

Question 67: A patient has a wound with undermining. This means:

The wound has separated after surgical closure
The wound is infected with anaerobic bacteria
The wound is healing from the inside out
Tissue destruction extends under intact skin around the wound edges (Correct answer)

Correct answer: Tissue destruction extends under intact skin around the wound edges

Undermining refers to tissue destruction beneath intact skin at the wound margins, creating a pocket that extends beyond the visible wound edge.

Question 68: A condom (external) catheter is most appropriate for:

Patients with urinary retention requiring continuous drainage
Female patients with stress urinary incontinence
Female patients who are unconscious
Male patients with urinary incontinence who can voluntarily void (Correct answer)

Correct answer: Male patients with urinary incontinence who can voluntarily void

Condom catheters are designed for male anatomy and are suitable for men who have urinary incontinence but retain the ability to void voluntarily.

Question 69: The correct hand hygiene technique using alcohol-based hand rub requires rubbing hands for at least:

60 seconds
5 seconds
20 seconds (Correct answer)
10 seconds

Correct answer: 20 seconds

Alcohol-based hand rub should be rubbed over all hand surfaces for at least 20 seconds (or until dry) to ensure adequate antimicrobial effect.

Question 70: When assessing a patient's bowel function, bright red blood in the stool most likely indicates bleeding from the:

Stomach or esophagus
Small intestine
Lower colon or rectum (Correct answer)
Pancreas

Correct answer: Lower colon or rectum

Bright red blood (hematochezia) indicates lower GI bleeding close to the rectum, as the blood has not been digested and retains its red color.

CNA Written Exam – NNAAP Nurse Aide Assessment

The NNAAP Nurse Aide Written Exam certifies competency across physical care skills, psychosocial care, and the professional role of the nurse aide, required for state CNA licensure.

Questions

120 min

Time Limit

70%

To Pass

Checking for saved progress...

Exam Rules

You can skip questions and return to them later
Flag questions for review before submitting
No feedback shown until you submit the entire exam
Unanswered questions count as wrong — answer everything
10 pretest questions are mixed in and don't affect your score
Timer auto-submits when time runs out
Your progress is auto-saved every 30 seconds