CNA Basic Nursing Skills #2 4

Question 1

A CNA is performing passive range of motion (PROM) on a resident's shoulder. The resident grimaces and says nothing, but the CNA notices increased muscle resistance midway through abduction. What is the MOST appropriate immediate action?

Accepted Answer

Stop the movement at the point of resistance and report the finding to the nurse

Answer

Range of motion should never be forced beyond the point of resistance or pain. Increased muscle resistance and nonverbal pain cues (grimacing) are signs that continuing could cause injury. The CNA must stop, note the limitation, and report to the nurse for further assessment.

Question 2

When applying a non-sterile elastic bandage (ACE wrap) to a resident's lower leg, a CNA should wrap in which direction and with what tension technique?

Accepted Answer

Upward from the foot toward the knee using overlapping spiral turns with consistent, moderate tension

Answer

Elastic bandages must be applied distal to proximal (foot toward knee) to promote venous return and prevent dependent edema. Spiral turns with 50% overlap and consistent moderate tension ensures even compression without cutting off circulation. Applying from proximal to distal or with uneven tension can cause tourniqueting or ineffective compression.

Question 3

A CNA is caring for a resident with a urinary catheter who reports lower abdominal discomfort and has not had any urine output in the drainage bag for 2 hours. The tubing is free of visible kinks. Which action should the CNA take FIRST?

Accepted Answer

Reposition the resident and check that the drainage bag is below the level of the bladder

Answer

Before escalating, the CNA should troubleshoot positional causes of obstruction. If the drainage bag is at or above bladder level, gravity-dependent flow stops. Repositioning the resident and ensuring the bag hangs below the bladder is within the CNA's scope and may immediately resolve the issue. Irrigating or replacing a catheter is outside CNA scope; clamping is contraindicated as it risks bladder distension and infection.

Question 4

A resident with dysphagia is on a pureed diet with nectar-thick liquids. During mealtime, the CNA notices the resident pocketing food in the left cheek and coughing after each sip of thickened juice. What is the PRIORITY concern and action?

Accepted Answer

Stop feeding, place the resident in a safe upright position, and immediately notify the nurse of possible aspiration risk

Answer

Coughing after swallowing on a thickened-liquid diet is a red flag for aspiration or silent aspiration. Pocketing combined with coughing indicates the current diet texture may not be safe. The CNA must stop feeding to prevent further risk, maintain the resident upright to aid airway protection, and report immediately to the nurse, who can reassess swallowing status or call for a speech therapist consult. Suctioning without nurse direction and switching liquid consistencies are outside CNA scope.

Question 5

When performing perineal care on a male resident with an intact foreskin, which technique is CORRECT?

Accepted Answer

Retract the foreskin, cleanse the glans in a circular motion from meatus outward, then return the foreskin to its natural position immediately after cleansing

Answer

For residents with intact foreskins, the CNA must retract the foreskin to cleanse the glans and underneath the foreskin where smegma accumulates. Critically, the foreskin MUST be returned to its natural position immediately after cleansing. Leaving it retracted can cause paraphimosis — a painful, potentially serious condition where the foreskin constricts the glans and impairs circulation. This step is non-optional and not dependent on resident preference.

CNA Practice Test

CNA Practice Test

CNA Basic Nursing Skills #2 4