CNA Basic Nursing Skills 3 — Questions and Answers

Question 1: Which technique is used to clean a wound from the center outward?

Circular from inner to outer edge (Correct answer)
Back and forth strokes
Downward strokes only
Upward strokes starting at the wound edge

Correct answer: Circular from inner to outer edge

Wounds are cleaned using circular strokes moving from the center outward to prevent contaminating clean tissue with microorganisms from the surrounding skin.

The clean-to-dirty principle dictates wound cleaning technique. Starting at the wound center and moving outward prevents dragging pathogens from surrounding skin into the open wound. Each stroke should use a fresh gauze or cotton ball. This technique minimizes infection risk and supports proper healing.

Question 2: A reddened, intact skin area over a bony prominence that does not blanch when pressed is classified as which stage of pressure injury?

Stage 1 (Correct answer)
Stage 2
Stage 3
Stage 4

Correct answer: Stage 1

A Stage 1 pressure injury is characterized by intact skin with non-blanchable redness, often over a bony prominence.

Pressure injuries are staged by depth of tissue involvement. Stage 1 involves intact skin with localized non-blanchable erythema. Stage 2 involves partial-thickness skin loss. Stage 3 involves full-thickness skin loss without exposed bone, tendon, or muscle. Stage 4 involves full-thickness tissue loss with exposed structures. Early identification and reporting of Stage 1 is essential for prevention.

Question 3: What is the purpose of applying a dry sterile dressing to a wound?

To apply medicated ointment
To protect the wound from contamination and absorb drainage (Correct answer)
To keep the wound moist for healing
To monitor the wound without disturbing it

Correct answer: To protect the wound from contamination and absorb drainage

A dry sterile dressing protects the wound from contamination and absorbs any drainage, promoting a clean environment for healing.

Dry sterile dressings create a physical barrier against pathogens, absorb wound exudate, and reduce trauma to the healing tissue. They are distinct from moist dressings, which are used to promote a moist wound environment for certain wound types. The CNA follows the nurse's or care plan instructions regarding dressing type and change frequency.

Question 4: When should a CNA report a wound change to the nurse?

Only if the resident complains of pain
Only at the end of the shift
When there is increased drainage, odor, redness, or swelling (Correct answer)
Only when instructed to observe it

Correct answer: When there is increased drainage, odor, redness, or swelling

Signs of infection or worsening — including increased drainage, odor, redness, or swelling — must be reported to the nurse promptly.

Wound assessment involves noting color, size, drainage type and amount, odor, and surrounding skin condition. Changes such as purulent drainage, foul odor, increased redness or warmth, swelling, or the resident reporting increased pain all suggest possible infection or deterioration. Early reporting enables the nurse to intervene before complications escalate.

Question 5: Why must the CNA reposition residents with limited mobility at least every two hours?

To prevent contractures only
To stimulate appetite
To prevent pressure injuries by relieving pressure on bony prominences (Correct answer)
To comply with Medicare billing requirements

Correct answer: To prevent pressure injuries by relieving pressure on bony prominences

Repositioning every two hours relieves sustained pressure on bony prominences, which reduces tissue ischemia and prevents pressure injuries.

Prolonged pressure compresses capillaries supplying the skin, causing ischemia and tissue necrosis. Common sites include the sacrum, heels, trochanters, elbows, and occiput. Turning schedules, pressure-reducing devices, and skin inspection are all components of a comprehensive pressure injury prevention program. The CNA plays a critical role by following turning schedules and documenting position changes.

Question 6: Which observation of a wound dressing should be reported to the nurse immediately?

The dressing is dry and intact
The dressing has a small amount of clear drainage
The dressing is saturated with bright red blood (Correct answer)
The dressing edges have lifted slightly

Correct answer: The dressing is saturated with bright red blood

Saturation of a dressing with bright red blood indicates active bleeding, which requires immediate nursing assessment.

Bright red blood saturation suggests active hemorrhage, which can be life-threatening if not addressed. Clear or light-colored drainage in small amounts may be expected for some wounds, and a lifted edge may need re-securing. However, significant active bleeding always warrants immediate nurse notification so appropriate interventions such as pressure application or physician notification can occur.

CNA Basic Nursing Skills 3

Which technique is used to clean a wound from the center outward?