CNA Infection Control and Safety 2 — Questions and Answers
Question 1: A resident becomes verbally agitated and starts shouting during personal care. From a safety perspective, what is the CNA's most important first action?
- Continue with the care task as quickly as possible to finish.
- Raise their voice to be heard over the resident's shouting.
- Ensure there is a clear path to the door and maintain a safe distance. (Correct answer)
- Immediately apply physical restraints to prevent escalation.
Correct answer: Ensure there is a clear path to the door and maintain a safe distance.
The CNA's immediate safety is the priority. Before attempting de-escalation, they must ensure they are not trapped and have an escape route. Maintaining personal space can also help de-escalate the situation by not making the resident feel crowded or threatened.
Question 2: A CNA is cleaning the room of a resident who has been discharged after a Clostridioides difficile (C. diff) infection. Which of the following is a critical step in the environmental cleaning process for this specific pathogen?
- Using a standard household cleaner is sufficient for all surfaces.
- Wiping surfaces with an alcohol-based solution to kill the bacteria.
- Using a bleach-based disinfectant or another EPA-approved sporicidal agent. (Correct answer)
- Airing out the room with an open window for several hours is the top priority.
Correct answer: Using a bleach-based disinfectant or another EPA-approved sporicidal agent.
C. diff forms spores that are highly resistant to standard disinfectants and alcohol. A bleach-based solution or an EPA-registered sporicidal disinfectant is required to effectively kill the spores and prevent transmission to the next resident.
Question 3: A resident with scabies is on contact precautions. When preparing to dispose of their bed linens, what is the most appropriate action for the CNA to take?
- Shake the linens vigorously in the hallway to remove any loose mites before bagging.
- Place the linens in a standard, unmarked laundry bag and leave it by the resident's door.
- Roll the linens carefully inward, place them in a specially marked, sealed bag inside the room, and wear gloves throughout. (Correct answer)
- Leave the linens on the floor for housekeeping staff, who have specialized training for this task.
Correct answer: Roll the linens carefully inward, place them in a specially marked, sealed bag inside the room, and wear gloves throughout.
To prevent the spread of scabies mites, linens should be handled minimally. Rolling them inward contains the mites. They must be placed in a labeled, sealed bag within the patient's room to prevent contaminating the environment and to alert laundry staff. Gloves are essential PPE for handling contaminated items.
Question 4: During a norovirus outbreak in the facility, which hand hygiene method is most effective for a CNA after providing care to a symptomatic resident?
- Using an alcohol-based hand sanitizer with at least 60% alcohol.
- Washing hands thoroughly with soap and water for at least 20 seconds. (Correct answer)
- Wiping hands with a disinfectant wipe and then applying hand sanitizer.
- Wearing gloves is sufficient, so no hand hygiene is needed immediately after removal.
Correct answer: Washing hands thoroughly with soap and water for at least 20 seconds.
Norovirus is resistant to alcohol-based hand sanitizers. The most effective way to remove the virus from hands is through the mechanical friction of washing with soap and water for at least 20 seconds.
Question 5: A CNA is assigned to a resident with a multi-drug resistant organism (MDRO) who is under contact precautions. The resident's family member is visiting and is not wearing any PPE. What is the CNA's most appropriate initial action?
- Immediately report the family member to the facility administrator for a policy violation.
- Ignore the situation as family members are exempt from PPE requirements.
- Ask the resident to tell their family member to put on a gown and gloves.
- Politely intercept the visitor, explain the precautions, and offer to help them put on the correct PPE. (Correct answer)
Correct answer: Politely intercept the visitor, explain the precautions, and offer to help them put on the correct PPE.
The CNA's primary responsibility is to maintain safety and infection control. The most professional and effective initial action is to educate the visitor about the need for PPE and assist them in applying it correctly. This protects the visitor, the resident, and prevents further spread of the MDRO within the facility.
Question 6: While caring for a resident with dementia who has a history of wandering, the CNA notices the resident is dressed in outdoor clothing and pacing near the exit. Which of the following actions is the best immediate safety intervention?
- Lock the resident in their room to prevent elopement.
- Gently approach the resident and redirect them to a supervised activity or common area. (Correct answer)
- Alert security immediately without approaching the resident.
- Tell the resident firmly that they are not allowed to leave.
Correct answer: Gently approach the resident and redirect them to a supervised activity or common area.
Redirecting a resident with dementia is a key de-escalation and safety technique. A calm, gentle approach that shifts their focus to a different, safe activity can prevent an elopement attempt without causing distress or agitation.
CNA Infection Control and Safety 2
A resident becomes verbally agitated and starts shouting during personal care.
From a safety perspective, what is the CNA's most important first action?