CNA Patient Care Procedure 2 — Questions and Answers
Question 1: A resident with a spinal cord injury at T6 or above suddenly develops a pounding headache, flushed skin, and a rapidly rising blood pressure. What is the CNA's IMMEDIATE priority action?
- Check for a fecal impaction.
- Take the resident's pulse and respirations.
- Elevate the head of the bed to 90 degrees (high-Fowler's position). (Correct answer)
- Offer the resident a drink of water.
Correct answer: Elevate the head of the bed to 90 degrees (high-Fowler's position).
The resident is exhibiting classic signs of autonomic dysreflexia, a medical emergency. The first and most critical action is to sit the resident upright to help lower their blood pressure. After raising the head of the bed, the CNA should then look for and remove the triggering stimulus, which is often a full bladder or bowel.
Question 2: You are assigned to provide post-mortem care. The family, due to their cultural beliefs, has requested to wash the body themselves. Which of the following is the most appropriate response?
- Politely explain that only facility staff are permitted to handle the body.
- Allow them access and provide them with the necessary supplies and privacy. (Correct answer)
- Tell them they can perform their ritual after standard facility post-mortem care is complete.
- Report the request to the charge nurse, as it is an unusual liability.
Correct answer: Allow them access and provide them with the necessary supplies and privacy.
Respecting cultural and religious preferences is a key component of holistic care, even after death. The appropriate action is to facilitate the family's request by providing them with the needed supplies (basin, cloths, clean linens, etc.) and ensuring their privacy.
Question 3: A CNA is caring for a resident receiving internal radiation therapy (brachytherapy) with a temporary implant. Which of the following precautions is MOST critical for the CNA to observe?
- Wear a lead apron whenever entering the resident's room.
- Limit close contact time with the resident. (Correct answer)
- Dispose of all linens in a biohazard bag.
- Encourage the resident to ambulate frequently in the hallway.
Correct answer: Limit close contact time with the resident.
With internal radiation sources, the patient can emit radiation. Safety protocols emphasize time, distance, and shielding. For CNAs, limiting the amount of time spent in close proximity to the patient is a primary safety measure to minimize radiation exposure. Specific shielding requirements and linen disposal procedures depend on the type and dose of the implant, but limiting time is a universal precaution.
Question 4: When providing oral care to an unconscious resident, which action is essential to prevent aspiration?
- Using a regular toothbrush with a small amount of toothpaste.
- Positioning the resident on their side (lateral position). (Correct answer)
- Rinsing the mouth with a full cup of water after cleaning.
- Placing a padded tongue blade to keep the mouth open.
Correct answer: Positioning the resident on their side (lateral position).
The greatest risk during oral care for an unconscious person is aspiration, which can lead to pneumonia. Positioning the resident on their side with their head turned allows fluids and secretions to drain out of the mouth instead of back into the throat and airway.
Question 5: A resident is scheduled for surgery in the morning and has a 'NPO after midnight' order. At 6 AM, the resident's spouse gives the resident a glass of water. What is the CNA's first action?
- Take the glass of water away from the resident.
- Document the event in the resident's chart.
- Immediately report the situation to the charge nurse. (Correct answer)
- Explain to the spouse why the resident cannot have water.
Correct answer: Immediately report the situation to the charge nurse.
Violating an NPO (nothing by mouth) order before surgery can be dangerous, potentially causing aspiration during anesthesia and leading to the cancellation of the surgery. The CNA's immediate priority is to report this to the nurse, who can then assess the situation and notify the surgical team. While other options may also be done, reporting is the first and most critical step for patient safety.
Question 6: During post-mortem care, you discover a wedding ring on the deceased resident's finger that the family was not aware of. What is the correct procedure?
- Leave the ring on the resident for the funeral home.
- Remove the ring and place it in the resident's personal belongings bag.
- Ask another CNA to witness you removing the ring and document it.
- Notify the charge nurse before removing the ring to be cataloged per facility policy. (Correct answer)
Correct answer: Notify the charge nurse before removing the ring to be cataloged per facility policy.
Valuables found during post-mortem care must be handled with extreme care and according to facility policy to prevent loss or misplacement. The correct action is to involve the charge nurse immediately. This ensures the item is properly documented, witnessed, and secured according to protocol before being given to the family. This protects the resident's property, the staff, and the facility.
CNA Patient Care Procedure 2
A resident with a spinal cord injury at T6 or above suddenly develops a pounding headache, flushed skin, and a rapidly rising blood pressure.
What is the CNA's IMMEDIATE priority action?