CNA Personal Hygiene and Grooming 2 — Questions and Answers
Question 1: A CNA is providing perineal care for an uncircumcised male resident with an indwelling catheter. Which of the following actions is a critical step to prevent injury?
- Cleansing the catheter tubing from the bifurcation towards the meatus.
- Using hot water to ensure the area is thoroughly disinfected.
- Applying powder under the scrotum after cleansing to prevent chafing.
- Gently retracting the foreskin, cleansing the glans, and immediately returning the foreskin to its natural position. (Correct answer)
Correct answer: Gently retracting the foreskin, cleansing the glans, and immediately returning the foreskin to its natural position.
It is crucial to retract the foreskin to clean the tip of the penis, but it must be immediately returned to its natural position after cleaning. Failure to do so can cause swelling and restrict blood flow, a serious condition called paraphimosis. Catheter tubing should be cleaned from the meatus outward. Water should be warm, not hot. Powder is only used if specified in the care plan.
Question 2: When providing oral care for an unconscious resident, which technique is most important for preventing aspiration?
- Using a large amount of water to thoroughly rinse the mouth.
- Positioning the resident flat on their back to access the mouth easily.
- Positioning the resident on their side with their head turned to the side. (Correct answer)
- Using a standard toothbrush with a small amount of toothpaste.
Correct answer: Positioning the resident on their side with their head turned to the side.
Positioning an unconscious resident on their side allows fluids and secretions to drain out of the mouth instead of into the airway, which is the most effective way to prevent aspiration pneumonia. Using excess water increases the risk of aspiration. The resident should never be flat on their back during oral care. A toothette or moistened swab is often used, and toothpaste is generally avoided due to the risk of choking.
Question 3: A resident who is taking anticoagulant medication (a blood thinner) requests to be shaved. What is the CNA's most appropriate action?
- Use a new, sharp disposable razor with plenty of shaving cream.
- Inform the resident they cannot shave while on this medication.
- Use an electric razor to shave the resident. (Correct answer)
- Refuse the request and report it to the family.
Correct answer: Use an electric razor to shave the resident.
Residents on anticoagulants are at a high risk for bleeding. An electric razor minimizes the risk of nicks and cuts compared to a blade razor. Using a blade razor, even a new one, poses an unnecessary risk. Prohibiting shaving is not necessary if the proper equipment is used. The CNA should perform the shave safely, not just report it.
Question 4: A CNA is assigned to provide nail care for a resident with peripheral neuropathy and type 2 diabetes. Which of the following is within the CNA's scope of practice?
- Trimming the resident's toenails straight across.
- Filing the resident's fingernails and toenails.
- Soaking the resident's feet in warm water, then cleaning and filing their fingernails only.
- Gently cleaning under the resident's fingernails and toenails with an orangewood stick and reporting any issues to the nurse. (Correct answer)
Correct answer: Gently cleaning under the resident's fingernails and toenails with an orangewood stick and reporting any issues to the nurse.
Due to poor circulation and decreased sensation, residents with diabetes and peripheral neuropathy are at high risk for infection and injury. CNAs are typically not permitted to cut or file the nails of diabetic residents; this should be done by a nurse or podiatrist. Soaking the feet is also often contraindicated. The safest and most appropriate action is to gently clean the nails and report any findings like long nails, discoloration, or skin breakdown to the nurse.
Question 5: A resident with advanced dementia has become resistant to bathing, shouting and hitting when the CNA approaches with a towel. Which strategy should the CNA try FIRST to de-escalate the situation and complete the task?
- Firmly tell the resident that the bath is necessary for their health and proceed quickly.
- Postpone the bath and try again later in the day or the next day.
- Ask another CNA to assist in holding the resident to ensure safety during the bath.
- Break the task into smaller steps, using a calm voice and simple instructions like, "Let's wash your hands first." (Correct answer)
Correct answer: Break the task into smaller steps, using a calm voice and simple instructions like, "Let's wash your hands first."
For residents with dementia, bathing can be frightening and confusing. Breaking the task down into simple, manageable steps and using a calm, reassuring approach can reduce anxiety and increase cooperation. Starting with a less intimidating step like washing hands can help ease them into the process. Using force or a firm tone will likely increase agitation. While postponing may sometimes be necessary, attempting a different, person-centered approach first is the best practice. Restraining the resident should be a last resort.
Question 6: When shaving a resident's face with a disposable razor, which of the following is a key safety and comfort measure?
- Shave against the direction of hair growth for a closer shave.
- Use cold water to help close the pores.
- Hold the skin taut and shave in the direction of hair growth. (Correct answer)
- Apply aftershave immediately to any nicks or cuts to disinfect them.
Correct answer: Hold the skin taut and shave in the direction of hair growth.
Holding the skin taut creates a smooth surface, and shaving in the direction of hair growth helps prevent skin irritation, razor burn, and nicks. Shaving against the grain increases the risk of cuts and irritation. Warm water should be used to soften the skin and hair. Aftershave should not be applied to broken skin as it can cause stinging and irritation.
CNA Personal Hygiene and Grooming 2
A CNA is providing perineal care for an uncircumcised male resident with an indwelling catheter.
Which of the following actions is a critical step to prevent injury?