CNA Preventing Patient Falls and Injuries 3 — Questions and Answers
Question 1: A resident with known orthostatic hypotension feels suddenly dizzy while being assisted from the toilet. What is the CNA's most immediate and appropriate action?
- Ask the resident to take deep breaths while you hold them up.
- Quickly guide them to the nearest chair.
- Gently and safely lower the resident back to the toilet or to the floor. (Correct answer)
- Immediately leave the resident to call the nurse for assistance.
Correct answer: Gently and safely lower the resident back to the toilet or to the floor.
The immediate priority is the resident's safety and preventing an injury from a fall. Gently lowering the resident to a safe, low surface like the toilet or the floor is the fastest way to prevent a fall caused by dizziness from orthostatic hypotension. While calling the nurse is crucial, it should be done after the resident is in a safe position.
Question 2: Which of the following environmental factors poses a subtle but significant fall risk specifically for a patient with peripheral neuropathy?
- A television left on at a low volume.
- Thick, high-pile carpeting in the hallway. (Correct answer)
- A window that lets in bright, natural light.
- Smooth, linoleum flooring in the bathroom.
Correct answer: Thick, high-pile carpeting in the hallway.
Peripheral neuropathy can cause a loss of sensation in the feet, making it difficult to perceive changes in surfaces. A thick, high-pile carpet can easily catch the foot of someone who cannot properly feel the floor, leading to a trip and fall. The other options are generally not considered specific fall risks related to this condition.
Question 3: A resident has recently been prescribed a diuretic. The CNA should be on high alert for which new behavior that significantly increases fall risk?
- Increased complaints of daytime sleepiness.
- A sudden decrease in appetite at meal times.
- Rushing to the bathroom with a sense of urgency. (Correct answer)
- Difficulty hearing conversations.
Correct answer: Rushing to the bathroom with a sense of urgency.
Diuretics increase urine production, leading to urinary frequency and urgency. This often causes residents to rush to the bathroom, which elevates the risk of tripping and falling, particularly in cluttered spaces or at night when it's dark.
Question 4: A resident with dementia, who has a bed alarm, becomes agitated and attempts to climb out of bed. The alarm sounds. What is the CNA's priority action?
- Call for help immediately before entering the room.
- Go to the resident, speak calmly, and attempt to redirect their attention. (Correct answer)
- Document the alarm and check on the resident within 15 minutes.
- Enter the room and sternly tell the resident to get back in bed.
Correct answer: Go to the resident, speak calmly, and attempt to redirect their attention.
For a resident with dementia, agitation is often a form of communication. The priority is to de-escalate the situation calmly. Approaching the resident with a calm voice and attempting to redirect them to a different activity or address an unmet need is the most appropriate first step. This person-centered approach can resolve the agitation without the need for more restrictive measures.
Question 5: Purposeful rounding using the "4 P's" is a key fall prevention strategy. Which of the following is NOT one of the core "4 P's"?
- Pain
- Potty
- Possessions
- Pillows (Correct answer)
Correct answer: Pillows
The core components of the "4 P's" of purposeful rounding are Pain, Potty (toileting needs), Positioning (comfort and safety), and Possessions (ensuring personal items are within reach). While adjusting pillows is part of ensuring good positioning, "Pillows" itself is not one of the four main categories.
Question 6: A CNA observes a resident bypassing the floor mats placed on the sides of their low bed by attempting to get out at the foot of the bed. What is the CNA's most appropriate action?
- Move the floor mats to the foot of the bed.
- Document this unusual behavior for the next shift.
- Immediately report the behavior to the nurse for care plan re-evaluation. (Correct answer)
- Remind the resident that they must exit from the side of the bed.
Correct answer: Immediately report the behavior to the nurse for care plan re-evaluation.
When a resident's behavior circumvents an established safety measure, it indicates the current plan is ineffective. The CNA's role is to ensure immediate safety and then report this significant change to the nurse. The nurse must assess the situation and the care team may need to devise a new, more effective intervention. Simply moving the mats or documenting without reporting does not adequately address the immediate safety risk.
CNA Preventing Patient Falls and Injuries 3
A resident with known orthostatic hypotension feels suddenly dizzy while being assisted from the toilet.
What is the CNA's most immediate and appropriate action?