CNA Safety and Infection Control 2 — Questions and Answers
Question 1: A CNA accidentally mixes a bleach-based toilet cleaner with an ammonia-based glass cleaner. What is the CNA's most immediate and critical priority?
- Find the Safety Data Sheets (SDS) for both cleaning products.
- Finish cleaning the bathroom as quickly as possible.
- Immediately and safely evacuate the resident from the area and alert the nurse. (Correct answer)
- Open a window and use a fan to ventilate the room.
Correct answer: Immediately and safely evacuate the resident from the area and alert the nurse.
Mixing bleach and ammonia creates toxic chloramine gas, which can cause severe respiratory irritation and can be life-threatening. The most critical priority is the immediate safety of the resident and the CNA. Evacuating the area and notifying a licensed nurse are the first steps to ensure safety and get proper medical and environmental assistance. While ventilating the room and checking the SDS are important, they are secondary to removing people from immediate danger.
Question 2: A resident with a known Clostridioides difficile (C. diff) infection has been using a personal tablet. The resident is being discharged. What is the most appropriate action for handling the tablet?
- Wipe the tablet with a standard alcohol-based sanitizer wipe.
- Tell the family the tablet cannot be safely cleaned and should be discarded.
- Carefully clean the tablet using a facility-approved, EPA-registered sporicidal disinfectant wipe, following the manufacturer's directions for electronics. (Correct answer)
- Submerge the tablet in a 1:10 bleach solution to ensure all spores are killed.
Correct answer: Carefully clean the tablet using a facility-approved, EPA-registered sporicidal disinfectant wipe, following the manufacturer's directions for electronics.
C. difficile forms spores that are resistant to alcohol and some standard disinfectants. The correct procedure is to use a sporicidal disinfectant, often a specific type of bleach or hydrogen peroxide wipe, that is approved for killing C. diff spores and is safe for electronics. Submerging the device would destroy it, and discarding it is unnecessary if proper disinfection can be performed. Standard alcohol sanitizers are not effective against C. diff spores.
Question 3: A CNA is caring for a resident who was just started on a new diuretic medication. Which of the following represents the MOST significant, yet indirect, safety risk the CNA should anticipate?
- A sudden increase in appetite and fluid intake.
- An increased risk of falls due to urgency and orthostatic hypotension. (Correct answer)
- An increased risk of social isolation from frequent bathroom trips.
- A heightened risk of skin breakdown from dehydration.
Correct answer: An increased risk of falls due to urgency and orthostatic hypotension.
Diuretics increase urination, which can cause urgency (a sudden, compelling need to urinate) and orthostatic hypotension (a drop in blood pressure upon standing that causes dizziness). This combination significantly increases the risk of falls, which is a major safety concern for the elderly. The other options are less immediate or less critical safety risks.
Question 4: While in a resident's room, a CNA sees smoke coming from a trash can. The resident is in the room and is ambulatory. According to the RACE fire safety protocol, what is the CNA's FIRST action?
- Rescue the resident by guiding them out of the room. (Correct answer)
- Activate the nearest fire alarm pull station.
- Confine the fire by closing the door to the room.
- Extinguish the fire with the nearest appropriate extinguisher.
Correct answer: Rescue the resident by guiding them out of the room.
The RACE acronym stands for Rescue, Alarm, Confine, Extinguish/Evacuate. The absolute first priority in a fire is to rescue anyone in immediate danger. Therefore, the CNA's first action should be to move the resident to a safe location away from the fire. The other actions (Alarm, Confine, Extinguish) are performed sequentially after ensuring human life is out of immediate harm.
Question 5: A CNA is assigned to care for a resident on protective (reverse) isolation. What is the primary purpose of this type of precaution?
- To protect the CNA and visitors from an infection the resident has.
- To prevent the resident from coming into contact with their own microorganisms.
- To protect a highly immunocompromised resident from pathogens in the environment. (Correct answer)
- To ensure all items entering the room are sterile.
Correct answer: To protect a highly immunocompromised resident from pathogens in the environment.
Protective, or reverse, isolation is used for residents who are highly susceptible to infection (e.g., due to chemotherapy or a compromised immune system). The goal is to protect the resident from germs carried by staff, visitors, or found in the general environment. This is the opposite of standard, contact, or droplet precautions, which aim to protect caregivers from a resident's infection.
Question 6: A CNA finds a single, used, uncapped needle on the floor of a resident's room. The sharps container is across the hallway. What is the safest immediate action for the CNA?
- Carefully pick up the needle by the plastic barrel and carry it to the sharps container.
- Use a broom and dustpan to sweep it up and then dispose of it.
- Leave the needle in place, notify the nurse, and keep the area clear to prevent injury to others. (Correct answer)
- Attempt to recap the needle using the one-handed scoop method before transporting it.
Correct answer: Leave the needle in place, notify the nurse, and keep the area clear to prevent injury to others.
The safest action is to avoid handling a found, uncapped needle, as this minimizes the risk of a needlestick injury. The CNA should immediately notify the nurse, who can follow facility protocol for hazardous waste disposal, which may involve using mechanical devices like tongs. Guarding the area prevents anyone else from being injured. Attempting to pick it up, sweep it, or recap it all carry a significant risk of injury.
CNA Safety and Infection Control 2
A CNA accidentally mixes a bleach-based toilet cleaner with an ammonia-based glass cleaner.
What is the CNA's most immediate and critical priority?