Assisting with Daily Living Flashcards

A resident with dysphagia is prescribed a nectar-thick liquid diet. During mealtime, you notice she is coughing after sipping her thickened juice. What is the most appropriate immediate action?

Answer: Stop feeding, have the resident sit upright, and report the coughing episode to the nurse immediately

Coughing after swallowing is a sign of possible aspiration in a resident with dysphagia. The CNA must stop the meal, keep the resident upright to prevent further aspiration risk, and report immediately to the nurse who can reassess the care plan. Continuing to feed, changing the diet without orders, or substituting thinner liquids would all increase aspiration risk and exceed the CNA's scope of practice.

When assisting a hemiplegic resident to dress, the CNA should put on the shirt sleeve in which order?

Answer: Weaker (affected) arm first, then stronger (unaffected) arm

The standard principle for dressing residents with one-sided weakness is 'weak side in first, strong side out last' for dressing and the reverse for undressing. Dressing the affected arm first requires less ROM manipulation and reduces the risk of injury to the weaker limb. This is a frequently tested advanced application because it is counterintuitive to many new aides.

A resident who is independent in oral care suddenly refuses to brush his teeth and becomes agitated when the toothbrush is offered. Which response by the CNA best reflects person-centered dementia care?

Answer: Pause, offer a calm explanation, try again later using a familiar routine or distraction technique, and report to the nurse if refusal persists

In person-centered dementia care, refusal is often situational and related to the resident's emotional state in that moment. The CNA should pause, avoid forcing care (which constitutes abuse), attempt re-engagement using routine, music, or gentle distraction, and try again. Persistent refusal must be reported to the nurse. Skipping care without reporting or forcing it are both inappropriate responses.

A bedridden resident's care plan specifies repositioning every 2 hours. During a repositioning at 2:00 AM, the CNA notices a reddened area over the sacrum that does not blanch when pressed. What does non-blanchable redness indicate, and what should the CNA do?

Answer: It indicates a Stage 1 pressure injury; reposition off the area, apply a barrier cream, and report findings to the nurse before the next scheduled assessment

Non-blanchable erythema (redness that does not turn white when pressed) over a bony prominence is a Stage 1 pressure injury. The CNA must relieve pressure immediately, apply any prescribed barrier cream per care plan, and report to the nurse promptly — not wait until morning or end of shift. Stage 2 involves partial-thickness skin loss (open wound), which is not described here. Treating it as normal would allow progression.

A resident with Parkinson's disease is eating lunch independently. The CNA observes that the resident's hand tremors have worsened today and food is falling off the spoon. The BEST intervention that supports the resident's independence while improving safety is:

Answer: Report to the nurse and suggest weighted utensils or adaptive equipment be added to the care plan

The CNA's role is to promote the highest level of independence possible while ensuring safety. Worsening tremors represent a change in condition that should be reported to the nurse, who can assess and order adaptive equipment (like weighted utensils or dycem mats) through occupational therapy. Taking over feeding removes independence unnecessarily, and unilaterally restricting the diet or modifying the meal without orders is outside CNA scope.

During perineal care for a female resident with an indwelling urinary catheter, which technique is MOST critical to prevent catheter-associated urinary tract infection (CAUTI)?

Answer: Clean front-to-back with separate strokes for each wipe, cleaning the urethral meatus and proximal catheter last after the surrounding perineal area

CAUTI prevention requires that the perineal area be cleaned front-to-back with separate wipes, and the urethral meatus with the proximal catheter is cleaned last after surrounding areas — this sequence prevents dragging rectal flora toward the urethra and along the catheter. Cleaning the catheter first (option D) or using circular motions at the insertion site (option A) risks introducing organisms into the urethra. The sequence of cleaning the inner labia before outer (option B) is incorrect anatomically.