Basic Nursing Skills 1 Flashcards

A CNA is performing passive range-of-motion exercises on a resident's shoulder. The resident suddenly grimaces and says the pain is a 4/10. What is the most appropriate immediate action?

Answer: Stop the exercise at that joint and report the pain to the nurse before continuing

Any pain during ROM exercises is a signal to stop immediately and report to the nurse before proceeding. Even mild pain (4/10) can indicate injury, inflammation, or worsening of a condition. Continuing—even with reduced range—without nursing assessment risks harm. The CNA's scope does not include determining whether it is safe to continue.

When performing perineal care on a female resident, the CNA has cleaned the perineum and is now cleaning the rectal area. Which action demonstrates correct technique?

Answer: Use a clean section of the washcloth and wipe from the perineum toward the rectal area

Perineal care always follows the front-to-back (perineum-to-rectum) direction to prevent introducing fecal bacteria into the urinary tract. After cleaning the perineum, the rectal area is cleaned by continuing in that same anterior-to-posterior direction using a clean section of cloth. Wiping from the rectal area toward the perineum (back to front) introduces pathogens and increases UTI risk.

A CNA is assisting a resident who had a left-sided stroke with hemiplegia to put on a button-front shirt. Which sequence is correct?

Answer: Thread the left (weaker) arm first, bring the shirt behind the back, then thread the right arm

The correct principle for dressing residents with unilateral weakness is 'weak side first, strong side last' for dressing, and the reverse for undressing. The affected (left, weaker) arm should be dressed first because it has limited range of motion — dressing the strong arm first would make it extremely difficult to maneuver the garment onto the weak arm afterward.

A CNA is measuring a resident's urinary output from an indwelling catheter drainage bag. The bag contains 650 mL. The CNA notes the urine is dark amber with visible sediment. What should the CNA do FIRST?

Answer: Empty the bag, document 650 mL, and report the color and sediment to the nurse

Dark amber urine with sediment are abnormal assessment findings that must be reported to the nurse promptly. The CNA still empties and accurately documents the output (which is a required task), but observation of abnormal characteristics — color, odor, sediment, or cloudiness — must be reported so the nurse can evaluate for possible infection, dehydration, or other pathology. Clamping the catheter without a nurse's order is outside the CNA's scope and dangerous.

A resident on a mechanical soft diet is eating lunch. The CNA notices the resident pocketing food in the left cheek and coughing intermittently after swallowing. What is the priority concern and action?

Answer: Aspiration risk; stop feeding, position the resident upright, and report the observations to the nurse before continuing the meal

Pocketing food and intermittent coughing after swallowing are classic warning signs of dysphagia and significant aspiration risk. The CNA must stop the meal immediately, keep the resident upright (to use gravity to reduce aspiration risk), and report to the nurse before the meal is resumed. Continuing to feed a resident showing these signs could result in aspiration pneumonia — a life-threatening complication.

A CNA is performing a bed bath on a bedridden resident and needs to change the bath water. After removing the soiled water, which action must occur BEFORE the CNA continues bathing?

Answer: Perform hand hygiene before filling the new basin with fresh warm water

Hand hygiene must be performed whenever gloves are removed or changed, and after handling soiled materials — including soiled bath water. Before filling a fresh basin, the CNA should perform hand hygiene to prevent transferring contamination to clean supplies and ultimately to the resident. While keeping the resident warm is important, infection control principles are not bypassed for comfort; maintaining proper draping throughout minimizes heat loss.