Basic Nursing Skills 10 Flashcards

A CNA is performing passive range-of-motion exercises on a resident's shoulder when the resident suddenly grimaces and tenses up but does not verbalize pain. What is the most appropriate immediate action?

Answer: Stop the exercise immediately, support the joint, and report the nonverbal pain signs to the nurse

Nonverbal cues such as grimacing, guarding, or muscle tensing are valid indicators of pain — especially in residents who have difficulty communicating. The CNA must stop immediately, support the joint in a neutral position, and report to the nurse. Proceeding risks injuring the joint or causing undue suffering.

While making an occupied bed, the CNA notices the bottom sheet has a small amount of dried blood from an earlier wound dressing change. The wound is fully dressed and not actively bleeding. What is the correct sequence of actions?

Answer: Change the soiled sheet immediately using standard precautions, then report the finding to the nurse

Soiled linens — including those with blood — are a potential source of infection and must be changed promptly using standard precautions (gloves, proper linen disposal). The CNA should then report the finding to the nurse so the wound status can be assessed. Covering the sheet or changing only part of the bedding does not address the infection-control concern.

A resident on a thickened-liquid diet chokes briefly on a sip of water brought by a family visitor. The choking resolves on its own and the resident says they feel fine. What should the CNA do FIRST?

Answer: Report the incident to the nurse and document it, even though the choking resolved

Any aspiration or choking event — even one that self-resolves — must be reported to the nurse immediately. Aspiration can have delayed pulmonary consequences (aspiration pneumonia), and the nurse needs to assess the resident and determine whether a speech therapy re-evaluation is needed. Documentation and incident reporting are also required.

A CNA is assisting with a bed bath for an unconscious resident who has a Foley catheter. In what order should body regions be washed?

Answer: Face → neck/chest → arms → abdomen → legs/feet → perineum (catheter area last)

The correct bed-bath sequence moves from cleanest to most contaminated areas: face first (least contaminated), then upper body, then lower body, and the perineal/catheter area last. This prevents transferring microorganisms from the perianal region to cleaner areas and reduces the risk of catheter-associated urinary tract infections (CAUTIs).

During a routine vital-signs check, a CNA obtains an axillary temperature of 99.2°F (37.3°C) on a resident who was just brought inside from a 30-minute outdoor activity on a warm day. What is the most appropriate action?

Answer: Wait 15–20 minutes for the resident to equilibrate to room temperature, then retake the temperature and report any persistent elevation to the nurse

External environmental factors — including recent physical activity or heat exposure — can transiently elevate axillary temperature, making it unreliable immediately after the event. The CNA should allow the resident to rest indoors for 15–20 minutes before retaking the temperature. Reporting 99.2°F without accounting for the confounding factor could lead to unnecessary interventions; however, any persistent elevation should still be reported.

A CNA notices that a resident's pressure injury dressing has partially lifted at one edge and a small amount of yellow-tinged drainage is visible on the inside of the dressing. The resident is not in pain. What is the correct action?

Answer: Leave the dressing in place, cover the lifted edge with medical tape to resecure it, and report the drainage observation to the nurse promptly

CNAs are NOT authorized to remove or replace wound dressings — that is within the nurse's scope. The correct action is to temporarily secure the lifted edge (to protect the wound from further contamination), then report immediately to the nurse so wound status and drainage can be assessed. Yellow-tinged drainage (serous or purulent) requires nursing evaluation. Delaying the report until end of shift is unsafe.