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 says nothing but grips the bed rail tightly. What is the MOST appropriate immediate action?

Answer: Stop the exercise immediately, note the point at which discomfort occurred, and report to the nurse

Non-verbal signs of pain — such as facial grimacing and guarded behavior — must be treated as pain indicators. The CNA must stop immediately to prevent injury, document the range at which discomfort appeared, and report to the nurse. Continuing in any form risks causing harm, and delaying reporting is outside scope-of-practice boundaries.

When applying an elastic (Ace) bandage to a resident's lower leg, which technique best prevents circulatory impairment?

Answer: Wrap distally to proximally with overlapping turns of 50%, anchoring firmly at the toes

Elastic bandages must be applied distal to proximal (toes toward the knee) to encourage venous return toward the heart. Overlapping each turn by approximately half prevents gaps while avoiding pressure points. Starting at the proximal end or wrapping proximal to distal would trap venous blood and worsen edema or cause ischemia.

A resident on a mechanical soft diet is receiving oral care. The CNA notices the resident has a loose tooth that was not documented previously. What is the correct course of action?

Answer: Report the finding to the nurse before continuing oral care

A newly identified loose tooth is a change in condition that must be reported to the nurse immediately before care continues. Proceeding without reporting — even cautiously — risks aspiration if the tooth dislodges. Documentation alone does not substitute for immediate verbal notification. Postponing care is not the right decision either, as the nurse may want to provide guidance on how to safely complete oral care.

A CNA is caring for a resident who uses a hearing aid. After cleaning the ear mold with a damp cloth, the resident complains the device produces a whistling sound. What is the MOST likely cause?

Answer: The ear mold is not seated properly in the ear canal

Whistling or feedback in a hearing aid most commonly results from an improperly seated ear mold, which allows amplified sound to escape and be re-amplified. While a low battery can cause distortion or cutting out, it typically does not cause whistling. Excessive volume is a less likely culprit after routine cleaning, and internal moisture would more likely cause distortion or silence rather than feedback.

A CNA notes that a resident's indwelling urinary catheter drainage bag has been positioned on the bed rail above the level of the bladder for the past 20 minutes. Which potential complication is of GREATEST concern?

Answer: Catheter-associated urinary tract infection due to retrograde urine flow

When the drainage bag is positioned above the bladder, urine can flow retrograde (backward) from the bag into the bladder, introducing bacteria and sharply increasing the risk of a catheter-associated urinary tract infection (CAUTI). This is the most serious and immediate concern. Urinary retention requires a kinked or elevated tubing beyond a brief period; spasms are a consequence of infection or irritation, not the primary immediate risk; and tubing tension is a positioning issue unrelated to bag elevation.

During a bed bath, the CNA observes a stage 2 pressure injury on the resident's coccyx that is listed in the care plan as a stage 1 from three days ago. The wound now has a shallow open crater with a pink wound bed and no necrotic tissue. What is the CNA's PRIORITY action?

Answer: Stop non-urgent care, cover the area loosely, and report the change to the nurse promptly

A change from stage 1 to stage 2 represents wound deterioration — a significant change in condition — that must be reported to the nurse promptly. CNAs do not independently reclassify pressure injuries or alter care plans. Proceeding with a dressing change based on an outdated care plan or delaying report until end of shift is inappropriate. The CNA should protect the area and notify the nurse so wound care can be reassessed and orders updated.