Basic Nursing Skills 11 Flashcards

A CNA is measuring a resident's blood pressure and obtains a reading of 118/76 mmHg in the right arm. The nurse asks the CNA to retake it in the left arm, where the reading is 102/68 mmHg. What is the most appropriate next action?

Answer: Record the higher reading and report the significant difference between arms to the nurse

A difference of more than 10–15 mmHg between arms can indicate subclavian artery stenosis or other vascular issues and must be reported. The higher reading is considered the reference value. The CNA should document both readings and immediately notify the nurse of the discrepancy — it is never appropriate to average or withhold this information.

While performing perineal care on a female resident with an indwelling urinary catheter, the CNA notices the catheter tubing has become kinked under the resident's thigh and urine has not drained into the bag for the past 30 minutes. The bag was empty at the start of care. What should the CNA do FIRST?

Answer: Reposition the tubing to relieve the kink and observe for urine flow

A kinked tube is a mechanical obstruction — the CNA's first action is to reposition the tubing to restore drainage. This is within the CNA scope of practice. Irrigation requires a nurse's order and sterile technique beyond CNA scope. Clamping the catheter would worsen the obstruction. The nurse should be notified if repositioning does not resolve the issue.

A resident on a thickened-liquid diet begins coughing vigorously immediately after swallowing a sip of nectar-thick juice. The resident stops coughing within 15 seconds, clears their throat, and says 'I'm fine.' What is the CNA's best course of action?

Answer: Stop the meal immediately, keep the resident upright, and report the episode to the nurse before continuing

Coughing after swallowing in a resident already on a modified-texture diet is a red flag for aspiration risk, even if the resident self-recovers. The CNA must stop the meal, maintain the resident upright (to reduce aspiration risk), and report to the nurse before resuming. Offering water violates the diet order. Continuing the meal risks repeated aspiration. Waiting until after the meal delays necessary assessment.

A CNA is collecting a 24-hour urine specimen. At 8:00 AM the CNA discards the first morning void and begins timing the collection. At 2:00 PM, the CNA accidentally discards a void instead of adding it to the collection container. What should the CNA do?

Answer: Notify the nurse immediately — the collection must be restarted from the current void

A 24-hour urine collection requires every void over the exact 24-hour window. Discarding even one specimen invalidates the entire collection because total volume and solute concentration will be inaccurate. The CNA must notify the nurse immediately so the collection can be properly restarted. Approximating volume or continuing without restarting produces unreliable results that could lead to misdiagnosis.

A resident who uses a manual wheelchair needs to be transferred to a bed located on the resident's weaker left side. The CNA has positioned the wheelchair at a 45-degree angle to the bed. To ensure the safest transfer, the CNA should pivot the resident so that the resident's weight is primarily borne by which leg?

Answer: The stronger right leg, which serves as the pivot point closest to the bed

When transferring toward the weaker side, the stronger leg should serve as the weight-bearing pivot. Positioning the wheelchair so the resident leads with the stronger leg toward the bed allows a shorter pivot arc and uses the resident's more stable limb for support. Loading weight through the weaker limb increases fall risk. The CNA supports from the weaker side, not from behind.

During morning care, a CNA notes that a resident's surgical wound dressing is saturated with serosanguineous drainage. The wound was dressed by a nurse two hours ago. The CNA's scope of practice does NOT include changing the dressing. What is the MOST appropriate action?

Answer: Reinforce the dressing with additional gauze, document the drainage amount and color, and notify the nurse

Reinforcing a saturated dressing (adding gauze on top without removing the original) is within CNA scope and keeps the wound covered while the CNA notifies the nurse. Leaving it saturated risks skin maceration and infection. Removing the dressing or applying pressure exceeds CNA scope and could harm the wound. Documentation of the drainage type, amount, and time is essential before notifying the nurse.