Basic Nursing Skills 12 Flashcards

A CNA is performing passive range-of-motion exercises on a resident's shoulder. The resident suddenly reports sharp pain at 90 degrees of abduction. What is the MOST appropriate immediate action?

Answer: Stop the movement, support the extremity, and report the pain to the nurse

When a resident reports pain during ROM exercises, the CNA must immediately stop movement and support the extremity in the position of comfort. Pain is a warning signal of possible injury, dislocation, or muscle tear. The nurse must be notified promptly so a clinical assessment can be made before exercises resume.

When applying antiembolic (TED) stockings to a resident, which finding should cause the CNA to stop and notify the nurse BEFORE application?

Answer: One leg is visibly more swollen and reddened than the other

Unilateral redness and swelling of a limb are classic signs of deep vein thrombosis (DVT). Applying compression stockings over a suspected DVT can dislodge the clot, causing a life-threatening pulmonary embolism. This finding must be reported to the nurse immediately and stockings must NOT be applied until cleared. The other findings are minor considerations that do not contraindicate application.

A CNA is caring for a resident on a fluid restriction of 1,000 mL per day. The resident's intake record shows 720 mL consumed by 2:00 PM. The resident asks for a full 8 oz (240 mL) cup of water. What should the CNA do?

Answer: Offer a smaller amount within the remaining allowance and notify the nurse of the intake status

With 720 mL consumed and a 1,000 mL daily limit, only 280 mL remains. Providing 240 mL is within the remaining allowance, but the CNA should offer a measured, appropriate portion and communicate the intake status to the nurse so the care team can monitor and distribute remaining fluid allowance across the shift. Simply refusing dismisses the resident's comfort; providing a full cup risks exceeding the restriction.

During perineal care for a female resident with an indwelling urinary catheter, which technique is CORRECT?

Answer: Clean from the urinary meatus outward along the catheter tubing for at least 4 inches, using a clean stroke each time

Proper catheter care requires cleaning from the urethral meatus outward along the catheter with a single downward stroke per wipe, never returning a soiled cloth toward the meatus. This prevents introducing bacteria into the urethra. Circular motions can redistribute microorganisms, and any back-to-front motion or cleaning the rectal area first risks fecal contamination of the catheter insertion site.

A resident who is on aspiration precautions and requires thickened liquids is found drinking thin water from a cup a family member brought in. The resident insists they prefer thin liquids. What is the MOST appropriate action by the CNA?

Answer: Remove the cup, calmly explain the aspiration risk, and report the incident to the nurse immediately

Aspiration precautions exist because thin liquids can enter the airway and cause aspiration pneumonia, which can be life-threatening. The CNA must stop the unsafe behavior, explain the risk to the resident in a respectful manner, and immediately notify the nurse. The nurse and care team can then address the resident's preferences through proper channels (e.g., a care conference, speech therapy reassessment). The CNA does not have authority to change diet orders or dismiss family members.

A CNA is assisting a resident with a transfer from bed to wheelchair using a gait belt when the resident's knees begin to buckle mid-transfer. Which action is SAFEST?

Answer: Ease the resident down to the floor in a controlled manner, protecting the head, and then call for help

When a resident begins to fall and cannot be safely redirected, the correct technique is to ease them to the floor in a controlled, guided descent — protecting the head and preventing injury from an uncontrolled fall. Attempting to lift a falling resident with a gait belt risks serious injury to both the resident and the CNA. Calling for help while the resident is actively buckling delays the immediate safety response. Rapidly pivoting into a wheelchair is unsafe when the resident cannot bear weight.