Basic Nursing Skills 15 Flashcards

A CNA is performing passive range-of-motion exercises on a resident with contractures. The resident suddenly grimaces and their muscle resistance increases significantly. What is the MOST appropriate immediate action?

Answer: Stop the movement, hold the joint at the point of resistance, and notify the nurse

When a resident shows signs of pain or significant increased resistance during ROM exercises, the CNA must stop at that point and hold — not push through — as forcing movement against resistance can cause injury, fractures, or muscle tears. The nurse must be notified promptly to reassess the care plan.

When applying an elastic (Ace) bandage to a resident's lower leg, the CNA notices the toes become pale and the resident reports numbness. After loosening the bandage, these symptoms persist after 5 minutes. What should the CNA do NEXT?

Answer: Remove the bandage entirely and immediately report to the nurse

Persistent pallor and numbness after loosening an elastic bandage indicate compromised circulation that is not self-resolving. The bandage must be completely removed and the nurse notified immediately, as these are signs of neurovascular compromise that require clinical reassessment. Rewrapping or waiting further delays necessary intervention.

A nurse asks a CNA to measure and record the urinary output of a resident with a Foley catheter. The drainage bag shows 480 mL since the last emptying 4 hours ago, but the CNA notices the urine is dark amber with visible sediment. What is the correct action?

Answer: Record 480 mL, note the appearance in the I&O record, and immediately notify the nurse

The CNA should record the accurate output (480 mL) and document the abnormal appearance in the I&O record, then immediately notify the nurse. Dark amber urine with sediment can indicate dehydration, infection, or kidney issues requiring prompt clinical evaluation. Both documentation AND immediate reporting are required — not one or the other.

A CNA is providing oral care to an unconscious resident. After positioning the resident in a lateral (side-lying) position with the head slightly down, the CNA should perform which action BEFORE beginning oral care?

Answer: Suction the oral cavity to remove any pooled secretions if suction is available

Before beginning oral care on an unconscious resident, the oral cavity should be suctioned to remove pooled secretions and reduce aspiration risk. An unconscious patient cannot protect their own airway, and accumulated secretions increase the danger of aspiration during manipulation of the mouth. Suctioning first is the priority safety step over positioning aids or comfort measures.

During a bed bath, the CNA is washing a resident who has a saline lock (intermittent IV device) in the right forearm. What is the CORRECT technique when washing that arm?

Answer: Wash around the insertion site carefully, moving from distal to proximal, avoiding direct pressure on the device

The CNA should wash around the saline lock site with care, using distal-to-proximal strokes (toward the heart to promote venous return), without applying pressure on the device or insertion site. CNAs must never remove IV components such as caps — that is outside their scope. Skipping the arm entirely is not acceptable hygiene practice.

A CNA is assisting a resident who had a left-sided stroke with lower extremity weakness to transfer from the bed to a wheelchair using a gait belt. Where should the wheelchair be positioned and on which side should the CNA stand?

Answer: Wheelchair on the right (stronger) side at a 45-degree angle; CNA stands on the resident's left (weaker) side

For a resident with left-sided weakness, the wheelchair is placed on the stronger (right) side at a 45-degree angle to minimize pivot distance and allow the resident to use their stronger leg to bear weight and pivot. The CNA stands on the weaker (left) side to support, guard, and guide the weakened limb during the transfer, preventing the weak leg from buckling.