Basic Nursing Skills 16 Flashcards

A CNA is caring for a resident with a stage 2 pressure ulcer on the coccyx. When repositioning the resident, which action is MOST important to prevent further skin breakdown?

Answer: Lift the resident completely off the surface using a mechanical lift for every turn

Using a mechanical lift to fully offload the resident prevents shear and friction forces that occur when sliding, which can worsen existing pressure ulcers. Sliding with a draw sheet still causes friction. Applying lotion directly to an open wound is inappropriate. Positioning on the ulcer — even briefly — causes further tissue damage.

During oral care for an unconscious resident, the CNA notices a small amount of secretions pooling at the back of the throat. What is the PRIORITY action?

Answer: Turn the resident's head to the side and use a suction device to clear the secretions before continuing oral care

Turning the head to the side uses gravity to prevent aspiration, and suctioning clears the airway before proceeding. Supine with head tilted back increases aspiration risk. Using a toothbrush without clearing secretions first is unsafe. Discontinuing care entirely is not appropriate when safe techniques are available.

A resident receiving enteral tube feedings via NG tube has a residual volume of 250 mL when the CNA checks it before the next feeding. What should the CNA do FIRST?

Answer: Re-instill the residual, hold the feeding, and report the finding to the nurse immediately

A residual of 250 mL is significantly elevated and indicates delayed gastric emptying, which is a safety concern for aspiration. The CNA should re-instill the residual to prevent electrolyte loss, hold the feeding, and promptly report to the nurse for further assessment and orders. CNAs do not independently adjust feeding rates or administer feedings after identifying a high residual without nursing direction.

A CNA is applying anti-embolism (TED) stockings to a resident. The resident states their toes feel numb and look bluish after the stocking is applied. What is the CORRECT response?

Answer: Remove the stocking immediately and report the circulatory change to the nurse

Bluish discoloration (cyanosis) and numbness indicate compromised circulation, which is a serious vascular emergency sign. The stocking must be removed immediately to restore circulation, and the nurse must be notified right away for further assessment. Waiting, partially adjusting the stocking, or reassuring the resident are all dangerous delays when circulation is impaired.

A CNA is performing a bed bath for a resident with a left-sided hemiplegia following a stroke. When dressing the resident in a pullover shirt, which sequence is correct?

Answer: Dress the affected (left) arm first, pull the shirt over the head, then thread the unaffected (right) arm through

The correct technique for dressing a hemiplegic resident is 'affected side first, unaffected side last' (and undressing is the reverse: unaffected first). This approach minimizes painful manipulation of the weaker arm with limited range of motion. Threading the shirt onto the affected arm first reduces stretching and potential injury to the shoulder joint.

A CNA is emptying a urinary catheter drainage bag and notices the urine is dark amber, has a strong odor, and there are visible sediment particles. The resident's temperature per the last nursing assessment was 38.4°C (101.1°F). Which action reflects BEST practice?

Answer: Empty the bag, document the urine characteristics and volume, and immediately report all findings to the nurse

The combination of abnormal urine characteristics (dark, malodorous, sediment) and an elevated temperature are significant signs of a possible urinary tract infection or systemic infection. The CNA's role is to accurately document all observations and report immediately to the nurse, who will determine the next steps including ordering a specimen or other interventions. Clamping a catheter is dangerous and outside CNA scope. Straining urine for specimens requires a nursing order.