Basic Nursing Skills 16 Flashcards

A resident with left-sided hemiplegia requires a gown change. The CNA should remove the soiled gown from the strong side first and dress the weak side first. Which of the following scenarios represents the CORRECT sequence when changing this resident's gown?

Answer: Remove from right (strong) arm first, then left; dress left (weak) arm first, then right

The correct technique is 'strong off first, weak on first.' Remove the gown from the unaffected (strong/right) side first because it has greater range of motion, making removal easier. Then dress the affected (weak/left) side first because it is less mobile and threading it through the sleeve is more difficult — leaving the stronger arm free to assist.

While providing oral care to an unconscious resident, which position and technique combination BEST prevents aspiration?

Answer: Lateral (side-lying) position with head slightly down; use swabs moistened with minimal fluid

An unconscious resident has no protective gag reflex, so the lateral (side-lying) position with slight head-down tilt uses gravity to allow fluids to drain out of the mouth rather than down the airway. Using minimally moistened swabs reduces the volume of fluid that could be aspirated. Semi- or high-Fowler's with rinsing risks pooling fluid at the back of the throat, and hyperextension opens the airway to aspiration.

A CNA is applying anti-embolism (TED) stockings to a resident. Which of the following actions, if performed, would be INCORRECT and could reduce their effectiveness?

Answer: Leaving the stockings on continuously for 24 hours without removal to maintain constant compression

Anti-embolism stockings must be removed at least once per shift (typically every 8 hours) to inspect the skin for pressure injuries, circulatory changes, and breakdown. Leaving them on for 24 hours without removal can mask developing skin problems and impair circulation if wrinkles form. The other options are all correct techniques: apply before rising to prevent venous pooling, turn inside-out for easier donning, and smooth wrinkles to ensure even pressure distribution.

A resident's care plan specifies a fluid restriction of 1,200 mL per day. The resident is tearful and asks for an extra glass of water, saying 'I'm so thirsty all the time.' What is the MOST appropriate response by the CNA?

Answer: Offer interventions such as mouth swabs, ice chips (counted in intake), sugar-free hard candy, or repositioning, and report the resident's distress to the nurse

The CNA cannot exceed the prescribed fluid restriction, but the resident's comfort is still a legitimate concern. Comfort measures — such as oral moistening swabs, small ice chips (which count toward intake at half their volume), hard candy to stimulate saliva, and good oral hygiene — can alleviate the sensation of thirst without violating the restriction. The CNA must also report the resident's distress to the nurse, who may reassess the plan or provide further interventions. Providing extra water overrides a medical order; refusing without alternatives is inadequate care.

When performing a bed bath on a resident with a stage 2 pressure injury on the sacrum, the CNA notices that the wound edges appear macerated (white, soft, waterlogged tissue). What is the MOST likely cause and the correct CNA action?

Answer: Maceration caused by excessive moisture from incontinence; the CNA should clean and dry the area thoroughly, apply a moisture barrier if part of the care plan, and report the change to the nurse

Maceration occurs when skin is exposed to excessive moisture (urine, feces, perspiration, or wound drainage) for prolonged periods, causing the tissue to soften and break down — which can worsen the pressure injury. The correct CNA action is to gently cleanse and thoroughly dry the periwound skin, apply a skin/moisture barrier if it is prescribed in the care plan, and immediately report the change in wound status to the nurse. CNAs never independently apply treatments beyond what is specified in the care plan and do not self-prescribe ointments. Maceration is not a normal healing sign.

A CNA is assisting a resident who uses a cane to ambulate to the bathroom. Halfway down the hallway, the resident says 'My legs feel very weak — I don't think I can make it.' The resident begins to lose balance. Which action should the CNA take FIRST?

Answer: Position yourself close to the resident, provide support by holding their gait belt or waist, guide them to lean against the wall or lower them safely to the floor using a controlled descent

When a resident begins to fall, the CNA's first priority is to prevent injury by controlling the descent — never by trying to stop or catch a full fall, which risks injury to both resident and CNA. The CNA should use the gait belt (if in place) or support the resident at the waist, widen their own stance for stability, and guide the resident either to lean safely against a wall or to lower them gently to the floor in a controlled manner. Leaving the resident unattended to get help or a wheelchair risks an uncontrolled fall. Attempting to carry a resident is a back-injury hazard and is not technique-appropriate.