Basic Nursing Skills 17 Flashcards

A CNA is performing passive range-of-motion exercises on a resident's shoulder when the resident grimaces and the joint suddenly feels resistant. What is the MOST appropriate immediate action?

Answer: Stop the movement immediately and report to the nurse

Sudden resistance combined with a pain response (grimacing) indicates possible injury risk such as muscle spasm, contracture worsening, or joint pathology. The CNA must stop immediately to prevent harm and report to the nurse for further assessment before continuing.

When positioning a resident in the lateral (side-lying) position, the CNA notices the resident's top knee is resting directly on the lower knee with no support. Which complication is MOST directly prevented by placing a pillow between the knees?

Answer: Pressure injury from bony prominence contact

When bony prominences (such as knees) press against each other, there is no soft tissue to distribute the pressure, creating a high risk for pressure injuries at the medial knee. A pillow separates these prominences to relieve point pressure.

A resident receiving a bed bath suddenly becomes diaphoretic, pale, and says they feel 'strange.' The CNA has just finished washing the resident's face and upper body. What should the CNA do FIRST?

Answer: Lower the head of the bed flat and call for the nurse immediately

Sudden diaphoresis, pallor, and a vague complaint of feeling 'strange' are signs of possible hemodynamic compromise (e.g., orthostatic hypotension, vasovagal response, or cardiac event). The CNA must ensure safety by lying the resident flat, which improves cerebral perfusion, and summon the nurse immediately. No care activity takes priority over this response.

A CNA is assisting a resident with dysphagia to eat. The resident has a dietary order for nectar-thick liquids. The family member at the bedside insists on giving the resident regular water because 'they always loved water.' What is the MOST appropriate CNA response?

Answer: Explain that only the nurse or physician can modify the thickened-liquid order, and offer to contact the nurse

A thickened-liquid order is a physician/speech-language pathologist directive based on aspiration risk assessment. The CNA has no authority to override or modify this order. The correct response is to respectfully explain this limitation and facilitate communication with the nurse, who can involve the care team if the family wants to revisit the order.

While changing a resident's indwelling urinary catheter drainage bag, the CNA notices the urine is dark amber with visible sediment and a strong odor. The resident denies pain but has a temperature of 37.9°C (100.2°F). Which action BEST reflects the CNA's role?

Answer: Report findings to the nurse promptly, as these may indicate a catheter-associated urinary tract infection

Dark, sediment-laden, malodorous urine combined with a low-grade fever are classic early indicators of a catheter-associated urinary tract infection (CAUTI). While the CNA cannot diagnose, they must recognize abnormal findings and report them promptly — not at end of shift — so the nurse can assess and initiate treatment if needed. Irrigating a catheter is outside CNA scope of practice.

A CNA is applying anti-embolism stockings (TED hose) to a resident who had knee surgery three days ago. Upon inspection, the CNA notices one leg is noticeably more swollen, warm, and reddish than the other. What is the CORRECT action?

Answer: Do not apply the stockings and notify the nurse immediately about the asymmetric leg findings

Unilateral leg swelling, warmth, and erythema following recent surgery are classic signs of deep vein thrombosis (DVT), a life-threatening condition. Applying compression to a suspected DVT can dislodge a clot and cause a pulmonary embolism. The CNA must withhold the stockings entirely and report to the nurse immediately for urgent evaluation.