Basic Nursing Skills 17 Flashcards

A CNA is performing passive range-of-motion exercises on a resident's shoulder when the resident suddenly grimaces and says nothing, but the CNA feels resistance. What is the MOST appropriate immediate action?

Answer: Stop the movement immediately and report the finding to the nurse

Resistance combined with a pain expression (grimacing) signals potential injury, spasm, or joint pathology. The CNA must stop immediately to prevent harm and report to the nurse for further assessment. Continuing in any form — even at reduced range — risks injury. Documentation comes after stopping and reporting, not before.

When performing perineal care on a female resident with an indwelling urinary catheter, which technique BEST prevents catheter-associated urinary tract infection (CAUTI)?

Answer: Clean from the urethral meatus outward along the catheter for at least 4 inches, using a single stroke per wipe

CAUTI prevention requires cleaning from the meatus outward along the catheter using a single downward stroke per wipe — never circular motion — to move microorganisms away from the insertion site. Circular motion can drag bacteria toward the meatus. CNAs must never remove or reinsert catheters, and routine antiseptic ointment is not evidence-based practice for catheter site care.

A CNA transfers a left-sided hemiplegic resident from bed to wheelchair using a gait belt. The wheelchair should be positioned at what angle relative to the bed, and on which side?

Answer: 45-degree angle on the resident's right (stronger) side

The wheelchair is always placed on the resident's stronger side — in this case the right — so the resident can use their stronger leg and arm to assist in the pivot. A 45-degree angle minimizes the arc of the transfer, reducing fall risk and CNA strain. Positioning on the affected side forces the resident to pivot over a non-functional limb, dramatically increasing fall risk.

A CNA notes that a resident's colostomy stoma appears dark purple-black rather than its usual pink-red color. Which action is CORRECT?

Answer: Report the finding to the nurse immediately without manipulating the stoma

A dark purple-black stoma indicates ischemia or necrosis — a medical emergency requiring immediate nurse notification. The CNA must observe and report, never apply compresses, resize appliances, or delay by documenting first. Any manipulation could worsen tissue damage. This is a classic 'report first, act never' CNA boundary situation.

During postmortem care, the CNA is working alone and has finished positioning the body in proper alignment. The nurse tells the CNA that the family will arrive in 20 minutes and requests that dentures be reinserted. The resident's dentures are in a labeled cup on the bedside table. What should the CNA do?

Answer: Insert the dentures promptly — rigor mortis onset makes reinsertion harder the longer you wait

Inserting dentures is a standard component of postmortem care and is within the CNA's scope. The clinical rationale is important: rigor mortis begins within 2–6 hours postmortem, starting in the face and jaw, which will make denture insertion progressively harder and eventually impossible. Acting promptly is both procedurally correct and clinically sound for preserving the resident's appearance for the family.

A CNA is assigned to a resident on droplet precautions for influenza who also requires ambulation training in the hallway. Which PPE combination is REQUIRED before exiting the room with the resident?

Answer: Both the CNA and the resident must wear surgical masks before leaving the room

Under droplet precautions, the CNA wears a surgical mask within 3 feet of the resident. Critically, the resident must also wear a surgical mask when leaving their room to prevent spreading respiratory droplets to other patients, staff, and visitors in the hallway — regardless of distance traveled. N95 respirators are required for airborne precautions (e.g., TB, measles), not droplet precautions. There is no '10-foot' or distance-based exception for the resident's mask.