Basic Nursing Skills 17 Flashcards

A CNA is performing passive range-of-motion exercises on a resident with severe osteoporosis. The resident suddenly reports sharp pain in the wrist during wrist flexion. What is the most appropriate immediate action?

Answer: Stop the movement immediately, support the joint, and report to the nurse

When a resident reports sharp or sudden pain during ROM exercises, the CNA must stop the movement immediately and support the joint to prevent further injury. Pain is a warning signal — especially critical in osteoporosis where fracture risk is elevated. The nurse must be notified so the resident can be assessed for potential injury. Continuing movement in any form, even at a slower pace, could worsen a possible fracture or ligament damage.

A CNA is assisting a post-surgical resident with ambulation using a gait belt. The resident begins to feel dizzy and says their legs feel weak. Which technique best protects both the resident and the CNA?

Answer: Widen your stance, bend your knees, lower the resident to the floor in a controlled manner using the gait belt

If a resident begins to fall, the CNA should never try to prevent the fall entirely, as this can injure both the resident and the CNA. The correct technique is to widen the base of support, bend the knees (not the back), and use the gait belt to lower the resident gently to the floor in a controlled manner. This minimizes injury risk. Attempting to hold the resident upright or pivot them increases the risk of muscle strain for the CNA and an uncontrolled fall for the resident.

A CNA is performing perineal care on a female resident who has an indwelling urinary catheter. After cleansing the perineum, in what order should the catheter tubing be cleaned, and how far should the CNA clean from the urethral meatus?

Answer: Clean from the meatus outward along the tubing using a downward stroke for at least 4 inches, using a clean stroke each time

Catheter care follows a clean-to-dirty principle. The CNA should clean from the urethral meatus outward along the catheter tubing for at least 4 inches, using a separate clean stroke for each wipe to avoid reintroducing microorganisms. Moving toward the body or using circular motions could drag bacteria toward the urethra, increasing the risk of catheter-associated urinary tract infection (CAUTI). The meatus area is always cleaned first before moving down the tubing.

A CNA is repositioning a comatose resident who is on a pressure-injury prevention protocol. The resident has a Stage 2 pressure injury on the left heel and is currently positioned supine. Which positioning strategy is most appropriate?

Answer: Float both heels off the mattress using a foam wedge placed under the calves and reposition every 4 hours

For a resident with a heel pressure injury, the standard of care is to 'float' the heels completely off the mattress by placing a support (foam wedge or pillow) under the calves — not under the knee, which can cause popliteal vein compression. Both heels should be floated, not just the injured one, to prevent new injuries. Repositioning should continue on the standard schedule (every 2 hours is ideal; 4 hours is suboptimal but the answer best reflects heel-specific offloading). Turning onto the injured heel is contraindicated, and heel protectors alone are insufficient for an existing Stage 2 injury.

During a bed bath, a CNA notices that a confused resident has an area of intact skin that is non-blanchable, dark red-purple discoloration over the coccyx with no open wound. The skin feels slightly boggy compared to surrounding tissue. How should this be documented and reported?

Answer: Report it immediately to the nurse as a suspected Deep Tissue Pressure Injury (DTPI) before completing the bath

Non-blanchable dark red, purple, or maroon discoloration of intact skin with a boggy or mushy texture are classic signs of a Deep Tissue Pressure Injury (DTPI), which represents damage to underlying soft tissue despite intact surface skin. This is a serious finding distinct from Stage 1 (non-blanchable erythema without bogginess in lighter skin or color changes in darker skin). The CNA must stop and report to the nurse immediately — DTPIs can evolve rapidly into full-thickness wounds. Documenting and waiting, or misclassifying the wound, delays treatment and violates the resident's right to timely care.

A CNA is caring for a resident who uses a hearing aid. After inserting the hearing aid, the resident reports a constant high-pitched whistling sound. The CNA has already confirmed the battery is new. What is the most likely cause and the correct intervention?

Answer: The hearing aid is not seated properly in the ear canal; the CNA should remove and reinsert it, ensuring a snug fit

A persistent high-pitched whistling or feedback sound from a hearing aid with a new battery is most commonly caused by an improper seal — the device is not fully or correctly seated in the ear canal, causing amplified sound to leak back into the microphone (acoustic feedback). The correct action is to remove the hearing aid and reinsert it carefully, ensuring a snug, proper fit. While high volume can also cause feedback, the first and most common cause to address is fit. A CNA should never irrigate a resident's ear; this requires a nursing or physician order and clinical assessment.