Basic Nursing Skills 18 Flashcards

A resident with a documented latex allergy is scheduled for wound care. The CNA notices the only available gloves in the room are standard latex examination gloves. What is the MOST appropriate action?

Answer: Report to the nurse immediately and obtain non-latex gloves before proceeding

A documented latex allergy is a serious safety concern that must never be bypassed. The CNA must stop, notify the nurse, and obtain non-latex (vinyl or nitrile) gloves before any care is provided. Washing latex gloves does not remove allergens, and double-gloving with latex still exposes the resident. Asking the resident to tolerate a known allergen is both unsafe and unethical.

While performing passive range-of-motion (PROM) exercises on a resident's right shoulder, the CNA feels crepitus (a grating or crackling sensation) and the resident grimaces but does not verbalize pain. What should the CNA do NEXT?

Answer: Stop the exercise immediately, note the resident's facial expression as a pain indicator, and report to the nurse

Crepitus can indicate joint damage, inflammation, or pathology and is never normal during PROM. A grimace is a non-verbal pain indicator — CNAs are trained to recognize behavioral pain cues, especially in residents who cannot or do not verbalize discomfort. The CNA must stop immediately and report both the crepitus and the non-verbal pain response to the nurse before any further exercise occurs.

A CNA is assisting with oral care for an unconscious resident. Which positioning consideration is MOST critical to prevent a life-threatening complication?

Answer: Place the resident in a lateral (side-lying) position with the head slightly lower than the body

An unconscious resident has no protective gag or swallow reflex, making aspiration pneumonia the primary life-threatening risk during oral care. Placing the resident in a lateral (side-lying) position with the head tilted slightly downward allows fluids and secretions to drain out of the mouth by gravity rather than pooling in the pharynx and being aspirated. Supine and upright positions increase aspiration risk significantly for unconscious patients.

A CNA is measuring a 24-hour urine output and finds the collection bag was accidentally discarded by a colleague 4 hours before the collection period ended. What is the correct action?

Answer: Report the error to the nurse immediately, document the incident, and anticipate that the 24-hour collection will need to restart

A 24-hour urine collection must be complete and uninterrupted to yield accurate results. Any breach — such as discarding the collection bag — invalidates the entire specimen. The CNA must immediately notify the nurse, document the error per facility policy, and understand that the collection will likely need to be restarted from hour zero. Estimating output, submitting partial specimens, or extending the window all produce inaccurate diagnostic data.

During a resident's bed bath, the CNA notices a new area of purple-maroon discoloration with an intact skin surface over the resident's sacrum. The skin is firm and boggy compared to surrounding tissue. Which action reflects the BEST understanding of this finding?

Answer: Stop the bath, cover the area, and notify the nurse immediately — this presentation suggests a deep tissue injury

Purple or maroon discoloration with intact skin, combined with firmness, bogginess, or temperature change, is the hallmark of a Deep Tissue Pressure Injury (DTPI) — a serious finding indicating damage to underlying muscle and fat layers. This is NOT a Stage 1 injury (which presents as non-blanchable erythema). A DTPI can evolve rapidly into a full-thickness wound. The CNA must stop and immediately report this to the nurse for urgent assessment and care planning.

A resident on droplet precautions for influenza needs to be transported to radiology. The resident is alert and can cooperate. Which of the following BEST describes the correct precautions during transport?

Answer: Both the resident and the CNA wear surgical masks; the radiology department is notified in advance

During transport outside the isolation room, a resident on droplet precautions must wear a surgical mask to contain respiratory droplets and protect others in hallways, elevators, and receiving departments. The CNA (and other staff in close contact) should also wear appropriate PPE. Notifying the receiving department in advance allows them to prepare an isolated space and reduces exposure time in shared areas. Transport is permitted when medically necessary — it is not automatically prohibited.