Basic Nursing Skills 19 Flashcards

A CNA is caring for a resident with a Stage 3 pressure injury on the sacrum. During repositioning, the CNA notices the wound has a foul odor and yellow-green exudate. What is the MOST appropriate immediate action?

Answer: Document the findings and report to the nurse before the next scheduled dressing change

The CNA's role is to observe, document, and promptly report changes in a resident's condition to the supervising nurse. Signs of infection such as foul odor and purulent exudate require immediate nursing assessment and possible wound culture or antibiotic therapy — all decisions that fall outside the CNA's scope of practice. The CNA should never independently alter wound care protocols, apply medications, or make treatment changes.

When performing passive range-of-motion (PROM) exercises on a resident's shoulder, the resident suddenly reports sharp pain mid-movement. Which response demonstrates correct technique?

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

Pain during ROM exercises is a warning sign that should never be ignored or pushed through, as it may indicate injury, inflammation, or a contraindicated movement. The CNA must stop immediately to prevent harm, support the limb in a comfortable position, and report the finding to the nurse so the care plan can be reassessed. Continuing movement through pain can cause serious injury.

A resident with a nasogastric (NG) tube in place becomes nauseated during tube feeding. The CNA notices the tube appears to have advanced further since the last care check. What should the CNA do FIRST?

Answer: Stop the feeding, do not manipulate the tube, and notify the nurse immediately

A displaced or migrated NG tube is a potentially life-threatening situation — if the tube has advanced into the bronchus or shifted position, continuing the feeding could cause aspiration pneumonia or worse. CNAs must not verify tube placement, reposition tubes, or aspirate NG tubes. The correct action is to stop the feeding immediately and notify the nurse, who has the authority and skill to verify tube placement before resuming.

A nurse has delegated perineal care to a CNA for a male resident with an indwelling urinary catheter. Which technique is CORRECT when cleaning the catheter?

Answer: Wipe from the meatus outward in one direction using a clean stroke, then discard the wipe

Correct catheter care requires wiping from the urethral meatus outward in a single, one-directional stroke using a clean cloth or wipe each time — this prevents introducing bacteria from the skin into the urethra. Circular scrubbing can cause trauma. Cleaning from the bag toward the patient introduces organisms toward the insertion site. The catheter-drainage bag junction should never be disconnected, as breaking the closed system is a primary cause of catheter-associated urinary tract infections (CAUTIs).

A CNA is assisting with postmortem care after a resident has been pronounced deceased. The family has requested the body be positioned for viewing. Which action reflects proper postmortem care technique?

Answer: Position the body with the head elevated on a pillow and close the eyes and mouth as soon as possible after death

Postmortem care should be performed promptly after death, before rigor mortis sets in (which begins approximately 2–6 hours after death). Elevating the head on a pillow and gently closing the eyes and mouth while tissues are still pliable allows for a more natural and peaceful appearance for the family. Removing tubes and lines is only done after the nurse confirms it is appropriate and after any required legal or policy review — CNAs do not independently remove medical devices postmortem.

A resident on fall precautions has a bed exit alarm. During your shift, the alarm sounds and you find the resident standing at the bedside holding the side rail, stating, 'I just need to use the bathroom.' The resident appears steady. What is the PRIORITY action?

Answer: Stay with the resident, call for assistance, and escort them safely to the bathroom with proper transfer technique

The immediate priority is resident safety. The CNA must stay with the resident — never leave them standing unsupported — and call for additional assistance if needed, then safely escort them to the bathroom using proper transfer and gait assistance techniques. Fall precautions do not mean the resident cannot ambulate; they mean supervised, safe movement is required. Applying a restraint without a physician order and care plan direction is inappropriate and potentially abusive. Documentation is important but not the first action when the resident is in a potentially unsafe position.