Basic Nursing Skills 20 Flashcards

A CNA is performing passive range-of-motion exercises on a resident's shoulder. The resident suddenly reports sharp pain during abduction. What is the MOST appropriate immediate action?

Answer: Stop the exercise immediately and report the pain to the nurse

When a resident reports sharp pain during ROM exercises, the CNA must stop immediately to prevent further injury. Pain is a warning signal that something may be wrong, and continuing — even at a reduced range — risks causing harm. The nurse must be notified promptly so the resident can be evaluated. Completing other joints before reporting would dangerously delay assessment.

When measuring urinary output for a resident on strict I&O, the CNA notes the graduate measures 240 mL but the resident's catheter drainage bag shows a markedly different level. Which action is MOST appropriate?

Answer: Empty and remeasure using the graduated cylinder as the standard, then report the discrepancy

The graduated cylinder is the accurate measurement tool for output because drainage bag calibration markings can be inaccurate. The CNA should empty the bag into the graduate for a precise reading and report any significant discrepancy to the nurse, as it may indicate a calibration issue or an error in previous documentation — both clinically significant. Averaging measurements or relying on bag markings introduces error.

A CNA is assisting a resident with hemiplegia to dress. The resident has right-sided weakness. When putting on a button-front shirt, what is the correct sequence?

Answer: Start with the right (weak) arm, then thread the left (strong) arm

The principle for dressing a resident with unilateral weakness is 'weak side first, strong side last' for putting on clothing, and 'strong side first, weak side last' for removing it. Starting with the affected (weak) right arm allows the garment to be properly positioned without overstretching, and the strong arm threads easily afterward. This protects the weak limb and promotes resident comfort and safety.

While providing perineal care to a female resident with an indwelling urinary catheter, the CNA should clean the catheter tubing in which direction?

Answer: From the insertion site outward, at least 4 inches down the tubing

Catheter care requires cleaning from the urinary meatus (insertion site) outward along the tubing — never toward the body — to move bacteria away from the bladder entry point. This reduces the risk of catheter-associated urinary tract infections (CAUTIs). Circular scrubbing at the meatus can introduce bacteria inward, and neglecting the tubing leaves it contaminated.

A resident who is on aspiration precautions is eating lunch. Midway through the meal, the resident becomes suddenly silent, stops eating, and begins making exaggerated swallowing efforts with a look of distress. There is NO audible coughing or vocalization. What should the CNA do FIRST?

Answer: Call for help immediately and prepare to perform abdominal thrusts

The silent presentation — no cough, no voice, distress with exaggerated swallowing — is a hallmark of complete airway obstruction, not partial choking. A complete obstruction is a life-threatening emergency. The CNA must call for help immediately and prepare to initiate abdominal thrusts (Heimlich maneuver). Offering liquid or encouraging coughing is appropriate only for partial obstructions. Blind finger sweeps are contraindicated as they can push the object deeper.

A CNA is repositioning a bedbound resident and notices a Stage 2 pressure injury on the resident's sacrum. The wound has a shallow open ulcer with a red-pink wound bed and no slough. Which action falls WITHIN the CNA's scope of practice?

Answer: Reposition the resident off the affected area, pad bony prominences, and report findings to the nurse

CNAs do not perform wound assessment documentation, wound measurement, or wound dressing changes — those are nursing responsibilities. What falls within a CNA's scope is pressure injury prevention and reporting: repositioning the resident to relieve pressure, using padding or foam wedges to protect bony prominences, and immediately reporting the wound to the charge nurse. Taking independent clinical action on the wound (irrigating, dressing) exceeds the CNA role.