Basic Nursing Skills 20 Flashcards

A resident on fluid restriction is asking for extra water. Their intake log shows they have consumed 1,650 mL of their 1,800 mL daily limit. The resident requests a 240 mL cup of water. What is the most appropriate action for the CNA?

Answer: Offer only 150 mL of water and document the intake accurately

The resident has 150 mL remaining within their prescribed 1,800 mL restriction. The CNA should offer that remaining allowance and document it accurately. Providing more than the prescribed limit violates the care plan. Denying all fluids ignores the remaining allowance. Giving excess fluids and notifying afterward is unsafe practice.

While performing perineal care on a female resident, the CNA notices a new area of reddened, excoriated skin in the perianal region that was not documented in the last shift's notes. The resident denies pain. What should the CNA do FIRST?

Answer: Complete the perineal care, then report and document the skin finding to the nurse

The CNA should complete the necessary perineal care to maintain the resident's hygiene and dignity, then promptly report the new skin finding to the nurse and document it. Abandoning care mid-task is inappropriate. CNAs should not independently apply treatments without nursing direction. Documenting without reporting to the nurse delays necessary intervention.

A CNA is assisting a resident with passive range-of-motion (ROM) exercises on the right shoulder following a stroke. The resident suddenly grimaces and says 'ouch' but then says 'I'm fine, keep going.' What is the correct response?

Answer: Stop the exercise immediately, ask the resident to rate their pain, and report to the nurse before continuing

Any expression of pain during ROM exercises requires the CNA to stop immediately. A resident's verbal consent to 'keep going' does not override the CNA's obligation to assess and report pain. ROM should never cause pain — if it does, it indicates a potential injury or complication that the nurse must evaluate before exercises resume.

A CNA is measuring a resident's blood pressure using a manual cuff. The first reading is 158/96 mmHg. The nurse asks the CNA to retake the measurement to confirm. What is the correct technique for obtaining an accurate second reading?

Answer: Wait at least 1–2 minutes, fully deflate the cuff, and retake on the same arm

A waiting period of at least 1–2 minutes allows venous blood to clear and prevents artificially elevated readings from venous congestion. The cuff must be fully deflated before reinflation. Re-inflating immediately on a partially deflated cuff causes inaccurate readings. Switching arms without waiting is acceptable in some protocols, but the wait time is the critical error to avoid — waiting on the same arm is the standard recommended technique for confirmation readings.

During morning care, a CNA notices that a resident's gastrostomy tube (G-tube) site has a small amount of dried, brownish drainage around the stoma that was present on the previous shift as well and is documented as 'baseline.' The tube is patent and the resident has no complaints. What should the CNA do?

Answer: Gently clean the site with warm water and a washcloth per care plan, then document the unchanged appearance

Documented baseline drainage that is unchanged does not constitute a new finding. The CNA should perform routine stoma skin care per the care plan (typically cleaning with warm water) and document that the site appears at baseline. Leaving dried secretions in place risks skin breakdown. Hydrogen peroxide is not appropriate for routine stoma care. Reporting as 'new' when it is documented as baseline creates unnecessary alarm.

A CNA is helping transfer a resident from bed to wheelchair using a gait belt. Midway through the transfer, the resident's knees begin to buckle. What is the safest immediate response?

Answer: Guide the resident into a controlled lowering to the floor, protecting their head, rather than attempting to hold full body weight

When a resident begins to fall during a transfer, the safest response is to control the descent to the floor — bending your knees, widening your stance, and guiding the resident down while protecting their head. Attempting to catch or hold a falling resident's full weight risks injury to both the resident and the CNA. Holding in place is not sustainable and increases fall injury risk. Pivoting quickly to the bed introduces unpredictable movement that can worsen the fall.