Illinois Nurse Assistant Competency Exam — Questions and Answers

Question 1: A nurse aide is caring for an aphasic resident who cannot speak but can write. The nurse aide should:

Speak louder in hopes the resident will regain the ability to speak
Provide paper and pen so the resident can write their needs and preferences (Correct answer)
Make all decisions for the resident since they cannot communicate
Report to the charge nurse that the resident is uncooperative

Correct answer: Provide paper and pen so the resident can write their needs and preferences

Providing writing tools allows aphasic residents to communicate their needs and maintain autonomy despite the inability to speak.

Question 2: When transferring a resident from a wheelchair to a bed using a gait belt, where should the belt be placed?

Around the resident's hips below the waistline
Around the resident's waist over their clothing (Correct answer)
Over the resident's bare skin at the abdomen
Around the resident's chest just below the axillae

Correct answer: Around the resident's waist over their clothing

The gait belt is applied snugly around the waist over clothing, with fingers fitting underneath, to provide safe gripping during transfers.

Question 3: A resident with a fresh surgical wound is noted to have bright red blood saturating the dressing. The nurse aide should:

Apply pressure over the dressing and call for the nurse immediately (Correct answer)
Irrigate the wound with saline to clean it
Remove the dressing and apply a new one
Document the finding and monitor the wound every 15 minutes

Correct answer: Apply pressure over the dressing and call for the nurse immediately

Active bleeding requires direct pressure to slow it while the nurse is urgently notified, as dressing changes require a nurse's assessment and order.

Question 4: What does the term 'adverse drug reaction' (ADR) refer to?

A harmful or unintended response to a medication at a normal dose (Correct answer)
The desired therapeutic effect of a drug
A drug interaction that improves efficacy
A planned dose reduction due to age

Correct answer: A harmful or unintended response to a medication at a normal dose

An adverse drug reaction is an unintended, harmful response that occurs at doses normally used for therapeutic purposes.

Question 5: A bladder retraining program for a patient who is incontinent would include:

Restricting the patient's fluid intake to reduce accidents
Inserting a urinary catheter to eliminate the need for toileting
Limiting the patient's mobility so they remain near the bathroom
Offering the patient the opportunity to void on a scheduled, regular schedule (Correct answer)

Correct answer: Offering the patient the opportunity to void on a scheduled, regular schedule

Bladder retraining involves scheduled toileting at regular intervals to help the patient reestablish voluntary bladder control.

Question 6: What should you do if you suspect a fellow healthcare worker is engaging in abusive behavior towards a patient?

Confront the worker directly and demand they stop.
Keep it to yourself to avoid causing conflict.
Tell the patient to ignore the behavior and focus on their care.
Report your concerns to the appropriate supervisor or authority immediately. (Correct answer)

Correct answer: Report your concerns to the appropriate supervisor or authority immediately.

Healthcare professionals have an ethical and legal obligation to protect patients from harm, including abuse. Reporting suspected abuse immediately to a supervisor or authority ensures that the situation can be investigated promptly and appropriate action taken to safeguard the patient. This is crucial for patient safety and maintaining a safe care environment.

Question 7: When helping a patient ambulate with a walker, the nurse assistant should position themselves:

Beside the patient on their stronger side only
Behind and slightly to the side of the patient's weaker side (Correct answer)
Behind the patient with both hands on their shoulders
Directly in front of the patient to guide them forward

Correct answer: Behind and slightly to the side of the patient's weaker side

The nurse assistant stands behind and slightly to the side of the patient's weaker side to provide support while not interfering with the walker.

Question 8: When assisting a resident with a partial weight-bearing (PWB) status to ambulate, the nurse aide should ensure the resident:

Touches only their toes to the floor on the affected side (Correct answer)
Bears full weight on both legs to build strength
Keeps the affected limb completely off the floor
Uses no assistive device since partial weight-bearing is low risk

Correct answer: Touches only their toes to the floor on the affected side

Partial weight-bearing means the resident touches their toes or rests limited weight on the affected side as directed — not full weight and not no weight.

Question 9: If a patient asks for assistance with a task that is beyond the scope of a CNA's responsibilities, what should you do?

Refuse to help and tell the patient they must wait for a nurse
Politely explain that the task is outside your scope of practice and inform a nurse. (Correct answer)
Agree to help the patient, as you are trying to be helpful.
Ignore the request and continue with your other duties.

Correct answer: Politely explain that the task is outside your scope of practice and inform a nurse.

CNAs have a defined scope of practice, and performing tasks outside of it can jeopardize patient safety and lead to legal issues. Politely explaining this limitation respects the patient while also ensuring that the request is directed to the appropriate healthcare professional, such as a nurse, who is qualified to handle it. This maintains professional boundaries and ensures the patient receives proper care.

Question 10: When applying elastic (TED) stockings, the nursing assistant should put them on:

Only at bedtime when swelling is greatest
While the resident is still in bed with legs elevated (Correct answer)
After the resident has been sitting up for 30 minutes
After the resident has walked to promote circulation

Correct answer: While the resident is still in bed with legs elevated

Elastic stockings should be applied before the resident gets out of bed to prevent blood from pooling in the legs while supine.

Question 11: When measuring a resident's blood pressure, the cuff should be placed:

About 1 inch above the antecubital space (Correct answer)
Loosely around the upper arm with two fingers gap
Below the wrist on the forearm
Directly over thick clothing for convenience

Correct answer: About 1 inch above the antecubital space

The lower edge of the blood pressure cuff should sit approximately 1 inch (2–3 cm) above the antecubital fossa for accurate readings.

Question 12: A resident's oxygen concentrator alarm sounds and the resident appears short of breath. The nursing assistant should:

Check the tubing for kinks, ensure the machine is plugged in, and immediately notify the nurse (Correct answer)
Increase the oxygen flow rate independently
Turn off the alarm and reassure the resident
Document the alarm and check back in an hour

Correct answer: Check the tubing for kinks, ensure the machine is plugged in, and immediately notify the nurse

A quick equipment check followed by immediate nurse notification ensures the resident receives timely clinical evaluation for a potentially life-threatening situation.

Question 13: A nursing assistant is observing a patient's respirations. Which finding requires immediate reporting?

Respirations of 8 per minute with periods of no breathing (Correct answer)
Rate of 16 breaths per minute
Slight variation in depth between breaths
Regular rhythm with equal depth

Correct answer: Respirations of 8 per minute with periods of no breathing

A rate of 8 breaths per minute with apnea periods is dangerously low and requires immediate reporting.

Question 14: What is the purpose of using open-ended questions when communicating with patients?

To encourage the patient to share more information in their own words (Correct answer)
To get quick yes-or-no answers for documentation efficiency
To test the patient's cognitive ability
To limit the conversation to necessary topics

Correct answer: To encourage the patient to share more information in their own words

Open-ended questions invite patients to express themselves fully, giving the care team richer information.

Question 15: What is the normal range for an adult's body temperature?

96°F to 98°F
95°F to 97°F
98.6°F to 100°F (Correct answer)
100°F to 102°F

Correct answer: 98.6°F to 100°F

The normal range for an adult's body temperature is generally considered to be 98.6°F (37°C), but it can fluctuate slightly. A range of 98.6°F to 100°F is typically considered within the normal limits, with variations depending on the individual, time of day, and measurement site. Temperatures above this range may indicate a fever, while significantly lower temperatures could suggest hypothermia.

Question 16: The purpose of using a draw sheet (lift sheet) when moving a resident up in bed is to:

Restrain the resident during repositioning
Reduce friction and shear forces on the resident's skin (Correct answer)
Keep the resident warm during the move
Replace the need for a second caregiver

Correct answer: Reduce friction and shear forces on the resident's skin

A draw sheet allows caregivers to slide the resident smoothly, reducing friction and shear that can damage fragile skin.

Question 17: A nursing assistant is measuring a patient's weight and notices a gain of 5 pounds since yesterday. This should be:

Ignored since daily fluctuations are normal
Rechecked in one week before reporting
Attributed to the patient eating more and not documented
Reported to the nurse as it may indicate fluid retention (Correct answer)

Correct answer: Reported to the nurse as it may indicate fluid retention

A sudden 5-pound weight gain can indicate fluid retention, which may signal cardiac or kidney problems and must be reported.

Question 18: A patient is about to be discharged and looks confused about their home care plan. The nurse aide should:

Notify the nurse that the patient appears confused about their plan (Correct answer)
Provide a full explanation of the discharge instructions
Reassure them it will be fine and help them pack
Encourage the patient to figure it out once they are home

Correct answer: Notify the nurse that the patient appears confused about their plan

Notifying the nurse ensures the patient receives proper discharge teaching within the appropriate scope of care.

Question 19: What is the most critical step before performing any clinical procedure?

Verifying patient identity and obtaining informed consent (Correct answer)
Checking the supply inventory
Reviewing the facility schedule
Updating the electronic record template

Correct answer: Verifying patient identity and obtaining informed consent

Patient identification and informed consent are essential safety measures that must precede any clinical procedure.

Question 20: Before applying a hearing aid, the nurse aide should verify the battery is working by:

Testing the aid with a battery tester only
Asking the resident if it worked yesterday
Turning up the volume and listening for a whistle (Correct answer)
Holding the device near a radio

Correct answer: Turning up the volume and listening for a whistle

Turning the volume up and cupping the hearing aid in the hand to listen for a whistle (feedback squeal) is the standard method to verify battery function.

Question 21: Which of the following best describes active-assistive range-of-motion exercises?

Resistance is added to strengthen muscles beyond normal range
The nurse assistant performs all movements without patient effort
The patient performs all movements independently without assistance
The patient uses their own strength assisted by the nurse assistant (Correct answer)

Correct answer: The patient uses their own strength assisted by the nurse assistant

Active-assistive ROM involves the patient using their own muscle strength with the nurse assistant providing additional support as needed.

Question 22: Which principle guides the selection of appropriate clinical interventions?

Tradition and historical practice only
Evidence-based practice guidelines (Correct answer)
Practitioner personal preference alone
Cost minimization as the sole factor

Correct answer: Evidence-based practice guidelines

Evidence-based practice integrates the best available research with clinical expertise and patient values to guide intervention selection.

Question 23: Which of the following is a nurse aide's ethical obligation when working with a resident who has dementia?

Agree with all delusions to make care easier, even harmful ones
Use therapeutic fibbing only when it prevents distress and is approved in the care plan (Correct answer)
Ignore the resident's verbal communications as they are not reliable
Correct the resident bluntly every time they state something inaccurate

Correct answer: Use therapeutic fibbing only when it prevents distress and is approved in the care plan

Therapeutic fibbing or validation techniques may be used when approved and necessary to avoid distress, but must never be used in a harmful or deceptive way.

Question 24: A resident's urinary output for an 8-hour shift is 150 mL. This finding should be:

Encouraged by offering more salt in the diet
Documented only at the end of the day
Considered normal and not mentioned
Reported to the nurse as it may indicate low output (Correct answer)

Correct answer: Reported to the nurse as it may indicate low output

Normal urine output is approximately 30 mL/hour; 150 mL in 8 hours (about 19 mL/hr) is below normal and must be reported.

Question 25: A nursing assistant notices a patient has not eaten 75% of their meal for the past three days. The BEST response is to:

Offer an alternative food without documenting
Assume the patient is not hungry and remove the tray
Encourage the patient to eat more and document intake accurately (Correct answer)
Tell the patient they must eat everything

Correct answer: Encourage the patient to eat more and document intake accurately

Documenting intake accurately and encouraging the patient alerts the nurse to potential nutritional concerns.

Question 26: When assisting a patient with personal hygiene, which of the following should you do first?

Assist the patient in brushing their teeth.
Provide oral care. (Correct answer)
Wash the patient's hands.
Comb the patient's hair.

Correct answer: Provide oral care.

When assisting a patient with personal hygiene, providing oral care is typically the first step. This helps to refresh the patient, remove bacteria, and can stimulate appetite if done before meals. Good oral hygiene is crucial for overall health and comfort, and it's often prioritized at the beginning of a hygiene routine.

Question 27: Which of the following is a common side effect of many narcotic pain medications that nurse aides should monitor for in residents?

Increased urine output
Hypertension
Diarrhea
Constipation (Correct answer)

Correct answer: Constipation

Narcotic analgesics slow gastrointestinal motility, frequently leading to constipation in residents receiving these medications.

Question 28: When is it appropriate to modify a standard clinical procedure?

Whenever it saves time
When patient-specific factors require adaptation based on clinical judgment (Correct answer)
Never, procedures must always be identical
Only when insurance requires changes

Correct answer: When patient-specific factors require adaptation based on clinical judgment

Clinical procedures may need modification based on individual patient factors, but changes should be guided by clinical judgment and documented.

Question 29: Which of the following statements about restorative care documentation is correct?

Only the physical therapist documents restorative care outcomes
Documentation is optional since restorative care is informal
Documentation is only required when the patient refuses care
The nurse assistant should document patient responses, participation, and any problems observed (Correct answer)

Correct answer: The nurse assistant should document patient responses, participation, and any problems observed

The nurse assistant must document the patient's participation, progress, and any concerns to ensure continuity of the restorative program.

Question 30: Which of the following is the correct procedure for assisting a patient with an unsteady gait to walk?

Walk behind the patient, supporting them by holding their arm. (Correct answer)
Walk in front of the patient to guide them forward.
Have the patient hold your arm while walking.
Always allow the patient to walk at their own pace without assistance.

Correct answer: Walk behind the patient, supporting them by holding their arm.

When assisting a patient with an unsteady gait to walk, the correct procedure is to walk slightly behind and to the side of the patient, providing support by holding their arm or using a gait belt. This position allows you to support them if they lose balance and prevents them from falling backward. Walking in front or having them hold your arm offers less effective support for an unsteady gait.

Question 31: A nursing assistant notices a patient's drainage tube is putting out less fluid than usual and the patient's abdomen appears more distended. This should be:

Corrected by repositioning the tube without notifying the nurse
Reported to the nurse immediately as it may indicate a blockage (Correct answer)
Noted and documented at the end of the shift only
Ignored since output can vary throughout the day

Correct answer: Reported to the nurse immediately as it may indicate a blockage

Decreased tube output combined with abdominal distension may indicate a blocked tube, requiring immediate nursing evaluation.

Question 32: Which of the following is an important step when assisting a patient with a bed bath?

Use soap only on the face and legs.
Do not provide privacy to the patient.
Expose only the area you are washing to ensure privacy. (Correct answer)
Ensure the water temperature is between 110°F and 120°F.

Correct answer: Expose only the area you are washing to ensure privacy.

When assisting a patient with a bed bath, it is crucial to expose only the area you are currently washing. This practice maintains the patient's dignity and privacy, which is a fundamental aspect of patient-centered care. Keeping other areas covered also helps to prevent chilling and maintain comfort.

Question 33: A nurse aide disagrees with a care plan decision made by the nurse. The best professional response is to:

Follow the plan without ever expressing a concern
Voice concerns to the nurse through proper communication channels (Correct answer)
Change the care approach without telling the nurse
Complain to other aides and do nothing official

Correct answer: Voice concerns to the nurse through proper communication channels

Professional ethics require raising concerns respectfully through proper channels rather than unilaterally changing care or remaining silent.

Question 34: What does the term 'flow sheet' refer to in long-term care documentation?

A list of all medications a resident is prescribed
A water intake tracking form only
A document tracking the flow of residents in and out of the facility
A preprinted form used to record routine care such as vital signs and ADLs (Correct answer)

Correct answer: A preprinted form used to record routine care such as vital signs and ADLs

Flow sheets allow staff to quickly document repetitive, routine care activities in a standardized format.

Question 35: Which observation about a resident's stool should be reported to the nurse immediately?

Soft stool following a high-fiber meal
Brown, formed stool with mild odor
Yellow stool in a breast-fed infant
Dark tarry stool (melena) (Correct answer)

Correct answer: Dark tarry stool (melena)

Dark, tarry (melena) stool indicates possible upper gastrointestinal bleeding and must be reported to the nurse immediately.

Question 36: Which behavior best demonstrates ethical conduct for a nurse aide?

Prioritizing care for residents who give better tips or gifts
Telling a resident what is best for them regardless of their wishes
Sharing interesting resident stories with family at home
Treating all residents equally regardless of their behavior or background (Correct answer)

Correct answer: Treating all residents equally regardless of their behavior or background

Ethical conduct requires treating all residents with equal dignity and respect regardless of their personality, behavior, or background.

Question 37: A nurse aide accidentally gives a resident the wrong meal tray, and the resident has a serious food allergy. This is an example of:

Malpractice
Battery
Negligence (Correct answer)
Slander

Correct answer: Negligence

Negligence occurs when a caregiver fails to provide the standard of care expected, resulting in harm—such as delivering an allergen-containing tray to the wrong resident.

Question 38: A resident receiving enteral (tube) feeding begins coughing, gagging, and showing signs of respiratory distress. The nursing assistant should:

Stop the feeding and call the nurse immediately (Correct answer)
Reposition the tube and continue the feeding
Give the resident water to clear the discomfort
Increase the feeding rate to get it done faster

Correct answer: Stop the feeding and call the nurse immediately

These symptoms suggest aspiration or tube displacement; feeding must stop immediately and the nurse must be notified.

Question 39: A nursing assistant measures a patient's blood glucose using a glucometer and gets a reading of 48 mg/dL. The correct action is to:

Assume the device is inaccurate and repeat in 30 minutes
Encourage the patient to rest and monitor for symptoms
Give the patient orange juice and report to the nurse immediately (Correct answer)
Document the reading and check again at the next scheduled time

Correct answer: Give the patient orange juice and report to the nurse immediately

A blood glucose of 48 mg/dL is dangerously low hypoglycemia; providing a fast-acting sugar and notifying the nurse immediately is critical.

Question 40: Which behavior change in a dementia patient should be reported to the nurse?

Patient suddenly becomes aggressive and combative without apparent cause (Correct answer)
Patient enjoys watching television in the common area
Patient is calm and cooperative during morning care
Patient asks to call a family member

Correct answer: Patient suddenly becomes aggressive and combative without apparent cause

Sudden unexplained aggression in a dementia patient can indicate pain, infection, or another medical issue requiring assessment.

Question 41: A nursing assistant notices a resident has not eaten more than 25% of meals for three consecutive days. The priority action is to:

Supplement meals with extra salt to improve taste
Offer the resident a larger portion at the next meal
Assume the resident is dieting and take no action
Document the intake and report the pattern to the nurse (Correct answer)

Correct answer: Document the intake and report the pattern to the nurse

Consistently poor food intake is a significant finding that can indicate medical or psychological issues and must be reported to the nurse.

Question 42: Which action by a nursing assistant demonstrates respect for a resident's cultural and religious beliefs during care?

Assuming all residents from the same background share identical practices
Proceeding with standard care routines regardless of stated beliefs
Reporting the resident's beliefs to the charge nurse as a problem
Asking the resident about preferences and accommodating them when possible (Correct answer)

Correct answer: Asking the resident about preferences and accommodating them when possible

Person-centered care requires nursing assistants to ask about and honor individual cultural and religious preferences when delivering care.

Question 43: What is the proper technique for taking a patient's pulse?

Press the index and middle fingers on the patient’s wrist or neck. (Correct answer)
Place the wrist on the patient’s chest and listen for a heartbeat.
Use your thumb to check the pulse.
Use the palm of your hand to check the pulse.

Correct answer: Press the index and middle fingers on the patient’s wrist or neck.

The proper technique for taking a patient's pulse involves using the pads of your index and middle fingers, not your thumb, to gently press on an artery. Common sites are the radial artery in the wrist or the carotid artery in the neck. This allows you to feel the pulsations and accurately count the heart rate.

Question 44: A confused resident tries to climb out of bed at night. The most appropriate nursing assistant action is to:

Apply wrist restraints to keep the resident in bed
Lower the bed to its lowest position and place the call light within reach (Correct answer)
Raise all side rails to their highest position
Tell the resident firmly to stay in bed

Correct answer: Lower the bed to its lowest position and place the call light within reach

Lowering the bed and ensuring call-light access are safe, non-restraint interventions that reduce fall injury risk.

Question 45: Which of the following is the correct procedure when documenting a patient’s vital signs?

Wait until the end of your shift to document vital signs.
Use general terms like “normal” or “stable” to describe vital signs.
Document the vital signs before taking them.
Record the vital signs in a timely manner, using the correct time and date. (Correct answer)

Correct answer: Record the vital signs in a timely manner, using the correct time and date.

Accurate and timely documentation of vital signs is crucial for patient safety and effective care planning. Recording them immediately after measurement ensures the information is current and prevents errors or omissions that could occur if documentation is delayed. This practice provides an accurate snapshot of the patient's condition at a specific moment, which is essential for monitoring changes and making informed medical decisions.

Question 46: A patient complains of chest pain and shortness of breath. The nursing assistant should:

Ask the patient to rate their pain and check back in an hour
Reassure the patient and help them relax
Help the patient walk to the nurses' station to report it
Call for the nurse immediately and stay with the patient (Correct answer)

Correct answer: Call for the nurse immediately and stay with the patient

Chest pain with shortness of breath can indicate a cardiac or pulmonary emergency; the nurse must be called immediately.

Question 47: A resident with an indwelling urinary catheter has urine that appears cloudy with a foul odor. The nursing assistant should:

Report the findings to the nurse immediately (Correct answer)
Irrigate the catheter with sterile water
Change the catheter bag
Increase the resident's fluid intake and monitor

Correct answer: Report the findings to the nurse immediately

Cloudy, foul-smelling urine in a catheterized resident is a sign of possible infection and requires immediate nurse notification.

Question 48: A resident's family member asks the nursing assistant about the resident's diagnosis. The nursing assistant should:

Whisper the diagnosis quietly so other residents don't hear
Explain that sharing medical information is not within their role and refer to the nurse (Correct answer)
Look up the chart and summarize key findings for the family
Share the diagnosis since the family has a right to know

Correct answer: Explain that sharing medical information is not within their role and refer to the nurse

Disclosing medical information is outside the nursing assistant's scope and may violate HIPAA; the nurse or physician should handle such requests.

Question 49: When should documentation of a service or intervention be completed?

At the end of the week in a batch
Only when requested by a supervisor
As soon as possible after the service is provided (Correct answer)
Within 30 days of service

Correct answer: As soon as possible after the service is provided

Timely documentation ensures accuracy and completeness, as details are freshest immediately after service delivery.

Question 50: When caring for a resident in contact precautions, the nursing assistant should wear gloves and gown:

Only when performing personal care tasks
Only when touching the resident's wound site
Only if the resident is visibly soiled
Whenever entering the resident's room (Correct answer)

Correct answer: Whenever entering the resident's room

Contact precautions require gloves and gown upon entry into the room because contaminated surfaces can spread pathogens even without direct patient contact.

Question 51: What is the purpose of transmission-based precautions?

To provide additional protection for patients with specific infections (Correct answer)
To simplify the care process
To replace standard precautions entirely
To reduce supply costs

Correct answer: To provide additional protection for patients with specific infections

Transmission-based precautions supplement standard precautions for patients with known or suspected infections requiring additional safeguards.

Question 52: A nursing assistant is preparing to perform perineal care on a female resident. In which direction should cleansing strokes be made?

From the rectum outward in all directions
Side to side in a circular motion
Back to front
Front to back (Correct answer)

Correct answer: Front to back

Cleansing front to back (from the urethral meatus toward the rectum) prevents fecal bacteria from contaminating the urethra and reducing UTI risk.

Question 53: A resident refuses to eat breakfast. The nursing assistant should first:

Call the family to convince the resident
Ask the resident why they are not eating and report the refusal to the nurse (Correct answer)
Remove the tray and document the refusal without comment
Insist the resident eat to maintain nutrition

Correct answer: Ask the resident why they are not eating and report the refusal to the nurse

The nursing assistant should respectfully ask about the refusal, then report it to the nurse so the care team can assess the cause.

Question 54: A nurse aide who uses social media posts a photo of a resident (with their face visible) to share a 'heartwarming moment.' This is:

Allowed if the resident smiled and seemed to consent at the time
Fine as long as the photo is set to private on their profile
A serious HIPAA violation that can lead to termination and legal action (Correct answer)
Acceptable if the caption does not include the resident's name

Correct answer: A serious HIPAA violation that can lead to termination and legal action

Posting any identifiable resident image on social media without formal written consent violates HIPAA and patient privacy laws.

Question 55: What is the foundational principle of professional ethics in INACE practice?

Following only personal moral beliefs
Acting in the best interest of the client or patient (Correct answer)
Avoiding all risk-taking
Maximizing organizational revenue

Correct answer: Acting in the best interest of the client or patient

The core of professional ethics is prioritizing the welfare and best interests of clients or patients above other considerations.

Question 56: When performing CPR on an adult, what is the recommended compression depth?

At least 2 inches (5 cm) (Correct answer)
At least 1 inch (2.5 cm)
At least 3 inches (7.5 cm)
At least 4 inches (10 cm)

Correct answer: At least 2 inches (5 cm)

Current guidelines recommend chest compressions of at least 2 inches deep for adults to effectively circulate blood.

Question 57: Which resident is at HIGHEST risk for developing a pressure injury?

A resident who is bedridden, incontinent, and has poor circulation (Correct answer)
An ambulatory resident who is continent and well-nourished
A resident who is overweight but fully mobile
A resident who changes position independently every two hours

Correct answer: A resident who is bedridden, incontinent, and has poor circulation

Immobility, incontinence, and poor circulation are major risk factors for pressure injuries as they lead to prolonged pressure and skin breakdown.

Question 58: What is the purpose of reassessment in ongoing patient care?

To generate additional billing codes
To complete regulatory paperwork only
To monitor treatment effectiveness and adjust the care plan (Correct answer)
To satisfy accreditation requirements exclusively

Correct answer: To monitor treatment effectiveness and adjust the care plan

Reassessment monitors how well the treatment plan is working and identifies needed adjustments to optimize patient outcomes.

Question 59: Which of the following practices helps prevent medication errors related to look-alike or sound-alike drug names?

Relying on memory rather than checking labels
Using tall man lettering and verifying spelling carefully on the MAR (Correct answer)
Grouping similar-looking medications together in the cart
Asking another aide to confirm the drug name verbally

Correct answer: Using tall man lettering and verifying spelling carefully on the MAR

Tall man lettering (e.g., HYDROmorphone vs. HYDROcodone) and careful MAR verification reduce confusion between look-alike or sound-alike drugs.

Question 60: A patient tells you they do not want a certain procedure done. What is the nurse aide's responsibility?

Report the refusal to the nurse immediately without forcing care (Correct answer)
Proceed with the procedure since it is ordered by the doctor
Document the refusal and say nothing to anyone
Try to convince the patient by explaining all the risks of refusal

Correct answer: Report the refusal to the nurse immediately without forcing care

Patients have the right to refuse care, and it is the nurse aide's duty to report this to the nurse promptly.

Question 61: A resident requests that their roommate not be told about their new diagnosis. The nurse aide should:

Respect the resident's privacy and share nothing with the roommate (Correct answer)
Ask the roommate if they would like to know
Mention it casually as it is already on the facility floor
Tell the roommate anyway to maintain transparency

Correct answer: Respect the resident's privacy and share nothing with the roommate

Each resident's medical information is strictly confidential and must not be disclosed to other residents or unrelated parties.

Question 62: A resident's stool appears black and tarry. The nursing assistant's best response is to:

Encourage more fiber in the diet
Assume the resident ate dark-colored foods and disregard it
Report the observation to the nurse right away (Correct answer)
Administer a laxative as per routine

Correct answer: Report the observation to the nurse right away

Black, tarry stool (melena) can indicate upper gastrointestinal bleeding and must be reported to the nurse immediately.

Question 63: When communicating with a non-English-speaking patient, which of the following is the most appropriate action?

Use a family member to translate the conversation.
Assume the patient understands based on gestures.
Speak louder to help the patient understand.
Use a professional interpreter to ensure accurate communication. (Correct answer)

Correct answer: Use a professional interpreter to ensure accurate communication.

Using a professional interpreter ensures that medical information is conveyed accurately and completely, respecting cultural nuances and avoiding misunderstandings. Unlike family members, professional interpreters are trained in medical terminology and ethics, guaranteeing patient confidentiality and unbiased communication. This approach is crucial for obtaining informed consent, assessing symptoms, and providing appropriate care to non-English-speaking patients.

Question 64: When assisting a resident with a colostomy bag, the nursing assistant should empty the pouch when it is:

Once per day regardless of fill level
Only when the resident requests
One-third to one-half full (Correct answer)
Completely full

Correct answer: One-third to one-half full

Emptying the colostomy pouch when one-third to one-half full prevents leakage and skin breakdown.

Question 65: A nurse aide observes redness on a resident's coccyx. Which action should be taken first?

Reposition the resident and document at the end of the week
Apply lotion and continue the shift
Document the finding and report it immediately to the charge nurse (Correct answer)
Wait until the end of the shift to report it

Correct answer: Document the finding and report it immediately to the charge nurse

Skin breakdown is a reportable change in condition that requires immediate documentation and nursing assessment.

Question 66: Which assessment tool is most commonly used to evaluate cognitive function?

Glasgow Coma Scale only
Body Mass Index (BMI)
Visual Analog Scale (VAS)
Mini-Mental State Examination (MMSE) (Correct answer)

Correct answer: Mini-Mental State Examination (MMSE)

The MMSE is widely used to screen for cognitive impairment and track changes in cognitive function over time.

Question 67: Which statement about using side rails is accurate under current nursing home safety standards?

Full side rails on both sides can be raised routinely as a safety measure
Nursing assistants may independently decide to raise full side rails
Side rails are classified as restraints if they prevent the resident from getting out of bed (Correct answer)
Side rails must always be fully raised for all residents at night

Correct answer: Side rails are classified as restraints if they prevent the resident from getting out of bed

CMS guidelines classify raised full side rails as restraints when they restrict a resident's ability to exit the bed voluntarily.

Question 68: A resident's nasogastric (NG) tube has become dislodged. The nurse aide's first action should be:

Clamp the tube and document the finding
Tape the tube back in place and continue feeding
Reinsert the tube to restore feeding
Notify the nurse immediately (Correct answer)

Correct answer: Notify the nurse immediately

The nurse aide must immediately notify the nurse because reinserting an NG tube is outside the scope of practice for a CNA.

Question 69: When caring for a resident who has sequential compression devices (SCDs) on their legs, the nurse aide should:

Remove the SCDs only when the resident is ambulating (Correct answer)
Apply SCDs only at night
Leave SCDs in place at all times, including during ambulation
Remove SCDs whenever the resident requests rest

Correct answer: Remove the SCDs only when the resident is ambulating

SCDs are removed when the resident ambulates, as walking itself provides the circulatory benefit the device is designed to deliver.

Question 70: When measuring a patient's blood pressure, you should place the cuff:

Around the patient’s neck.
Over the patient’s wrist.
Around the patient’s ankle.
Just above the elbow. (Correct answer)

Correct answer: Just above the elbow.

When measuring a patient's blood pressure, the cuff should be placed on the upper arm, with the lower edge positioned approximately one inch (2.5 cm) above the antecubital fossa (the crease of the elbow). This ensures the cuff is correctly positioned over the brachial artery for accurate measurement. Incorrect placement can lead to inaccurate readings.

Question 71: When assessing capillary refill time, the nursing assistant presses on a patient's fingernail and releases. Normal color should return within:

15 seconds
2 seconds (Correct answer)
5 seconds
10 seconds

Correct answer: 2 seconds

Normal capillary refill time is less than 2 seconds; longer times may indicate poor circulation.

Question 72: Which situation represents a conflict of interest for a nurse aide?

Attending a facility in-service training on fire safety
Completing required continuing education hours
Using a gait belt taught in orientation for resident transfers
Being listed as a beneficiary in a resident's will (Correct answer)

Correct answer: Being listed as a beneficiary in a resident's will

Being named in a resident's will creates a financial conflict of interest and is prohibited; it can also be considered financial exploitation.

Question 73: Which statement by a nurse aide demonstrates professional boundaries in communication?

'I'll tell you a secret about another patient to make you feel better.'
'I'll give you my personal phone number so you can call me anytime.'
'You can count on me to be here and give you the best care I can during my shift.' (Correct answer)
'You're my favorite patient — I'll make sure you get special treatment.'

Correct answer: 'You can count on me to be here and give you the best care I can during my shift.'

Offering reliable care during a shift maintains professional boundaries while still conveying commitment and compassion.

Question 74: Which action by the NA correctly demonstrates disaster preparedness?

Keeping personal cell phone charged to livestream emergencies
Locking all supply closets before evacuating residents
Memorizing the location of emergency exits and fire extinguishers on their unit (Correct answer)
Deciding independently which residents to evacuate first

Correct answer: Memorizing the location of emergency exits and fire extinguishers on their unit

Knowing the location of exits and emergency equipment is essential disaster preparedness for the NA.

Question 75: A resident with a hearing impairment does not have their hearing aids in. What is the BEST communication strategy?

Shout directly into the resident's ear
Speak to the family member present instead of the resident
Face the resident, speak clearly and at a moderate pace, and use gestures (Correct answer)
Write all communication on paper since speaking is ineffective

Correct answer: Face the resident, speak clearly and at a moderate pace, and use gestures

Facing the resident and speaking clearly allows lip-reading and visual cues, which are important communication aids for hearing-impaired individuals.

Question 76: Which type of communication includes facial expressions, body posture, and eye contact?

Verbal communication
Written communication
Therapeutic communication
Non-verbal communication (Correct answer)

Correct answer: Non-verbal communication

Non-verbal communication encompasses all body language signals, which often convey emotions and attitudes more powerfully than words alone.

Question 77: When collecting a clean-catch midstream urine specimen, what is the first step the nursing assistant must teach the resident?

Clean the urethral area with antiseptic wipes before starting to urinate (Correct answer)
Collect the first stream of urine into the cup
Refrigerate the cup before use
Begin urinating directly into the specimen cup

Correct answer: Clean the urethral area with antiseptic wipes before starting to urinate

Cleaning the perineal area before collection removes contaminants to ensure an accurate specimen.

Question 78: What is the significance of the expiration date on a medication label?

It marks the date after which the medication may no longer be safe or effective (Correct answer)
It indicates when the prescription was written
It shows when the medication should be reordered from the pharmacy
It tells the nurse aide how long ago the medication was dispensed

Correct answer: It marks the date after which the medication may no longer be safe or effective

After the expiration date, a medication's potency or safety cannot be guaranteed, and it should not be administered.

Question 79: What is the first action you should take if a patient falls?

Check for injuries before moving the patient. (Correct answer)
Call for help, then lift the patient back into bed.
Immediately move the patient to a sitting position.
Take the patient’s vital signs right away.

Correct answer: Check for injuries before moving the patient.

If a patient falls, the immediate first action is to check for any injuries before attempting to move them. Moving an injured patient without assessing their condition could worsen potential fractures or other trauma. Once injuries are assessed and deemed safe, or medical help arrives, a plan for movement can be made.

Question 80: When a nurse aide witnesses an incident involving a resident, proper documentation should be:

Objective, factual, and completed promptly after the incident (Correct answer)
Delayed until the charge nurse has time to observe the situation
Written in pencil so corrections can be made easily
Subjective and include the aide's personal opinions about what happened

Correct answer: Objective, factual, and completed promptly after the incident

Proper documentation must be objective, factual, and completed in a timely manner to ensure an accurate legal record.

Question 81: What role does nonverbal communication play in professional interactions?

It conveys up to 70% of the message and must align with verbal communication (Correct answer)
It replaces the need for verbal communication
It is irrelevant in professional settings
It only matters during presentations

Correct answer: It conveys up to 70% of the message and must align with verbal communication

Nonverbal cues including body language, tone, and facial expressions significantly impact how messages are received and interpreted.

Question 82: What information should be provided when calling emergency services?

Just your name and phone number
Only the address
Only the type of emergency
Location, nature of emergency, number of victims, and current condition (Correct answer)

Correct answer: Location, nature of emergency, number of victims, and current condition

Complete information helps dispatchers send appropriate resources and provide pre-arrival instructions.

Question 83: During a bed bath, the water temperature should be tested by the nurse aide using:

A thermometer set to exactly 98.6°F
The inside of the wrist before applying to the resident (Correct answer)
The resident's verbal confirmation only
The back of the hand after the bath begins

Correct answer: The inside of the wrist before applying to the resident

The inside of the wrist is sensitive to temperature and is used to test water before exposing the resident to avoid burns.

Question 84: Which of the following actions breaks the chain of infection at the 'mode of transmission' link?

Wearing gloves and washing hands between patient contacts (Correct answer)
Administering antibiotics to treat an existing infection
Immunizing residents against influenza
Isolating an infected patient in a private room

Correct answer: Wearing gloves and washing hands between patient contacts

Hand hygiene and barrier precautions interrupt the pathway by which pathogens travel from reservoir to host, directly breaking the mode of transmission link.

Question 85: A resident with diabetes reports feeling shaky, sweaty, and confused between meals. The nursing assistant should:

Withhold food until the next scheduled meal
Report symptoms to the nurse immediately as signs of hypoglycemia (Correct answer)
Offer a high-fiber snack and monitor
Tell the resident to rest and check back in an hour

Correct answer: Report symptoms to the nurse immediately as signs of hypoglycemia

Shakiness, diaphoresis, and confusion in a diabetic resident suggest hypoglycemia, which is a medical emergency requiring immediate nurse notification.

Question 86: When a nursing assistant observes signs of a possible stroke in a resident (facial drooping, arm weakness, speech difficulty), the correct action is to:

Call for the nurse immediately and note the time symptoms began (Correct answer)
Let the resident rest and check again in 30 minutes
Help the resident walk to the nurses' station
Give the resident water to see if swallowing improves

Correct answer: Call for the nurse immediately and note the time symptoms began

Stroke is a medical emergency where time is critical; immediately alerting the nurse and noting symptom onset time enables faster life-saving treatment decisions.

Question 87: Which position is most appropriate for a resident who is experiencing difficulty breathing (dyspnea)?

Prone (face down)
Fowler's or semi-Fowler's position (Correct answer)
Left lateral (Sims') position
Supine (flat on back)

Correct answer: Fowler's or semi-Fowler's position

Fowler's or semi-Fowler's position elevates the head and chest, allowing the diaphragm to descend and improving lung expansion.

Illinois Nurse Assistant Competency Exam

The INACE certifies nurse assistants in Illinois, testing knowledge of basic nursing skills, patient care, safety procedures, and professional responsibilities required for CNA certification.

Questions

90 min

Time Limit

70%

To Pass

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These practice questions were written with AI tools. They are not real exam questions. Exam facts are checked against the official sources listed below. Not reviewed by a subject-matter expert. Editorial policy

Sources & references

Exam facts on this page (fees, format, dates, passing scores) are checked against these official sources; the date is our last check. Editorial policy

dph.illinois.gov — Score validity · verified Oct 2026
nurseaidetesting.com — Test dates, test delivery, eligibility, passing score, retake policy, score release, fees, retake fee · verified Oct 2026