Illinois Nurse Assistant Competency Exam — Questions and Answers

Question 1: A resident with diabetes reports feeling shaky, sweaty, and confused between meals. The nursing assistant should:

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

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 2: If a patient refuses to participate in their restorative care exercises, the nurse assistant should:

Offer rewards to bribe the patient into compliance
Skip restorative care permanently since the patient refused
Respect the refusal, document it, and report it to the nurse (Correct answer)
Force the patient to perform the exercises to maintain their care plan

Correct answer: Respect the refusal, document it, and report it to the nurse

Patients have the right to refuse care; the nurse assistant must respect this, document the refusal, and notify the nurse.

Question 3: When caring for a resident in contact precautions, the nursing assistant should wear gloves and gown:

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

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

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

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 5: When making an occupied bed, the nursing assistant should raise the bed to:

The highest position and leave it raised
A comfortable working height, then lower it when finished (Correct answer)
Knee height only
The lowest position throughout

Correct answer: A comfortable working height, then lower it when finished

Raising the bed to working height prevents back injury; it must be lowered to the lowest position after care is complete for resident safety.

Question 6: A nurse aide notices bruising in unusual locations on a resident who is not mobile. This should FIRST be:

Reported immediately to the charge nurse (Correct answer)
Discussed with the resident's roommate
Photographed by the nurse aide for evidence
Documented in the nurse aide's personal notes

Correct answer: Reported immediately to the charge nurse

Unexplained bruising on an immobile resident is a potential sign of abuse that must be reported immediately to the charge nurse.

Question 7: Which principle guides the selection of appropriate clinical interventions?

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

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 8: When assessing a patient's level of consciousness, which response indicates the LOWEST level of responsiveness?

Patient responds only to pain (Correct answer)
Patient is drowsy but arousable
Patient responds to verbal commands
Patient is confused but oriented to name

Correct answer: Patient responds only to pain

Responding only to painful stimuli indicates a severely decreased level of consciousness.

Question 9: A bladder retraining program for a patient who is incontinent would include:

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

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

Asking the resident if it worked yesterday
Turning up the volume and listening for a whistle (Correct answer)
Testing the aid with a battery tester only
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 11: A nursing assistant is preparing to perform perineal care on a female resident. In which direction should cleansing strokes be made?

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

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

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

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 13: What is the purpose of the Illinois Health Care Worker Background Check Act for nurse aides?

To confirm that aides have completed at least five years of experience
To ensure aides have passed an English language proficiency test
To protect residents by screening out individuals with disqualifying criminal histories (Correct answer)
To verify that aides have college degrees in nursing

Correct answer: To protect residents by screening out individuals with disqualifying criminal histories

Illinois law requires background checks for health care workers to protect vulnerable residents from individuals with histories of abuse or relevant crimes.

Question 14: Which resident is at HIGHEST risk for developing a pressure injury?

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

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 15: A resident's advance directive states 'Do Not Resuscitate' (DNR). The nursing assistant finds the resident unresponsive and not breathing. The correct action is to:

Begin CPR because the nursing assistant's duty overrides the DNR
Begin CPR while another staff member checks the chart
Wait 5 minutes before notifying the nurse
Call for the nurse immediately without beginning CPR (Correct answer)

Correct answer: Call for the nurse immediately without beginning CPR

A valid DNR order means CPR should not be initiated; the nursing assistant must notify the nurse immediately and follow the documented care plan.

Question 16: Which action is correct when applying an elastic (ACE) bandage to a resident's lower leg?

Wrap from the foot upward toward the knee (Correct answer)
Wrap in a figure-eight pattern starting at the thigh
Apply the bandage as tightly as possible for best support
Wrap from the knee downward toward the foot

Correct answer: Wrap from the foot upward toward the knee

Elastic bandages are applied from distal to proximal (foot to knee) to promote venous return and prevent swelling.

Question 17: A resident's urinary catheter drainage bag should always be positioned:

Clipped to the bedrail at mattress height
Above the level of the bladder
At the same level as the bladder
Below the level of the bladder (Correct answer)

Correct answer: Below the level of the bladder

The drainage bag must remain below bladder level at all times to allow urine to drain by gravity and prevent backflow.

Question 18: When documenting medication administration, which information is most essential to record?

The name of the pharmacist who dispensed the drug
The time, dose, route, and any resident response (Correct answer)
The cost of the medication
The resident's insurance provider

Correct answer: The time, dose, route, and any resident response

Accurate documentation of time, dose, route, and resident response ensures continuity of care and legal accountability.

Question 19: When performing mouth care on an unconscious resident, the nurse aide should position the resident:

In a high Fowler's position
Flat on their back with head tilted back
In a prone position
On their side with head turned to the side (Correct answer)

Correct answer: On their side with head turned to the side

Positioning an unconscious resident on their side with the head turned prevents aspiration of fluids during oral care.

Question 20: Which action BEST helps a nursing assistant accurately measure a patient's blood pressure?

Have the patient cross their legs during measurement
Take the measurement while the patient is walking
Allow the patient to rest quietly for at least 5 minutes before measurement (Correct answer)
Place the cuff over thick clothing for comfort

Correct answer: Allow the patient to rest quietly for at least 5 minutes before measurement

Allowing the patient to rest 5 minutes before measurement ensures a more accurate baseline blood pressure reading.

Question 21: While assisting a resident with a bath, the NA notices the resident's face drooping on one side. The BEST immediate action is:

Help the resident lie down and dim the lights
Give the resident a drink of water to see if swallowing is normal
Continue the bath and report at end of shift
Stop the activity, stay with the resident, and call for the nurse immediately (Correct answer)

Correct answer: Stop the activity, stay with the resident, and call for the nurse immediately

Facial drooping is a stroke warning sign; the NA must stop all activities and summon the nurse immediately.

Question 22: 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)
Use your thumb to check the pulse.
Place the wrist on the patient’s chest and listen for a heartbeat.
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 23: A resident tells the nurse aide, 'I haven't had a bowel movement in four days.' How should the aide respond first?

Encourage the resident to drink more water and forget it
Document the complaint and report it to the charge nurse immediately (Correct answer)
Administer a laxative from the medication cart
Tell the resident this is normal and nothing to worry about

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

Reporting and documenting changes in elimination patterns allows the charge nurse to assess and intervene appropriately.

Question 24: What is the correct way for a nursing assistant to respond when a resident refuses a prescribed treatment?

Postpone reporting until the end of the shift
Proceed with the treatment since it is prescribed
Document the refusal and report it to the nurse (Correct answer)
Convince the resident by explaining it is doctor's orders

Correct answer: Document the refusal and report it to the nurse

Competent residents have the right to refuse treatment; the nursing assistant must document and promptly report the refusal to the nurse.

Question 25: Which adaptive device would most help a patient with limited hand grip to eat independently?

A feeding tube placed by the nurse
A standard metal fork and knife
Blended food to eliminate the need for utensils
Built-up handled utensils with thick grips (Correct answer)

Correct answer: Built-up handled utensils with thick grips

Built-up handled utensils have wider grips that require less hand strength and dexterity, promoting independent eating.

Question 26: When is it appropriate to modify a standard clinical procedure?

Never, procedures must always be identical
When patient-specific factors require adaptation based on clinical judgment (Correct answer)
Whenever it saves time
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 27: When assisting a resident with the use of an incentive spirometer, the nurse aide should instruct the resident to:

Use the device only in a sitting position in a chair
Hold their breath for 30 seconds after each breath
Exhale deeply and forcefully into the mouthpiece
Inhale slowly and deeply to raise the piston or ball (Correct answer)

Correct answer: Inhale slowly and deeply to raise the piston or ball

The incentive spirometer is a device for slow, deep inhalation to expand the lungs and prevent atelectasis.

Question 28: 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 29: Which position is most appropriate for a resident who is experiencing difficulty breathing (dyspnea)?

Fowler's or semi-Fowler's position (Correct answer)
Left lateral (Sims') position
Prone (face down)
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.

Question 30: When performing a head-to-toe observation, which area should the nursing assistant examine for signs of jaundice?

Palms of the hands
Inside of the mouth only
Sclera of the eyes and skin (Correct answer)
Fingernails and toenails

Correct answer: Sclera of the eyes and skin

Jaundice causes yellowing of the skin and the whites of the eyes (sclera), making these the primary areas to assess.

Question 31: Which observation about urine output should be reported to the nurse?

Urine is pale yellow and clear
Urine appears dark amber and has a strong odor (Correct answer)
Patient voided 300 mL over 8 hours
Patient voided once in the morning

Correct answer: Urine appears dark amber and has a strong odor

Dark amber urine with a strong odor may indicate dehydration or infection and must be reported to the nurse.

Question 32: How should a nurse aide document a resident's refusal of a bath?

'Resident was difficult and refused care again today.'
Document the bath as completed to avoid paperwork issues
Leave the documentation blank for that shift
'Resident refused bath; stated she did not want one today; charge nurse notified.' (Correct answer)

Correct answer: 'Resident refused bath; stated she did not want one today; charge nurse notified.'

Documenting a refusal includes the specific care declined, the resident's stated reason, and notification of the charge nurse.

Question 33: Which scenario is an example of a nurse aide exceeding their scope of practice?

Reminding a resident to take their medication from a nurse-prepared cup
Assisting a resident with ambulation using a gait belt
Changing a sterile wound dressing independently (Correct answer)
Taking and recording a resident's blood pressure

Correct answer: Changing a sterile wound dressing independently

Changing a sterile wound dressing requires nursing-level skills and is beyond the certified nurse aide's scope of practice.

Question 34: Which of the following is an important step when assisting a patient with a bed bath?

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

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 35: A nurse aide leaves a resident's chart open at the nurse's station where visitors can read it. This violates:

The charge nurse's personal preferences
The facility's staffing policy
The resident's activity schedule
HIPAA privacy regulations (Correct answer)

Correct answer: HIPAA privacy regulations

Leaving medical records visible to unauthorized individuals constitutes a HIPAA privacy breach.

Question 36: A resident receiving oxygen therapy suddenly pulls out the nasal cannula and the tubing becomes kinked. The NA's priority is:

Straighten the tubing, reapply the cannula, and notify the nurse (Correct answer)
Encourage the resident to breathe deeply without the oxygen
Document the incident and wait for the nurse's instructions
Increase the oxygen flow rate to compensate for lost oxygen

Correct answer: Straighten the tubing, reapply the cannula, and notify the nurse

The NA should restore oxygen delivery by fixing the tubing and reapplying the cannula, then notify the nurse.

Question 37: A nurse aide is asked to witness a resident signing a legal document. The aide should:

Call the family before deciding whether to sign
Refuse and refer the matter to the charge nurse or facility administration (Correct answer)
Sign only if the document does not involve the aide personally
Sign as a witness since the aide knows the resident well

Correct answer: Refuse and refer the matter to the charge nurse or facility administration

Nurse aides should not witness legal documents as it may create conflicts of interest and liability; this should be referred to administration.

Question 38: When performing perineal care on a female resident, the correct wiping direction is:

Back to front to clean more thoroughly
Front to back, using a clean area of cloth for each stroke (Correct answer)
Side to side using the same cloth section throughout
In a circular motion around the urethral opening

Correct answer: Front to back, using a clean area of cloth for each stroke

Front-to-back wiping with a clean surface for each stroke prevents transferring rectal bacteria to the urethra, reducing UTI risk.

Question 39: A resident who is non-weight-bearing on the right leg needs to use a cane. On which side should the cane be held?

No cane is needed if using a walker
Left (unaffected) side (Correct answer)
Right (affected) side
Either side is acceptable

Correct answer: Left (unaffected) side

A cane is held on the stronger (unaffected) side to shift weight away from the weaker leg and improve stability.

Question 40: A resident refuses to eat breakfast. The nursing assistant should first:

Call the family to convince the resident
Remove the tray and document the refusal without comment
Ask the resident why they are not eating and report the refusal to the nurse (Correct answer)
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 41: Which observation about a wound should be reported to the nurse IMMEDIATELY?

The wound looks pink and moist
The wound dressing is intact and not saturated
The wound has a small dry scab forming
There is new redness, warmth, swelling, or purulent discharge (Correct answer)

Correct answer: There is new redness, warmth, swelling, or purulent discharge

Redness, warmth, swelling, and purulent discharge are classic signs of infection that require prompt nursing assessment and possible intervention.

Question 42: What is the proper technique for performing a two-person assist transfer from bed to wheelchair?

One person lifts at the shoulders, the other at the knees, on a count (Correct answer)
Each person grabs an arm and swings the patient
One person does all the lifting while the other watches
The patient is dragged across the bed surface

Correct answer: One person lifts at the shoulders, the other at the knees, on a count

A coordinated two-person lift with one at the shoulders and one at the knees distributes weight and reduces injury risk for both staff and patient.

Question 43: The correct technique for inserting a rectal suppository includes:

Applying the suppository to the anal opening only
Positioning the resident supine and inserting 1 inch
Positioning the resident in Sims' position and inserting past the internal sphincter (Correct answer)
Inserting the suppository with gloved fingers as far as possible

Correct answer: Positioning the resident in Sims' position and inserting past the internal sphincter

The resident is placed in Sims' position, and the suppository is inserted past the internal sphincter (about 1–1.5 inches in adults) to be effective.

Question 44: Which of the following actions protects a nurse aide from accusations of theft?

Leaving valuables where found and telling a coworker as a witness
Keeping resident valuables in a locked drawer at the nurses' station
Reporting and documenting any found money or valuables to the charge nurse (Correct answer)
Placing valuables in the resident's drawer and not mentioning it

Correct answer: Reporting and documenting any found money or valuables to the charge nurse

Reporting and documenting found valuables to the charge nurse creates an official record that protects the aide from theft accusations.

Question 45: While assisting a resident with oral care, the nursing assistant notices the resident's gums are red and bleeding. The appropriate action is to:

Stop, document, and report findings to the nurse (Correct answer)
Rinse with mouthwash only going forward
Continue brushing more gently and say nothing
Apply more toothpaste to soothe the gums

Correct answer: Stop, document, and report findings to the nurse

Changes in oral tissue such as redness or bleeding are abnormal observations that must be reported to the nurse.

Question 46: A resident has a vest restraint applied. How often should the nursing assistant check on the resident and perform range-of-motion exercises?

Every 4 hours
Every 2 hours (Correct answer)
Once per shift
Only when the resident calls

Correct answer: Every 2 hours

Restrained residents must be checked and repositioned with ROM exercises at least every 2 hours to prevent complications.

Question 47: 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:

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

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 48: Which action best protects a resident's privacy during perineal care?

Asking family members to assist
Turning off the room lights
Performing care quickly to minimize exposure
Using a bath blanket to cover unexposed areas (Correct answer)

Correct answer: Using a bath blanket to cover unexposed areas

Draping the resident with a bath blanket while exposing only the area being cleaned protects dignity and privacy.

Question 49: In electronic health records (EHR), what is the purpose of a unique login for each staff member?

To prevent staff from accessing records after their shift ends
To track how long each staff member spends on the computer
To limit access to only one computer per staff member
To ensure accountability and maintain a clear audit trail (Correct answer)

Correct answer: To ensure accountability and maintain a clear audit trail

Unique logins create an audit trail linking documentation entries to the specific individual who made them.

Question 50: 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 chest just below the axillae
Over the resident's bare skin at the abdomen
Around the resident's waist over their clothing (Correct answer)

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 51: When taking an oral temperature, how long should the thermometer remain in place if using a glass thermometer?

3–5 minutes (Correct answer)
1 minute
30 seconds
7–10 minutes

Correct answer: 3–5 minutes

A glass thermometer must remain under the tongue for 3–5 minutes to obtain an accurate oral temperature reading.

Question 52: When helping a patient ambulate with a walker, the nurse assistant should position themselves:

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

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

Refrigerate the cup before use
Clean the urethral area with antiseptic wipes before starting to urinate (Correct answer)
Begin urinating directly into the specimen cup
Collect the first stream of urine into the 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 54: A patient diagnosed with depression rarely speaks. The nurse aide should:

Speak briefly, make warm eye contact, and let them know you are available (Correct answer)
Use humor aggressively to lift their mood
Report immediately that the patient is uncooperative
Avoid trying to engage them to prevent irritation

Correct answer: Speak briefly, make warm eye contact, and let them know you are available

Brief, warm interactions without pressure give depressed patients consistent human connection without overwhelming them.

Question 55: A nurse aide observes redness on a resident's coccyx. Which action should be taken first?

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
Reposition the resident and document at the end of the week

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

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

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 57: 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 58: Which approach best respects a patient's dignity during personal care?

Talking to a coworker about other patients while providing care
Turning on the TV so the patient is distracted
Performing care quickly without interruption
Explaining each step of care before performing it (Correct answer)

Correct answer: Explaining each step of care before performing it

Explaining each step before performing it allows the patient to anticipate actions and feel in control of their care.

Question 59: What is the purpose of a draw sheet (pull sheet) during repositioning?

To restrain the resident during movement
To reduce friction and shear on the resident's skin (Correct answer)
To prevent the resident from rolling out of bed
To measure the resident's weight during transfer

Correct answer: To reduce friction and shear on the resident's skin

A draw sheet reduces friction and shear forces on the skin during repositioning, decreasing the risk of pressure injury development.

Question 60: 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
One-third to one-half full (Correct answer)
Only when the resident requests
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 61: During a bed bath, the water temperature should be tested by the nurse aide using:

The inside of the wrist before applying to the resident (Correct answer)
A thermometer set to exactly 98.6°F
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 62: A resident becomes agitated and starts yelling. The nurse aide's FIRST response should be:

Remain calm, speak softly, and try to identify the cause of the agitation (Correct answer)
Leave the room immediately and call security
Physically restrain the resident to prevent harm
Tell the resident that yelling is inappropriate and against facility rules

Correct answer: Remain calm, speak softly, and try to identify the cause of the agitation

A calm, quiet tone de-escalates agitation and helps identify triggers, which is the foundation of safe therapeutic communication.

Question 63: Which action by a nursing assistant demonstrates proper body mechanics when lifting?

Twisting the back while holding the load
Keeping the load close to the body and bending at the knees (Correct answer)
Lifting with one arm to save time
Bending at the waist with straight knees

Correct answer: Keeping the load close to the body and bending at the knees

Keeping the load close and bending at the knees protects the spine and uses the stronger leg muscles to bear the weight.

Question 64: Which of the following is an example of protecting a resident's dignity during personal care?

Talking to a coworker about another resident while providing care
Leaving the room door open for easy access while bathing the resident
Hurrying through care without explaining steps to save time
Explaining each step of care before performing it and draping appropriately (Correct answer)

Correct answer: Explaining each step of care before performing it and draping appropriately

Explaining care steps and using proper draping protects the resident's dignity, privacy, and autonomy.

Question 65: Which of the following is the correct way to correct an error in a paper medical record?

Draw a single line through the error, write the correct information, and initial it (Correct answer)
Cross out the entire entry and start over on a new line
Use correction fluid to cover the mistake and write the correct information
Erase the error and write the correction neatly

Correct answer: Draw a single line through the error, write the correct information, and initial it

A single line through the error maintains legibility of the original entry while clearly marking it as incorrect, following legal documentation standards.

Question 66: Which action best prevents the spread of infection when a nursing assistant moves from one resident's room to another?

Wear a gown for every resident interaction
Wipe hands on a clean paper towel and proceed
Change gloves in the hallway
Perform hand hygiene between resident contacts (Correct answer)

Correct answer: Perform hand hygiene between resident contacts

Hand hygiene between every resident contact is the single most effective measure to prevent cross-contamination.

Question 67: Why is it important to check for drug allergies before administration?

To determine the correct billing code
To complete insurance paperwork
To satisfy pharmacy inventory requirements
To prevent potentially life-threatening allergic reactions (Correct answer)

Correct answer: To prevent potentially life-threatening allergic reactions

Checking allergies prevents serious reactions including anaphylaxis, which can be fatal if not identified beforehand.

Question 68: What is the correct order of steps when performing hand hygiene with soap and water?

Apply soap, wet, lather, dry, rinse
Rinse, apply soap, lather briefly, dry on uniform
Wet, apply soap, lather 20 seconds, rinse, dry, turn off faucet with towel (Correct answer)
Wet, lather 5 seconds, rinse, shake dry

Correct answer: Wet, apply soap, lather 20 seconds, rinse, dry, turn off faucet with towel

Effective hand washing requires wetting first, applying soap, lathering for at least 20 seconds, rinsing, drying, and using the towel to turn off the faucet.

Question 69: When communicating with a patient who has difficulty hearing, which of the following is the best approach?

Write everything down for the patient to read.
Avoid speaking and use gestures to communicate.
Speak slowly, clearly, and face the patient while speaking. (Correct answer)
Speak loudly and quickly.

Correct answer: Speak slowly, clearly, and face the patient while speaking.

Speaking slowly, clearly, and facing the patient allows them to utilize both auditory and visual cues, such as lip-reading, which significantly aids comprehension for individuals with hearing difficulties. Speaking loudly can distort sounds, and speaking quickly makes it harder to process information. This approach maximizes the patient's ability to understand and participate in communication.

Question 70: 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
Asking the resident about preferences and accommodating them when possible (Correct answer)
Reporting the resident's beliefs to the charge nurse as a problem

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

After the resident has walked to promote circulation
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

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 72: A resident from a different cultural background declines certain foods for religious reasons. The nurse aide should:

Encourage the resident to try the food anyway
Assume the resident will change their mind later
Provide the food but let the resident decide at meal time
Respect the preference and report it to the dietary team (Correct answer)

Correct answer: Respect the preference and report it to the dietary team

Respecting cultural and religious food preferences is part of person-centered, ethical care and must be communicated to the dietary team.

Question 73: When providing care to a resident with a colostomy, the nurse aide should empty the pouch when it is:

Only when the resident requests it
Changed at the same time every 24 hours
Completely full and leaking
One-third to one-half full (Correct answer)

Correct answer: One-third to one-half full

Emptying the pouch when one-third to one-half full prevents leakage and reduces the risk of skin breakdown around the stoma.

Question 74: Which observation should the nursing assistant report when caring for a resident receiving oxygen via nasal cannula?

The resident is breathing through the nose
The flowmeter reads the ordered rate
The cannula prongs are seated comfortably in the nostrils
Redness or irritation around the nose and ears from the tubing (Correct answer)

Correct answer: Redness or irritation around the nose and ears from the tubing

Pressure from oxygen tubing can cause skin breakdown around the nose and ears and must be reported and treated promptly.

Question 75: Which question is MOST appropriate for a nursing assistant to ask when using a standardized pain assessment?

'You look fine — are you sure you are in pain?'
'Do you want me to call the doctor for you?'
'On a scale of 0 to 10, how would you rate your pain right now?' (Correct answer)
'Would you like me to give you something for the pain?'

Correct answer: 'On a scale of 0 to 10, how would you rate your pain right now?'

Using the 0–10 numeric rating scale is a standardized, objective way to assess and document pain intensity.

Question 76: A nursing assistant notices a small reddened area over a resident's coccyx that does not blanch when pressed. This finding should be:

Noted in the resident's personal journal only
Covered with a dressing chosen by the nursing assistant
Documented and reported to the nurse immediately (Correct answer)
Moisturized and monitored for 24 hours before reporting

Correct answer: Documented and reported to the nurse immediately

Non-blanchable redness indicates a Stage 1 pressure injury and must be reported to the nurse right away for further assessment.

Question 77: What is the correct order for donning personal protective equipment (PPE)?

Mask, gloves, gown, goggles
Gloves, gown, mask, goggles
Gown, mask, goggles, gloves (Correct answer)
Goggles, gloves, mask, gown

Correct answer: Gown, mask, goggles, gloves

The correct donning sequence (gown, mask, goggles, gloves) ensures proper coverage and minimizes contamination risk.

Question 78: What is the correct sequence for a physical assessment?

Auscultation, percussion, palpation, inspection
Inspection, palpation, percussion, auscultation (Correct answer)
Percussion, auscultation, inspection, palpation
Palpation, inspection, auscultation, percussion

Correct answer: Inspection, palpation, percussion, auscultation

The standard physical assessment sequence is inspection (visual), palpation (touch), percussion (tapping), and auscultation (listening).

Question 79: When measuring a resident's output from a urinary drainage bag, the nurse aide should:

Record the amount in tablespoons for accuracy
Pour urine into a graduate at eye level to read the measurement (Correct answer)
Measure only once per shift regardless of amount
Estimate the amount visually without measuring

Correct answer: Pour urine into a graduate at eye level to read the measurement

Urine must be poured into a graduate (measuring container) and read at eye level to ensure an accurate measurement.

Question 80: What role does nonverbal communication play in professional interactions?

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

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 81: What is the meaning of 'respondeat superior' in healthcare settings?

Employers can be held liable for employees' negligent acts (Correct answer)
All staff must respond to a superior's commands
Healthcare workers must report abuse to supervisors
Patients have the right to refuse treatment

Correct answer: Employers can be held liable for employees' negligent acts

Respondeat superior is a legal doctrine meaning employers may be held legally responsible for negligent acts of their employees performed during work.

Question 82: A resident on a blood thinner has a deep laceration that is bleeding heavily. The NA should apply:

Hydrogen peroxide to slow bleeding
A tourniquet above the wound immediately
Direct pressure with a clean cloth or gloved hand and call for help (Correct answer)
Ice directly to the open wound

Correct answer: Direct pressure with a clean cloth or gloved hand and call for help

Direct pressure is the standard first-aid response for heavy bleeding while awaiting the nurse.

Question 83: When communicating with a non-English-speaking patient, which of the following is the most appropriate action?

Assume the patient understands based on gestures.
Speak louder to help the patient understand.
Use a family member to translate the conversation.
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 84: A resident is ordered a 'sublingual' medication. Where should the nurse aide assist in placing it?

Placed in the ear
Swallowed with water
Applied to the skin
Under the tongue (Correct answer)

Correct answer: Under the tongue

Sublingual medications are placed under the tongue where they dissolve and are rapidly absorbed into the bloodstream.

Question 85: When counting a patient's pulse, the nursing assistant notes it is irregular. What is the correct action?

Count for exactly 15 seconds and multiply by four
Record only the rate and do not mention the rhythm
Count for a full 60 seconds and report the irregularity to the nurse (Correct answer)
Ask the patient if they feel any pain

Correct answer: Count for a full 60 seconds and report the irregularity to the nurse

An irregular pulse should be counted for a full 60 seconds and the irregularity reported to the nurse for further evaluation.

Question 86: When a patient is silent but appears to be in pain, the nurse aide should:

Ask them to rate their pain only if they initiate conversation
Proceed with care and document 'patient comfortable'
Assume they are comfortable since they are not complaining
Observe nonverbal cues and report possible pain to the nurse (Correct answer)

Correct answer: Observe nonverbal cues and report possible pain to the nurse

Nonverbal signs such as grimacing, guarding, or restlessness are valid indicators of pain that must be reported.

Question 87: Which action helps communicate caring when a patient has difficulty speaking after a stroke?

Assuming they cannot understand and speaking to family instead
Giving them time to speak and listening patiently (Correct answer)
Talking over them so communication continues
Finishing their sentences quickly to move on

Correct answer: Giving them time to speak and listening patiently

Allowing adequate time shows respect and helps the patient communicate at their own pace without frustration.

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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