Illinois Nurse Assistant Competency Exam — Questions and Answers

Question 1: What is the purpose of an advance directive?

To give doctors authority to perform any necessary procedure
To authorize a nurse aide to make medical decisions
To allow hospitals to discharge patients sooner
To document a person's healthcare wishes before they lose decision-making capacity (Correct answer)

Correct answer: To document a person's healthcare wishes before they lose decision-making capacity

An advance directive documents a person's healthcare preferences before they become unable to communicate them, guiding future medical decisions.

Question 2: The nurse assistant's primary responsibility within a restorative care team is to:

Design the patient's rehabilitation program and set goals
Decide when the patient no longer needs restorative services
Carry out the restorative care plan as directed by the nurse and therapists (Correct answer)
Evaluate whether restorative care is medically appropriate

Correct answer: Carry out the restorative care plan as directed by the nurse and therapists

The nurse assistant implements the restorative care plan developed by licensed nurses and therapists, not design or evaluate it.

Question 3: When performing passive range-of-motion exercises, the nurse aide should move each joint to the point of:

Pain, then back off slightly
Maximum stretch beyond resistance
Slight resistance, then stop (Correct answer)
A fixed count of 20 repetitions regardless of response

Correct answer: Slight resistance, then stop

Passive ROM should be performed until slight resistance is felt; pushing beyond resistance can cause injury.

Question 4: Which action best protects a resident's privacy during perineal care?

Performing care quickly to minimize exposure
Turning off the room lights
Asking family members to assist
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 5: Which principle guides the selection of appropriate clinical interventions?

Evidence-based practice guidelines (Correct answer)
Cost minimization as the sole factor
Practitioner personal preference alone
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 6: A bladder retraining program for a patient who is incontinent would include:

Inserting a urinary catheter to eliminate the need for toileting
Restricting the patient's fluid intake to reduce accidents
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 7: A resident's systolic blood pressure reading is 158 mmHg. The nursing assistant should:

Repeat the reading in 24 hours without reporting
Record it and report it to the nurse immediately (Correct answer)
Advise the resident to drink more water
Ignore it since it is close to normal

Correct answer: Record it and report it to the nurse immediately

A systolic reading of 158 mmHg is above the normal range and must be recorded and reported to the nurse promptly.

Question 8: What is the purpose of a professional code of ethics?

To generate revenue for professional organizations
To create barriers to entry for new professionals
To establish standards of conduct and protect the public (Correct answer)
To replace legal requirements entirely

Correct answer: To establish standards of conduct and protect the public

A code of ethics establishes expectations for professional conduct and serves to protect both the public and the profession.

Question 9: What is the ethical obligation regarding continuing education?

Avoiding new approaches to maintain consistency
Focusing solely on the most profitable skills
Completing only the minimum required hours
Maintaining current knowledge and competence throughout ones career (Correct answer)

Correct answer: Maintaining current knowledge and competence throughout ones career

Professionals have an ethical duty to maintain and update their knowledge and skills to provide competent service.

Question 10: A patient complains of chest pain and shortness of breath. The nursing assistant should:

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

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 11: During an initial assessment, what should be documented first?

Insurance information
Family social history only
Discharge planning notes
Chief complaint and history of present illness (Correct answer)

Correct answer: Chief complaint and history of present illness

The chief complaint and history of present illness establish the reason for the visit and provide context for the examination.

Question 12: What is the single most effective method for preventing the spread of infection?

Isolating all patients
Proper hand hygiene (Correct answer)
Using antibiotics prophylactically
Wearing a face shield at all times

Correct answer: Proper hand hygiene

Hand hygiene is consistently identified as the most effective measure for preventing healthcare-associated infections.

Question 13: When a resident is using a mechanical lift for transfer, the sling should be:

Left in place under the resident at all times
Removed immediately once the resident is seated
Replaced with a new sling after every use
Removed when it is safe to do so per facility policy (Correct answer)

Correct answer: Removed when it is safe to do so per facility policy

Sling removal follows facility policy; some slings are designed to remain in place while others should be removed after transfer for comfort and skin integrity.

Question 14: When should documentation of a service or intervention be completed?

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

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

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

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

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
Offer rewards to bribe the patient into compliance
Skip restorative care permanently since the patient refused

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 17: Which of the following is an example of a chemical restraint?

Locking a door to prevent wandering
Bedrails raised to confine a resident
Medication given to sedate a resident for staff convenience (Correct answer)
A vest restraint tied to a wheelchair

Correct answer: Medication given to sedate a resident for staff convenience

Administering sedating medication for staff convenience rather than clinical need constitutes a chemical restraint and is a form of abuse.

Question 18: 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 19: 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.

Question 20: Which of the following statements about medical records is correct?

Medical records may be shared freely with any staff member
Medical records belong to the nurse aide who wrote them
Medical records are legal documents that can be used in court (Correct answer)
Medical records should be stored at the nurse aide's workstation

Correct answer: Medical records are legal documents that can be used in court

Medical records are legal documents and must be treated with care, accuracy, and confidentiality.

Question 21: A resident is at risk for pressure injuries. Which bony prominence should the nursing assistant inspect most carefully when the resident is in a supine position?

Ankles and shins
Heels and sacrum (Correct answer)
Knees and elbows
Shoulders and wrists

Correct answer: Heels and sacrum

The heels and sacrum are the primary pressure points in the supine position and are most susceptible to pressure injury.

Question 22: When changing a soiled bed with an incontinent resident, which practice best prevents cross-contamination?

Shaking soiled linens to remove debris before disposal
Rolling soiled linens inward away from the clean surface (Correct answer)
Placing soiled linens on the floor temporarily
Carrying soiled linens against the uniform to the laundry cart

Correct answer: Rolling soiled linens inward away from the clean surface

Rolling soiled linens inward contains contamination and prevents the spread of microorganisms to other surfaces.

Question 23: 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
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
Fine as long as the photo is set to private on their profile

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 24: A nursing assistant notices a wet floor in the hallway. What is the FIRST action to take?

Mop the floor yourself immediately
Ask a visitor to stand by the wet area
Post a wet floor sign and notify housekeeping (Correct answer)
Continue walking and report it later

Correct answer: Post a wet floor sign and notify housekeeping

The first step is to warn others by posting a sign and then reporting it to the appropriate staff to clean up.

Question 25: Which action is correct when applying an elastic (ACE) bandage to a resident's lower leg?

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

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 26: 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)
Around the resident's chest just below the axillae
Over the resident's bare skin at the abdomen

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 27: When dressing a patient with a weak or paralyzed arm, the correct technique is to:

Always use adaptive equipment regardless of patient ability
Dress the stronger arm first, then the weaker arm
Dress the weaker or affected arm first, then the stronger arm (Correct answer)
Skip the affected arm and focus only on the strong arm

Correct answer: Dress the weaker or affected arm first, then the stronger arm

The weak or affected limb is dressed first because it has limited range, making it easier before the garment is partially on.

Question 28: When transporting a resident during a building evacuation, a resident in a wheelchair should be moved:

Down stairs using a fire-safe evacuation chair or with trained staff assistance, never the elevator (Correct answer)
Down the stairs forward-facing using the elevator as a backup
By leaving them in a stairwell until fire personnel arrive
Via the elevator, which is reserved for resident use during drills

Correct answer: Down stairs using a fire-safe evacuation chair or with trained staff assistance, never the elevator

Elevators must never be used during fire evacuations; evacuation chairs or trained staff carry wheelchair users down stairs.

Question 29: Which of the following is an example of protecting a resident's dignity during personal care?

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

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 30: A resident begins showing signs of an allergic reaction shortly after a new medication is given. The FIRST action of the nurse aide should be:

Hold all future doses and wait for the next shift
Document the reaction and continue monitoring
Notify the nurse immediately (Correct answer)
Give antihistamine without waiting for orders

Correct answer: Notify the nurse immediately

Any suspected allergic reaction must be reported to the nurse immediately so medical intervention can be provided promptly.

Question 31: What is the normal range for an adult's body temperature?

98.6°F to 100°F (Correct answer)
100°F to 102°F
96°F to 98°F
95°F to 97°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 32: A confused resident tries to climb out of bed at night. The most appropriate nursing assistant action is to:

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

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 33: 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
Administer a laxative from the medication cart
Document the complaint and report it to the charge nurse immediately (Correct answer)
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 34: A resident tells the nurse aide they do not want their daughter to know about their medical condition. The nurse aide should:

Explain that family members are automatically entitled to all medical information
Honor the resident's request and inform the charge nurse of this preference (Correct answer)
Tell the daughter anyway because family has a right to know
Document the request and share the information only if the daughter asks directly

Correct answer: Honor the resident's request and inform the charge nurse of this preference

Residents have the right to control who receives their health information; this preference should be respected and communicated to the care team.

Question 35: When performing postmortem care, the nursing assistant should:

Remove all IV lines and tubes immediately
Leave all tubes and dressings in place until instructed by the nurse (Correct answer)
Reposition the body in a prone position
Notify the family before the nurse

Correct answer: Leave all tubes and dressings in place until instructed by the nurse

All tubes, catheters, and dressings should remain in place until the nurse and/or medical examiner instructs their removal.

Question 36: What is the purpose of a draw sheet (pull sheet) during repositioning?

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

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 37: When applying a cold pack to reduce swelling, the nursing assistant should:

Apply it for 60 minutes continuously
Cover it with a cloth or towel before applying (Correct answer)
Leave it in place until the swelling subsides
Apply it directly to the skin for maximum effect

Correct answer: Cover it with a cloth or towel before applying

A cloth barrier must be placed between the cold pack and skin to prevent frostbite or tissue damage.

Question 38: 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 39: When assessing capillary refill time, the nursing assistant presses on a patient's fingernail and releases. Normal color should return within:

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

Correct answer: 2 seconds

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

Question 40: Which behavior demonstrates therapeutic communication with a resident?

Sharing personal stories to relate to the resident
Maintaining eye contact and nodding while listening (Correct answer)
Asking only yes-or-no questions to keep conversations short
Finishing the resident's sentences to save time

Correct answer: Maintaining eye contact and nodding while listening

Maintaining eye contact and active listening signals respect and encourages the resident to communicate openly.

Question 41: Which scenario is an example of a nurse aide exceeding their scope of practice?

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

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 42: A resident's medication order reads 'ac.' When should this medication be administered?

Before meals (Correct answer)
At bedtime
After meals
Every four hours

Correct answer: Before meals

The abbreviation 'ac' stands for 'ante cibum,' a Latin phrase meaning before meals.

Question 43: A nursing assistant is preparing to give a bed bath. Which water temperature is safe for bathing a resident?

120°F (48.9°C)
95°F (35°C)
105–110°F (40.5–43.3°C) (Correct answer)
90°F (32.2°C)

Correct answer: 105–110°F (40.5–43.3°C)

Bath water should be kept between 105–110°F to be comfortable and safe, particularly for residents with reduced sensation.

Question 44: During care, a nursing assistant notices a new bruise on a patient's arm that the patient cannot explain. The appropriate action is to:

Apply ice to the bruise and continue care
Document it and report it to the nurse, as it may indicate abuse or a fall (Correct answer)
Assume the patient bumped themselves and ignore it
Wait to see if more bruises appear before reporting

Correct answer: Document it and report it to the nurse, as it may indicate abuse or a fall

Unexplained bruises must be documented and reported to the nurse to rule out falls, abuse, or bleeding disorders.

Question 45: When performing CPR on an adult, what is the recommended compression depth?

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

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

At the same level as the bladder
Clipped to the bedrail at mattress height
Above the level of 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 47: Which statement about applying a dry sterile dressing is correct?

The nurse aide should touch only the outer edges of sterile dressings (Correct answer)
The nurse aide should always re-wet dry dressings before applying
Sterile technique is not required for dry dressings
The nurse aide can apply sterile dressings to any wound independently

Correct answer: The nurse aide should touch only the outer edges of sterile dressings

When handling sterile dressings, only the outer edges should be touched to maintain sterility of the surface that contacts the wound.

Question 48: A resident's urinary output for an 8-hour shift is 150 mL. This finding should be:

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)
Encouraged by offering more salt in the diet

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

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

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 50: How should a professional handle a situation where institutional policy conflicts with ethical standards?

Advocate for policy change while following ethical guidelines (Correct answer)
Ignore both and use personal judgment alone
Always follow institutional policy without question
Resign immediately without addressing the issue

Correct answer: Advocate for policy change while following ethical guidelines

Professionals should advocate for policy changes while maintaining ethical standards, seeking resolution through proper channels.

Question 51: A resident receiving insulin should be monitored for which complication if a meal is skipped after the injection?

Hypertension
Hypoglycemia (Correct answer)
Hyperglycemia
Hyperkalemia

Correct answer: Hypoglycemia

Insulin lowers blood glucose; if a meal is skipped after administration, blood glucose can drop dangerously low, causing hypoglycemia.

Question 52: A resident's blood pressure reading is 88/50 mmHg, and the resident reports dizziness. The NA should:

Help the resident to a safe position, do not leave them, and notify the nurse (Correct answer)
Document the finding and report it at the next scheduled check
Administer oral fluids and recheck blood pressure in one hour
Have the resident stand up slowly to normalize blood pressure

Correct answer: Help the resident to a safe position, do not leave them, and notify the nurse

Hypotension with dizziness requires immediate nurse notification; the NA keeps the resident safe and does not leave them.

Question 53: A nurse aide notices a resident's IV site is swollen, cool, and pale. This most likely indicates:

Infiltration (Correct answer)
Air embolism
Phlebitis
Septicemia

Correct answer: Infiltration

Swelling, coolness, and pallor at an IV site indicate infiltration, where IV fluid has leaked into surrounding tissue.

Question 54: A resident becomes agitated and starts yelling. The nurse aide's FIRST response should be:

Tell the resident that yelling is inappropriate and against facility rules
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

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 55: Which technique correctly demonstrates the 'lock and block' body mechanics principle when lifting a heavy object?

Bending at the waist with legs straight
Holding the object at arm's length away from the body
Keeping the back straight and lifting with leg muscles (Correct answer)
Twisting the torso while lifting

Correct answer: Keeping the back straight and lifting with leg muscles

Proper body mechanics require a straight back and using the large leg muscles to generate lifting force, protecting the lumbar spine.

Question 56: A resident with dementia tries to pull out a feeding tube repeatedly. The BEST approach is to:

Restrain the resident's hands immediately to protect the tube
Ignore the behavior since the resident has dementia
Notify the nurse and use redirection techniques as a first step (Correct answer)
Tell the resident they will be punished for pulling the tube

Correct answer: Notify the nurse and use redirection techniques as a first step

Notifying the nurse and attempting redirection respects the resident's dignity and follows the least-restrictive care approach before considering restraints.

Question 57: A nurse aide who witnesses a peer verbally abusing a resident is legally and ethically required to:

Wait to see if it happens again before reporting
Assume it was a misunderstanding and say nothing
Tell the abusive coworker to stop but take no further action
Report the incident to the supervisor right away (Correct answer)

Correct answer: Report the incident to the supervisor right away

Witnessing abuse creates an immediate obligation to report the incident to a supervisor to protect the resident from further harm.

Question 58: A nurse aide who disagrees with a care plan instruction should:

Refuse to provide care until the plan is changed
Follow the care plan and discuss concerns with the charge nurse (Correct answer)
Ignore the instruction and follow personal judgment
Cross out the instruction and document a personal note

Correct answer: Follow the care plan and discuss concerns with the charge nurse

Nurse aides must follow established care plans while using proper channels—speaking with the charge nurse—to raise professional concerns.

Question 59: When assisting a patient with personal hygiene, which of the following should you do first?

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

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 60: Which statement best describes the purpose of the care plan in resident communication?

It replaces verbal communication between staff members
It is updated only when a resident's condition significantly changes
It is only used by nurses and physicians, not nurse aides
It guides all team members in providing consistent, individualized care (Correct answer)

Correct answer: It guides all team members in providing consistent, individualized care

The care plan ensures all team members, including nurse aides, deliver coordinated and individualized care based on the resident's needs and goals.

Question 61: During a bed bath, the nursing assistant should change the bath water when it becomes:

Soapy, dirty, or cool (Correct answer)
Cooler than room temperature
Used for more than 15 minutes
Slightly discolored

Correct answer: Soapy, dirty, or cool

Bath water should be changed when it becomes soapy, dirty, or cool to maintain hygiene and resident comfort.

Question 62: A nursing assistant is measuring a patient's weight and notices a gain of 5 pounds since yesterday. This should be:

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

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 63: A newly hired nurse aide observes a long-term coworker skipping hand hygiene between resident rooms. The appropriate action is to:

Politely mention it or report it to the charge nurse as an infection control concern (Correct answer)
Say nothing because the coworker has more experience
Follow the coworker's example since they are more experienced
Only mention it if a resident gets sick as a result

Correct answer: Politely mention it or report it to the charge nurse as an infection control concern

Infection control is everyone's responsibility; failing to perform hand hygiene endangers residents and must be addressed regardless of seniority.

Question 64: The correct technique for inserting a rectal suppository includes:

Positioning the resident supine and inserting 1 inch
Applying the suppository to the anal opening only
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 65: A resident's medication is labeled 'topical.' How is this medication administered?

By mouth
Applied directly to the skin or mucous membranes (Correct answer)
By injection
Through a feeding tube

Correct answer: Applied directly to the skin or mucous membranes

Topical medications are applied directly to the skin or mucous membranes for local or systemic effects.

Question 66: A patient's blood pressure reading is 90/60 mmHg. This reading is considered:

Hypotensive and should be reported to the nurse (Correct answer)
Hypertensive and requires immediate intervention
Normal for an adult
Within acceptable range and needs no follow-up

Correct answer: Hypotensive and should be reported to the nurse

A blood pressure of 90/60 mmHg is hypotensive and can indicate inadequate perfusion, requiring prompt nursing evaluation.

Question 67: A resident's roommate asks the nurse aide about the resident's diagnosis. The nurse aide should:

Share general information since they share a room
Decline to share and explain that information is private (Correct answer)
Tell the roommate to ask the resident directly
Refer the roommate to the charge nurse for details

Correct answer: Decline to share and explain that information is private

HIPAA protects all patient health information; the nurse aide must decline to share a resident's diagnosis with the roommate.

Question 68: When a patient is crying and upset, the nurse aide's first response should be to:

Leave the room to give them privacy
Immediately notify the nurse of a behavioral issue
Sit quietly and offer a tissue, allowing them to express feelings (Correct answer)
Tell them everything will be fine

Correct answer: Sit quietly and offer a tissue, allowing them to express feelings

Sitting quietly and offering comfort shows empathy and gives the patient space to express their emotions without dismissing them.

Question 69: A resident using a walker suddenly feels dizzy and grabs the nursing assistant's arm. The safest response is to:

Lower the resident to the floor in a controlled manner (Correct answer)
Let go so the resident can steady themselves
Pull the resident toward a nearby chair quickly
Try to hold the resident upright at all costs

Correct answer: Lower the resident to the floor in a controlled manner

Controlled lowering to the floor prevents injury from an uncontrolled fall and protects both the resident and the nursing assistant.

Question 70: A resident tells you they are feeling suicidal. The nurse aide's first action should be to:

Document it and report it at the end of the shift
Promise to keep it a secret so the resident trusts you
Stay with the resident and immediately notify the nurse (Correct answer)
Tell the resident to think positive thoughts and check back later

Correct answer: Stay with the resident and immediately notify the nurse

A suicidal statement is a psychiatric emergency; the aide must stay with the resident and notify the nurse immediately.

Question 71: Which type of precaution is used for ALL patient encounters regardless of diagnosis?

Standard precautions (Correct answer)
Airborne precautions
Droplet precautions only
Contact precautions only

Correct answer: Standard precautions

Standard precautions are applied to all patient care situations as the minimum level of infection prevention.

Question 72: What is the proper technique for taking a patient's pulse?

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

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 73: Which technique helps prevent aspiration when feeding a resident who has difficulty swallowing (dysphagia)?

Feeding the resident quickly to minimize fatigue
Tilting the resident's head back to open the airway
Placing food on the stronger side of the mouth with the chin slightly down (Correct answer)
Offering thin liquids first since they are easier to swallow

Correct answer: Placing food on the stronger side of the mouth with the chin slightly down

Placing food on the stronger side and tucking the chin reduces aspiration risk by directing food away from the airway.

Question 74: A resident reports feeling dizzy when standing up from a chair. This symptom is MOST associated with:

Hypertension
Hyperglycemia
Peripheral edema
Orthostatic hypotension (Correct answer)

Correct answer: Orthostatic hypotension

Dizziness upon standing is a classic sign of orthostatic hypotension, a drop in blood pressure when changing positions.

Question 75: During a bed bath, the water temperature should be tested by the nurse aide using:

The back of the hand after the bath begins
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

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 76: When assisting a resident with a mechanical lift transfer, the nursing assistant must ensure:

The lift is operated at maximum speed to minimize hang time
Two staff members are present during the lift (Correct answer)
The resident holds the lift straps during transfer
The sling is placed under only the resident's torso

Correct answer: Two staff members are present during the lift

Safe mechanical lift use requires at least two staff members—one to operate the lift and one to guide and stabilize the resident.

Question 77: Which is an example of financial exploitation of a resident?

Delivering the resident's mail to them unopened
Reminding the resident that their family brought flowers
Assisting a resident in writing a letter to their bank
Borrowing money from a resident with a promise to repay later (Correct answer)

Correct answer: Borrowing money from a resident with a promise to repay later

Borrowing money from a resident is financial exploitation, a form of abuse that must be reported and can result in criminal charges.

Question 78: 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)
Isolating an infected patient in a private room
Administering antibiotics to treat an existing infection
Immunizing residents against influenza

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

Tell the resident to rest and check back in an hour
Report symptoms to the nurse immediately as signs of hypoglycemia (Correct answer)
Offer a high-fiber snack and monitor
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 80: A nursing assistant is asked to observe a patient's stool. Which observation is MOST important to report?

Stool that is black, tarry, and has a foul odor (Correct answer)
Stool passed once daily in the morning
Brown, formed stool of normal consistency
Stool that is slightly soft in consistency

Correct answer: Stool that is black, tarry, and has a foul odor

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

Question 81: Which of the following is an example of subjective documentation that should be avoided?

'Resident's skin is warm and dry.'
'Resident ambulated 50 feet with a walker.'
'Resident seems to be in a bad mood today.' (Correct answer)
'Resident ate 75% of lunch tray.'

Correct answer: 'Resident seems to be in a bad mood today.'

Saying a resident 'seems' to be in a bad mood is an interpretation, not a factual observation.

Question 82: Invasion of privacy can occur when a nurse aide:

Documents a resident's vital signs in the medical record
Reports a resident's fall to the charge nurse
Assists a resident with bathing using proper draping
Talks about a resident's personal life with other residents (Correct answer)

Correct answer: Talks about a resident's personal life with other residents

Sharing a resident's personal information with other residents who have no need to know violates the resident's right to privacy.

Question 83: Before applying a hearing aid, the nurse aide should verify the battery is working by:

Turning up the volume and listening for a whistle (Correct answer)
Asking the resident if it worked yesterday
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 84: A patient rates their pain as 8 out of 10 on the pain scale. The nursing assistant's FIRST action should be:

Reposition the patient and then reassess in four hours
Report the pain level to the nurse promptly (Correct answer)
Tell the patient to relax and breathe deeply
Administer pain medication from the supply cart

Correct answer: Report the pain level to the nurse promptly

A pain score of 8/10 is severe and must be reported to the nurse immediately so appropriate interventions can be ordered.

Question 85: When collecting a clean-catch midstream urine specimen, what is the first step the nursing assistant must teach the resident?

Begin urinating directly into the specimen cup
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

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 86: When a resident in restraints calls for help and the call light is unanswered, the nurse aide who passes the room should:

Ask another nurse aide to respond after completing their assignment
Continue to their current task and report it later
Inform the charge nurse and let them decide
Stop and respond to the resident immediately (Correct answer)

Correct answer: Stop and respond to the resident immediately

Restrained residents are vulnerable and any response to distress must be immediate — all staff are responsible for responding to calls for help.

Question 87: A nurse aide discovers a coworker documenting care that was never provided. What should the aide do?

Correct the coworker's charting themselves
Discuss it only with other coworkers
Report the falsification to the supervisor or charge nurse (Correct answer)
Ignore it because it is not their responsibility

Correct answer: Report the falsification to the supervisor or charge nurse

Falsifying medical records is fraud and a serious ethical violation that must be reported to a supervisor.

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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