State Tested Nursing Assistant (STNA) Exam — Questions and Answers

Question 1: Mr. Roark, a newly admitted conscious client, has been put to bed. Before leaving him alone, the FIRST action would be to:

Inspect his skin
Complete the listing of clothing and valuables
Make sure he knows how to use the call light (Correct answer)
Ask him if he is hungry

Correct answer: Make sure he knows how to use the call light

For a newly admitted conscious client, ensuring their safety and ability to call for help is the absolute first priority before leaving them alone. The call light is their primary means of communication for needs or emergencies. Explaining its use and placing it within easy reach empowers the client and prevents potential distress or harm.

Question 2: A resident who is lying in bed suddenly becomes short of breath. After calling for help, the nurse aide's next action should be to:

Raise the head of the bed. (Correct answer)
Take the resident's vital signs.
Elevate the resident's feet.
Ask the resident to take deep breaths.

Correct answer: Raise the head of the bed.

When a resident suddenly becomes short of breath, the immediate action after calling for help is to raise the head of the bed. This position, known as Fowler's position, helps to expand the lungs and ease breathing by reducing pressure on the diaphragm. It provides immediate relief and improves oxygen intake while waiting for further medical assistance.

Question 3: A resident with dementia wanders toward an exit door. What is the safest immediate action?

Physically restrain the resident to stop the wandering
Lock the resident in their room to prevent elopement
Gently redirect the resident away from the exit and notify the nurse (Correct answer)
Ignore it since the door is locked anyway

Correct answer: Gently redirect the resident away from the exit and notify the nurse

Gentle redirection protects safety while preserving dignity, and the nurse must be notified to address the wandering risk.

Question 4: A resident with dementia frequently tries to get out of bed without assistance, despite being a high fall risk. Which of the following actions by the STNA is the most appropriate initial response?

Apply soft wrist restraints to prevent the resident from getting up.
Ask the physician for an order for a sedative to keep the resident calm.
Inform the resident that they will be secluded in their room if they don't stay in bed.
Ensure the resident's call light is within reach and the bed is in the lowest position. (Correct answer)

Correct answer: Ensure the resident's call light is within reach and the bed is in the lowest position.

The most appropriate and least restrictive initial action is to use safety measures like lowering the bed and ensuring the call light is accessible. This respects the resident's freedom of movement while prioritizing safety. Restraints, chemical or physical, should only be used as a last resort when all other alternatives have failed and with a physician's order.

Question 5: What is the role of the Long-Term Care Ombudsman?

To advocate for the rights and welfare of nursing home residents (Correct answer)
To audit billing practices of Medicare and Medicaid
To manage staffing schedules at long-term care facilities
To inspect facilities for infection control compliance

Correct answer: To advocate for the rights and welfare of nursing home residents

The ombudsman is an independent resident advocate who investigates complaints and works to resolve problems in long-term care facilities.

Question 6: Which action by the nursing assistant best supports a resident's spiritual and emotional well-being?

Sharing personal religious beliefs to comfort the resident
Discouraging religious discussions to maintain professionalism
Inviting the resident to attend your religious services
Respecting and facilitating the resident's own spiritual practices (Correct answer)

Correct answer: Respecting and facilitating the resident's own spiritual practices

Respecting and facilitating the resident's own spiritual practices honors their individuality and supports holistic well-being without imposing the nursing assistant's beliefs.

Question 7: Which of the following statements is TRUE in regards to administering a cleansing enema?

The enema bag should be placed at the same height as the patient’s anus
The enema bag should be hung on the IV pole with the tubing at the bottom (Correct answer)
The enema bag should be hung 24 inches above the bed
The enema bag should be secured to the bed frame

Correct answer: The enema bag should be hung on the IV pole with the tubing at the bottom

When administering a cleansing enema, the enema bag is typically hung on an IV pole to utilize gravity for a controlled flow of the solution into the rectum. The tubing should be positioned at the bottom of the bag to allow the fluid to drain effectively. The height of the bag, usually 12-18 inches above the patient's anus, is crucial for regulating the flow rate and preventing discomfort.

Question 8: A person’s radial pulse is 40 beats in 30 seconds. What is this person’s pulse rate?

70 beats per minute
80 beats per minute (Correct answer)
75 beats per minute
90 beats per minute

Correct answer: 80 beats per minute

To calculate a pulse rate per minute from a shorter measurement, you multiply the count by the factor needed to reach 60 seconds. If a person's radial pulse is 40 beats in 30 seconds, you multiply 40 by 2 (since 30 seconds x 2 = 60 seconds). Therefore, 40 beats * 2 equals 80 beats per minute.

Question 9: A resident who is inactive is at the risk of constipation. In addition to increased activity and exercise, which of the following actions helps to prevent constipation?

Low fiber diet
High protein diet
Adequate fluid intake (Correct answer)
Regular mealtimes

Correct answer: Adequate fluid intake

Adequate fluid intake is crucial for preventing constipation because water helps soften stool and adds bulk, making it easier to pass through the digestive system. Dehydration can lead to hard, dry stools, exacerbating constipation. Combined with increased activity and a high-fiber diet, proper hydration is a cornerstone of maintaining bowel regularity.

Question 10: When responding to a client on the intercom you should:

Say, "The nurse will answer your call."
Give your name and position and say “May I help you?" (Correct answer)
Say, "What do you want?"
Ask for the client's name.

Correct answer: Give your name and position and say “May I help you?"

When responding to a client on the intercom, it is professional and reassuring to identify yourself and your role, then offer assistance. This provides clarity, establishes trust, and ensures the client knows who they are speaking with and that their needs will be addressed promptly and respectfully.

Question 11: Social service needs of residents are best addressed when the nursing assistant:

Limits resident interactions to reduce emotional risk
Arranges family meetings without nurse involvement
Makes all social decisions for the resident
Observes and reports changes in social behavior to the care team (Correct answer)

Correct answer: Observes and reports changes in social behavior to the care team

Observing and reporting changes in social behavior ensures the interdisciplinary team can address social service needs collaboratively and appropriately.

Question 12: Which of the following statements BEST describes abduction?

When you extend the extremity
When you move the extremity away from the body (Correct answer)
When you bend the extremity
When you move the extremity towards the body

Correct answer: When you move the extremity away from the body

In anatomical terminology, abduction refers to the movement of a limb or body part away from the midline of the body. For example, lifting your arm out to the side is abduction of the shoulder. Conversely, adduction is the movement towards the midline of the body.

Question 13: When a nursing assistant walks into a client's room, she discovers a trashcan on fire. The first thing a nursing assistant does is:

Attempt to douse the flames.
Set off the fire alert.
Take the patient out. (Correct answer)
Ask the nurse for assistance.

Correct answer: Take the patient out.

When referring to fire scenarios, the term "RACE" stands for rescue, alarm, contain, and extinguish. To avoid danger, you must first save the client.

Question 14: A slipknot is used when securing a restraint so that:

Body alignment is maintained while wearing the restraint.
The restraint can be removed quickly when needed. (Correct answer)
The restraint cannot be removed by the resident.
It can be easily observed whether the restraint is applied correctly.

Correct answer: The restraint can be removed quickly when needed.

A slipknot is used when securing a restraint so that it can be removed quickly and easily in an emergency. This allows for rapid release if the resident needs immediate medical attention, if the restraint is causing distress, or if there's a safety concern. The ability to quickly remove the restraint is crucial for resident safety and well-being.

Question 15: Gloves should be worn for which of the following procedures?

Feeding a resident
Ambulating a resident
Emptying a urinary drainage bag (Correct answer)
Brushing a resident's hair

Correct answer: Emptying a urinary drainage bag

Gloves should always be worn when there is a potential for contact with body fluids, secretions, excretions, or contaminated items, as per standard precautions. Emptying a urinary drainage bag involves direct contact with urine, which is a body fluid, making glove use essential to prevent the spread of microorganisms and protect the healthcare worker from potential pathogens.

Question 16: Which of the following is checked by the nursing assistant in the resident's care plan before shaving?

reducing the guidelines in relation to clotting difficulties. (Correct answer)
any prior ADL rejections.
The resident's household razor is present.
past cardiac health issues.

Correct answer: reducing the guidelines in relation to clotting difficulties.

To learn about potential clotting issues and whether an electric razor is preferable to a traditional one, it is important to review the shaving instructions in the resident's plan of care.

Question 17: A resident with dementia repeatedly asks for their deceased mother. The nursing assistant should:

Ignore the question each time it is asked
Redirect the resident gently to a comforting activity or topic (Correct answer)
Tell the resident their mother is coming soon
Remind the resident firmly that their mother has died

Correct answer: Redirect the resident gently to a comforting activity or topic

Gentle redirection avoids causing repeated grief while still acknowledging the resident's emotional state, which is the most therapeutic approach for dementia care.

Question 18: Which of the following options is FALSE in regards to feeding a patient?

Allow the patient time to swallow before offering another bite
Feed the patient while they are in a sitting position
Record the amount of food that the patient consumed using a percentage
Use a fork to feed the patient (Correct answer)

Correct answer: Use a fork to feed the patient

Using a fork to feed a patient is generally considered unsafe, especially for those with swallowing difficulties or impaired motor skills. Forks can be sharp and pose a risk of injury to the mouth or throat, or increase the risk of choking. STNAs should typically use a spoon for feeding to ensure patient safety and better control of food portions.

Question 19: All long-term-care nurse aides must be competency evaluated and must complete a distinct education course, These requirements are set by:

CDC
OSHA
FDA
OBRA (Correct answer)

Correct answer: OBRA

The Omnibus Budget Reconciliation Act (OBRA) of 1987 established federal standards for nursing home care, including comprehensive requirements for nurse aide training and competency evaluation. These regulations were put in place to improve the quality of care provided to residents in long-term care facilities.

Question 20: How long should the nursing assistant clean hands fully and completely after adequately washing them?

Twenty seconds. (Correct answer)
Fifteen seconds.
Ten seconds.
Five seconds.

Correct answer: Twenty seconds.

The CDC and most other handwashing guidelines advise spending 20 seconds cleaning your hands.

Question 21: Which of the following illnesses doesn't call for safety precautions when flying?

Measles.
TB
Chickenpox.
MRSA. (Correct answer)

Correct answer: MRSA.

The disease MRSA is spread by skin-to-skin contact. Airborne or droplet precautions are not necessary.

Question 22: You are assigned a hemiplegia patient. Which of the following options BEST describes what the patient’s medical condition is?

The patient’s entire right side of his or her body is paralyzed (Correct answer)
The patient has been diagnosed with a blood condition
The patient’s lower half of his or her body is paralyzed
The patient has blood clots in his or her lower extremities

Correct answer: The patient’s entire right side of his or her body is paralyzed

Hemiplegia is a medical term derived from 'hemi-' meaning half, and '-plegia' meaning paralysis. Therefore, a patient with hemiplegia experiences paralysis affecting one entire side of their body, either the right or the left. This condition is distinct from paralysis of only the lower half of the body (paraplegia) or general blood conditions.

Question 23: The nursing assistant should verify the water's temperature before getting a client ready for a hot Sitz bath. It is desirable for the water to be at:

from 105°F to 120°F
from 95°F to 110°F (Correct answer)
from 65°F to 80°F
from 80°F to 93°F

Correct answer: from 95°F to 110°F

For a hot Sitz bath, the water should be between 95°F and 110°F in temperature. A client exposed to too-hot or too-cold water may burn, and their muscles will contract instead than relax. In addition to relieving tension and easing muscular spasms, a hot Sitz bath can soften exudates, speed up the healing process (especially after perianal surgery), lessen congestion, and offer comfort in the perineal area.

Question 24: The resident's three top priorities when taking a bath are:

Sanitation, warmth, and safety.
Warmth, seclusion, and leisure.
Privacy, security, and safety. (Correct answer)
Security, comfort, and slumber.

Correct answer: Privacy, security, and safety.

When a resident is taking a bed bath, their top priorities are safety, security, and privacy.

Question 25: Which of the following is considered a normal age-related change?

Bladder holding less urine (Correct answer)
Dementia
Wheezing when breathing
Contractures

Correct answer: Bladder holding less urine

As people age, the bladder muscle can become less elastic and its capacity to hold urine may decrease, leading to more frequent urination. This is a common physiological change associated with the aging process. Unlike dementia, contractures, or wheezing, which are typically signs of disease or specific conditions, a reduced bladder capacity is often a normal age-related alteration.

Question 26: When changing a patient who is incontinent, what safety gear should be worn?

robe and mask.
gown and gloves. (Correct answer)
A mask, a gown, and gloves.
N-95 face covering.

Correct answer: gown and gloves.

As a proper contact precaution, the nursing assistant should wear a gown and gloves at most.

Question 27: When arranging a patient's room, you should do all of the following EXCEPT:

Adjust the back and knee rests as directed
Check lighting
Administer medications (Correct answer)
Check signal cords

Correct answer: Administer medications

Administering medications is a task that falls outside the scope of practice for a State Tested Nursing Assistant (STNA). This responsibility requires specialized training, assessment skills, and licensure held by registered nurses (RNs) or licensed practical nurses (LPNs). STNAs focus on direct patient care, comfort, and safety, which includes checking signal cords, adjusting bed positions, and ensuring adequate lighting, but not medication administration.

Question 28: When cleansing the genital area during perineal care, the nurse aide should:

Cleanse the rectal area first, before cleansing the genital area.
Use the same area on the washcloth for each washing and rinsing stroke for a female resident.
Cleanse the penis with a circular motion starting from the base and moving toward the tip.
Replace the foreskin when pushed back to cleanse an uncircumcised penis. (Correct answer)

Correct answer: Replace the foreskin when pushed back to cleanse an uncircumcised penis.

When providing perineal care for an uncircumcised male, the foreskin must be gently retracted to ensure thorough cleaning of the glans. After cleaning, it is absolutely critical to return the foreskin to its natural position. Failure to do so can lead to paraphimosis, a painful and serious condition where the retracted foreskin becomes trapped and restricts blood flow.

Question 29: When a resident with dementia becomes combative during personal care, the nursing assistant should:

Document the behavior and skip the personal care entirely
Involve multiple staff members to hold the resident down
Firmly continue the task to complete it quickly
Stop, allow the resident to calm down, and try again using a calm approach (Correct answer)

Correct answer: Stop, allow the resident to calm down, and try again using a calm approach

Stopping and allowing the resident to calm down before trying again with a calm approach reduces agitation and maintains the resident's dignity and safety.

Question 30: A resident's wife recently died. The resident is now staying in his room all the time and eating very little. The best response by the nurse aide is to:

Remind the resident to be thankful for the years he shared with his wife.
Understand the resident is grieving and give him chances to talk. (Correct answer)
Avoid mentioning his wife when caring for him.
Tell the resident that he needs to get out of his room at least once a day.

Correct answer: Understand the resident is grieving and give him chances to talk.

The resident is experiencing grief, which is a normal and profound reaction to the loss of a loved one. The best response is to offer empathy and support, creating an environment where the resident feels comfortable expressing their feelings. Encouraging conversation and active listening validates their emotions and helps them process their grief.

Question 31: Of these, MRSA is an example of which?

A collection of rules for activities intended to protect citizens.
A bacterial strain that is resistant to antibiotics and is challenging to treat. (Correct answer)
A type of bacterium that responds well to antibiotic treatment.
A mental note to help recall what to do in the event of a facility fire.

Correct answer: A bacterial strain that is resistant to antibiotics and is challenging to treat.

Methicillin-resistant Staphylococcus aureus, or MRSA, is extremely resistant to the majority of antibiotic therapies.

Question 32: Due to ethnic, racial, and cultural factors, which of the following groups is LESS likely to be diagnosed with diabetes?

African Americans
Hispanics
White Americans (Correct answer)
Native Americans

Correct answer: White Americans

Statistical data consistently shows that certain ethnic and racial groups, including Hispanics, Native Americans, and African Americans, have a significantly higher prevalence and incidence of diabetes compared to White Americans. These disparities are attributed to a complex interplay of genetic predispositions, socioeconomic factors, lifestyle, and access to healthcare. Therefore, White Americans are less likely to be diagnosed with diabetes among the options provided.

Question 33: What does 'least restrictive environment' mean in long-term care?

Staff must never use any safety equipment
Residents must share rooms to maximize social interaction
Providing care with the fewest limitations on the resident's freedom (Correct answer)
Residents are not supervised during activities

Correct answer: Providing care with the fewest limitations on the resident's freedom

The least restrictive environment principle means maximizing resident freedom and autonomy while still providing necessary safe care.

Question 34: Encouraging a client to take part in activities for daily living (ADLS) such as bathing, combing hair, and feeding is:

The family's responsibility.
Necessary for rehabilitation. (Correct answer)
Done only when time permits.
A violation of client rights.

Correct answer: Necessary for rehabilitation.

Encouraging clients to participate in Activities of Daily Living (ADLs) is fundamental for their rehabilitation and overall well-being. It promotes independence, helps maintain existing physical and cognitive abilities, and can improve self-esteem. Active participation in self-care tasks is a key component of restorative care.

Question 35: A resident is found on the floor. After calling for help, what is the CNA's next priority?

Help the resident stand up immediately
Move the resident to the bed to prevent further injury
Stay with the resident and keep them calm until the nurse arrives (Correct answer)
Document the incident and continue with other duties

Correct answer: Stay with the resident and keep them calm until the nurse arrives

The CNA must stay with the resident to monitor and provide reassurance while preventing further injury until a nurse assesses the situation.

Question 36: A patient has a new cast on his right arm. While caring for him, it is important to FIRST observe for:

Signs of crumbling at the cast end.
Pulse above the cast.
Warmth and color of fingers. (Correct answer)
Color and hardness of the cast.

Correct answer: Warmth and color of fingers.

When a patient has a new cast, it is crucial to monitor for signs of impaired circulation, which can occur if swelling develops under the cast. Observing the warmth and color of the fingers (or toes, if a leg cast) distal to the cast provides immediate indicators of blood flow. Coldness, pallor, or a bluish discoloration (cyanosis) would signal a circulatory compromise requiring urgent attention.

Question 37: A resident asks to go outside alone in cold weather. What should the CNA do?

Allow it freely since it is the resident's right
Call the family to decide for the resident
Refuse because the weather is dangerous
Check the care plan and assist per its guidelines, then notify the nurse (Correct answer)

Correct answer: Check the care plan and assist per its guidelines, then notify the nurse

The care plan guides safe activity decisions, balancing autonomy with safety, and the nurse should be informed of any concerns.

Question 38: A resident asks the CNA not to tell their spouse about a new diagnosis. What should the CNA do?

Do nothing since the diagnosis is the physician's responsibility
Tell the spouse anyway since they have a right to know
Honor the resident's confidentiality and inform the nurse of the request (Correct answer)
Document it but share the information with the spouse discreetly

Correct answer: Honor the resident's confidentiality and inform the nurse of the request

Residents have the right to control their own health information; the nurse should be informed to ensure this preference is respected by all staff.

Question 39: As the nurse aide begins his/her assignment, which of the following should the nurse aide do first?

Check all the nurse aide's assigned residents.
Assist a resident who has called for assistance to get off the toilet. (Correct answer)
Collect linen supplies for the shift.
Start bathing a resident who has physical therapy in one hour.

Correct answer: Assist a resident who has called for assistance to get off the toilet.

When starting an assignment, the nurse aide's priority should always be to address immediate resident needs, especially those related to safety, comfort, or elimination. A resident calling for assistance to get off the toilet indicates an urgent need that should be addressed promptly before routine tasks like collecting supplies or starting scheduled baths, ensuring the resident's dignity and comfort.

Question 40: A resident refuses to take their scheduled medication. What should the nursing assistant do?

Administer it anyway to protect the resident's health
Document the refusal without telling anyone
Convince the resident by hiding it in food
Respect the refusal and report it to the nurse (Correct answer)

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

Residents have the right to refuse treatment; the nursing assistant must honor this and report it to the nurse for follow-up.

Question 41: The doctor has told the resident that his cancer is growing and that he is dying. When the resident tells the nurse aide that there is a mistake, the nurse aide should:

Suggest the resident ask for more tests.
Understand that denial is a normal reaction. (Correct answer)
Ask if the resident is afraid of dying.
Remind the resident the doctor would not lie.

Correct answer: Understand that denial is a normal reaction.

Denial is one of the five stages of grief and is a common initial reaction when facing a terminal diagnosis. It serves as a psychological defense mechanism to cope with overwhelming news. The nurse aide should recognize this as a normal part of the grieving process and offer supportive presence without challenging the resident's current state of mind.

Question 42: The MOST serious problem that wrinkles in bedclothes can cause is:

Bleeding and shock
Sleeplessness
Restlessness
Decubitus ulcers (Correct answer)

Correct answer: Decubitus ulcers

Wrinkles in bedclothes create friction and pressure points against a patient's skin, especially for those with limited mobility. This constant pressure and shearing force can impede blood flow to the affected areas, leading to tissue damage and the formation of decubitus ulcers, also known as pressure sores. Preventing these ulcers is a critical aspect of an STNA's role in maintaining patient skin integrity and comfort.

Question 43: A resident frequently paces the hallways and appears restless. The nursing assistant should:

Ignore the behavior as long as no one complains
Tell the resident to return to their room immediately
Observe the behavior, ensure safety, and report to the nurse (Correct answer)
Restrain the resident to prevent falls

Correct answer: Observe the behavior, ensure safety, and report to the nurse

Observing, ensuring safety, and reporting allows the nurse to assess whether the restlessness is related to a mental health issue, pain, medication, or another cause.

Question 44: An adult patient’s heart rate is regular and 85 bpm. What action should the nursing assistant take?

Notify the doctor immediately
No action is needed
Document the vital sign (Correct answer)
Document and report it to the nurse

Correct answer: Document the vital sign

An adult heart rate of 85 beats per minute (bpm) is considered within the normal range, which typically falls between 60 and 100 bpm. Since the pulse is regular and within normal limits, the appropriate action for the nursing assistant is to accurately document this vital sign. There is no immediate need to report it to the nurse or doctor unless other concerning symptoms are present or it deviates significantly from the patient's baseline.

Question 45: How should you record a patient’s output?

Using cubic meters and liters
Using cubic centimeters or milliliters (Correct answer)
Using millimeters and centimeters
Using grams and kilograms

Correct answer: Using cubic centimeters or milliliters

In healthcare, patient output, such as urine, emesis, or wound drainage, is consistently measured and recorded using the metric units of cubic centimeters (cc) or milliliters (mL). These units are equivalent (1 cc = 1 mL) and are the standard for accurate fluid balance tracking. This ensures uniformity and precision in patient care documentation.

Question 46: Which of the following would affect a nurse aide's status on the state's nurse aide registry and also cause the nurse to be ineligible to work in a nursing home?

Failing to show up for work without calling to report the absence.
Having a finding for resident neglect. (Correct answer)
Having been terminated from another facility for repeated tardiness.
Missing a mandatory infection control in-service training program.

Correct answer: Having a finding for resident neglect.

A finding of resident neglect, abuse, or misappropriation of resident property on the state's nurse aide registry will result in ineligibility to work in a nursing home. These are serious offenses that directly compromise resident safety and well-being, leading to permanent disqualification. Other disciplinary issues like tardiness or absence do not typically result in such a severe consequence.

Question 47: Which of the following options is NOT an age-related condition that all residents must adapt to?

Reduced ability to see
Varying sleep habits
Reduced ability to feel pain
Inability to learn new skills (Correct answer)

Correct answer: Inability to learn new skills

The inability to learn new skills is a false statement regarding age-related conditions. While the speed of learning may change, older adults retain the capacity to learn throughout their lives, often benefiting from different teaching methods or more time. Other options like reduced pain sensation, varying sleep habits, and reduced vision are common physiological changes associated with aging, but the ability to learn is not inherently lost.

Question 48: A resident who was previously social now stays in their room and refuses meals. This change most likely indicates:

A preference for alone time
Normal aging behavior
Dissatisfaction with roommate assignment
A possible psychological or physical health decline requiring assessment (Correct answer)

Correct answer: A possible psychological or physical health decline requiring assessment

A sudden change in social behavior and refusal of meals can indicate depression, illness, or other health changes that require professional assessment.

Question 49: A resident is on a bladder retraining program. The nurse aide should expect the resident to:

Have a schedule for toileting. (Correct answer)
Have an indwelling urinary catheter.
Wear an incontinent brief in case of an accident.
Have a fluid intake restriction to prevent sudden urges to urinate.

Correct answer: Have a schedule for toileting.

Bladder retraining programs are designed to help residents regain control over urination by establishing a regular, timed toileting schedule. This involves taking the resident to the bathroom at specific intervals, gradually increasing the time between voids. The goal is to re-establish a predictable pattern of urination and improve bladder capacity, reducing episodes of incontinence.

Question 50: A resident asks the nursing assistant to keep a secret about abuse from another staff member. What should the CNA do?

Report the abuse immediately as a mandatory reporter (Correct answer)
Wait to see if the resident mentions it again
Tell only the accused staff member to resolve it internally
Keep the secret to maintain the resident's trust

Correct answer: Report the abuse immediately as a mandatory reporter

CNAs are mandatory reporters and must immediately report all suspected or disclosed abuse, regardless of confidentiality requests.

Question 51: Which of the following is a resident's right under the Omnibus Budget Reconciliation Act (OBRA) of 1987?

To choose their own roommate, regardless of availability.
To receive care only from physicians employed by the facility.
To be free from physical and chemical restraints imposed for discipline or convenience. (Correct answer)
To have the facility manage all their personal finances.

Correct answer: To be free from physical and chemical restraints imposed for discipline or convenience.

The Omnibus Budget Reconciliation Act (OBRA) of 1987 established a set of regulations to protect the rights of residents in long-term care facilities, including the right to be free from unnecessary physical or chemical restraints.

Question 52: A resident's religious dietary restrictions are not being followed by the kitchen. What should the CNA do?

Report the issue to the nurse or dietary supervisor immediately (Correct answer)
Document it in the chart and wait for the next care conference
Bring in food from outside without telling anyone
Tell the resident to accept what is served

Correct answer: Report the issue to the nurse or dietary supervisor immediately

Residents have the right to have their religious and cultural preferences honored, and the appropriate supervisor must be notified promptly.

Question 53: Before touching a resident who is crying to offer comfort, the nurse aide should consider:

Whether the resident has family that visits routinely.
Whether the resident has been sad recently.
The resident's cultural background. (Correct answer)
The resident's recent vital signs.

Correct answer: The resident's cultural background.

Cultural background significantly influences how individuals express and receive comfort, especially physical touch. Before offering comfort through touch, it is crucial to consider the resident's cultural norms and personal preferences. This ensures the gesture is perceived as supportive and respectful, rather than intrusive or inappropriate.

Question 54: A nurse aide finds a resident looking in the refrigerator at the nurses' station at 5 a.m. The resident, who is confused, explains he needs breakfast before he leaves for work. The best response by the nurse aide is to:

Remind him that he is retired from his job and in a nursing home.
Tell him that residents are not allowed in the nurses' station.
Ask the resident about his job and if he is hungry. (Correct answer)
Help the resident back to his room and into bed.

Correct answer: Ask the resident about his job and if he is hungry.

When a confused resident expresses a desire related to a past life, such as going to work, the best approach is to engage them in their reality rather than correcting or reorienting them. Asking about their job and if they are hungry validates their feelings and provides an opportunity to gently redirect them. This technique, known as validation therapy, helps reduce agitation and fosters trust.

Question 55: While flossing the client's teeth, which motion is incorrect?

Gently slide the floss between the teeth, up and down.
Don't forget to floss the backs of the final teeth on the top, bottom, right, and left of the mouth.
For each tooth, use a fresh piece of floss. (Correct answer)
With each hand, place the floss between the middle fingers.

Correct answer: For each tooth, use a fresh piece of floss.

It is not required to floss every tooth with a fresh piece of floss. Take an eighteen-inch length of floss out of the dispenser; this will cover every tooth. After flossing every other tooth, simply move on to a new section of floss. The other options are the proper flossing techniques.

Question 56: Of the following, which would NOT be a suitable meal for a patient who is three years old?

Sandwich, divided into little pieces.
Hotdog cut up into small bits. (Correct answer)
Pieces of apple.
Pretzel sticks.

Correct answer: Hotdog cut up into small bits.

A bite-sized chunk of hotdog might easily block the child's airway and result in choking. This would probably not happen before the sandwich fell apart.

Question 57: When a resident is combative and tries to hit the nurse aide, it is important for the nurse aide to:

Explain that if the resident is not calm a restraint may be applied.
Call for help to make sure there are witnesses.
Step back to protect yourself from harm while speaking in a calm manner. (Correct answer)
Show the resident that the nurse aide is in control.

Correct answer: Step back to protect yourself from harm while speaking in a calm manner.

When a resident is combative and attempts to hit, the nurse aide's first priority is to ensure their own safety and de-escalate the situation. Stepping back creates a safe distance, while speaking calmly can help reduce the resident's agitation. This approach prioritizes safety and attempts to calm the resident without escalating the confrontation.

Question 58: What are protozoa?

Plant-like organisms
1-celled animals (Correct answer)
Things that grow in living cells
1-celled organism that can cause an infection

Correct answer: 1-celled animals

Protozoa are single-celled eukaryotic organisms that are classified as animal-like protists. They are microscopic and possess characteristics similar to animals, such as motility and heterotrophic nutrition. While some can cause infections, their fundamental classification is as one-celled animals, distinguishing them from bacteria (which are prokaryotes) or fungi (plant-like organisms).

Question 59: Which of the following is the correct procedure for serving a meal to a client who must be fed?

Serve the tray along with all the other trays, and then come back to feed the client
Have the kitchen hold the tray for one hour
Bring the tray to the client last; feed after you have served all other clients
Bring the tray into the room when you are ready to feed the client (Correct answer)

Correct answer: Bring the tray into the room when you are ready to feed the client

For a client who needs to be fed, bringing the tray into the room only when the nurse aide is ready to feed them ensures the food remains at the appropriate temperature and is served fresh. This practice prevents the client from waiting unnecessarily or the food getting cold, promoting a more pleasant and nutritious meal experience.

Question 60: When feeding a resident, frequent coughing can be a sign that the resident is:

Needs to drink more fluids
Getting full
Choking
Having difficulty swallowing (Correct answer)

Correct answer: Having difficulty swallowing

Frequent coughing during feeding is a primary indicator of dysphagia, or difficulty swallowing. This reflex occurs when food or liquid accidentally enters the trachea (windpipe) instead of the esophagus, triggering the body's attempt to prevent aspiration. It's a critical sign that requires immediate attention and often a swallowing evaluation to prevent serious complications like aspiration pneumonia.

Question 61: A resident who recently lost a spouse is crying and says they do not want to talk. The best response is to:

Tell the resident to stay strong
Sit quietly with the resident and offer presence (Correct answer)
Leave immediately and check back later
Change the subject to distract them

Correct answer: Sit quietly with the resident and offer presence

Sitting quietly with a grieving resident provides comfort through presence without forcing conversation, which supports emotional well-being.

Question 62: Which behavior is a common sign of depression in an elderly resident?

Elevated mood and talkativeness
Withdrawal from activities and social interaction (Correct answer)
Increased interest in hobbies
Increased appetite and energy

Correct answer: Withdrawal from activities and social interaction

Withdrawal from activities and social interaction is a hallmark sign of depression, particularly in elderly residents.

Question 63: Which of the following is considered a physical restraint requiring physician order?

A non-skid mat placed under the resident's feet
A raised toilet seat used for transfers
A call light placed within resident reach
A full side rail raised on both sides of the bed (Correct answer)

Correct answer: A full side rail raised on both sides of the bed

Full bilateral side rails are classified as restraints because they prevent the resident from freely exiting the bed.

Question 64: When cleaning a client's dentures at the sink the reason that either line the emesis basin with a paper towel or fill the sink with water is to:

Protect the basin from scratches.
Guard against breaking the dentures. (Correct answer)
Prevent contamination of the dentures.
Hide the dentures from view.

Correct answer: Guard against breaking the dentures.

Dentures are fragile and can easily break if dropped onto a hard surface. Lining the emesis basin with a paper towel or filling the sink with water creates a cushioned barrier. This precaution helps absorb impact and prevents the dentures from cracking or shattering if they are accidentally dropped during cleaning.

Question 65: Which statement by a resident requires immediate reporting to the nurse?

I feel sad sometimes.
I have a plan to end my life. (Correct answer)
I wish things were different.
I miss my family.

Correct answer: I have a plan to end my life.

A statement about having a plan to end one's life indicates suicidal ideation with intent and requires immediate reporting to the nurse for safety intervention.

Question 66: In order for a microbe to survive it must have somewhere to live. What is the term used to describe the area where the microbe lives?

Method of transmission
Portal of entry
Source
Reservoir (Correct answer)

Correct answer: Reservoir

In the chain of infection, a 'reservoir' is defined as the natural environment or habitat where a pathogen or microbe normally lives and multiplies. This can be a human, an animal, soil, water, or inanimate objects. For a microbe to survive and potentially cause an infection, it must have a suitable reservoir to reside in and reproduce.

Question 67: Which of the following should you observe and record when admitting a client?

How much the client has eaten and drunk
The color of the stool and amount of urine voided
Insurance information
Bruises, marks, rashes, or broken skin (Correct answer)

Correct answer: Bruises, marks, rashes, or broken skin

Upon admission, it is crucial for a nurse aide to thoroughly observe and document the client's skin condition, including any existing bruises, marks, rashes, or areas of broken skin. This baseline assessment is vital for identifying potential neglect, abuse, or pre-existing conditions, and for monitoring changes in skin integrity throughout their stay, contributing to comprehensive care.

Question 68: A resident tells you another resident is hitting them. What is the CNA's first action?

Ensure the resident's immediate safety and report to the nurse at once (Correct answer)
Document the complaint and report at the end of the shift
Suggest the two residents resolve the issue between themselves
Confront the alleged aggressor directly

Correct answer: Ensure the resident's immediate safety and report to the nurse at once

Immediate safety comes first, then prompt reporting to the nurse who will investigate and intervene appropriately.

Question 69: When trying to communicate with a resident who speaks a different language than the nurse aide, the nurse aide should:

Use pictures and gestures (Correct answer)
Face the resident and speak softly when talking.
Repeat words often if the resident does not understand.
Assume when the resident nods his/her head that the message is understood.

Correct answer: Use pictures and gestures

When a language barrier exists, non-verbal communication methods like pictures, gestures, and demonstrations are essential tools. These methods can convey basic needs, instructions, and emotions more effectively than simply repeating words or speaking loudly. Using visual and physical cues helps bridge the communication gap and ensures better understanding.

Question 70: A resident asks the CNA to witness their signature on a legal document. What should the CNA do?

Sign as a witness since the resident trusts them
Decline and refer the resident to the charge nurse or social worker (Correct answer)
Sign only if the document is a simple personal letter
Ask another CNA to witness it instead

Correct answer: Decline and refer the resident to the charge nurse or social worker

CNAs should not witness legal documents as this creates conflicts of interest and liability; the charge nurse or social worker should handle such requests.

Question 71: While giving a bed bath, the nurse aide hears the alarm from a nearby door suddenly go off. The nurse aide should:

Stop the bed bath and go check on the location of all assigned residents.
Report the alarm to the charge nurse immediately.
Make the resident being bathed safe and go check the door right away. (Correct answer)
Wait a few minutes to see if the alarm stops.

Correct answer: Make the resident being bathed safe and go check the door right away.

A door alarm indicates a potential safety risk, such as a resident eloping or an unauthorized person entering. The nurse aide's primary responsibility is to ensure the safety of the resident currently in their care before responding to the alarm. Once the resident is safe, the nurse aide must immediately investigate the alarm to prevent harm or address the security breach.

Question 72: To help prevent resident falls, the nurse aide should:

Encourage residents to wear larger-sized, loose-fitting clothing.
Remind residents who use call lights that they need to wait patiently for staff.
Always raise side rails when any residents are in his/her bed.
Leave residents' beds at the lowest level when care is complete. (Correct answer)

Correct answer: Leave residents' beds at the lowest level when care is complete.

Leaving residents' beds at the lowest level when care is complete is a critical fall prevention strategy. This minimizes the distance a resident would fall if they were to get out of bed unassisted, significantly reducing the risk of injury. It ensures the safest possible environment for residents when they are not actively being attended to.

Question 73: When giving a customer a bath, which of the following is correct?

Even if the client does a lousy job, force them to give themselves a bath.
Make sure a sheet or towel is covering any areas that aren't being cleaned right now. (Correct answer)
Wipe the perineal area carefully from back to front with the washcloth.
After the customer has taken a shower, lotion their feet, making sure to get between their toes.

Correct answer: Make sure a sheet or towel is covering any areas that aren't being cleaned right now.

Covering parts not being washed is essential to maintaining privacy and keeping a client warm. Wipe from front to back when cleaning the perineal region. While the customer helps with ADLs, provide them with assistance. Lotioning the area between your toes increases your risk of fungal infections.

Question 74: When a resident refuses a bedbath, the nurse aide should:

Wait a while and then ask the resident again. (Correct answer)
Offer the resident a bribe.
Tell the resident that the nursing home policy requires daily bathing.
Remind the resident that people who smell don't have friends.

Correct answer: Wait a while and then ask the resident again.

Residents have the right to refuse care, and their autonomy must be respected. If a resident initially refuses a bedbath, waiting a while and then gently asking again allows for a potential change in their mood or readiness. This approach maintains their dignity and provides an opportunity for them to accept care later without feeling coerced.

Question 75: Which action best protects a resident's right to privacy during personal care?

Closing the curtain and explaining each step before touching (Correct answer)
Asking family members to observe to ensure quality care
Performing care quickly without explanation to minimize exposure
Leaving the door open so staff can assist quickly

Correct answer: Closing the curtain and explaining each step before touching

Closing the curtain and explaining care beforehand respects both privacy and dignity.

Question 76: Which scenario describes neglect by a nursing assistant?

Reporting a resident's complaint of pain to the nurse
Failing to reposition a resident who cannot move independently (Correct answer)
Offering a resident a choice of beverages with meals
Notifying the nurse before leaving the unit for a break

Correct answer: Failing to reposition a resident who cannot move independently

Failing to turn and reposition an immobile resident is neglect that can result in pressure injuries and other harm.

Question 77: Which of the following statements is true about residents who are restrained?

Their posture and alignment are improved.
They are at a greater risk of developing pressure sores. (Correct answer)
They are at lower risk of developing pneumonia.
They are not at risk of falling.

Correct answer: They are at a greater risk of developing pressure sores.

Residents who are restrained are at a significantly higher risk of developing pressure sores. Restraints restrict movement, leading to prolonged pressure on specific body areas and impaired circulation. This lack of repositioning and reduced blood flow increases the likelihood of skin breakdown and the formation of pressure ulcers.

Question 78: What is the minimum requirement before applying a restraint in a long-term care facility?

A physician order plus informed consent from the resident or legal representative (Correct answer)
Family consent is sufficient
Documentation of three prior falls in the past month
Nurse supervisor approval during an emergency

Correct answer: A physician order plus informed consent from the resident or legal representative

Restraints require a physician order and informed consent; they should be the least restrictive option used only when alternatives have failed.

Question 79: A resident frequently talks about feeling worthless and hopeless. Which action should the nursing assistant take first?

Leave the resident alone to process their feelings
Report the statements to the nurse immediately (Correct answer)
Tell the resident these feelings will pass
Distract the resident with an activity

Correct answer: Report the statements to the nurse immediately

Statements indicating worthlessness and hopelessness may signal depression or suicidal ideation and must be reported to the nurse immediately for proper assessment.

Question 80: Which behavior by a CNA constitutes financial abuse of a resident?

Notifying the nurse when a resident's wallet is missing
Borrowing money from a resident with intention to repay (Correct answer)
Reporting that a resident gave away jewelry to a visitor
Helping a resident balance their checkbook upon request

Correct answer: Borrowing money from a resident with intention to repay

Borrowing money from a resident is financial exploitation regardless of repayment intent.

State Tested Nursing Assistant (STNA) Exam

The STNA exam certifies individuals to work as nursing assistants, demonstrating competency in providing basic care under the supervision of a licensed nurse.

Questions

90 min

Time Limit

75%

To Pass

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