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

Question 1: When a resident is expressing anger, the nurse aide should consider:

Remind the resident that everyone gets angry.
Listen closely to the resident's concerns. (Correct answer)
Ask the resident to speak in a kinder tone.
Correct the resident's misperceptions.

Correct answer: Listen closely to the resident's concerns.

When a resident is expressing anger, the most effective response is to listen actively and attentively to their concerns. This validates their feelings, shows respect, and helps the nurse aide understand the root cause of the anger. Understanding the underlying issue is the first step toward resolving the problem or de-escalating the situation.

Question 2: A resident frequently talks about feeling worthless and hopeless. Which action should the nursing assistant take first?

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

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

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

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 4: An agitated resident must be turned every two hours all night long. The first action of the nurse aide when waking up this resident is to:

Speak quietly and calmly. (Correct answer)
Shout her name.
Touch her shoulder.
Turn on the light.

Correct answer: Speak quietly and calmly.

When waking an agitated resident, a calm and quiet approach is crucial to avoid startling or further distressing them. Speaking gently helps to orient the resident and reduces the likelihood of an escalated agitated response. This promotes a sense of safety and minimizes confusion.

Question 5: A resident who uses a wheelchair wants to self-propel to the dining room but it will make them late for the meal. What should the CNA do?

Allow the resident to self-propel and notify dietary if they will be late (Correct answer)
Push the wheelchair to ensure the resident arrives on time
Discourage self-propelling to prevent exhaustion
Ask the family to decide what is best

Correct answer: Allow the resident to self-propel and notify dietary if they will be late

Residents have the right to independence and self-determination; minor schedule adjustments should accommodate their autonomy.

Question 6: A resident refuses to eat, bathe, or participate in any activities for several days. The nursing assistant should:

Respect the resident's wishes and document nothing
Tell other residents to encourage the person
Report the behavior change to the nurse (Correct answer)
Force the resident to participate for their own good

Correct answer: Report the behavior change to the nurse

A sudden change in behavior such as refusing care and activities may indicate a mental health issue and must be reported to the nurse for evaluation.

Question 7: A resident has an indwelling urinary catheter. While making rounds, the nurse aide notices that there is no urine in the drainage bag. The nurse aide should first:

Ask the resident to try urinating.
Offer the resident fluid intake.
Obtain a new urinary drainage bag.
Check for kinks in the tubing. (Correct answer)

Correct answer: Check for kinks in the tubing.

If there is no urine in an indwelling urinary catheter drainage bag, the nurse aide's first and most immediate action should be to check for any kinks or obstructions in the tubing. This is a common and easily rectifiable cause of blocked urine flow, which can prevent discomfort and potential complications for the resident. Addressing this simple issue first can often resolve the problem.

Question 8: When a resident is combative and tries to hit the nurse aide, it is important for the nurse aide to:

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

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 9: Before bathing a client, the nursing assistant should:

Gather a change of clothing
Check for a doctor's order
All of the above
Close the door and pull the curtain (Correct answer)

Correct answer: Close the door and pull the curtain

Ensuring a client's privacy is a fundamental right and a key aspect of respectful care, especially during personal hygiene tasks like bathing. Closing the door and pulling the curtain creates a private and comfortable environment for the client. This action maintains their dignity and promotes trust.

Question 10: Which of the following should you observe and record when admitting a client?

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

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

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

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: An STNA is assisting a resident with bathing. The resident's family member, who is visiting, asks the STNA for the resident's recent blood pressure readings. How should the STNA respond?

Politely state that they cannot share that information and direct the family member to the charge nurse. (Correct answer)
Ask the resident in front of the family member if it's okay to share the information.
Leave the resident's medical chart at the bedside for the family to review.
Provide the blood pressure readings since it is a direct family member asking.

Correct answer: Politely state that they cannot share that information and direct the family member to the charge nurse.

Under HIPAA, an STNA cannot share a resident's protected health information (PHI) without the resident's consent. The proper response is to protect the resident's privacy and refer the family member to the licensed nurse who can follow the facility's protocol for releasing information.

Question 13: You are assigned a hemiplegia patient. Which of the following options BEST describes what the patient’s medical condition is?

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

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

Take the patient out. (Correct answer)
Attempt to douse the flames.
Set off the fire alert.
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 15: A resident asks to go outside alone in cold weather. What should the CNA do?

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)
Allow it freely since it is the resident's right

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

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

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

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

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 18: When communicating with a resident who has severe anxiety, the nursing assistant should:

Speak quickly to complete tasks efficiently
Discuss the cause of their anxiety in detail
Avoid making eye contact to reduce pressure
Remain calm and use a slow, reassuring tone (Correct answer)

Correct answer: Remain calm and use a slow, reassuring tone

A calm, slow, and reassuring tone helps reduce anxiety by providing the resident with a sense of safety and stability.

Question 19: Before feeding a resident, what is the best reason to wash the resident's hands?

The resident may still touch his/her mouth or food. (Correct answer)
It improves resident morale and appetite.
The resident needs to keep meal routines.
It reduces the risk of spreading airborne diseases.

Correct answer: The resident may still touch his/her mouth or food.

Washing a resident's hands before a meal is a critical infection control measure. Even if the resident is being fed, they may still touch their mouth, face, or the food itself. Handwashing removes germs, preventing their transfer from the resident's hands to their mouth or food, thereby significantly reducing the risk of illness and infection.

Question 20: A resident who recently lost a spouse is crying and says they do not want to talk. The best response is to:

Leave immediately and check back later
Tell the resident to stay strong
Sit quietly with the resident and offer presence (Correct answer)
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 21: A resident has diabetes. Which of the following is a common sign of low blood sugar?

Fever
Shakiness (Correct answer)
Thirst
Vomiting

Correct answer: Shakiness

Shakiness is a common and important sign of low blood sugar (hypoglycemia) in individuals with diabetes. Other symptoms can include dizziness, sweating, hunger, confusion, and weakness, as the body reacts to the lack of glucose needed for energy. Recognizing these signs promptly is crucial for intervention.

Question 22: A resident who was previously social now stays in their room and refuses meals. This change most likely indicates:

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

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 23: Which approach is most effective when caring for a resident experiencing a panic attack?

Leave the room and return when the resident calms down
Stay with the resident, speak calmly, and encourage slow breathing (Correct answer)
Administer a PRN medication without nurse authorization
Restrain the resident to prevent injury

Correct answer: Stay with the resident, speak calmly, and encourage slow breathing

Staying with the resident, speaking calmly, and guiding slow breathing helps reduce the intensity of a panic attack by providing reassurance and regulation techniques.

Question 24: When should you wash your hands?

At least twice daily
Before and after contact with a patient (Correct answer)
When you notice they look or feel dirty
When the charge nurse tells you to

Correct answer: Before and after contact with a patient

Handwashing is a cornerstone of infection control and must be performed before and after every contact with a patient. This practice prevents the transmission of microorganisms between patients, from the environment to the patient, and from the patient to the healthcare worker. It is a critical step in maintaining a safe and hygienic environment for everyone.

Question 25: Gloves should be worn for which of the following procedures?

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

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

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

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 27: Which of the following questions asked to the resident is most likely to encourage conversation?

Are you feeling tired today?
What are your favorite foods? (Correct answer)
Is the water warm enough?
Do you want to wear this outfit?

Correct answer: What are your favorite foods?

Open-ended questions, such as 'What are your favorite foods?', encourage more than a simple 'yes' or 'no' answer. They invite the resident to share details, memories, and preferences, fostering a more meaningful conversation. This approach allows the nurse aide to learn more about the resident and build rapport.

Question 28: When responding to a client on the intercom you should:

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

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 29: A resident with dementia becomes agitated during evening hours. This behavior pattern is known as:

Catastrophic reaction
Perseveration
Sundowning (Correct answer)
Confabulation

Correct answer: Sundowning

Sundowning refers to increased confusion, agitation, and behavioral changes that occur in late afternoon or evening in residents with dementia.

Question 30: Which stage of grief involves a resident bargaining with God to reverse their diagnosis?

Acceptance
Denial
Bargaining (Correct answer)
Anger

Correct answer: Bargaining

In the bargaining stage of Kübler-Ross's grief model, individuals attempt to negotiate or make deals in hopes of changing their situation.

Question 31: It is NOT appropriate to measure the patient's typical upper arm blood pressure when the patient:

suffers with heart failure.
cries, "This is the fifth time today."
Has both left and right arm IV catheters. (Correct answer)
had the lymph nodes surrounding the left arm's axilla excised.

Correct answer: Has both left and right arm IV catheters.

The intravenous flow of the patient will be impeded by a blood pressure cuff if they have IV catheters in both arms.

Question 32: Considering the resident's activity, which of the following sets of vital signs should be reported to the charge immediately?

After eating: 97.0* 64-24
After walking exercise: 98.2* 98-28
While watching television: 98.8* 72-14
Resting: 98.6* 98-32 (Correct answer)

Correct answer: Resting: 98.6* 98-32

A respiratory rate of 32 breaths per minute for a resting patient is significantly elevated above the normal adult range (typically 12-20 breaths per minute). This tachypnea could indicate respiratory distress, infection, or other serious underlying conditions. Such a vital sign warrants immediate reporting to the charge nurse for further assessment and intervention.

Question 33: When arranging a patient's room, you should do all of the following EXCEPT:

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

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 34: Before assisting a client into a wheelchair, the FIRST action would be to check if the:

Door to the room is closed.
Floor is slippery.
Wheels of the chair are locked. (Correct answer)
Client is adequately covered.

Correct answer: Wheels of the chair are locked.

The primary concern when transferring a client into a wheelchair is safety. Locking the wheels prevents the chair from moving or rolling away during the transfer process. This crucial step minimizes the risk of falls and injury to both the client and the nurse aide.

Question 35: Which of the following statements BEST describes abduction?

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

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 36: The resident's weight is obtained routinely as a way to check the resident's:

Growth and development
Nutrition and health (Correct answer)
Activity level
Adjustment to the facility

Correct answer: Nutrition and health

Routine weight monitoring is a vital part of assessing a resident's nutritional status and overall health. Significant weight changes, whether gain or loss, can indicate underlying health issues, nutritional deficiencies, fluid retention, or the effectiveness of medical treatments. It provides crucial data for the healthcare team to make informed decisions about care.

Question 37: A resident refuses to take their scheduled medication. What should the nursing assistant do?

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

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 38: When providing foot care to a resident it is important for the nurse aide to:

Apply lotion, including between the toes
Remove calluses and corns
Check the feet for skin breakdown (Correct answer)
Keep the water cool to prevent burns

Correct answer: Check the feet for skin breakdown

When providing foot care, especially for residents with conditions like diabetes or circulatory issues, it is paramount for the nurse aide to thoroughly inspect the feet for any signs of skin breakdown. Early detection of redness, sores, blisters, or other abnormalities can prevent serious complications such as infections or ulcers. Removing calluses or applying lotion between toes are generally not within an STNA's scope or recommended practice.

Question 39: 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:

Take the resident's vital signs.
Raise the head of the bed. (Correct answer)
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 40: A resident with dementia wanders toward an exit door. What is the safest immediate action?

Gently redirect the resident away from the exit and notify the nurse (Correct answer)
Physically restrain the resident to stop the wandering
Lock the resident in their room to prevent elopement
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 41: A resident who is incontinent of urine has an increased risk of developing:

Dementia
Dehydration
Urinary tract infection (Correct answer)
Pressure sores

Correct answer: Urinary tract infection

Residents who are incontinent of urine are at a significantly increased risk of developing urinary tract infections (UTIs). This is because urine can remain in contact with the skin, creating a moist environment where bacteria can multiply and potentially ascend into the urethra, leading to infection. Proper hygiene and frequent changes are crucial to mitigate this risk.

Question 42: Validation therapy is most appropriate for which type of resident?

Residents with dementia experiencing confusion about time and place (Correct answer)
Residents with physical disabilities
Residents recovering from surgery
Residents with newly diagnosed hypertension

Correct answer: Residents with dementia experiencing confusion about time and place

Validation therapy acknowledges and respects the feelings of residents with dementia, reducing distress by entering their reality rather than correcting it.

Question 43: Which of the following is the correct method for measuring a patient's radial pulse?

Press firmly with the index finger on the patient's neck and count the beats for 15 seconds.
Place the thumb on the patient’s wrist and count the beats for 30 seconds.
Use the index and middle fingers to press lightly on the patient's wrist and count the beats for one full minute. (Correct answer)
Use the stethoscope to listen to the heartbeats in the patient’s chest and count the beats for one full minute.

Correct answer: Use the index and middle fingers to press lightly on the patient's wrist and count the beats for one full minute.

To accurately measure a radial pulse, the nurse aide should use the pads of their index and middle fingers (not the thumb, which has its own pulse) to lightly press on the radial artery on the patient's wrist. Counting the beats for a full minute provides the most accurate reading, especially if the pulse is irregular, ensuring a comprehensive assessment of heart rate.

Question 44: All long-term-care nurse aides must be competency evaluated and must complete a distinct education course, These requirements are set by:

FDA
OSHA
OBRA (Correct answer)
CDC

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 45: How many chest compressions to rescue breaths should be given during a 2 rescuer CPR for children and infants?

15:2 (Correct answer)
30:2
30:1
15:1

Correct answer: 15:2

For 2-rescuer CPR on children and infants, the recommended compression-to-ventilation ratio is 15 compressions to 2 breaths. This ratio is used because children and infants often experience cardiac arrest due to respiratory issues, making more frequent ventilations beneficial. This differs from adult CPR, which typically uses a 30:2 ratio for both single and two rescuers.

Question 46: 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:

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

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 47: 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
Bring the tray into the room when you are ready to feed the client (Correct answer)
Bring the tray to the client last; feed after you have served all other clients
Have the kitchen hold the tray for one hour

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

A non-skid mat placed under the resident's feet
A call light placed within resident reach
A raised toilet seat used for transfers
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 49: A resident frequently paces the hallways and appears restless. The nursing assistant should:

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

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 50: 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.
Help the resident back to his room and into bed.
Ask the resident about his job and if he is hungry. (Correct answer)
Tell him that residents are not allowed in the nurses' station.

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 51: While the nurse aide tries to dress a confused resident, the resident keeps trying to grab a hairbrush. The nurse aide should:

Try to dress the resident more quickly.
Restrain the resident's hand.
Give the resident the hairbrush to hold. (Correct answer)
Put the hairbrush away and out of sight.

Correct answer: Give the resident the hairbrush to hold.

For a confused resident, providing a familiar object or redirecting their attention can help calm them and reduce agitation. Giving the resident the hairbrush to hold offers a distraction and a sense of control, allowing the nurse aide to continue with dressing without escalating the situation. This approach respects the resident's current state and promotes cooperation.

Question 52: The resident's three top priorities when taking a bath are:

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

Correct answer: Privacy, security, and safety.

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

Question 53: When feeding a resident, frequent coughing can be a sign that the resident is:

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

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 54: A resident who has cancer is expected to die within the next couple of days. Nursing care for this resident should focus on:

Helping the resident through the stages of grief.
Keeping the resident's care routine, such as for bathing.
Providing for the resident's comfort. (Correct answer)
Giving the resident a lot of quiet time and privacy.

Correct answer: Providing for the resident's comfort.

For a resident nearing the end of life, the primary focus of nursing care shifts to palliative care, which prioritizes comfort, pain management, and emotional support. Ensuring the resident's physical and emotional comfort is paramount during this sensitive time, allowing them to experience peace and dignity. While other aspects of care are important, comfort takes precedence.

Question 55: Which of the following is a right that is included in the Resident's Bill of Rights?

To have staff available that speak different languages on each shift.
To have religious services offered at the facility daily.
To make decisions and participate in own care. (Correct answer)
To have payment plan options that are based on financial need.

Correct answer: To make decisions and participate in own care.

The Resident's Bill of Rights guarantees residents the fundamental right to make decisions and participate in their own care. This includes the right to accept or refuse treatment, be involved in care planning, and choose their healthcare providers. This right emphasizes autonomy and self-determination, ensuring residents have control over their health and well-being.

Question 56: Which of the following demonstrates a barrier to effective communication?

Paraphrasing what the patient says
Responding to the patient by saying “Don’t worry your doctor always knows best” (Correct answer)
Using a professional interpreter
Engaging in active listening

Correct answer: Responding to the patient by saying “Don’t worry your doctor always knows best”

Responding to a patient with phrases like 'Don’t worry your doctor always knows best' is a barrier to effective communication because it dismisses their feelings and concerns. This type of response can make the patient feel unheard, invalidate their anxieties, and discourage them from expressing further questions or fears. Effective communication requires active listening, empathy, and encouraging open dialogue.

Question 57: Which of the following statements is true about residents who are restrained?

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

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

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

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 59: 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
Source
Reservoir (Correct answer)
Portal of entry

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 60: A nurse gets a doctor's permission to use a jacket restraint on a patient, and she assigns a nursing assistant to help with the restraint. Which of the following observations suggests that the nursing assistant used the restraint inappropriately?

a safety knot in the straps used for restraint.
The jacket restraint should be fastened so that the client's skin and the restraint can be easily touched by two fingers.
belts used to restrain jackets that release tension when pressure is applied.
securely fastened restraint straps to the side rails. (Correct answer)

Correct answer: securely fastened restraint straps to the side rails.

To prevent unintentional harm in the unlikely event that the side rail is unfastened, the restraint straps should always be fastened to the bed frame rather than the side rail itself. Applying a constraint should be done with a half-bow or safety knot since they are easy to remove in an emergency and do not tighten when force is placed against them. One or two fingers should be able to readily slip between the client's skin and the jacket constraint once it is fastened.

Question 61: Which of the following is essential care when giving a resident a bath?

Before helping a patient clean their face, clean their perinea.
When giving the patient a bath, use cool water to encourage improved circulation.
Take care of the resident in every way possible to save energy.
Permit caregiving to encourage a feeling of independence. (Correct answer)

Correct answer: Permit caregiving to encourage a feeling of independence.

Encouraging the resident to take part in their care will boost their self-confidence and grant them independence. Cleaning the perineum before the face or using cool water instead of comfortably warm water is incorrect.

Question 62: During hand washing, the nurse aide accidentally touched the inside of the sink while rinsing the soap off. The NEXT action is to:

Dry the hands and turn off the faucet with the paper towel.
Allow the water to run over the hands for two minutes.
None of the above
Repeat the wash from the beginning. (Correct answer)

Correct answer: Repeat the wash from the beginning.

Touching a contaminated surface like the inside of the sink after washing but before drying re-contaminates the hands. To ensure proper infection control and maintain hand hygiene, the entire handwashing procedure must be repeated from the beginning. This eliminates any pathogens picked up from the sink.

Question 63: If you have a patient who cannot independently perform range of motion, your job is to help them by performing passive range of motion (PROM). PROM will help the patient with all of the following EXCEPT:

Protect his or her muscles from atrophy
Increase his or her circulation
Increase his or her joint motion
Increase his or her nutrition (Correct answer)

Correct answer: Increase his or her nutrition

Passive Range of Motion (PROM) exercises involve a caregiver moving a patient's joints through their full range of motion when the patient cannot do so independently. PROM is beneficial for preventing muscle atrophy, improving circulation, and maintaining joint flexibility. However, these exercises do not directly influence or increase a patient's nutritional intake or status, which is primarily determined by diet.

Question 64: While flossing the client's teeth, which motion is incorrect?

For each tooth, use a fresh piece of floss. (Correct answer)
Don't forget to floss the backs of the final teeth on the top, bottom, right, and left of the mouth.
Gently slide the floss between the teeth, up and down.
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 65: The MOST serious problem that wrinkles in bedclothes can cause is:

Decubitus ulcers (Correct answer)
Restlessness
Sleeplessness
Bleeding and shock

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

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

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 67: A person drinks 1 cup of apple juice with their breakfast. How many milliliters should be recorded?

360 mL
240 mL (Correct answer)
120 mL
180 mL

Correct answer: 240 mL

In healthcare, a standard conversion for fluid measurement is that 1 cup is approximately equivalent to 8 fluid ounces. Since 1 fluid ounce is roughly 30 milliliters (mL), multiplying 8 ounces by 30 mL/ounce yields 240 mL. Therefore, 1 cup of apple juice should be recorded as 240 mL for accurate intake tracking.

Question 68: A resident who is normally talkative suddenly becomes withdrawn and tearful. What should the CNA do?

Leave the resident alone to respect their privacy
Assume the resident is tired and check again the next day
Contact the family immediately without telling the nurse
Report the change in behavior to the nurse and document observations (Correct answer)

Correct answer: Report the change in behavior to the nurse and document observations

Sudden changes in a resident's mood or behavior are significant clinical observations that must be reported to the nurse promptly.

Question 69: When a resident with dementia becomes combative during personal care, the nursing assistant should:

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

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 70: 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.
Ensure the resident's call light is within reach and the bed is in the lowest position. (Correct answer)
Inform the resident that they will be secluded in their room if they don't stay in bed.

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 71: When lifting a heavy object, the correct method would be to bend at the:

Knees, keeping your back straight. (Correct answer)
Knees and waist.
Waist, rounding your shoulders.
Waist, keeping your legs straight.

Correct answer: Knees, keeping your back straight.

When lifting heavy objects, proper body mechanics are crucial to prevent injury. Bending at the knees and keeping the back straight allows the strong leg muscles to bear the weight, rather than straining the weaker back muscles. This technique minimizes stress on the spine and reduces the risk of musculoskeletal injuries.

Question 72: Which of the following, if observed as a sudden change in the resident, is considered a possible warning sign of a stroke?

Contractures
Slurred speech (Correct answer)
Irregular heartbeat
Dementia

Correct answer: Slurred speech

Slurred speech (dysarthria) is a common and critical warning sign of a stroke. A stroke occurs when blood flow to a part of the brain is interrupted, which can impair the brain's ability to control speech muscles. Recognizing this sudden change is crucial for prompt medical intervention, which can significantly improve outcomes.

Question 73: 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:

Avoid mentioning his wife when caring for him.
Understand the resident is grieving and give him chances to talk. (Correct answer)
Remind the resident to be thankful for the years he shared with his wife.
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 74: A resident tells you they want to file a complaint about their care. What is the nursing assistant's responsibility?

Tell the resident complaints must go through family only
Inform the resident of their right to contact the ombudsman (Correct answer)
Resolve the complaint privately without involving management
Discourage the complaint to avoid trouble for the facility

Correct answer: Inform the resident of their right to contact the ombudsman

Residents have the right to voice grievances and must be informed they can contact the long-term care ombudsman.

Question 75: A customer is wearing a face mask for oxygen therapy. For this client, which of the following is contraindicated?

Cotton bedding is used.
conversing with guests.
consuming his lunch.
shave using an electric blade. (Correct answer)

Correct answer: shave using an electric blade.

Safety precautions should be put in place for a client receiving oxygen therapy to avoid explosions. It is not permitted to use electric hair dryers or razors when the oxygen is operating. A client's hair can produce an electrical spark when combed, which has the potential to cause an explosion. If the patient wants to eat and interact with guests, the face mask can be taken off. It is also advised to use cotton bed linens to reduce static electricity.

Question 76: An older, mentally unstable patient becomes irate when the nursing assistant urges him to contact her for help because he wants to use the restroom alone. "Go away from me!" It says. "I wish to leave without informing you!" What's the best way for the nursing assistant to respond?

I apologize, sir, but it is simply not feasible.
Fine. We were just trying to be extra cautious, I suppose.
Want to take a tumble?
I'll bring you a urinal to use. (Correct answer)

Correct answer: I'll bring you a urinal to use.

The greatest method to encourage patient independence while also ensuring safety is to use a urinal.

Question 77: While giving a bed bath, the nurse aide hears the alarm from a nearby door suddenly go off. The nurse aide should:

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

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 78: A resident who is alert and oriented declines a bath. What is the appropriate response?

Involve the family to override the resident's decision
Respect the refusal, offer alternatives, and document and report (Correct answer)
Insist until the resident agrees for their own health
Proceed with the bath since hygiene is medically necessary

Correct answer: Respect the refusal, offer alternatives, and document and report

A competent resident's right to refuse care must be respected; the CNA should offer alternatives, document, and notify the nurse.

Question 79: Before touching a resident who is crying to offer comfort, the nurse aide should consider:

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

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 80: Which is an example of psychological or emotional abuse?

Gently correcting a resident who is confused about the date
Raising one's voice briefly in a noisy environment
Threatening to withhold meals if the resident does not cooperate (Correct answer)
Using simple language when explaining a procedure

Correct answer: Threatening to withhold meals if the resident does not cooperate

Threatening to withhold basic needs is emotional abuse and is strictly prohibited.

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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