Utah Nursing Assistant Registry (UNAR) Written Knowledge Exam — Questions and Answers

Question 1: When transferring a patient from bed to wheelchair, which principle is MOST important?

Perform the transfer alone to protect patient privacy
Use proper body mechanics and encourage patient participation (Correct answer)
Always use a mechanical lift regardless of patient ability
Complete the transfer as quickly as possible

Correct answer: Use proper body mechanics and encourage patient participation

Proper body mechanics protect the nurse aide from injury, and encouraging patient participation maintains the patient's strength and dignity.

Question 2: The abbreviation 'SOB' in medical charting refers to:

Shortness of breath (Correct answer)
Side of bed
Sudden onset bleeding
Significant observed behavior

Correct answer: Shortness of breath

SOB stands for shortness of breath and is an important clinical finding that must be documented and reported promptly.

Question 3: A CNA counts a resident's pulse for 30 seconds and gets 36 beats. What should be documented as the pulse rate?

18 beats per minute
54 beats per minute
72 beats per minute (Correct answer)
36 beats per minute

Correct answer: 72 beats per minute

A 30-second count is multiplied by 2 to get the beats per minute: 36 × 2 = 72 bpm.

Question 4: Which joint movement involves bending a joint to decrease the angle between two bones?

Flexion (Correct answer)
Extension
Abduction
Circumduction

Correct answer: Flexion

Flexion decreases the angle at a joint, such as bending the elbow or knee.

Question 5: Which resident situation requires the CNA to report vital signs to the nurse immediately rather than waiting until the end of the shift?

A pulse of 72 bpm and respirations of 16 per minute
A temperature of 98.8°F and blood pressure of 120/80 mmHg
A respiratory rate of 8 breaths per minute and SpO2 of 90% (Correct answer)
A blood pressure of 118/76 mmHg after mild exertion

Correct answer: A respiratory rate of 8 breaths per minute and SpO2 of 90%

A respiratory rate of 8 breaths per minute (bradypnea) combined with SpO2 of 90% indicates potential respiratory compromise and requires immediate reporting.

Question 6: Which statement is an example of using 'I' language appropriately in patient communication?

'I can't deal with patients like you.'
'You are being difficult right now.'
'I noticed you seem uncomfortable — is there something I can help with?' (Correct answer)
'I think you should stop complaining.'

Correct answer: 'I noticed you seem uncomfortable — is there something I can help with?'

'I' language focuses on observations and the nursing assistant's response rather than blaming the patient, which keeps communication respectful and solution-focused.

Question 7: A patient with dementia becomes confused and calls out for their mother. The nursing assistant should:

Restrain the patient to prevent wandering
Firmly remind the patient that their mother is deceased
Ignore the outburst and continue with the task
Redirect the patient calmly and focus on their emotional need for comfort (Correct answer)

Correct answer: Redirect the patient calmly and focus on their emotional need for comfort

Redirecting and addressing the underlying emotional need is more effective and compassionate than correcting the reality of a patient with dementia.

Question 8: A nursing assistant is transporting a patient on contact precautions to an X-ray. Which action is correct?

Only the nursing assistant needs to wear PPE during transport
No special precautions are needed during transport
The patient cannot leave the room under any circumstances
Place a gown on the patient and notify receiving staff (Correct answer)

Correct answer: Place a gown on the patient and notify receiving staff

During transport of patients on contact precautions, infected areas should be covered with a clean gown or sheet, and receiving staff must be notified to prepare.

Question 9: What is the correct minimum duration for washing hands with soap and water according to CDC guidelines?

5 seconds
60 seconds
20 seconds (Correct answer)
10 seconds

Correct answer: 20 seconds

The CDC recommends scrubbing hands for at least 20 seconds (about the time it takes to hum 'Happy Birthday' twice) to effectively remove pathogens.

Question 10: _________ is a traditional charting?

Narrative (Correct answer)
SOAPE
Problem-Oriented Medical Record
DARE

Correct answer: Narrative

Narrative charting is considered a traditional method of documentation where healthcare providers write descriptive notes in a chronological, free-text style. It involves detailing patient observations, interventions, and responses without a highly structured format. While other options like Problem-Oriented Medical Record (POMR), SOAPE, and DARE are structured approaches, narrative charting represents the foundational and often earliest form of medical record-keeping.

Question 11: When shaving a male resident with a safety razor, the nursing assistant should shave in which direction?

In a circular motion around the jaw
In the direction of hair growth to prevent skin irritation (Correct answer)
Upward only from chin to cheeks
Against the direction of hair growth for a closer shave

Correct answer: In the direction of hair growth to prevent skin irritation

Shaving in the direction of hair growth reduces the risk of razor burn, cuts, and skin irritation.

Question 12: How should a nursing assistant assist with ambulation?

Pull the patient by the arm
Use a gait belt, walk slightly behind on the patient's weak side, and encourage proper posture (Correct answer)
Only ambulance very slowly
Walk ahead of the patient

Correct answer: Use a gait belt, walk slightly behind on the patient's weak side, and encourage proper posture

Proper ambulation assistance provides support while encouraging maximum patient independence.

Question 13: Which of the following is a common sign of depression in elderly residents?

Improved sleep patterns
Excessive talking and laughter
Withdrawal from social activities and loss of interest in usual hobbies (Correct answer)
Increased appetite and energy

Correct answer: Withdrawal from social activities and loss of interest in usual hobbies

Withdrawal, loss of interest, and low energy are hallmark signs of depression that nursing assistants should report.

Question 14: What is the RACE protocol for fire emergencies?

React, Activate, Calm, Evacuate
Run, Alert, Call, Exit
Rescue, Alarm, Contain, Extinguish/Evacuate (Correct answer)
Remain, Assess, Control, Evaluate

Correct answer: Rescue, Alarm, Contain, Extinguish/Evacuate

RACE provides a prioritized sequence of actions during a fire emergency in a healthcare setting.

Question 15: A resident begins coughing and appears to be choking during a meal. What should the NA do first?

Give the resident a large drink of water
Pat the resident firmly on the back and resume feeding
Continue offering food and wait to see if it resolves
Stop feeding immediately and call for the nurse (Correct answer)

Correct answer: Stop feeding immediately and call for the nurse

Coughing during eating may signal aspiration; the NA must stop feeding immediately and notify the nurse to assess the resident.

Question 16: What should a nursing assistant do upon finding an area of redness on a patient's skin that does not blanch (turn white) when pressed?

Report it immediately to the nurse (Correct answer)
Apply a warm compress to the area and continue routine care
Massage the reddened area vigorously to improve circulation
Cover it with an adhesive bandage and monitor it independently

Correct answer: Report it immediately to the nurse

Non-blanchable redness is a sign of a Stage 1 pressure injury indicating compromised blood flow, and must be reported immediately to the nurse for professional assessment and care planning.

Question 17: Which statement about oral care for an unconscious resident is correct?

Brush teeth normally in the supine position for best access
Skip oral care for unconscious residents because they cannot eat
Only rinse the mouth with water since toothbrushing is dangerous
Position the resident on their side, use a small amount of fluid, and suction if available to prevent aspiration (Correct answer)

Correct answer: Position the resident on their side, use a small amount of fluid, and suction if available to prevent aspiration

Unconscious residents are at high aspiration risk; side-lying positioning and minimal fluid prevent fluid from entering the airway during oral care.

Question 18: Which factor can cause a pulse oximeter reading to be falsely LOW?

Anxiety
Fever
Poor peripheral circulation or cold fingers (Correct answer)
High altitude

Correct answer: Poor peripheral circulation or cold fingers

Poor peripheral circulation, cold extremities, or nail polish can interfere with the light sensor and produce falsely low SpO2 readings.

Question 19: Which nursing assistant action best prevents skin breakdown in a bedridden patient?

Regular repositioning combined with keeping skin clean and dry (Correct answer)
Applying lotion to all areas of redness immediately
Massaging bony prominences vigorously to increase circulation
Keeping the patient in one comfortable position throughout the shift

Correct answer: Regular repositioning combined with keeping skin clean and dry

Regular repositioning relieves sustained pressure while keeping skin clean and dry addresses moisture — together these two interventions target the main causes of skin breakdown.

Question 20: A tympanic thermometer measures temperature at which location?

The forehead
Under the tongue
The eardrum (tympanic membrane) (Correct answer)
The armpit

Correct answer: The eardrum (tympanic membrane)

A tympanic thermometer measures infrared heat energy from the tympanic membrane (eardrum) to estimate core body temperature.

Question 21: Why is recapping a needle using a two-handed technique dangerous?

It wastes time during patient care
It dulls the needle tip
It significantly increases the risk of needlestick injury (Correct answer)
It is only dangerous if done quickly

Correct answer: It significantly increases the risk of needlestick injury

Two-handed recapping places one hand in the path of the needle tip, which is the leading cause of needlestick injuries; OSHA prohibits this practice.

Question 22: A resident who uses supplemental oxygen is smoking in the bathroom. What should the nursing assistant do?

Immediately remove the resident from the area and report to the nurse (Correct answer)
Allow it as long as no one sees
Remove the oxygen briefly so the resident can finish
Warn the resident but allow them to finish

Correct answer: Immediately remove the resident from the area and report to the nurse

Oxygen is highly flammable; smoking near oxygen is a fire emergency requiring immediate action and nurse notification.

Question 23: Which patient condition significantly increases the risk of developing pressure injuries?

Regular ambulation three times per day
Good nutritional status with high protein intake
Adequate daily hydration of 2 liters
Urinary or bowel incontinence (Correct answer)

Correct answer: Urinary or bowel incontinence

Incontinence continuously exposes the skin to moisture, urine, and stool — chemical irritants that weaken the skin's protective barrier and dramatically increase the risk of skin breakdown.

Question 24: End-of-shift verbal reporting to the oncoming nursing assistant should include:

Changes in resident condition, care provided, and unfinished tasks (Correct answer)
Gossip about residents' family members
Personal opinions about the nurse supervisor
Only positive updates to maintain morale

Correct answer: Changes in resident condition, care provided, and unfinished tasks

Handoff reporting ensures continuity of care by communicating relevant clinical changes, completed care, and pending tasks.

Question 25: When providing eye care for a resident with eye drainage, which technique is correct?

Use the same part of the washcloth for both eyes to save time
Apply warm compresses only if ordered, otherwise skip eye care
Wipe from the inner canthus (near nose) to the outer canthus, using a clean area of cloth for each eye (Correct answer)
Wipe from the outer corner inward on both eyes simultaneously

Correct answer: Wipe from the inner canthus (near nose) to the outer canthus, using a clean area of cloth for each eye

Wiping from inner to outer canthus with a clean cloth surface for each eye prevents cross-contamination between eyes.

Question 26: A nursing assistant notices a wet floor in the hallway. What should be done FIRST?

Walk around the spill to avoid it
Place a wet floor sign and clean the spill (Correct answer)
Report it to the charge nurse and continue working
Wait for housekeeping to arrive before doing anything

Correct answer: Place a wet floor sign and clean the spill

The immediate priority is preventing falls by marking the hazard and cleaning the spill as quickly as possible.

Question 27: A resident has an IV in their right arm. When putting on a hospital gown, the nursing assistant should:

Leave the affected arm undressed and drape a blanket over it
Remove the IV, dress the resident, then reinsert the IV
Cut the sleeve if the gown will not fit over the IV site
Thread the gown sleeve over the IV bag and tubing, then over the arm (Correct answer)

Correct answer: Thread the gown sleeve over the IV bag and tubing, then over the arm

The gown sleeve is threaded over the IV bag and tubing first, then carefully down the arm to avoid disrupting the IV line.

Question 28: A nursing assistant notices a resident is hoarding food in their room. The BEST first action is to:

Remove all the food without explaining why
Take no action because this is a common harmless habit
Report the behavior to the nurse and document the observation (Correct answer)
Tell other staff so they can confront the resident together

Correct answer: Report the behavior to the nurse and document the observation

Hoarding behavior can indicate underlying anxiety or past trauma and should be reported and documented for clinical assessment.

Question 29: A resident with diabetes needs foot care after their bath. Which action is specifically important for this resident?

Soak feet in hot water for 20 minutes to soften calluses
Apply lotion between the toes generously to keep them moisturized
Inspect the feet thoroughly for cuts, sores, redness, or any skin changes and report findings (Correct answer)
Trim toenails with clippers as part of routine diabetic foot care

Correct answer: Inspect the feet thoroughly for cuts, sores, redness, or any skin changes and report findings

Diabetic residents are at high risk for foot complications; the nursing assistant must carefully inspect the feet and immediately report any abnormalities.

Question 30: A nursing assistant opens a sterile package and notices a package seam has come apart. What should be done?

Tape the seam and continue
Use the outer items only, which remain sterile
Use the supplies quickly before contamination spreads
Discard the package as the sterile field is compromised (Correct answer)

Correct answer: Discard the package as the sterile field is compromised

Any break in packaging integrity means the sterile field is compromised; the entire package must be discarded and a new sterile package obtained.

Question 31: Which of the following is the nursing assistant's responsibility when an outbreak of gastrointestinal illness is suspected on a unit?

Independently investigate the source of the outbreak
Follow facility infection control protocols and report all symptomatic patients to the nurse (Correct answer)
Administer anti-diarrheal medications to affected patients
Restrict all patient movement without notifying the charge nurse

Correct answer: Follow facility infection control protocols and report all symptomatic patients to the nurse

During a suspected outbreak, the nursing assistant's role is to follow established protocols, report symptomatic patients to the nurse, and maintain strict hand hygiene and standard precautions.

Question 32: A cognitively intact resident tells the nursing assistant they are afraid of a specific treatment. The nursing assistant should:

Listen to the fear, provide reassurance, and inform the nurse of the resident's concern (Correct answer)
Ask the resident to sign a refusal form and leave
Tell the resident their fear is irrational
Proceed with the treatment because the nurse ordered it

Correct answer: Listen to the fear, provide reassurance, and inform the nurse of the resident's concern

Residents have the right to express fears about their care, and nursing assistants must listen, reassure, and report to the nurse.

Question 33: A patient who uses a cane for balance should hold it on which side?

The stronger or unaffected side (Correct answer)
Either side — patient preference determines placement
The weaker or affected side
Alternating sides during each step

Correct answer: The stronger or unaffected side

Holding the cane on the stronger side allows the patient to shift weight onto the cane when stepping with the weaker leg.

Question 34: Which water temperature is appropriate for a patient's bath?

120–125°F (49–52°C)
115–120°F (46–49°C)
95–100°F (35–38°C)
105–115°F (40–46°C) (Correct answer)

Correct answer: 105–115°F (40–46°C)

Bath water should be between 105–115°F to be comfortable and safe, preventing burns especially in patients with reduced sensation.

Question 35: A nursing assistant enters a room and finds a resident unresponsive and not breathing. What is the FIRST action?

Begin CPR immediately without calling for help
Check the resident's advance directive before doing anything
Reposition the resident and wait one minute to reassess
Call out for help and activate the emergency response system (Correct answer)

Correct answer: Call out for help and activate the emergency response system

Activating the emergency response system (calling for help) ensures a trained team and equipment arrive quickly while allowing CPR to begin.

Question 36: After taking a blood pressure, how should the CNA position the resident's arm before removing the cuff?

Extended straight down at the side
Raised above the head
Supported at heart level (Correct answer)
Crossed over the chest

Correct answer: Supported at heart level

The arm should be supported at heart level for an accurate reading and resident comfort before and after the measurement.

Question 37: Which patients are MOST likely to require passive ROM exercises?

Patients who are ambulatory and independent
Patients who can follow instructions but need encouragement
Unconscious or paralyzed patients who cannot move on their own (Correct answer)
Patients who are anxious about exercising

Correct answer: Unconscious or paralyzed patients who cannot move on their own

Passive ROM is indicated for patients who cannot initiate or complete joint movement on their own, such as those who are unconscious or paralyzed.

Question 38: The catheter drainage bag should always be kept:

At the level of the patient's bladder
Higher than the patient's bladder to promote flow
Lower than the patient's bladder to allow gravity drainage (Correct answer)
Clipped to the bedrail at any convenient height

Correct answer: Lower than the patient's bladder to allow gravity drainage

The drainage bag must remain below the level of the bladder so urine drains by gravity and does not flow back into the bladder, which could cause infection.

Question 39: Which of the following is an example of a communication barrier in a healthcare setting?

Introducing yourself by name to each patient
Asking if the patient has any questions
Using the call light system to reach staff
Pain or discomfort that makes it hard for the patient to focus (Correct answer)

Correct answer: Pain or discomfort that makes it hard for the patient to focus

Physical discomfort like pain can significantly reduce a patient's ability to focus on and retain information, creating a major communication barrier.

Question 40: What is aspiration and how is it prevented?

Only thick liquids cause aspiration
Aspiration is food or liquid entering the airway; prevented by upright positioning and proper feeding techniques (Correct answer)
Aspiration is not dangerous
It cannot be prevented

Correct answer: Aspiration is food or liquid entering the airway; prevented by upright positioning and proper feeding techniques

Aspiration can cause pneumonia and death; proper positioning and feeding techniques significantly reduce risk.

Question 41: A patient is placed on airborne precautions for suspected tuberculosis. Which type of room is required?

A semi-private room with a curtain drawn
Any private room with the door closed
Positive pressure room
Negative pressure airborne infection isolation room (AIIR) (Correct answer)

Correct answer: Negative pressure airborne infection isolation room (AIIR)

Airborne precautions require a negative pressure AIIR where air is exhausted outside or filtered, preventing airborne pathogens from escaping into the corridor.

Question 42: Which observation made during personal care must be reported to the nurse immediately?

Resident prefers a morning bath instead of an evening bath
Resident has a skin tear on the forearm with active bleeding (Correct answer)
Resident's hair is slightly tangled and needs combing
Resident has dry skin on the lower legs

Correct answer: Resident has a skin tear on the forearm with active bleeding

A skin tear with active bleeding is an urgent finding requiring immediate nurse notification for assessment and wound care.

Question 43: The purpose of therapeutic communication in nursing assistant care is to:

Entertain residents with personal stories
Fill time during slow periods
Give medical advice to residents
Build trust and support the resident's emotional and physical well-being (Correct answer)

Correct answer: Build trust and support the resident's emotional and physical well-being

Therapeutic communication uses purposeful techniques to establish trust and promote the resident's overall well-being.

Question 44: A resident's blood pressure was 118/76 mmHg this morning and is now 88/58 mmHg after standing up. This drop is called:

Hypertensive crisis
Orthostatic (postural) hypotension (Correct answer)
Essential hypertension
White coat syndrome

Correct answer: Orthostatic (postural) hypotension

Orthostatic hypotension is a significant drop in blood pressure (≥20 mmHg systolic or ≥10 mmHg diastolic) upon standing, which increases fall risk.

Question 45: What type of sleep surface is recommended to help prevent pressure injuries in high-risk patients?

A waterbed mattress filled with standard water
A very firm mattress to provide strong support
A pressure-redistributing mattress or overlay (Correct answer)
A standard foam hospital mattress

Correct answer: A pressure-redistributing mattress or overlay

Pressure-redistributing mattresses and overlays spread body weight over a larger surface area, reducing the concentration of pressure on individual bony prominences.

Question 46: What does 'I&O' stand for in medical documentation?

Instructions and orders
Intake and output (Correct answer)
Information and orientation
Injury and observation

Correct answer: Intake and output

I&O stands for intake and output, which tracks all fluids consumed and excreted to monitor fluid balance.

Question 47: How should a CNA respond to a resident with dementia who is confused and agitated?

Ignore the behavior
Speak calmly, redirect attention, validate feelings, and maintain a safe environment (Correct answer)
Argue with them about reality
Restrain them immediately

Correct answer: Speak calmly, redirect attention, validate feelings, and maintain a safe environment

Calm redirection and validation are more effective than confrontation for managing confusion and agitation in dementia.

Question 48: Which of the following is an example of an appropriate boundary a nursing assistant must maintain with residents who have mental health conditions?

Making promises about outcomes of their mental health treatment
Sharing personal problems with the resident to build trust
Maintaining a professional, supportive relationship without becoming personally involved in their personal affairs (Correct answer)
Giving the resident your personal phone number so they can call when anxious

Correct answer: Maintaining a professional, supportive relationship without becoming personally involved in their personal affairs

Nursing assistants must maintain professional therapeutic boundaries, which include avoiding dual relationships and unrealistic promises.

Question 49: What is 'maceration' in skin care?

Softening and deterioration of skin caused by prolonged exposure to moisture (Correct answer)
Discoloration of the skin resulting from bruising or bleeding under the surface
Hardening and thickening of the skin from prolonged sun exposure
Cracking and fissuring of skin caused by excessive dryness

Correct answer: Softening and deterioration of skin caused by prolonged exposure to moisture

Maceration is the softening and breakdown of skin tissue caused by prolonged exposure to moisture such as urine, wound drainage, or sweat, making the skin highly vulnerable to damage.

Question 50: How is blood pressure measured?

Using a thermometer
By counting pulse rate
Using a stethoscope and sphygmomanometer, listening for Korotkoff sounds over the brachial artery (Correct answer)
Only by palpation

Correct answer: Using a stethoscope and sphygmomanometer, listening for Korotkoff sounds over the brachial artery

Blood pressure measurement requires listening for the appearance and disappearance of Korotkoff sounds.

Question 51: A patient refuses to take a bath on their scheduled day. The nursing assistant should:

Call the family to convince the patient
Skip the bath and reschedule without documenting
Bathe the patient anyway to maintain hygiene standards
Document the refusal and inform the nurse (Correct answer)

Correct answer: Document the refusal and inform the nurse

Patients have the right to refuse care; the nursing assistant must document the refusal and notify the nurse to ensure appropriate follow-up.

Question 52: What is sundowning in dementia care?

Morning confusion
A sleeping disorder
Increased confusion and agitation that occurs in the late afternoon and evening (Correct answer)
A medication side effect

Correct answer: Increased confusion and agitation that occurs in the late afternoon and evening

Sundowning is common in dementia patients and may be related to fatigue, reduced lighting, and disruption of circadian rhythms.

Question 53: A resident who was previously social suddenly refuses meals and stops leaving their room. The nursing assistant should FIRST:

Respect the resident's wishes and document nothing
Assume the resident is just tired and will improve on their own
Force the resident to join group activities immediately
Report the behavioral change to the nurse as a potential sign of depression or illness (Correct answer)

Correct answer: Report the behavioral change to the nurse as a potential sign of depression or illness

Sudden withdrawal and refusal to eat are significant behavioral changes that must be reported to the nurse promptly.

Question 54: A nursing assistant finishes emptying a bedpan and then needs to assist with oral care. When should gloves be changed?

After completing both tasks to conserve supplies
Only if visible soiling is present on the gloves
Before assisting with oral care — between tasks on the same patient (Correct answer)
Only if the patient has a known infection

Correct answer: Before assisting with oral care — between tasks on the same patient

Gloves must be changed between tasks on the same patient when moving from a contaminated body site to a clean body site to prevent cross-contamination.

Question 55: A gait belt should be placed:

Directly against the patient's bare skin at the waist
Around the patient's hips below the waist
Around the patient's waist over their clothing (Correct answer)
Around the patient's chest under the arms

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

A gait belt is placed snugly around the patient's waist over clothing, allowing the nursing assistant to maintain a firm grip during transfers and ambulation.

Question 56: Which observation about a resident's mental status should be reported to the nurse IMMEDIATELY?

The resident takes longer than usual to fall asleep
The resident says they prefer not to watch TV today
The resident suddenly cannot recognize their own family members (Correct answer)
The resident asks for an extra dessert at dinner

Correct answer: The resident suddenly cannot recognize their own family members

Sudden inability to recognize family members indicates an acute change in mental status that requires immediate nursing evaluation.

Question 57: Which of the following is the correct interpretation of 'least restrictive environment' in long-term care?

Keeping facility doors unlocked at all times
Allowing residents to move to any room in the facility they prefer
Providing care that limits a resident's freedom only as much as clinically necessary (Correct answer)
Using the lowest dose of sedating medication possible

Correct answer: Providing care that limits a resident's freedom only as much as clinically necessary

The least restrictive environment principle requires that any limitation on a resident's freedom be the minimum necessary to meet clinical needs.

Question 58: Which pathogen is typically managed with droplet precautions?

Tuberculosis
Measles
C. difficile
Pertussis (whooping cough) (Correct answer)

Correct answer: Pertussis (whooping cough)

Pertussis is transmitted by respiratory droplets and requires droplet precautions; measles and TB require airborne precautions, and C. diff requires contact precautions.

Question 59: When providing perineal care to a female resident, the nursing assistant should clean in which direction?

Front to back (Correct answer)
Back to front
In a circular motion
Side to side

Correct answer: Front to back

Cleaning front to back prevents contamination of the urethra and vagina with bacteria from the rectal area.

Question 60: Which nutritional components are most critical for wound healing and maintaining skin integrity?

Increased sodium and potassium levels
Calcium and Vitamin D supplementation
Protein, Vitamin C, and zinc (Correct answer)
High carbohydrates and low dietary fat

Correct answer: Protein, Vitamin C, and zinc

Protein is essential for tissue repair and building new cells, Vitamin C supports collagen synthesis for wound closure, and zinc is required for cell growth and immune function — all critical for healing.

Question 61: A nursing assistant discovers broken glass on a patient's floor. Which is the safest method to clean it up?

Use a broom and dustpan or tongs — never use bare hands or unprotected fingers (Correct answer)
Vacuum the broken glass immediately
Pick up large pieces with bare hands and sweep smaller pieces
Cover with a towel and wait for housekeeping

Correct answer: Use a broom and dustpan or tongs — never use bare hands or unprotected fingers

Broken glass must always be collected with mechanical means (broom/dustpan, tongs, forceps) to prevent cuts; bare hands must never be used.

Question 62: A CNA is measuring a resident's axillary temperature. How long should the thermometer be held in place when using a glass thermometer?

3 minutes
10 minutes
1 minute
5 minutes (Correct answer)

Correct answer: 5 minutes

An axillary (underarm) temperature with a glass thermometer requires approximately 5 minutes to get an accurate reading.

Question 63: Which movement turns the palm of the hand to face downward?

Supination
Eversion
Pronation (Correct answer)
Inversion

Correct answer: Pronation

Pronation rotates the forearm so the palm faces downward or posteriorly.

Question 64: A resident's care plan includes 'validation therapy' as an intervention. This approach involves:

Using written checklists for the resident to validate their own behavior
Correcting the resident's false beliefs with factual information
Acknowledging and accepting the resident's feelings and subjective reality without judgment (Correct answer)
Validating the resident's right to refuse all care

Correct answer: Acknowledging and accepting the resident's feelings and subjective reality without judgment

Validation therapy acknowledges the emotional truth behind a dementia patient's statements rather than correcting factual errors, reducing distress.

Question 65: A CNA notices a resident's pulse oximeter reading is 88%. What action should the CNA take first?

Increase the resident's activity level
Document the reading and check again in one hour
Administer oxygen immediately
Reposition the probe and reassess, then report to the nurse if still low (Correct answer)

Correct answer: Reposition the probe and reassess, then report to the nurse if still low

The CNA should first check for probe issues (nail polish, poor circulation, movement), then report the persistent low reading to the nurse; administering oxygen requires a nurse's order.

Question 66: A resident with dementia repeatedly asks to go home every few minutes. What is the BEST nursing assistant response?

Use therapeutic fibbing and say 'We'll go soon' then redirect her attention (Correct answer)
Lock her room door so she cannot wander
Tell her firmly that this IS her home now
Ignore the request until she stops asking

Correct answer: Use therapeutic fibbing and say 'We'll go soon' then redirect her attention

Therapeutic redirection and compassionate responses reduce distress in dementia patients better than confrontation or restraint.

Question 67: How often should a bedridden patient be repositioned to help prevent pressure injuries?

Every 2 hours (Correct answer)
Once per shift
Every 15 minutes
Every 6 hours

Correct answer: Every 2 hours

Standard clinical guidelines recommend repositioning bedridden patients at least every 2 hours to relieve sustained pressure and restore blood flow to at-risk areas.

Question 68: Which restraint alternative should a nursing assistant try FIRST for a restless resident?

Apply a vest restraint with a nurse's order
Offer a comfort item or repositioning (Correct answer)
Use side rails on all four sides of the bed
Ask the family to come sit with the resident

Correct answer: Offer a comfort item or repositioning

Least-restrictive alternatives such as repositioning, comfort items, or diversional activities should be tried before any restraint.

Question 69: How should a nursing assistant properly dry a patient's skin after bathing?

Scrub vigorously with a terry cloth to remove dead skin cells
Leave skin slightly damp to prevent excessive dryness
Use hot water rinse to open pores before drying
Pat skin dry gently, paying special attention to skin folds (Correct answer)

Correct answer: Pat skin dry gently, paying special attention to skin folds

Gently patting the skin dry, especially in folds (groin, under breasts, between toes), prevents moisture buildup that leads to maceration, fungal infections, and skin breakdown.

Question 70: A resident who is bedridden needs nail care. Which action is within the nursing assistant's scope for fingernail care?

Using nail scissors to cut the nails at an angle
Filing nails smooth and cleaning under nails with an orange stick (Correct answer)
Trimming cuticles to keep them neat
Cutting nails with nail clippers as part of routine hygiene

Correct answer: Filing nails smooth and cleaning under nails with an orange stick

Nursing assistants typically may only file nails and clean under them; cutting nails (especially in diabetic or at-risk residents) usually requires a nurse or podiatrist.

Question 71: A resident has an advance directive stating they do not want CPR. During a medical emergency, the nursing assistant should:

Begin CPR immediately to preserve life
Follow the advance directive and notify the nurse right away (Correct answer)
Ask the family present whether to proceed with CPR
Call 911 and let emergency responders decide

Correct answer: Follow the advance directive and notify the nurse right away

Advance directives are legally binding instructions; staff must honor the document and immediately notify the nurse.

Question 72: What does 'hyperextension' of a joint mean?

Bending a joint to an extreme angle of flexion
Extending a limb beyond its normal straight position (Correct answer)
Moving a limb inward past the body's midline
Rapidly extending and retracting a joint

Correct answer: Extending a limb beyond its normal straight position

Hyperextension extends a joint beyond its normal anatomical straight position, such as bending the wrist backward.

Question 73: What does the term 'sundowning' refer to in residents with dementia?

Increased confusion, agitation, or behavioral changes that worsen in the late afternoon or evening (Correct answer)
Sleeping excessively during daytime hours
Refusing meals in the evening
A scheduled outdoor activity program at sunset

Correct answer: Increased confusion, agitation, or behavioral changes that worsen in the late afternoon or evening

Sundowning describes the worsening of dementia-related behaviors that typically occurs in the late afternoon and evening.

Question 74: If a patient begins to fall during ambulation, what is the CORRECT nurse aide response?

Lower the patient to the floor in a controlled and gradual manner (Correct answer)
Try to hold the patient upright with full strength to prevent any fall
Step away quickly to avoid being injured
Shout for help before taking any action

Correct answer: Lower the patient to the floor in a controlled and gradual manner

A controlled lowering to the floor prevents serious injury; trying to hold a falling patient upright can injure both the patient and the nurse aide.

Question 75: When assisting a patient with a cane, the nursing assistant should walk:

Two steps behind the patient
In front of the patient to guide them
On the patient's stronger side
On the patient's weaker side (Correct answer)

Correct answer: On the patient's weaker side

The nursing assistant stands on the patient's weaker side to provide support where the patient is most vulnerable to losing balance.

Question 76: In an electronic health record, what does an electronic signature (e-signature) signify?

That the person who logged the entry takes professional responsibility for the documented information (Correct answer)
That the entry was reviewed by a physician
That the entry can no longer be edited by anyone
That the document is encrypted

Correct answer: That the person who logged the entry takes professional responsibility for the documented information

An e-signature holds the same legal weight as a handwritten signature and indicates the person's professional accountability for the entry.

Question 77: What is the PRIMARY purpose of ROM exercises for a nursing home resident?

To increase cardiovascular endurance
To prepare the patient for surgery
To maintain joint flexibility and prevent contractures (Correct answer)
To build muscle mass and strength

Correct answer: To maintain joint flexibility and prevent contractures

The primary goal of ROM exercises is to maintain joint flexibility and prevent contractures caused by disuse.

Question 78: What is the safest way to dispose of a used razor blade after shaving a resident?

Wrap it in tissue and place it in the regular trash
Rinse it and leave it on the sink for reuse
Return it to the resident's bathroom cabinet
Drop it in a sharps container (Correct answer)

Correct answer: Drop it in a sharps container

Sharp objects such as razor blades must go into a puncture-resistant sharps container to prevent needlestick or laceration injuries.

Question 79: What does 'dangling' mean in the context of patient mobility?

Elevating the legs above heart level during rest
Hanging a limb off the side of the bed for passive stretching
Swinging a limb during active ROM exercises
Sitting on the edge of the bed with legs hanging down before standing (Correct answer)

Correct answer: Sitting on the edge of the bed with legs hanging down before standing

Dangling involves having the patient sit at the edge of the bed with feet hanging down to allow blood pressure to adjust before standing.

Question 80: When communicating with a resident who has Alzheimer's disease and is confused, you should:

Speak quickly to keep them focused
Argue to correct their misunderstanding of reality
Ignore them until they are more lucid
Use simple, short sentences and a calm tone (Correct answer)

Correct answer: Use simple, short sentences and a calm tone

Simple, short sentences and a calm tone reduce confusion and anxiety in residents with cognitive impairment.

Question 81: When documenting vital signs, the CNA should record which of the following in addition to the values?

The date, time, site used, and any resident complaints related to the measurement (Correct answer)
The name of the nurse who ordered the vital signs
The CNA's personal opinion of the resident's condition
Only the values with no additional notes

Correct answer: The date, time, site used, and any resident complaints related to the measurement

Accurate documentation includes the date, time, measurement site, the values obtained, and any relevant observations or resident complaints.

Question 82: How should soiled patient linen be handled to prevent infection spread?

Shake linen out before placing in the hamper to remove debris
Wash hands only after bagging linen — gloves are not required
Roll soiled linen inward and place in a leak-proof linen bag without shaking (Correct answer)
Carry linen against the body for support when transporting

Correct answer: Roll soiled linen inward and place in a leak-proof linen bag without shaking

Soiled linen must be rolled or folded inward and bagged without shaking to prevent dispersing microorganisms into the air and environment.

Question 83: Which stage of a pressure injury is characterized by full-thickness tissue loss with exposed or palpable bone, tendon, or muscle?

Stage 3
Stage 4 (Correct answer)
Unstageable
Stage 2

Correct answer: Stage 4

Stage 4 pressure injuries involve the deepest tissue damage, with full-thickness loss and exposed or directly palpable bone, tendon, or muscle, sometimes with slough or eschar present.

Question 84: What is the proper use of a gait belt?

Wrap around the patient's neck
Gait belts are optional
Only use on wheelchair patients
Secure around the patient's waist over clothing, used for transfers and ambulation assistance (Correct answer)

Correct answer: Secure around the patient's waist over clothing, used for transfers and ambulation assistance

Gait belts provide a secure handhold for assisting with standing, walking, and transfers.

Question 85: What is the purpose of positioning and repositioning?

Repositioning is unnecessary
Only for comfort
To prevent pressure injuries, maintain alignment, promote comfort, and prevent complications of immobility (Correct answer)
Only done during baths

Correct answer: To prevent pressure injuries, maintain alignment, promote comfort, and prevent complications of immobility

Regular repositioning prevents skin breakdown, respiratory complications, and musculoskeletal problems.

Question 86: What are the proper techniques for wheelchair safety?

Lock brakes before transfers, position footrests properly, use seatbelt if ordered, and check tire pressure (Correct answer)
Wheelchair safety is the patient's responsibility
Only lock brakes when parking
No safety checks are needed

Correct answer: Lock brakes before transfers, position footrests properly, use seatbelt if ordered, and check tire pressure

Wheelchair safety prevents falls and injuries during transfers and transport.

Question 87: Which action is contraindicated (should NOT be done) when caring for a patient with signs of a developing pressure injury?

Repositioning the patient every 2 hours to relieve pressure
Vigorously massaging reddened bony prominences (Correct answer)
Reporting any skin changes to the supervising nurse
Keeping the wound area appropriately clean

Correct answer: Vigorously massaging reddened bony prominences

Massaging reddened bony prominences is contraindicated because it can further damage already compromised capillaries and tissue, worsening the injury rather than helping it.

Question 88: A resident has an aluminum wheelchair. When is it safe to use a standard electrical outlet near this resident?

Only when the wheelchair is not touching the outlet (Correct answer)
It is never a special concern with metal wheelchairs
Always, as aluminum does not conduct electricity
Whenever the nurse gives permission

Correct answer: Only when the wheelchair is not touching the outlet

Metal objects including wheelchairs can conduct electricity, so electrical equipment should be used with care to avoid contact with the resident or the chair.

Question 89: Which of the following is an example of a chemical hazard in a long-term care facility?

Unlabeled cleaning solutions stored in resident rooms (Correct answer)
A soiled linen bag left in the hallway
A resident's personal television
An occupied wheelchair near the nurses' station

Correct answer: Unlabeled cleaning solutions stored in resident rooms

Unlabeled or improperly stored chemical cleaning products pose a poisoning and exposure hazard, especially to cognitively impaired residents.

Question 90: What is the FIRST action a nurse aide should take before beginning ROM exercises?

Apply warm compresses to all joints
Check the patient's blood pressure
Notify the patient's family
Wash hands and explain the procedure to the patient (Correct answer)

Correct answer: Wash hands and explain the procedure to the patient

Hand hygiene and explaining the procedure promotes infection control and gains the patient's cooperation and consent.

Question 91: What is validation therapy?

A physical therapy technique
Acknowledging and accepting a confused resident's feelings and reality rather than correcting them (Correct answer)
A medical test
Proving the resident wrong

Correct answer: Acknowledging and accepting a confused resident's feelings and reality rather than correcting them

Validation therapy respects the emotional truth of what a confused person is experiencing rather than forcing reality correction.

Question 92: A resident with schizophrenia tells you that the food is poisoned. How should the nursing assistant respond?

Acknowledge the resident's concern calmly and report the statement to the nurse (Correct answer)
Argue that the food is safe and list all the ingredients
Agree with the resident to avoid conflict
Refuse to serve the resident any more meals

Correct answer: Acknowledge the resident's concern calmly and report the statement to the nurse

Nursing assistants should acknowledge concerns without reinforcing delusions and report unusual statements to the nurse.

Question 93: How should a nursing assistant assist with bathing?

Maintain privacy, check water temperature, wash from cleanest to dirtiest areas, and promote independence (Correct answer)
Bathe without explaining the procedure
Only provide a towel
Skip if the patient refuses

Correct answer: Maintain privacy, check water temperature, wash from cleanest to dirtiest areas, and promote independence

Bathing should respect privacy, ensure safety, follow clean-to-dirty principles, and encourage patient participation.

Question 94: What is the correct technique for oral care?

Brush teeth and tongue gently, floss if able, and provide mouth rinse while maintaining aspiration precautions (Correct answer)
Oral care is optional
Use only dry gauze
Only provide mouthwash

Correct answer: Brush teeth and tongue gently, floss if able, and provide mouth rinse while maintaining aspiration precautions

Regular oral care prevents infection, improves comfort, and maintains dignity.

Question 95: Which resident would be most appropriate for an axillary temperature measurement instead of oral?

A resident who is sleeping
A confused resident who cannot hold the thermometer under their tongue safely (Correct answer)
A resident who has had recent abdominal surgery
A resident with a hip replacement

Correct answer: A confused resident who cannot hold the thermometer under their tongue safely

A confused or uncooperative resident who cannot safely hold a thermometer under the tongue should have their temperature taken axillary to prevent injury.

Question 96: Proxemics in patient communication refers to:

The tone of voice used when speaking to patients
The management of personal space and physical distance during interaction (Correct answer)
The speed at which information is delivered to patients
The use of touch to comfort patients

Correct answer: The management of personal space and physical distance during interaction

Proxemics is the study of personal space; maintaining appropriate distance respects patient boundaries and helps establish trust.

Question 97: Which situation is a contraindication for performing ROM exercises on a specific joint?

The patient has mild arthritis in the joint
The patient has a recent fracture in that area (Correct answer)
The patient is confined to bed rest
The patient has mild joint stiffness in the morning

Correct answer: The patient has a recent fracture in that area

ROM exercises should not be performed on or near a recent fracture site because movement can displace the fracture and cause further injury.

Question 98: What is a contracture?

Permanent shortening of muscles and tendons causing joint rigidity (Correct answer)
Temporary joint swelling after exercise
A muscle cramp during mobility activities
Pain felt in a joint during movement

Correct answer: Permanent shortening of muscles and tendons causing joint rigidity

A contracture is the permanent shortening of muscles and tendons that results in the joint becoming fixed in a rigid position.

Question 99: A resident with Alzheimer's disease accuses the nursing assistant of stealing her jewelry. The BEST response is to:

Calmly offer to help look for the jewelry without taking the accusation personally (Correct answer)
Argue and insist the accusation is false
Tell the resident their family must have taken it
Ignore the resident and walk away

Correct answer: Calmly offer to help look for the jewelry without taking the accusation personally

Accusatory behavior is a common dementia symptom; staying calm and helping search redirects without escalating conflict.

Question 100: What is the purpose of maintaining a consistent routine for residents with dementia?

It eliminates the need for verbal communication
It allows staff to take longer breaks
It prevents residents from asking questions about their care
It reduces anxiety and confusion by providing predictable structure (Correct answer)

Correct answer: It reduces anxiety and confusion by providing predictable structure

Consistent routines reduce anxiety, confusion, and behavioral disturbances in residents with dementia.

Utah Nursing Assistant Registry (UNAR) Written Knowledge Exam

The UNAR written exam tests competency across OBRA-defined nursing assistant domains required for entry onto the Utah State Nurse Aide Registry. Candidates must pass both the written knowledge exam and a manual skills evaluation to become a certified nursing assistant in Utah.

100

Questions

90 min

Time Limit

75%

To Pass

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