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

Question 1: When interacting with a resident who has an intellectual disability, the nursing assistant should:

Use simple, clear language and allow extra time for the resident to respond (Correct answer)
Assume the resident cannot make any decisions for themselves
Speak only to family members or guardians, never directly to the resident
Speak loudly and slowly, as if the resident has a hearing impairment

Correct answer: Use simple, clear language and allow extra time for the resident to respond

Clear, simple language and extra response time respect the resident's communication needs without being demeaning.

Question 2: A resident newly diagnosed with a terminal illness tells the CNA, "The lab made a mistake. I'm not sick." Which stage of grief does this show?

Acceptance
Depression
Denial (Correct answer)
Bargaining

Correct answer: Denial

Refusing to believe the diagnosis is a classic sign of denial.

Question 3: How many fingers should be able to slide under a properly applied gait belt?

Three fingers
One finger
Two fingers (Correct answer)
No fingers — it should be very tight

Correct answer: Two fingers

A correctly applied gait belt allows two fingers to slide underneath, confirming it is snug enough to be functional but not so tight as to restrict breathing.

Question 4: A nursing assistant is about to apply gloves after washing hands. The gloves package is torn. What should be done?

Discard and obtain an intact glove package (Correct answer)
Use the gloves but double-glove
Use the gloves only for non-sterile tasks
Tape the package and use the gloves

Correct answer: Discard and obtain an intact glove package

Gloves from a torn package may be contaminated or damaged, so they must be discarded and replaced with gloves from an intact package.

Question 5: Which of the following BEST describes the nursing assistant's role in behavior management?

Deciding independently which behavioral interventions to use
Observing, documenting, and reporting behavioral changes to the nurse (Correct answer)
Diagnosing the cause of behavioral symptoms and creating a treatment plan
Administering PRN medications when behavioral symptoms worsen

Correct answer: Observing, documenting, and reporting behavioral changes to the nurse

Nursing assistants are responsible for observing and reporting behaviors, not diagnosing or independently implementing clinical interventions.

Question 6: Which body area is most commonly at risk for pressure injuries in a patient who is bedridden on their back?

Abdomen and chest
Sacrum and coccyx (Correct answer)
Forearms and elbows
Shoulders and upper back

Correct answer: Sacrum and coccyx

The sacrum and coccyx are bony prominences that bear significant direct pressure when a patient lies in the supine (back-lying) position, making them the most common site for pressure injuries.

Question 7: What is proper body mechanics for nursing assistants?

Body mechanics are not important
Lift with the back
Wide base of support, bend at knees not waist, keep objects close to body, and avoid twisting (Correct answer)
Twist while carrying heavy loads

Correct answer: Wide base of support, bend at knees not waist, keep objects close to body, and avoid twisting

Proper body mechanics prevent back injuries and enable safe patient handling.

Question 8: When a nursing assistant charts 'resident ambulated 20 feet with walker, tolerated well,' this is an example of:

Subjective documentation
A physician progress note
An incident report
Objective, factual documentation (Correct answer)

Correct answer: Objective, factual documentation

Objective documentation records specific, measurable facts observed by the caregiver without interpretation or opinion.

Question 9: When providing care to a resident with bipolar disorder during a manic episode, the nursing assistant should:

Encourage the resident to do as much activity as possible to tire them out
Allow the resident to skip all scheduled care routines
Speak in a calm, low-key manner and maintain a calm environment (Correct answer)
Engage in lengthy debates to help the resident focus

Correct answer: Speak in a calm, low-key manner and maintain a calm environment

A calm environment and low-key communication help reduce stimulation during manic episodes.

Question 10: A resident from a different cultural background refuses care from a male nursing assistant. The correct response is to:

Have the charge nurse speak with the resident about accepting male caregivers
Document the refusal as non-compliance in the medical record
Accommodate the preference by assigning a female NA whenever possible (Correct answer)
Explain that all staff are professional and the preference cannot be honored

Correct answer: Accommodate the preference by assigning a female NA whenever possible

Cultural and personal preferences regarding caregiver gender are a resident right and should be accommodated whenever staffing allows.

Question 11: What is range of motion (ROM)?

The degree of movement possible at a joint through its full arc of motion (Correct answer)
A type of exercise machine
A medical diagnosis
A nursing skill level

Correct answer: The degree of movement possible at a joint through its full arc of motion

ROM exercises maintain joint flexibility and prevent contractures in patients with limited mobility.

Question 12: 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)
Only the values with no additional notes
The name of the nurse who ordered the vital signs
The CNA's personal opinion of the resident's condition

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 13: What is a POLST (Provider Order for Life-Sustaining Treatment) form?

A medical order signed by a provider that states the patient's treatment wishes and travels with the patient (Correct answer)
A facility admission checklist
A financial document naming who pays for care
A form only used after death

Correct answer: A medical order signed by a provider that states the patient's treatment wishes and travels with the patient

A POLST is an actionable medical order reflecting a seriously ill patient's wishes that goes with them across care settings.

Question 14: Which of the following is the infection that only affects the immune-suppressed?

Secondary infection
Nosocomial infection
Opportunistic infection (Correct answer)
Primary infection

Correct answer: Opportunistic infection

An opportunistic infection is an infection that primarily affects individuals with compromised immune systems. Pathogens that are typically harmless to healthy individuals can cause severe disease when the host's immune defenses are weakened, such as in patients with HIV/AIDS, those undergoing chemotherapy, or transplant recipients. These infections "take advantage" of the opportunity presented by a suppressed immune response.

Question 15: A nursing assistant notices a wet floor in the hallway. What should be done FIRST?

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

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

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

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 17: What is the difference between active and passive ROM?

Passive means no movement
Active ROM is performed by the patient; passive ROM is performed by the caregiver (Correct answer)
Active uses machines
They are the same

Correct answer: Active ROM is performed by the patient; passive ROM is performed by the caregiver

Active ROM builds strength; passive ROM maintains flexibility when patients cannot move independently.

Question 18: A nursing assistant forgot to document a resident's vital signs at 8 AM. It is now 11 AM. What is the correct way to handle this?

Ask another CNA to sign the 8 AM entry
Skip the entry since too much time has passed
Change the time on the chart to 8 AM so it looks timely
Write a late entry with the current time and note it as a late entry for 8 AM (Correct answer)

Correct answer: Write a late entry with the current time and note it as a late entry for 8 AM

A late entry is acceptable and must be labeled as such, documenting both the time of the actual event and the time of the entry.

Question 19: What are seizure precautions?

Restraining the patient during seizures
Leaving the patient alone during seizures
Placing objects in the patient's mouth
Padding side rails, keeping suction equipment nearby, and having oxygen available (Correct answer)

Correct answer: Padding side rails, keeping suction equipment nearby, and having oxygen available

Seizure precautions prevent injury without restricting the patient during the seizure itself.

Question 20: Which statement about a resident's right to privacy is correct?

Staff may search a resident's room anytime for safety reasons
Residents have the right to send and receive personal mail unopened (Correct answer)
Privacy rights can be suspended if a resident has dementia
Privacy applies only to medical information, not personal belongings

Correct answer: Residents have the right to send and receive personal mail unopened

Residents retain the right to private communication, including sending and receiving mail without staff interference.

Question 21: At the beginning of an initial interview, the patient wants to discuss his perceptions of why he felt ill but the interviewer wants to know the chronology of his symptoms to complete the history interview. The interviewer should:

Inform him that time is of the essence
Politely interrupt him and continue with closed-ended questions.
Allow him to complete his thoughts (Correct answer)
Inform him that an extra charge will be made if more time is needed for the interview.

Correct answer: Allow him to complete his thoughts

At the beginning of an initial interview, it is crucial to establish rapport and allow the patient to express their primary concerns and perceptions without interruption. Allowing the patient to complete their thoughts demonstrates active listening and respect, which can lead to a more comprehensive and accurate history later. Politely interrupting or imposing time limits early on can hinder trust and prevent the patient from sharing vital information.

Question 22: Which system includes the lungs and is affected by conditions such as COPD and pneumonia?

Respiratory system (Correct answer)
Integumentary system
Nervous system
Endocrine system

Correct answer: Respiratory system

The respiratory system brings oxygen in and removes carbon dioxide. COPD and pneumonia affect the lungs and breathing, so aides should watch for shortness of breath, coughing and changes in breathing.

Question 23: Neglect of a nursing facility resident is best described as:

Offering emotional support without clinical training
Failure to provide necessary care, resulting in harm or risk of harm (Correct answer)
Performing care tasks in a different order than the care plan specifies
Providing care that the resident did not explicitly request

Correct answer: Failure to provide necessary care, resulting in harm or risk of harm

Neglect is the failure to fulfill caregiving obligations, which can cause physical or emotional harm to the resident.

Question 24: _________ is a traditional charting?

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

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

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

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 26: How should perineal care be performed?

Use cold water
Clean in any direction
Clean from front to back, use warm water and mild soap, and maintain patient dignity (Correct answer)
Skip drying the area

Correct answer: Clean from front to back, use warm water and mild soap, and maintain patient dignity

Front-to-back technique prevents urinary tract infections; warm water promotes comfort.

Question 27: Which assessment tool is commonly used by healthcare teams to evaluate a patient's risk for developing pressure injuries?

Glasgow Coma Scale
Visual Analog Pain Scale
Braden Scale (Correct answer)
APGAR Score

Correct answer: Braden Scale

The Braden Scale assesses six risk factors — sensory perception, moisture, activity, mobility, nutrition, and friction/shear — to calculate a patient's overall risk for pressure injury development.

Question 28: A CNA documents a resident's meal intake as '100%' when the resident only ate about half the meal. This is an example of:

Acceptable rounding in documentation
Falsification of medical records (Correct answer)
An objective observation
A late entry

Correct answer: Falsification of medical records

Documenting inaccurate intake percentages is falsification and can affect the resident's care plan and nutritional management.

Question 29: A fire alarm sounds while a nursing assistant is bathing a resident. What should be done first?

Dress the resident and prepare to evacuate (Correct answer)
Finish the bath quickly to avoid leaving the resident wet
Leave the resident immediately to find the fire
Wait for a nurse to give specific instructions before doing anything

Correct answer: Dress the resident and prepare to evacuate

The resident's safety requires covering and protecting them before evacuation; leaving a wet, undressed resident creates additional risk.

Question 30: When caring for a patient with Clostridioides difficile (C. diff), which hand hygiene method is required after removing gloves?

Soap and water handwashing (Correct answer)
Alcohol-based hand rub only
Either soap or hand rub is acceptable
No additional hand hygiene is needed if gloves were worn

Correct answer: Soap and water handwashing

Soap and water must be used for C. diff because alcohol-based hand rubs do not effectively kill C. diff spores.

Question 31: A confused resident wanders into another resident's room and begins going through their belongings. The nursing assistant should:

Physically block the doorway and raise your voice to stop them
Allow it since the wandering resident cannot help themselves
Gently redirect the wandering resident back to their own room while protecting both residents' dignity (Correct answer)
Report only to the family of the wandering resident

Correct answer: Gently redirect the wandering resident back to their own room while protecting both residents' dignity

Gentle redirection protects both residents' safety and privacy while maintaining dignity for the resident with cognitive impairment.

Question 32: Which of the following would NOT typically require an incident report?

A nursing assistant accidentally giving a resident someone else's meal tray
A resident refusing their afternoon snack (Correct answer)
A resident found wandering near an exit door
A resident found on the floor

Correct answer: A resident refusing their afternoon snack

A resident refusing a snack is a routine preference or refusal that should be documented in the chart but does not require an incident report.

Question 33: What does the 'R' in the RACE fire emergency acronym stand for?

Reset
Run
Rescue (Correct answer)
Report

Correct answer: Rescue

RACE stands for Rescue, Alarm, Confine, and Extinguish/Evacuate — Rescue is always the first step.

Question 34: A resident with a history of alcohol use disorder is exhibiting tremors, sweating, and confusion. The nursing assistant should:

Offer the resident a drink to calm their nerves
Ask the resident if they need more blankets for the sweating
Report the symptoms to the nurse immediately as they may indicate withdrawal (Correct answer)
Ignore the symptoms since they are expected with this diagnosis

Correct answer: Report the symptoms to the nurse immediately as they may indicate withdrawal

Tremors, sweating, and confusion can be signs of alcohol withdrawal, which is a medical emergency requiring immediate nurse notification.

Question 35: What should be documented about nutritional intake?

Documentation is not needed
Only calorie counts
Percentage of meal eaten, fluid amounts consumed, any swallowing difficulties, and food preferences (Correct answer)
Only whether the patient ate

Correct answer: Percentage of meal eaten, fluid amounts consumed, any swallowing difficulties, and food preferences

Detailed nutritional documentation helps the care team assess adequacy and adjust plans.

Question 36: Which patient should be given thickened liquids according to standard dysphagia precautions?

A patient who has dentures
A patient with a physician/SLP order for thickened liquids (Correct answer)
A patient who has refused plain water
Any elderly patient over age 75

Correct answer: A patient with a physician/SLP order for thickened liquids

Thickened liquids are a medical intervention ordered by a physician or speech-language pathologist based on a formal swallowing evaluation — they should not be given without an order.

Question 37: A resident chooses to follow a specific religious diet that differs from the facility menu. The facility should:

Offer the religious diet only on recognized religious holidays
Explain that standard menus are required for nutritional balance
Accommodate the dietary request to the extent possible (Correct answer)
Allow the practice only if a religious leader provides written confirmation

Correct answer: Accommodate the dietary request to the extent possible

Residents have the right to practice their religion, including dietary observances, and the facility must make reasonable accommodations.

Question 38: What motion can be controlled by the patient?

Voluntary (Correct answer)
Involuntary

Correct answer: Voluntary

Voluntary motion refers to any movement that a patient can consciously control, such as breathing, shifting position, or moving a limb. In radiography, minimizing voluntary motion is crucial for obtaining clear images, and it can often be achieved through clear communication and patient cooperation.

Question 39: What is the Heimlich maneuver?

CPR on an unconscious person
Abdominal thrusts to dislodge an airway obstruction in a conscious choking person (Correct answer)
Mouth-to-mouth resuscitation
A back slap technique only

Correct answer: Abdominal thrusts to dislodge an airway obstruction in a conscious choking person

The Heimlich maneuver uses upward abdominal thrusts to force air from the lungs and expel the obstruction.

Question 40: A CNA obtains a blood pressure reading that seems much higher than the resident's baseline. What is the BEST next step?

Document the reading and say nothing unless asked
Discard the reading and record the previous day's value
Recheck the blood pressure in the same arm after a few minutes and report the finding to the nurse (Correct answer)
Immediately call 911

Correct answer: Recheck the blood pressure in the same arm after a few minutes and report the finding to the nurse

Rechecking after a short rest confirms whether the elevated reading is accurate, and the finding must always be reported to the nurse for clinical decision-making.

Question 41: A dying resident breathes deeply and rapidly, then stops breathing for several seconds, and the pattern repeats. What is this breathing pattern called?

Cheyne-Stokes respirations (Correct answer)
Kussmaul respirations
Orthopnea
Bradypnea

Correct answer: Cheyne-Stokes respirations

Cheyne-Stokes respirations alternate periods of deep, rapid breathing with periods of apnea and are common near death.

Question 42: The nurse asks the CNA to obtain orthostatic blood pressures. In which order should measurements be taken?

Standing only, comparing left arm to right arm
Sitting only, three times in a row
Lying down (supine), then sitting, then standing — with a brief wait between each position change (Correct answer)
Standing, then sitting, then lying down

Correct answer: Lying down (supine), then sitting, then standing — with a brief wait between each position change

Orthostatic blood pressure is measured supine, then sitting, then standing (with 1–3 minutes between position changes) to detect positional pressure drops.

Question 43: A nursing assistant notices a resident has unexplained bruising on their arms. The BEST action is to:

Report the observation to the nurse immediately (Correct answer)
Apply lotion and monitor the bruising over several days
Document the bruising in the care plan without notifying anyone
Ask the resident's roommate if they witnessed anything

Correct answer: Report the observation to the nurse immediately

Unexplained injuries are a possible sign of abuse and must be reported to the nurse immediately for assessment.

Question 44: Which factor can cause a pulse oximeter reading to be falsely LOW?

Poor peripheral circulation or cold fingers (Correct answer)
Anxiety
Fever
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 45: Which of the following is an example of a non-pharmacological approach to managing agitation in a dementia patient?

Giving the resident an extra dose of their antipsychotic medication
Physically restraining the resident in a chair
Playing familiar music from the resident's era (Correct answer)
Asking other residents to talk the person out of their distress

Correct answer: Playing familiar music from the resident's era

Music therapy using familiar songs is an evidence-based non-pharmacological intervention that can calm agitation in dementia.

Question 46: A resident's call light is on but the nursing assistant is busy with another task. What is the correct action?

Finish the current task completely before responding
Tell the resident to wait until the shift ends
Ignore it until a nurse becomes available
Ask a coworker to respond immediately (Correct answer)

Correct answer: Ask a coworker to respond immediately

Call lights must be answered promptly; if you cannot respond, immediately ask a coworker to do so.

Question 47: What is the correct minimum duration for washing hands with soap and water according to CDC guidelines?

20 seconds (Correct answer)
10 seconds
60 seconds
5 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 48: What is proper hand hygiene technique?

Wash hands once per shift
Wet hands, apply soap, scrub all surfaces for at least 20 seconds, rinse, and dry with clean towel (Correct answer)
Only use hand sanitizer
Quick rinse under water

Correct answer: Wet hands, apply soap, scrub all surfaces for at least 20 seconds, rinse, and dry with clean towel

Proper hand washing is the single most effective way to prevent infection spread.

Question 49: A resident's family member asks the nursing assistant to move the resident to a different room without the resident's knowledge. The NA should:

Refuse entirely and tell the family to leave
Comply, since family members are decision-makers for residents
Move the resident's belongings but not the resident
Discuss the request with the resident and then report to the nurse (Correct answer)

Correct answer: Discuss the request with the resident and then report to the nurse

Residents have the right to be informed of and involved in decisions that affect their living arrangements.

Question 50: Which of the following BEST describes the purpose of the minimum data set (MDS) in long-term care documentation?

A list of minimum staffing requirements for nursing homes
A billing invoice sent to insurance companies
A form for documenting daily vital signs
A standardized assessment tool used to evaluate resident needs and plan care in Medicare/Medicaid facilities (Correct answer)

Correct answer: A standardized assessment tool used to evaluate resident needs and plan care in Medicare/Medicaid facilities

The MDS is a federally mandated comprehensive assessment tool used in nursing facilities to evaluate residents and guide individualized care planning.

Question 51: You think that one of your doctor colleagues is drinking too much alcohol and it's affecting her work. The most appropriate action to take is:

Confront her in front of the rest of the practice
Refer her to an impaired physician's program
It depends on how "hot" she is (Correct answer)
Join her for some drinks after work
Report her to the police.

Correct answer: It depends on how "hot" she is

When a healthcare professional suspects a colleague is impaired by substance abuse, the most appropriate and ethical action is to report them to a designated impaired physician's program or the relevant professional board. These programs provide confidential support, monitoring, and rehabilitation, ensuring patient safety while offering the colleague a chance for recovery. Ignoring the issue or confronting them unprofessionally could endanger patients and violate professional responsibilities.

Question 52: A nursing assistant finishes emptying a bedpan and then needs to assist with oral care. When should gloves be changed?

Only if visible soiling is present on the gloves
After completing both tasks to conserve supplies
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 53: Which of the following is the correct order for DONNING (putting on) PPE?

Eye protection, gloves, gown, mask
Gloves, gown, mask, eye protection
Mask, gloves, gown, eye protection
Gown, mask/respirator, eye protection, gloves (Correct answer)

Correct answer: Gown, mask/respirator, eye protection, gloves

The CDC sequence for donning PPE is gown first, then mask or respirator, then eye protection, and finally gloves.

Question 54: What should a nursing assistant do if a resident refuses a safety device such as non-slip footwear?

Document the refusal and report it to the nurse (Correct answer)
Accept the refusal without any further action
Distract the resident and apply it without consent
Force the footwear on to protect the resident

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

Residents have the right to refuse care, but the nursing assistant must document the refusal and inform the nurse so the care team can address the safety risk.

Question 55: When should a nursing assistant wear eye protection during care?

Only during surgical procedures
Only when the nurse requests it
Only when caring for residents with known infections
When there is risk of splashing blood, body fluids, or secretions (Correct answer)

Correct answer: When there is risk of splashing blood, body fluids, or secretions

Standard precautions require eye protection whenever there is a risk of splashing or spraying of blood or body fluids, regardless of the resident's diagnosis.

Question 56: What is the minimum alcohol concentration required for an alcohol-based hand rub to be effective against most pathogens?

50%
80%
60% (Correct answer)
40%

Correct answer: 60%

The CDC recommends hand sanitizers containing at least 60% alcohol to effectively reduce the number of germs on hands.

Question 57: What is the normal body temperature range?

97.8°F to 99.1°F (36.5°C to 37.3°C) (Correct answer)
100°F to 102°F
95°F to 96°F
103°F to 105°F

Correct answer: 97.8°F to 99.1°F (36.5°C to 37.3°C)

Normal body temperature has a small range around 98.6°F/37°C with slight individual variation.

Question 58: 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 blood pressure of 118/76 mmHg after mild exertion
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)

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 59: Which observation about a resident's urine should be reported to the nurse?

Clear urine in the usual amount
Urine voided at the usual times
Dark, cloudy or foul-smelling urine, or blood in the urine (Correct answer)
Pale yellow urine

Correct answer: Dark, cloudy or foul-smelling urine, or blood in the urine

Dark, cloudy or foul-smelling urine, or blood in it, can signal infection or other problems. Nursing assistants observe and report; they do not diagnose.

Question 60: How should a nursing assistant assist with dressing?

Dress the affected side first and undress it last, promoting independence and respecting preferences (Correct answer)
Dress the unaffected side first
Skip dressing if the patient has difficulty
Choose clothing for the patient

Correct answer: Dress the affected side first and undress it last, promoting independence and respecting preferences

The affected-first rule prevents pain and injury; patient choice maintains dignity.

Question 61: The nursing assistant observes a resident pulling out their own hair repeatedly. This behavior is BEST described as:

Purposeful attention-seeking that should be ignored
A self-stimulatory or compulsive behavior that should be reported and documented (Correct answer)
A sign that the resident's hair is too long and needs trimming
A normal grooming habit

Correct answer: A self-stimulatory or compulsive behavior that should be reported and documented

Repetitive self-injurious behaviors like hair pulling require documentation and reporting to the nurse for clinical evaluation.

Question 62: A resident receiving palliative care asks the CNA to call a chaplain. What should the CNA do?

Share the CNA's own religious views instead
Promptly report the request so a chaplain can be arranged (Correct answer)
Ignore the request because spiritual care is not part of nursing care
Tell the resident to wait until a family member visits

Correct answer: Promptly report the request so a chaplain can be arranged

Meeting spiritual needs is part of holistic end-of-life care, so the request should be passed on promptly.

Question 63: A resident with post-traumatic stress disorder (PTSD) becomes very upset when a male nursing assistant enters the room without knocking. This reaction is BEST understood as:

Medication side effects causing over-sensitivity
A sign of dementia progressing rapidly
A PTSD trigger response related to a past traumatic experience (Correct answer)
Poor manners and rudeness from the resident

Correct answer: A PTSD trigger response related to a past traumatic experience

PTSD triggers are reactions to stimuli that remind the person of past trauma, and care routines should be adapted to minimize them.

Question 64: Informed consent means the resident:

Has a family member approve procedures on their behalf
Can only consent if the physician is present to explain the risks
Signs a general consent form at admission covering all future procedures
Receives complete information and voluntarily agrees to each procedure (Correct answer)

Correct answer: Receives complete information and voluntarily agrees to each procedure

Informed consent requires that residents receive full information about a procedure and agree to it freely before it is performed.

Question 65: What does 'reality orientation' involve when used with confused residents?

Agreeing with whatever the resident believes to reduce conflict
Gently providing accurate information about time, place, and person to reduce confusion (Correct answer)
Using loud, direct commands to redirect behavior
Avoiding all conversation about current events

Correct answer: Gently providing accurate information about time, place, and person to reduce confusion

Reality orientation provides gentle reminders of factual information to help oriented residents maintain awareness of their surroundings.

Question 66: Which of the following is an example of a physical restraint?

Turning off the television in the resident's room
Raising the head of the bed 30 degrees
Applying mittens that prevent the resident from removing an IV (Correct answer)
Placing a tray table close to a wheelchair

Correct answer: Applying mittens that prevent the resident from removing an IV

A physical restraint is any device that restricts freedom of movement; mittens that prevent self-removal of a medical device qualify as a restraint.

Question 67: A resident has an aluminum wheelchair. When is it safe to use a standard electrical outlet near this resident?

Always, as aluminum does not conduct electricity
It is never a special concern with metal wheelchairs
Only when the wheelchair is not touching the outlet (Correct answer)
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 68: 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
Validating the resident's right to refuse all care
Correcting the resident's false beliefs with factual information
Acknowledging and accepting the resident's feelings and subjective reality without judgment (Correct answer)

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 69: What are the stages of grief and how should a CNA respond?

CNAs should not address grief
There is only one stage
Denial, anger, bargaining, depression, acceptance — provide empathetic support at each stage (Correct answer)
Grief always follows the same timeline

Correct answer: Denial, anger, bargaining, depression, acceptance — provide empathetic support at each stage

The Kubler-Ross stages describe common grief responses; CNAs support residents by being present and empathetic at each stage.

Question 70: What is proper nail care for patients?

Nail care is not a CNA responsibility
Soak, trim straight across (not rounded), file smooth, and never cut diabetic patients' nails without orders (Correct answer)
Cut nails as short as possible
Only file nails never cut

Correct answer: Soak, trim straight across (not rounded), file smooth, and never cut diabetic patients' nails without orders

Proper nail care prevents injury and infection; diabetic patients require special precautions due to poor circulation.

Question 71: How should a nursing assistant assist with bathing?

Skip if the patient refuses
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

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 72: Before ambulating a patient for the first time after a period of bed rest, the nursing assistant should:

Ambulate the patient only after their meal for energy
Dangle the patient at the edge of the bed first and assess for dizziness (Correct answer)
Have the patient stand immediately to assess strength
Check if the patient can walk by having them stand in the room

Correct answer: Dangle the patient at the edge of the bed first and assess for dizziness

Dangling allows the patient's blood pressure to adjust gradually to the upright position, reducing the risk of orthostatic hypotension and falls.

Question 73: A resident asks the CNA for help writing a living will. What should the CNA do?

Report the request to the nurse or social worker (Correct answer)
Tell the resident living wills are not legal in Utah
Sign the document as a witness
Help the resident fill out the form

Correct answer: Report the request to the nurse or social worker

Advance directives are legal documents outside the CNA's scope, so the request should be referred to the appropriate staff.

Question 74: What is the main goal of hospice care?

To provide comfort, dignity, and quality of life for the resident and family (Correct answer)
To move the resident to a hospital
To prolong life with aggressive treatment
To cure the terminal illness

Correct answer: To provide comfort, dignity, and quality of life for the resident and family

Hospice focuses on comfort and quality of life instead of cure, and it also supports the family.

Question 75: Which of the following are the components of the chain of infections?

Host, Infectious agent, Reservoir, portal of exit
Portal of exit, Host, Infectious agent, Reservoir
Mode of transmission, Host, Infectious agent, Portal of entry, Portal of exit
Portal of entry, Infectious agent, Host, Reservoir, Portal of exit, Mode of transmission (Correct answer)

Correct answer: Portal of entry, Infectious agent, Host, Reservoir, Portal of exit, Mode of transmission

The chain of infection describes the sequential process by which an infectious agent is transmitted from one host to another. Its components include the infectious agent (pathogen), reservoir (where it lives), portal of exit (how it leaves the reservoir), mode of transmission (how it travels), portal of entry (how it enters a new host), and a susceptible host. Breaking any link in this chain can prevent the spread of infection.

Question 76: What is the primary cause of pressure injuries?

Excessive moisture from perspiration
Prolonged pressure on bony prominences that compresses blood vessels (Correct answer)
Inadequate daily fluid intake
Poor nutritional intake

Correct answer: Prolonged pressure on bony prominences that compresses blood vessels

Prolonged pressure on bony prominences is the primary cause of pressure injuries because it compresses blood vessels, blocking circulation and depriving tissue of oxygen and nutrients.

Question 77: What is a contracture?

A permanent tightening of muscles, tendons, and joints due to prolonged immobility (Correct answer)
A muscle strain
A broken bone
A skin condition

Correct answer: A permanent tightening of muscles, tendons, and joints due to prolonged immobility

Contractures develop when joints are not moved through their range, causing permanent shortening of surrounding tissues.

Question 78: 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)
Only provide mouthwash
Oral care is optional
Use only dry gauze

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 79: What is a pressure injury (also known as a pressure ulcer or bedsore)?

An injury caused by prolonged pressure on the skin that cuts off blood flow (Correct answer)
A rash caused by an allergic reaction to bedding
A bruise resulting from a fall or physical trauma
A skin infection caused by bacteria entering through a cut

Correct answer: An injury caused by prolonged pressure on the skin that cuts off blood flow

A pressure injury results from prolonged pressure on the skin that reduces blood flow to the tissue, causing damage or death of the skin and underlying tissue.

Question 80: Which action by a nursing assistant BEST demonstrates person-centered care for a resident with a mental health condition?

Limiting the resident's choices to reduce decision fatigue
Following the care plan without discussing preferences with the resident
Treating all residents with mental health conditions the same way
Learning the resident's personal history and preferences to individualize their care (Correct answer)

Correct answer: Learning the resident's personal history and preferences to individualize their care

Person-centered care requires understanding each resident as an individual, including their history, preferences, and personality.

Question 81: Which action is considered falsification of medical records?

Correcting an error with a single line
Signing only your own entries
Documenting care that was not actually performed (Correct answer)
Writing a late entry labeled as such

Correct answer: Documenting care that was not actually performed

Documenting care that was not given is falsification and is illegal, unethical, and grounds for license revocation.

Question 82: What constitutes abuse and neglect in long-term care?

Only physical hitting
Abuse does not occur in care facilities
Physical harm, emotional harm, sexual abuse, financial exploitation, and failure to provide necessary care (Correct answer)
Only withholding food

Correct answer: Physical harm, emotional harm, sexual abuse, financial exploitation, and failure to provide necessary care

Abuse and neglect take many forms; CNAs are mandated reporters who must report suspected abuse immediately.

Question 83: Which situation requires a nursing assistant to perform hand hygiene BEFORE a task even when gloves will be worn?

Only after removing gloves
Assisting with ambulation only
Before any patient contact or care task (Correct answer)
Only when the patient has a documented infection

Correct answer: Before any patient contact or care task

Hand hygiene must be performed before patient contact regardless of glove use, because gloves can have microscopic defects and hands may contaminate the glove exterior.

Question 84: What is a resident's right regarding personal choices?

Residents must follow all facility rules
Residents have the right to make decisions about their own care, schedules, and daily activities (Correct answer)
Staff decide everything for residents
Personal choice is a privilege, not a right

Correct answer: Residents have the right to make decisions about their own care, schedules, and daily activities

Self-determination means residents maintain control over personal decisions to the greatest extent possible.

Question 85: How does palliative care differ from hospice care?

Palliative care can be provided at any stage of a serious illness, even alongside curative treatment (Correct answer)
Palliative care is provided only in hospitals
Palliative care is only for residents expected to die within days
Palliative care stops all medications

Correct answer: Palliative care can be provided at any stage of a serious illness, even alongside curative treatment

Palliative care focuses on comfort and symptom relief and can be given together with treatment aimed at cure.

Question 86: The right difference between PIE and SOAPE formats is

PIE is part of a medical model, and SOAPE is not.
Both are same
SOAPE is from a medical model, whereas PIE is from the nursing process. (Correct answer)
PIE is a part of SOAPE.

Correct answer: SOAPE is from a medical model, whereas PIE is from the nursing process.

The SOAPE (Subjective, Objective, Assessment, Plan, Evaluation) format is a structured documentation method primarily used within the medical model, often by physicians and other healthcare providers. In contrast, the PIE (Problem, Intervention, Evaluation) format is specifically designed to align with the nursing process, focusing on identifying patient problems, outlining nursing interventions, and evaluating their effectiveness. This distinction highlights their different origins and primary users within the healthcare team.

Question 87: What type of sleep surface is recommended to help prevent pressure injuries in high-risk patients?

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

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 88: What are the proper techniques for wheelchair safety?

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

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 89: What is the purpose of positioning and repositioning?

Only for comfort
To prevent pressure injuries, maintain alignment, promote comfort, and prevent complications of immobility (Correct answer)
Repositioning is unnecessary
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 90: How is respiration counted?

Count breaths for 30-60 seconds without telling the patient, noting rate, depth, and pattern (Correct answer)
Tell the patient to breathe normally
Only count for 10 seconds
Count only inhales

Correct answer: Count breaths for 30-60 seconds without telling the patient, noting rate, depth, and pattern

Respirations should be counted covertly because awareness can change breathing patterns.

Question 91: How should a nursing assistant assist with ambulation?

Only ambulance very slowly
Use a gait belt, walk slightly behind on the patient's weak side, and encourage proper posture (Correct answer)
Pull the patient by the arm
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 92: What is HIPAA's impact on CNA practice?

CNAs can share any information
CNAs must protect resident health information and only discuss it with authorized care team members (Correct answer)
Only nurses follow HIPAA
HIPAA does not apply to CNAs

Correct answer: CNAs must protect resident health information and only discuss it with authorized care team members

All healthcare workers, including CNAs, must comply with HIPAA privacy protections.

Question 93: What is sundowning in dementia care?

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

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 94: When measuring urinary output from a catheter bag, the nursing assistant should:

Estimate the amount by looking at the fill line on the bag
Drain the bag directly into the toilet and record an estimate
Empty the bag into a graduated measuring container at eye level and document (Correct answer)
Report only to the nurse and not document independently

Correct answer: Empty the bag into a graduated measuring container at eye level and document

Accurate output measurement requires using a graduated container and reading at eye level to ensure precision, then documenting the exact amount.

Question 95: What does a Stage 1 pressure injury look like?

A wound covered with yellow slough tissue
A blister filled with clear or bloody fluid
A full-thickness open ulcer with exposed bone or muscle
Non-blanchable redness on otherwise intact skin (Correct answer)

Correct answer: Non-blanchable redness on otherwise intact skin

Stage 1 pressure injuries present as intact skin with localized, non-blanchable redness, indicating early damage to superficial tissue without any open wound.

Question 96: Which of the following HAI’s are commonly seen in your Hospital?

Skin infection
Surgical wound infection
Respiratory tract infection (RTI)
Urinary Tract Infection (UTI) (Correct answer)

Correct answer: Urinary Tract Infection (UTI)

Urinary Tract Infections (UTIs) are among the most common hospital-acquired infections (HAIs), particularly in hospitalized patients. They are frequently associated with the use of indwelling urinary catheters, which can introduce bacteria into the urinary tract. Proper catheter care and early removal are crucial strategies to prevent these infections.

Question 97: When using a transfer belt to move a resident, where should the belt be placed?

Around the resident's thighs
Around the resident's hips below the waist
Around the resident's chest under the arms
Around the resident's waist over clothing (Correct answer)

Correct answer: Around the resident's waist over clothing

The transfer (gait) belt is placed snugly around the resident's waist over clothing, not on bare skin.

Question 98: A nursing assistant notices a resident is hoarding food in their room. The BEST first action is to:

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
Remove all the food without explaining why

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 99: Which resident behavior is MOST consistent with a panic attack?

Gradual onset of mild sadness over several weeks
Slow, rhythmic breathing with eyes closed
Sudden intense fear with racing heart, shortness of breath, and chest tightness (Correct answer)
Increased appetite and elevated mood

Correct answer: Sudden intense fear with racing heart, shortness of breath, and chest tightness

Panic attacks typically present with sudden, intense fear accompanied by physical symptoms including rapid heartbeat, shortness of breath, and chest tightness.

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 reduces anxiety and confusion by providing predictable structure (Correct answer)
It prevents residents from asking questions about their care

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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