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

Question 1: What does 'dangling' mean in the context of patient mobility?

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

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 2: Which of the following is an example of financial abuse of a resident?

Borrowing money from a resident with no intention to repay it (Correct answer)
Assisting a resident in making a purchase at the facility store
Notifying the business office about a resident's billing question
Helping a resident balance their checkbook at their request

Correct answer: Borrowing money from a resident with no intention to repay it

Taking or borrowing money from a resident without intending to repay constitutes financial exploitation and is a form of abuse.

Question 3: A patient winces in pain and says 'that hurts' during a ROM exercise. What should the nurse aide do?

Continue at a slower pace since discomfort is normal
Reduce the number of repetitions and continue
Apply ice and then continue the exercise
Stop immediately and report the complaint to the nurse (Correct answer)

Correct answer: Stop immediately and report the complaint to the nurse

Pain is never considered normal during ROM exercises; the nurse aide must stop and report any pain to the supervising nurse.

Question 4: Where should the nurse aide grip a gait belt when assisting a patient?

Directly on the patient's skin for a firm grip
Only at the very front of the belt
Underneath the patient's arms for maximum lift
At the sides or back of the belt, over clothing (Correct answer)

Correct answer: At the sides or back of the belt, over clothing

The gait belt should be gripped at the sides or back over clothing to provide secure control without causing injury.

Question 5: A patient who uses a cane for balance should hold it on which side?

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

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 6: Which technique helps ensure a patient understood the instructions given by the nursing assistant?

Provide a detailed written handout and assume they will read it
Speak louder and more slowly the second time
Have the patient demonstrate or repeat back the key information (teach-back method) (Correct answer)
Ask 'Do you understand?' and accept a 'yes' answer

Correct answer: Have the patient demonstrate or repeat back the key information (teach-back method)

The teach-back method, where the patient restates or demonstrates what they learned, is the most reliable way to confirm genuine understanding.

Question 7: What does 'reality orientation' involve when used with confused residents?

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

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

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

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 9: Droplet precautions are required for a patient with influenza. What is the maximum distance at which droplet transmission can occur?

10 feet
1 foot
6 feet (Correct answer)
3 feet

Correct answer: 6 feet

Droplets typically travel up to 6 feet (approximately 2 meters) from the source, which is why a surgical mask is required within that distance.

Question 10: 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
Report the behavior to the nurse and document the observation (Correct answer)
Take no action because this is a common harmless habit
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 11: Which population is most susceptible to Hospital acquired infections?

Nurses
Inpatients (Correct answer)
Doctors
Outpatients

Correct answer: Inpatients

Inpatients are the population most susceptible to Hospital-Acquired Infections (HAIs) because they are admitted to the hospital for medical care. Their susceptibility stems from factors such as prolonged exposure to healthcare environments, undergoing invasive procedures, having weakened immune systems due to illness, and the presence of multiple comorbidities.

Question 12: Which resident situation requires the CNA to report vital signs to the nurse immediately rather than waiting until the end of the shift?

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

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 13: What is proper hand hygiene technique?

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

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 14: What is proper body mechanics for nursing assistants?

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

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 15: 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)
Ignore the request until she stops asking
Lock her room door so she cannot wander
Tell her firmly that this IS her home now

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 16: When performing a wound dressing change, which of the following indicates a wound infection that should be reported immediately?

Slight serous (clear) drainage
Increased warmth, redness, swelling, and purulent drainage (Correct answer)
Slight pink coloring at wound edges
Scab formation over the wound

Correct answer: Increased warmth, redness, swelling, and purulent drainage

Signs of wound infection include increased redness, warmth, edema, purulent (pus-like) drainage, and increased pain — all of which require prompt reporting to the nurse.

Question 17: What is the correct technique for oral care?

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

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 18: Under HIPAA, a nursing assistant may share a resident's medical information with:

Only those directly involved in the resident's care who have a need to know (Correct answer)
Friends and family who express concern for the resident
Any staff member who asks about the resident
Other residents who ask about a fellow resident's condition

Correct answer: Only those directly involved in the resident's care who have a need to know

HIPAA requires that protected health information only be shared on a need-to-know basis with care team members directly involved in the resident's treatment.

Question 19: A nursing assistant observes that a patient who normally talks a lot is unusually quiet today. The correct action is to:

Respect the patient's silence and say nothing
Report the change in behavior to the supervising nurse (Correct answer)
Ask other staff if they noticed the same thing before doing anything
Assume the patient is tired and leave them alone

Correct answer: Report the change in behavior to the supervising nurse

A change in a patient's communication pattern or mood is a reportable observation because it may indicate a change in physical or mental health status.

Question 20: 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 asks for an extra dessert at dinner
The resident suddenly cannot recognize their own family members (Correct answer)
The resident says they prefer not to watch TV today

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 21: A patient is on contact precautions for MRSA. Which PPE must a nursing assistant wear before entering the room?

Eye protection and gloves only
Gown and gloves (Correct answer)
N95 respirator and gloves
Surgical mask and gown

Correct answer: Gown and gloves

Contact precautions require at minimum a gown and gloves to prevent transmission through direct or indirect contact with the patient or environment.

Question 22: What kind of documentation is the following? 0800-1300 0 45, pain scale 0/10, hand and leg, strong to the right, weak to the left. Skin pink, warm and dry, turgor good, incision to Rt. Anterior chest wall erythema or edema ...................Jane Night, LPN.

Shift report
Nurse's Notes
Kardex
Narrative (Correct answer)

Correct answer: Narrative

The provided example, with its continuous prose describing observations like pain scale, physical assessment findings, and an incision in chronological order, is characteristic of narrative documentation. Narrative charting involves writing descriptive notes to detail the patient's condition, interventions, and responses. It tells the 'story' of the patient's status and care over a period, rather than using a structured format like a Kardex or specific nurse's notes templates.

Question 23: Which observation made during personal care must be reported to the nurse immediately?

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

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 24: Which is the correct way to report a near-miss safety event where no one was harmed?

Only report it if the supervisor asks
Report it verbally but do not document it
Keep it private to avoid paperwork
Complete an incident report and notify the charge nurse (Correct answer)

Correct answer: Complete an incident report and notify the charge nurse

Near-miss events must be reported and documented to identify safety hazards and prevent future actual injuries.

Question 25: Which sign indicates possible fluid overload (too much fluid) in a resident?

Swollen ankles and shortness of breath (Correct answer)
Sunken eyes and dry skin
Rapid weight loss over 24 hours
Decreased blood pressure and confusion

Correct answer: Swollen ankles and shortness of breath

Edema (swollen ankles) and shortness of breath are signs that fluid is accumulating in the body, indicating possible fluid overload requiring nurse notification.

Question 26: Which water temperature is safest when filling a basin for a resident's hand and foot soak?

Warm — between 105°F and 110°F
Cool — below 85°F to prevent burns
Comfortably warm — between 95°F and 105°F, verified with thermometer (Correct answer)
Hot — around 110°F to soften skin

Correct answer: Comfortably warm — between 95°F and 105°F, verified with thermometer

Water for soaks should be 95–105°F and always checked with a thermometer before placing a resident's skin in it.

Question 27: What is the correct position for a resident during a seizure?

On their side to prevent aspiration (Correct answer)
On their back with head tilted up
Held still to prevent injury
Upright in a chair to keep the airway open

Correct answer: On their side to prevent aspiration

Positioning the resident on their side (recovery position) helps prevent aspiration of secretions during and after a seizure.

Question 28: How should a nursing assistant assist with bathing?

Only provide a towel
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

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 29: Which of the following are the components of the chain of infections?

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

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 30: Which position is generally best for performing ROM exercises on the upper extremities of a bedridden patient?

High Fowler's (nearly upright)
Side-lying with the arm underneath
Prone (lying face down)
Supine (lying on back) (Correct answer)

Correct answer: Supine (lying on back)

The supine position provides easy access to all upper extremity joints and keeps the patient stable during exercises.

Question 31: A resident is agitated and combative during personal care. What is the most appropriate response?

Ask a family member to hold the resident still
Stop the care, ensure resident safety, allow time to calm, and notify the nurse (Correct answer)
Speak louder to get the resident's attention and continue
Restrain the resident and quickly complete the care

Correct answer: Stop the care, ensure resident safety, allow time to calm, and notify the nurse

Combative behavior can signal pain, fear, or cognitive distress; care should stop, the resident must be kept safe, and the nurse notified.

Question 32: A resident has limited range of motion in their right arm. When dressing them, the nursing assistant should:

Dress the weaker right arm first, then the stronger left (Correct answer)
Use adaptive clothing only if ordered by the physician
Dress the stronger left arm first, then the weaker right
Ask the resident to dress themselves to promote independence

Correct answer: Dress the weaker right arm first, then the stronger left

The weak or affected limb is dressed first because it has limited movement, making it easier to thread through sleeves before the stronger arm.

Question 33: When documenting vital signs, the CNA should record which of the following in addition to the values?

The CNA's personal opinion of the resident's condition
Only the values with no additional notes
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

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 34: After completing ROM exercises, what should the nurse aide do?

Only report findings if the patient complained of severe pain
Leave the patient in whatever position feels most comfortable without charting
Document the exercises performed and report any patient complaints to the nurse (Correct answer)
Wait until the end of the shift to document to save time

Correct answer: Document the exercises performed and report any patient complaints to the nurse

Timely documentation and reporting ensure continuity of care and allow the supervising nurse to address any concerns promptly.

Question 35: A resident on forced fluids (encouraged to drink more) refuses additional water. What should the NA do?

Document that the goal was met regardless
Force the resident to drink the water
Stop all fluid encouragement permanently
Offer alternate beverages acceptable on their diet and notify the nurse of the refusal (Correct answer)

Correct answer: Offer alternate beverages acceptable on their diet and notify the nurse of the refusal

The NA should offer appealing alternatives within the diet order, document actual intake accurately, and report persistent refusal to the nurse.

Question 36: 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 37: When taking a rectal temperature, the CNA should insert the lubricated thermometer probe approximately how far into the rectum for an adult?

2 inches
3 inches
1 inch (Correct answer)
1/2 inch

Correct answer: 1 inch

For an adult, the thermometer should be inserted about 1 inch (2.5 cm) into the rectum to obtain an accurate temperature.

Question 38: Which of the following is an infection ,that is acquired in the hospital that was not present or incubating at the time of hospitalization?

Secondary infection
Community acquired infection
Primary infection
Nosocomial infection (Correct answer)

Correct answer: Nosocomial infection

A nosocomial infection, also known as a Hospital-Acquired Infection (HAI), is an infection that a patient acquires while receiving medical care in a healthcare facility. Crucially, these infections were not present or incubating at the time of the patient's admission. They often arise due to exposure to pathogens within the hospital environment or during medical procedures.

Question 39: Which of the following is a correct principle of wound care related to infection control?

Clean wounds from the outer edges toward the center
Clean wounds from the center outward to avoid introducing contamination (Correct answer)
Direction of cleaning does not matter if gloves are worn
Use the same swab stroke for multiple passes over the wound

Correct answer: Clean wounds from the center outward to avoid introducing contamination

Wounds are cleaned from the center (cleanest area) outward to prevent dragging microorganisms from surrounding skin into the wound.

Question 40: Which action represents the ethical principle of beneficence in nursing assistant practice?

Performing only the minimum care required by the shift assignment
Taking actions specifically intended to promote the resident's well-being (Correct answer)
Following policies even when they do not serve the resident's best interest
Telling the resident what care will be given without asking for their input

Correct answer: Taking actions specifically intended to promote the resident's well-being

Beneficence means actively doing good for the resident and placing their well-being at the center of every care decision.

Question 41: What is the difference between active and passive ROM?

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

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 42: What is the purpose of labeling a resident's personal belongings upon admission?

It is required only for residents with dementia
To prevent theft and mix-ups between residents (Correct answer)
To determine the value of the resident's property
To allow staff to borrow items if needed

Correct answer: To prevent theft and mix-ups between residents

Labeling belongings protects residents' property rights and prevents mix-ups, especially in shared-room settings.

Question 43: Which action is contraindicated (should NOT be done) when caring for a patient with signs of a developing pressure injury?

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

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 44: When performing ROM exercises on a patient with arthritis, the nurse aide should:

Apply firm pressure to push through the stiffness
Avoid all movement of arthritic joints to prevent damage
Perform gentle movements within the patient's pain tolerance (Correct answer)
Skip exercises entirely on days the patient reports increased pain

Correct answer: Perform gentle movements within the patient's pain tolerance

Gentle ROM exercises within pain tolerance help maintain joint mobility in arthritis patients; complete avoidance leads to further stiffness.

Question 45: A resident tells you something confidential and asks you not to tell anyone. If the information involves a safety concern, you should:

Tell other nursing assistants but not the nurse
Keep it secret to respect their wishes
Confront the resident about the safety concern yourself
Report it to the nurse because resident safety is the priority (Correct answer)

Correct answer: Report it to the nurse because resident safety is the priority

Confidentiality has limits; safety concerns must always be reported up the chain of care to protect the resident.

Question 46: Which liquid consistency is described as pourable but moves slower than water and coats a spoon?

Pudding thick
Nectar thick (Correct answer)
Thin liquid
Honey thick

Correct answer: Nectar thick

Nectar-thick liquids have the consistency of nectar or tomato juice and flow more slowly than thin liquids, reducing aspiration risk.

Question 47: A CNA documents a resident's meal intake as '100%' when the resident only ate about half the meal. This is an example of:

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

Correct answer: Falsification of medical records

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

Question 48: 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
Call out for help and activate the emergency response system (Correct answer)
Check the resident's advance directive before doing anything
Reposition the resident and wait one minute to reassess

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 49: What is a contracture?

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

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 50: What can a tech do to minimize voluntary motion?

Tell the patient to breathe in
Tell the patient to breathe out
Communicate effectively (Correct answer)

Correct answer: Communicate effectively

To minimize voluntary motion during a radiographic procedure, a technologist should communicate effectively with the patient. This involves clearly explaining the procedure, providing precise instructions on how to hold still, and offering reassurance. Good communication helps the patient understand their role and cooperate, reducing the likelihood of movement that could blur the image.

Question 51: What type of ROM exercise is performed entirely by the nurse aide without any effort from the patient?

Active-assistive ROM
Passive ROM (Correct answer)
Active ROM
Resistive ROM

Correct answer: Passive ROM

Passive ROM is performed by the nurse aide for the patient when the patient cannot move the joint themselves.

Question 52: When combing the hair of a resident with long, tangled hair, the nursing assistant should begin combing:

From the middle outward in both directions
At the ends and work up toward the scalp (Correct answer)
From one side of the head to the other horizontally
At the scalp and work down to the ends

Correct answer: At the ends and work up toward the scalp

Starting at the ends and working toward the scalp prevents painful pulling and minimizes hair breakage.

Question 53: What does 'hyperextension' of a joint mean?

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

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

Use the gloves but double-glove
Discard and obtain an intact glove package (Correct answer)
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 55: What is 'maceration' in skin care?

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

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 56: One complete respiration consists of which of the following?

One exhalation only
One inhalation and one exhalation (Correct answer)
One inhalation only
Two inhalations and one exhalation

Correct answer: One inhalation and one exhalation

One respiration = one complete breath cycle: one inhalation (chest rise) plus one exhalation (chest fall).

Question 57: What is a pressure injury (also known as a pressure ulcer or bedsore)?

A rash caused by an allergic reaction to bedding
An injury caused by prolonged pressure on the skin that cuts off blood flow (Correct answer)
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 58: How should a CNA handle a resident who is crying?

Offer comfort, listen empathetically, provide privacy, and report to the nurse (Correct answer)
Ignore it
Tell them to stop crying
Leave the room

Correct answer: Offer comfort, listen empathetically, provide privacy, and report to the nurse

Emotional support through presence, empathetic listening, and reporting helps address the underlying cause.

Question 59: When documenting ROM exercises, what information is essential to include?

The exercises performed, patient response, and any pain complaints (Correct answer)
Only whether the patient cooperated or refused
The nurse aide's personal observations about the patient's prognosis
Only the time the exercises were completed

Correct answer: The exercises performed, patient response, and any pain complaints

Complete documentation must include the exercises performed, the patient's response and tolerance, and any pain or unusual observations.

Question 60: Which of the following is an example of a non-pharmacological approach to managing agitation in a dementia patient?

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

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 61: 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
Only when the patient has a documented infection
Before any patient contact or care task (Correct answer)

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 62: 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 63: What is range of motion (ROM)?

A type of exercise machine
A medical diagnosis
The degree of movement possible at a joint through its full arc of motion (Correct answer)
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 64: A resident has a partial weight-bearing restriction. During AM care, which action is correct when transferring them to a shower chair?

Ask another resident to help support them
Have the resident bear full weight briefly to pivot
Use a gait belt and allow only the prescribed amount of weight bearing (Correct answer)
Skip the shower and do a bed bath instead

Correct answer: Use a gait belt and allow only the prescribed amount of weight bearing

A gait belt must be used and the resident may only bear the amount of weight specified in the care plan.

Question 65: What type of sleep surface is recommended to help prevent pressure injuries in high-risk patients?

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

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 66: 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
Whenever the nurse gives permission
Only when the wheelchair is not touching the outlet (Correct answer)
It is never a special concern with metal wheelchairs

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 67: Which movement brings a limb toward the body's midline?

Rotation
Abduction
Supination
Adduction (Correct answer)

Correct answer: Adduction

Adduction moves a limb toward the midline of the body, while abduction moves it away.

Question 68: Which action by a nursing assistant BEST demonstrates person-centered care for a resident with a mental health condition?

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

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 69: Which resident behavior signals the highest fall risk?

A resident who is alert and uses a call light before getting up
A resident who is non-ambulatory and stays in a wheelchair
A resident who sleeps most of the day
A resident who is confused and tries to get out of bed without help (Correct answer)

Correct answer: A resident who is confused and tries to get out of bed without help

Confusion combined with impulsive attempts to get out of bed creates the highest fall risk because the resident lacks insight into their own instability.

Question 70: Which resident behavior is MOST consistent with a panic attack?

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

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 71: What are the signs of abnormal vital signs that should be reported?

Only extremely high values
No vital sign changes need reporting
Temperature above 101°F or below 97°F, pulse below 60 or above 100, BP above 140/90 or below 90/60 (Correct answer)
Only temperature changes matter

Correct answer: Temperature above 101°F or below 97°F, pulse below 60 or above 100, BP above 140/90 or below 90/60

Abnormal vital signs may indicate deteriorating condition and require prompt reporting to the nurse.

Question 72: A resident with a history of alcohol use disorder is exhibiting tremors, sweating, and confusion. The nursing assistant should:

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

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 73: When changing a resident's soiled brief (adult incontinence product), in what position should the resident be placed first?

Supine (flat on back) throughout the entire procedure
Standing at the side of the bed with staff support
Sitting up in bed at a 90-degree angle
Side-lying to remove the soiled brief and perform perineal care before repositioning (Correct answer)

Correct answer: Side-lying to remove the soiled brief and perform perineal care before repositioning

Rolling the resident to the side-lying position allows the nursing assistant to remove the soiled brief, perform thorough perineal care, and apply a clean brief effectively.

Question 74: A resident who wears a hearing aid needs a shower. What should the nursing assistant do with the hearing aid before the shower?

Turn it off but leave it in place
Leave it in — modern aids are waterproof
Cover it with a plastic bag while showering
Remove it and store it safely in its case (Correct answer)

Correct answer: Remove it and store it safely in its case

Hearing aids must be removed before bathing or showering because water can permanently damage the device.

Question 75: 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
Lying down (supine), then sitting, then standing — with a brief wait between each position change (Correct answer)
Sitting only, three times in a row
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 76: What is culturally competent care?

Only following Western medical practices
Providing care that respects and accommodates patients' cultural beliefs, practices, and preferences (Correct answer)
Treating everyone exactly the same regardless of culture
Ignoring cultural differences

Correct answer: Providing care that respects and accommodates patients' cultural beliefs, practices, and preferences

Cultural competence recognizes that health beliefs and care preferences vary across cultures and adapts care accordingly.

Question 77: A resident expresses feelings of worthlessness and says 'I just want to die.' What is the CORRECT nursing assistant action?

Reassure them that everyone feels that way sometimes and move on
Tell the resident to cheer up and think positively
Stay with the resident, take the statement seriously, and immediately report it to the nurse (Correct answer)
Document the statement at the end of your shift

Correct answer: Stay with the resident, take the statement seriously, and immediately report it to the nurse

Any statement suggesting suicidal ideation must be reported immediately to the nurse — staying with the resident ensures safety.

Question 78: How often should a bedridden patient be repositioned to help prevent pressure injuries?

Every 6 hours
Every 2 hours (Correct answer)
Every 15 minutes
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 79: A patient becomes angry and raises their voice at the nursing assistant. The best immediate response is to:

Threaten to have the patient removed from the facility
Raise your voice to match the patient's tone to assert control
Leave the room without explanation
Stay calm, speak in a low and steady voice, and acknowledge the patient's frustration (Correct answer)

Correct answer: Stay calm, speak in a low and steady voice, and acknowledge the patient's frustration

Remaining calm and acknowledging the patient's feelings can de-escalate the situation and demonstrates professionalism and empathy.

Question 80: A resident develops a red area on the sacrum during morning care. The nursing assistant's first action should be to:

Position the resident on their back and check again in an hour
Report the finding to the nurse immediately and document it (Correct answer)
Rub the area briskly with lotion to increase circulation
Apply a bandage to protect the area and continue the bath

Correct answer: Report the finding to the nurse immediately and document it

A red area on a bony prominence may signal a stage 1 pressure injury and must be reported to the nurse immediately so treatment can begin.

Question 81: Which nutritional components are most critical for wound healing and maintaining skin integrity?

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

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 82: 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
Place a wet floor sign and clean the spill (Correct answer)
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 83: A resident with schizophrenia tells you that the food is poisoned. How should the nursing assistant respond?

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

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

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

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 85: How is blood pressure measured?

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

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

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

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 87: When documenting in the medical record, a nursing assistant should NEVER:

Leave blank spaces in chart entries (Correct answer)
Use clear, concise language
Use blue or black ink
Sign with their name and title

Correct answer: Leave blank spaces in chart entries

Blank spaces in documentation can be filled in later by someone else, creating a legal and safety risk.

Question 88: Which thermometer site provides the most accurate core body temperature reading?

Oral
Tympanic
Axillary
Rectal (Correct answer)

Correct answer: Rectal

Rectal temperature is considered the most accurate because it measures internal core body temperature directly.

Question 89: After taking a blood pressure, how should the CNA position the resident's arm before removing the cuff?

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

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 90: A resident uses dentures. How should the nursing assistant handle the dentures when cleaning them?

Brush them with regular fluoride toothpaste
Hold them over a sink lined with a towel or basin of water (Correct answer)
Soak them in hot water to sterilize
Clean them over an empty sink to save time

Correct answer: Hold them over a sink lined with a towel or basin of water

Dentures should be cleaned over a padded surface or basin of water to prevent breakage if dropped.

Question 91: When a family member becomes verbally aggressive toward you, the best response is to:

Argue back to defend yourself
Make a complaint to other residents
Remain calm, set a respectful boundary, and involve the charge nurse (Correct answer)
Leave without saying anything

Correct answer: Remain calm, set a respectful boundary, and involve the charge nurse

De-escalation through calm communication and involving a supervisor protects both staff and the therapeutic environment.

Question 92: How should soiled patient linen be handled to prevent infection spread?

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

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 93: A nursing assistant witnesses a coworker not washing hands between residents. What is the appropriate action?

Assume the coworker used hand sanitizer instead
Remind the coworker of hand hygiene policy and report to the charge nurse if it continues (Correct answer)
Report immediately to the state licensing board
Say nothing to avoid conflict with the coworker

Correct answer: Remind the coworker of hand hygiene policy and report to the charge nurse if it continues

Hand hygiene lapses are an infection control issue; address it respectfully with the coworker and escalate to the charge nurse if necessary.

Question 94: How is respiration counted?

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

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 95: What is the purpose of positioning and repositioning?

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

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 96: During a care task, a resident says 'I feel like nobody cares about me.' The best response is:

'You shouldn't feel that way — you get great care here.'
'I care about you. Can you tell me more about what you're feeling?' (Correct answer)
'Don't worry, everyone feels that way sometimes.'
'I'll let the nurse know you said that.'

Correct answer: 'I care about you. Can you tell me more about what you're feeling?'

Validating the resident's feelings and inviting them to share more demonstrates empathy and opens therapeutic dialogue.

Question 97: When transferring a patient from bed to wheelchair, where should the wheelchair be placed?

On the patient's weaker side to encourage strength
Directly in front of the bed, facing the patient
At the foot of the bed, perpendicular to it
On the patient's stronger side at a 45-degree angle to the bed (Correct answer)

Correct answer: On the patient's stronger side at a 45-degree angle to the bed

Placing the wheelchair on the patient's stronger side at a 45-degree angle allows them to pivot using their stronger limbs, improving safety and reducing fall risk.

Question 98: 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 loudly and slowly, as if the resident has a hearing impairment
Speak only to family members or guardians, never directly to the resident

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 99: When communicating with a visually impaired patient, the nursing assistant should:

Always use hand signals rather than verbal instructions
Announce yourself by name when entering and narrate actions before doing them (Correct answer)
Speak louder than usual to compensate for their vision loss
Avoid conversation since visual cues are unavailable

Correct answer: Announce yourself by name when entering and narrate actions before doing them

Announcing yourself and narrating actions helps visually impaired patients understand what is happening, reducing fear and promoting trust.

Question 100: Which of the following is an example of a chemical hazard in a long-term care facility?

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

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.

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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