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

Question 1: When a nursing assistant charts 'resident ambulated 20 feet with walker, tolerated well,' this is an example of:

An incident report
Subjective documentation
A physician progress note
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 2: What is a contracture?

Pain felt in a joint during movement
Permanent shortening of muscles and tendons causing joint rigidity (Correct answer)
Temporary joint swelling after exercise
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 3: A patient asks the nursing assistant about their diagnosis. The nursing assistant should:

Explain the diagnosis in as much detail as possible
Tell the patient to ask their nurse or doctor (Correct answer)
Look up the information and provide the patient with your own interpretation
Say 'I am not allowed to tell you anything about your condition'

Correct answer: Tell the patient to ask their nurse or doctor

Diagnosing and explaining medical conditions is outside the nursing assistant's scope of practice; the nurse or physician is the appropriate person to address these questions.

Question 4: When communicating with a resident who has Alzheimer's disease and is confused, you should:

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

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

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

Question 5: Which action shows empathy when a resident is crying and upset?

Leaving the room to give them privacy immediately
Telling them to cheer up because things could be worse
Changing the subject to distract them
Sitting beside them and saying 'I can see you're upset — I'm here.' (Correct answer)

Correct answer: Sitting beside them and saying 'I can see you're upset — I'm here.'

Empathy involves acknowledging feelings and offering presence, which helps residents feel heard and supported.

Question 6: A CNA obtains a blood pressure reading that seems much higher than the resident's baseline. What is the BEST next step?

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

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 7: Which term describes a pulse that is irregular, with beats occurring at uneven intervals?

Bradycardia
Tachycardia
Arrhythmia (Correct answer)
Bounding

Correct answer: Arrhythmia

An arrhythmia (or dysrhythmia) is an irregular heart rhythm where beats do not occur at regular intervals.

Question 8: What are the proper techniques for wheelchair safety?

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

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

Wheelchair safety prevents falls and injuries during transfers and transport.

Question 9: A resident on contact precautions needs a shower. What PPE should the nursing assistant wear during this shower?

No PPE is needed in the shower environment since water cleans everything
Gloves only, as the water dilutes organisms
Gloves and gown at minimum per facility contact precaution policy (Correct answer)
A full-face shield, gown, gloves, and N95 mask for all showers

Correct answer: Gloves and gown at minimum per facility contact precaution policy

Contact precautions require at minimum gloves and a gown when providing direct care to prevent transfer of organisms to staff and the environment.

Question 10: Which of the following are the components of the chain of infections?

Portal of exit, Host, Infectious agent, Reservoir
Portal of entry, Infectious agent, Host, Reservoir, Portal of exit, Mode of transmission (Correct answer)
Host, Infectious agent, Reservoir, portal of exit
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 11: Which water temperature is safest when filling a basin for a resident's hand and foot soak?

Cool — below 85°F to prevent burns
Warm — between 105°F and 110°F
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 12: Which action is contraindicated (should NOT be done) when caring for a patient with signs of a developing pressure injury?

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

Correct answer: Vigorously massaging reddened bony prominences

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

Question 13: When documenting a rectal temperature, the CNA should note the reading followed by which letter to indicate the site?

A
O
T
R (Correct answer)

Correct answer: R

The letter 'R' is recorded after a rectal temperature reading to indicate the measurement site (e.g., 99.6°F R).

Question 14: When documenting a skin tear found during care, the nursing assistant should include:

A diagnosis of what caused the wound
Only the treatment applied
Location, size, color, surrounding skin condition, and who was notified (Correct answer)
Only the location of the wound

Correct answer: Location, size, color, surrounding skin condition, and who was notified

Thorough wound documentation includes location, size, appearance, surrounding tissue condition, and notification of the supervising nurse.

Question 15: After completing ROM exercises, what should the nurse aide do?

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

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

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
Apply firm pressure to push through the stiffness

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

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

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

Finish the bath quickly to avoid leaving the resident wet
Leave the resident immediately to find the fire
Dress the resident and prepare to evacuate (Correct answer)
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 19: What is sundowning in dementia care?

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

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

Apply lotion and monitor the bruising over several days
Report the observation to the nurse immediately (Correct answer)
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 21: 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
Cover it with a plastic bag while showering
Leave it in — modern aids are waterproof
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 22: Which of the following BEST describes the nursing assistant's role in behavior management?

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

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 23: A resident with anxiety disorder uses deep breathing exercises as part of their care plan. The nursing assistant should:

Support and encourage the resident to use the exercises, especially during stressful moments (Correct answer)
Teach the resident a different technique not in the care plan
Notify the nurse that the resident seems too focused on breathing
Discourage the exercises as they take too much time during care

Correct answer: Support and encourage the resident to use the exercises, especially during stressful moments

Nursing assistants should reinforce care-planned coping strategies, as deep breathing is an evidence-based anxiety management tool.

Question 24: 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
Limiting the resident's choices to reduce decision fatigue
Following the care plan without discussing preferences with the resident
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 25: Which of the following is the correct order for DONNING (putting on) PPE?

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

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 26: 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 27: When cleaning around a wound or skin breakdown area, what is the correct direction to clean?

Clean in circular motions starting from any point
Clean from the outer edges inward toward the wound center
Clean only the surrounding skin and avoid touching near the wound
Clean from the wound center outward toward the surrounding skin (Correct answer)

Correct answer: Clean from the wound center outward toward the surrounding skin

Cleaning from the center of the wound outward prevents bacteria from the surrounding (dirtier) skin from being introduced into the wound where they can cause infection.

Question 28: Which body area is most commonly at risk for pressure injuries in a patient who is bedridden on their back?

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

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 29: At what fill level should a sharps container be replaced to prevent needlestick injuries?

When completely full
75% full (Correct answer)
50% full
25% full

Correct answer: 75% full

Sharps containers should be replaced when they are three-quarters (75%) full to prevent overfilling, which increases the risk of needlestick injuries during disposal.

Question 30: 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 allow staff to borrow items if needed
To determine the value of the resident's property

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.

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.

Questions

30 min

Time Limit

75%

To Pass

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