1. A CNA is about to take a resident's oral temperature. The resident just finished drinking a hot cup of coffee. What should the CNA do?
- A. Take the temperature immediately to get an accurate reading
- B. Wait at least 15 minutes before taking the oral temperature ✓
- C. Switch to a rectal temperature without checking with the nurse
- D. Document that the temperature could not be taken
Consuming hot or cold substances raises or lowers oral tissue temperature for approximately 15 minutes. Taking a measurement sooner produces a falsely elevated or depressed reading. The CNA should wait 15–20 minutes to ensure an accurate baseline oral temperature.
2. When performing hand hygiene with soap and water, the minimum amount of time a CNA should scrub the hands together is:
- A. 5 seconds
- B. 10 seconds
- C. 20 seconds ✓
- D. 60 seconds
The CDC and most state CNA curricula specify at least 20 seconds of vigorous scrubbing with soap and water to mechanically remove transient microorganisms. Shorter durations are insufficient to adequately reduce pathogen transmission.
3. While assisting a resident to walk down the hallway with a gait belt, the resident suddenly becomes pale, says she feels faint, and her knees begin to buckle. What should the nurse aide do FIRST?
- A. Hold the gait belt firmly, widen your stance, and ease the resident slowly to the floor while protecting her head ✓
- B. Let go of the gait belt and hurry to the nurses' station to get help
- C. Pull the resident upright by her arms and quickly walk her back to her room
- D. Leave the resident standing against the wall and go find a wheelchair
Under standard U.S. nurse-aide safety practice (federal OBRA-based competency curricula and NNAAP skill standards), when an ambulating resident begins to fall the aide must never leave the resident or try to stop the fall by pulling her up. The correct FIRST action is to keep hold of the gait belt, take a wide stance, pull the resident close, and gently guide her down to the floor (or a chair if immediately at hand), protecting her head. Only after the resident is safely lowered does the aide use the call light or call out for the nurse. Leaving the resident, releasing the belt, or yanking her upright by the arms risks a serious fall injury.
4. Which pulse site is MOST commonly used by a CNA to measure a resident's pulse rate?
- A. Apical
- B. Femoral
- C. Radial ✓
- D. Carotid
The radial pulse, located on the thumb side of the inner wrist, is the standard peripheral site used by CNAs for routine pulse measurement because it is easily accessible and reliable. The apical site is used when a radial pulse is irregular or difficult to palpate, typically by a nurse using a stethoscope.
5. A CNA is caring for a resident placed on Contact Precautions. After providing care and before leaving the room, the CNA should remove personal protective equipment (PPE) in which order?
- A. Mask, gloves, gown, hand hygiene
- B. Gloves, gown, mask or respirator, hand hygiene ✓
- C. Gown, mask, gloves, hand hygiene
- D. Hand hygiene, gloves, gown, mask
The CDC sequence for removing PPE to minimize self-contamination is: gloves first (most contaminated), then gown, then mask or respirator, followed by hand hygiene. Removing gloves first prevents contaminating the face or clothing when removing the gown and mask.
6. A normal adult resting respiratory rate is:
- A. 6–10 breaths per minute
- B. 12–20 breaths per minute ✓
- C. 22–28 breaths per minute
- D. 30–36 breaths per minute
The accepted normal resting respiratory rate for adults is 12–20 breaths per minute. Rates below 12 (bradypnea) or above 20 (tachypnea) at rest should be reported to the nurse, as they may indicate a medical problem.
7. A CNA is assisting a resident who has one-sided weakness (right-sided hemiplegia) to walk with a cane. On which side should the CNA stand?
- A. On the resident's right (weak) side ✓
- B. Behind the resident
- C. On the resident's left (strong) side
- D. In front of the resident
The CNA stands on the resident's weak or affected side to provide support and to be able to prevent a fall if the weakened limb gives way. The cane is held on the strong side, while the CNA guards the weak side.
8. Which of the following is the MOST effective way to break the chain of infection?
- A. Wearing a mask at all times
- B. Performing proper hand hygiene ✓
- C. Isolating all residents in private rooms
- D. Wearing gloves for all resident contact
Hand hygiene is universally recognized as the single most effective measure to interrupt the chain of infection and prevent the spread of healthcare-associated infections. While PPE including masks and gloves are important, consistent and proper hand hygiene is the cornerstone of infection prevention.
9. A CNA is taking a resident's blood pressure. The cuff should be applied so that it is:
- A. Placed directly over the antecubital space (inner elbow)
- B. About 1–2 inches (2.5–5 cm) above the antecubital space ✓
- C. Tightly wrapped so no finger can slide underneath
- D. Positioned on the forearm midway between wrist and elbow
Standard blood pressure measurement technique requires the cuff to be placed 1–2 inches above the antecubital fossa so the lower edge does not obstruct the stethoscope placement over the brachial artery. Placing the cuff over the fossa or on the forearm produces inaccurate readings.
10. A resident's axillary (armpit) temperature is 98.6°F (37°C). How should the CNA interpret this finding?
- A. This is a normal axillary temperature ✓
- B. This indicates a low-grade fever
- C. This indicates hypothermia
- D. The reading must be rechecked because axillary temperatures should not reach 98.6°F
Axillary temperatures are typically about 1°F lower than oral temperatures, and normal axillary temperature is commonly taught as approximately 96.6°F to 98.6°F. Therefore, an axillary reading of 98.6°F is at the upper end of the normal axillary range, not hypothermia and not necessarily a low-grade fever.