Nursing Home Care: Ethical Dilemmas and Best Practices, Exams of Nursing

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CNA Multiple Choice Questions With Complete Solutions A healthy diet is one that: a. The person will eat. b. Emphasizes whole grains, fruits and vegetables, lean meats and low-fat dairy. c. The person's primary care provider prescribes. d. The person grew up eating. Correct Answer b. Emphasizes whole grains, fruits and vegetables, lean meats and low-fat dairy. A nurse assistant helps a female resident meet self-esteem needs in all of the following ways EXCEPT: a. Addressing her in the way she prefers to be addressed. b. Doing everything for her so that she does not have to do anything. c. Taking care to protect her privacy and modesty. d. Taking an interest in the resident as an individual. Correct Answer b. Doing everything for her so that she does not have to do anything. A nurse assistant helps a resident who needs assistance with walking back to bed after using the bathroom. After getting the resident back in bed, the nurse assistant fails to place the resident's call signal within reach. Two hours later, the resident needs to use the bathroom and attempts to reach the call signal. Unable to do so, the resident attempts to get out of bed and falls. This is an example of: a. Larceny b. HIPAA violation c. Negligence

d. Abuse Correct Answer c. Negligence A nurse assistant helps Mrs. Smith, a resident of a nursing home, to meet her love and belonging needs by: a. Ensuring Mrs. Smith has enough to eat. b. Helping Mrs. Smith get ready to attend a group activity. c. Encouraging Mrs. Smith to do as much for herself as possible. d. Making sure that Mrs. Smith feels safe and secure. Correct Answer b. Helping Mrs. Smith get ready to attend a group activity. A nurse assistant must care for people from many different cultures. How should the nurse assistant handle this? a. Advise people in the healthcare facility that they must follow the facility's policies and procedures. b. Seek to understand each person as an individual, accommodating the person's preferences whenever possible. c. Use own personal cultural beliefs to guide the person's care. d. Avoid caring for people who are from a different culture. Correct Answer b. Seek to understand each person as an individual, accommodating the person's preferences whenever possible. A resident is receiving nutrition through a G-Tube. Which of the following actions should the nurse assistant take? a. Keep the resident lying flat for 30 minutes after a tube feeding b. Give the resident water by mouth c. Use cotton balls moistened with alcohol to clean around the resident's nose and mouth

d. Keep the head of the bed elevated for 30 mins following a tube feeding Correct Answer d. Keep the head of the bed elevated for 30 mins following a tube feeding A resident with arthritis complains of pain, feeling stiff and having trouble moving. You should: a. Medicate the patient and apply a heating pad. b. Report the complaint of pain to your supervising nurse. c. Dress the person warmly and exercise the joints vigorously. d. Apply a heating pad. Correct Answer b. Report the complaint of pain to your supervising nurse. A situation that arises in healthcare where there may be more that one good or moral solution is an example of what type of dilemma? a. Ethical moral b. Moral decision c. Ethical dilemma d. Ethical integrity Correct Answer c. Ethical dilemma All of the following are potential complications of restraints EXCEPT: a. Death. b. Low self-esteem and depression. c. Nerve and tissue damage. d. Drowning. Correct Answer b. Low self-esteem and depression. All of the following are risk factors for falling EXCEPT: a. Poor eyesight. b. Regular exercise

c. Poor mobility. d. Medication effects Correct Answer a. Poor eyesight. All of the following can affect a person's appetite EXCEPT: a. Medications the person is taking. b. An inability to smell the food. c. Pain. d. The person's fluid balance. Correct Answer d. The person's fluid balance. All of the following can affect the choices a person makes about food EXCEPT: a. The person's height b. The person's culture c. The person's religious beliefs d. The person's ability to prepare food Correct Answer a. The person's height As soon as it is safe to do so, how should you position a person who is having a seizure? a. Flat on the person's back b. On the person's side c. Seated, with the person's head between the knees d. On the person's stomach Correct Answer b. On the person's side Assisting people with bathing, eating, walking, and dressing are what type of activities? a. Principles of care. b. Routine activities of care c. Activities of daily living

d. Physical activities of care Correct Answer c. Activities of daily living Before using any equipment, you should: a. Check to make sure it is working properly. b. Unplug it. c. File an incident report. d. Stand up straight. Correct Answer a. Check to make sure it is working properly. Empathy is the quality of: a. Acting in a way to gain the trust of others. b. Pitching in to work as part of a team. c. Recognizing another person's hardship, accompanied by a desire to help relieve that hardship. d. Seeking to understand another person's situation, point of view or feelings. Correct Answer d. Seeking to understand another person's situation, point of view or feelings. How often should a person's incontinence pad or briefs be changed? a. When you detect an odor b. Whenever they become soiled c. At the end of the shift d. Every hour Correct Answer b. Whenever they become soiled If you have a cut or open sore on your hand, what must you do to protect yourself and others from infection? a. Avoid providing care for people with infections. b. Stay away from work until the wound heals. c. Wear gloves while providing care.

d. Handle only clean items. Correct Answer c. Wear gloves while providing care. It is 2:00 in the afternoon. How would you express this using the 24-hour clock? a. 2 p.m. b. 0200 c. 1400 d. 2 a.m. Correct Answer c. 1400 It is acceptable for a CNA to accept money or gifts from those in your care or their family members. a. True b. False Correct Answer b. False Mr. Bowler is 85 years old. He has dementia and requires close supervision to make sure that he does not hurt himself. He also requires a great deal of help with his activities of daily living (ADLs). What healthcare setting would provide the most appropriate care for Mr. Bowler? a. Acute care setting b. Nursing home setting c. Hospital setting d. Sub-acute care setting Correct Answer b. Nursing home setting Mr. Jameson, age 86, always talks about his days as a leader in his union but he hardly ever talks about the present. When he starts to talk about the past, you should: a. Tell him not to dwell on the past.

b. Tell him how interesting it must have been in those days and ask him some questions about it. c. Change the subject by asking him what he would like to do today. d. Remind Mr. Jameson that he is retired now. Correct Answer b. Tell him how interesting it must have been in those days and ask him some questions about it. Mr. Johnson was admitted to the hospital for pneumonia and was hospitalized for 4 days. What word best describes Mr. Johnson? a. Outpatient b. Resident c. Inpatient d. Client Correct Answer c. Inpatient Mr. Rollins is receiving oxygen therapy. You would avoid using which method to take his temperature? a. Oral method b. Axillary method c. Rectal method d. Tympanic method Correct Answer a. Oral method Mr. Singer has orders to have his fluid intake measured. At breakfast, Mr. Singer drinks an 8-oz carton of milk, a glass of orange juice and a cup of coffee. The glass holds 180 mL and the coffee cup holds 120 mL. How much fluid, in mL, did Mr. Singer drink? a. 308 mL b. 300 mL c. 540 mL

d. 18 mL Correct Answer c. 540 mL Mrs. Cummings has an indwelling urinary catheter. When caring for Mrs. Cummings you should: a. Remove the catheter to provide perineal care. b. Secure the tubing and urine drainage bag to the side rail of the bed. c. Make sure the tubing and urine drainage bag are lower than Mrs. Cummings' bladder. d. Disconnect the urine drainage bag from the tubing to empty it. Correct Answer c. Make sure the tubing and urine drainage bag are lower than Mrs. Cummings' bladder. Mrs. Ito can use the toilet to meet her elimination needs, but she needs help transferring to the bathroom, sitting down on the toilet and getting up from it. When assisting Mrs. Ito with elimination you should: a. Make sure the toilet paper and call signal are within her reach, and then leave her alone (but stay nearby and check on her every 5 minutes). b. Stay with Mrs. Ito in the bathroom c. Encourage Mrs. Ito to use a bedpan instead, because it is safer. d. Encourage Mrs. Ito to use a portable commode instead, because it is less work to assist her to transfer to the commode. Correct Answer a. Make sure the toilet paper and call signal are within her reach, and then leave her alone (but stay nearby and check on her every 5 minutes). Mrs. James is deaf. What can you do to make sure she understands the information you have just given her?

a. Get help from a translator. b. Write the information down for her. c. Speak in the loudest voice possible. d. All of the above Correct Answer b. Write the information down for her. Mrs. Klein uses the toilet to void. The nurse asks you to obtain a urine specimen. Which piece of equipment would be best to use to obtain a urine specimen from Mrs. Klein? a. A bottle b. A urinal c. A commode hat d. A bedpan Correct Answer c. A commode hat Mrs. Lewis has recently been diagnosed with diabetes and must eat meals at regular times. Today is a fasting day in her religion. She knows that she needs to eat because of her disease, and she knows that her religion says that sick people don't have to fast. Yet when you serve her food, she tells you that she feels funny about eating. You could: a. Tell her that she shouldn't feel bad. b. Avoid talking about religion and serve her food without saying anything. c. Tell her that she doesn't really have to eat if she doesn't want to. d. Tell her that you can understand that it must feel strange to eat on a fasting day and encourage her to talk about it. Correct Answer d. Tell her that you can understand that it must feel strange to eat on a fasting day and encourage her to talk about it.

Mrs. Morgan's daughter always watches closely how you provide care to her mother and seems critical of some of the things you do. What would be the best way for you to handle this situation? a. Ask Mrs. Morgan to tell her daughter that she likes the care you provide. b. Tell Mrs. Morgan's daughter that her mother likes the care she is receiving. c. Tell Mrs. Morgan's daughter that what you are doing is the right and only way to provide care. d. Explain to Mrs. Morgan's daughter what you are doing and why you are doing it, and ask her what care measures she found to be effective when she was caring for Mrs. Morgan at home. Correct Answer d. Explain to Mrs. Morgan's daughter what you are doing and why you are doing it, and ask her what care measures she found to be effective when she was caring for Mrs. Morgan at home. Mrs. Powell has had little appetite since her husband of 65 years passed away recently. What action could a nurse assistant take to encourage Mrs. Powell to eat? a. Remind Mrs. Powell that if she does not eat, she could get sick. b. Sit with Mrs. Powell while she is eating and make pleasant conversation. c. Explain to Mrs. Powell the importance of following the MyPlate guidelines. d. Tell Mrs. Powell that is she does not finish her meal, she cannot have dessert. Correct Answer b. Sit with Mrs. Powell while she is eating and make pleasant conversation.

Mrs. Singer is a home health client. Complications of diabetes have caused her to lose feeling in her legs. Because of her condition, what type of injury is Mrs. Singer at high risk for? a. Poisoning b. Burns c. Entrapment d. Electrical shock Correct Answer b. Burns Mrs. Summers can get out of bed but she can only walk a few feet before becoming very weak. She is able to sit up without assistance. Which piece of equipment would be best to use when assisting Mrs. Summers with elimination? a. Bedpan b. Toilet c. Portable commode d. Indwelling urinary catheter Correct Answer c. Portable commode Mrs. Tyler has just been admitted to the nursing home. What measurements will you obtain? a. Blood pressure, temperature, respiratory rate, pulse rate b. Height c. Weight d. All of the above Correct Answer d. All of the above Mrs. Wilson's pulse is very weak. How would you describe her pulse? a. Shallow b. Thready c. Bounding d. Irregular Correct Answer b. Thready

Non-maleficence is defined as: a. The belief that all people deserve fair and equal treatment b. The concept of avoiding harm or hurt c. Understanding the right way to behave and acting accordingly d. The desire to do good and promote health Correct Answer b. The concept of avoiding harm or hurt One of your co-workers has cut herself with a knife while cutting up fruit for a smoothie-making activity with the residents, and she is bleeding severely. What is the first thing you should do? a. Call 9-1-1 and monitor her for shock. b. Put on a pair of gloves and then go to her aid. c. Put a dressing over the cut and apply pressure to stop the bleeding. d. Rinse the cut with water. Correct Answer b. Put on a pair of gloves and then go to her aid. People who do not drink enough liquids can experience: a. Dehydration. b. Nausea. c. Loss of hearing in the higher ranges. d. Diarrhea. Correct Answer a. Dehydration Restraints must be released at least: a. Every shift. b. Every hour. c. Every 2 hours, and more often if necessary. d. Whenever a relative visits. Correct Answer b. Every hour.

Sexuality is: a. The physical act of having sexual intercourse. b. The ability to form intimate relationships with others. c. How people perceive themselves and express themselves sexually. d. Knowing whether you are a girl or a boy. Correct Answer c. How people perceive themselves and express themselves sexually. Taking care to secure tools used for documentation is a part of what legislation? a. Health Insurance Probability and Accountability Act b. Health Insurance Portability and Accountability Act c. Health Insurance Portance and Accountability Act d. Health Insurance Protections and Accountability Act Correct Answer b. Health Insurance Portability and Accountability Act Temperature, pulse, respirations, and blood pressure usually are taken together and are referred to as: a. Life measurements. b. Vital signs. c. Routine measurements. d. Monitoring Correct Answer b. Vital signs. The doctor has ordered a meal supplement shake for Mrs. Johnson, to be served between lunch and dinner. Today when you tell Mrs. Johnson it is time for her shake, she shakes her head and says she does not want it today. What should you do? a. Report Mrs. Johnson's refusal of the shake to the nurse. b. Return the shake to the refrigerator and try offering it to Mrs. Johnson again later.

c. Record Mrs. Johnson's refusal of the shake in her chart, but do not report it to the nurse. d. Nothing; it is all right if Mrs. Johnson skips the shake because it might spoil her appetite for dinner. Correct Answer a. Report Mrs. Johnson's refusal of the shake to the nurse. The goal of the healthcare team is to: a. Minimize healthcare costs by spreading the workload over many people. b. Make sure the person is sent home from the facility as soon as possible. c. Provide personalized quality care that meets the person's physical, emotional, social and spiritual needs. d. Make decisions on behalf of the person receiving care. Correct Answer c. Provide personalized quality care that meets the person's physical, emotional, social and spiritual needs. The leader of the healthcare team is the: a. Doctor b. Registered nurse (RN) c. Advanced practice nurse d. Person receiving care Correct Answer d. Person receiving care The legal document that gives the responsibility for decision making on the person's behalf to someone else? a. Durable power of attorney b. Living Will c. Advanced directive d. Living trust Correct Answer a. Durable power of attorney

The nurse asks you to obtain a midstream (clean catch) urine specimen. What should you do? a. Collect and store all of the urine the person voids in a 24-hour period. b. Empty urine from the bedpan into a specimen container. c. Remind the person to start the stream of urine, then stop, then collect the urine sample from the restarted stream of urine. d. Provide catheter care before obtaining the urine sample. Correct Answer c. Remind the person to start the stream of urine, then stop, then collect the urine sample from the restarted stream of urine. The nurse has asked you to measure the level of oxygen in Mr. Simon's blood. What equipment will you use? a. A tympanic thermometer b. Stethoscope c. Sphygmomanometer d. Pulse oximeter Correct Answer d. Pulse oximeter Threatening a person with physical harm or the withdrawal of support is an example of what type of abuse? a. Sexual abuse b. Emotional abuse c. Neglect d. Financial abuse Correct Answer b. Emotional abuse To avoid damaging the skin of a person who is unable to move without help, you should reposition the person: a. Whenever you can fit it into your schedule. b. At least every 4 hours. c. According to the schedule in the person's care plan.

d. When you come to work and before you go home. Correct Answer c. According to the schedule in the person's care plan. To protect yourself, the person receiving care and your employer, you must always work within your? a. Scope of practice b. Work practice scope c. Best working practice d. Scope of working practice Correct Answer a. Scope of practice What are the ethical principles or fundamental guidelines that are relevant to healthcare workers? a. Justice, fidelity, honesty, loyalty, beneficence b. Autonomy, justice, beneficence, non-maleficence, fidelity c. Fidelity, courtesy justice, loyalty, integrity d. Dependability, fidelity, honesty, loyalty Correct Answer b. Autonomy, justice, beneficence, non-maleficence, fidelity What does it mean to "force fluids?" a. To force a person to drink 8 ounces of liquid every hour. b. To encourage a person to drink as much fluid as possible. c. To encourage a person to urinate frequently to keep the bladder empty. d. To do offer a person strong fluid like coffee or tea in the place of juice or water. Correct Answer b. To encourage a person to drink as much fluid as possible. What equipment is needed to measure a radial pulse? a. Sphygmomanometer b. Stethoscope

c. Watch with a second hand d. All of the above Correct Answer c. Watch with a second hand What instrument is used to listen to sounds when obtaining a blood pressure or an apical pulse measurement? a. Stethoscope b. Diaphragm c. Sphygmomanometer d. Thermometer Correct Answer a. Stethoscope What is one time when you must wear gloves? a. When you give someone a back rub b. When you cough or sneeze c. When you serve meal trays d. When you touch blood or other body fluids Correct Answer d. When you touch blood or other body fluids What is the first sign of a pressure injury? a. A reddened area on the skin b. A fever c. An open sore d. Bleeding Correct Answer a. A reddened area on the skin What is the most important thing you can do to control the spread of microbes? a. Bag all contaminated linens. b. Wash your hands. c. Always cover bedpans and urinals when carrying them from place to place.

d. Eat a well-balanced diet and stay healthy. Correct Answer b. Wash your hands. What is the purpose of a scheduled toileting program for a person with dementia who is incontinent? a. To punish the person for episodes of incontinence b. To teach the person how to use the toilet again c. To give the person the opportunity for elimination just before the person would normally void or have a bowel movement based on the person's normal elimination patterns to reduce the risk of incontinence d. To reduce the number of times the nurse assistant needs to help the person with elimination Correct Answer c. To give the person the opportunity for elimination just before the person would normally void or have a bowel movement based on the person's normal elimination patterns to reduce the risk of incontinence What is the purpose of the pain scale? a. To determine where the pain is located. b. To find out when the pain started c. To help a person describe the characteristics of their pain. d. To help a person communicate their level of pain. Correct Answer d. To help a person communicate their level of pain. What is the term for the inability to control bowel movements and/or urine elimination? a. Incontinence. b. Dehydration. c. Diarrhea. d. Constipation Correct Answer a. Incontinence.

What should you do if a fire alarm sounds while you are at work? a. Leave the building and go home. b. Ask another nurse assistant what to do. c. Follow your employer's policies for responding to a fire alarm. d. Ignore the fire alarm, because it is probably only a fire drill. Correct Answer c. Follow your employer's policies for responding to a fire alarm. What term best describes the loss of mental abilities often resulting in a nursing home admission? a. Mental affect impairment b. Cognitive mental impairment c. Cognition impairment d. Cognitive impairment Correct Answer d. Cognitive impairment When a person with cognitive changes experiences pain, which of the following is true? a. They may not be able to find the words to say they are in pain or how severe it is. b. They may be preoccupied by the pain and not be able to report changes in their level of pain. c. They may not be in as much pain now but are remembering a time they were in pain. d. All of the above Correct Answer d. All of the above When emptying an ostomy appliance, you should: a. Raise the head of the person's bed.

b. Place the bottom opening of the ostomy in a bedpan before opening the clip. c. Rinse the appliance with water between 110° F and 115° F. d. Place deodorant in the appliance, whether or not the person uses it. Correct Answer b. Place the bottom opening of the ostomy in a bedpan before opening the clip. When entering the room of a person who is blind, you should: a. Walk up quietly and touch the person on the back. b. Knock on the door, wait for a response and introduce yourself. c. Knock on the door and go in. d. Talk in a low voice. Correct Answer b. Knock on the door, wait for a response and introduce yourself. When is an ostomy appliance used? a. When a person is incontinent of urine or feces b. When a stool sample is required of the person c. When a person has had the bladder or a portion of the bowel surgically removed d. Before, during or after surgery Correct Answer c. When a person has had the bladder or a portion of the bowel surgically removed When serving meals to people with paraplegia or paralysis: a. Place the tray so that it is far from the paralyzed side. b. Sit closest to the person's affected side. c. Make sure the person is supine in the chair or bed. d. Encourage the person to eat in private. Correct Answer b. Sit closest to the person's affected side.

When you are the sender, what should you do after you deliver your message? a. Expect the person to do what you told them. b. Ask for confirmation that the message was understood. c. Communicate the next message. d. Look for written communication. Correct Answer b. Ask for confirmation that the message was understood. When you take dirty linens to the laundry hamper, you should: a. Shake them first. b. Hold them away from your uniform. c. Take only one sheet at a time to prevent contamination. d. Save steps by tossing them into the laundry hamper from a short distance. Correct Answer b. Hold them away from your uniform. When you treat someone with respect, you are applying which principle of care? a. Infection control b. Dignity c. Independence d. Safety Correct Answer b. Dignity Where is care provided for a person who requires treatment for a sudden injury or illness? a. Sub-acute care setting b. Home setting c. Acute care setting d. Long-term care setting Correct Answer c. Acute care setting Where is the brachial pulse located?

a. The inside of the elbow b. At the top of the heart, just under the left nipple c. On the inside of the wrist at the base of the thumb d. On the inside of the groin where the thigh meets the hip Correct Answer a. The inside of the elbow Which action is a nurse assistant's responsibility? a. Administering medications b. Communicating verbal orders related to the person's medical care to the nurse c. Assisting people with activities of daily living (ADLs) d. Analyzing and interpreting data Correct Answer c. Assisting people with activities of daily living (ADLs) Which action supports a person's legal rights under HIPAA? a. A nurse assistant declines a resident's request for health information about another resident. b. A hospital stops documenting patient care on paper records and begins using a computer instead. c. A nursing home has a policy that says all residents will receive equal treatment, regardless of their ability to pay for services. d. A nurse obtains informed consent from a person before the person undergoes a surgical procedure. Correct Answer a. A nurse assistant declines a resident's request for health information about another resident. Which action would be appropriate to meet a resident's safety and security needs? a. Encouraging the person to do as much for themselves as possible

b. Answering the person's requests for help promptly c. Locking the person in their room d. Providing the person with privacy when the person has visitors Correct Answer b. Answering the person's requests for help promptly Which document details the care the person requires and the methods, equipment and frequency for providing that care? a. The electronic medical record b. The nursing notes c. The flow sheet d. The care plan Correct Answer d. The care plan Which is true of chronic pain? a. It usually lasts less than six months b. Older people often have at least on condition that causes chronic pain c. It is most often related to surgery d. Nothing can be done about it Correct Answer b. Older people often have at least on condition that causes chronic pain Which legislation establishes quality standards for the care of residents of nursing homes? a. Ombudsman Act (OA) b. Occupational Safety and Health Administration (OSHA) c. Omnibus Budget Reconciliation Act (OBRA) d. Resident Rights Act (RRA) Correct Answer c. Omnibus Budget Reconciliation Act (OBRA) Which legislation supports a patient's resident's or client's right to make decisions on their own behalf?

a. Health Insurance Portability and Accountability Act (HIPAA) b. Advance Directive Act c. Patient Self-Determination Act d. Patient Autonomy Act Correct Answer c. Patient Self- Determination Act Which measurement is outside of the normal range for an adult? a. Temperature, 99F b. Respirations, 10 breaths/min c. Pulse, 63 beats/min d. Blood pressure, 107/70 mm Hg Correct Answer b. Respirations, 10 breaths/min Which nutrient helps the body build and repair tissue? a. Carbohydrates b. Fat c. Protein d. Water Correct Answer c. Protein Which nutrient supplies the body with its most basic form of energy? a. Carbohydrates b. Vitamins and minerals c. Protein d. Fat Correct Answer a. Carbohydrates Which observation should you report to the nurse? a. Mrs. Zimmer is having difficulty having a bowel movement. b. Mr. Thomas does not seem like himself today. c. Mrs. Nolan told you that she does not want to attend the group activity today.

d. All of the above Correct Answer d. All of the above Which of the following are NOT one of the six principles of care? a. Communication b. Safety c. Rights d. Independence Correct Answer c. Rights Which of the following could be a sign of a stroke? a. Profuse sweating b. Convulsions c. Fainting d. Drooping on one side of the face Correct Answer d. Drooping on one side of the face Which of the following could be a sign or symptom of a myocardial infarction? a. Blurred vision b. Nausea c. Aura d. Shock Correct Answer b. Nausea Which of the following could increase a person's risk for developing a urinary tract infection? a. Not drinking enough water b. Not emptying the bladder completely c. Having an indwelling urinary catheter d. All of the above Correct Answer d. All of the above