CNA Practice Test – Basic Nursing Skills – Part 2

An indwelling urinary catheter is used to drain the bladder into a bag outside the body. In males, it is a long tube with a balloon that is inflated after being inserted. The tube that drains the urine must not be tugged or become kinked. In males, it is attached to the client’s inner thigh by tape or a special fastening device. Never attach the tube to anything except the client’s inner thigh. The drainage bag should remain lower than the client’s bladder to prevent back-flow of urine.

Clients or objects which are heavy should never be moved or lifted by one person. The risk for falls or injuries, for both client and nurse aide, increases with heavy loads. Ask for assistance before attempting to pull or roll a heavy patient. Use good body mechanics by using your leg muscles to avoid back injury.

When a client is having difficulty breathing, Fowler’s position can provide relief. When sitting in Fowler’s position, the client is upright at 90 degrees, allowing the chest to expand as much as possible. Prone (on the abdomen), supine (on the back), and lateral (on the side) are all flat positions, which can make respiratory distress worse.

When a physician orders a restraint for a client, staff must strictly follow the protocols to maintain the client’s safety. The nurse aide should become familiar with the policies regarding restraints. The policy will state the defined times to monitor the client, directions for reporting on the client’s status, as well as directions for documenting all observations.

When transferring a client, the nurse aide should be positioned to support the client by using the legs. Keep your back straight and locked; do not turn or twist. If you bend, do so at the hips, not the waist. Before beginning the transfer, assess how much the client is able to do. If you have any doubts, always ask for assistance from a co-worker.

A quad-cane has four tips to provide a broad base to support the client while walking. The client holds the cane in the strong or unaffected side. To walk, place the cane about an arm’s length away, with all four tips touching the ground at the same time. Step forward with the weak leg, using the cane for stability.

It is important to maintain proper spinal position with lifting. The risk of injury to the low back increases when using the back muscles, bending at the waist, twisting, or trying to lift when the load is too heavy. Common injuries associated with lifting are strains, sprains and herniated discs. For heavy loads, always find another person to help.

Diabetes is a disease that results when the pancreas does not make enough insulin to decrease or control the amount of sugar in the blood. Clients with diabetes must check their blood sugar levels every day. They require medication, which can include insulin injections, in order to remain healthy.

Whenever giving client care, remember that the patient’s safety comes first. Unplugging a malfunctioning device will stop any sparks or smoke. If the client, or anyone nearby, is on oxygen, the sparks could trigger a fire, so you may need to quickly move people out of the area. After everyone is safe, notify the nurse of the incident. Never use another client’s personal items; this is strictly prohibited because of possible infection.

When helping a client walk who is recovering from a stroke, the nurse aide should stay on the client’s weak side. Walk next to, and slightly behind, the client in order to be ready to suddenly support the weak side. If the client is using a walker or cane, allow space for the device. While walking, be alert to avoid possible fall hazards. The client should wear slippers or shoes with rubber soles for traction.

A bedridden client can quickly develop pressure sores if allowed to remain in one position. To prevent the skin from breaking down, reposition the client at least every two hours. Use pillows to support the client and to relieve places where skin can rub, such as between the legs or at the tailbone. Always keep the skin clean and dry. A sheepskin on the bed or wheelchair provides extra padding, but does not replace repositioning. Observe the skin for reddened areas and report them to the nurse. Special beds and flotation mattresses are helpful in preventing pressure sores.

The nurse aide should be familiar with all fire safety policies and protocols. When a fire alarm sounds, all staff must respond to keep clients safe. Remember “R.A.C.E.” to quickly act. R = Rescue/Remove all people who can not take care of themselves. A = Alarm, if it has not already been done. Pulling the alarm can be done at the same time as rescue. C = Confine/Contain the fire or smoke by closing doors to prevent or slow the spread. Smoke is especially dangerous for everyone. E = Extinguish the fire if possible, using a handheld fire extinguisher. Attempt to extinguish only small fires, as long as you can remain safe and have an escape route.

Physical restraints are devices or equipment that prevent normal movement. Examples are arm or leg restraints, hand mitts, or vests. It is against the law to use restraints unless necessary to treat a client’s medical symptoms, or if there is a risk of harming self or others. Restraints are not used for punishment, convenience, or a method of control. Either a physician’s order or the client’s consent is required before a restraint can be applied.

Clients who have had a stroke often have one-sided weakness or paralysis. They may not be able to use that side of their body, or may not even be aware of the affected side. This is called “one-side neglect.” Rehabilitation services will help the patient recover as well as possible, but as the client’s caregiver, you can encourage the client to use the unaffected side by placing the signaling device where the client can reach it to call for assistance.

While smoking by clients and visitors may not be appropriate, the nurse aide may not take away their cigarettes or matches. However, the nurse aide can certainly report these actions to the charge nurse. The nurse aide should also be familiar with policies regarding smoking or smoking areas, to inform smokers if there are designated places. All staff must be aware of fire extinguisher locations and what to do in the event of a fire. Notifying the nurse or maintenance department of any damaged electrical wiring or sockets, as well as faulty electrical equipment can prevent a fire.

NPO is a common medical term that means the client can not eat or drink anything, including water or ice chips. A doctor orders a patient to be NPO for situations such as before surgery or certain lab work. If a client is ill or has a gastrointestinal condition, the doctor may write an order to be NPO until the cause is known. The nurse aide can provide mouth care for a client who is NPO. Placing a “NPO” sign over the client’s bed will remind all staff members not to give the client anything to eat or drink.

Once linen has been in a client’s room, it is no longer considered to be clean. Each client’s room can have pathogens or sources of possible infection that could be spread by objects from that room. Opened supplies or items with sterile packaging that has been opened should also be discarded, even if not used.

When a client is unable to speak clearly or has trouble forming words, a speech therapist can help improve problems from strokes, physical defects, and swallowing disorders. Speech therapists work with both adults and children. They are qualified to evaluate, diagnose, and treat clients.

A restraint may be either physical or chemical. Its purpose is to protect the client from harming himself or others. Only a physician may order a restraint, and guidelines are strict. A pain medication may help calm a client or relieve behavior associated with severe pain, but it is not in the restraint category.

After giving care, or when leaving the client’s room, always ensure that the client’s call signal is within reach. Clients must always have access to caregivers. For safety, bed should be in the lowest position, with bed rails up. Restraints may never be applied without an order from the client’s doctor.

A radial pulse is found at the client’s wrist. To locate it, place your index and middle fingers on the hollow area below the thumb. Apply light pressure to feel the pulse. Count each beat for 30 seconds and multiply by 2 to get the pulse rate. If the client has an irregular heartbeat, count for 60 seconds. Record the pulse rate in the client’s chart.

Fire extinguishers are classified by the materials they can snuff out. Think “ABC.” Class A fire extinguishers are used for paper, wood, textiles, and some plastics. Class B is used for flammable liquids, such as oil or gasoline. Class C extinguishers are for electrical fires. All fire extinguishers have labels on them to identify which type of fire they can be used for.

The Heimlich maneuver (abdominal thrusts) is the first aid method for helping people who have food or an object caught in their upper airway. When a client appears to be choking, the nurse aide must act quickly to clear the airway. Call for help. To perform abdominal thrusts, stand behind the client. Make a fist with your dominant hand. Place this fist just above the client’s navel. Wrap your other hand firmly around the fist. Pull inward and upward, pressing into the client’s abdomen with quick and forceful upward thrusts, as if you are trying to lift the client off his or her feet from this position. Continue the abdominal thrusts in quick succession until the object is expelled.

300 cc is a metric measurement meaning 300 cubic centimeters. In medicine around the world, the metric system is used for all length, weight, volume, and temperature measurements. The metric system is based on units of ten, and is more precise than other methods of measurement.

When working a manual bed, be sure to first lock the bed by pressing down the levers on the wheels at the head and foot of the bed. At the end of the bed there are three cranks which control the bed height, as well as raising and lowering the head and feet. Cranks are turned clockwise (left to right) to raise each section, and counter-clockwise to lower them. After positioning the client, always fold the cranks under the bed to prevent others from tripping or falling.

When converting milliliters (ml) to ounces (oz) remember that 30 ml = 1 ounce. Although an ounce is slightly more, the amounts are considered to be equal by doctors and pharmacists.

Every staff member is responsible for keeping clients safe at all times. This includes monitoring all equipment and reporting when anything needs repair. Never use broken equipment or try to create a temporary solution if equipment is not working properly. Tag the broken bed and move it so that another client can’t use it. Replace it immediately with one that has functioning side rails.

The nurse aide should be familiar with all fire safety policies and protocols. When a fire alarm sounds, all staff must respond to keep clients safe. Remember “R.A.C.E.” to quickly act. R = Rescue/Remove all people who can not take care of themselves. A = Alarm, if it has not already been done. Pulling the alarm can be done at the same time as rescue. C = Confine/Contain the fire or smoke by closing doors to prevent or slow the spread. Smoke is especially dangerous for everyone. E = Extinguish the fire if possible, using a handheld fire extinguisher. Attempt to extinguish only small fires, as long as you can remain safe and have an escape route.

Side rails are important for keeping clients from falling out of bed. They also allow a way for clients to grab on to the railing to reposition themselves. However, if the client is agitated, confused, has a head injury or history of seizures, padding the side rails can prevent injuries or entrapment. Some facilities have bed rail pads or bumpers in stock. Use a mattress pad to make a side rail pad. Make sure the bed is always in the lowest position.

Client safety during transfer begins with the bed in the lowest position. This allows the client to easily reach the floor when standing and pivoting to sit in the wheelchair. The brakes of the wheelchair should be locked and the footrests completely out of the way.