CNA Final Review Flashcards
(446 cards)
1
Q
What is another term for nursing assistant?
A
Nurse’s Aide
2
Q
What can a CNA do to help a resident who can’t fall asleep?
A
Offer a snack, give a backrub
3
Q
What is tuberculosis and how does it spread?
A
A disease that affects the lungs and is spread through droplets
4
Q
How does Covid spread?
A
Covid is airborne, and can also be spread through droplets
5
Q
What is the medical word for fainting or passing out?
A
Syncope
6
Q
What is the medical word for a bloody nose?
A
Epistaxis
7
Q
What does perseveration refer to?
A
Inappropriate and constant repetition of an act or phrase
8
Q
What is an orthotic?
A
A brace or splint used to support the body
9
Q
What are social determinants of health?
A
The 5 conditions in the environment that influence quality of life:
Economic stability
Access to education
Access to healthcare
Safe neighborhoods
A social community with friends
10
Q
What do you do if you suspect one of your patients doesn’t have one of the 5 social determinants of health?
A
Let the Nurse know
11
Q
What does combative mean in a medical context?
A
Refers to a patient who is angry and won’t cooperate
12
Q
What is apnea?
A
Without breathing; sleep apnea is a condition where people stop breathing temporarily in their sleep
13
Q
When you hear the systolic immediately while taking blood pressure what is the problem?
A
The blood pressure is high, and you didn’t inflate the cuff high enough
14
Q
Fill in the blank: Apnea literally means _______.
A
Without breathing
15
Q
What is adaptive equipment?
A
Any tool or device used to help with ADLs
16
Q
What are the range of motion rules?
A
Stop if there is resistance or the person complains of pain, follow the care plan, support the joint; usually involves 3 to 5 repetitions
17
Q
What is the armpit temperature called?
A
Axillary; it usually runs one degree lower than an oral temperature
18
Q
What are the shaving guidelines?
A
Shave with the hair growth: down on the face and up on the neck
19
Q
What is important to know about cold packs?
A
Used to decrease pain and prevent swelling; applied with a barrier, checked after 5 minutes, removed after 20 minutes; can cause an injury similar to a burn if left on too long
20
Q
What is a sharps container for?
A
To dispose of anything that might be sharp, like needles, razors, or lab tubes
21
Q
What is c-diff?
A
Clostridium difficile - an intestinal infection causing severe diarrhea and is very contagious; requires contact precautions and actual handwashing as it is immune to hand sanitizer
22
Q
What is misappropriation?
A
Taking something that isn’t yours, usually from work; examples include bringing home a box of gloves or charging a personal item on the company credit card
23
Q
Who is affected by a resident dying?
A
Everyone involved, including the staff; counseling help is available if staff members need it
24
Q
How do you care for a dying patient?
A
Take care of their physical needs, turn and do oral care every 2 hours, give a bed bath as needed; if they stop breathing, get the nurse to verify there isn’t a heartbeat
25
What is a draw sheet?
A flat sheet that goes across the middle of the bed; also called a lift sheet or a turn sheet, depending on its use
26
What is delegation?
Authorizing someone else to do a task on your behalf; the nurse delegates direct patient care to the CNA
27
What are the 5 rights of delegation?
The right person, right task, right circumstance, right direction, and right supervision
28
What is sexual harassment?
Unwelcome sexual advances or remarks; should be reported to a supervisor or human resources
29
How do you help with a bedpan?
Position a bedpan with the thinner edge at the person’s back, sit the person up (Fowler’s), give them the call light and provide privacy
30
What is the type of bedpan called that is used for a patient who has had hip surgery?
Fracture Pan
31
What is a low sodium diet?
Also called NAS (no added salt), the person on this diet should eat foods low in salt and cannot add any additional salt to their food; usually used for people with high blood pressure or kidney disease
32
What does the affected side mean?
Weak side
33
If a patient wants to leave the facility against medical advice (AMA) what does that mean?
They want to leave without being discharged and against the wishes of their doctor
34
What should you do if a patient wants to leave AMA?
Tell the Nurse
35
What does flexed or flexion mean?
When a joint is bent or when the angle of a joint is decreased, the opposite of extension
36
What does disoriented mean?
Associated with confusion; a person who is disoriented may not know the date or time, where they are, or even who they are
37
What is a bowel program?
Also called bowel training; the purpose is to help an incontinent patient regain control of their bowel function by providing BRP or a commode at regularly scheduled times
38
What does alignment mean?
Keeping the body straight or having good posture
39
What is a developmental disability?
Having a physical or mental impairment that becomes apparent shortly after birth or during childhood and delays, limits, or prevents the progression of normal development
40
What is battery?
Offensive touching or use of force on a person without their consent
41
What is flatus or flatulence?
This is the medical term for gas (farts)
42
What is restorative care?
Another term for rehabilitation; helping a person return to his highest level of physical, emotional, or economic function
43
What is a medical record?
A legal document where a patient’s information is kept and care is recorded
44
What is a minimum data set?
A federal form filled out on nursing home residents about the degree of assistance or skilled care they need
45
Define restraint.
Anything that restricts a person’s freedom of movement; it can be physical or chemical (a medication)
46
Define unbecoming.
inappropriate
47
What is normal growth and development for an infant?
Infancy is from birth to 1 year; infants learn to smile, laugh, and say simple words; they progress from drinking milk to eating solids
48
What is normal growth and development for a toddler?
Toddlerhood is from age 1 to age 3; toddlers become physically coordinated, able to run and jump; they become toilet trained and have a vocabulary that can express emotions; they are self-centered, have trouble following rules, and have separation anxiety when separated from a parent
49
What is normal growth and development for a preschooler?
Preschool is from age 3 to 5; preschoolers dress themselves, have a good imagination, and ask questions; they begin to notice the difference between genders and understand the difference between right and wrong
50
What is normal growth and development for a school age child?
School age is from 5 to 12 years; characterized by growth spurts, developing gender identity, and wanting approval from peers and adults; they will develop morals, logical thinking, and the ability to understand other people’s perspectives
51
What should you do if you discover a coworker stealing from a resident?
This is financial abuse; treat the same as any abuse and report it to your supervisor and Adult Protective Services
52
What is palliative care?
Care with a goal of relieving pain, symptoms, and emotional and physical stress but not curing disease; often part of hospice care, but can be found in other places as well
53
What is included in vital signs?
Temperature, pulse, respirations, and blood pressure
54
What is the normal range for blood pressure?
90-140 over 60-90
55
What do you do if a vital sign is out of range?
Repeat it and then report it to the nurse
56
Give examples of acute diseases or conditions.
Broken bones, the flu or a cold, heart attack, chicken pox, appendicitis
57
What is foot drop?
When the foot droops or bends abnormally from injury or atrophy; treatment includes keeping the foot in proper alignment by using a board (foot board) for the feet to rest against, or using a brace designed to prevent it
58
What is a common symptom of congestive heart failure?
Edema (swelling) in the feet
59
How should you use a gait belt?
Apply it over clothes and hold onto it with an underhand grip
60
What GI condition can result in stomach pain and the leaking of small amounts of thin watery stool?
Fecal impaction
61
How should you clean a stoma?
Wipe the stoma gently, clean the skin around it with mild soap and water, and ensure ostomy appliances fit closely
62
What is validation therapy?
Communicating that a resident’s opinions and feelings are acknowledged, respected, and heard, regardless of agreement
63
What should you do when a resident with dementia talks about their past?
Allow them to express their reality and ask questions that encourage sharing
64
What is it called if you touch a patient without their consent?
Physical abuse or battery
65
What is the primary job of the respiratory system?
To supply oxygen and remove carbon dioxide
66
Oxygenated blood is carried by?
Arteries
67
Oxygen is considered a _______.
life sustaining treatment
68
How is hepatitis A transmitted?
Fecal-oral transmission, often from unwashed hands of food preparation workers
69
When your patient is on oxygen what should you not let them do?
smoke
70
What should you check when a patient is on oxygen?
Flow rate and signs of irritation or pressure from the nasal cannula
71
What should you ensure if the oxygen is supplied by a tank?
The tank has enough oxygen and is positioned securely
72
What is the most common form of dementia?
Alzheimer’s
73
What are common symptoms of dementia?
Short term memory loss, pacing, wandering, sundowning
74
When brushing out tangled hair where should you start?
At the ends, or tips, of the hair
75
Is pain subjective or objective?
Subjective
76
What should always be done with a patient’s report of pain?
always reported to the nurse
77
What is the best position for a resident at mealtime?
Seated upright in a comfortable position, at eye level with the caregiver
78
If someone appears to be choking and they are coughing what should you do?
Encourage them to continue coughing
79
When your Parkinson’s patient who is very shaky
Take them out but stay with them
80
Which body system is affected by Parkinson’s?
The nervous system
81
What are signs of anemia (low red blood count)?
Dizziness, Fatigue, Pale skin
82
Parkinson’s is considered?
A progressive disease; medications may slow it down but there is no cure
83
What is defamation?
Slander; communicating a false statement that implies a negative image about a person or business
84
What is an interdisciplinary team?
A group of healthcare providers from many disciplines (Dr, Nurse) who work together to ensure a patient's needs are being met
85
What is the competency evaluation?
The tests you take to become certified as a CNA; written test (75%), Skills test (Pass or Fail)
86
How long do you have to take it (competency evaluation) after you complete your CNA course?
Within a Year
87
After feeding a patient who is on aspiration precautions or after a feeding tube has been given you should..
Keep the head of the bed up 30-45 degrees; even if the patient doesn’t want their head up
88
Communicable or contagious means..
A disease can spread or be transmitted from one person to another
89
If a resident has a contagious disease should they have a roommate?
No; although residents with non-contagious diseases frequently share a room, roommates who share a room should use their own personal care items
90
What information should a CNA obtain on a new admit?
All vital signs, height and weight
91
What is the proper process for using a walker?
The person should set the walker 10-18 inches in front of them, then step toward it
92
What should the average fluid output be for a healthy adult?
At least 1500 mLs; low urine output (oliguria, less than 500 mLs) should be reported to the nurse
93
What is PVD?
Peripheral Vascular Disease; chronic disease with poor circulation in the extremities
94
What is COPD?
Chronic Obstructive Pulmonary Disease; usually caused by smoking (SOB need O2); sitting with the head of the bed up
95
When taking a blood pressure what should you consider when choosing an arm to use?
Never use an arm with an IV, cast, shunt; never take a blood pressure on the same side as a mastectomy
96
What is phantom pain?
Pain that the patient perceives in a body part that has been amputated
97
What is an artificial body part called?
A prosthetic or a prosthesis
98
What are complications of immobility?
Atrophy (skinny), contractures (shortens), pneumonia, blood clots
99
What is the difference between a safety razor and a straight razor?
A straight razor is old-fashioned - like a knife with a handle; a safety razor is like a disposable razor
100
When is it appropriate to flirt with a patient or resident?
Never
101
How can the elderly prevent loss of bone and muscle strength?
Exercise, especially weight bearing
102
What assistance can you give a resident with their mail?
Deliver mail to them; you can offer help but don’t open it unless they want help
103
What should you check when delivering a patient tray?
Check for correct name and diet
104
For liquid or fluid intake what should you count?
Anything that is liquid at room temperature
105
What is projection?
Blaming someone else for your own uncomfortable or unacceptable actions or feelings
106
What is an ileostomy?
When the entire large colon is removed and the end of the small intestine is brought to the surface of the abdomen in a stoma; liquid stool, prone to dehydration
107
What is a plate guard or a plate rim?
A device that clips onto the edge of a plate; food can be scooped against the rim so it doesn’t fall off the edge of the plate
108
What should you do if a resident has blood in their urine?
Report it to the nurse; let her see it if possible
109
How do you operate a fire extinguisher?
The acronym PASS: P - Pull the pin; A - Aim at the base of the fire; S - Squeeze the handle; S - Spray
110
How should you document the valuables residents bring to the nursing home with them?
General terms, don’t make assumptions; use words like white, metal, and blue instead of gold, diamond, gem
111
What is the most common injury for CNAs in the workplace?
Back injury
112
What is required before hot or cold treatments can be used?
A doctor's order
113
What should you do if a resident refuses necessary treatment?
Report it to the nurse
114
Are residents allowed to have personal items?
Yes; they should be labeled or marked with the resident's name
115
Who should be responsible to keep the facility clean?
Everyone on the healthcare team
116
What is dialysis?
A process commonly used for patients in kidney failure; it cleans the blood
117
What is an incident report?
A form filled out any time there is an accident or injury that tells the details of what happened; a CNA can fill it out or add comments to one filed by the nurse
118
If you have to evacuate the facility because of an emergency how do you know what to do?
The facility has evacuation plans, usually found at the nurses station
119
What is the CNAs responsibility if they are assisting in a procedure that involves a sterile field?
Never touch anything in the sterile field; also never reach across it
120
What is a suffix and/or prefix?
A prefix always comes at the beginning of a word and usually indicates location, time, number, or status; a suffix always comes at the end of a word and usually indicates the procedure, condition, disorder, or disease
121
When should you wear gloves?
If it is warm, wet, and not yours
122
If your patient asks you a question about their disease..
Direct their questions to the nurse
123
What is a normal result of aging for the nervous system?
Slower reflexes and reaction time
124
What happens when the urinary system ages?
Kidney function decreases; the person is at a higher risk for urinary tract infections
125
What are your body’s specific defense mechanisms?
Antibodies developed by having an illness or being immunized
126
What are your body's nonspecific defense mechanisms?
Intact skin, coughing, sneezing, tears, white blood cells
127
When you transfer a resident from a bed to their chair where should they put their hands?
They should push up from the bed if they are able, and/or place their hands on your arms
128
If the resident has a weak side how should you transfer them?
Use a gait belt and do a pivot transfer; the resident pivots on their strong side
129
Common symptoms of anxiety are..
Hyperventilation, feeling dizzy, dry mouth, insomnia, nausea
130
If you see something spilled in the hall should you clean it up or wait for housekeeping?
Any safety hazard should be dealt with immediately by the person who discovers it first
131
What should you do if a feeding pump is beeping?
Tell the nurse; don’t ever silence it without saying something
132
What causes varicose veins?
The veins in the legs lose elasticity and the valves become weak, allowing blood to pool in them
133
What should you worry about if you are shaving a resident who is on oxygen?
Don’t use the electric razor; never take off or turn off the oxygen unless you check with the nurse first; work around it
134
What is an important thing to remember when caring for a blind resident?
Always introduce yourself and give your title when you enter their room
135
What is a bedside commode?
A portable rolling toilet with a bucket that needs to be emptied and cleaned after use
136
What is dyspnea?
Shortness of breath, painful or difficult breathing
137
What is dysuria?
Painful urination
138
What is the most likely cause of cloudy vision in the elderly?
Cataracts
139
What is the best thing to do for an Alzheimer’s patient who likes to wander?
Provide a safe place for them to wander in or take them for a walk
140
What is the best way to approach an Alzheimer’s or dementia patient?
Speak calmly; use their name and simple words and directions; have a quiet environment and a consistent routine
141
Where should you discard a used razor?
sharps container
142
What is partial weight bearing?
The patient can put weight on their good leg but they cannot put weight on their bad leg
143
When using a tub for baths what should you remember?
Sanitize it between residents
144
An Alzheimer’s patient doesn’t recognize her son a good response would be..
Isn’t it nice your son is here to visit!
145
When your patient with dementia is getting sick but can’t tell you what might you notice first?
A change in behavior
146
How might this dementia patient indicate pain?
Groaning, grunting, grimacing, folding over
147
If your patient is crying what should you do?
Spend time with them; try to build a good rapport by showing sympathy and concern
148
What is HIPAA?
The Health Insurance Portability and Accountability Act
149
What does HIPAA cover/protect?
It’s about protecting patient information; it covers when and how information can be shared, and how records are stored and disposed of
150
If a patient is receiving anticoagulants (blood thinners) can you shave them?
Not with a blade; you should use an electric razor
151
What body system is most affected by multiple sclerosis?
The nervous system; it causes increasing muscle weakness and fatigue, occurs more frequently in younger people
152
Do the elderly have sexual needs and what can the CNA do?
Yes, they do (basic physical need); the CNA should provide privacy
153
What is a common symptom of depression?
Low levels of energy
154
What is ombudsman?
The patient’s representative; they investigate problems, complaints, and grievances
155
List tips for caring for dentures safely.
Lukewarm water; line the sink with a paper towel and fill with water; hold firmly in 1 hand while brushing with the other; store in water; transport in a denture cup
156
What should you report to the next shift when they take over for you?
Any problems the residents had, or anything out of the ordinary that happened
157
If the resident is found climbing out of bed in the middle of the night what is the most likely reason?
They need to use the bathroom
158
What is osteoporosis?
Excessive loss of bone tissue; frequent bone fractures
159
Are ice cream and popsicles counted as liquids?
Yes, anything that is liquid at room temperature is counted as a liquid
160
What would be the best way to transfer a resident who has both legs amputated?
Get plenty of help and use a mechanical lift
161
What observations could be noted about urine?
Amount, color, clarity, presence of sediment or blood
162
When was OBRA (Omnibus Budget Reconciliation Act) passed?
1987
163
How can you reduce communication errors?
Get feedback; ask the resident if they understand
164
If a resident falls and you think they might be injured (especially a hip injury) what should you do?
Don’t move them; stay with them; keep them in the same position and send someone to get the nurse
165
Why do the elderly fall so often?
They have poor balance and are often confused, so they don’t recognize a dangerous situation
166
Which disease makes the patient more likely to fall?
Parkinson’s disease; the muscles have tremors and are rigid
167
Which systems are kidneys part of?
The urinary system
168
What are some guidelines for the nurses station phone?
Never use it for a personal call; never take doctor’s orders - the nurse has to do that
169
If you are feeding a patient who has had a stroke what should you be aware of?
The food should be placed in the unaffected side of the mouth (their good side)
170
What is an MI?
A myocardial infarction; heart attack
171
What are signs and symptoms of an MI?
Chest pain or pressure, sweating, shortness of breath, nausea/vomiting, arm/neck/back pain
172
How is HIV most commonly spread?
Through unprotected sexual contact
173
What important step should you take every time you leave a resident?
Give them their call light; make sure it is on their strong side
174
What is leukemia?
Cancer of the white blood cells
175
Where would be the safest place to leave a hearing aid when taking the resident to a shower?
In the resident's room
176
What is the last stage of an illness before death?
The terminal stage
177
If a patient has supplemental feedings what is the CNA’s responsibility?
Offer it to the resident frequently
178
How often should catheter care be provided?
Every day and prn
179
What is systole or systolic?
When the heart is contracting; the top number of a blood pressure (the first sound you hear)
180
What is diastole or diastolic?
When the heart is relaxed; the bottom number of a blood pressure (the last sound you hear)
181
What should you do if you find a syringe with a needle on the floor?
Put it in the sharps container just the way it is; do not recap the needle
182
What does bedfast mean?
It is the same as bedrest; the person cannot get up
183
What would you do to help a patient with hand tremors?
Assist with feeding, especially hot liquids
184
If a resident is in bed on their side how would they be positioned?
Legs flexed (bent) at the knees with a pillow between them, a pillow behind their back, and one between their arms
185
What is the main cause of emphysema?
Smoking
186
When should a sputum sample be collected?
First thing in the morning
187
What are some signs and symptoms of Parkinson’s disease?
Tremors, muscle stiffness, general weakness, shuffling, stooped posture, freezing, repetitive hand motions
188
What can increase an older person’s risk for constipation?
Medications and immobility; give fluids and encourage exercise to alleviate or help with constipation
189
What does the abbreviation NPO stand for?
Nothing by mouth
190
What is peristalsis?
The wave-like muscle movement that moves the food through the intestines
191
What is a trochanter roll?
A pillow or rolled towel placed along the outside of the hip and upper leg of a patient in bed to keep their leg from turning out
192
What is the drug therapy for cancer called?
Chemotherapy
193
What can you do for a patient who is in respiratory distress (having trouble breathing)?
Elevate the head of the bed, check to make sure the oxygen is working
194
How should you remove dentures?
Upper - pull down and out; lower - pull up and forward
195
What does it mean to ambulate a resident with assistance?
To help them walk
196
What would be more likely to make a resident fall a non-skid rug or a highly polished floor?
A highly polished floor
197
If you are feeding a resident when should you offer fluids?
Frequently
198
What should you do if a resident's family offers you a tip?
Refuse politely, explain that CNAs are not allowed to take tips
199
What is included in the circulatory system?
Heart, blood vessels (veins and arteries)
200
What care do you give a patient who has had hip surgery?
Keep the legs apart using an abduction pillow; don’t let the resident cross their legs or bend the hip more than 90 degrees
201
Residents' personal items?
Should be labeled according to the facility’s policies
202
What are general rules to follow with side rails?
If you are turning a resident toward the side for any reason, have the side rail up on the side they are turning towards; if you leave a full rail up, it is considered a restraint
203
When positioning a resident in a wheelchair?
The spine should be straight
204
If the patient has a gastrostomy (feeding) tube how should they be positioned?
With the head of the bed up at 45 degrees
205
Where does a CNA usually take a pulse?
The radial artery (wrist)
206
What is a normal pulse?
60-100
207
Where do you take a tympanic temperature?
in the ear
208
When should a new rash be reported?
immediately
209
What is a bed cradle used for?
Used to protect the feet; it is a metal frame that holds the sheets off the person's feet and keeps them from getting bed sores on their toes
210
What is the result when there is not enough blood flow to the heart?
Chest Pain
211
If your patient is on dialysis how would you take a blood pressure?
Don’t take it on the arm used for dialysis; take it on the other arm
212
For wheelchair safety what should you be aware of?
Back the wheelchair down ramps; brakes are locked
213
What is an in-house transfer?
Transferring a resident from one room to another in the same facility
214
When you are walking a patient who has a Foley catheter what should you do with the bag?
Keep it below the level of the bladder
215
Define dementia.
A progressive deterioration of mental abilities
216
What does communication require?
A sender, a message, and a receiver
217
What are common symptoms of dehydration?
Dry mouth, dark concentrated urine, constipation
218
What is the name of the table that goes over the patient's bed often used to place meals on?
overbed table
219
Should you soak fingernails before or after you cut them?
before
220
What is sundowning and when does it occur?
When the patient gets more confused in the evening
221
What should you use to shave a person who is on oxygen?
A regular safety razor; not an electric shaver
222
What level of Maslow’s Hierarchy of needs encourages patients to be the best they can be?
Self-actualization (the top level)
223
What are the levels of Maslow’s Hierarchy of needs and which has to be met first?
Physical (first), safety and security, love and belonging, self-esteem, self-actualization
224
Which level of need would not be met if you don’t answer a call light?
Security
225
What is another name for a soft diet?
Mechanical; used for patients who have difficulty chewing, swallowing, or who have mouth pain
226
What is dysphagia and how do we help a patient with dysphagia eat?
Difficulty swallowing; we should position them in Fowler’s and feed them with a mechanical soft diet
227
What is dysphasia?
Dysphasia is difficulty communicating; difficulties speaking and understanding speech
228
With normal aging most people..
Stay generally active, are in good health
229
What is the name of the membrane found in your nose and mouth?
Mucous membrane
230
If a patient is ambulatory which scale would you use to weigh them?
The standing/upright scale
231
What does disinfecting do?
Kills most of the pathogens or germs by using a chemical that is too strong to be used on the skin
232
If your patient is on oxygen and a family member begins smoking what should you do?
Ask them to put it out immediately
233
How should disinfectants be stored?
Locked up
234
What is the first thing you should do as you prepare to transfer a patient?
Consider their abilities and limitations
235
Define delusions.
A false personal belief that is maintained in spite of obvious proof to the contrary (believing you are someone else)
236
Define hallucination.
Perceiving something with your senses that is not real
237
How do you label a specimen you have collected before you send it to the lab?
Include the date, the patient’s name, and date and time it was collected, and the type of test ordered; sometimes also a doctor's name and the initials of those who gathered it
238
Define osteoarthritis.
A wear and tear joint disease more common in the elderly
239
What is the problem and what should you do if your patient develops a soft spot or redness on her heel?
A pressure ulcer is starting; elevate the heels off of the mattress and report it to the nurse
240
If your patient has a feeding tube what is an important thing for you to do?
Watch for kinks in the tubing; report choking or vomiting immediately; provide oral hygiene; be very careful when repositioning the patient
241
What can you do when you are ambulating a resident to prevent them from falling?
Use a gait belt
242
Define aphasia.
A condition where the patient cannot communicate (stroke); they may not be able to speak or understand what is being said to them
243
How do we care for the feet of a diabetic?
Breathe, rinse, and dry thoroughly; check for broken, cracked, or damaged skin; clipping toenails is allowed if the facility permits
244
When your patient is wearing oxygen and also had electrical equipment what should you worry about?
Turn equipment off before unplugging it to prevent sparks; make sure there are no damaged cords, and if there is then get them replaced fast and let the nurse know
245
Define geriatrics.
The branch of medicine that focuses on caring for people later in life
246
How do you collect a 24 hour urine sample?
Have the patient urinate and don’t save it, mark the time; for the next 24 hours save all the urine in one container and keep it in the fridge; at the end of the 24 hours have the patient urinate one more time, label it and deliver it to the lab
247
How do you collect a stool sample?
Using a clean container and a small stick, scoop the stool into the container from a collecting device; deliver it to the lab as soon as possible
248
Alcohol?
Is a carcinogen according to several health organizations
249
What does it mean if something is sterilized and how is it usually done?
Sterilized means the absence of any microbes; usually done in an autoclave using steam
250
What is a chemical disinfection?
When an object is cleaned with a strong chemical that removes most but not all pathogens
251
What should you do if your patient's disease can be transmitted through droplets?
Wear a Mask
252
How can you prevent your patient from being burned?
Warn them if there are hot liquids on their trays
253
How can HIV (AIDS) or HBV (hepatitis B) be transmitted?
Through blood and bodily fluid; contact with a dirty needle or syringe or sexual intercourse
254
Where do you find the rules for each facility?
In their policy book
255
Faucets are?
Dirty, unclean, full of bacteria
256
Who is the most susceptible to disease?
The elderly, the young, and anyone already sick
257
What are characteristics of a good CNA?
Dependable, caring, sensitive, mature, good ethics, positive, knowledgeable
258
What is the purpose of white blood cells?
They are your body's natural defense against disease; they fight infection
259
What is Huntington’s disease (chorea)?
A hereditary disease that appears in midlife; causes irreversible and progressive loss of muscle control and loss of mental abilities
260
What is a care plan?
A specific plan for each resident listing goals and needs written by the nurse; found at the nurses station usually in the patient's chart
261
What should you worry about if your patient has a cast?
Always check for feeling and warmth of the fingers below the cast
262
To maintain the best stability how should you leave the wheels on a wheelchair?
Facing Foreward
263
Define microorganism.
A living thing that cannot be seen with the naked eye (bacteria, virus, fungus)
264
What is the best way to prevent contamination?
Hand washing; the next best way is wearing gloves
265
Define antisepsis.
A practice that kills microorganisms or stops them from growing
266
Why are we finding so many diseases now that do not respond to antibiotics?
Antibiotics have been inappropriately used or overused and it causes bacteria to grow resistant to them
267
How do we add moisture to the patient's oxygen?
The oxygen flows through a container of water called a humidifier; high enough for the oxygen to bubble as it passes through
268
What can someone have if they are on a clear liquid diet?
Only liquids that you can see through (water, broth, jello, tea, coffee)
269
What is included in a full liquid diet?
Anything that is liquid (milk, ice cream, pudding, soup); also anything from a clear liquid diet
270
What treatment should be provided immediately for a laceration?
Direct pressure to stop the bleeding
271
In residents with poor circulation is their skin temperature usually warmer or cooler than normal?
Cooler
272
List something patients can do if they have edema (swelling) in their feet or legs.
Elevate their feet and avoid constrictive clothing
273
What organization requires ongoing training about blood-borne pathogens and hazardous waste?
OSHA (Occupational Safety and Health Administration)
274
What should you do first if you make an error?
Tell the supervisor
275
What is post mortem care?
Care of the body after death
276
What skill will CNAs most often be ordered to provide after surgery?
Frequent vital signs
277
What are 2 main purposes of monitoring a patient's weight?
See if they are retaining fluid and assess nutritional status
278
What is the opening of a colostomy called?
Stoma
279
If a patient is masturbating in a public area what should you do?
Move them to their room or a more private area to respect their right of privacy
280
Why is being empathetic better than being sympathetic?
Sympathy shows pity whereas empathy shows understanding
281
What is the purpose of range of motion?
To keep joints mobile and prevent contractures
282
How do you measure a resident's height if they can’t stand and have contractures so they can’t lie straight?
Use a tape measure and follow the curves of their body
283
What is the difference between active and passive range of motion?
Passive - CNA does it; Active - Patient does it
284
How many hours does a CNA have to work every 2 years to recertify?
200 hours
285
List the main signs and symptoms of diabetics.
Polyuria (increased urine), polydipsia (increased thirst), polyphagia (increased hunger)
286
What is the difference between subjective and objective information?
Subjective - What the resident says (symptom); Objective - Facts that can be observed (sign)
287
What should you do if you are walking a patient who starts to fall?
Assist her to lie down, tell the nurse, look for abnormal signs and symptoms
288
List several ways you can best talk to a patient who is hearing impaired.
Slowly, clearly, distinctly, low pitch, face-to-face
289
Give an example of a chronic disease.
Cancer, Parkinson’s, dementia, Alzheimer’s, diabetes
290
What are the 5 stages of grieving?
Denial, anger, bargaining, depression, acceptance
291
What could it mean if a Foley bag has no urine in it the entire shift?
Catheter has fallen out, kidney failure, kinked, under patient's leg
292
Why do diabetics have a high risk of foot sores?
Decreased circulation and sensation
293
What are defense mechanisms used for?
To block unpleasant feelings or anxiety, to avoid conflict
294
Define reality orientation.
Helping a patient gain as much reality as possible; call them by name, tell them the date, time of day, etc.
295
What is the difference between acute and chronic disease?
Acute - Sudden, treatable; Chronic - Gradual, long term
296
What organization/legislation sets the rules on nurse’s aide training and certification?
OBRA (1987)
297
What patients usually have sitz baths ordered?
Postpartum patients and patients who have had rectal surgery
298
What term means to retain fluid in the tissues?
Edema
299
What is a nosocomial infection?
An infection acquired in healthcare facilities or hospitals (HAI)
300
Define aspiration.
Fluid or particles entering the lung instead of going down the GI tract; coughing or choking
301
What does lethargic mean?
A lowered level of consciousness including drowsiness, indifference, and reduced level of activity
302
What is another way to describe diabetics?
Hyperglycemia
303
What situations could cause aspirations if you aren’t careful?
Providing oral care to an unconscious person; feeding a resident too fast
304
What is the immediate care for a resident who is vomiting?
Turn their head to the side to prevent aspiration
305
Why is it important for intake and output to be even?
To avoid fluid imbalance
306
What is included in output besides urine?
Liquid stool, emesis, blood/wound drainage, sweat, saliva
307
Define pathogen.
A microbe that is harmful and causes infection, sometimes commonly referred to as a germ
308
What is the goal of rehabilitation?
To help a patient do as much as possible, as well as possible, for as long as possible
309
What is the main reason for straining urine?
To check for kidney stones
310
What should be documented as output for incontinent patients?
The number of times they wet the bed
311
List the times excellent oral care would be needed.
Patient is unconscious, on oxygen, on tube feedings, frequent vomiting
312
What term is a written document that gives another person the right to make decisions for you if you are unable?
Power of attorney
313
What causes dehydration?
More output than intake; frequently caused by vomiting or diarrhea or heavy sweating
314
Define hospice.
Care of terminally ill (less than 6 months to live)
315
Why should you NOT slide a patient across the sheets?
It causes friction, shearing, and skin tears
316
What else causes friction and shearing?
Leaving the head of the bed up too high for too long allowing the resident to slide down the bed
317
What is the ratio of breaths to compressions in infant CPR if you are doing it alone?
30 compressions, 2 breaths
318
Why is it important to weigh patients with congestive heart failure every morning?
They can retain fluid which causes weight gain
319
Define standard or universal precaution.
Deciding what PPE to use based on risk of exposure; infection control precautions used for all patients to reduce the spread of infection
320
List the risks of prolonged bed rest.
Pneumonia, bed sores, contractures, weakness
321
Why shouldn’t leftover cleansers be stored in an empty glass jar?
You can’t tell what they are without a proper label so they are a potential hazard
322
Why can’t bleaches and cleansers be mixed together to store?
They can give off a dangerous gas
323
A patient ate turkey, potatoes, gravy, jello, mashed carrots, juice, cake, and ice cream - what 3 items are counted as intake for I and O?
Jello, juice, ice cream
324
What pressure is the point where the first sound of the blood pressure is heard?
Systolic pressure
325
What should you do if a patient can’t eat some foods for religious reasons?
Tell the nurse or dietician; make sure they get other options
326
What letter in the alphabet is the abbreviation for the word “with”?
C
327
What position should a patient be put in if he is going into shock?
Trendelenburg
328
What system should you use for telling a blind person what is on their plate?
The clock method
329
What key step can be taken to ensure accurate weights are taken on patients?
Balance the scale first, weigh at the same time every day, weigh on the same scale, in the same amount of clothing
330
Why is it better for residents to get dressed instead of wearing pajamas all day?
It helps them feel better about themselves
331
Do patients with dementia do better in a structured environment that changes a lot?
Structured, safe, unchanging environment
332
List factors that can affect vital signs.
Time of the day, eating/drinking, smoking, medications/stress, gender/weight
333
What is the 2nd most common cause of accidents in the elderly?
burns
334
If a patient has a weak right side what side is dressed first?
The right (weak) side, also called the affected side
335
If you don’t know how to perform a task what book at the facility will tell you how?
Policy and procedure manual
336
On admission to a facility what do you do if a patient says they already know their weight
To verify for accuracy; we want to use the same scale that will be used throughout their stay
337
What is a sitz bath?
A method for soaking the perineal area to clean wounds, promote healing, decrease pain, and improve circulation
338
Define TED hose and explain their purpose?
They are elastic stockings to improve circulation in the legs; they prevent blood clots and edema
339
What should you do if your patient is diabetic and when you go to check on him he is very lethargic?
Check his blood sugar and notify the nurse
340
How should you respond to a suicidal patient?
ALWAYS take the threat seriously and tell the nurse
341
How often should immobile patients be repositioned?
every 1-2 hours
342
What does R.A.C.E stand for?
R - rescue or remove; A - alarm or activate; C - confine or contain; E - extinguish or evacuate
343
What measurement is usually used to record intake and output?
Cubic centimeters (cc) or milliliters (mLs)
344
What direction should you shave on a man's face?
In the direction that the hair grows (down on the cheek, up on the neck)
345
How often should a shave be offered?
Daily
346
How do you fix charting errors?
Cross out the error with a single line and initial the mistake
347
How often should restraints be removed and repositioned?
Every 1-2 hours (check on the patient every 15 minutes)
348
What is the first step you should take if you suspect that someone is choking?
ask, "are you choking"
349
How many CC’s or mLs are in an ounce?
30
350
How do you treat someone having a seizure?
Support their head so they don’t injure themselves; clear the area; be there to support them after
351
Why should females be wiped and cleaned from front to back?
To avoid UTIs
352
What program uses both state and federal money to help pay for care needed?
Medicaid
353
When should respirations be counted?
When the patient is unaware that you are taking them
354
If you suspect patient abuse what should you do?
Tell the RN or supervisor; report to APS
355
What is the normal range for temperature?
98-99
356
How to take a rectal temp?
Use a red thermometer, lubricate it, insert 1 inch or less, don’t let go of the thermometer, provide peri-care after
357
Which patients should be offered HS snacks?
All patients, unless they are NPO
358
Why is cutting toenails not usually included in routine nail care?
Not all patients can have it done; it must be ordered separately; not all facilities allow CNAs to clip toenails
359
What should you do first if you make an error when caring for a patient?
Tell the nurse
360
What is the most common accident for the elderly?
falls
361
What chamber of the heart receives the blood that is returning from the body?
Right Atrium
362
List key steps that should be taken for good body mechanics.
Never twist your body; keep feet 12 inches (shoulder width) apart; lift with legs not back; hold object close; get help
363
What if you need to move something that is very heavy?
Do not attempt to lift it; try to push or pull the object
364
List ways to avoid pressure sores.
Reposition (2 hrs); pad bony areas with pillows; good skin care; good nutrition
365
Why should residents be encouraged to do as much for themselves as possible?
They’ll feel more self-reliant; it keeps them active; it is good for their self-esteem
366
If you are feeding a blind person what should you remember?
Always tell them what you are feeding them
367
What time is it if it is 2015 in military time?
8:15 P.M.
368
Do ALL elderly patients get dementia?
No, only about 15%; however, this makes up most of the people you take care of
369
What is the purpose of SDS sheets?
They tell about chemicals or hazardous materials; what to do if they are swallowed or spilled
370
What does MSDS stand for?
Material Safety Data Sheet; the new acronym for SDS (safety data sheet)
371
What term means paralyzed from the waist down?
Paraplegia
372
When should TED hose be applied?
Before getting out of bed in the morning, or when feet are elevated before swelling begins
373
Define negligence.
Not providing the care that a patient needs or not performing it safely
374
What is CVA?
Cerebrovascular accident or stroke
375
How often should an elderly patient’s hair be shampooed?
At least once a week
376
What is an open ended question?
Any questions that require more than a yes or no answer
377
Where should restraints be tied when the person is in bed?
On the bed frame; never on the side rails; using a quick release knot
378
What instrument do you need to take an apical pulse?
A stethoscope (and a clock with a second hand)
379
What part of the body usually has poor circulation in diabetic patients?
Feet
380
Pulses are located over what type of blood vessel?
Artery
381
What liquid is most important for patients to drink enough of?
Water; it helps with elimination of waste
382
What is the position called when the resident is flat on their back?
Supine
383
How can you best help a blind resident walk?
Allow them to hold your arm
384
Where is the radial pulse taken?
The wrist, using 2 fingers; never your thumb because it has its own pulse
385
Define log rolling and explain why it is done.
Moving the patient while keeping the body in alignment; used for patients with neck, back, or hip injury; you need 2 people, move the patient on the count of 3 with a draw sheet; the patient should cross their arms and have a pillow in between their legs
386
What type of seizure causes the person to fall asleep suddenly?
Narcolepsy
387
What is the best way to prevent contractures?
Range of Movement
388
What is the purpose of the Heimlich maneuver?
Choking and has no air exchange; thumb side up against the abdomen just above the navel; you would recognize when a person needs this
389
What should you say if a patient wants to tell you a secret?
You can tell me anything you want, but I can’t keep it a secret if the nurse needs to know
390
How often should oral care be provided for patients who are unconscious?
Every 2 hours
391
What often causes falls in the home?
Throw rugs and poor vision with a cluttered environment
392
What term means for muscles to shrink
Atrophy
393
What is a written statement about the life-saving measures a patient wants to be taken?
A living will, often used in conjunction with a POLST form
394
What is a mini stroke called?
Transient ischemic attack
395
What temperature should bath water be?
100-105 degrees or warm to the touch
396
What is the ratio of compression to breaths in 1 man adult CPR?
30 compressions and 2 breaths
397
What nutrient is needed for tissue to grow and repair?
Protein
398
What nutrient do we get the most of our energy from?
Carbs
399
What is included in non-verbal communication?
Body language, gestures, facial expressions
400
What type of seizure has tonic-clonic contractions?
Grand Mal
401
How long should you wait to take a temperature if the patient has had anything to eat or drink?
15 to 30 minutes
402
Where is the apical pulse taken?
The chest, over the heart
403
What does the abbreviation QID mean?
4 times a day
404
What position is it when the patient is lying flat on their stomach?
Prone
405
What is the least accurate way to measure temperature?
Axillary
406
What letter of the alphabet is the abbreviation for the word without?
S
407
What is always required before restraints can be used?
Doctor's order
408
What should be done first in the case of a fire?
Rescue the patient and remove the patient from danger
409
What pressure is the point where the last sound of the blood pressure is heard?
Diastolic pressure
410
What should you do if you find a patient masturbating in his room?
Close the door and leave the room and give him his privacy
411
What procedure should be performed if a victim is not breathing and has no heartbeat?
CPR (cardiopulmonary resuscitation)
412
What position should unconscious patients be in during oral care?
Lateral (side-laying)
413
What should the aide do if she finds a piece of broken equipment?
Tell the supervisor or RN; don’t use it until it is fixed
414
What program in the government is managed by the Social Security Administration and pays for health care for the elderly?
Medicare
415
When should linens that are wet or soiled be changed?
Immediately
416
When a patient is dying what is the last sense to leave?
Hearing
417
If you are angry with a patient who should you talk to?
The supervisor and RN (not coworkers or the patient's family)
418
What does QS stand for?
Quantity sufficient
419
What does the abbreviation HS stand for?
Hour of sleep or bedtime
420
How often does a CNA certification need to be renewed?
Every 2 years
421
What utensil should be used when feeding patients?
A spoon
422
What is the #1 way to prevent the spread of infection?
Hand Washing
423
Everything in an isolation room is considered to be…
Contaminated - everything should be single use and disposed into a biohazard container; laundry and trash should be double bagged
424
What is the most important step in good communication?
Listening
425
List patient rights.
Privacy, confidentiality, respect, care, free from abuse, have visitors, visit in private + more
426
What should you do if you find leftover medications in your patient’s room?
Tell the nurse, do not give them to the patient
427
What term means the buildup of plaque and fat in the arteries?
Atherosclerosis
428
When is it ok to call a resident by their first name?
When the resident requests it
429
What type of seizure causes brief periods of inattention and staring into space?
Petit Mal
430
How can you best treat bleeding or hemorrhaging?
Apply direct pressure
431
How many ounces are in 1 cup?
8
432
Should canes be used on the patient's weak or strong side?
Strong
433
Is dry heat or wet heat more intense and potentially dangerous?
Wet - a hot washcloth is more intense than a hot pack
434
If the patient has a weak right side what side is undressed first?
The left (strong) side, also called the unaffected side
435
List rules for handling linens.
Don’t shake, don’t put them on the floor, don’t return clean/unused ones to the closet, stack in order of use and flip
436
What should the average intake be for a healthy adult?
1500 to 2000 CC’s (mLs)
437
What can you do to decrease the risk of drying the skin of elderly patients?
Use less soap, use lotion, don't bathe everyday
438
List 3 times using restraints would be appropriate.
Resident safety, safety of others, pulling out tubes
439
What is the term for being paralyzed from the neck down?
Quadriplegia
440
Who acts as the case manager for home care patients?
The RN
441
What body parts are included in the partial bed bath?
Face, hands, axillary, back, peri area
442
What is the purpose of bladder training?
To help the patient gain control of their bladder once the catheter is removed
443
List requirements for caring for a patient in traction.
Keep weights off the floor, keep the patient in good body alignment, avoid bumping them or traction equipment
444
What is the danger of using hot packs on the legs of people with edema?
Bad burns since sensation is often decreased; more swelling
445
Define hemiplegia.
Paralysis on one side of the body (right or left)
446
What is an inventory list?
A list of all the patient’s belongings
