STNA Practice Test

The bed alarm is the least invasive and will keep the client safe. All restraints require a physician’s order.

The hotdog cut up into bite-size pieces could easily plug the child’s airway and cause them to choke. The sandwich would most likely fall apart before this could happen.

Using a urinal is the best way to promote the patient’s independence while still maintaining safety.

The ideal temperature of the water for a hot Sitz bath is between 95°F and 110°F. Water that is too hot will burn the client, and water that is too cold will cause the muscles to tighten up rather than relax. A hot Sitz bath will provide relaxation and relieve muscle spasms, soften exudates, hasten the suppuration process, hasten healing (in cases of perianal surgeries), reduce congestion, and provide comfort in the perineal area.

The restraint straps should be secured to the bed frame and never to the side rail to avoid accidental injury in the event that the side rail is released. A half-bow or safety knot should be used for applying a restraint because it does not tighten when force is applied against it and allows quick and easy removal of the restraint in case of emergency. The jacket restraint should be secured, and one to two fingers should slide easily between the restraint and the client’s skin.

If the patient has IV catheters in both arms, a blood pressure cuff will impede their intravenous flow.

The acronym “RACE” is used for fire situations- Rescue, alarm, contain, extinguish. First you must rescue the client to prevent harm.

It is necessary to check the shaving instructions in the resident’s plan of care to be aware of any problems clotting and the necessity of using an electric razor as opposed to a traditional one.

Residents should be fully assisted and supervised when turning in order to prevent falls.

A client who is on oxygen therapy should have safety measures implemented in order to prevent explosion. Use of electric razors or hair dryers while the oxygen is running is not allowed. Combing a client’s hair can also create a spark of electricity from his hair that could set off an explosion. The face mask can be removed if the client wishes to eat and converse with visitors. Use of cotton bedclothes is also encouraged to decrease static electricity.

MRSA is a disease transmitted by skin-to-skin contact. It does not require airborne or droplet precautions.

IV drug use is one of the many ways that it is possible to contract the hepatitis C virus.

Most guidelines for handwashing (including the CDC) recommend washing hands for 20 seconds.

The nursing assistant should wear a gown and gloves at most as correct contact precautions.

MRSA stands for methicillin-resistant Staphylococcus aureus and is very resistant to most antibiotic treatments.

Frequent handwashing is the best way to prevent infection without a doubt. The other measures are supportive.

Keeping the bag below the level of the cavity ensures that bacteria cannot migrate up from the bag and up into the bladder due to gravity.

It is unnecessary to use a new piece of floss for each tooth. Break off an 18-inch of floss from the dispenser; this will do for all the teeth. Just move to a new section of floss after every second tooth is flossed. The other choices are correct steps in flossing.

Allowing the resident to participate in care will raise their self esteem and allow autonomy. It is inappropriate to clean the perineal area before the face, or to use cool water rather than comfortably warm water.

It is the duty of the nursing assistant to report any red pressure spots on the resident to the nurse. The nursing assistant may not apply any prescription ointments. Talcum powder is not recommended. A second staff member is not needed for perineal care.

In order to maintain privacy and keep a client warm, it is important to cover areas that are not being bathed. When cleaning the perineal area, wipe front to back. Have the client assist with ADLs, but support them. Do not lotion between toes because it predisposes them to fungal infections.

Safety, security, and privacy are most important to the resident during a bed bath.

Diabetic clients often have special instructions regarding nail trimming. Check the chart for specific orders.

Able clients can perform this procedure by themselves once they have been taught by the nurse. Ostomy care is done aseptically (rules of cleanliness). It does not require a doctor’s order for changing the ostomy pouch. The collection bag must be changed when it is full or when the adhering seal is broken. A client with an ostomy will have a change in the normal bowel movement. The fecal matter will be collected through an appliance that is held over the stoma by a special adhesive or paste.

Support the client in their own individual religious needs. Treat any religious objects in their room with respect.

Maintaining a routine is incredibly important to Alzheimer’s patients. Hallucinations and a decrease in appetite are common. It is important to frequently reorient the patient.

Reorienting the patient frequently is the most important aspect of care. Keeping the client locked in their room could agitate them, as could asking them their name (which they might not remember).

Speaking calmly in a neutral manner can soothe an agitated client. Restraints are not appropriate for a client who is merely confused and can be placated.

Careful drying is essential to avoid maceration of the penis. To decrease the risk for infection, wash the penis from the tip the base to reduce the risk for introducing microorganisms into the urethral meatus. Effective cleaning requires soap and thorough rinsing. It’s also essential to remove secretions that accumulate under the foreskin because they can lead to inflammation and are associated with the development of penile cancer. The foreskin of uncircumcised men must be retracted for cleaning, then replaced to prevent paraphimosis (capistration).

The nursing assistant should place the cane on the side that is the strongest so that it can support the weak side.

A mechanical lift should be used for immobile or NWB residents. A gait belt should never be used on an immobile resident to lift them and should be used on individuals who are FWB or PWB.

It is best for the patient to perform as much of the bath as possible, with the nursing assistant helping out when necessary.

A bedridden client needs to be turned every 2 hours, have adequate nutrition, and cough and deep breathe to prevent potential complications of pressure ulcers and pneumonia. Massage can minimize the pain, but placing the client immobile is not the correct answer. Active and passive range of motion exercises and hydration are also appropriate answers to prevent contractures and promote skin integrity.

Velcro clothing, slip-on shoes, and rubber grippers make it easier for the client to dress and grip objects. Zippers, ties, and buttons may be difficult for the client to use.

Bathing a resident without his or her permission is an example of battery. Keeping a resident isolated from others as a form of punishment is an example of involuntary seclusion.

Abuse in nursing facilities, or even suspicion of abuse, should be reported immediately to the nursing assistant’s supervisor. This requires more intervention than the nursing assistant’s scope of practice covers. Waiting or notifying the nurse only about bruises may delay getting the resident help.

HIPAA requires you to keep client’s health information confidential. Period.

The physician needs to order restraints before they can be legally applied. No one else can ask for restraints for a patient or it is considered battery.

The OBRA act helps residents to achieve their highest points of physical, psychological, and mental functioning, as well as make choices about their lives.

The ability to file a grievance in a nursing home or other nursing care facility is considered a legal right as defined by the Patient Bill of Rights.

The ombudsman’s job is to ensure that residents’ complaints are heard.

Hand gestures are an example of nonverbal communication.

The number of respirations is slightly too fast to be considered normal and could be considered a respiratory problem.

It is very important to report a symptomatic low blood pressure to the nurse for further investigation.

Someone with diabetes should always eat regular meals to keep their blood sugar relatively stable. Numbness in the feet is neuropathy, a common side effect of diabetes.

Any pulse outside the range of 60 to 100 should be reported immediately to the nurse for the resident’s safety.

Emesis (vomiting) in the diabetic client can indicate a potential for blood sugar imbalance. This should be reported to the nurse for further assessment.

This should be reported to the patient’s nurse immediately.

Waiting fifteen minutes ensures the temperature of the mouth will be more accurate. Axillary temperatures in the elderly are often not the best measure.

The radial pulse is the most easily accessible location to take a pulse.

The abbreviation of “cc” is no longer appropriate in the medical field. Only ‘ml’ should be used. A 16-ounce glass is approximately 480 ml.

The sputum produced upon awakening is the most concentrated sputum and will yield the most accurate result.

This correctly describes how Sims position is different than left lateral position. A pillow is placed between the knees in both positions listed.

Residents on bedrest must be turned every 2 hours to maintain skin integrity.

High Fowlers is a description of the patient sitting straight up in bed, meaning the bed itself has to be at a 90 degree angle to support them.

Lowering the bed to the lowest level is important for safety. Mitering the corners of sheets is recommended, as is raising side rails. Never place soiled linens on the floor.

Securing the catheter to the lateral aspect of the patient’s thigh ensures it cannot be painfully pulled during the bath.

Wrinkles and creases in the sheets can contribute to bed sores.

Drinking fluids will help to lubricate the secretions so that the patient can cough them up easier.

A cool washcloth can make a patient with a fever feel better. The nursing assistant may not administer medications.

Elastic stockings or anti-embolic stockings are applied before the client gets out of bed. Otherwise the legs can swell from sitting or standing. Stockings are hard to put on when the legs are swollen. The client lies in bed while they are off. This prevents the legs from swelling.

Stretching the bandage slightly maintains uniform tension on the bandage. Wrapping the bandage loosely wouldn’t secure the bandage on the arm. Using heavy pressure would cause circulatory impairment. Beginning the wrapping at the upper arm would cause uneven application of the bandage. For example, elastic stockings are applied distal to proximal to promote venous return.

To abduct is to move away, to adduct is to move closer or toward.

Nursing assistants may not administer medications- it is not within their scope of practice. Only RNs, LPNs, and other properly licensed personnel may give medications.

Inserting an indwelling urinary catheter requires sterile technique, which is not a component of nursing assistant skills.

As a nursing assistant, you can’t just leave your patients without transferring their care elsewhere. The nursing supervisor can assist with this process if you are too sick to do so yourself. A fever means that you are an infection risk to residents.

The nursing assistant cannot ask the patient to measure his own urine, or delay in emptying it. Once the patient is finished, he should ring the bell so that she can measure it and empty it herself.

It is appropriate to review this with the charge nurse of the unit before answering yes or no.

Medications may not be given by a nursing assistant. Alert the charge nurse to ensure that there is a nurse provided for each client in the assignment.

When changing a dressing, always note the color, odor, amount, and consistency of the drainage on the old dressing. Dressings that do not require the use of sterile technique or to apply medication to the wound will often be assigned to your care. Make sure that you follow the correct steps in doing the procedure, such as cleansing the wound and the skin using circular motions and starting from the clean areas to the dirty. The wound is considered clean and the skin dirty. Apply clean dressings afterwards. Hold all dressings by the corners as you apply them. Do not contaminate the center of the bandages. Tape the dressing in place, leaving the edges free. Do not tape completely around the edges of the bandage.

The job of the nursing assistant is to make sure there are no kinks in the tubing and to secure the connecting tubing in place. The other choices are all responsibilities of a physician.

Sweating, as well as confusion and tremors, are signs of hypoglycemia.

Diabetes is a disease process that occurs due to a disease of the endocrine system and subsequently affects all other systems.

Emphysema is the only truly irreversible disease listed. Asthma may be “outgrown” after childhood, and chickenpox is an acute, short-lived illness. Hypertension may be “cured” with diet, exercise, and medication.

Hypoxia means that the cells do not have enough oxygen. It is a life-threatening condition. The brain is very sensitive to inadequate oxygen. Restlessness is an early sign, as are dizziness and disorientation. Hypoxia will have increased respiratory rate, increased pulse rate, but not increased temperature. Cyanosis, or bluish discoloration of the skin, is a late sign of hypoxia.

Speaking slowly and clearly is the key to helping hard-of-hearing clients understand what you’re saying.

Falls are the number one cause of accidental death in this age group. Work hard to prevent them!

Cauliflower is gas-forming. Other examples of gas-forming foods are beans, cabbage, radishes, and cucumbers.

Family stress does not typically interfere with elimination. Aging, medications, and infection do have a direct effect on elimination.