Itemm1mofm150
A resident falls from her chair when she has a seizure. Before the nurs
m m m m m m m m m m m m m
e arrives, the seizure is finished and the nurse aide observes the resid
m m m m m m m m m m m m
ent is breathing. What should the nurse aide do next?
m m m m m m m m m
A. Getmthememergencymcart
B. Turnmthemresidentmontomhermside
C. Checkmifmthemresidentmismablemtomtalk
D. Helpmthemresidentmbackmintomthemchair
Incorrectm
Rationale:mAftermamseizure,msalivammaympoolminmthemmouthmandmthemindividualmmaymalsomvomit.mTurningmthemresiden
tmontomthemsidempreventsmaspirationmbymallowingmthemfluidsmtomdrainmoutmofmthemmouth.mThismismthemmostmimportantm
actionmformthemnursemaidemtomtakeminmthismsituation.mThemnursemaidemshouldmnotmleavemthemresidentmunattendedmand
mshouldmnotmmovemthemresidentmuntilmcheckedmbymthemnurse.m
Reference(s):
Examplesmofmreferencesmwheremknowledgemformthismquestionmismcoveredminclude:
1.mCarter,mP.m(2012).mLippincottmTextbookmformNursingmAssistantsm(3rdmEd.).mPhiladelphia,mPA:mWoltersmKluwer/Lippi
ncottmWilliamsm&mWilkins.mPagem220.
2.mSorrentino,mS.m(2011).mMosby'smTextbookmformLong-
TermmCaremNursingmAssistantsm(6thmEd.).mSt.mLouis,mMO:mElseviermMosby.mPagem706.
Markmitemmformreview
Itemm2mofm150
To prevent skin tears or shearing when moving the resident, the nurse
m m m m m m m m m m m
aide should
m m
A. wearmglovesmtomreducemfrictionmagainstmthemskin.
B. avoidmpullingmormslidingmthemresidentmwhenmmoved.
C. tellmthemresidentmtombemcarefulmandmfollowmdirections.
D. askmthemresidentmtomkeepmarmsmheldmovermthemresident'smhead.
Correctm
Rationale:mThemskinmofmanmelderlymresidentmismthinmandmfragile.mPullingmbedmsheetsmagainstmthemresident’smskin,morm
slidingmthemresidentmwhenmmovingmormtransferring,mcanmcauseminjurymtomthemskin,msuchmasmskinmtears.mThismismthemr
esultmofmshearing.mGreatmcaremismneededmtompreventmskinmtears.mActionsmlikemrollingmormusingmamturningmsheet,mslide
,mormtransfermsheetmcanmhelpmreducemthemriskmofmskinminjury.m
Wearingmglovesmwhenmtransferringmamresidentmmaymbemappropriatemifmthemnursemaidemismatmriskmofmexposuremtomblo
odmormbodymfluids,mbutmitmwillmnotmpreventmshearingmormskinmtears.mTellingmthemresidentmtomfollowmdirectionsmormhavin
gmthemresidentmholdmarmsmovermthemheadmwillmnotmpreventmskinmtearsmormshearing.m
Understandingmhowmtompreventmskinmtearsmismimportantmformthemnursemaidemwhomsharesmresponsibilitymformthemsafet
ymofmresidents.mThemnursemaidemshouldmbemawaremthatmskinmtearsmarempainful,mandmthemskinmopeningmalsomincrease
smthemresident’smriskmforminfection.
Reference(s):
Examplesmofmreferencesmwheremknowledgemformthismquestionmismcoveredminclude:
1.mAlvare,mS..mFuzy,mJ.,mandmRymer,mS.m(2009).mHartman’smNursingmAssistantmCare:mLong-
TermmCaremandmHomemHealth.mAlbuquerque,mNM:mHartmanmPublishing,mInc.mPagesm149mandm197.m
,2.mSorrentino,mS.m(2011).mMosby'smTextbookmformLong-
TermmCaremNursingmAssistantsm(6thmEd.).mSt.mLouis,mMO:mElseviermMosby.mPagesm225mandm538-539.
Markmitemmformreview
,Itemm3mofm150
What should a nurse aide do with a used disposable razor?
m m m m m m m m m m
A. Throwmthemrazormawayminmamtrashmcan.
B. Placemthemrazorminmamsharpsmcontainermimmediately.
C. Clean,mrinse,mandmdrymthemrazormsomitmcanmbemusedmagain.
D. Wrapmthemrazorminmampapermtowelmuntilmitmcanmbemthrownmaway.
Correctm
Rationale:mAmdisposablemrazormismamsafetymconcernmbecausemitmismconsideredmamsharpmandmamusedmrazormismlikelymt
omalsomhavembloodmcellsmonmit.mSincemitmismconsideredmamsharpmandmpotentiallymcontaminatedmwithmbloodmcells,mitmm
ustmbemdisposedmofminmthemSharpsmcontainer.mSafemdisposalmofmsharpsmismampartmofmthemnursemaide’smresponsibilitym
becausemitmpertainsmtomthemsafetymofmthemresident.m
Themnursemaidemmustmalwaysmbemawaremofmsafetymofmallmresidents,mbutmespeciallymconcernedmformresidentsmwhomar
emconfusedmandmcouldmbemaccidentallymharmedmhandlingmamrazormthatmwasmleftmout.
Reference(s):
Examplesmofmreferencesmwheremknowledgemformthismquestionmismcoveredminclude:
1.mCarter,mP.m(2012).mLippincottmTextbookmformNursingmAssistantsm(3rdmEd.).mPhiladelphia,mPA:mWoltersmKluwer/Lipp
incottmWilliamsm&mWilkins.mPagem370.m
2.mSorrentino,mS.m(2011).mMosby'smTextbookmformLong-
TermmCaremNursingmAssistantsm(6thmEd.).mSt.mLouis,mMO:mElseviermMosby.mPagem321.
Itemm4mofm150
Which of the following is the best example of using reality orientation f
m m m m m m m m m m m m
or a resident with early dementia?
m m m m m
A. "Yourmsonmplansmtomvisitmtodaymatm2:00mp.m."
B. "Youmareminmthemnursingmhome.mImammheremtomhelpmyou."
C. "ThismismyourmdaughtermAnna.mDomyoumremembermher?"
D. "Lookmatmthemtime.mLunchmisminm30mminutes.mAremyoumfeelingmhungry?"
Incorrectm
Rationale:mRealitymorientationmismamprocessmofmremindingmandmorientingmthemresidentmtomperson,mplace,mandmtime.mF
ormamresidentmwithmearlymdementia,mputtingmtimemintomthemcontextmofmthemdaymandmroutinemcanmbemhelpful.mLunchmis
mampartmofmamlifemroutine,mandm remindingmthemresidentmaboutmthatmandmrelatingmitmtomeatingmandmbeingmhungrymcanmb
emreassuringmandmhelpful.m
InmthemearliermstagesmofmAlzheimer’smdisease,mwhenmamresidentmmaymbemawaremandmfrightenedmbymlossmofmmemory,
mavoidmcontributingmtomthemresident’smanxietymbymmakingmstatementsmsuchmas,m"Don’tmyoumremembermyourmdaughte
r?"
Reference(s):
Examplesmofmreferencesmwheremknowledgemformthismquestionmismcoveredminclude:
1.mDuganmD.m(2012).mNursingmAssisting:mAmFoundationminmCaregivingm(3rdmEd.).mAlbuquerque,mNM.mHartmanmPubli
shing,mInc.mPagem415.m
2.mHedman,mS.,mFuzy,mJ.,mandmRymer,mS.m(2010).mHartman'smNursingmAssistantmCare:mLong-
TermmCarem(2ndmEd.).mAlbuquerque,mNM:mHartmanmPublishing,mInc.mPagem359.
Markmitemmformreview
Itemm5mofm150
, While feeding a resident, the nurse aide notices that the resident is co
m m m m m m m m m m m m
ughing a lot after each drink of fluid. What is the appropriate response
m m m m m m m m m m m m m
by the nurse aide?
m m m
A. Allowmthemresidentmmoremtimemtomswallow.
B. Usemamstrawmwhenmgivingmthemresidentmfluids.
C. Addmamthickeningmproductmtomthemresident'smfluids.
D. Stopmfeedingmandmaskmamnursemtomcheckmthemresident.
Correctm
Rationale:mWhenmamresidentmcoughsmfrequentlymaftermdrinkingmfluids,mitmmaymindicatemthatmthemresidentmismhavingms
omemdifficultymswallowing.mThismdifficultymswallowingmcanmresultminmfluidsmgoingmintomthemresident’smlung.mThismcondi
tionmismknownmasmaspiration.mItmcanmresultminmthemdevelopmentmofmseriousmmedicalmconditions,msuchmasmpneumonia,
mwhichmmaymrequiremmedicalmattention.m
Themnursemaidmshouldmnotifymthemnursemimmediately.mThemresidentmwillmrequiremanmevaluationmofmthemresident’smabil
itymtomswallow.mThickeningmagentsmaremsometimesmaddedmtomliquidsmformresidentsmthatmhavemdifficultymswallowingmfl
uids,mbutmthemusemofmthesemthickenersmismdecidedmbymthemphysicianmandmnotmthemnursemaide.
Reference(s):
Examplesmofmreferencesmwheremknowledgemformthismquestionmismcoveredminclude:
1.mSorrentino,mS.m(2011).mMosby'smTextbookmformLong-
TermmCaremNursingmAssistantsm(6thmEd.).mSt.mLouis,mMO:mElseviermMosby.mPagesm386-387.m
2.mAlvare,mS..mFuzy,mJ.,mandmRymer,mS.m(2009).mHartman’smNursingmAssistantmCare:mLong-
TermmCaremandmHomemHealth.mAlbuquerque,mNM:mHartmanmPublishing,mInc.mPagem268.
Itemm6mofm150
A resident wears a hand splint. Which observation should the nurse ai
m m m m m m m m m m m
de report to the nurse immediately?
m m m m m
A. Themresident'smfingersmaremcoldmandmblueminmcolor.
B. Themsplintmwasmremovedmasmscheduledminmthemcaremplan.
C. Themresidentmasksmtomhavemthemsplintmremovedmformamfewmminutes.
D. Themresidentmasksmthemnursemaidemtomrepositionmthemarmmwithmthemsplint.
Correctm
Rationale:mWhenmamresidentmwearsmamsplint,mitmismimportantmtommakemsuremthemsplintmismappliedmproperlymandmismno
tmcausingmpressuremthatmcouldmaffectmcirculation.mIfmnotmproperlymapplied,mthemsplintmcanmcausempressure.mWhenmamr
esidentmwearsmamsplint,mthemcaremplanmmaymalsomincludemscheduledmperiodsmformremovingmthemsplintmtomallowmthems
kinmtombemopenmtomairmandmtompromotemcirculation.mWhenmamresidentmwearsmamsplint,mitmismimportantmtomobservemfor
manymchangesminmskinmcolorminmthemextremity,mwhichmifmobservedmshouldmbemreportedmtomthemnursemimmediately.mSk
inmcolormchangesmandmchangesminmthemtemperaturemofmthemextremitymcouldmalsombemsignsmofmimpairedmcirculation.
Reference(s):
Examplesmofmreferencesmwheremknowledgemformthismquestionmismcoveredminclude:
1.mCarter,mP.mandmGoldschmidt,mW.m(2010).mmLippincott'smTextbookmformLong-
TermmCaremNursingmAssistants:mAmHumanisticmApproachmtomCaregiving.mPhiladelphia,mPA:mWoltersmKluwer/Lippinco
ttmWilliamsm&mWilkins.mPagem159.m
2.mSorrentino,mS.m(2011).mMosby'smTextbookmformLong-
TermmCaremNursingmAssistantsm(6thmEd.).mSt.mLouis,mMO:mElseviermMosby.mPagem429.
Markmitemmformreview
A resident falls from her chair when she has a seizure. Before the nurs
m m m m m m m m m m m m m
e arrives, the seizure is finished and the nurse aide observes the resid
m m m m m m m m m m m m
ent is breathing. What should the nurse aide do next?
m m m m m m m m m
A. Getmthememergencymcart
B. Turnmthemresidentmontomhermside
C. Checkmifmthemresidentmismablemtomtalk
D. Helpmthemresidentmbackmintomthemchair
Incorrectm
Rationale:mAftermamseizure,msalivammaympoolminmthemmouthmandmthemindividualmmaymalsomvomit.mTurningmthemresiden
tmontomthemsidempreventsmaspirationmbymallowingmthemfluidsmtomdrainmoutmofmthemmouth.mThismismthemmostmimportantm
actionmformthemnursemaidemtomtakeminmthismsituation.mThemnursemaidemshouldmnotmleavemthemresidentmunattendedmand
mshouldmnotmmovemthemresidentmuntilmcheckedmbymthemnurse.m
Reference(s):
Examplesmofmreferencesmwheremknowledgemformthismquestionmismcoveredminclude:
1.mCarter,mP.m(2012).mLippincottmTextbookmformNursingmAssistantsm(3rdmEd.).mPhiladelphia,mPA:mWoltersmKluwer/Lippi
ncottmWilliamsm&mWilkins.mPagem220.
2.mSorrentino,mS.m(2011).mMosby'smTextbookmformLong-
TermmCaremNursingmAssistantsm(6thmEd.).mSt.mLouis,mMO:mElseviermMosby.mPagem706.
Markmitemmformreview
Itemm2mofm150
To prevent skin tears or shearing when moving the resident, the nurse
m m m m m m m m m m m
aide should
m m
A. wearmglovesmtomreducemfrictionmagainstmthemskin.
B. avoidmpullingmormslidingmthemresidentmwhenmmoved.
C. tellmthemresidentmtombemcarefulmandmfollowmdirections.
D. askmthemresidentmtomkeepmarmsmheldmovermthemresident'smhead.
Correctm
Rationale:mThemskinmofmanmelderlymresidentmismthinmandmfragile.mPullingmbedmsheetsmagainstmthemresident’smskin,morm
slidingmthemresidentmwhenmmovingmormtransferring,mcanmcauseminjurymtomthemskin,msuchmasmskinmtears.mThismismthemr
esultmofmshearing.mGreatmcaremismneededmtompreventmskinmtears.mActionsmlikemrollingmormusingmamturningmsheet,mslide
,mormtransfermsheetmcanmhelpmreducemthemriskmofmskinminjury.m
Wearingmglovesmwhenmtransferringmamresidentmmaymbemappropriatemifmthemnursemaidemismatmriskmofmexposuremtomblo
odmormbodymfluids,mbutmitmwillmnotmpreventmshearingmormskinmtears.mTellingmthemresidentmtomfollowmdirectionsmormhavin
gmthemresidentmholdmarmsmovermthemheadmwillmnotmpreventmskinmtearsmormshearing.m
Understandingmhowmtompreventmskinmtearsmismimportantmformthemnursemaidemwhomsharesmresponsibilitymformthemsafet
ymofmresidents.mThemnursemaidemshouldmbemawaremthatmskinmtearsmarempainful,mandmthemskinmopeningmalsomincrease
smthemresident’smriskmforminfection.
Reference(s):
Examplesmofmreferencesmwheremknowledgemformthismquestionmismcoveredminclude:
1.mAlvare,mS..mFuzy,mJ.,mandmRymer,mS.m(2009).mHartman’smNursingmAssistantmCare:mLong-
TermmCaremandmHomemHealth.mAlbuquerque,mNM:mHartmanmPublishing,mInc.mPagesm149mandm197.m
,2.mSorrentino,mS.m(2011).mMosby'smTextbookmformLong-
TermmCaremNursingmAssistantsm(6thmEd.).mSt.mLouis,mMO:mElseviermMosby.mPagesm225mandm538-539.
Markmitemmformreview
,Itemm3mofm150
What should a nurse aide do with a used disposable razor?
m m m m m m m m m m
A. Throwmthemrazormawayminmamtrashmcan.
B. Placemthemrazorminmamsharpsmcontainermimmediately.
C. Clean,mrinse,mandmdrymthemrazormsomitmcanmbemusedmagain.
D. Wrapmthemrazorminmampapermtowelmuntilmitmcanmbemthrownmaway.
Correctm
Rationale:mAmdisposablemrazormismamsafetymconcernmbecausemitmismconsideredmamsharpmandmamusedmrazormismlikelymt
omalsomhavembloodmcellsmonmit.mSincemitmismconsideredmamsharpmandmpotentiallymcontaminatedmwithmbloodmcells,mitmm
ustmbemdisposedmofminmthemSharpsmcontainer.mSafemdisposalmofmsharpsmismampartmofmthemnursemaide’smresponsibilitym
becausemitmpertainsmtomthemsafetymofmthemresident.m
Themnursemaidemmustmalwaysmbemawaremofmsafetymofmallmresidents,mbutmespeciallymconcernedmformresidentsmwhomar
emconfusedmandmcouldmbemaccidentallymharmedmhandlingmamrazormthatmwasmleftmout.
Reference(s):
Examplesmofmreferencesmwheremknowledgemformthismquestionmismcoveredminclude:
1.mCarter,mP.m(2012).mLippincottmTextbookmformNursingmAssistantsm(3rdmEd.).mPhiladelphia,mPA:mWoltersmKluwer/Lipp
incottmWilliamsm&mWilkins.mPagem370.m
2.mSorrentino,mS.m(2011).mMosby'smTextbookmformLong-
TermmCaremNursingmAssistantsm(6thmEd.).mSt.mLouis,mMO:mElseviermMosby.mPagem321.
Itemm4mofm150
Which of the following is the best example of using reality orientation f
m m m m m m m m m m m m
or a resident with early dementia?
m m m m m
A. "Yourmsonmplansmtomvisitmtodaymatm2:00mp.m."
B. "Youmareminmthemnursingmhome.mImammheremtomhelpmyou."
C. "ThismismyourmdaughtermAnna.mDomyoumremembermher?"
D. "Lookmatmthemtime.mLunchmisminm30mminutes.mAremyoumfeelingmhungry?"
Incorrectm
Rationale:mRealitymorientationmismamprocessmofmremindingmandmorientingmthemresidentmtomperson,mplace,mandmtime.mF
ormamresidentmwithmearlymdementia,mputtingmtimemintomthemcontextmofmthemdaymandmroutinemcanmbemhelpful.mLunchmis
mampartmofmamlifemroutine,mandm remindingmthemresidentmaboutmthatmandmrelatingmitmtomeatingmandmbeingmhungrymcanmb
emreassuringmandmhelpful.m
InmthemearliermstagesmofmAlzheimer’smdisease,mwhenmamresidentmmaymbemawaremandmfrightenedmbymlossmofmmemory,
mavoidmcontributingmtomthemresident’smanxietymbymmakingmstatementsmsuchmas,m"Don’tmyoumremembermyourmdaughte
r?"
Reference(s):
Examplesmofmreferencesmwheremknowledgemformthismquestionmismcoveredminclude:
1.mDuganmD.m(2012).mNursingmAssisting:mAmFoundationminmCaregivingm(3rdmEd.).mAlbuquerque,mNM.mHartmanmPubli
shing,mInc.mPagem415.m
2.mHedman,mS.,mFuzy,mJ.,mandmRymer,mS.m(2010).mHartman'smNursingmAssistantmCare:mLong-
TermmCarem(2ndmEd.).mAlbuquerque,mNM:mHartmanmPublishing,mInc.mPagem359.
Markmitemmformreview
Itemm5mofm150
, While feeding a resident, the nurse aide notices that the resident is co
m m m m m m m m m m m m
ughing a lot after each drink of fluid. What is the appropriate response
m m m m m m m m m m m m m
by the nurse aide?
m m m
A. Allowmthemresidentmmoremtimemtomswallow.
B. Usemamstrawmwhenmgivingmthemresidentmfluids.
C. Addmamthickeningmproductmtomthemresident'smfluids.
D. Stopmfeedingmandmaskmamnursemtomcheckmthemresident.
Correctm
Rationale:mWhenmamresidentmcoughsmfrequentlymaftermdrinkingmfluids,mitmmaymindicatemthatmthemresidentmismhavingms
omemdifficultymswallowing.mThismdifficultymswallowingmcanmresultminmfluidsmgoingmintomthemresident’smlung.mThismcondi
tionmismknownmasmaspiration.mItmcanmresultminmthemdevelopmentmofmseriousmmedicalmconditions,msuchmasmpneumonia,
mwhichmmaymrequiremmedicalmattention.m
Themnursemaidmshouldmnotifymthemnursemimmediately.mThemresidentmwillmrequiremanmevaluationmofmthemresident’smabil
itymtomswallow.mThickeningmagentsmaremsometimesmaddedmtomliquidsmformresidentsmthatmhavemdifficultymswallowingmfl
uids,mbutmthemusemofmthesemthickenersmismdecidedmbymthemphysicianmandmnotmthemnursemaide.
Reference(s):
Examplesmofmreferencesmwheremknowledgemformthismquestionmismcoveredminclude:
1.mSorrentino,mS.m(2011).mMosby'smTextbookmformLong-
TermmCaremNursingmAssistantsm(6thmEd.).mSt.mLouis,mMO:mElseviermMosby.mPagesm386-387.m
2.mAlvare,mS..mFuzy,mJ.,mandmRymer,mS.m(2009).mHartman’smNursingmAssistantmCare:mLong-
TermmCaremandmHomemHealth.mAlbuquerque,mNM:mHartmanmPublishing,mInc.mPagem268.
Itemm6mofm150
A resident wears a hand splint. Which observation should the nurse ai
m m m m m m m m m m m
de report to the nurse immediately?
m m m m m
A. Themresident'smfingersmaremcoldmandmblueminmcolor.
B. Themsplintmwasmremovedmasmscheduledminmthemcaremplan.
C. Themresidentmasksmtomhavemthemsplintmremovedmformamfewmminutes.
D. Themresidentmasksmthemnursemaidemtomrepositionmthemarmmwithmthemsplint.
Correctm
Rationale:mWhenmamresidentmwearsmamsplint,mitmismimportantmtommakemsuremthemsplintmismappliedmproperlymandmismno
tmcausingmpressuremthatmcouldmaffectmcirculation.mIfmnotmproperlymapplied,mthemsplintmcanmcausempressure.mWhenmamr
esidentmwearsmamsplint,mthemcaremplanmmaymalsomincludemscheduledmperiodsmformremovingmthemsplintmtomallowmthems
kinmtombemopenmtomairmandmtompromotemcirculation.mWhenmamresidentmwearsmamsplint,mitmismimportantmtomobservemfor
manymchangesminmskinmcolorminmthemextremity,mwhichmifmobservedmshouldmbemreportedmtomthemnursemimmediately.mSk
inmcolormchangesmandmchangesminmthemtemperaturemofmthemextremitymcouldmalsombemsignsmofmimpairedmcirculation.
Reference(s):
Examplesmofmreferencesmwheremknowledgemformthismquestionmismcoveredminclude:
1.mCarter,mP.mandmGoldschmidt,mW.m(2010).mmLippincott'smTextbookmformLong-
TermmCaremNursingmAssistants:mAmHumanisticmApproachmtomCaregiving.mPhiladelphia,mPA:mWoltersmKluwer/Lippinco
ttmWilliamsm&mWilkins.mPagem159.m
2.mSorrentino,mS.m(2011).mMosby'smTextbookmformLong-
TermmCaremNursingmAssistantsm(6thmEd.).mSt.mLouis,mMO:mElseviermMosby.mPagem429.
Markmitemmformreview
