Question 1

The nursing assistant helps a resident to the bathroom and observes that the toilet seat is loose and dirty, and the floor around the toilet is wet. What is the best action for the nursing assistant to take?

Accepted Answer

The nursing assistant's best action is to take the resident to another bathroom that is available and report that the resident's bathroom needs to be cleaned and repaired. The nursing assistant should not try to clean up the bathroom and try to repair it when the resident needs to use the bathroom. Having the resident use a bedpan on a chair in the resident's room does not provide privacy or comfort. Simply throwing a towel under a sink to mop up water on the floor is unacceptable, as it does not address the source of the problem. Having a resident grab the bar when using a loose toilet seat may end in a fall.

Question 2

Which regulation states that a resident's unit in a long-term care facility must be clean, safe, orderly, and free of obstacles in the pathway?

Accepted Answer

In long-term care facilities, these policies are set by OBRA regulations. OSHA focuses on safety and health regulations, while both Medicare and Medicaid regulate criteria for federal payment of health care services.

Question 3

The nursing assistant observes that the trash can is overflowing in the resident's room, and the resident reports nearly having fallen because of it. What best action should the nursing assistant take?

Accepted Answer

The nursing assistant's best action in this situation is to gather the trash and remove it from the room. Donning or putting on clean gloves is necessary when removing the trash. The trash is overflowing, so just picking up what is on the floor does not address the issue of the full trash can. Taking time to look for housekeeping leaves the resident at risk of a fall. It is the responsibility of the entire health care team to provide a clean and safe environment. It should not be the resident's responsibility to call for trash removal when the trash can starts getting full. The health care team should be observant of the resident's environment and intervene before a situation becomes unsafe.

Question 4

The nursing assistant prepares to gather clothing and dress the resident as part of morning care. What action does the nursing assistant take?

Accepted Answer

Asking which items the resident wants to wear and getting permission from the resident before opening the wardrobe or drawers shows respect and care for the resident. Moving a puzzle from a table without permission shows a lack of care and respect for the resident's personal items. The resident should be encouraged to have personal items around the room. Removing them and storing them also shows a lack of care or respect for the resident's place of living. The nursing assistant needs to ask the resident about personal clothing items because their family may launder the items. Clothing that is laundered by the facility may need to be tagged so that personal items are not lost, so the nursing assistant should not gather personal items in with the linens. The nursing assistant may send the facility's linens for laundering.

Question 5

The nursing assistant enters a resident's room and detects an offensive odor. What is the best action for the nursing assistant to take?

Accepted Answer

The nursing assistant (NA) should check around the resident's environment for the cause of the offensive odor and promptly remove and clean it. If the resident was incontinent, the NA should clean the resident and place clean linens as needed. If the trash is the source of the odor, then the NA should properly remove it. The NA would not ask the resident if the resident smells it too because that would be embarrassing and disrespectful to the resident. Spraying air freshener and airing out the room by opening the window only temporarily masks and dilutes the odor, which will soon return. Closing the door isolates the resident when the resident wants the door open and will not keep the odor in the room because the air circulates in the building.

Question 6

The nursing assistant is caring for a client and the Kardex states to place the client in reverse Trendelenburg. The nursing assistant enters the client's room and observes that the head of the mattress is lower than the foot of the bed. What is the correct action for the nursing assistant to take?

Accepted Answer

The nursing assistant (NA) observes that the client is in Trendelenburg because the head of the mattress is lower than the foot of the mattress. To correct this, the NA should move the head of the mattress to be higher than the foot of the bed to achieve reverse Trendelenburg position. The NA should report the position found and the action taken to the nurse. Raising the head of the bed and leaving the foot gatch flat is called Fowler's position. Increasing the head of the bed up at the same time the foot of bed is down also places the client in Fowler's with the knee gatch down.

Question 7

The nursing assistant is caring for a resident and moves the head of the bed to a comfortable position. What is the next action the nursing assistant should take?

Accepted Answer

Whenever using a mechanical bed, the nursing assistant would make any necessary bed adjustments and the next action would be to fold the bed crank under the bed so no one, including the nursing assistant getting ready to do the other listed actions, could hit or trip on the crank. The nursing assistant would go on to offer a blanket and make sure the call light and other items are in reach before leaving the room. The other listed items could be performed in any order after properly storing the bed crank.

Question 8

The nursing assistant is helping to safely transfer a resident from their bed to a specialty bed. Upon which observation should the nursing assistant tell the health care team to stop? The nursing assistant observes:

Accepted Answer

The nursing assistant (NA) observes the situation for safe transfer of the resident from the current bed to the specialty bed. The NA should stop the health care team if there is an observation of something that needs to be corrected. In this scenario the NA should stop the team because the specialty wheels are unlocked-this would be one or more wheels because it could lead to the bed moving during the transfer resulting in the resident falling. Using a transfer board under the resident, having the beds flat and at the same height, and the rails down helps with a safe and efficient transfer.

Question 9

The nursing assistant observes the following on the overbed table: water pitcher and disposable cup, box of tissues, open package of damp crackers and a full urinal with urine spilled on the table. What action(s) should the nursing assistant take? Select all that apply.

Accepted Answer

The nursing assistant (NA) should not store the open soggy crackers with the clean items found inside of the overbed table but should throw them away. The NA should empty and clean the urinal and place it on the rail away from food and water and remind the client to put the urinal after use on the bed rail. The NA will need to clean the overbed table and make sure that there is a clean pitcher and cup because the previous ones were in the area with the spilled urine. If dry, the box of tissues may be stored on the nearby nightstand. If damp, they should also be thrown away and replaced with a new box.

Question 10

The nursing assistant saw a resident from room 1101 who is confused enter their assigned resident's room 1102 and appear to take an object out of the room. Which best action should the nursing assistant take?

Accepted Answer

Because the nursing assistant (NA) is unsure if the other resident has an item, the best action is to find out whether an item has truly been taken. The NA can do this by observing the resident who left the room to see if that resident pulls out an item and then determining if it could belong to the other resident. It is unwarranted to interrupt the other resident's activity and ask the resident to look if there is anything missing. It is a violation to search any resident's personal storage without their permission. This includes both residents' rooms in the provided scenario.

Question 11

The nursing assistant moves the client from the bed to the chair by the left side of the bed. What is the best location for the nursing assistant to leave the call light?

Accepted Answer

The best location to leave the call light is within easy reach of the client, which in this case is the left side of the bed, because this is where the client has been moved. Leaving the call light on the right side of the bed is too far out of reach. Though the bedside table or windowsill may be within reach for the client, there is nowhere to secure the call light.

Question 12

The nursing assistant is caring for a client in a private room who is loud, confused, and at times kicks off their blanket, sheets, and clothing. What action should the nursing assistant take?

Accepted Answer

The client should be checked first for any comfort and safety issues before the room door is closed. Confused clients are not always able to express their needs. Closing the privacy curtain does not dampen the sound. Asking the client experiencing confusion to stay covered will not help because the client will soon continue the behaviors.

Question 13

The nursing assistant observes that the resident's note cards and letters are falling onto the floor. What is the first action the nursing assistant should take?

Accepted Answer

The first action the nursing assistant (NA) should take is to pick up the items and explain that the letters and note cards falling onto the floor present a tripping hazard for the resident. After explaining the problem, then the NA provides the resident with choice and control over the situation by asking where the resident wants to put personal items so they can still be easily accessed. Next, the NA could provide suggestions to help the resident attractively display their personal items. Finally, the NA can offer to help the resident to properly organize and secure the items from falling onto the floor.

Question 14

Residents are permitted to furnish and decorate their rooms with their own belongings as long as the belongings:

Accepted Answer

The safety standards established by the Omnibus Budget Reconciliation Act (OBRA) should never be compromised. Even if residents are permitted to furnish and decorate their rooms with their own belongings, they must abide by the safety standards established by OBRA and the facility. Although it is best when roommates agree with and respect each other's rights and preference, it is not necessary in this situation. The other options are not a consideration.

Question 15

The nursing assistant collects a urine specimen and prepares it according to the institution's policy and procedure. What is the best location for the nursing assistant to place the specimen?

Accepted Answer

The nursing assistant (NA) follows the Omnibus Budget Reconciliation Act (OBRA) guidelines to maintain a clean unit that minimizes the spread of germs that may cause illnesses. Therefore, the best location for the NA to place the specimens is in the designated place on the unit, the soiled utility room. The medication room, clean utility room, and nursing station should not contain items that may be contaminated with disease-causing microorganisms.

Question 16

The main reason why a nursing assistant must be familiar with the equipment used in the facility is to:

Accepted Answer

The nursing assistant should make sure how to use this equipment. This will help to keep both the assistant and the person cared for safe. Although the other options are not wrong, they are not the main reason it is important that a nursing assistant be familiar with the equipment being used for resident care.

Question 17

The main reason a nursing assistant shows respect for a resident's belongings is to:

Accepted Answer

When the nursing assistant shows respect for, and takes an interest in, a client's or resident's personal belongings, the assistant is letting the person know that they are truly cared for. Although the other options are not wrong, they are not the main reason the nursing staff respects a resident's belongings.

Question 18

The nursing assistant should employ which principles to provide proper use of side rails? Select all that apply.

Accepted Answer

The nursing assistant (NA) employs safe principles of using side rails by raising the rails while transporting a client. The care plan and Kardex have the information regarding the use of side rails that the NA should follow. A raised side rail may be in place so the client may reposition. If a client is confused, raising the side rails in an attempt to keep the client in bed may result in an increased risk for injury. The facility policy regarding the use of side rails should be followed, and the family does not supersede the policy.

Question 19

What is the main reason the nursing assistant maintains the residents' environment in the health care facility?

Accepted Answer

Environmental conditions, such as a room's cleanliness, temperature, noise level, and quality of light, affect how the resident feels. The remaining options need to be considered, but not the main reason environment control is important. The temperature and lighting and noise level is adjusted for the resident's comfort and not their family or staff. The nursing assistant puts the resident first, and OBRA monitoring expectations will also be met.

Question 20

A resident tells the nursing assistant that their roommate is always playing the TV much too loud. In order to prevent conflict among the residents, the nursing assistant should explore which possible solution(s) to this problem? Select all that apply.

Accepted Answer

Too much noise can affect the client's or resident's ability to rest and relax. Nursing assistants help to minimize noise by: answering phones promptly; keeping their voices down when talking to coworkers; reporting noisy equipment that needs to be oiled or adjusted; closing the person's door when the person is trying to rest; and encouraging clients or residents to use headphones when listening to TV or music in their rooms. Having the resident take hearing aids out is not an option. One should try to mediate the problem before asking the nurse to intervene. Doing nothing will not solve this problem.

Quiz 6: The Patients or Residents Environment