Question 1

The nursing assistant is caring for a resident diagnosed with a stroke and left-sided paralysis who has a fever and is sweating profusely. What action should the nursing assistant take?

Accepted Answer

The nursing assistant observes that the resident has a fever and is sweating so the linens and bed clothes are most likely wet. The nursing assistant should observe what bed linens and pajamas need to be changed and provide clean dry linens. Placing a fresh draw sheet will not help if the resident is in wet pajamas. Washing and drying the skin and changing the pajamas would leave the resident in wet bed linens. Washing the skin may elicit chilling. The resident's fever is going down through active sweating, so there is no indication of chilling in the scenario. If the resident was also chilling, the wet bed linens and pajamas would increase the risk for skin breakdown.

Question 2

The nursing assistant is caring for an unconscious resident with incontinence. What action should the nursing assistant take?

Accepted Answer

The nursing assistant should place a bed protector under the unconscious resident and check every 2 hours for incontinence, cleanse the skin, and provide dry linens. Every 2 hours the nursing assistant should reposition the resident. Placing a rubberized draw sheet would trap moisture and break down the skin. If the resident uses incontinence briefs, a cotton draw sheet would not wick the moisture away as effectively as the bed protector. Using a disposable pad with the incontinence brief increases the heat from the plastic and does not wick the moisture effectively, increasing the risk for skin breakdown. Incontinence briefs are usually used for clients with incontinence who are ambulating and moving.

Question 3

The nursing assistant is caring for a client with a draining wound. The drainage has gotten onto the bed linens. What is the appropriate action for the nursing assistant to take?

Accepted Answer

Disposable bed protectors, also called "incontinence pads," are often used on the beds of people with draining wounds. The bed protector is placed under the person and on top of the bottom sheet, pulling the moisture away from the person's body by the top absorbent layers. The waterproof layer keeps the liquid from soiling the linens underneath. A folded towel or a bath blanket would not protect the linens underneath from having drainage seep into it. The nursing assistant could pad the wound dressing more, but the wound may be draining by gravity underneath and that is why the bed protector is needed.

Question 4

Which technique is used to prevent the spread of infection when handling soiled linens?

Accepted Answer

Confining the soiled area to the inside of the linens helps to ensure that other people, such as the workers in the laundry, do not come in contact with the potentially infectious material. Linens, whether clean or dirty, are never held against the uniform/body since that contaminates the clothing. Dirty linens should be placed in the linen hamper or linen bag immediately, never on the floor or on any other surface including the mattress or bed frame. If body fluids or substances leak through onto the mattress, it must be cleaned with cleaning solution before clean linens are placed on the bed.

Question 5

What should be done with the clean linen not used to change a resident's bed?

Accepted Answer

Extra linens brought into a person's room are considered soiled and, therefore, must not be returned to the clean linen cart or used for another person. The remaining options are not acceptable since they all increase the risk of infection to the residents.

Question 6

Which statement shows a lack of understanding about appropriate bedmaking techniques?

Accepted Answer

Dust is a transport mechanism for microbes. Shaking linens stirs up dust from the floor. The dust then settles on surfaces in the room and can be easily transferred onto eating utensils or into a wound, causing an infection. The remaining options are appropriate actions regarding bedmaking techniques.

Question 7

The purpose of a mitered corner is to:

Accepted Answer

Mitering is a way of folding and tucking the sheet so that it lies flat and neat against the mattress. Mitered corners are made at the foot of the bed to hold the top sheet, blanket, and bedspread in place. Mitering would not achieve what the other options suggest.

Question 8

When making the bed of a comatose client, it is true that:

Accepted Answer

All the standard principles of client and resident care apply whether the person is conscious or unconscious: it is important to talk reassuringly to a person and to provide for modesty, even if the person is not aware of the surroundings. A client's or resident's bed linens are changed on an as-needed basis and according to facility policy. This schedule is not based on whether the person is conscious. The beds of people who are unconscious or in a coma are made with the person in the bed; this is called making an occupied bed.

Question 9

The nursing assistant prepares a bed for a client who will be returning from surgery. What is the appropriate action for the nursing assistant to take?

Accepted Answer

The nursing assistant best prepares for the client returning from surgery by having an open bed in high position. The bed will be moved over and locked when the client arrives on a stretcher and will need to be transferred to the bed. The linens from the stretcher will be removed because they could be soiled or wet. Leaving the bed in a closed position does not properly prepare for receiving the client back to the unit.

Question 10

The nursing assistant prepares to change the bed of a resident with no history of incontinence. After washing hands, what is the best order for the nursing assistant to gather the linens?

Accepted Answer

The nursing assistant needs to anticipate the linens needed to remake the bed. The bedspread is not usually replaced in a linen change. The nursing assistant gathers the linens in the order best meeting the resident's needs. Since the resident is not incontinent, the order includes mattress pad, bottom sheet, top sheet, blanket, and pillowcase.

Question 11

A mitered corner is made at the bottom of the bed after which the piece of linen is centered and unfolded across the bed?

Accepted Answer

It is only after the top sheet, the blanket, and the bedspread have been centered and unfolded across the bed that the bottom sheet can be tucked to form the mitered corner at the bottom of the bed.

Question 12

To minimize the risk of infection, the pillow is placed on the bed:

Accepted Answer

The pillow is always placed on the bed so that the open end of the pillowcase faces away from the door. This gives the bed a neat and tidy appearance while minimizing the risk of pathogens being introduced onto the pillow itself.

Question 13

A nursing assistant can prevent back injury when making beds by:

Accepted Answer

Making beds requires the nursing assistant to bend over the bed. This process could be repeated over several beds or even several times on the same bed during a day. Raising the bed to a comfortable height promotes good body mechanics, which help to reduce strain on the nursing assistant's back. Working on a bed that is too low may strain the back. The remaining options do not relate to back injuries.

Question 14

It is true that when making an occupied bed, the nursing assistant will:

Accepted Answer

When making an occupied bed, the dirty mattress pad, bottom sheet, and draw sheet are fanfolded along the person's back and then a clean mattress pad, bottom sheet, and draw sheet are applied on that side. Not all people will be able to roll independently or assist in lifting their bodies. The bedmaking process removes dirty linen from only half of the bed at a time.

Question 15

The experienced nursing assistant is observing a beginning nursing assistant who is making an unoccupied bed for a resident with incontinence. At which step should the experienced nursing assistant intervene? The beginning nursing assistant:

Accepted Answer

The nursing assistant should intervene before the beginning nursing assistant returns unused linens to the linen cart. Once linens are taken to a resident's room, the items cannot be returned because doing so could lead to the spread of pathogens. The beginning nursing assistant should wash hands before applying gloves to strip the bed and make it. The beginning assistant should check for items in the bed before placing the linens in a hamper. Placing an extra bed protector on the bed with a resident with incontinence may help keep the resident dry.

Question 16

Which statement establishes that the nursing assistant understands when bed linen is changed?

Accepted Answer

Any time the linens become soiled or excessively wrinkled, the nursing assistant must remake the person's bed by changing as many of the linens as necessary to ensure a clean, dry, wrinkle-free bed for the client or resident. At the minimum, the linens are changed completely according to the schedule at the facility (e.g., every day or every other day). Changing the linen when suggested by the nurse occurs, but it is not the primary reason to do so.

Question 17

The purpose of the bath blanket is to:

Accepted Answer

A bath blanket is gathered along with the bed linens and is used to provide modesty and warmth during procedures that involve exposing the client or resident by removing or folding down the top linens. The bath blanket is not intended to be a towel or to provide additional padding. The bath blanket is not a moisture barrier and so it would not protect from moisture.

Question 18

In order to decrease the risk of pressure ulcers on the feet, a toe pleat is an important feature in the bed linen for a client who is:

Accepted Answer

Make a toe pleat by grasping the top sheet, the blanket, and the bedspread over the person's feet and pulling the linens straight up. The toe pleat allows the person who spends much of the time in bed to move feet freely and helps to relieve pressure on the feet from tightly tucked linens. The other options represent problems not exclusively related to mobility and its effect on the resident.

Question 19

To promote good body mechanics when making a bed, the nursing assistant will:

Accepted Answer

Make sure that the bed is positioned at a comfortable working height to promote good body mechanics since doing so will minimize back strain. Not all people can or should be removed from the bed.

Question 20

To promote infection control when making a bed, what is the appropriate action for the nursing assistant to take?

Accepted Answer

The nursing assistant's best action is to place the clean linens on a clean and dry table close to the client's bed, so the linens do not touch surfaces with increased pathogens, such as damp surfaces or the floor. The nursing assistant should collect needed linens in the order to be used and hold them 18 inches away from the uniform to prevent transferring pathogens. Washing the hands is needed before gathering linens from the linen cart, but clean gloves are not. Wearing gloves outside the client's room is against policy and regulations from various health care agencies. Linens should never be shaken because it spreads pathogens into the air.

Quiz 19: Bedmaking