Certified Nursing Assistant Role and Rights

1.Mrs. Ellison's daughter holds out a pill from her purse and says, "Please give this to my mother. It is only a vitamin." The pill is not on the medication record you can see. What should you do?

2.A coworker asks you to insert a sterile urinary catheter because you watched one yesterday and the unit is busy. You have never been trained or signed off on that task. What should you do?

3.Mr. Pavlik uses oxygen at the flow the nurse set. His son asks you to turn the dial higher because his father looks sleepy. You have not been told to change oxygen. What should you do?

4.A physician phones the unit and tells you to start a new treatment for Ms. Grant. You are the only person who picked up the phone. The nurse is in a room nearby. What should you do?

5.Mr. Boyd has a new red patch on his calf. A coworker says, "Just chart that it is a clot." He also says the leg feels warm. What should you write and do?

6.Ms. Romero asks which of two antibiotics is better for her cough. Both names are on a paper in her drawer. You have heard of one of them. What should you say?

7.The mechanical lift is the method on Mr. Stone's plan. You have never used this model, and no trained partner is free. He needs to get off the bed for a routine change of scenery. What should you do?

8.Your shift is ending and the nurse is in a medication room. Two of your residents have call lights on, and your replacement has not arrived. What should you do?

9.The aide assigned to the east hall did not come in. Three call lights are on there, and you have finished a task on your own hall. The nurse does not know the lights are on. What should you do?

10.You are about to start a scheduled bath when you see Mr. Cole on the floor beside his bed. He is awake and says his hip hurts. No one else has seen him. What do you do first?

11.You are carrying clean linen when smoke rolls out of a wastebasket in Mr. Adler's room. He is awake in a chair beside the basket, and the flames are still inside it. What should you do first?

12.Mr. Webb clutches his chest during a walk and says the pain is new and heavy. A shower was next on your list. He is sweaty and frightened. What should you do?

13.You measured Ms. Quinn's pulse at 112 while she rested, and she feels anxious. A family group chat is open on your phone. What is the right report?

14.You told the nurse that Mr. Hanna is hard to wake and his breathing is 8 times a minute. The nurse says, "Later," and turns back to a stack of routine papers. He is still hard to wake. What should you do?

15.The nurse who is about to pass medications smells of alcohol, slurs words, and stumbles. Residents are waiting. What should you do?

16.A classmate on orientation wants a photo of Ms. Delgado's wound for a school assignment. Ms. Delgado is asleep and has not agreed. The phone is personal. What should you do?

17.In the break room, two aides name a resident and discuss an HIV test result they saw on a screen. You are not involved in a need to know. What should you do?

18.Twenty dollars is missing from Mr. Ellis's drawer. You saw a coworker alone in the room earlier. You did not see the money taken. What should you do?

19.Ms. Porter says, "The night aide slapped my face." A faint red area is on her left cheek. She is afraid to return to her room. What should you do?

20.While bathing Mr. Choi you see several bruises on the upper arms that look like finger marks. He says, "Please do not make a fuss." The bruises were not in yesterday's report. What should you do?

21.Residents on one coworker's assignment are often still soiled at the start of your shift. This is the third morning. The coworker says they were checked. What should you do?

22.You hear a coworker say to a resident, "Shut up, you old fool," after the resident asked for water. The resident starts to cry. What should you do?

23.Ms. Ibrahim flinches when bathing starts, has a torn nightgown, and tells you, "Someone hurt me last night." You see dried blood on the sheet. What should you do?

24.A nephew puts a pen in Mr. Rowe's hand and says, "Sign the check." Mr. Rowe looks frightened and whispers, "I do not want to." The nephew says it is none of your business. What should you do?

25.A coworker shuts Ms. Calder in her room for the afternoon because she yelled during a game. The door is held closed. She is not a danger to herself, and no one has asked for seclusion. What should you do?

26.You find Mr. Nash tied to the bed with a sheet knotted around his waist. There is no restraint order you know of, and he says he wanted to sit up. He is in the middle of the mattress and breathing easily. What should you do?

27.Ms. Owen can turn in bed using one half-rail, which the plan lists as an enabler she can lower herself. A coworker wants all four rails up so she will not get out for any reason. She does not have a restraint order. What should you do?

28.Mr. Bennett refuses his scheduled shower. He is clean, alert, and not in distress. A coworker suggests telling him there will be no dinner if he refuses. What should you do?

29.You are about to change Ms. Gold's brief in a shared room. The curtain is open and a maintenance worker is in the doorway. She asks you to wait. What should you do?

30.Mr. Silva tells you he does not want his brother to visit this afternoon. The brother is in the lobby and says he has a right to come in. Mr. Silva is alert. What should you do?

31.The hallway is cold. A coworker borrows Mrs. Lang's sweater from her chair for another resident and says it will be returned someday. Mrs. Lang did not agree. What should you do?

32.Mr. Hart wants to file a grievance about cold coffee and a rude response from staff. He asks if staff will punish him for writing it. What should you do?

33.A poster with the long-term care ombudsman's phone number is in the hall. Ms. Reeves asks you to help her read the number because she wants to call. A coworker says the call will cause trouble. What should you do?

34.At lunch in the public cafeteria, your friend asks why a named resident was moved to hospice care. Other diners can hear. You know the answer from work. What should you do?

35.You are charting that Mr. Diaz refused breakfast. He said, "I am not hungry," and ate nothing. A coworker suggests writing, "He was stubborn and lazy." What should you enter?

36.You plan to bathe Ms. Ingram at 10 a.m. It is 9:30, and a coworker tells you to chart the bath now so the afternoon will look lighter. She has not been bathed. What should you do?

37.Your coworker asks you to initial the evening care flow sheet for residents you did not see. The coworker says, "We all do it when we are behind." What should you do?

38.On a paper note, you wrote the wrong room number for a urine output. The ink is dry. Facility policy uses a single line for paper corrections. What should you do?

39.You forgot to chart a 2 p.m. bowel movement until 6 p.m. The resident is fine, and the note is still needed. What is the honest way to enter it?

40.Mrs. Kemp slides from her chair to the floor while you are present. She says she is unhurt, and you see no blood. The nurse checks her and asks for an incident form. What do you document?

41.Mr. Alvarez asks to read his clinical record. You have the screen open for your charting. He is alert. What should you do?

42.While you make the bed, Ms. Jordan says, "I do not want machines keeping me alive. Please tell someone." She is alert and serious. You are not the person who writes advance directives. What should you do?

43.Mr. Patel's plan and wristband show a current do-not-resuscitate order that the nurse reviewed with you at the start of the shift. You enter and he is not breathing. What should you do?

44.The nurse told you at report that Ms. Berger is a full code. You now find her unresponsive and not breathing normally. You are trained in the facility's emergency response. What should you do?

45.While cleaning a drawer at the nurse's request, you find a living will in an envelope with Ms. Ortega's name on it. She did not ask you to discard papers. What should you do?

46.Your cousin is admitted to another hall. You are curious about the diagnosis. You are not assigned to that hall and have no care task there. The record is one click away. What should you do?

47.A coworker forgot a login and asks to use yours "for one set of vitals" on a resident you both know. You are standing at the computer. What should you do?

48.You want to finish two notes at home. The easiest way would be to send the screens to your personal email. The notes include names and blood pressures. What should you do?

49.A printed roster with resident names and room numbers is lying in the lobby trash, which is open to visitors. What should you do?

50.An unknown caller asks whether Mrs. Benton is on the unit and what surgery she had. The caller says they are a neighbor. Your policy is that aides do not release resident information by phone. What should you do?

51.A person with a camera says they are a reporter and asks you to comment on a resident who was injured in a fall. You are in the lobby. What should you do?

52.After you help Mr. Klein to the chapel, he offers you cash "for the extra kindness." Policy forbids accepting money from residents. He is insistent but calm. What should you do?

53.Ms. Howard says she is changing her will to leave you her savings because you are the only one who cares. She asks you to sit with the notary tomorrow. What should you do?

54.A resident who is alert asks you to dinner off the unit and says the relationship could be romantic. You are the assigned aide today. What should you do?

55.Mr. Flores whispers, "I slipped off the toilet, but do not tell. They will not let me stay." He is back in bed and says his wrist hurts. You did not see the slip. What should you do?

56.A resident says, "An aide pinched me in the shower. Do not tell or I will get in trouble." There is a small bruise, and the resident is shaking. What should you do?

57.You suspect a coworker is rough during care, but you have not seen a blow. This morning a resident flinched and said, "Please do not send that person back." What should you do?

58.A new aide asks why a nurse aide registry exists if the facility already has a time clock. What is the accurate point to make?

59.You did not turn Mr. Samuels at noon, and at 2 p.m. his sacrum is red. No one asks you yet. Charting a turn you did not do would make the record look complete. What should you do?

60.Mr. Greene asks to see a different doctor. He is alert and does not need you to choose one. A coworker says residents take whoever the building assigns. What should you do?

61.You are about to check Mr. Flores's blood pressure. He is awake and asks what you are doing with the cuff. You have not explained it yet. What should you do?

62.A clerk asks you to have Ms. Martin sign a surgical consent while she is sleepy and asking what the operation is. The nurse is not in the room. What should you do?

63.Mr. Doyle is hard to wake at breakfast, slumps in the chair, and his family says last night's pills were "to keep him quiet." You do not give medications. What should you do?

64.Ms. Pratt is trying to get out of bed. She is not in danger yet. She often needs the toilet at this hour, and no restraint is ordered. A coworker reaches for a belt to tie her in. What should you try first?

65.Mr. Sanders has an ordered wrist restraint and a care plan you were trained to follow. It is time for the check the plan requires. Which action matches usual safe practice?

66.Ms. Nguyen is alert, not aggressive, and likes to chat in the hall. A coworker locks her in her room so the hall will stay quiet for a meeting. She asks to come out. What is the right response?

67.Mr. Cole has refused a shave. He is alert, and there is no emergency. A coworker pins his arms and shaves him anyway, saying the family likes him neat. What should you do?

68.You are frustrated that Mr. Allen keeps standing up. You almost say, "Sit down or I will tie you to the chair." He is unsteady but has no restraint order. What should you do instead?

69.A visitor spills soapy water near the shower door and walks on. Mr. Gray is heading that way in socks. You see the puddle. What should you do?

70.The nurse delegates a finger-stick blood sugar on a resident. You have never been trained or checked off on that skill in this facility. The nurse is rushed. What should you do?

71.The nurse tells you to give Mr. Perry his pills because the medication aide is late. The pills are in a cup with his name. You are a nurse aide and do not give medications in this facility. What should you do?

72.A classmate says no state is allowed to require more than 75 hours of nurse aide training because 75 is the federal number. You are reviewing the rule together. What is accurate?

73.A coworker says in-service education is optional if the aide already passed the test years ago. You work in a nursing facility covered by the federal rule. What is accurate?

74.Which action belongs in your assignment today? The nurse has trained you and checked you off on vital signs. Mr. Ali has no arm restrictions.

75.You can report only one item before you are pulled to a room. Which observation do you report immediately?

76.While turning Ms. Phelps you see a reddened sacrum about the size of a quarter. It stays red when you press it. She says it is sore. What should you report?

77.At the end of the shift, the nurse asks how your group was. One resident refused lunch, and another has a new cough. Everyone else ate and had no new complaints. What do you report?

78.A coworker asks you to help with a two-person transfer that the plan requires. Your own resident is safe, dry, and has the call light. You have been trained on the transfer. What should you do?

79.You and another aide disagree about who will take the next admission. The disagreement gets sharp in front of a new resident who is already anxious. What should you do?

80.Halfway through the shift you can see you will not finish three baths and the walking program. Two coworkers are also behind. No one is in immediate danger. What should you do?

81.You are about to give Mrs. Kaplan a bed bath. The gown, linen, wash basin, and gloves are still in three different places. She is uncovered and waiting. What should you do?

82.You wake with vomiting and diarrhea before a day shift. You feel too ill to give care and a coworker offers to trade nothing. What should you do?

83.A needle left in a resident's blanket sticks your finger. You did not see it before the puncture. What should you do?

84.You need to move an occupied bed and then help the resident turn. The bed is at its lowest height, which makes you bend and twist. A coworker can help with the turn. What should you do?

85.Mr. Shah is confused about the year and asks you to witness his signature on a paper that transfers his house to a visitor. The visitor is rushing him. He cannot explain the paper. What should you do?

86.Ms. Rios wants to attend her care-planning conference this afternoon. A coworker says conferences are staff only. She is alert and has asked twice. What should you do?

87.Mr. Blake asks you to drop a sealed letter in the outgoing mail. He does not want it read. There is no reason to think it contains a weapon or a danger you can see. What should you do?

88.Ms. Okada asks you to help her call her sister. She can speak privately once the call is connected. A speakerphone in the dayroom is the only phone you see at first. A private phone is available. What should you do?

89.Mr. Levy wants the same hat every day. It is clean, safe, and not a facility uniform issue. A coworker hides it because it does not match the day's activity theme. What should you do?

90.A worship service is offered in the chapel. Ms. Adeyemi wants to go. Mr. Clark does not, and a coworker says everyone on the hall should attend so the count will look good. What should you do?

91.The nurse brings Mr. Santos his medicine. He tells you, "I do not want that pill," and asks you not to let anyone hide it in his food. What should you do?

92.Ms. Dreher says she was told she will be moved out tomorrow and she does not agree. She asks you to put her in a taxi before anyone notices. She is alert and there is no unsafe emergency. What should you do?

93.Mr. Pike, who has dementia, is at the exit in a gown during a snowstorm, trying to leave for "the office." At the same time, Ms. Allen, who is alert, tells the nurse she wants to leave against medical advice and is waiting in the lobby. You are closest to Mr. Pike. What should you do?

94.A surveyor asks how often residents on your assignment are turned. Last night one turn was late, and a coworker told you to say "every two hours exactly" no matter what. What should you do?

95.During a survey, a coworker asks you to chart a bath they did not give so the book will look complete. The resident is still unwashed. What should you do?

96.The door alarm sounds. Mrs. Kim, who is confused, is at the exterior door in a thin gown. The air outside is freezing, and the door has started to open. What should you do?

97.The physical therapist tells you in the hall that Mr. Dean can now walk with a walker. His current plan still says mechanical lift with two people only. The therapist has not updated anything you can see. What should you do?

98.Mr. Hassan is on nectar-thick liquids. The tray arrives with thin water and a regular soup. He is thirsty and reaches for the water. What should you do?

99.Ms. Vogel has a documented allergy to strawberries, and the dessert is strawberry ice cream. She does not notice and picks up the spoon. What should you do?

100.Two residents have switched chairs in the dining room. You need to take a blood pressure on Mr. Cole before lunch. Both men are alert, and neither is wearing a visible name band in the chair. What should you do?

101.You start a bed bath and realize after uncovering an arm that this is Mr. King's roommate, not Mr. King. The roommate looks startled and says, "Wrong person." What should you do?

102.Mr. Boyd is in the dining room and needs a brief change. You could speak at a normal volume from the doorway. Several families are present. What should you do?

103.The computer at the hall desk shows a resident's record, and the screen faces families walking by. You are done with the entry. What should you do?

104.Mr. Adeyemi is on contact precautions. He has not been bathed in two days because staff say the gown takes too long. He is wet, and his call light works. What should you do?

105.You find Mrs. Paul's call light unplugged. She cannot reach a phone, and she says a staff member unplugged it because it rang too often. She needs the toilet. What should you do?

106.During a visit, Mrs. Chen's son slaps her hand hard and calls her a burden. She pulls away and looks frightened. Other visitors are in the room. What should you do?

107.Mr. Harris is alert and understands he can fall. He refuses the gait belt for a short walk and can explain that choice. The plan lists the belt. The nurse is at the desk. What should you do?

108.The wheelchair you were going to use has brakes that do not lock. Mr. Ortiz is ready for a routine ride to activities. Another working chair is in the equipment bay. What should you do?