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Alabama CNA practice questions

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Question 1Physical Care and Basic Nursing Skills

A nursing assistant moves from one resident to the next. When is hand hygiene required?

  1. Before and after contact with each resident Correct answer.
  2. Only when gloves are not available
  3. Only after contact with body fluids
  4. Only at the start and end of the shift

Explanation

Hand hygiene is performed before and after every resident contact, whether or not gloves are worn. Washing with soap and water or using an alcohol-based rub each time is what breaks the chain of infection transmission.

Question 2Physical Care and Basic Nursing Skills

A nursing assistant is about to take an oral temperature, but the resident has just finished a cup of hot coffee. What should the nursing assistant do?

  1. Take it after a cold water rinse
  2. Wait about 15 minutes, then take it Correct answer.
  3. Take the reading now and record it
  4. Add one degree to allow for the drink

Explanation

Hot or cold food and drinks change the temperature inside the mouth, so a waiting period of about 15 minutes is needed before an oral reading. The thermometer must measure body temperature, not the beverage.

Question 3Physical Care and Basic Nursing Skills

Where should the artery marker on a blood pressure cuff be placed?

  1. Over the brachial artery on the inner arm Correct answer.
  2. Anywhere on the arm if it fits snugly
  3. Over the radial artery at the wrist
  4. On the back of the upper arm

Explanation

The cuff is wrapped so the marker sits over the brachial artery on the inner aspect of the upper arm. This places the bladder directly over the artery being occluded so the reading is accurate.

Question 4Physical Care and Basic Nursing Skills

A resident is confined to bed and cannot move independently. How often should the nursing assistant change the resident's position?

  1. Every 4 hours
  2. Every 30 minutes
  3. Every 2 hours Correct answer.
  4. Once each shift

Explanation

Residents who cannot reposition themselves are turned at least every 2 hours to relieve pressure over bony areas. Frequent turning is a primary way to prevent pressure injuries.

Question 5Physical Care and Basic Nursing Skills

Where does the nursing assistant place the fingers to count a radial pulse?

  1. In the bend of the elbow
  2. At the side of the neck
  3. On the little-finger side of the wrist
  4. On the thumb side of the wrist Correct answer.

Explanation

The radial artery runs along the thumb side of the wrist, where it can be felt with two fingertips. Light pressure is used so the pulse is not obliterated.

Question 6Physical Care and Basic Nursing Skills

A nursing assistant is wearing gloves while providing perineal care. When should the gloves be removed?

  1. After leaving the resident's room
  2. Right after the task is finished Correct answer.
  3. Only when they are visibly soiled
  4. At the end of the shift

Explanation

Gloves are removed as soon as the care task is complete and before touching clean items such as the door handle or chart. Hands are washed immediately afterward.

Question 7Physical Care and Basic Nursing Skills

Passive range of motion is best described as exercise in which

  1. The NA moves the joint for the resident Correct answer.
  2. The resident moves each joint without help
  3. The resident works the joint against resistance
  4. The joint is moved only as far as it hurts

Explanation

In passive range of motion the nursing assistant supports the limb and moves the joint through its normal arc while the resident relaxes. Active range of motion, by contrast, is performed by the resident.

Question 8Physical Care and Basic Nursing Skills

Which of these items is recorded as intake on an intake and output record?

  1. Urine measured from the bedpan
  2. Vomitus collected in a basin
  3. Ice chips the resident ate Correct answer.
  4. Drainage from a wound

Explanation

Anything taken into the body by mouth or tube is intake, and ice chips count as fluid intake. Vomitus, urine, and wound drainage all leave the body and are recorded as output.

Question 9Physical Care and Basic Nursing Skills

A resident becomes dizzy and pale when getting up. What should the nursing assistant do?

  1. Help the resident stand up quickly
  2. Give the resident a drink of cold water
  3. Have the resident dangle legs before standing Correct answer.
  4. Lay the resident flat and take a pulse

Explanation

Dizziness on rising suggests a drop in blood pressure with position change. Sitting on the edge of the bed with the legs dangling lets the body adjust before standing.

Question 10Physical Care and Basic Nursing Skills

When feeding a resident who has trouble swallowing, the nursing assistant should

  1. Feed quickly so the food stays warm
  2. Place each bite at the back of the tongue
  3. Give thin liquids with every bite
  4. Have the resident sit up and tuck the chin Correct answer.

Explanation

An upright position with the chin tucked protects the airway and helps food move down safely. Bites are small, and the resident is given time to chew and swallow between bites.

Question 11Physical Care and Basic Nursing Skills

To keep urine flowing properly, the drainage bag of an indwelling catheter should be

  1. Kept below the level of the bladder Correct answer.
  2. Held level with the bladder
  3. Raised above the bladder
  4. Set on the bed beside the resident

Explanation

Gravity drains urine into the bag only when the bag hangs below bladder level. Keeping it low also prevents urine from flowing backward into the bladder and causing infection.

Question 12Physical Care and Basic Nursing Skills

When should the nursing assistant apply elastic anti-embolic stockings?

  1. After the resident has walked
  2. Only when the legs look swollen
  3. Before the resident gets out of bed Correct answer.
  4. At bedtime after the evening bath

Explanation

Stockings are applied before the resident gets up, while blood has not yet pooled in the legs. They are removed briefly for skin care and replaced as ordered.

Question 13Physical Care and Basic Nursing Skills

A reddened area over a resident's heel does not turn white when pressed. The nursing assistant should recognize this as

  1. A rash caused by moisture
  2. A stage 1 pressure injury Correct answer.
  3. A skin tear from friction
  4. A normal response to pressure

Explanation

Nonblanchable redness of intact skin is the defining sign of a stage 1 pressure injury. It is reported at once and pressure over the area is relieved.

Question 14Physical Care and Basic Nursing Skills

In which position is a resident usually placed for a cleansing enema?

  1. Flat on the back with legs extended
  2. Left side with the right knee bent Correct answer.
  3. On the right side with both knees bent
  4. Sitting upright in a chair

Explanation

The left lateral position follows the natural curve of the colon and helps the solution flow into the bowel. The right knee is drawn up for comfort and better exposure.

Question 15Physical Care and Basic Nursing Skills

During a seizure, the nursing assistant's priority is to

  1. Put a spoon between the teeth
  2. Hold the resident's arms and legs still
  3. Offer the resident a sip of water
  4. Protect the head and clear the area Correct answer.

Explanation

The goal is to prevent injury, so the head is protected and nearby objects are moved away. Nothing is placed in the mouth, and the movements are never restrained.

Question 16Physical Care and Basic Nursing Skills

When giving mouth care to an unresponsive resident, the nursing assistant should

  1. Hold the mouth open with a tongue blade
  2. Rinse the mouth with a full glass of water
  3. Turn the head to the side Correct answer.
  4. Keep the resident flat on the back

Explanation

Turning the head to the side lets fluid drain out instead of running into the throat. Only small amounts of fluid are used, and suction is kept nearby.

Question 17Physical Care and Basic Nursing Skills

To obtain an accurate weight, the nursing assistant should

  1. Use the same scale at the same time of day Correct answer.
  2. Weigh the resident right after a meal
  3. Estimate if standing is hard
  4. Use a different scale each week

Explanation

Weighing on the same scale, at the same time, with similar clothing makes comparisons from day to day meaningful. A change of scale can create an apparent gain or loss that is not real.

Question 18Physical Care and Basic Nursing Skills

When counting respirations, the nursing assistant should

  1. Count for one full minute without saying so Correct answer.
  2. Count for 15 seconds and multiply by two
  3. Have the resident count the breaths aloud
  4. Ask the resident to breathe deeply

Explanation

Respirations are counted for a full minute while the resident believes the pulse is being taken. If the resident knows the breathing is being watched, the rate may change.

Question 19Physical Care and Basic Nursing Skills

A resident must collect a midstream urine specimen. The nursing assistant should

  1. Collect the first few drops that come out
  2. Cleanse first, then collect the middle portion Correct answer.
  3. Ask the resident to hold urine for six hours
  4. Take urine from the catheter drainage bag

Explanation

Cleansing the area first and catching the urine after the stream has started keeps the sample free of skin organisms. The specimen is labeled and sent to the lab promptly.

Question 20Physical Care and Basic Nursing Skills

While a warm compress is in place, what should the nursing assistant do?

  1. Leave it on for a full hour
  2. Apply it directly to bare skin
  3. Check the skin every 5 minutes Correct answer.
  4. Place it on the abdomen of a resident with fever

Explanation

Heat applications are checked frequently, usually every 5 minutes, and are generally limited to about 20 minutes. The skin is inspected for redness, blistering, or complaints of burning.

Question 21Physical Care and Basic Nursing Skills

A resident drinks 8 oz of coffee, 4 oz of juice, and 240 mL of water. What is the total intake in milliliters?

  1. 600 mL Correct answer.
  2. 480 mL
  3. 540 mL
  4. 720 mL

Explanation

One ounce equals 30 mL, so 8 oz is 240 mL and 4 oz is 120 mL. Adding 240 + 120 + 240 gives a total intake of 600 mL.

Question 22Physical Care and Basic Nursing Skills

An apical pulse is 92 and the radial pulse is 76. What should the nursing assistant do with this finding?

  1. Record it as a normal finding
  2. Report a pulse deficit of 16 to the nurse Correct answer.
  3. Recheck the pulses next shift
  4. Begin CPR right away

Explanation

The difference between the apical and radial rates is the pulse deficit, here 16 beats. A deficit means some heartbeats do not produce a peripheral pulse and must be reported promptly.

Question 23Physical Care and Basic Nursing Skills

A pressure injury over the sacrum shows full-thickness skin loss with visible fat but no exposed muscle, tendon, or bone. This is

  1. Stage 2 pressure injury
  2. Stage 4 pressure injury
  3. Stage 3 pressure injury Correct answer.
  4. Deep tissue pressure injury

Explanation

Stage 3 injuries extend through the full thickness of the skin into subcutaneous fat, but muscle, tendon, and bone remain covered. Exposed deep structures are what define stage 4.

Question 24Physical Care and Basic Nursing Skills

A resident is choking and cannot speak, cough, or breathe. What should the nursing assistant do?

  1. Give abdominal thrusts Correct answer.
  2. Sweep the mouth with a finger
  3. Give the resident a glass of water
  4. Have the resident lie down and rest

Explanation

Silent choking with no air movement means the airway is completely blocked and abdominal thrusts are needed to force the object out. The emergency response system is activated at the same time.

Question 25Physical Care and Basic Nursing Skills

A resident is receiving a tube feeding. How should the nursing assistant position the resident?

  1. Trendelenburg, for one hour after the feeding
  2. Prone, with the head of the bed raised
  3. Flat on the back, head turned to the side
  4. Semi-Fowler's, head raised 30 degrees Correct answer.

Explanation

An upright torso of at least 30 degrees keeps formula moving down and reduces the chance of regurgitation into the lungs. The position is maintained during the feeding and for about 30 minutes afterward.

Question 26Physical Care and Basic Nursing Skills

When should the nursing assistant wash the hands with soap and water rather than use an alcohol-based hand rub?

  1. Between residents when the hands look and feel clean
  2. After removing gloves following a routine set of vital signs
  3. Before entering a resident's room to deliver a meal tray
  4. When the hands are visibly soiled with blood or body fluids Correct answer.

Explanation

Alcohol-based hand rub works well for routine decontamination when hands are not visibly dirty, but soap and water is required whenever hands are visibly soiled with blood or body fluids and after care of residents with C. difficile or norovirus. Washing physically removes soil and the spores that alcohol does not kill.

Question 27Physical Care and Basic Nursing Skills

A resident is on bed rest and cannot reposition independently. How often should the nursing assistant turn the resident?

  1. Every 15 minutes
  2. Once each shift
  3. Every 4 hours
  4. At least every 2 hours Correct answer.

Explanation

Pressure builds in tissues that stay against a surface, so a dependent resident is turned and repositioned on a schedule of at least every 2 hours, and more often if the care plan or skin condition requires it. The turn is combined with skin inspection and good body mechanics.

Question 28Physical Care and Basic Nursing Skills

Why should the nursing assistant avoid using the thumb when counting a radial pulse?

  1. The thumb is usually too weak to feel a pulse
  2. The thumb cannot reach the radial artery on the thumb side of the wrist
  3. The thumb must support the wrist during the count
  4. The thumb's own pulse may be confused with the resident's Correct answer.

Explanation

The thumb has a strong pulse of its own, so a thumb placed on the radial artery can be felt as the resident's beat and produce a false count. The index and middle fingertips are used instead because they sense the arterial pulsation without adding a beat.

Question 29Physical Care and Basic Nursing Skills

Which item is allowed on a clear liquid diet?

  1. Whole milk
  2. Strained apple juice Correct answer.
  3. Vanilla pudding
  4. Cream of chicken soup

Explanation

A clear liquid diet contains only items that are transparent and liquid at room temperature, such as strained juices, broth, gelatin, and clear soda. Milk products, pudding, and creamed soups are opaque and are not part of a clear liquid diet.

Question 30Physical Care and Basic Nursing Skills

A resident has just finished a cup of hot coffee. When should the nursing assistant take an oral temperature?

  1. Wait at least 15 to 30 minutes before taking it Correct answer.
  2. Take it right away, since heat does not affect the reading
  3. Take it rectally instead, without waiting
  4. Take it after rinsing the mouth with cold water

Explanation

Hot or cold food and drink, and smoking, change the temperature inside the mouth for a while, so an oral reading taken right away is inaccurate. The standard is to wait about 15 to 30 minutes, or to use another route if the temperature is needed sooner.

Question 31Physical Care and Basic Nursing Skills

Before applying an ice bag to a resident's arm, the nursing assistant should

  1. Place the bag directly against the skin for best effect
  2. Fill the bag, squeeze out the air, and wrap it in a towel Correct answer.
  3. Warm the bag in hot water so the cold is less intense
  4. Fill the bag to the top with crushed ice and fasten the cap securely

Explanation

An ice bag is filled partway with crushed ice, air is expelled so the ice lies against the inside of the bag, and the bag is covered before it touches skin. Air trapped inside reduces contact and the towel protects tissue from direct cold injury.

Question 32Physical Care and Basic Nursing Skills

Which action is correct when applying a gait belt to a resident?

  1. Buckle the belt loosely so it can slide up and down
  2. Place the belt around the chest just under the arms
  3. Place the belt around the waist, over the clothing Correct answer.
  4. Apply the belt directly against the resident's bare skin

Explanation

A gait belt is placed around the waist on top of the resident's clothing so the assistant can grip it without pulling on the arms or shoulders. It is snug enough to stay in place but should not be so tight that it restricts breathing or circulation.

Question 33Physical Care and Basic Nursing Skills

A resident has a physician-ordered wrist restraint. How often should the nursing assistant check the circulation in the restrained hand?

  1. Every 30 minutes
  2. Every 15 minutes Correct answer.
  3. Once per shift
  4. Every 2 hours

Explanation

Circulation, color, warmth, and sensation in a restrained limb are checked at least every 15 minutes so that a tight or slipped restraint is caught before tissue is damaged. The restraint is also released and the limb exercised on the schedule set by policy and the care plan.

Question 34Physical Care and Basic Nursing Skills

After giving care to a resident on contact precautions, in what order should the nursing assistant remove personal protective equipment?

  1. Mask, then gown, then goggles, then gloves
  2. Goggles, then mask, then gloves, then gown
  3. Gloves, then goggles, then gown, then mask Correct answer.
  4. Gown, then gloves, then mask, then goggles

Explanation

Equipment is removed from the most contaminated to the least contaminated, so gloves come off first, followed by eye protection and then the gown. The mask is removed last, by the ties or straps only, after leaving the room or at the doorway as policy directs.

Question 35Physical Care and Basic Nursing Skills

How full should a colostomy pouch be when the nursing assistant empties it?

  1. When it is about one-third to one-half full Correct answer.
  2. Only when the resident reports discomfort
  3. When it is completely full so fewer changes are needed
  4. When it has been in place for 24 hours, regardless of size

Explanation

A pouch is emptied when it is roughly one-third to one-half full, because a heavy pouch pulls on the skin barrier and can leak or detach. Emptying on that schedule also controls odor and protects the skin around the stoma.

Question 36Physical Care and Basic Nursing Skills

A resident needs to provide a sputum specimen. When is the best time to collect it?

  1. Early in the morning before the resident eats Correct answer.
  2. During the afternoon when the resident is most alert
  3. Immediately after the resident eats breakfast
  4. Just before the resident goes to sleep at night

Explanation

Secretions pool in the airways overnight, so a specimen collected on waking, before food or drink, gives the best sample. The resident rinses the mouth with water and coughs deeply from the chest rather than spitting saliva.

Question 37Physical Care and Basic Nursing Skills

A resident is receiving oxygen through a nasal cannula. Which action by the nursing assistant is safe?

  1. Increasing the oxygen flow rate if the resident feels short of breath
  2. Placing the oxygen tank flat on the bed beside the resident
  3. Applying petroleum jelly to the resident's nostrils each shift
  4. Keeping the oxygen tank upright and secured in a holder Correct answer.

Explanation

Oxygen supports combustion, so the tank is kept upright and fastened in a holder, away from open flame and heat, and no one smokes in the room. Petroleum-based products are avoided near oxygen, and only authorized staff change the flow rate.

Question 38Physical Care and Basic Nursing Skills

A 24-hour urine collection begins at 7 a.m. What should the nursing assistant do with the first voided specimen at 7 a.m.?

  1. Discard it, then save every specimen after that Correct answer.
  2. Save it, then discard the final specimen the next morning
  3. Save it only if the resident reports pain on urination
  4. Combine it with the next specimen before saving

Explanation

The collection period starts with an empty bladder, so the first specimen is discarded and the 7 a.m. start time is recorded. Every specimen after that, including the one voided at the end of the 24 hours, is collected and kept cold as directed.

Question 39Physical Care and Basic Nursing Skills

While changing a dressing, the nursing assistant sees that the edges of a surgical incision have separated. What should the nursing assistant do?

  1. Wait and report it at the end of the shift along with other changes
  2. Clean the wound with hydrogen peroxide and continue the dressing change
  3. Press the edges together and apply a fresh dressing
  4. Stop, cover the wound with a sterile dressing, and report it at once Correct answer.

Explanation

Separation of a surgical wound (dehiscence) can progress to the organs protruding (evisceration), which is an emergency. The assistant stops care, covers the wound with a sterile dressing, stays with the resident, and notifies the nurse immediately.

Question 40Physical Care and Basic Nursing Skills

A resident with shortness of breath is lying flat in bed. What should the nursing assistant do?

  1. Place the resident in a prone position with extra pillows
  2. Raise the head of the bed to a high Fowler's position Correct answer.
  3. Lower the head of the bed and turn the resident onto the side
  4. Keep the resident flat and apply a cool cloth to the forehead

Explanation

Sitting the resident up lets the diaphragm drop and the lungs expand, which eases breathing. High Fowler's position, or an upright seated position with arms supported, is used for residents with dyspnea, and the nurse is notified of the change.

Question 41Psychosocial Care and Mental Health Needs

Which nursing assistant action best protects a resident's sense of dignity during a bath?

  1. Explaining each step and asking permission Correct answer.
  2. Rushing so the resident has more free time
  3. Talking about other residents while giving care
  4. Leaving the door open so other staff can see in

Explanation

Dignity in care means protecting privacy, offering choices, and telling the resident what will happen before it happens. Explaining each step and asking permission keeps the resident in control of her own body and care.

Question 42Psychosocial Care and Mental Health Needs

A resident who had a stroke can still feed herself slowly. What should the nursing assistant do?

  1. Ask another resident to help her finish
  2. Discourage self-feeding to prevent spills
  3. Feed the resident so mealtime is shorter Correct answer.
  4. Let her feed herself and allow extra time

Explanation

Promoting independence supports self-esteem and keeps remaining abilities intact. A resident who can feed herself should be allowed to do so, even if it takes longer.

Question 43Psychosocial Care and Mental Health Needs

Which statement by the nursing assistant is an example of reality orientation?

  1. Tell me more about the farm where you grew up.
  2. You're right - it's 1952 and you're at home.
  3. We don't need to talk about where you are.
  4. You are in Mobile, and today is Tuesday. Correct answer.

Explanation

Reality orientation gives the resident true, simple information about person, place, and time. It is stated calmly and repeated as needed rather than argued about.

Question 44Psychosocial Care and Mental Health Needs

A resident enjoys talking about his years working on the railroad. The best response is to:

  1. Listen and ask about that time in his life Correct answer.
  2. Redirect him to a group activity right away
  3. Change the subject to current events
  4. Tell him the past is gone and to focus on today

Explanation

Reminiscence lets the resident review his life, which supports identity and self-worth, especially in later life. Listening and asking questions encourages that process.

Question 45Psychosocial Care and Mental Health Needs

Which response is the best example of active listening?

  1. Telling the resident about your own problems
  2. Nodding and saying, "You miss your sister." Correct answer.
  3. Writing notes without looking up at the resident
  4. Finishing the resident's sentences for her

Explanation

Active listening means giving full attention, using body language that shows interest, and reflecting back what the resident seems to feel. It invites the resident to keep talking.

Question 46Psychosocial Care and Mental Health Needs

A resident says, "I'm scared about my surgery tomorrow." Which reply shows empathy?

  1. Don't worry, you'll be fine.
  2. You should try to think about something else.
  3. My aunt had that surgery and she was fine.
  4. You seem frightened. What worries you most? Correct answer.

Explanation

Empathy means recognizing the resident's feeling and showing that you understand it, which invites further discussion. Naming the emotion without judging is the key element.

Question 47Psychosocial Care and Mental Health Needs

Two nursing assistants discuss a resident's depression diagnosis in the cafeteria. This is:

  1. Acceptable if no visitors are nearby
  2. Required so both can give safe care
  3. A breach of the resident's confidentiality Correct answer.
  4. Acceptable if they speak quietly

Explanation

A resident's diagnosis is protected health information that may be shared only with those who need it for care. Discussing it in a public area where others can overhear is a breach of confidentiality.

Question 48Psychosocial Care and Mental Health Needs

A resident who usually stays in his room comes to a group activity. The nursing assistant should:

  1. Remind him that other residents come every day
  2. Tell him attendance is required from now on
  3. Praise him for coming and welcome him warmly Correct answer.
  4. Point out that he usually stays in his room

Explanation

Positive reinforcement means praising a behavior you want to see again, which makes it more likely to continue. Warm attention when he attends makes the activity rewarding.

Question 49Psychosocial Care and Mental Health Needs

Which change in a resident most suggests depression rather than normal aging?

  1. Getting up once at night to urinate
  2. Loss of interest in favorite activities Correct answer.
  3. Needing more time to recall familiar names
  4. Walking more slowly than he used to

Explanation

Loss of interest or pleasure in things once enjoyed is a core sign of depression and is not explained by normal aging. Memory lapses, nocturia, and slower gait are more typical age-related changes.

Question 50Psychosocial Care and Mental Health Needs

A resident says, "Everyone would be better off if I were dead." The nursing assistant should:

  1. Keep it private because it was told in confidence
  2. Report it to the nurse and stay nearby Correct answer.
  3. Tell the resident not to talk that way
  4. Assume it is attention-seeking and continue care

Explanation

Any statement suggesting the resident wants to die is a possible suicide threat and must be taken seriously. The nursing assistant reports to the nurse at once and does not leave the resident alone.