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Hawaii CNA practice questions

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Question 1Basic Nursing Skills

Which action should the nurse aide take before and after contact with each resident?

  1. apply a new pair of gloves
  2. use an alcohol-based rub only when the hands look dirty
  3. wipe the hands with a dry towel
  4. perform hand hygiene Correct answer.

Explanation

Hand hygiene is the single most effective way to prevent the spread of infection and is required before and after every resident contact. Gloves are task-specific and never replace hand washing. Soap and water are required whenever hands are visibly soiled.

Question 2Basic Nursing Skills

When the nurse aide counts a resident's pulse at the thumb side of the wrist, which artery is being used?

  1. radial Correct answer.
  2. brachial
  3. popliteal
  4. carotid

Explanation

The radial artery runs along the thumb side of the inner wrist and is the site most commonly used for routine pulse counting. It is easy to reach, comfortable for the resident, and does not require pressure on the neck.

Question 3Basic Nursing Skills

When counting respirations, the nurse aide should:

  1. count one rise and one fall as a single breath Correct answer.
  2. count only the chest rises, not the falls
  3. ask the resident to breathe more deeply during the count
  4. inform the resident that the count is starting

Explanation

One complete respiration is one inhalation plus one exhalation. Counting without telling the resident helps prevent changes in breathing rate. A rate is typically counted for a full minute or for 30 seconds and doubled when breathing is regular.

Question 4Basic Nursing Skills

After caring for a resident who is on contact precautions, which piece of personal protective equipment should be removed last?

  1. goggles
  2. gown
  3. mask Correct answer.
  4. gloves

Explanation

PPE is removed in an order that keeps the most contaminated items away from the face. Gloves come off first, then eye protection, then the gown, and the mask or respirator is removed last, usually by the ties or straps. Hands are then cleaned immediately.

Question 5Basic Nursing Skills

An unconscious resident needs mouth care. The nurse aide should:

  1. place the resident flat on the back
  2. insert fingers to hold the mouth open
  3. use a large amount of toothpaste and water
  4. turn the resident's head to the side Correct answer.

Explanation

Turning the head to the side lets fluids drain out and reduces the risk of aspirating them into the lungs. Only small amounts of fluid are used, and the mouth is gently opened with a padded swab or mouth prop, never with the fingers.

Question 6Basic Nursing Skills

A blood pressure cuff that is much too small for the resident's arm will most likely make the reading:

  1. falsely low
  2. the same as a correctly sized cuff
  3. falsely high Correct answer.
  4. impossible to obtain

Explanation

A cuff that is too small requires extra pressure to compress the artery, so the recorded value reads higher than the true blood pressure. A cuff that is too large tends to give a falsely low reading. The cuff bladder should wrap around about 80 percent of the arm.

Question 7Basic Nursing Skills

A resident who has been on bed rest sits up and reports dizziness. The nurse aide's best first action is to:

  1. walk the resident to the bathroom quickly
  2. give the resident a drink of water
  3. take the resident's temperature
  4. help the resident lie back down Correct answer.

Explanation

Dizziness on sitting up suggests orthostatic hypotension, a drop in blood pressure when changing position. The safe response is to lower the resident back down to prevent a fall, then report the episode. Rising slowly in stages helps prevent it in the future.

Question 8Basic Nursing Skills

A resident in a vest restraint must have the restraint released and the resident repositioned at least every:

  1. 1 hour
  2. 2 hours Correct answer.
  3. 15 minutes
  4. 30 minutes

Explanation

Restraints must be released, the resident repositioned, and range of motion offered at least every two hours. Circulation, breathing, and skin are checked more often according to facility policy and the care plan. Restraints are used only when less restrictive measures have failed.

Question 9Basic Nursing Skills

A resident's apical pulse is 92 beats per minute and the radial pulse is 76 beats per minute. What pulse deficit should the nurse aide report?

  1. 168
  2. 76
  3. 16 Correct answer.
  4. 92

Explanation

Pulse deficit is the difference between the apical rate and the radial rate, found by subtracting the radial from the apical count. A deficit means some heartbeats are not strong enough to produce a radial pulse. The aide reports the deficit to the nurse rather than recording only one rate.

Question 10Basic Nursing Skills

A resident's intake record shows 6 ounces of juice at breakfast. How many milliliters should the nurse aide record?

  1. 360 mL
  2. 60 mL
  3. 240 mL
  4. 180 mL Correct answer.

Explanation

One ounce equals 30 milliliters, so 6 ounces is 6 times 30, or 180 mL. Intake and output are recorded in milliliters so the nurse can compare totals accurately. All fluids taken by mouth, tube, or IV are included.

Question 11Basic Nursing Skills

A nurse aide is helping collect a clean-catch midstream urine specimen. The aide should:

  1. cleanse the area and collect urine midstream Correct answer.
  2. collect urine from the drainage bag
  3. collect the entire voided amount in the container
  4. ask the resident to limit fluids for 12 hours before

Explanation

A clean-catch midstream specimen requires cleansing the meatus, starting the stream into the toilet, and then collecting the middle portion in the sterile container. This reduces contamination from skin organisms. The specimen is labeled and sent to the lab promptly.

Question 12Basic Nursing Skills

After positioning a bedpan under a resident who is lying on the back, the nurse aide's next step is to:

  1. leave the resident flat on the back
  2. raise the head of the bed to a sitting position Correct answer.
  3. remove the pan after one minute
  4. ask the resident to hold the breath while the pan is in place

Explanation

Raising the head of the bed to a sitting position uses gravity to help the resident void and is more comfortable and private. The aide stays nearby, provides toilet tissue, and answers the call light promptly. The pan is removed as soon as the resident is finished.

Question 13Basic Nursing Skills

Which action best helps prevent pressure injuries in a resident who is bedbound?

  1. place a rubber ring under the sacrum
  2. massage the reddened bony areas firmly on each shift
  3. keep the head of the bed raised as high as possible
  4. reposition the resident at least every two hours Correct answer.

Explanation

Repositioning at least every two hours relieves pressure on bony prominences before tissue damage occurs. Skin is kept clean and dry and is inspected with each turn. Reddened areas are never massaged, and ring cushions are no longer recommended.

Question 14Basic Nursing Skills

A resident's abdominal dressing has become soiled with stool. The nurse aide should:

  1. remove the dressing and apply a new one from the supply cart
  2. clean the dressing with alcohol and leave it in place
  3. tape a dry gauze pad over the soiled dressing
  4. tell the nurse that the dressing needs to be changed Correct answer.

Explanation

Changing a wound dressing is outside the nurse aide's scope when sterile technique or a prescribed dressing is involved. The aide protects the dressing, keeps the area as clean as possible, and reports to the nurse right away. The nurse decides what change is needed.

Question 15Basic Nursing Skills

A resident's oral temperature is 35.2 degrees Celsius (95.6 degrees Fahrenheit). The nurse aide should:

  1. record it as normal and continue care
  2. recheck it in four hours and report only if it is still low
  3. report the reading to the nurse right away Correct answer.
  4. give the resident a hot shower to warm up

Explanation

A temperature below about 36 degrees Celsius (96.8 degrees Fahrenheit) is below normal and may signal hypothermia or another serious problem. The aide reports abnormal values promptly rather than waiting. Warming measures are ordered by the nurse.

Question 16Basic Nursing Skills

A resident is receiving oxygen through a nasal cannula. Which action by the nurse aide is correct?

  1. use a wool blanket to keep the resident warm
  2. lay the oxygen tank flat on the bed while it is in use
  3. apply petroleum jelly to the nostrils
  4. check the skin behind the ears and around the nose Correct answer.

Explanation

Tubing and prongs press on the skin behind the ears and around the nose, so these areas are checked for redness, irritation, and breakdown. Oxygen supports combustion, so petroleum products and static-producing fabrics are avoided. Tanks are secured upright, never left loose on the bed.

Question 17Basic Nursing Skills

When providing routine catheter care, the nurse aide should cleanse:

  1. with the drainage bag hung on the bed rail
  2. by pulling gently on the tubing to check it is secure
  3. from the urinary meatus outward Correct answer.
  4. in circles that move toward the meatus

Explanation

Cleansing moves from the meatus outward, away from the urinary opening, to carry microorganisms away from the body. Front-to-back strokes prevent stool from reaching the urethra. The bag stays below bladder level and off the floor, and the tubing is never pulled.

Question 18Basic Nursing Skills

Which action helps prevent falls for a resident who is at risk for falling?

  1. keep the call light within reach Correct answer.
  2. keep the bed in the highest position
  3. use a wheelchair for all of the resident's movement
  4. leave the side rails down at all times

Explanation

A call light within reach lets the resident ask for help instead of trying to get up alone. The bed is kept low and locked, the floor is clear, and the resident is toileted on a schedule. Restricting all movement weakens the resident further.

Question 19Basic Nursing Skills

While performing range-of-motion exercises, a resident says the movement hurts. The nurse aide should:

  1. push through the discomfort to keep the joint loose
  2. give the resident an over-the-counter pain pill
  3. stop exercising that joint for the rest of the day
  4. stop the movement and report it to the nurse Correct answer.

Explanation

Range-of-motion exercises should move the joint only to the point of resistance, never to the point of pain. Pain during movement may signal injury or another problem and is reported to the nurse. The nurse then decides how to continue the exercise program.

Question 20Basic Nursing Skills

A resident receiving a cleansing enema reports sudden severe abdominal cramping. The nurse aide should:

  1. stop the enema and tell the nurse Correct answer.
  2. tell the resident that cramping is expected
  3. slow the flow of the solution and continue
  4. raise the container higher to finish faster

Explanation

Severe cramping may signal a serious problem such as perforation or impaction and is a reason to stop the procedure immediately. The aide stays with the resident, observes for changes, and reports to the nurse. Mild fullness is expected but sharp pain is not.

Question 21Basic Nursing Skills

The main purpose of a gait belt when transferring a resident is to:

  1. give the aide a firm grasp on the resident Correct answer.
  2. serve as a restraint while the resident is seated
  3. hold the resident's full weight during the transfer
  4. keep the resident's knees from bending

Explanation

A gait belt gives the aide a secure handhold on the resident's body so the resident can be guided and, if needed, lowered safely. It does not support the resident's full weight and is not a lifting device. The belt is snug over clothing with room for two fingers underneath.

Question 22Basic Nursing Skills

Which observation about a resident's elastic (TED) stockings should be reported to the nurse?

  1. the stockings feel snug around the calf
  2. the stockings are applied before the resident gets out of bed
  3. the toes are cool and pale while the stockings are on Correct answer.
  4. the stockings are removed for bathing each day

Explanation

Cool, pale toes suggest the stockings are reducing arterial circulation and need to be rechecked by the nurse. Elastic stockings are applied before the resident gets out of bed and removed for skin care at least twice a day. Any change in color, temperature, or sensation is reported.

Question 23Basic Nursing Skills

A resident with Clostridioides difficile diarrhea is on contact precautions. Which action by the nurse aide is correct?

  1. share a stethoscope between residents after wiping it off
  2. wash hands with soap and water after glove removal Correct answer.
  3. wear gloves only when emptying the bedpan
  4. clean hands with an alcohol-based rub after glove removal

Explanation

Alcohol-based rubs do not reliably kill C. difficile spores, so soap and water handwashing is required after contact with these residents. Gloves and a gown are worn for every contact and equipment stays in the room. The aide also cleans shared items with a facility-approved spore-killing product.

Question 24Basic Nursing Skills

Which is a correct guideline when applying a warm compress to a resident's leg?

  1. check the skin under the compress every few minutes Correct answer.
  2. use water hot enough to feel very warm on the aide's wrist
  3. leave the compress in place for at least one hour
  4. place the compress directly on bare skin for best effect

Explanation

Heat increases the risk of burns, especially in residents with reduced sensation or circulation, so the skin is checked frequently. The compress is covered and applied for a limited time ordered by the nurse. Water temperature is tested on the aide's inner wrist, not judged by the resident's report alone.

Question 25Basic Nursing Skills

A resident has been moaning and guarding the abdomen but says, "I'm fine." The nurse aide should:

  1. record that the resident has no pain
  2. report the moaning and guarding to the nurse Correct answer.
  3. wait until the resident asks for pain medication
  4. tell the resident that pain is a normal part of aging

Explanation

Facial expression, moaning, guarding, and changes in behavior are valid signs of pain, even when the resident denies it. The aide reports what was observed so the nurse can assess and treat. The aide never decides that pain is absent or unavoidable.

Question 26Basic Nursing Skills

When washing the hands with soap and water, the nurse aide should scrub for:

  1. As long as the hands look clean
  2. At least 20 seconds Correct answer.
  3. About 10 seconds
  4. At least 5 seconds

Explanation

Soap and water need contact time to lift and rinse away germs, so the hands are scrubbed, including between the fingers and under the nails, for at least 20 seconds before rinsing. Visible cleanliness alone does not mean the hands are free of organisms.

Question 27Basic Nursing Skills

Which action is correct when counting a resident's respirations?

  1. Tell the resident to breathe deeply during the count
  2. Ask the resident to hold still and breathe through the mouth
  3. Count each rise and fall of the chest as one respiration Correct answer.
  4. Count only the inhalations for 15 seconds and multiply by 4

Explanation

One respiration is one complete cycle of the chest rising and falling. The count is done without announcing it, because a resident who knows breathing is being watched may change the rate and make the reading inaccurate.

Question 28Basic Nursing Skills

When giving mouth care to a resident who is unconscious, the nurse aide should:

  1. Place the resident flat on the back with the head centered
  2. Swab the mouth with a large sponge soaked in water
  3. Turn the head to the side and use only small amounts of fluid Correct answer.
  4. Hold the mouth open with a tongue blade for the entire procedure

Explanation

An unconscious resident cannot swallow or cough, so fluid must be kept to small amounts and the head turned to the side so it drains out rather than being aspirated. Suction should be available, and the resident should never be left with fluid pooling in the mouth.

Question 29Basic Nursing Skills

Where should an indwelling urinary catheter drainage bag be kept?

  1. Below the level of the bladder and off the floor Correct answer.
  2. Hanging from the side rail of the bed
  3. Resting on the floor beside the bed
  4. Level with the bladder so urine flows evenly

Explanation

Gravity drains urine down the tubing, so the bag must hang below the bladder to prevent urine from flowing backward into the bladder and causing infection. Keeping the bag off the floor prevents contamination of the drainage port and tubing.

Question 30Basic Nursing Skills

Which action is correct when feeding a resident who is at risk for aspiration?

  1. Offer fluids through a straw so the meal goes faster
  2. Seat the resident upright and give small bites of food Correct answer.
  3. Encourage the resident to talk during the meal to stay alert
  4. Have the resident lean back so food slides down easily

Explanation

An upright position lets gravity help move food down and small bites give the resident time to chew and swallow completely. The aide should also check the mouth for pocketed food and stop if the resident coughs or gurgles.

Question 31Basic Nursing Skills

A nurse aide is collecting a sputum specimen from a resident. Which action is correct?

  1. Ask the resident to breathe into the container through the nose
  2. Collect the specimen right after the resident finishes breakfast
  3. Have the resident spit saliva into the specimen container
  4. Collect the specimen early in the morning before the resident eats Correct answer.

Explanation

Sputum is best collected in the morning before eating or drinking, when secretions have pooled in the airway and are easiest to cough up. The resident should cough deeply from the chest so the specimen comes from the lungs rather than the mouth.

Question 32Basic Nursing Skills

A resident's pulse oximeter reads 89% on room air and the resident is drowsy and hard to wake. What should the nurse aide do first?

  1. Have the resident walk around the room and then recheck the reading
  2. Stay with the resident and notify the nurse immediately Correct answer.
  3. Write the reading on the flow sheet and recheck it next shift
  4. Lay the resident flat and place a cool cloth on the forehead

Explanation

A low oxygen saturation combined with a change in alertness is an urgent finding that needs the nurse at once. The aide stays with the resident to keep monitoring and to summon help, because the resident is not safe to leave alone.

Question 33Basic Nursing Skills

A resident has a reddened area over one hip that does not turn pale when pressed. What should the nurse aide do?

  1. Massage the reddened area firmly to improve circulation
  2. Leave the area open to air and check it again next week
  3. Keep pressure off the area and report it to the nurse Correct answer.
  4. Apply a heating pad to the area for 20 minutes

Explanation

Skin that stays red after pressure is relieved is an early pressure injury and must be reported so a care plan can protect the area. Pressure is kept off, the resident is repositioned on a schedule, and the skin is kept clean and dry.

Question 34Basic Nursing Skills

While helping a resident with a bath, the nurse aide sees that the skin around the resident's IV catheter is swollen and cool to the touch. What should the nurse aide do?

  1. Flush the catheter with saline to see if it still works
  2. Raise the arm and go on with the bath as planned
  3. Rub the swollen area to move the fluid away
  4. Stop the bath and report the finding to the nurse Correct answer.

Explanation

Swelling and coolness around an IV site suggest that fluid is leaking into the tissue instead of the vein, which the nurse must evaluate. The aide does not adjust, flush, or remove the IV and reports the finding right away.

Question 35Personal Care Skills

When providing perineal care for a female resident, in which direction should the nursing assistant wash?

  1. From the outer thighs inward to the perineum
  2. From the urethra toward the rectum Correct answer.
  3. From the rectum toward the urethra
  4. In a circular motion starting at the outer labia

Explanation

Washing from front to back keeps stool away from the urethra, which helps prevent urinary tract infection. A clean area of the washcloth is used for each stroke.

Question 36Personal Care Skills

Before giving a bed bath, how should the nursing assistant test the bath water?

  1. Run the water as hot as the resident's skin can stand
  2. Sprinkle a few drops on the inner wrist Correct answer.
  3. Ask the resident to judge by touching the basin
  4. Dip a bare fingertip into the water

Explanation

Water for a bed bath should be comfortably warm, and the inner wrist is sensitive enough to detect heat that could burn a resident. Hot water is dangerous for residents with reduced sensation.

Question 37Personal Care Skills

A resident removes their dentures for the night. How should the nursing assistant store them?

  1. Place them in a labeled container filled with cool water Correct answer.
  2. Place them in a cup of hot water to soak overnight
  3. Wrap them in a tissue and set them on the bedside table
  4. Leave them in a dry, covered cup until morning

Explanation

Dentures must stay moist so they do not warp or crack, and a label keeps them from being lost or confused with another resident's. Cool water is used because heat can damage the material.

Question 38Personal Care Skills

Which action best protects a resident's privacy during a bed bath?

  1. Closing the door and pulling the privacy curtain Correct answer.
  2. Draping a towel over the chest only
  3. Completing the bath quickly without talking to the resident
  4. Asking the roommate to step out but leaving the door open

Explanation

Closing the door and pulling the curtain keep the resident from being seen by people in the hall or in the room. Uncovering only the area being washed also protects dignity.

Question 39Personal Care Skills

A resident is unresponsive and needs mouth care. How should the nursing assistant position the resident?

  1. Flat on the back with the head raised on two pillows
  2. On the side with the head turned toward the mattress Correct answer.
  3. On the back with the chin tilted up
  4. Sitting fully upright in a chair

Explanation

An unresponsive resident cannot swallow or cough, so fluid can drain into the airway. Turning the resident to the side and the head toward the mattress lets fluid run out of the mouth.

Question 40Personal Care Skills

A resident with diabetes asks the nursing assistant to trim his toenails. What should the nursing assistant do?

  1. Soak the feet first, then cut the nails with clippers
  2. Round the corners of the nails with clippers to prevent ingrowth
  3. Explain that the nurse must be told and not cut the nails Correct answer.
  4. Trim the toenails straight across and file the corners

Explanation

Residents with diabetes often have poor circulation and reduced feeling in the feet, so a small cut can become a serious infection. Toenail trimming for these residents is done by a nurse or podiatrist.

Question 41Personal Care Skills

When shaving a resident with a safety razor, in which direction should the nursing assistant move the razor?

  1. In circles over each area of the face
  2. Against the direction of hair growth
  3. In the direction the hair grows Correct answer.
  4. Back and forth in short, quick strokes

Explanation

Shaving in the direction the hair grows reduces irritation and razor burn. The skin is held taut and the razor is rinsed between strokes.

Question 42Personal Care Skills

How should the nursing assistant keep a resident warm and covered during a bed bath?

  1. Keep the room door open for ventilation
  2. Use a bath blanket and uncover only the part being washed Correct answer.
  3. Place a folded towel over the resident's eyes
  4. Wash the whole body quickly with cool water

Explanation

A bath blanket keeps the resident warm while only the area being washed is exposed. This also protects the resident's privacy and dignity.

Question 43Personal Care Skills

When washing a resident's eyes during a bed bath, the nursing assistant should cleanse...

  1. From the inner corner toward the outer corner Correct answer.
  2. Reusing the same part of the washcloth for the second eye
  3. With soap and water while rubbing briskly
  4. From the outer corner toward the inner corner

Explanation

Washing from the inner corner outward carries drainage away from the tear duct, and a different area of the cloth is used for each eye to avoid spreading infection. Plain water is used around the eyes.

Question 44Personal Care Skills

How often should an immobile resident generally be repositioned to help prevent pressure injuries?

  1. Once each shift
  2. Only when the resident asks
  3. Every 6 hours
  4. At least every 2 hours Correct answer.

Explanation

Turning and repositioning at least every 2 hours relieves pressure on skin over bony areas. Residents at higher risk may need more frequent turning as stated in the care plan.

Question 45Personal Care Skills

Which action helps prevent shearing when moving a resident up in bed?

  1. Pulling the resident under the arms
  2. Using a draw sheet and lifting rather than dragging Correct answer.
  3. Asking the resident to push with the heels while being pulled
  4. Raising the head of the bed as high as possible first

Explanation

Shearing occurs when skin stays in place while the body slides beneath it, so lifting with a draw sheet protects the skin. Dragging also causes friction damage.

Question 46Personal Care Skills

A resident has an episode of incontinence. Which action best protects the skin?

  1. Cleanse gently and apply a barrier cream as ordered Correct answer.
  2. Use baby powder to absorb moisture
  3. Wash the area with hot water and rubbing alcohol
  4. Wipe with a dry washcloth and leave the area open to air

Explanation

Urine and stool irritate skin and can quickly cause breakdown. Gentle cleansing followed by a barrier product, as ordered, protects the skin.

Question 47Personal Care Skills

When placing a bedpan under a resident, the nursing assistant should...

  1. Warm the rim of the pan before placing it under the hips Correct answer.
  2. Place the pan on the mattress edge and ask the resident to sit on it
  3. Ask the resident to roll onto the pan and then leave the room
  4. Slide the pan under the resident from the side while the resident lies flat

Explanation

A warmed rim is more comfortable and helps the resident relax. The pan is placed with the resident's help and the resident is never left sitting on it longer than needed.

Question 48Personal Care Skills

A resident has an indwelling urinary catheter. Where should the drainage bag be kept?

  1. Hanging on the side rail above the mattress
  2. Resting on the floor beside the bed
  3. At the same height as the bladder
  4. Below the level of the bladder Correct answer.

Explanation

Keeping the bag below the bladder allows urine to drain by gravity and prevents urine from flowing back into the bladder. The bag is also kept off the floor to reduce contamination.

Question 49Personal Care Skills

When should the nursing assistant apply elastic compression stockings?

  1. In the morning before the resident gets out of bed Correct answer.
  2. Right after the resident has walked to the bathroom
  3. At bedtime after the legs have been elevated
  4. Whenever the resident complains of leg discomfort

Explanation

Stockings work best when applied before the legs have swelled from hanging down, so morning application before rising is standard. Wrinkles are smoothed out after application.

Question 50Personal Care Skills

When combing a resident's tangled hair, the nursing assistant should begin...

  1. By wetting the hair with hot water and pulling the comb through
  2. At the scalp and work down toward the ends
  3. At the ends and work up toward the scalp Correct answer.
  4. In the middle and work in both directions

Explanation

Starting at the ends and working upward untangles hair with the least pulling and pain. Working in small sections and holding the hair above the comb also reduces discomfort.