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Kentucky CNA (SRNA) study materials
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Kentucky CNA (SRNA) practice questions

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Question 1Physical Care Skills - Activities of Daily Living

A resident is unable to feed herself but can swallow normally. Which action should the nurse aide take?

  1. Feed the resident quickly to finish before the tray cools
  2. Sit at eye level and offer one bite at a time Correct answer.
  3. Mix all foods together in one bowl before feeding
  4. Place the tray on the bedside table out of reach

Explanation

When assisting with eating, the aide should sit at or below eye level, allow the resident to set the pace, and offer one item at a time so the resident can chew and swallow safely. Rushing or combining foods removes the resident's control and raises choking risk.

Question 2Physical Care Skills - Activities of Daily Living

Which is the correct way to brush a dependent resident's teeth?

  1. Use a firm-bristle brush to remove plaque faster
  2. Brush in a circular motion at the gum line using a soft toothbrush Correct answer.
  3. Brush only the front surfaces that are visible
  4. Scrub hard back and forth across the crowns of the teeth

Explanation

Oral care uses a soft toothbrush with gentle circular motions along the gum line, cleaning all tooth surfaces plus the tongue. Hard scrubbing or a firm brush can damage gums and enamel.

Question 3Physical Care Skills - Activities of Daily Living

A resident is on bed rest. How often should the nurse aide reposition the resident, at minimum?

  1. Once per shift
  2. Every 30 minutes
  3. Every 8 hours
  4. Every 2 hours Correct answer.

Explanation

Repositioning at least every 2 hours relieves pressure over bony prominences and helps prevent pressure injuries. Turning schedules may be individualized but 2 hours is the standard minimum.

Question 4Physical Care Skills - Activities of Daily Living

Which technique correctly demonstrates use of a draw sheet to move a resident up in bed?

  1. Lift the resident by the arms while two aides pull
  2. Roll the sheet close to the resident's body and move on the count of three Correct answer.
  3. Slide the resident with one rapid hard pull
  4. Pull the sheet from the top edge only

Explanation

Rolling the draw sheet close to the body gives a firm grip and reduces friction and shear, and coordinated counting protects both resident and staff. Sudden pulls or lifting by the arms can injure the resident's shoulders.

Question 5Physical Care Skills - Activities of Daily Living

When giving a bed bath, in what order should body areas be washed?

  1. Perineum first, then face, then extremities
  2. Feet first, then the face, then the perineum, then arms
  3. Back first, then face, then legs, then perineum
  4. Eyes first, then face, then the rest of the body, perineum last Correct answer.

Explanation

Bathing proceeds from cleanest to dirtiest: eyes (using the inner-to-outer corner of each eye), then face and upper body, and the perineal area last. This order limits the spread of microorganisms.

Question 6Physical Care Skills - Activities of Daily Living

A resident has weakness on the left side after a stroke. On which side should the nurse aide dress the resident first?

  1. The weak left side Correct answer.
  2. Alternate sides each day
  3. The strong right side
  4. Either side, since order does not matter

Explanation

Dress the affected or weak side first and undress it last, so clothing can be worked over the stronger side more easily and the resident keeps more control and dignity.

Question 7Physical Care Skills - Activities of Daily Living

A resident is sitting on the edge of the bed and feels dizzy when standing. What should the nurse aide do first?

  1. Have the resident sit and dangle the legs before trying again Correct answer.
  2. Walk the resident anyway to build tolerance
  3. Lower the resident flat and leave the room
  4. Grab the resident and pull to a standing position

Explanation

Dizziness on standing suggests orthostatic hypotension. The safe response is to keep the resident seated and let the legs dangle so blood pressure can adjust, then reassess before attempting to stand.

Question 8Physical Care Skills - Activities of Daily Living

How should the nurse aide care for a resident's hearing aid when it is not in use?

  1. Turn it off, remove the battery, and store it in a labeled container Correct answer.
  2. Wrap it in a tissue and place it in the laundry
  3. Leave it on the bedside tray table uncovered
  4. Soak it in warm water and mild soap

Explanation

Hearing aids are turned off, batteries removed to prevent corrosion, and stored dry in a labeled case. Moisture damages the electronics, and loose storage risks loss or breakage.

Question 9Physical Care Skills - Activities of Daily Living

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

  1. In small circles around the perineum
  2. Side to side across the perineum
  3. Back to front
  4. Front to back Correct answer.

Explanation

Wiping front to back moves from the less contaminated urethral area toward the anal area, reducing the risk of urinary tract infection. The washcloth should be changed with each stroke.

Question 10Physical Care Skills - Activities of Daily Living

Which statement is correct about the position of a resident during a shampoo in bed?

  1. The resident's head is tilted back over the basin edge with a towel under the shoulders Correct answer.
  2. The resident sits fully upright with no support to the neck
  3. The resident lies flat with the head level on the pillow
  4. The resident turns onto the stomach for shampooing

Explanation

For an in-bed shampoo the head is positioned over the basin or trough with the neck supported and towels protecting the bedding, so water drains away from the face and ears.

Question 11Physical Care Skills - Activities of Daily Living

A resident's fingernails are long, thick, and yellowed, and the resident has diabetes. What should the nurse aide do?

  1. Apply an over-the-counter fungal cream and continue
  2. Cut the nails short with the shared toenail clippers
  3. Soak and trim the nails deeply into the corners
  4. Report to the nurse, since nail care for a diabetic resident may be restricted Correct answer.

Explanation

Residents with diabetes have poor circulation and reduced sensation, so nail care that risks breaks in the skin should be referred to the nurse or a podiatrist. The aide should not trim thick or problem nails independently.

Question 12Physical Care Skills - Activities of Daily Living

What is the correct method for shaving a resident with a safety razor?

  1. Lather the area, shave in the direction of hair growth, and rinse the razor often Correct answer.
  2. Shave with a blade saved from a previous resident
  3. Use quick short strokes without lathering
  4. Shave against the hair growth on dry skin

Explanation

Warm lather softens hair, shaving with the grain reduces irritation, and frequent rinsing keeps the blade from clogging. Razors are single-resident items and must never be shared.

Question 13Physical Care Skills - Activities of Daily Living

A resident uses a cane. Where should the cane be placed when the resident walks?

  1. Carried in the weaker hand and lifted after each step
  2. Held in front of the body in both hands
  3. On the weaker side, moved forward with the stronger leg
  4. On the stronger side, moved forward with the weaker leg Correct answer.

Explanation

A cane is used on the unaffected or stronger side to widen the base of support and take weight off the weak leg; it moves forward together with the weaker leg. This is the standard gait pattern taught for cane use.

Question 14Physical Care Skills - Activities of Daily Living

A resident is to be transferred from bed to chair with a mechanical lift. What should the nurse aide verify before lifting?

  1. Only one aide is available to run the lift
  2. The lift battery light is green and the wheels are locked on only one side
  3. The resident's feet are off the mattress
  4. The sling is the correct size and fully under the resident, and the straps are attached correctly Correct answer.

Explanation

Safe mechanical lift use requires correct sling sizing and placement under the resident, correct attachment of straps, locked wheels, and enough staff per facility policy. Skipping these checks can cause the resident to fall from the sling.

Question 15Physical Care Skills - Activities of Daily Living

Which observation about a resident's skin should the nurse aide report to the nurse?

  1. A small scar from a childhood injury
  2. Dry skin on the lower legs after a bath
  3. Freckles on the forearms
  4. A new reddened area over the sacrum that does not blanch Correct answer.

Explanation

A non-blanching reddened area over a bony prominence is an early sign of pressure injury and must be reported promptly. Scars, freckles, and post-bath dryness are not acute findings.

Question 16Physical Care Skills - Activities of Daily Living

How should the nurse aide help a resident who has an artificial eye remove and clean it?

  1. Rinse the prosthesis in alcohol and insert it wet
  2. Report to the nurse and follow facility policy, as artificial eye care may be a nurse's responsibility Correct answer.
  3. Remove it and store it dry overnight on the nightstand
  4. Pop the eye out by pressing hard on the eyelid without cleansing

Explanation

Care of an artificial eye often falls within nursing scope or requires specific training and orders. The aide should report and follow facility policy rather than performing removal independently.

Question 17Physical Care Skills - Activities of Daily Living

A resident is placed in the lateral position. Which support should the nurse aide provide?

  1. The top leg pulled straight down over the side of the bed
  2. A pillow between the knees and one at the back Correct answer.
  3. Both arms tucked under the body
  4. The head left unsupported

Explanation

In the lateral position a pillow between the knees keeps the legs aligned and prevents pressure between bony prominences; a pillow at the back maintains the position. The head must be supported and arms kept comfortable.

Question 18Physical Care Skills - Activities of Daily Living

Which action best protects a resident's dignity during a bath?

  1. Discuss the resident's medical history with a visitor
  2. Wash quickly with the curtain pulled back
  3. Leave the door open for ventilation
  4. Expose only the area being washed and keep the rest covered Correct answer.

Explanation

Exposing only the part being washed and draping the rest preserves privacy and warmth while the bath is given. Privacy includes closed doors or curtains and keeping personal information confidential.

Question 19Physical Care Skills - Activities of Daily Living

How often should a resident's urinary drainage bag be emptied and how should it be handled?

  1. Empty when it is about half to two-thirds full, keeping the spout from touching the container Correct answer.
  2. Empty when full and let the spout rest on the floor
  3. Empty with the bag held above the bladder
  4. Empty only once a day regardless of volume

Explanation

Emptying the bag before it is overfull prevents backflow and tension on tubing, and keeping the spout off the collection container and floor prevents contamination. The bag must always stay below bladder level.

Question 20Physical Care Skills - Activities of Daily Living

A resident wears elastic compression stockings. Which action is correct when applying them?

  1. Apply lotion to the legs and put them on wet
  2. Apply them at bedtime after the resident has been up all day
  3. Roll them down to the ankle and leave them there
  4. Apply them in the morning before the resident gets out of bed Correct answer.

Explanation

Compression stockings are applied before the legs have been dependent, typically in the morning before arising, when swelling is least. They should be smooth without wrinkles and never rolled down, because rolling creates a tourniquet effect.

Question 21Physical Care Skills - Activities of Daily Living

A resident is at risk for aspiration. Which mealtime practice should the nurse aide follow?

  1. Encourage talking while chewing
  2. Have the resident sit upright and check for pocketed food after the meal Correct answer.
  3. Have the resident lie back during the meal
  4. Give fluids with a straw while the resident is reclined

Explanation

An upright position and attention to mouth checks after eating reduce aspiration risk. Talking while chewing and reclined drinking make it easier for food or liquid to enter the airway.

Question 22Physical Care Skills - Activities of Daily Living

Which is the correct way to assist a resident with handwashing before a meal?

  1. Use hand sanitizer only and skip soap and water
  2. Wash the resident's hands with soap and warm running water, cleaning between the fingers Correct answer.
  3. Wipe the palms with a dry paper towel
  4. Use a basin of standing water shared with another resident

Explanation

Hand hygiene uses soap and running water, with friction over all surfaces including between fingers and under nails, then drying. Standing water and dry wiping do not remove soil and organisms effectively.

Question 23Physical Care Skills - Activities of Daily Living

A resident who is usually continent has been wetting the bed for two days. What is the nurse aide's best action?

  1. Ignore it because occasional wetting is normal aging
  2. Scold the resident for wetting the bed
  3. Restrict the resident's fluids after dinner without an order
  4. Report the change to the nurse and continue providing skin care and absorbent protection Correct answer.

Explanation

A change from a resident's usual pattern may signal a urinary tract infection, medication effect, or other problem, so it should be reported. The aide continues comfort care and does not independently restrict fluids.

Question 24Physical Care Skills - Activities of Daily Living

Which statement about safe use of a gait belt is correct?

  1. It is used only when the resident is lying in bed
  2. It is placed loosely so the resident can slip out easily
  3. It is fastened around the chest under the arms
  4. It is applied snugly around the waist over clothing with enough room for two fingers Correct answer.

Explanation

A gait belt fits snugly at the waist over clothing, with room for a couple of fingers, and is grasped to steady the resident during transfers and walking. It is never placed around the chest or ribs and should not be loose.

Question 25Physical Care Skills - Activities of Daily Living

When a resident is receiving a tub bath, which safety step is most important?

  1. Fill the tub to the top for warmth
  2. Keep the bathroom door open and the light off
  3. Add bath oil to make the tub slick
  4. Stay with the resident and never leave the side Correct answer.

Explanation

Drowning and falls can occur quickly in a tub, so the resident must never be left alone. Water depth and temperature are checked, the tub is not overfilled, and non-skid measures are used.

Question 26Physical Care Skills - Activities of Daily Living

A resident is unconscious and the nurse aide is providing mouth care. How should the resident be positioned?

  1. Flat on the back with the head tilted back
  2. On the side with the head turned toward the aide Correct answer.
  3. On the back with a pillow under the knees
  4. Sitting upright in a chair

Explanation

An unconscious resident cannot swallow or protect the airway, so mouth care is given in a side-lying position with the head turned to let fluids drain out. This position lowers the risk of aspiration. Suction should be available if the resident has secretions.

Question 27Physical Care Skills - Activities of Daily Living

When a resident's dentures are not being worn, where should the nurse aide keep them?

  1. In a labeled container filled with cool water Correct answer.
  2. On the bedside table in direct sunlight
  3. Wrapped in a dry paper towel in a drawer
  4. In the resident's bedside water pitcher

Explanation

Dentures can warp or crack if they dry out, so they are stored covered in cool water in a container labeled with the resident's name. The label prevents loss or mix-ups. Hot water should not be used because it can distort the denture material.

Question 28Physical Care Skills - Activities of Daily Living

While making an unoccupied bed, a clean sheet touches the floor. What should the nurse aide do?

  1. Set it aside and use a clean sheet Correct answer.
  2. Brush off the visible dirt
  3. Turn the soiled side down
  4. Shake it out and use it anyway

Explanation

Linens that touch the floor are considered contaminated and must not be used on the bed. Shaking linens spreads microorganisms into the air. The aide should place the sheet in the laundry and get a clean one.

Question 29Physical Care Skills - Activities of Daily Living

When making an occupied bed, which action helps keep the resident safe?

  1. Raise the side rail on the far side of the bed Correct answer.
  2. Lower both side rails before starting
  3. Roll the resident toward the aide without support
  4. Ask the resident to sit on the edge of the bed

Explanation

Raising the side rail on the far side gives the resident something to hold and prevents rolling out while the aide changes the linens. The aide should also raise the bed to a comfortable working height. The near side rail is lowered only while working on that side.

Question 30Physical Care Skills - Activities of Daily Living

During range-of-motion exercises, a resident says the movement hurts. What should the nurse aide do?

  1. Move the joint faster to finish quickly
  2. Push a little further to stretch the joint
  3. Continue but skip that joint next time
  4. Stop the movement and report the pain Correct answer.

Explanation

Range-of-motion exercises should never cause pain; forcing a joint can cause injury. The aide should stop the movement and report the pain to the nurse. The nurse can then determine whether the exercise plan needs to be changed.

Question 31Physical Care Skills - Activities of Daily Living

A resident is lying supine. How can the nurse aide protect the heels from pressure?

  1. Place a pillow under the lower legs so the heels float Correct answer.
  2. Place a pillow under the head only
  3. Tie the feet together with a sheet
  4. Raise the foot of the bed as high as possible

Explanation

Heels are common pressure points when a resident lies on the back. A pillow under the lower legs lifts the heels off the mattress so they are not bearing weight. The aide should check the heels regularly for redness or breakdown.

Question 32Physical Care Skills - Activities of Daily Living

A resident who had a stroke keeps food on the right side of the mouth after swallowing. What should the nurse aide do?

  1. Offer only thin liquids at meals
  2. Check the right cheek and cue the resident to swallow Correct answer.
  3. Give larger bites so the resident chews more
  4. Stop all oral intake until the next shift

Explanation

After a stroke, decreased sensation on the affected side can cause food to collect in the cheek. The aide should check that side after each swallow and remind the resident to swallow. Pocketed food raises the risk of choking and aspiration, so it should be reported.

Question 33Physical Care Skills - Activities of Daily Living

Which action best helps prevent dehydration in a resident who needs help drinking?

  1. Offer small amounts of fluid often and record intake Correct answer.
  2. Give fluids only with meals
  3. Offer a full pitcher once per shift
  4. Wait until the resident asks for a drink

Explanation

Residents who depend on others may not ask for fluids, so the aide should offer small amounts frequently throughout the day. Recording intake helps the care team spot low fluid intake early. Thirst is often a late sign of dehydration in older adults.

Question 34Physical Care Skills - Activities of Daily Living

A resident is on a bladder training program. What should the nurse aide do?

  1. Take the resident to the toilet on the scheduled times Correct answer.
  2. Put a diaper on and check once a day
  3. Ask the resident to hold urine as long as possible
  4. Limit all fluids after lunch

Explanation

Bladder training uses a regular toileting schedule to help the resident regain control. The aide should assist at the planned times and provide privacy. Restricting fluids can cause dehydration and does not improve bladder control.

Question 35Physical Care Skills - Activities of Daily Living

Which action is correct when giving a bedpan to a resident?

  1. Keep the head of the bed flat during use
  2. Warm the rim and place the wide end under the buttocks Correct answer.
  3. Place the narrow end under the buttocks
  4. Leave the resident on the bedpan for an hour

Explanation

Warming the bedpan rim improves comfort, and the wide end goes under the buttocks so the opening is positioned correctly. The head of the bed should be raised for comfort and easier breathing. The resident should not be left on the bedpan for long periods because pressure can damage the skin.

Question 36Physical Care Skills - Activities of Daily Living

How should the nurse aide check the temperature of bath water?

  1. Ask the resident to test it with a foot
  2. Check with a thermometer or the inner wrist Correct answer.
  3. Assume warm tap water is always safe
  4. Use the back of the hand only briefly

Explanation

Bath water should be checked with a thermometer or by testing it on the inner wrist, which is sensitive to heat. Older adults often have decreased sensation and may not feel water that is too hot. Water that is too hot can burn or dry the skin.

Question 37Physical Care Skills - Activities of Daily Living

Which step is most important when assisting a resident with a shower?

  1. Use a bath mat only outside the shower
  2. Close the bathroom door and leave the resident alone
  3. Turn the water on after the resident is seated
  4. Seat the resident on a non-skid shower chair Correct answer.

Explanation

A non-skid shower chair gives the resident a stable seat and lowers the risk of falling in a wet area. The aide should stay with the resident and test the water before the resident gets in. Safety comes before privacy or speed.

Question 38Physical Care Skills - Activities of Daily Living

A resident has an IV in the right arm. When removing the gown, which arm should be freed first?

  1. The left arm, the arm without the IV Correct answer.
  2. The right arm, the arm with the IV
  3. Both arms at the same time
  4. The arm the resident prefers

Explanation

When removing a gown from a resident with an IV, free the arm without the IV first, then ease the gown over the IV arm and tubing. When putting a gown on, the IV arm goes in first. This method keeps the tubing from being pulled out.

Question 39Physical Care Skills - Activities of Daily Living

Which action is correct when providing foot care to a resident with diabetes?

  1. Cut calluses with a sharp blade
  2. Dry carefully between the toes and inspect the skin Correct answer.
  3. Soak the feet for 30 minutes in hot water
  4. Apply lotion between the toes

Explanation

Diabetes can reduce circulation and sensation in the feet, so daily inspection and careful drying between the toes are important. Soaking in hot water, cutting calluses, and putting lotion between the toes can lead to burns, injury, or infection. Any redness, cracking, or sore should be reported.

Question 40Physical Care Skills - Activities of Daily Living

How should the nurse aide clean a resident's eyeglasses?

  1. Use a dry tissue in circles
  2. Use warm water, mild soap, and a soft cloth Correct answer.
  3. Use alcohol wipes on the lenses
  4. Use hot water and bleach

Explanation

Warm water with mild soap and a soft cloth cleans lenses without scratching them. Hot water, bleach, and alcohol can damage lens coatings. A dry tissue can grind dust into the lens and cause scratches.

Question 41Physical Care Skills - Activities of Daily Living

Which approach is best when speaking to a resident who is hard of hearing?

  1. Cover your mouth while speaking
  2. Face the resident and speak clearly at a normal volume Correct answer.
  3. Speak rapidly to finish sooner
  4. Shout directly into the resident's ear

Explanation

Facing the resident allows lip reading and facial cues, and clear speech at a normal volume is easier to understand than shouting. Shouting can distort words and be uncomfortable. The aide should also reduce background noise.

Question 42Physical Care Skills - Activities of Daily Living

Which action is correct when filing a resident's nails?

  1. File only after a long soak in hot water
  2. File in one direction with an emery board Correct answer.
  3. File back and forth quickly
  4. Use scissors to cut close to the skin

Explanation

Filing in one direction helps prevent the nail from splitting or tearing. An emery board is safer than scissors, which can cut the skin. Any red, swollen, or painful areas around the nail should be reported.

Question 43Physical Care Skills - Activities of Daily Living

Which action best promotes sleep for a resident?

  1. Give caffeine in the evening
  2. Turn on bright lights in the evening
  3. Wake the resident every hour to check
  4. Keep a regular bedtime routine and reduce noise Correct answer.

Explanation

A consistent bedtime routine and a quiet, dim environment help the body prepare for sleep. Caffeine and bright lights in the evening make falling asleep harder. Frequent unnecessary waking disrupts sleep cycles.

Question 44Physical Care Skills - Activities of Daily Living

How often should a nurse aide reposition a resident who is at risk for pressure injuries?

  1. Every 15 minutes during sleep
  2. Only when the resident asks
  3. At least every 2 hours and as needed Correct answer.
  4. Once every shift

Explanation

Repositioning at least every 2 hours helps relieve pressure on bony areas and supports skin health. The schedule may be individualized by the care plan. Repositioning should be documented and combined with skin checks.

Question 45Physical Care Skills - Activities of Daily Living

Which action is correct for a resident with an indwelling urinary catheter?

  1. Keep the drainage bag above the bladder
  2. Keep the tubing free of kinks and below the bladder Correct answer.
  3. Coil the tubing on the bed
  4. Hang the bag on a bed rail

Explanation

Urine flows by gravity, so the bag must stay below the bladder and the tubing must not kink or loop. This prevents urine from backing up into the bladder and reduces infection risk. The bag should be hung on the bed frame, not the side rail.

Question 46Physical Care Skills - Activities of Daily Living

Which instruction is correct when a resident uses a walker?

  1. Carry the walker while walking
  2. Step forward first, then move the walker
  3. Lean on the walker with most of your weight
  4. Move the walker forward first, then step into it Correct answer.

Explanation

A walker provides a stable base when it is moved forward first and the resident then steps into it. The resident should stand upright and use the walker for balance, not lean full body weight on it. The aide stays nearby on the weaker side.

Question 47Physical Care Skills - Activities of Daily Living

A resident is transferring from bed to a chair with a pivot transfer. What should the nurse aide do?

  1. Leave the wheelchair wheels unlocked
  2. Lock both wheels and pivot toward the resident's stronger side Correct answer.
  3. Keep the bed at the highest position
  4. Pull the resident up by the arms

Explanation

Locking the wheelchair wheels keeps it from rolling during the transfer, and pivoting toward the stronger side uses the resident's best support. The aide should use a gait belt and let the resident help as much as possible. Pulling on the arms can cause injury to both people.

Question 48Physical Care Skills - Activities of Daily Living

A resident with dementia needs help with dressing and becomes upset when given several instructions. What should the nurse aide do?

  1. Dress the resident quickly without talking
  2. Give one simple step at a time and allow time to respond Correct answer.
  3. Ask another resident to explain the steps
  4. Speak louder and repeat all steps at once

Explanation

Residents with dementia process information best when given one simple instruction at a time with time to respond. A calm voice and a quiet setting reduce distress. Rushing or giving many directions at once can increase confusion and agitation.

Question 49Physical Care Skills - Basic Nursing Skills

An alcohol-based hand rub is appropriate in most situations. In which situation must the nurse aide wash with soap and water instead?

  1. The aide's hands are damp after rinsing a water pitcher
  2. The aide's hands are visibly soiled with stool Correct answer.
  3. The aide has just removed clean gloves after making an unoccupied bed
  4. The aide is entering the room to deliver a meal tray

Explanation

Soap and water is required when hands are visibly soiled with blood, stool, or other body fluids, and after caring for residents with C. difficile or norovirus. Alcohol-based rubs do not remove dirt and do not kill bacterial spores, so they cannot substitute in these cases.

Question 50Physical Care Skills - Basic Nursing Skills

When counting a resident's respirations, the aide should:

  1. Keep the fingers on the wrist as though still counting the pulse Correct answer.
  2. Count for 15 seconds and multiply by two
  3. Tell the resident that breathing is now being counted
  4. Ask the resident to breathe deeply so breaths are easier to hear

Explanation

Respirations are counted right after the pulse without telling the resident, because awareness changes the rate and depth. Keeping the fingers on the wrist disguises the count; a regular rate is counted for 30 seconds and doubled.