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Massachusetts CNA study materials
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Massachusetts CNA practice questions

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Question 1Basic nursing skills and clinical care

A resident has an infection caused by Clostridioides difficile. Which hand hygiene method should the aide use after giving care?

  1. Use an alcohol rub, then rinse with water
  2. Wipe hands with a dry paper towel
  3. Use an alcohol-based hand rub alone
  4. Wash hands with soap and running water Correct answer.

Explanation

Alcohol-based hand rubs do not reliably destroy C. difficile spores, so soap and water must be used. The friction of washing with soap and running water physically removes the spores from the hands.

Question 2Basic nursing skills and clinical care

Which respiratory rate is within the normal range for a resting adult?

  1. 16 breaths per minute Correct answer.
  2. 26 breaths per minute
  3. 6 breaths per minute
  4. 36 breaths per minute

Explanation

A normal resting adult respiratory rate is about 12 to 20 breaths per minute. Rates outside this range are reported to the nurse because they can signal illness or distress.

Question 3Basic nursing skills and clinical care

While counting a resident's radial pulse for 30 seconds, the aide counts 34 beats. What heart rate should be recorded?

  1. 51 beats per minute
  2. 34 beats per minute
  3. 68 beats per minute Correct answer.
  4. 102 beats per minute

Explanation

When a pulse is counted for 30 seconds, the number of beats is multiplied by two to obtain the rate per minute. Thirty-four times two equals 68 beats per minute.

Question 4Basic nursing skills and clinical care

How often should an aide reposition a resident who cannot move independently?

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

Explanation

Residents who cannot shift their own weight need to be turned and repositioned at least every two hours. This relieves pressure over bony areas and helps prevent pressure injuries.

Question 5Basic nursing skills and clinical care

Which item is recorded on the intake side of an intake and output record?

  1. 40 mL of drainage from a wound
  2. 240 mL of water swallowed with medications Correct answer.
  3. 300 mL of urine emptied from a catheter bag
  4. 150 mL of emesis collected in a basin

Explanation

Intake means anything that goes into the body by mouth or by tube, so water taken with medications counts as intake. Urine, emesis, and wound drainage are measured as output.

Question 6Basic nursing skills and clinical care

When giving perineal care to a female resident, in which direction should the aide wash?

  1. From the anus toward the urethra
  2. From the front toward the back Correct answer.
  3. From the back toward the front
  4. In circles around the anus first

Explanation

Washing from the urinary area toward the anus carries organisms away from the urethra. Wiping the other direction can pull fecal bacteria into the urinary tract and cause infection.

Question 7Basic nursing skills and clinical care

After finishing care for a resident who is at risk for falls, which action should the aide take before leaving the room?

  1. Remove the side rails to allow free movement
  2. Raise the bed to waist height for easier access
  3. Lower the bed and put the call light nearby Correct answer.
  4. Turn off the call light system

Explanation

A bed left in the low position is closer to the floor if the resident tries to get up or falls. Placing the call light within reach lets the resident ask for help instead of attempting to move alone.

Question 8Basic nursing skills and clinical care

A resident is receiving oxygen through a nasal cannula. Which instruction is most important for the aide to give visitors?

  1. Keep the door closed while oxygen is running
  2. Do not smoke or use flame near the oxygen Correct answer.
  3. Turn the oxygen off during meals
  4. Use only wool blankets near the resident

Explanation

Oxygen supports combustion, so open flames and smoking near the resident can cause arapid, severe fire. Everyone entering the room must be told not to smoke or use anything that sparks or burns.

Question 9Basic nursing skills and clinical care

When counting a resident's respirations, what should the aide do?

  1. Tell the resident to breathe slowly and evenly
  2. Count for 10 seconds, then multiply by six
  3. Keep fingers on the wrist and count silently Correct answer.
  4. Ask the resident to hold still and count out loud

Explanation

People change their breathing pattern when they know it is being watched. Leaving the fingers on the wrist as if still counting the pulse lets the aide observe respirations without the resident altering them.

Question 10Basic nursing skills and clinical care

How should the resident's arm be positioned when the aide takes a blood pressure?

  1. Crossed over the chest
  2. Hanging down at the side of the bed
  3. Supported at the level of the heart Correct answer.
  4. Raised above the head

Explanation

The arm must be supported so the cuff sits at the same level as the heart. If the arm is above or below heart level, gravity adds to or subtracts from the reading and the result is inaccurate.

Question 11Basic nursing skills and clinical care

A resident is on contact precautions. After giving care, which piece of personal protective equipment should the aide remove first?

  1. Mask
  2. Gloves Correct answer.
  3. Gown
  4. Goggles

Explanation

Gloves are the most contaminated item and are removed first, followed by goggles, then gown, then mask. Removing the cleanest items first would contaminate the aide's hands and clothing.

Question 12Basic nursing skills and clinical care

Which action helps an indwelling urinary catheter drain properly?

  1. Clamping the tubing during the day
  2. Raising the bag above the bladder
  3. Hanging the bag below bladder level Correct answer.
  4. Resting the drainage bag on the floor

Explanation

Gravity moves urine down the tubing only when the bag stays below the bladder. If the bag is higher, urine can flow backward into the bladder and cause infection.

Question 13Basic nursing skills and clinical care

A clean-catch midstream urine specimen is ordered. What should the aide do?

  1. Save all the urine passed over 24 hours
  2. Collect the first few drops that the resident passes
  3. Collect the middle portion after voiding begins Correct answer.
  4. Empty urine from the catheter drainage bag

Explanation

Voiding a small amount first flushes organisms from the urethra, so the middle portion better reflects what is in the bladder. The container is then capped and labeled and sent to the lab promptly.

Question 14Basic nursing skills and clinical care

When helping a resident to walk, how should the aide use a gait belt?

  1. Grasp the belt at the sides or the back Correct answer.
  2. Leave the belt loose so the resident can breathe
  3. Fasten the belt snugly around the resident's chest
  4. Pull on the belt to move the resident forward

Explanation

The aide holds the belt at the sides or back to steady the resident and to control a stumble. A properly fitted belt around the waist gives a firm grip without pulling the resident off balance.

Question 15Basic nursing skills and clinical care

A resident has a vest restraint ordered. How often should the aide check circulation and skin around the restraint?

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

Explanation

The resident in a restraint is checked at least every 15 minutes for breathing, circulation, skin color, and safety. The restraint is also released and the resident repositioned at set intervals, usually every two hours.

Question 16Basic nursing skills and clinical care

A resident has trouble swallowing. Which position is best during meals and for a short time afterward?

  1. In a semi-reclining position at 30 degrees
  2. On the left side with the head turned
  3. Sitting upright at about 90 degrees Correct answer.
  4. Flat on the back with the head lowered

Explanation

Sitting upright lets gravity move food down the esophagus and keeps the airway protected. The resident should stay upright for about 30 minutes after eating to reduce the chance of aspiration.

Question 17Basic nursing skills and clinical care

Before applying a hot pack to a resident's skin, what should the aide do?

  1. Apply the pack for at least 60 minutes
  2. Place the pack directly on the skin
  3. Warm the area with a heating pad first
  4. Wrap the pack in a cloth or towel Correct answer.

Explanation

A layer of cloth protects the skin from direct heat and reduces the risk of a burn. The aide also checks the skin frequently and removes the pack if it becomes red or the resident reports pain.

Question 18Basic nursing skills and clinical care

During a sterile dressing change, a piece of sterile gauze touches the resident's bed linen. What should the aide do?

  1. Discard the gauze and use a new sterile piece Correct answer.
  2. Rinse the gauze with sterile water and use it
  3. Ask the nurse to apply the gauze first
  4. Use the gauze quickly before it dries

Explanation

Anything sterile that touches a nonsterile surface is considered contaminated. The contaminated item is thrown away and a fresh sterile piece is used to keep the wound protected.

Question 19Basic nursing skills and clinical care

A 24-hour urine collection has been ordered. What should be done with the first urine the resident voids at the start of the collection?

  1. It is mixed with the next specimen
  2. It is saved with all the other urine
  3. It is discarded and the time is recorded Correct answer.
  4. It is sent to the lab by itself

Explanation

The first void empties urine that formed before the collection period began, so it is discarded. The start time is noted, and every specimen after that is collected until exactly 24 hours later.

Question 20Basic nursing skills and clinical care

Which route gives the most reliable core body temperature?

  1. Oral
  2. Tympanic
  3. Axillary
  4. Rectal Correct answer.

Explanation

The rectal route reflects core temperature most closely because it is measured inside the body. Oral readings are affected by drinking and breathing, and axillary readings are the least accurate.

Question 21Basic nursing skills and clinical care

A resident becomes dizzy when getting out of bed. How should the aide check for orthostatic hypotension?

  1. Check the pulse only, since pressure does not change
  2. Take the blood pressure after a meal
  3. Measure blood pressure lying, then standing Correct answer.
  4. Take one blood pressure while the resident walks

Explanation

Orthostatic hypotension is a drop in blood pressure when the resident moves from lying to sitting or standing. Comparing readings taken in both positions shows whether the pressure falls with position change.

Question 22Basic nursing skills and clinical care

A resident begins having a seizure. What should the aide do?

  1. Hold the resident's arms and legs still
  2. Protect the head and move nearby objects away Correct answer.
  3. Try to hold the resident's tongue down with a spoon
  4. Give the resident a drink of water

Explanation

During a seizure the priority is protecting the resident from injury, so the head is cushioned and hard objects are moved aside. Nothing is placed in the mouth, and the resident is turned onto the side once the movements stop.

Question 23Basic nursing skills and clinical care

A resident has a colostomy pouch. When should the aide empty it?

  1. When it is about one-third to one-half full Correct answer.
  2. Once every 24 hours regardless of contents
  3. Only when the resident asks for it
  4. Only when it is completely full

Explanation

A pouch that is emptied when it is about one-third to one-half full stays sealed and is less likely to leak or pull away from the skin. Waiting until it is full puts weight on the seal and can cause skin breakdown.

Question 24Basic nursing skills and clinical care

The aide finds a reddened area on a resident's heel that does not fade when pressed. What does this mean?

  1. A normal finding in older adults
  2. A moisture rash that needs powder
  3. A bruise that will fade in a day
  4. A pressure injury that needs reporting Correct answer.

Explanation

Redness that does not blanch when pressed shows that tissue damage has already begun. It is reported to the nurse right away, and pressure is kept off the area.

Question 25Basic nursing skills and clinical care

When should anti-embolism stockings be applied?

  1. After the resident has walked for the day
  2. In the morning, before the resident gets up Correct answer.
  3. At bedtime, after the legs have been elevated
  4. Only when the resident complains of leg pain

Explanation

Stockings work best when they are put on before the legs have swollen from standing or sitting. Applying them in the morning, before the resident gets out of bed, keeps pressure evenly distributed.

Question 26Basic nursing skills and clinical care

When must the nursing assistant perform hand hygiene?

  1. Only when the hands look visibly soiled
  2. Only after contact with an infected resident
  3. Before and after contact with each resident Correct answer.
  4. Only at the beginning and end of the shift

Explanation

Hand hygiene is the single most effective way to prevent the spread of infection in a care setting. It is performed before and after every episode of resident contact, whether or not gloves were worn.

Question 27Basic nursing skills and clinical care

Why is Fowler's position, with the head of the bed raised 45 to 60 degrees, used for a resident?

  1. To keep pressure off the resident's heels and hips
  2. To keep the resident's hips and knees sharply bent
  3. To prevent the resident from sliding down in the bed
  4. To make breathing and eating easier for the resident Correct answer.

Explanation

Raising the head of the bed lets gravity help the chest expand and keeps the airway more open, so breathing is easier. The upright angle also makes swallowing and eating safer than a flat position.

Question 28Basic nursing skills and clinical care

A pulse oximeter placed on a resident's finger reads 95%. What does this reading tell the aide?

  1. How much oxygen is being carried in the blood Correct answer.
  2. The resident's heart rate is within normal range
  3. The resident's blood pressure is normal
  4. The number of breaths taken each minute

Explanation

A pulse oximeter estimates oxygen saturation, which is the percentage of hemoglobin carrying oxygen. It does not measure pulse rate, blood pressure, or respiratory rate, although many devices display a pulse reading as well.

Question 29Basic nursing skills and clinical care

Which practice gives the most useful record when weighing a resident?

  1. Using whatever scale is closest to the room
  2. Weighing the resident with shoes on
  3. Using the same scale at the same time of day Correct answer.
  4. Weighing at a different time each day

Explanation

Body weight normally shifts during the day with meals, fluids, and activity, and different scales are calibrated differently. Using one scale at a consistent time makes small real changes visible instead of hiding them in daily variation.

Question 30Basic nursing skills and clinical care

While counting a radial pulse, the aide notices that the rhythm is irregular. What should the aide do?

  1. Count for 15 seconds and multiply by four
  2. Record the pulse as normal and continue care
  3. Count the pulse for a full minute Correct answer.
  4. Ask the resident to take a deep breath and recount

Explanation

An irregular rhythm produces uneven spacing between beats, so a short count multiplied out can be badly off. Counting for a full minute captures every beat and gives the accurate rate and rhythm to report.

Question 31Basic nursing skills and clinical care

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

  1. Flat on the back with the head of the bed raised
  2. Lying on the right side with the legs straight
  3. Sitting upright on the edge of the bed
  4. Lying on the left side with the right knee bent Correct answer.

Explanation

The left side-lying position follows the natural curve of the descending colon, so solution flows with gravity into the lower bowel. Bending the right knee supports the body and helps the resident stay comfortable and relaxed.

Question 32Basic nursing skills and clinical care

A cold pack has been applied to a resident's sprained ankle. How long should it typically stay in place?

  1. No more than 20 minutes at a time Correct answer.
  2. Continuously for 2 hours
  3. For 45 minutes at a time
  4. Until the skin turns numb and white

Explanation

Cold reduces swelling and pain, but prolonged exposure narrows blood vessels enough to injure tissue. Limiting application to about 20 minutes protects the skin, and the aide checks the skin during and after the treatment.

Question 33Basic nursing skills and clinical care

How should the aide care for a resident's hearing aid?

  1. Store it in direct sunlight to dry
  2. Clean the earpiece with rubbing alcohol
  3. Soak it in warm water overnight
  4. Wipe it with a dry cloth and store it dry Correct answer.

Explanation

Hearing aids contain delicate electronics that are damaged by moisture and harsh chemicals. Wiping with a dry cloth and storing the device dry and away from heat keeps it working and ready to use.

Question 34Basic nursing skills and clinical care

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

  1. About 15 to 30 minutes later Correct answer.
  2. Right away, before the mouth cools down
  3. After the resident rinses with cold water
  4. At any point within the next hour

Explanation

Hot or cold food and drink change the temperature inside the mouth for a period of time. Waiting roughly 15 to 30 minutes allows the mouth to return to body temperature so the reading reflects core temperature.

Question 35Basic nursing skills and clinical care

A resident has a new cast on the lower arm. Which finding should the aide report to the nurse right away?

  1. The fingers are pale, cool, and swollen Correct answer.
  2. The cast has a faint, clean smell
  3. The cast feels slightly warm and dry
  4. The resident can wiggle all the fingers

Explanation

Pale, cool, swollen fingers suggest that circulation is being compressed by swelling under the cast. This can progress to permanent damage, so it is reported immediately rather than at the end of the shift.

Question 36Basic nursing skills and clinical care

How should the resident be positioned during and after a tube feeding?

  1. With the head of the bed raised at least 30 degrees Correct answer.
  2. On the left side with the head of the bed flat
  3. Flat on the back with the head lowered
  4. Sitting up only while the formula is running

Explanation

Keeping the upper body elevated lets gravity keep formula in the stomach and reduces the chance of it flowing back up into the airway. The elevation is maintained for a period after the feeding ends, not just while it runs.

Question 37Basic nursing skills and clinical care

Which item is allowed on a clear liquid diet?

  1. Whole milk
  2. Oatmeal
  3. Cream soup
  4. Apple juice Correct answer.

Explanation

A clear liquid diet contains only fluids and foods that are liquid at room temperature and leave little residue in the bowel. Apple juice meets that standard, while milk and grain products leave residue and are not clear liquids.

Question 38Basic nursing skills and clinical care

The only blood pressure cuff available is too small for the resident's arm. What effect does this have on the reading?

  1. The reading will not be affected
  2. The reading will be falsely low
  3. The reading will be falsely high Correct answer.
  4. The reading cannot be obtained at all

Explanation

A cuff that is too narrow must be inflated to a higher pressure to compress the artery, which inflates the measured value. The aide should find a correctly sized cuff rather than record a misleading number.

Question 39Basic nursing skills and clinical care

Which set of signs suggests that a resident's blood sugar may be too low?

  1. Flushed, dry skin with deep, rapid breathing
  2. Slow, slurred speech with one-sided weakness
  3. Fever, cough, and chest tightness
  4. Shakiness, sweating, and confusion Correct answer.

Explanation

Low blood sugar deprives the brain of glucose and triggers a stress response, producing trembling, clammy sweating, and altered thinking. These signs call for prompt reporting and treatment because confusion can progress quickly.

Question 40Basic nursing skills and clinical care

A resident who is lying in bed begins to vomit. What should the aide do first?

  1. Leave the resident alone to get supplies
  2. Turn the resident onto the side Correct answer.
  3. Give the resident a sip of water to rinse
  4. Wait until the vomiting stops before acting

Explanation

Turning the resident to the side lets vomit drain out of the mouth instead of being breathed into the lungs. Keeping the airway clear is the first priority before any cleanup or summoning of supplies.

Question 41Personal care and activities of daily living

When should a nurse aide perform hand hygiene?

  1. Only after removing gloves
  2. Only when the hands look dirty
  3. Before and after each resident contact Correct answer.
  4. At the beginning of the shift and after breaks

Explanation

Hand hygiene is required before and after every contact with a resident, and also after contact with body fluids or contaminated items. Gloves do not replace handwashing, and hands can carry organisms even when they appear clean. This practice is the single most effective way to prevent the spread of infection.

Question 42Personal care and activities of daily living

A resident is unresponsive. How should the aide give mouth care?

  1. Turn the resident to one side and use little water Correct answer.
  2. Lay the resident flat with the mouth closed
  3. Use a hard toothbrush and plenty of toothpaste and water
  4. Wait until the resident is awake and alert

Explanation

An unresponsive resident cannot swallow or protect the airway, so positioning on the side allows fluids to drain out of the mouth. Only a small amount of water or mouth rinse should be used. Oral care is still required daily even when the resident cannot eat or respond.

Question 43Personal care and activities of daily living

Where should the aide clean a resident's dentures?

  1. In the resident's drinking glass
  2. Over water or a towel-lined basin Correct answer.
  3. Directly in a dry bathroom sink
  4. In a dishwasher with the family's dishes

Explanation

Dentures are fragile and can break if dropped onto a hard surface, so cleaning is done over a basin of water or a sink lined with a towel. A washcloth or soft brush and denture cleanser are used. The resident's own cup or a dry sink offers no protection from breakage.

Question 44Personal care and activities of daily living

A resident has weakness on the right side. In what order should the aide help with dressing?

  1. Both sleeves at the same time
  2. Right sleeve first, then the left Correct answer.
  3. Right sleeve last, after the left
  4. Left sleeve first, then the right sleeve

Explanation

Clothing is put on the weak or affected side first so the limb does not have to be pushed and pulled through sleeves. When undressing, the affected side is taken out last. This order protects the weak arm and shoulder from injury.

Question 45Personal care and activities of daily living

When giving perineal care to a female resident, the aide should wash

  1. From the back toward the front
  2. In circles around the whole area
  3. From the front toward the back Correct answer.
  4. Only with soap and no water

Explanation

Washing from the urinary area toward the rectum moves bacteria away from the urethra and reduces the risk of urinary tract infection. A clean washcloth and fresh water are used for each stroke. Front-to-back cleaning applies to both bathing and toileting care.

Question 46Personal care and activities of daily living

Before helping a resident eat, the aide should

  1. Help the resident wash hands and sit up Correct answer.
  2. Put food in the mouth quickly to save time
  3. Lay the resident flat in bed before the meal
  4. Rush so the food stays warm

Explanation

Hand hygiene before eating and an upright position support safe swallowing and respect the resident's dignity. Sitting up also reduces the risk of choking and aspiration. Rushing a meal takes away the resident's control over the pace of eating.

Question 47Personal care and activities of daily living

When shaving a male resident with a safety razor, the aide should

  1. Wet the beard and shave with the grain Correct answer.
  2. Use cold water and no lather on the face
  3. Shave dry skin with a razor used by another resident
  4. Shave against the grain for a closer shave

Explanation

Warm water and lather soften the beard, and shaving in the direction of hair growth reduces nicks and irritation. Each resident must have his own razor because shared razors can transmit bloodborne infection. The aide should also check whether the resident takes a blood thinner, which raises bleeding risk.

Question 48Personal care and activities of daily living

When providing catheter care, the aide should

  1. Pull firmly on the tubing to check it is secure
  2. Disconnect the tubing from the drainage bag
  3. Clean the catheter from the meatus outward Correct answer.
  4. Wash toward the meatus, starting at the bag

Explanation

Cleaning starts at the urinary meatus and moves down the catheter, away from the body, so organisms are not carried into the bladder. The tubing is never pulled or disconnected because that causes injury and introduces infection. The drainage bag is kept below the bladder at all times.

Question 49Personal care and activities of daily living

A resident wears a hearing aid. Which action helps communication?

  1. Shout directly into the ear that has the hearing aid
  2. Face the resident and speak in a normal tone Correct answer.
  3. Speak while standing behind the resident
  4. Turn up the television so it is louder

Explanation

Facing the resident allows lip reading and facial cues, and a normal tone is easier to understand than shouting. Background noise should be reduced rather than increased. The aide should also check that the hearing aid is on, clean, and has a working battery.

Question 50Personal care and activities of daily living

A resident has an order for passive range of motion. What should the aide do?

  1. Perform the exercises once a week
  2. Have the resident do all the exercises alone
  3. Force the joint past the point where the resident reports pain
  4. Support the limb and move it slowly to resistance Correct answer.

Explanation

In passive range of motion the aide does the work, supporting the limb and moving each joint gently until resistance or discomfort is felt. Forcing a joint causes pain and injury. Exercises are done on the ordered schedule, usually daily or several times a day.