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Missouri CNA practice questions

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Question 1Role of the Nurse Assistant and Basic Nursing Skills

Which of these tasks may a nursing assistant perform as part of routine care?

  1. Taking a resident's temperature with an electronic thermometer Correct answer.
  2. Changing the wound care plan for a resident
  3. Deciding how much insulin a resident needs
  4. Teaching a resident to use a new walker

Explanation

Nursing assistants carry out basic nursing skills that fall within their training and are delegated by the nurse, and measuring vital signs is one of them. Choosing medication doses, teaching new skills, and revising a care plan all require a licensed professional.

Question 2Role of the Nurse Assistant and Basic Nursing Skills

A nursing assistant is about to touch a resident after being in the hallway. Which action best prevents the spread of germs?

  1. Using the same pair of gloves for two residents in a row
  2. Wearing gloves at all times while in the hallway
  3. Wiping the hands on a towel after touching the door
  4. Cleaning the hands with alcohol-based rub before touching the resident Correct answer.

Explanation

Hand hygiene is performed before and after every resident contact, and an alcohol-based rub is acceptable when the hands are not visibly soiled. Gloves are not a substitute for hand cleaning and must never be shared between residents.

Question 3Role of the Nurse Assistant and Basic Nursing Skills

A resident who uses a walker is at risk for falls. Which action should the nursing assistant take?

  1. Raise the bed to the highest position so staff can see the resident
  2. Place the call light within reach and keep the bed in the lowest position Correct answer.
  3. Ask the resident to walk without the walker to build strength
  4. Keep the call light out of reach so the resident will not trip on the cord

Explanation

Fall prevention includes keeping needed items and the call light within reach and leaving the bed low with the wheels locked. A high bed and an out-of-reach call light both increase the chance that the resident will try to get up alone.

Question 4Role of the Nurse Assistant and Basic Nursing Skills

A nursing assistant sees a coworker grab and yank a resident's arm while scolding the resident. What should the assistant do first?

  1. Say nothing, because the coworker has more experience
  2. Report the incident to the charge nurse right away Correct answer.
  3. Confront the coworker in front of the resident
  4. Write a note in the resident's chart and tell no one

Explanation

Yanking a resident and scolding them is a form of abuse, and every nursing assistant is a mandated reporter. Suspected abuse must be reported immediately to the nurse in charge, who then follows facility and state reporting rules.

Question 5Role of the Nurse Assistant and Basic Nursing Skills

Before using a gait belt to help a resident walk, the nursing assistant should make sure the belt is:

  1. Fastened snugly around the waist over the clothing Correct answer.
  2. Placed against bare skin under the shirt
  3. Looped around the resident's wrists for control
  4. Buckled around the chest just under the arms

Explanation

A gait belt is worn over clothing, snug around the waist, so the assistant can grip it without pulling on the resident's arm or clothing. Placing it on bare skin can cause pinching and skin damage.

Question 6Role of the Nurse Assistant and Basic Nursing Skills

While giving a bed bath, the nursing assistant notices a new reddened area on a resident's heel. What should the assistant do?

  1. Write it off as a bruise and continue the bath
  2. Cover the area with lotion and check again next week
  3. Massage the area firmly to increase circulation
  4. Report the finding to the charge nurse Correct answer.

Explanation

Any new change in the skin is reported to the nurse promptly so it can be assessed and treated before it worsens. Reddened areas over pressure points are never massaged, because that can damage tissue further.

Question 7Role of the Nurse Assistant and Basic Nursing Skills

A visitor asks the nursing assistant whether a resident has cancer. How should the assistant respond?

  1. Review the resident's chart with the visitor to be helpful
  2. Give a general answer that hints at the diagnosis
  3. Tell the visitor that resident information is private Correct answer.
  4. Answer truthfully if the visitor says they are close family

Explanation

A resident's health information is confidential and is shared only with those the resident has authorized or as the law requires. The assistant should protect privacy and refer the visitor to the nurse.

Question 8Role of the Nurse Assistant and Basic Nursing Skills

Which technique shows correct body mechanics when lifting a heavy object?

  1. Bend the knees and keep the load close Correct answer.
  2. Twist the upper body while lifting to save time
  3. Bend at the waist and keep the legs straight
  4. Hold the load at arm's length away from the body

Explanation

Using the strong leg muscles and keeping the load near the body reduces strain on the back. Twisting while lifting and holding a load away from the body both increase the risk of back injury.

Question 9Role of the Nurse Assistant and Basic Nursing Skills

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

  1. Take it right away, since the mouth is already warm
  2. Wait about 15 to 30 minutes before taking it Correct answer.
  3. Take it only after the resident has eaten a full meal
  4. Take it now and subtract one degree from the result

Explanation

Hot or cold food and drink change the temperature inside the mouth, so the assistant waits roughly 15 to 30 minutes before an oral reading. Adjusting the reading by hand is never acceptable.

Question 10Role of the Nurse Assistant and Basic Nursing Skills

Which method gives the most accurate respiratory rate?

  1. Count the breaths without telling the resident, while still holding the wrist Correct answer.
  2. Tell the resident you are counting breaths and ask them to breathe normally
  3. Count only the breaths the resident takes through the mouth
  4. Count for five seconds and multiply the number by twelve

Explanation

People change their breathing when they know it is being watched, so the assistant counts respirations without announcing it, often while still appearing to count the pulse. A full minute count gives the most reliable rate.

Question 11Role of the Nurse Assistant and Basic Nursing Skills

A resident can move an arm only with help. How should the nursing assistant perform range-of-motion exercises?

  1. Have the resident push hard against the assistant's hand
  2. Skip the joint whenever the resident says it feels stiff
  3. Support the limb and move the joint slowly and gently Correct answer.
  4. Move the joint quickly up to the point of pain

Explanation

In passive range of motion the assistant supports the limb and moves each joint slowly and gently, stopping short of pain. Forcing a joint or stopping exercises entirely can lead to stiffness and contractures.

Question 12Role of the Nurse Assistant and Basic Nursing Skills

To help prevent pressure injuries, how often should a bedbound resident usually be repositioned?

  1. Once every shift
  2. Only when the resident asks to be moved
  3. About every two hours Correct answer.
  4. Once a day during the bath

Explanation

Repositioning at least every two hours relieves pressure on skin over bony areas and is a standard part of pressure injury prevention. The schedule may be adjusted by the nurse for residents with fragile skin.

Question 13Role of the Nurse Assistant and Basic Nursing Skills

Which is the correct way for a nursing assistant to document care?

  1. Write 'resident was rude again' to describe behavior
  2. Sign a coworker's name when the coworker is busy
  3. Leave out any care the resident refused to keep the record brief
  4. Record what was observed and done, using objective facts Correct answer.

Explanation

Documentation is factual, objective, and complete, describing what was seen and what care was given. Opinions, omissions, and signing for another person make the record unreliable and are prohibited.

Question 14Role of the Nurse Assistant and Basic Nursing Skills

Which action is correct when removing personal protective equipment after resident care?

  1. Pull the gloves off by the fingertips so they snap loose
  2. Remove the gloves and gown, then clean the hands Correct answer.
  3. Hold the used gown against the body while walking to the sink
  4. Touch the front of the mask while taking it off

Explanation

Contaminated items are removed before leaving the room, and hand hygiene is done right after the equipment is off. The outside of gloves and the front of the mask are considered contaminated and are not touched with bare hands.

Question 15Role of the Nurse Assistant and Basic Nursing Skills

A resident drinks 4 ounces of juice, 8 ounces of water, and 6 ounces of tea. What is the total intake in milliliters?

  1. 540 mL Correct answer.
  2. 720 mL
  3. 360 mL
  4. 240 mL

Explanation

The three amounts add up to 18 ounces, and one ounce equals about 30 milliliters, so 18 times 30 gives 540 mL. Intake is recorded in milliliters so the total can be compared with output.

Question 16Role of the Nurse Assistant and Basic Nursing Skills

A resident has trouble swallowing. Which action should the nursing assistant take while feeding?

  1. Have the resident lie flat during the meal
  2. Make sure the resident sits upright and eats slowly Correct answer.
  3. Encourage the resident to eat quickly before the food cools
  4. Give fluids through a straw to make swallowing easier

Explanation

Sitting upright and eating slowly lowers the risk that food or fluid will enter the airway. Straws and a flat position both increase the chance of choking and aspiration.

Question 17Role of the Nurse Assistant and Basic Nursing Skills

The blood pressure cuff available is too small for a resident's arm. How will this affect the reading?

  1. It will make the pulse rate appear faster
  2. It will have no effect on the reading
  3. It will read lower than the true pressure
  4. It will read higher than the true pressure Correct answer.

Explanation

A cuff that is too small requires extra pressure to compress the artery, so the measurement comes out falsely high. The correct cuff size is chosen by matching the bladder to the arm circumference.

Question 18Role of the Nurse Assistant and Basic Nursing Skills

A resident has a physician's order for a physical restraint. How often must the restraint be released and the resident repositioned?

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

Explanation

Restraints are released, the resident repositioned, and needs such as toileting and fluids offered at least every two hours, with more frequent checks in between. This limits the harm that immobility and restraint can cause.

Question 19Role of the Nurse Assistant and Basic Nursing Skills

Which action is correct when caring for a resident who has an indwelling urinary catheter?

  1. Hang the drainage bag on the side rail above the bladder
  2. Keep the drainage bag below the level of the bladder Correct answer.
  3. Clean the outside of the tubing with alcohol every shift
  4. Disconnect the tubing each shift to check for sediment

Explanation

Gravity drainage depends on the bag staying below the bladder, which also prevents urine from flowing back and causing infection. The system is kept closed and is not disconnected for inspection.

Question 20Role of the Nurse Assistant and Basic Nursing Skills

A nursing assistant is collecting a sputum specimen. Which action is correct?

  1. Collect saliva from the mouth into the cup
  2. Hold the cup near the mouth and wait for saliva
  3. Ask the resident to cough sputum into the cup Correct answer.
  4. Label the cup with the roommate's name

Explanation

A sputum specimen must come from deep in the lungs, so the resident is asked to cough up material into the container. Saliva is not sputum and will make the test unreliable.

Question 21Safety and Emergency Procedures

A fire starts in a resident's room. What should the nurse aide do first?

  1. Extinguish the flames with water from the sink
  2. Move the resident out of the room Correct answer.
  3. Close all doors on the unit
  4. Call the resident's family

Explanation

Fire response follows RACE: rescue anyone in immediate danger first, then activate the alarm, confine the fire, and evacuate. Removing the resident from the room is the rescue step and comes before anything else.

Question 22Safety and Emergency Procedures

A nurse aide is using a fire extinguisher on a small fire. Which action is part of the PASS sequence?

  1. Squeeze the handle while sweeping side to side Correct answer.
  2. Spray in short bursts while backing away quickly
  3. Pull the pin after spraying begins
  4. Aim the nozzle at the top of the flames

Explanation

PASS stands for Pull the pin, Aim at the base of the fire, Squeeze the handle, and Sweep side to side. Sweeping while squeezing the handle covers the burning material evenly.

Question 23Safety and Emergency Procedures

Which bed setup best reduces fall risk for a resident who is alert and walks with help?

  1. Bed raised, head at 45 degrees
  2. High bed with both side rails up
  3. Bed in Trendelenburg position
  4. Bed at lowest level, locked Correct answer.

Explanation

A bed at its lowest level with the wheels locked keeps the resident's feet close to the floor and prevents the bed from rolling when weight shifts. High beds increase the distance and severity of any fall.

Question 24Safety and Emergency Procedures

A resident has a physician-ordered vest restraint. How often must the nurse aide check the resident?

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

Explanation

Federal rules require a restrained resident to be checked at least every 15 minutes, with release, repositioning, and needs addressed at regular intervals. Less frequent checks allow injury or circulation problems to go unnoticed.

Question 25Safety and Emergency Procedures

An adult resident is choking, cannot speak, and has a weak cough. What should the nurse aide do?

  1. Offer water to wash the food down
  2. Lay the resident flat and start CPR
  3. Wait for the cough to clear the object
  4. Give abdominal thrusts Correct answer.

Explanation

A choking adult who cannot speak and has a weak cough needs abdominal thrusts to force air out and clear the airway. Coughing is encouraged only while the cough is strong and the person can still breathe.

Question 26Safety and Emergency Procedures

A resident begins having a generalized seizure in bed. Which action should the nurse aide take?

  1. Turn the resident onto the side Correct answer.
  2. Hold the resident's limbs to stop the jerking
  3. Place a spoon between the resident's teeth
  4. Give sips of water once the jerking stops

Explanation

During a seizure, protect the head and turn the person to the side so secretions can drain and the tongue does not block the airway. Never restrain movements or place anything in the mouth.

Question 27Safety and Emergency Procedures

For an adult in cardiac arrest, at what rate should chest compressions be given?

  1. About 150 per minute
  2. About 40 per minute
  3. About 60 per minute
  4. 100 to 120 per minute Correct answer.

Explanation

High-quality CPR for an adult uses compressions at a rate of 100 to 120 per minute with a depth of about 2 inches. Slower or faster rates reduce blood flow to the brain and heart.

Question 28Safety and Emergency Procedures

After a fall, a resident is pale, clammy, and has a rapid pulse. How should the aide position the resident while waiting for help?

  1. Sitting upright with feet down
  2. Lying on the side in a curled position
  3. Flat on the back, legs elevated Correct answer.
  4. Standing to keep blood flowing

Explanation

These are signs of shock, which call for lying flat with the legs elevated to help blood return to the heart and brain while emergency help is summoned. Keep the resident warm and give nothing by mouth.

Question 29Safety and Emergency Procedures

Which item should be kept away from a resident who is receiving oxygen?

  1. A plastic water pitcher
  2. A water-based lotion
  3. Petroleum-based lip balm Correct answer.
  4. Cotton sheets

Explanation

Oxygen supports combustion, so petroleum-based products on the face or hands can ignite and cause burns. Water-based lubricants, cotton linens, and plastic items are safe to use.

Question 30Safety and Emergency Procedures

Before helping a resident into a wheelchair, the aide should first:

  1. Tilt the chair back onto its rear wheels first
  2. Remove the armrests from the chair
  3. Lock the wheels and raise the footplates Correct answer.
  4. Place the chair at the foot of the bed

Explanation

Locking the wheels and moving the footplates out of the way keeps the chair from rolling and gives the resident a clear place to put the feet during the transfer.

Question 31Safety and Emergency Procedures

Which use of a side rail is acceptable?

  1. Rails up to keep a resident from getting out of bed
  2. Rails up on both sides for a confused resident
  3. Rails up as a substitute for a bed alarm
  4. One rail up to help a resident turn in bed Correct answer.

Explanation

A single side rail used to help a resident turn or reposition is a mobility aid, not a restraint. Rails used to keep someone from getting out of bed restrict freedom of movement and require an order and monitoring.

Question 32Safety and Emergency Procedures

Where should the call light be placed for a resident who uses it?

  1. Within reach on the bed or overbed table Correct answer.
  2. Clipped to the IV pole far above the resident's reach
  3. On the wall behind the bed
  4. In the bedside drawer

Explanation

The call light must be within reach so the resident can summon help without getting up, which lowers fall risk. The aide explains how to use it and answers promptly.

Question 33Safety and Emergency Procedures

A bottle of cleaning solution spills on the bathroom floor. What should the aide do first?

  1. Rinse the floor with hot water
  2. Keep residents away and tell the nurse Correct answer.
  3. Mix it with another cleaner to neutralize it
  4. Wipe it up quickly with a cloth and continue care

Explanation

A spilled cleaning product is a hazard to everyone on the unit, so the first step is to keep residents away and notify the nurse or supervisor, who directs cleanup with proper supplies and protective equipment.

Question 34Safety and Emergency Procedures

A resident with dementia is found standing near the unit exit. What is the best action?

  1. Apply a restraint to keep the resident in bed
  2. Tell the resident that leaving is against the rules
  3. Close the resident's door so the exit is out of sight
  4. Walk with the resident back to a safe area Correct answer.

Explanation

A resident with dementia who is heading for an exit should be approached calmly and walked back to a safe area, then the nurse is told so the care plan can be reviewed. Arguing or restraining increases agitation and risk.

Question 35Safety and Emergency Procedures

A resident has a bleeding cut on the forearm that is not spurting. The aide should:

  1. Elevate the arm above the heart for ten minutes
  2. Wash the wound with hydrogen peroxide first
  3. Press firmly on the wound with a clean dressing Correct answer.
  4. Apply a tourniquet above the elbow

Explanation

Direct pressure with a clean dressing slows bleeding and allows a clot to form. Elevation and further medical help follow if bleeding continues.

Question 36Safety and Emergency Procedures

A resident spills hot coffee on the forearm, leaving a reddened area. What should the aide do first?

  1. Hold the arm under cool running water Correct answer.
  2. Apply ice directly to the burned skin
  3. Rub butter or ointment on the burn
  4. Pop any blisters that form

Explanation

Cool running water for about 20 minutes stops the burning process and eases pain. Ice, greasy substances, and opened blisters can damage tissue or lead to infection.

Question 37Safety and Emergency Procedures

The fire alarm sounds and the unit must be evacuated. Which resident should the aide move first?

  1. The resident whose family is visiting now
  2. The resident who can walk without any help
  3. The resident who has lived there longest
  4. The resident closest to the fire Correct answer.

Explanation

Evacuation starts with those in the greatest immediate danger, meaning residents closest to the fire, followed by those who cannot move themselves.

Question 38Safety and Emergency Procedures

A resident falls while the aide is helping her to the bathroom. After the resident is checked, the aide should:

  1. Report the fall to the nurse promptly Correct answer.
  2. Ask the resident's roommate to watch for changes
  3. Wait until the end of the shift to tell the nurse
  4. Document it in the chart as the aide's own note

Explanation

Any fall is reported to the nurse promptly so the resident can be assessed for injury. The aide reports what happened and does not chart assessments or complete incident reports independently.

Question 39Safety and Emergency Procedures

A resident is receiving a warm compress. Which finding should the aide report right away?

  1. The resident's pulse is 78 beats per minute
  2. The compress feels warm to the aide's hand
  3. The skin under the compress is bright red Correct answer.
  4. The resident says the warmth is soothing

Explanation

Bright redness, blistering, or pain during heat application can signal a burn, so the treatment is stopped and reported. Mild warmth and a feeling of comfort are expected.

Question 40Safety and Emergency Procedures

A resident is found holding an empty bottle of mouthwash and is drowsy. What should the aide do first?

  1. Give the resident bread to absorb it
  2. Give the resident a large glass of milk to drink
  3. Call poison control and emergency help Correct answer.
  4. Make the resident vomit right away

Explanation

A drowsy resident with an empty bottle may have swallowed a poison. Emergency help and poison control direct treatment, while the aide stays with the resident and keeps the bottle for reference.

Question 41Infection Control

Standard precautions require the nursing assistant to wear gloves and other personal protective equipment when:

  1. a sign on the door lists precautions
  2. providing care to any resident Correct answer.
  3. the resident tells the assistant about an infection
  4. the charge nurse writes an order for equipment

Explanation

Standard precautions are used with every resident because a person can carry germs without any signs of illness. They are not limited to residents with a known or reported infection.

Question 42Infection Control

The most common way germs spread from one resident to another in a long-term care facility is through:

  1. food served from the kitchen
  2. insects found in the building
  3. the hands of staff and residents Correct answer.
  4. air currents from a central vent

Explanation

Most germs in resident care travel on hands, which touch residents, equipment, and surfaces. That is why hand hygiene is required before and after every contact.

Question 43Infection Control

When removing PPE after resident care, which item is removed first?

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

Explanation

Gloves are the most contaminated item and come off first, without touching the bare skin with the soiled outer surface. Goggles and gown follow, and the mask is removed last after leaving the room, with hand hygiene at the end.

Question 44Infection Control

Clean gloves should be replaced:

  1. only at the end of the shift
  2. whenever the resident asks for new ones
  3. after each pair of residents
  4. whenever they are torn or dirty Correct answer.

Explanation

A torn or soiled glove no longer blocks germs and must be changed at once. Gloves are also changed between residents, with hand hygiene after removal.

Question 45Infection Control

When carrying used bed linens, the nursing assistant should:

  1. press them against the chest for balance
  2. shake them out to remove crumbs
  3. roll them on the floor to save time
  4. hold them away from the body Correct answer.

Explanation

Used linen carries germs and is held away from the uniform so it does not touch clothing or skin. Linen is never shaken, because shaking sends germs into the air, and it goes straight into the laundry bag.

Question 46Infection Control

A resident who is coughing should be taught to:

  1. turn toward the nearest roommate
  2. hold the breath to stop the cough
  3. cough into both open hands
  4. cover the mouth and nose with a tissue Correct answer.

Explanation

Covering coughs with a tissue and then discarding it and cleaning the hands keeps droplets from reaching others. Hands alone are a poor barrier because they then touch people and surfaces.

Question 47Infection Control

A resident has frequent watery stools caused by Clostridioides difficile. The nursing assistant should clean the hands with:

  1. a sanitizing gel over the gloves
  2. an alcohol-based hand rub only
  3. a baby wipe and lotion
  4. soap and running water Correct answer.

Explanation

Alcohol rubs do not reliably kill C. difficile spores, while soap and water with friction lifts and rinses them away. Gloves are worn for care, and hands are washed with soap and water after the gloves come off.

Question 48Infection Control

Which precautions are required for a resident with active tuberculosis?

  1. droplet precautions
  2. contact precautions
  3. protective isolation
  4. airborne precautions Correct answer.

Explanation

Tuberculosis spreads on tiny droplet nuclei that stay suspended in the air, so airborne precautions such as an N95 respirator and a negative-pressure room are used, along with standard precautions.

Question 49Infection Control

A resident on droplet precautions must leave the room for a test. The nursing assistant should:

  1. put a surgical mask on the resident Correct answer.
  2. ask the resident to walk the hallway first
  3. remove the resident's gown before leaving
  4. open the room window during the trip

Explanation

A mask on the resident traps respiratory droplets at the source while the resident is outside the room. Standard precautions and hand hygiene still apply during transport.

Question 50Infection Control

A resident with a draining wound infected with MRSA is on contact precautions. Before entering the room, the nursing assistant puts on:

  1. a gown and an N95 respirator
  2. a gown and gloves Correct answer.
  3. a mask and shoe covers
  4. gloves only

Explanation

Contact precautions require a gown and gloves for every entry into the room, along with equipment kept just for that resident. MRSA spreads by direct and indirect contact, so hand hygiene follows glove removal.