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North Carolina CNA practice questions

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Question 1Personal Care and Activities of Daily Living

A nurse aide is about to begin morning care for a resident. What should the aide do first?

  1. Fill the basin with hot water from the tap
  2. Wash hands with soap and warm water Correct answer.
  3. Put on gloves and start the bath
  4. Ask the resident to sit on the bed edge

Explanation

Hand hygiene is performed before any resident contact and before gloves are applied. Gloves are not a substitute for handwashing, and water temperature must be checked before use.

Question 2Personal Care and Activities of Daily Living

When giving a bed bath, the nurse aide should use water that is

  1. steaming hot to kill germs
  2. as hot as the resident can tolerate
  3. warm, not hot Correct answer.
  4. cold to cool

Explanation

Bath water should be comfortably warm because hot water can burn or dry fragile skin, and the aide must test the temperature first. Very hot water is never used on a resident's skin.

Question 3Personal Care and Activities of Daily Living

A resident who is unconscious needs mouth care. How should the nurse aide position the resident?

  1. Sitting fully upright in a chair
  2. Flat on the back with the head level
  3. On the side with the head turned to the side Correct answer.
  4. On the stomach with the face down

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 reduces the risk of aspiration.

Question 4Personal Care and Activities of Daily Living

To help prevent pressure injuries, the nurse aide should reposition an immobile resident at least every

  1. 8 hours
  2. 4 hours
  3. 2 hours Correct answer.
  4. 6 hours

Explanation

Standard practice is to turn and reposition an immobile resident at least every two hours, and more often if the skin is fragile. Pressure on one area for long periods damages skin and tissue.

Question 5Personal Care and Activities of Daily Living

A resident is taking a shower. Which action keeps the resident safest?

  1. Lock the bathroom door during the shower
  2. Place a nonskid mat on the shower floor Correct answer.
  3. Turn the water to the hottest setting
  4. Leave the resident alone to protect privacy

Explanation

Wet shower floors are slippery, so a nonskid surface is a key fall precaution. The aide stays within reach and never locks the door, because a locked door blocks help in an emergency.

Question 6Personal Care and Activities of Daily Living

An alert resident can drink fluids independently. What should the nurse aide do?

  1. Restrict fluids after 4 pm every day
  2. Offer fluids often and record the amounts Correct answer.
  3. Withhold fluids until the next meal
  4. Give only ice chips instead of liquids

Explanation

Residents need frequent offers of fluids to prevent dehydration, and intake is measured and recorded. Fluid restrictions are ordered by the healthcare provider, not decided by the aide.

Question 7Personal Care and Activities of Daily Living

When cleaning a resident's eyeglasses, the nurse aide should

  1. clean them with a scouring pad and soap
  2. store them face down on the nightstand
  3. rinse them in very hot water and bleach
  4. use warm water and dry with a soft cloth Correct answer.

Explanation

Warm water and a soft cloth clean lenses without scratching them, and the glasses are stored in a case when not worn. Harsh chemicals and abrasive materials damage lenses and frames.

Question 8Personal Care and Activities of Daily Living

A resident will receive a bath. Which action protects the resident's privacy?

  1. Keeping the privacy curtain pulled back
  2. Bathing the resident in a public hallway
  3. Closing the door and using the privacy curtain Correct answer.
  4. Leaving the bathroom door open

Explanation

Exposing a resident's body unnecessarily violates dignity and privacy rights. Doors, curtains, and drapes are used to keep the resident covered as much as possible during care.

Question 9Personal Care and Activities of Daily Living

After using the toilet, a female resident needs perineal care. The nurse aide should wash

  1. in circles around the anus, then forward
  2. from the front toward the back Correct answer.
  3. only the outer skin with a dry cloth
  4. from the back toward the front

Explanation

Washing from the front toward the back keeps bacteria from the anal area away from the urinary opening. This direction reduces the risk of urinary tract infection.

Question 10Personal Care and Activities of Daily Living

Which action is correct when caring for a resident's dentures?

  1. Soak them in bleach overnight every night
  2. Line the sink and use cool water Correct answer.
  3. Rinse them in hot water to kill bacteria
  4. Clean them with hot water and toothpaste

Explanation

Dentures can break or warp, so a towel or basin liner is placed in the sink as a cushion and cool or lukewarm water is used. Hot water warps the material and bleach damages dentures and tissues.

Question 11Personal Care and Activities of Daily Living

While giving catheter care, the nurse aide should

  1. clean from the bag upward toward the body
  2. pull gently on the tubing to test it
  3. disconnect the tubing to wash it in the sink
  4. clean away from the meatus, downward Correct answer.

Explanation

The catheter is cleaned starting at the point where it enters the body and moving away, so bacteria are not carried into the urinary tract. The closed drainage system is never disconnected by the aide.

Question 12Personal Care and Activities of Daily Living

How often should the nurse aide offer oral care to a resident who wears dentures?

  1. Once a week
  2. Only before bedtime
  3. After breakfast only
  4. Twice a day and after meals Correct answer.

Explanation

Mouth care is provided at least twice daily and after meals to remove food and bacteria. Dentures are also removed and cleaned as part of that routine.

Question 13Personal Care and Activities of Daily Living

When making an occupied bed, the nurse aide should

  1. shake soiled linens in the air to remove crumbs
  2. raise the bed to a safe working height Correct answer.
  3. leave the side rail down on the far side
  4. roll the resident onto the stomach to change linens

Explanation

Raising the bed to waist height protects the aide's back and keeps the resident safe from falling. Soiled linens are rolled inward and never shaken, because shaking spreads germs into the air.

Question 14Personal Care and Activities of Daily Living

Before shaving a resident with an electric razor, the nurse aide should

  1. check the skin for cuts or irritation Correct answer.
  2. warm the razor in hot water for a minute
  3. apply thick shaving cream to the face
  4. use a blade razor if the hair is long

Explanation

The skin is checked first so areas of irritation, cuts, or rashes can be avoided and reported. Electric razors are used on dry skin without shaving cream.

Question 15Personal Care and Activities of Daily Living

When a resident's hearing aid is not being worn, the nurse aide should

  1. turn it off and store it in its case Correct answer.
  2. leave it on the bedside table uncovered
  3. wash it in warm soapy water
  4. keep it turned on and in the resident's ear

Explanation

Hearing aids are turned off when removed, the battery compartment is opened, and the device is stored in a labeled case. Water and heat damage the electronics.

Question 16Personal Care and Activities of Daily Living

A nurse aide is helping a resident perform range-of-motion exercises. The aide should

  1. skip joints that the resident says are stiff
  2. move the joint quickly to save time
  3. force the joint past the point of resistance
  4. stop if the resident reports pain Correct answer.

Explanation

Exercises are done slowly and gently within the resident's comfort, and pain is a signal to stop and report. Forcing a joint can cause injury.

Question 17Personal Care and Activities of Daily Living

Before shampooing a resident's hair in bed, the nurse aide should

  1. cut out mats with scissors
  2. braid the hair before washing it
  3. comb the hair to remove tangles Correct answer.
  4. apply very hot water to loosen dirt

Explanation

Gently combing out tangles first makes washing easier and avoids pulling on the scalp. Hot water is not used, and mats are worked out gradually rather than cut.

Question 18Personal Care and Activities of Daily Living

When helping a resident to stand from a chair, the nurse aide should

  1. let the resident wrap arms around the aide's neck
  2. grip the gait belt at the waist Correct answer.
  3. lift with the back and keep the feet together
  4. pull upward on the resident's arms

Explanation

The gait belt gives the aide a secure hold at the resident's waist without pulling on the arms or neck. The aide bends the knees and keeps a wide base of support while lifting.

Question 19Personal Care and Activities of Daily Living

A resident has trouble swallowing. Which action is safest while feeding the resident?

  1. Offer thin liquids through a straw
  2. Feed quickly so the food stays warm
  3. Have the resident sit upright for meals Correct answer.
  4. Let the resident talk while chewing

Explanation

Sitting upright lets food and fluid move down safely with gravity and lowers the risk of aspiration. Talking while chewing and using a straw both increase choking risk.

Question 20Personal Care and Activities of Daily Living

While giving a bath, the nurse aide sees a red area over the resident's hip that does not fade when pressed. What should the aide do?

  1. Apply lotion and recheck in one week
  2. Report it to the nurse and avoid pressure Correct answer.
  3. Cover it with a bandage and wait
  4. Rub the area to increase blood flow

Explanation

A red area that does not blanch is an early pressure injury and must be reported to the nurse. Pressure is kept off the area, and it is never massaged, because rubbing causes more tissue damage.

Question 21Personal Care and Activities of Daily Living

A resident who is incontinent of urine needs care. The nurse aide should

  1. restrict the resident's fluids all day
  2. leave the wet brief on for the shift
  3. use powder to cover the wet skin
  4. wash and dry the skin before a new brief Correct answer.

Explanation

Urine left on the skin breaks it down and leads to rash or pressure injury, so the skin is cleaned and dried thoroughly before a fresh brief is applied. Fluids are not restricted without an order.

Question 22Personal Care and Activities of Daily Living

A resident with a weak right leg uses a cane. Where should the cane be placed when walking?

  1. In either hand, held still while stepping
  2. In the right hand, moved with the weak leg
  3. In the left hand, moved with the weak leg Correct answer.
  4. In the left hand, moved before the strong leg

Explanation

The cane is held on the unaffected side and moves forward at the same time as the weak leg. This shifts weight away from the weak side and gives the most stable support.

Question 23Personal Care and Activities of Daily Living

A resident must be turned using the logrolling method. The nurse aide should

  1. turn the shoulders first, then the hips
  2. keep the spine straight and turn as one unit Correct answer.
  3. lift the hips, then the head and shoulders
  4. pull the resident toward you by the shoulders

Explanation

Logrolling keeps the head, trunk, and hips aligned and moves the body as a single unit, which protects the spine. Twisting the body during the turn can cause injury.

Question 24Personal Care and Activities of Daily Living

A resident with diabetes asks the nurse aide to trim the toenails. The aide should

  1. soak the feet in hot water first, then cut
  2. cut the corners down to prevent ingrown nails
  3. tell the nurse and let a podiatrist do it Correct answer.
  4. trim the nails very short with scissors

Explanation

Diabetes causes poor circulation and reduced sensation in the feet, so even a small cut can become an infection that heals poorly. Nail trimming for these residents is done by a podiatrist or per facility policy.

Question 25Personal Care and Activities of Daily Living

A resident has weakness on the left side after a stroke. When helping the resident dress, the nurse aide should

  1. put the shirt on the right arm first
  2. put the shirt on the left arm first Correct answer.
  3. let the resident dress without any help
  4. dress the left arm last and undress it last

Explanation

Clothing goes on the affected side first and comes off the affected side first, so the weak limb is not forced through sleeves. The resident is encouraged to do as much as possible with the strong side.

Question 26Personal Care and Activities of Daily Living

When preparing a tub bath for a resident, the nurse aide should make sure the water is

  1. cool, about 80 degrees Fahrenheit
  2. warm, about 105 degrees Fahrenheit Correct answer.
  3. hot, about 120 degrees Fahrenheit
  4. cold, with ice added for comfort

Explanation

Bath water should be comfortably warm, roughly 100 to 105 degrees Fahrenheit, because hot water can burn or dry fragile skin and cold water is uncomfortable. The aide stays with the resident and never leaves a resident alone in the tub.

Question 27Personal Care and Activities of Daily Living

Before serving a meal tray to a resident, the nurse aide should

  1. compare the diet card with the tray Correct answer.
  2. ask the resident to choose a different meal
  3. taste the food to check the seasoning
  4. remove the cover and let the food sit for 30 minutes

Explanation

Comparing the diet card to the tray verifies that the resident receives the prescribed diet and that the tray belongs to that resident. This check prevents allergic reactions and errors such as giving thickened liquids or a low-sodium diet to the wrong person.

Question 28Personal Care and Activities of Daily Living

A resident stays in bed most of the day. The nurse aide should make sure the call light and personal items are

  1. stored in the closet
  2. locked in the bedside drawer
  3. kept in the hallway
  4. placed within easy reach Correct answer.

Explanation

Items a resident uses daily, along with the call light, belong within reach so the resident can stay independent and summon help without stretching or climbing out of bed. This reduces falls and promotes dignity.

Question 29Personal Care and Activities of Daily Living

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

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

Explanation

Residents who cannot reposition themselves are usually turned at least every two hours, and more often if the care plan says so, to relieve pressure over bony areas. Frequent turning also gives the aide a chance to check the skin.

Question 30Personal Care and Activities of Daily Living

When applying elastic stockings to a resident, the nurse aide should

  1. apply them before the resident gets up Correct answer.
  2. put them on after the resident walks
  3. rub lotion on the legs first
  4. roll the tops down to the ankle

Explanation

Elastic stockings work best when applied in the morning before the resident gets out of bed, before swelling develops in the legs. The aide checks the skin, smooths out wrinkles, and leaves the tops in place rather than rolling them down.

Question 31Personal Care and Activities of Daily Living

A resident has weakness on the left side after a stroke. When feeding this resident, the nurse aide should place food

  1. in the cheek on the weak side
  2. on the back of the tongue
  3. on the right side of the mouth Correct answer.
  4. on the left side of the mouth

Explanation

Food is placed on the stronger, unaffected side of the mouth so the resident can move it around and swallow it more safely. Food pocketed in the weak cheek can be missed and later cause choking.

Question 32Personal Care and Activities of Daily Living

When giving a resident a back massage, the nurse aide should

  1. use vigorous strokes over the shoulder blades
  2. massage for at least 15 minutes
  3. avoid reddened areas over bony prominences Correct answer.
  4. apply alcohol to cool the skin

Explanation

Reddened areas over bony prominences may already be pressure damage, and massaging them can cause further injury. The aide uses gentle strokes with lotion on intact skin and reports any redness that does not fade.

Question 33Personal Care and Activities of Daily Living

When washing a resident's feet, the nurse aide should

  1. soak the feet for at least 30 minutes
  2. use hot water to improve circulation
  3. cut blisters open to drain them
  4. dry carefully between the toes Correct answer.

Explanation

Moisture trapped between the toes softens the skin and encourages fungal growth, so the toes are dried thoroughly. Any blisters, cracks, or red areas are reported rather than treated by the aide.

Question 34Personal Care and Activities of Daily Living

A resident who recently had hip surgery must stay flat and cannot lift the hips. Which item should the nurse aide use when the resident needs to have a bowel movement?

  1. a warmed regular bedpan
  2. a standard bedpan
  3. an incontinence brief instead
  4. a fracture pan Correct answer.

Explanation

A fracture pan is shallow with a handle, so it can be slipped under a resident who cannot raise the hips, such as after hip surgery. Leaving the resident in stool in a brief is not an acceptable substitute for toileting.

Question 35Personal Care and Activities of Daily Living

When giving a bed bath, the nurse aide should wash the resident's

  1. clean areas before soiled areas Correct answer.
  2. feet first, then the face
  3. the back first, then the face
  4. the perineum before the face

Explanation

Washing proceeds from the cleanest area to the dirtiest so that soil from one part of the body is not carried to another. The face and upper body are washed first, with the perineal area and buttocks left for last.

Question 36Personal Care and Activities of Daily Living

A resident can put on a shirt but needs help with buttons. The nurse aide should

  1. choose a shirt without buttons
  2. dress the resident fully
  3. button the shirt first
  4. let the resident do the parts they can Correct answer.

Explanation

Self-care is encouraged by letting residents do whatever they are able and helping only with the parts they cannot manage. Doing the whole task for the resident takes away exercise, choice, and a sense of control.

Question 37Personal Care and Activities of Daily Living

When caring for a resident's fingernails, the nurse aide should

  1. use the same nail file for all residents
  2. soak the hands for 30 minutes first
  3. file the nails in one direction Correct answer.
  4. cut the cuticles to keep them neat

Explanation

Filing in one direction prevents the nail from splitting and tearing, and individual equipment is used for each resident. Cuticles are never cut because breaks in the skin around the nail invite infection.

Question 38Personal Care and Activities of Daily Living

A resident is unconscious. When providing mouth care, the nurse aide should

  1. keep the resident flat on the back and brush vigorously
  2. give sips of water so the resident can rinse
  3. turn the head to the side and use small amounts of fluid Correct answer.
  4. hold the mouth open with a tongue blade and swab deeply

Explanation

An unconscious resident cannot swallow or protect the airway, so the head is turned to the side and only small amounts of fluid are used, with suction ready if available. Mouth care is still needed regularly for comfort and to keep the mouth clean.

Question 39Personal Care and Activities of Daily Living

A resident had hip replacement surgery. Which action should the nurse aide take when helping with personal care?

  1. have the resident lean forward to reach the toes
  2. help the resident cross the legs to wash the feet
  3. raise the knees toward the chest to wash the legs
  4. keep the legs apart and limit hip bending Correct answer.

Explanation

After hip replacement, hip precautions limit bending the hip past 90 degrees and keep the legs from crossing, which can dislocate the new joint. The aide supports the legs apart and asks the resident to avoid reaching down for the feet.

Question 40Personal Care and Activities of Daily Living

A resident with dementia becomes upset and refuses a bath. The nurse aide should

  1. stop and try again later using a calm approach Correct answer.
  2. have two aides hold the resident still
  3. finish the bath quickly while the resident objects
  4. tell the resident the bath is required today

Explanation

A resident who resists care is not forced; the aide stops, stays calm, and tries again later, perhaps breaking the task into smaller steps. Refusals and any change in behavior are reported to the nurse.

Question 41Safety, Infection Control, and Emergency Care

A resident has diarrhea caused by Clostridioides difficile. Which action is required after providing care?

  1. Wash hands with soap and water Correct answer.
  2. Use an alcohol-based hand rub
  3. Wipe hands with a disinfectant wipe
  4. Wear gloves instead of washing hands

Explanation

Alcohol-based hand rubs do not reliably destroy C. difficile spores, so soap and water handwashing is required after contact with an affected resident. Gloves are worn during care but never replace hand hygiene.

Question 42Safety, Infection Control, and Emergency Care

When preparing to enter a resident's room, which item of personal protective equipment should be applied first?

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

Explanation

The standard donning order is gown first, then mask or respirator, then eye protection, and gloves last so they cover the gown cuffs. Following a consistent order reduces the chance of contaminating already-applied equipment.

Question 43Safety, Infection Control, and Emergency Care

An aide discovers a fire in a resident's room. What is the first priority?

  1. Close all doors on the unit
  2. Activate the fire alarm
  3. Extinguish the fire
  4. Move residents in danger to safety Correct answer.

Explanation

The RACE sequence begins with rescuing anyone in immediate danger, followed by activating the alarm, confining the fire, and then extinguishing or evacuating. Human life takes priority over property and equipment.

Question 44Safety, Infection Control, and Emergency Care

A resident is choking, cannot speak, and is turning blue. What should the aide do?

  1. Sweep the mouth with a finger
  2. Give sips of water
  3. Start chest compressions
  4. Give abdominal thrusts Correct answer.

Explanation

A resident who cannot speak or cough has a complete airway obstruction and needs abdominal thrusts (Heimlich maneuver) immediately. Blind finger sweeps can push the object deeper, and fluids or compressions are not the correct first response for a conscious choking adult.

Question 45Safety, Infection Control, and Emergency Care

What is the correct rate for chest compressions during adult CPR?

  1. 100 to 120 per minute Correct answer.
  2. 140 to 160 per minute
  3. 60 to 80 per minute
  4. 80 to 100 per minute

Explanation

Current CPR guidelines call for compressions at a rate of 100 to 120 per minute in adults. Rates that are too slow or too fast reduce the effectiveness of circulation.

Question 46Safety, Infection Control, and Emergency Care

Under standard precautions, the aide should wear gloves when anticipating which type of contact?

  1. Only with residents who have a diagnosed infection
  2. Only when the resident requests it
  3. Only inside an isolation room
  4. Contact with blood or body fluids Correct answer.

Explanation

Standard precautions apply to every resident regardless of diagnosis; gloves are worn whenever contact with blood, body fluids, secretions, excretions, mucous membranes, or non-intact skin is likely. Relying on a known diagnosis would miss many sources of infection.

Question 47Safety, Infection Control, and Emergency Care

Which action best helps prevent falls for a resident who is unsteady when walking?

  1. Keep the room dim so the resident sleeps
  2. Ask the resident to call only for emergencies
  3. Apply a vest restraint at bedtime
  4. Keep the bed low with the call light in reach Correct answer.

Explanation

A low bed and an accessible call light reduce the chance that a resident will attempt an unassisted transfer or climb over rails. Restraints increase injury risk and require a physician's order, and discouraging calls for help raises fall risk.

Question 48Safety, Infection Control, and Emergency Care

An aide is stuck by a contaminated needle. What should the aide do first?

  1. Cover the site with a bandage
  2. Squeeze the puncture site hard
  3. Wash the site with soap and water Correct answer.
  4. Report it at the end of the shift

Explanation

The exposed area should be washed promptly with soap and water to reduce contamination, and the exposure must then be reported immediately so post-exposure evaluation can begin. Squeezing or milking the wound is discouraged because it can force contaminants deeper into tissue.

Question 49Safety, Infection Control, and Emergency Care

Which personal protective equipment is required when entering the room of a resident with active pulmonary tuberculosis?

  1. A surgical mask
  2. An N95 respirator Correct answer.
  3. A face shield
  4. Gloves and a gown only

Explanation

Tuberculosis spreads by the airborne route, so a fit-tested N95 or higher-level respirator is required along with a negative-pressure room. A surgical mask does not seal tightly enough to filter small droplet nuclei.

Question 50Safety, Infection Control, and Emergency Care

A resident is having a tonic-clonic seizure. Which action is appropriate?

  1. Hold the arms and legs still
  2. Give water once the shaking stops
  3. Place a spoon between the teeth
  4. Ease the resident to the floor and protect the head Correct answer.

Explanation

During a seizure the aide should protect the resident from injury by guiding them to the floor, cushioning the head, and clearing nearby hazards. Nothing is placed in the mouth and the movements are never restrained.