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Pennsylvania CNA study materials
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Pennsylvania CNA practice questions

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Question 1Role of the Nurse Aide

A nurse aide is caring for four residents. Which task falls within the nurse aide's scope of practice?

  1. Inserting a sterile urinary catheter
  2. Completing the admission assessment on a new resident
  3. Bathing a resident and changing the bed linens Correct answer.
  4. Choosing the dose of a resident's pain medication

Explanation

Nurse aides provide basic personal care and comfort measures that do not require a nursing license, and bathing and changing linens are routine personal care. Choosing medication doses, completing initial assessments, and inserting sterile catheters are licensed nursing acts.

Question 2Role of the Nurse Aide

What gives a nurse aide the authority to perform a nursing task for a resident?

  1. Delegation by a licensed nurse under state law Correct answer.
  2. A verbal request from a coworker
  3. Permission from the resident's family
  4. The aide's own judgment that the task is safe to do

Explanation

A nurse aide performs nursing tasks only when a licensed nurse delegates them, and only if state law and facility policy permit that delegation. The aide must also be trained and competent in the task before accepting it.

Question 3Role of the Nurse Aide

A nurse aide notices that a resident's urine is dark and has a strong odor. What should the aide do first?

  1. Wait until the end of the shift to see whether it changes
  2. Call the resident's family to ask what to do
  3. Report the observation to the licensed nurse promptly Correct answer.
  4. Write the finding in the care plan as a nursing diagnosis

Explanation

Nurse aides observe and report but do not diagnose or change the care plan. A change in a resident's condition should be reported to the licensed nurse right away so it can be evaluated.

Question 4Role of the Nurse Aide

At home, a nurse aide talks on the phone about a resident's medical condition. Which statement about this situation is correct?

  1. This is fine as long as the resident's name is left out
  2. This is fine only after the resident is discharged
  3. This is fine if the friend does not know the resident
  4. Resident information must not be shared with outsiders Correct answer.

Explanation

Confidential resident information may be shared only with those who need it to provide care. Discussing a resident at home violates the resident's right to privacy and facility confidentiality policy, even without using a name.

Question 5Role of the Nurse Aide

What is the purpose of the Pennsylvania Nurse Aide Registry?

  1. It tracks aides who met training and competency requirements Correct answer.
  2. It schedules the shifts that each aide must work
  3. It sets the hourly wage that facilities must pay aides
  4. It replaces the facility's own employee personnel file for the aide

Explanation

The state registry documents that an aide completed an approved training and competency evaluation program, which allows the aide to work in Medicare- and Medicaid-certified facilities. It also records substantiated findings of abuse, neglect, or misappropriation of property.

Question 6Role of the Nurse Aide

A nurse aide sees a coworker yell at a resident and roughly grab the resident's arm. What should the aide do?

  1. Report the incident immediately to the charge nurse Correct answer.
  2. Say nothing, because the coworker has more experience
  3. Ask the resident whether they want it reported
  4. Discuss it with other aides before deciding

Explanation

Every member of the care team must report suspected abuse right away, following facility policy and state law. The aide does not investigate, wait for permission, or decide whether the resident wants it reported.

Question 7Role of the Nurse Aide

A resident keeps sliding forward and trying to get out of a chair. What is the nurse aide's best action?

  1. Raise all four side rails without telling the nurse
  2. Tie a sheet around the resident's waist to hold them in the chair
  3. Stay with the resident, offer toileting, and tell the nurse Correct answer.
  4. Ask another aide to hold the resident in the chair

Explanation

A physical restraint may be used only with a physician's order, for a specific medical reason, and never as a convenience or a substitute for supervision. The aide should first look for the cause, such as needing to toilet, and report the behavior to the nurse.

Question 8Role of the Nurse Aide

A nurse aide is charting at the end of the shift. Which entry is written correctly?

  1. Resident was in a terrible mood all afternoon today
  2. At 2:15 p.m., resident drank 120 mL, voided 200 mL Correct answer.
  3. Resident seemed fine, and I did not check on them much
  4. Resident probably has a urinary tract infection now

Explanation

Good charting is objective, specific, timed, and measurable. It records what was observed and done, not opinions, guesses, or diagnoses.

Question 9Role of the Nurse Aide

A licensed nurse asks a nurse aide to do a task the aide has never been trained to do. What should the aide do?

  1. Do the task anyway because the resident needs it done
  2. Refuse the task and walk away without saying anything
  3. Ask another aide to do it quietly and say nothing about it
  4. Tell the nurse the aide is not trained for this task Correct answer.

Explanation

A nurse aide may accept only tasks that have been delegated and that the aide is trained and competent to perform. The aide should tell the nurse so the task can be reassigned or the aide properly trained and supervised.

Question 10Role of the Nurse Aide

A resident has a valid do-not-resuscitate (DNR) order in the chart. The aide finds the resident unresponsive with no pulse. What should the aide do?

  1. Cover the resident and continue rounds quietly
  2. Call for help and follow the DNR order Correct answer.
  3. Begin CPR immediately, as with any resident
  4. Wait for the family to decide what to do

Explanation

When a valid DNR order is in place, CPR is not started. The aide calls for help, stays with the resident, and follows the facility's procedure for a resident who has died.

Question 11Role of the Nurse Aide

A nurse aide photographs a resident's wound to show a friend how bad it looks. This action is:

  1. Acceptable if the aide deletes the photo afterwards
  2. A breach of the resident's privacy that must not happen Correct answer.
  3. Acceptable if the wound heals quickly afterwards
  4. Acceptable if the resident's face is not in the picture

Explanation

Taking or sharing a resident's image without authorization violates the resident's right to privacy and facility policy, even when no name or face appears. Resident photos may be taken only for care purposes and by approved methods.

Question 12Role of the Nurse Aide

Who is responsible for developing a resident's nursing care plan?

  1. The registered nurse Correct answer.
  2. The physical therapy assistant
  3. The nurse aide assigned to the resident
  4. The resident's social worker

Explanation

The registered nurse develops the nursing care plan, often with input from the resident, family, and other team members. Aides contribute observations, but they do not write the plan.

Question 13Role of the Nurse Aide

Under OBRA, what is the minimum number of in-service education hours a nurse aide must complete each year?

  1. At least 4 hours
  2. No in-service hours are required
  3. At least 40 hours
  4. At least 12 hours Correct answer.

Explanation

Federal OBRA requirements call for at least 12 hours of in-service education each year, along with regular performance reviews, so aides keep their skills and knowledge current.

Question 14Role of the Nurse Aide

Two nurse aides disagree about the right way to transfer a resident. What is the best action?

  1. Keep arguing until one of them gives in
  2. Transfer the resident alone so the arguing stops
  3. Postpone the transfer until the next shift
  4. Ask the charge nurse to clarify the correct procedure Correct answer.

Explanation

Disagreements about care should be settled by the licensed nurse, who can clarify the procedure and the care plan. The resident's safety comes first, and the transfer should not be delayed or done unsafely.

Question 15Role of the Nurse Aide

A resident offers a nurse aide $50 for extra help. What should the aide do?

  1. Accept it and share it with the other aides
  2. Accept it but not tell the supervisor
  3. Politely decline and explain the facility's gift policy Correct answer.
  4. Accept it, because the resident offered the money freely

Explanation

Accepting money or gifts from residents is prohibited because it can be seen as taking advantage of a dependent person and may be treated as misappropriation. The aide should decline politely and follow facility policy.

Question 16Role of the Nurse Aide

A nurse aide accidentally documents in the wrong resident's chart. What is the correct action?

  1. Erase the entry carefully so no one can tell it was there
  2. Mark the entry as an error per policy and tell the nurse Correct answer.
  3. Tear the page out of the chart and rewrite it neatly
  4. Leave the entry alone and hope that no one notices it later

Explanation

The chart is a legal record, so entries are corrected according to facility policy, usually with a single line, the word error, the aide's initials, and the date. The nurse must also be told because the wrong chart now contains incorrect information.

Question 17Role of the Nurse Aide

A nurse aide leaves a resident with poor balance standing alone in the bathroom while getting supplies, and the resident falls. This is best described as:

  1. Negligence, because the standard of care was not met Correct answer.
  2. Privacy invasion, because the resident was in the bathroom
  3. Assault, because the resident was frightened
  4. Defamation, because the resident's reputation was harmed

Explanation

Negligence is failing to provide the care a reasonable, prudent aide would provide in the same situation, resulting in harm. Leaving a resident with poor balance unsupported breaches the standard of care.

Question 18Role of the Nurse Aide

A resident is free to be in the dayroom, but a nurse aide locks the resident's wheelchair so they cannot leave. This may be:

  1. Defamation, because the resident's good name was damaged
  2. False imprisonment, because the resident was not free to leave Correct answer.
  3. Negligence, because the aide acted without a nurse's order
  4. Battery, because the resident was touched without consent

Explanation

False imprisonment is restricting a person's movement or freedom without lawful justification. Locking a wheelchair to keep a resident from leaving is an unlawful restriction and must be reported.

Question 19Role of the Nurse Aide

A resident with mild dementia refuses a morning shower but agrees to bathe in the evening. What should the nurse aide do?

  1. Give the shower anyway because hygiene is required
  2. Tell the resident they cannot eat until they shower
  3. Skip all bathing for the rest of the week
  4. Honor the resident's choice and inform the nurse Correct answer.

Explanation

Residents have the right to make choices about their own care, including when to bathe. The aide respects the choice, offers alternatives, and reports the change so the care plan reflects what actually happens.

Question 20Role of the Nurse Aide

A resident complains to a nurse aide about the food. What should the aide do?

  1. Listen, take it seriously, and report it Correct answer.
  2. Say nothing and hope the resident forgets
  3. Tell the resident to stop complaining
  4. Promise the food will be changed tomorrow

Explanation

Residents have the right to voice grievances without fear of retaliation. The aide listens, does not argue or make promises outside their authority, and reports the concern through the proper channel.

Question 21Role of the Nurse Aide

How does a nurse aide contribute to a resident's care plan?

  1. By changing the plan without telling the nurse
  2. By writing new nursing goals into the written plan
  3. By reporting what works and what does not in care Correct answer.
  4. By signing the plan as complete for the year

Explanation

Aides spend the most time providing direct care, so they report observations that help the nurse update the plan. Only the licensed nurse revises the care plan.

Question 22Role of the Nurse Aide

A nurse aide suspects that a resident is being neglected by a family member during visits. What should the aide do?

  1. Confront the family member directly
  2. Wait until there is proof before telling anyone
  3. Ask other residents whether they saw anything
  4. Report the suspicion right away to the nurse Correct answer.

Explanation

Suspected abuse or neglect must be reported immediately to the supervisor and to the state as required by law. The aide does not need proof and does not investigate or confront anyone.

Question 23Role of the Nurse Aide

A nurse aide tells a resident, Get into bed right now or I will make you. The resident is frightened. This may be:

  1. False imprisonment, because the resident could not leave
  2. Defamation, because the resident's reputation was hurt
  3. Negligence, because no physical harm occurred
  4. Assault, because the resident feared harm Correct answer.

Explanation

Assault is a threat that makes a person reasonably fear immediate physical harm, even if no contact occurs. Threatening a resident this way is also a form of verbal abuse and must be reported.

Question 24Role of the Nurse Aide

Which of these is a resident right protected by federal law?

  1. The right to have visitors only when staff are free
  2. The right to have their mail opened and read by staff
  3. The right to be free from restraints used for convenience Correct answer.
  4. The right to keep money only if the administrator agrees

Explanation

Under OBRA, residents have the right to be free from physical and chemical restraints imposed for discipline or convenience. They also have rights to private mail, to visitors, and to manage their own money.

Question 25Role of the Nurse Aide

A nurse aide has several tasks to complete. Which should be done first?

  1. Answering a call light for help with toileting Correct answer.
  2. Filing papers at the nurses' station counter
  3. Making an unoccupied bed in room 112
  4. Restocking the supply closet with linens

Explanation

Call lights and requests for help with toileting are urgent because a resident may fall or become incontinent while waiting. Non-urgent tasks such as bed making, restocking, and filing can wait.

Question 26Role of the Nurse Aide

Which task is within a nurse aide's scope of practice?

  1. Give a resident the prescribed morning pills
  2. Insert a urinary catheter into a resident
  3. Change a sterile surgical dressing
  4. Take a resident's blood pressure Correct answer.

Explanation

Nurse aides are trained and permitted to perform routine tasks such as bathing, feeding, ambulation, and measuring vital signs. Giving medications, inserting catheters, and changing sterile dressings are invasive or licensed procedures that must be done by a licensed nurse.

Question 27Role of the Nurse Aide

During morning care, a resident says, "I feel dizzy and my chest feels tight." What should the nurse aide do?

  1. Write the complaints in the chart and finish the assignment
  2. Tell the resident to rest and check back after lunch
  3. Help the resident walk to the bathroom to see if it passes
  4. Report the complaints to the charge nurse right away Correct answer.

Explanation

Any new or worsening symptom, such as dizziness or chest tightness, must be reported to the licensed nurse promptly so the resident can be assessed. The aide does not evaluate the symptom, delay reporting, or substitute charting for telling the nurse.

Question 28Role of the Nurse Aide

A visitor in the hallway asks a nurse aide, "What is wrong with the man in room 12?" How should the aide respond?

  1. He has pneumonia, but he is getting better each day.
  2. You should look at his chart if you want to know more.
  3. I cannot share information about residents. Correct answer.
  4. Ask the aide who took care of him yesterday.

Explanation

A resident's health information is confidential and may be shared only with those who need it to provide care. The aide must not confirm, deny, or discuss a resident's condition with visitors, family, or other residents.

Question 29Role of the Nurse Aide

What should a nurse aide do before entering a resident's room?

  1. Knock and wait for permission to enter Correct answer.
  2. Enter quickly so the resident is not kept waiting
  3. Call the resident's name from the hallway
  4. Open the door quietly and look inside first

Explanation

Residents have a right to privacy and personal dignity, so the aide knocks, announces themselves, and waits for permission before entering. Entering without permission or calling from the hall does not respect that right.

Question 30Role of the Nurse Aide

A resident with arthritis is able to feed herself but eats very slowly. What is the nurse aide's best action?

  1. Leave the tray and come back after the other residents
  2. Feed the resident so the meal is finished on time
  3. Let the resident eat at her own pace and offer help Correct answer.
  4. Ask the nurse to order a feeding tube for the resident

Explanation

The nurse aide's role includes promoting independence and self-care for as long as the resident is able; eating slowly is acceptable, and the aide can offer setup or encouragement. Taking over feeding or abandoning the tray removes the resident's choice and does not respect dignity.

Question 31Role of the Nurse Aide

A resident tells the nurse aide, "I want to change my living will." What should the aide do?

  1. Report the request to the charge nurse Correct answer.
  2. Explain the choices on the form and help fill it out
  3. Tell the resident that a living will cannot be changed
  4. Write the change in the aide's notes and sign it

Explanation

Advance directives are legal documents, and the aide's role is to bring the resident's wish to the nurse or social worker who can address it. Aides do not explain, complete, or alter these documents themselves.

Question 32Role of the Nurse Aide

While changing the sheets, a nurse aide finds a resident's wallet under the mattress. What should the aide do?

  1. Give it to the charge nurse and document it Correct answer.
  2. Leave it where it was found and say nothing
  3. Look inside the wallet to identify the owner
  4. Keep it in the aide's pocket until the shift ends

Explanation

A resident's belongings are the resident's property, and found items are reported and turned over according to facility policy with documentation. Aides do not search through a resident's belongings or keep them.

Question 33Role of the Nurse Aide

A resident is sitting alone and crying, saying she misses her home. What should the nurse aide do?

  1. Leave the resident alone so they can collect themselves
  2. Listen to the resident and report to the nurse Correct answer.
  3. Tell the resident to focus on the activities offered
  4. Tell the resident that everyone feels sad sometimes

Explanation

When a resident is tearful or upset, the aide listens, offers comfort, and reports the change to the nurse so the care team can follow up. Dismissing the feeling or leaving the resident alone does not meet the resident's psychosocial needs.

Question 34Role of the Nurse Aide

A resident asks the nurse aide for a snack, but the resident has a test scheduled soon and the aide is unsure whether food is allowed. Who should the aide ask?

  1. The resident's roommate
  2. The dietary aide on duty
  3. The charge nurse Correct answer.
  4. An aide with more seniority

Explanation

When an order or instruction is unclear, the aide asks the licensed nurse responsible for the resident's care. Other aides, dietary staff, and other residents cannot clarify whether food is permitted before a procedure.

Question 35Role of the Nurse Aide

Near the end of the shift, a nurse aide realizes that two assigned tasks are unfinished. What should the aide do?

  1. Skip the resident's documentation to save time
  2. Leave a note for the next shift and go home
  3. Sign off on the tasks as if they were completed
  4. Tell the charge nurse which tasks are unfinished Correct answer.

Explanation

Unfinished care is reported to the charge nurse before the aide leaves so the nurse can reassign or complete it. Care is never documented as done when it was not done.

Question 36Role of the Nurse Aide

A resident tells the nurse aide that during a religious holiday she is not allowed to eat meat. What should the aide do?

  1. Tell the charge nurse and the dietitian Correct answer.
  2. Call the resident's church without asking first
  3. Tell the resident that the diet cannot be changed
  4. Ask the other residents what they think

Explanation

The aide respects the resident's religious practices and passes the request to the nurse and dietary staff so it can be addressed within the resident's diet order. Aides do not change diets on their own or contact outside parties without the resident's direction.

Question 37Role of the Nurse Aide

A resident asks the nurse aide personal questions about the aide's recent divorce. How should the aide respond?

  1. Change the subject to the resident's own needs Correct answer.
  2. Ask the resident to stop asking personal questions
  3. Refuse to talk and leave the room at once
  4. Tell the resident all about the aide's divorce

Explanation

The aide keeps the relationship focused on the resident's care and shares little or no personal information. Redirecting the conversation protects both the resident and the aide's professional role.

Question 38Role of the Nurse Aide

A resident's adult child stops the nurse aide in the hallway and demands to see the resident's medical record. What should the aide do?

  1. Refer the family member to the charge nurse Correct answer.
  2. Read the chart aloud to the family in private
  3. Explain the resident's diagnosis in simple terms
  4. Hand over the chart so the family can look

Explanation

A resident's record may be released only through the facility's formal process, usually handled by the nurse or medical records staff. Aides do not show, read, or explain records to family members, even when the request seems reasonable.

Question 39Role of the Nurse Aide

A supervisor asks a nurse aide to make up a resident's vital signs because the aide did not have time to take them. What is the aide's best response?

  1. Refuse the request and report it to the supervisor Correct answer.
  2. Record the made-up numbers to save time
  3. Write the made-up numbers in pencil and fix them later
  4. Ask another aide to sign the vital signs

Explanation

Falsifying documentation is never acceptable, even when a coworker or supervisor asks; the aide refuses and reports the request through the chain of command. Made-up values can hide a real change in the resident's condition and harm the resident.

Question 40Role of the Nurse Aide

A resident with dementia becomes angry during a bath and calls the nurse aide names. What is the aide's best response?

  1. Tell the resident that name-calling is not allowed
  2. Warn the resident that the aide can refuse care
  3. Stay calm, speak kindly, and tell the nurse Correct answer.
  4. Walk away and refuse to care for the resident again

Explanation

Aides respond to difficult behavior calmly and respectfully and report it so the nurse can look for a cause such as pain, fear, or illness. Arguing, threatening, or abandoning the resident is not acceptable, especially when dementia may be driving the behavior.

Question 41Promotion of Safety

A fire starts in a resident's room. According to the RACE sequence, what should the nurse aide do first?

  1. Confine the fire by turning off oxygen
  2. Activate the fire alarm
  3. Close all doors on the unit
  4. Rescue the resident from the room Correct answer.

Explanation

RACE stands for Rescue, Alarm, Confine, and Extinguish or Evacuate, and the steps are performed in that order. The first priority is to remove anyone in immediate danger before sounding the alarm or containing the fire.

Question 42Promotion of Safety

A nurse aide is putting out a small wastebasket fire with a fire extinguisher. Which set of steps follows the PASS technique?

  1. Pull the pin, aim at the base, squeeze, sweep side to side Correct answer.
  2. Aim at the base and spray in one spot until the alarm sounds
  3. Squeeze the handle first, then aim at the smoke and spray
  4. Pull the pin and aim at the top of the flames, then sweep quickly

Explanation

PASS means Pull the pin, Aim at the base of the fire, Squeeze the handle, and Sweep the nozzle from side to side. Aiming at the base puts the extinguishing agent on the burning material rather than on the flames.

Question 43Promotion of Safety

Which resident has the greatest risk for falls?

  1. A resident who takes a diuretic and hurries to the toilet at night Correct answer.
  2. A resident who wears glasses and reads in the dayroom
  3. A resident who uses a cane and always asks for help to the bathroom
  4. A resident who eats in the dining room and walks to activities

Explanation

Fall risk rises with urgency, nocturia, and hurrying, especially in a dark room. A diuretic increases nighttime urination, and rushing to the bathroom adds to the danger.

Question 44Promotion of Safety

A resident has a physician-ordered wrist restraint. Which action by the nurse aide is appropriate?

  1. Loosen the restraint only when the resident complains
  2. Leave the restraint in place during meals so the resident stays safe
  3. Check the skin and remove the restraint for exercise at intervals Correct answer.
  4. Tie the restraint straps tightly to the movable side rail

Explanation

Restraints are released, the skin is checked, and range of motion is provided at scheduled intervals while the resident is monitored frequently. They are never tied to side rails and are removed for meals and whenever the resident can be safely supervised without them.

Question 45Promotion of Safety

A resident begins to have a seizure while sitting in a chair. What should the nurse aide do?

  1. Hold the resident's arms and legs still until the seizure stops
  2. Put a spoon between the teeth to keep the airway open
  3. Give the resident a sip of water to stop the seizure
  4. Ease the resident to the floor and protect the head Correct answer.

Explanation

During a seizure the resident is lowered to a safe surface with the head protected, tight clothing loosened, and hard objects moved away. Nothing is placed in the mouth and the movements are never restrained.

Question 46Promotion of Safety

A resident is choking and cannot speak or cough. What should the nurse aide do?

  1. Wait a few minutes to see if the choking clears
  2. Give abdominal thrusts Correct answer.
  3. Give the resident a glass of water
  4. Lay the resident flat and check the pulse

Explanation

A resident who cannot speak or cough has a completely blocked airway and needs abdominal thrusts immediately. Help is summoned at the same time, because this is a life-threatening emergency.

Question 47Promotion of Safety

A nurse aide finds an unlabeled bottle of cleaning fluid in a resident's bedside stand. What should the nurse aide do?

  1. Pour it into a labeled container and keep it for the unit
  2. Remove it from the resident's room and report it Correct answer.
  3. Use it only on floors, never on surfaces near food
  4. Leave it in place and tell the resident not to drink it

Explanation

An unlabeled chemical cannot be identified, so it is taken out of the resident's area and reported to the nurse or supervisor. Chemicals are never poured into other containers and never left within a resident's reach.

Question 48Promotion of Safety

Which action shows safe use of electrical equipment in a resident's room?

  1. Pulling the plug out by the cord
  2. Keeping cords out from under rugs and furniture Correct answer.
  3. Using an extension cord for the television set
  4. Wiping a plugged-in lamp with a wet cloth and water

Explanation

Cords under rugs or furniture can be damaged, overheat, and start a fire, so they are kept clear. Extension cords are avoided in resident care areas, and electrical items are never handled with wet hands or unplugged by the cord.

Question 49Promotion of Safety

A resident falls in the bathroom but is not injured. What should the nurse aide do?

  1. Tell the family that no report is needed since there is no injury
  2. Report the fall to the nurse and complete an incident report Correct answer.
  3. Wait until the end of the shift to mention the fall
  4. Write the fall in the resident's record as a minor event

Explanation

Every fall, with or without injury, is reported to the nurse promptly and documented through the facility's incident reporting process. Nurse aides report facts; they do not decide whether a report is necessary.

Question 50Promotion of Safety

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

  1. Keep the oxygen tubing coiled under the pillow
  2. Use petroleum jelly on the resident's nose
  3. Post a no-smoking sign and keep flames away Correct answer.
  4. Turn the oxygen flow up if the resident seems short of breath

Explanation

Oxygen supports combustion, so smoking, open flames, and sparks are kept away from the resident and the equipment. Only water-based lubricants are used, and the flow rate is set by the nurse or respiratory therapist, never by the aide.