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Texas CNA practice questions

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Question 1Role of the Nurse Aide

A resident's family member asks a nurse aide to change the dressing on the resident's surgical wound. What is the best response?

  1. Change the dressing because the family member asked politely and it is a simple task
  2. Ask a coworker to change it while the aide watches
  3. Tell the family it is fine and put on a fresh dry bandage
  4. Report the request to the charge nurse and let the nurse perform it Correct answer.

Explanation

Wound care over a surgical site is a nursing procedure that requires a license and training the aide does not have. The aide stays within the assigned role and makes sure the request reaches the licensed nurse.

Question 2Role of the Nurse Aide

A nurse aide needs to report a change in a resident's condition. Which person should the aide notify first?

  1. The resident's physician, before anyone else is told
  2. The resident's family during their next visit
  3. The licensed nurse supervising the resident's care Correct answer.
  4. The facility administrator at the front office

Explanation

The aide reports changes to the licensed nurse who supervises care on the unit, and that nurse decides what happens next. Going around the nurse delays the clinical response.

Question 3Role of the Nurse Aide

Which task can a licensed nurse legally delegate to a trained nurse aide?

  1. Deciding whether a resident's pain medicine is working
  2. Completing the resident's initial admission assessment and care plan
  3. Teaching a resident how to give an insulin injection
  4. Measuring and recording a resident's temperature and pulse Correct answer.

Explanation

Delegation to an aide covers routine tasks that fall within the aide's training, such as vital signs. Assessment, teaching, and evaluation of a resident's response to treatment stay with the licensed nurse.

Question 4Role of the Nurse Aide

Which agency maintains the Texas nurse aide registry?

  1. The Centers for Medicare & Medicaid Services
  2. The facility's human resources department
  3. The Texas Health and Human Services Commission Correct answer.
  4. The Texas Board of Nursing

Explanation

Texas keeps its nurse aide registry under the Texas Health and Human Services Commission, which tracks certification status and findings of abuse, neglect, or misappropriation.

Question 5Role of the Nurse Aide

A nurse aide sees a coworker jerk a resident's arm and speak harshly during a transfer. What should the aide do?

  1. Report it to the charge nurse immediately Correct answer.
  2. Report it only if the resident complains about the coworker first
  3. Wait until the shift ends and mention it to the coworker privately
  4. Say nothing, because the coworker is also certified and knows the rules

Explanation

Rough handling is a form of abuse, and every nurse aide is a mandated reporter. The aide reports right away so the resident is protected and the facility can investigate.

Question 6Role of the Nurse Aide

A nurse aide's friend asks which residents are on the aide's unit. What is the best response?

  1. Tell the friend only about the residents the aide knows well
  2. Explain that resident information cannot be shared Correct answer.
  3. Name the residents, since the friend does not work in health care
  4. Show the friend the assignment sheet in the hallway

Explanation

Information about who lives in a facility is protected health information. The aide may not confirm or discuss residents with anyone who is not involved in their care.

Question 7Role of the Nurse Aide

A resident offers a nurse aide a $50 bill after a morning of care. What should the aide do?

  1. Politely refuse and follow facility policy Correct answer.
  2. Split it with the other aides who helped that morning
  3. Keep it, since the resident is allowed to give gifts
  4. Accept it and tell the nurse later during report

Explanation

Accepting money from a resident creates a conflict of interest and may be considered exploitation. The aide declines politely and follows the facility's gift policy.

Question 8Role of the Nurse Aide

A nurse aide is having money problems and wants advice. What is the most professional action on the job?

  1. Share the details with residents who ask how the aide is doing
  2. Keep personal matters out of care and discuss them off duty Correct answer.
  3. Ask the resident's family for a short-term loan
  4. Bring the problem up in the middle of a care task

Explanation

Personal problems belong outside resident care; discussing them with residents or families blurs professional boundaries. The aide keeps the focus on the resident during work hours.

Question 9Role of the Nurse Aide

A resident has a signed advance directive in the chart. What is the nurse aide's role?

  1. Explain the legal meaning of each document to the resident and family
  2. Honor the resident's wishes and report questions to the nurse Correct answer.
  3. Remove the directive from the chart if the family disagrees
  4. Decide when the directive should be put into effect

Explanation

The aide supports the resident's documented choices and passes any questions along to the licensed nurse. Interpreting and applying advance directives is not an aide task.

Question 10Role of the Nurse Aide

Which task may a nurse aide perform as part of routine resident care?

  1. Flushing a peripheral IV line with saline
  2. Applying lotion to dry skin on a resident's legs Correct answer.
  3. Deciding how much pain medication to give
  4. Changing the oxygen flow rate on a nasal cannula

Explanation

Skin care such as applying lotion is a basic nursing task taught in nurse aide training and done under the care plan. IV lines, oxygen settings, and medication doses are licensed nursing responsibilities.

Question 11Role of the Nurse Aide

A charge nurse tells a nurse aide to insert a urinary catheter because the unit is short-staffed. The aide has never been trained for this. What is the aide's best action?

  1. Perform it because the nurse asked directly
  2. Decline and tell the nurse the task is outside the aide's training Correct answer.
  3. Ask another aide who has watched it once to do it instead
  4. Perform it after watching a short training video online that morning

Explanation

An aide may only perform tasks for which the aide has been trained and that are properly delegated. A nurse's request does not make an untrained, invasive procedure acceptable, so the aide declines and reports the situation.

Question 12Role of the Nurse Aide

Why must a nurse aide complete required in-service education to stay certified?

  1. Only to fill time when the unit is quiet
  2. So the facility can reduce the aide's hourly wage
  3. To keep skills and knowledge current and maintain certification Correct answer.
  4. So the aide can begin performing licensed nursing duties on the unit

Explanation

Continuing education keeps the aide's practice up to date and is required to renew certification and remain employed. It does not expand the aide into licensed duties.

Question 13Role of the Nurse Aide

A resident is found on the floor. After staying with the resident and calling for help, what must the aide do?

  1. Wait until the end of the week to tell the supervisor
  2. Discuss the fall with other residents to find a witness
  3. Report the incident and complete the facility's report Correct answer.
  4. Write in the chart that nothing unusual happened

Explanation

Every fall is reported to the nurse right away and documented through the facility's incident reporting process. Accurate reporting protects the resident and helps prevent repeat falls.

Question 14Role of the Nurse Aide

A nurse aide does not understand a written instruction in the care plan. What is the best action?

  1. Ask the resident to explain what they think it means
  2. Guess at the meaning and continue care
  3. Skip that part of the care and say nothing
  4. Ask the licensed nurse to explain the instruction Correct answer.

Explanation

The aide must understand what is being asked before acting, and the licensed nurse is the right person to clarify. Guessing or skipping care puts the resident at risk.

Question 15Role of the Nurse Aide

A nurse aide's shift has ended but some assigned care is not finished. What should the aide do?

  1. Clock out and finish the care without pay
  2. Ask a resident's family member to finish the care
  3. Report unfinished care to the nurse before leaving Correct answer.
  4. Leave quietly so the next shift does not notice

Explanation

The aide may not simply walk away from unmet resident needs. Unfinished care is handed off by reporting it to the licensed nurse before leaving the unit.

Question 16Role of the Nurse Aide

A nurse aide has several call lights to answer. Which resident should the aide check on first?

  1. A resident who wants the blinds adjusted
  2. A resident who is short of breath and pressing the call light Correct answer.
  3. A resident who needs help choosing clothes for the day
  4. A resident who asks for a glass of water during the meal pass

Explanation

Care is prioritized by urgency, and breathing difficulty is a life-threatening change that needs immediate attention and a report to the nurse. Comfort requests can wait until urgent needs are met.

Question 17Role of the Nurse Aide

A resident can still dress independently but takes a long time. What action best supports the resident's independence?

  1. Tell the resident that dressing will be done by staff from now on
  2. Do the buttons for the resident without asking
  3. Dress the resident quickly so the aide stays on schedule
  4. Allow extra time and encourage the resident to do what they can Correct answer.

Explanation

Restorative care means supporting the resident's own abilities rather than doing everything for them. Allowing time and encouraging self-care preserves strength, dignity, and function.

Question 18Role of the Nurse Aide

A resident asks the nurse aide, "Do I have cancer?" The chart lists a new diagnosis. What is the best response?

  1. Say that the chart has no information about cancer
  2. Tell the resident the exact diagnosis listed in the chart
  3. Change the subject and leave the room quickly
  4. Encourage the resident to ask the nurse or physician Correct answer.

Explanation

Explaining a diagnosis is the responsibility of the licensed nurse or physician. The aide responds with empathy and helps the resident get the information from the right person.

Question 19Role of the Nurse Aide

A nurse aide posts a story on social media about a "funny" thing a resident did, without using the resident's name. Why is this a problem?

  1. It may still identify the resident and violates privacy rules Correct answer.
  2. It is only a problem if a coworker reports it
  3. It is fine if the post is deleted before the end of the shift
  4. It is fine, because no name or room number was used

Explanation

Privacy rules protect any information that could identify a resident, not just names, and details plus a facility location can be enough. Posting about residents is never acceptable.

Question 20Role of the Nurse Aide

A resident refuses a scheduled shower for the third day in a row. What should the aide do?

  1. Insist that the resident shower today for hygiene and skin health
  2. Ask another aide to convince the resident
  3. Document the refusal and try again later without telling anyone
  4. Respect the refusal, offer choices, and report it to the nurse Correct answer.

Explanation

Residents have the right to refuse care, and the aide may offer alternatives without pressuring. Repeated refusals are reported so the nurse can explore the reason and adjust the plan.

Question 21Role of the Nurse Aide

A nurse aide expects to be late for a scheduled shift. What is the correct action?

  1. Arrive late without calling and hope that no one notices the delay
  2. Call the facility as early as possible to report the delay Correct answer.
  3. Ask a coworker to clock in on the aide's behalf
  4. Skip the shift entirely and call in the next morning

Explanation

Staffing depends on aides arriving when scheduled, so the aide notifies the facility promptly so coverage can be arranged. Silence or a substitute clock-in is dishonest and leaves residents short of help.

Question 22Role of the Nurse Aide

A resident follows religious practices that affect food and prayer times. How should the aide respond?

  1. Ignore the request since all residents follow the same routine
  2. Explain that the facility schedule cannot be changed for religion
  3. Ask the resident to keep religious practices private
  4. Respect the practices and report them to the nurse Correct answer.

Explanation

Respecting cultural and religious needs is part of person-centered care. The aide honors the practice and tells the nurse so the care plan and schedule can accommodate it.

Question 23Role of the Nurse Aide

What determines which tasks a nurse aide may legally perform?

  1. Whatever the resident's family requests in writing
  2. The aide's own comfort level and experience
  3. State law and the delegation rules of the nurse practice act Correct answer.
  4. The number of years the aide has worked at the facility

Explanation

An aide's legal limits come from state law and the rules governing delegation from licensed nurses, not from personal confidence or seniority. Duties outside those limits are refused and reported.

Question 24Role of the Nurse Aide

A nurse aide disagrees with how a coworker approaches a resident's care. What is the most professional action?

  1. Post about the situation online without names
  2. Argue with the coworker in front of residents
  3. Discuss the concern privately with the charge nurse Correct answer.
  4. Stop speaking to the coworker for the rest of the shift

Explanation

Concerns about care are handled privately through the chain of command so the nurse can evaluate and correct the issue. Public arguments or silence disrupt the team and leave the problem unresolved.

Question 25Role of the Nurse Aide

A resident is being moved to another unit. What is the nurse aide's role in the transfer?

  1. Sign the transfer orders on behalf of the physician
  2. Pack the resident's belongings as directed by the nurse Correct answer.
  3. Explain the discharge instructions to the family
  4. Give a verbal report of the resident's condition to the receiving nurse

Explanation

The aide helps with tasks such as gathering and labeling belongings and assisting with transport. Clinical reporting, orders, and teaching belong to licensed staff.

Question 26Role of the Nurse Aide

A nurse aide notices a change in a resident's skin. Which team member should the aide inform?

  1. The facility social worker
  2. The resident's family
  3. Another aide on the unit
  4. The nurse in charge Correct answer.

Explanation

Nurse aides observe and report; they do not diagnose or decide on treatment. Observations about a resident's condition go to the licensed nurse responsible for that resident's care. The nurse then decides what action, if any, is needed and who else should be told.

Question 27Role of the Nurse Aide

Which entry is most appropriate for a nurse aide to write in a resident's record?

  1. Resident probably slept poorly
  2. Resident ate half of breakfast Correct answer.
  3. Resident seemed in a bad mood
  4. Resident is difficult to care for

Explanation

Documentation by nursing staff should be factual, specific, and measurable so any team member can understand what happened. Judgments, labels, and guesses do not belong in the record. Reporting what was actually eaten is an objective observation.

Question 28Role of the Nurse Aide

A nurse aide sees a new bruise on a resident's arm that the resident cannot explain. What should the aide do?

  1. Ask other residents how it happened
  2. Report the bruise to the nurse right away Correct answer.
  3. Write it in the chart and tell no one
  4. Wait a few days to see if it fades

Explanation

An unexplained injury may be a sign of abuse or of a medical problem, and both must be reported promptly. Nurse aides are required to report suspected abuse or neglect immediately according to facility policy. Investigating the injury is not the aide's role.

Question 29Role of the Nurse Aide

A resident asks the nurse aide, "What is this new pill for?" What is the best response?

  1. Look the drug up and explain it to the resident
  2. Explain what a coworker said about the drug
  3. Read the label on the bottle to the resident
  4. Tell the resident to ask the nurse Correct answer.

Explanation

Teaching residents about medications is the responsibility of the licensed nurse, not the nurse aide. The aide should refer the question to the nurse and may pass the question along so it is answered. Guessing or reading labels can give wrong or incomplete information.

Question 30Role of the Nurse Aide

A resident's care plan lists a special positioning schedule. What is the nurse aide's role?

  1. Decide whether the schedule suits the resident
  2. Follow the schedule and report problems Correct answer.
  3. Use the schedule only when the nurse is present
  4. Change the schedule when the aide sees fit

Explanation

The care plan is developed by the licensed nurse with the care team and directs the care aides give. The aide carries out the plan and reports what works or does not work. Changing the plan is not within the aide's authority.

Question 31Role of the Nurse Aide

A nurse aide is assigned to a different unit for the shift. What action is most appropriate?

  1. Ask another aide to take the assignment
  2. Check in with the nurse on that unit Correct answer.
  3. Give care the way the home unit does it
  4. Refuse the assignment as unfamiliar

Explanation

When floated, the aide joins a new team and takes direction from the nurse responsible for that unit. That nurse provides information about the residents' needs and the routines in use. Refusing outright or assuming old routines apply can put residents at risk.

Question 32Role of the Nurse Aide

A resident wants to make a private phone call. What should the nurse aide do?

  1. Stay nearby to listen to the call
  2. Provide privacy and time for the call Correct answer.
  3. Ask the resident who is calling
  4. Say calls must wait until after lunch

Explanation

Residents have the right to private communication with whomever they choose. The aide supports that right by helping the resident reach a phone and giving privacy. Listening in or restricting calls violates resident rights.

Question 33Role of the Nurse Aide

A resident tells the nurse aide, "The night aide is rough and it hurts." How should the aide respond?

  1. Listen and report the concern Correct answer.
  2. Promise to keep it a secret
  3. Tell the resident to file a complaint alone
  4. Say the night aide is always gentle

Explanation

Residents have the right to voice grievances without fear of retaliation, and aides must pass concerns to the nurse. Listening respectfully and reporting protects the resident from possible harm. The aide does not judge whether the complaint is valid.

Question 34Role of the Nurse Aide

Two nurse aides are discussing a resident's medical history in the elevator when visitors step in. What should they do?

  1. Finish quickly and change the subject
  2. Lower their voices so visitors cannot hear
  3. Continue, because no names were used
  4. Stop talking until they are alone Correct answer.

Explanation

Resident information may be shared only with team members who need it to provide care, and never where others can overhear. Leaving the conversation unfinished is safer than continuing in public. Using no names does not make the discussion acceptable in a public area.

Question 35Role of the Nurse Aide

A nurse aide notices new swelling in one of a resident's ankles. What is the aide's role?

  1. Report the observation to the nurse promptly Correct answer.
  2. Note the swelling in the chart and wait
  3. Wrap the ankle with an elastic bandage
  4. Elevate the ankle and recheck at the end of the shift

Explanation

A change in a resident's condition must be reported to the licensed nurse, who assesses the resident and decides on treatment. Aides observe and report rather than choose interventions. Delayed reporting could allow a serious problem to worsen.

Question 36Role of the Nurse Aide

During a shift, a nurse aide needs to make a personal phone call about a family matter. What is the best action?

  1. Make the call at the nurses' station while charting
  2. Ask for a break and call privately Correct answer.
  3. Borrow a resident's phone in an empty room
  4. Take the call while walking a resident to the dining room

Explanation

Personal business should be handled away from residents and during break time. Using work areas or resident equipment for personal calls is unprofessional and may expose private information. Asking the nurse for a break keeps resident care covered.

Question 37Role of the Nurse Aide

When should a nurse aide record the care that was provided?

  1. Before the care is given
  2. Right after the care is given Correct answer.
  3. The next morning before report
  4. At the end of the shift all at once

Explanation

Charting should be done as soon as possible after care so the record is accurate and current. The record must never be written before the care or filled in later from memory. Other team members rely on the chart to make care decisions.

Question 38Role of the Nurse Aide

A resident tells the aide, "I get dizzy when I stand, but please don't tell my daughter." What is the best action?

  1. Tell the daughter at her next visit
  2. Keep it private because the resident asked
  3. Report the dizziness to the nurse without promising secrecy Correct answer.
  4. Write the remark in the chart and do nothing more

Explanation

Dizziness on standing is a safety risk that can lead to a fall and must be reported to the nurse. The aide can respect the resident's wish not to tell the daughter while still reporting to the care team, which is not the same as telling family. Promising secrecy would block needed care.

Question 39Role of the Nurse Aide

A coworker asks the aide to sign off on a bed bath the coworker did not give. What should the aide do?

  1. Sign, since the coworker will owe a favor
  2. Sign only if the resident did not notice
  3. Refuse and tell the nurse what happened Correct answer.
  4. Leave the record blank and say nothing

Explanation

Signing for care that was not provided is falsification of a medical record, even when a coworker asks. It also deprives the resident of care the record says was given. The aide must refuse and report the request so the resident receives the care and the record stays truthful.

Question 40Role of the Nurse Aide

A resident asks the aide to sign as a witness on a legal paper about the resident's property. What is the best response?

  1. Sign, but write 'aide' after the signature
  2. Ask a coworker to sign in the aide's place
  3. Sign, because the resident asked and trusts the aide
  4. Politely decline and tell the nurse Correct answer.

Explanation

Nurse aides should not act as witnesses on a resident's legal documents because of the risk of conflict of interest and undue influence. The aide's role is to support the resident's rights, not to take part in legal transactions. Reporting the request lets the nurse help the resident get proper assistance.

Question 41Promotion of Safety

Before assisting a resident to stand, which action is most important for preventing a fall?

  1. Lock the bed wheels. Correct answer.
  2. Raise the bed to its highest level.
  3. Ask the resident to hurry.
  4. Place the call light out of reach.

Explanation

A bed that can roll or shift is a major fall hazard during a transfer. Locking the wheels keeps the bed stable while the resident stands. The bed should also be at a safe height and the resident should never be rushed.

Question 42Promotion of Safety

When should a nursing assistant perform hand hygiene?

  1. Before and after each resident. Correct answer.
  2. Only after visible soiling.
  3. Only at the start of the shift.
  4. Only when gloves are not available.

Explanation

Hand hygiene is required before and after contact with each resident, even when gloves are worn. This prevents the spread of germs between residents and staff. Visible dirt is not required for hand hygiene to be necessary.

Question 43Promotion of Safety

A fire starts on the unit. What should the nursing assistant do first?

  1. Move residents in immediate danger. Correct answer.
  2. Turn off oxygen at the tank.
  3. Call each resident's family.
  4. Close every door on the unit before moving anyone.

Explanation

Fire response begins with rescuing anyone in immediate danger. After residents are moved to safety, staff activate the alarm, contain the fire by closing doors, and evacuate as directed. Family notification is not the first priority.

Question 44Promotion of Safety

Which action shows correct body mechanics when lifting?

  1. Hold the load away from the body.
  2. Lift using the back muscles.
  3. Twist the body while lifting.
  4. Bend at the knees. Correct answer.

Explanation

Bending at the knees and keeping the back straight uses the strong leg muscles and lowers injury risk. The load should be held close to the body, and twisting should be avoided. Lifting with the back muscles strains the spine.

Question 45Promotion of Safety

What is the best way to reduce a resident's risk of falling when leaving the room?

  1. Keep the call light within reach. Correct answer.
  2. Place the call light on the far wall.
  3. Put the call light under the pillow.
  4. Leave the call light on the floor.

Explanation

Residents who can reach the call light are less likely to try to get up alone. The light should be placed where the resident can use it without stretching or climbing. Hiding or dropping the light removes the resident's way to call for help.

Question 46Promotion of Safety

How should the nursing assistant confirm a resident's identity before giving care?

  1. Call the resident by a nickname.
  2. Use two identifiers. Correct answer.
  3. Ask the roommate to confirm the name.
  4. Check the room number only.

Explanation

Two identifiers, such as name and date of birth, are used to confirm identity before care. Room numbers and nicknames are not reliable identifiers. The resident's wristband or a conscious resident's statement can be used.

Question 47Promotion of Safety

Before transferring a resident into a wheelchair, what should the nursing assistant do?

  1. Leave the seat belt unfastened.
  2. Stand on the wheelchair footrests.
  3. Lock the wheelchair wheels. Correct answer.
  4. Tip the chair backward before transfer.

Explanation

Locking the wheels keeps the wheelchair from rolling away during the transfer. The footrests should be moved out of the way, not used as a step. The seat belt is fastened after the resident is seated.

Question 48Promotion of Safety

A resident spills water on the bathroom floor. What should the nursing assistant do?

  1. Clean it and post a wet-floor sign. Correct answer.
  2. Cover it with a towel and walk away.
  3. Leave it for housekeeping to clean at the end of shift.
  4. Spread it to dry faster.

Explanation

Spills should be cleaned up promptly to prevent slips and falls. A wet-floor sign warns others while the area is still damp. Leaving a spill or covering it does not remove the hazard.

Question 49Promotion of Safety

Which is an acceptable alternative to using a restraint on a restless resident?

  1. Raise all four side rails at night.
  2. Tie a sheet across the resident's chest.
  3. Apply a vest to keep the resident seated.
  4. Stay with the resident during a procedure. Correct answer.

Explanation

Restraints are used only when less restrictive measures fail and are ordered by a provider. Staying with the resident, redirecting, or offering activities are preferred alternatives. Sheets, vests, and all four side rails can act as restraints and are not acceptable substitutes.

Question 50Promotion of Safety

A resident begins to have a seizure. What should the nursing assistant do?

  1. Give water as soon as it stops.
  2. Hold the arms and legs still.
  3. Protect the head from injury. Correct answer.
  4. Place a spoon between the teeth.

Explanation

During a seizure, the priority is protecting the resident from injury, especially to the head. Objects should never be placed in the mouth, and the limbs should not be restrained. Care is given after the seizure according to the care plan.