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Washington CNA practice questions

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Question 1Physical Care Skills: Activities of Daily Living

When should a nursing assistant perform hand hygiene?

  1. At the start of each shift
  2. Before and after contact with each resident Correct answer.
  3. Only after removing gloves
  4. Only when the hands are visibly soiled

Explanation

Hand hygiene is performed before and after every contact with a resident and again after gloves are removed. Gloves can have tiny defects and do not remove organisms from the hands.

Question 2Physical Care Skills: Activities of Daily Living

How should the NA give mouth care to an unresponsive resident?

  1. Turn the head to the side and suction as needed Correct answer.
  2. Skip mouth care until the resident is fully awake
  3. Place a small amount of water in the mouth to rinse it
  4. Brush the teeth with the head flat and the mouth closed

Explanation

An unresponsive resident cannot swallow or clear secretions, so the head is turned to the side and suction must be available. Only a small amount of solution is used and the mouth is not rinsed with water that could be aspirated.

Question 3Physical Care Skills: Activities of Daily Living

How should the NA care for a resident's dentures when they are not being worn?

  1. Leave them on the sink for the next shift
  2. Wrap them in a tissue and set them on the nightstand
  3. Soak them overnight in hot water
  4. Store them in a labeled cup of cool water Correct answer.

Explanation

Dentures are kept moist so they do not warp and are stored in a labeled container so they are not lost or confused with another resident's. Hot water can distort the plastic.

Question 4Physical Care Skills: Activities of Daily Living

In which direction should the NA wash a female resident's perineal area?

  1. Use one part of the washcloth for the whole area
  2. Wipe side to side across the perineum
  3. Wipe from the rectum toward the urinary meatus
  4. Wipe from the urinary meatus toward the rectum Correct answer.

Explanation

Cleansing from the urinary meatus toward the rectum moves organisms away from the urethra and reduces the risk of urinary tract infection. A clean area of the cloth is used for each stroke.

Question 5Physical Care Skills: Activities of Daily Living

How should the NA handle soiled linens removed from a bed?

  1. Shake them out over the bed to remove crumbs
  2. Set them on the floor until the bed is done
  3. Stack them on the chair beside the bed
  4. Hold dirty linens away from the body Correct answer.

Explanation

Soiled linens are held away from the uniform and placed directly in the hamper to prevent the spread of microorganisms. Linens are never shaken, placed on the floor, or left on furniture in the room.

Question 6Physical Care Skills: Activities of Daily Living

When feeding a resident who has trouble swallowing, the NA should:

  1. Offer fluids through a straw to speed the meal
  2. Place food on the weaker side of the mouth
  3. Give small bites and check the mouth is empty Correct answer.
  4. Feed quickly so the food stays warm

Explanation

Small bites and an empty mouth before the next bite reduce the risk of choking and aspiration in a resident with swallowing difficulty. Straws and rapid feeding increase that risk.

Question 7Physical Care Skills: Activities of Daily Living

How often should the NA reposition a resident who is on bed rest?

  1. Only when the resident complains
  2. Every 6 hours
  3. Once each shift
  4. At least every 2 hours Correct answer.

Explanation

Pressure on the skin is relieved by turning and repositioning at least every 2 hours while the resident is in bed. Waiting for the resident to complain allows tissue damage to develop.

Question 8Physical Care Skills: Activities of Daily Living

A resident with diabetes asks for nail care. What should the NA do?

  1. Check facility policy, which may require a podiatrist Correct answer.
  2. Trim corns and calluses with scissors before soaking
  3. Soak the feet in hot water before cutting the nails
  4. Cut the toenails short in a rounded curve with clippers

Explanation

Residents with diabetes often have poor circulation and reduced sensation in the feet, so nail and foot care may be assigned to a podiatrist by facility policy. The NA never trims corns, calluses, or cuts into the skin.

Question 9Physical Care Skills: Activities of Daily Living

When giving a bed bath, how should the NA wash the eyes?

  1. Last, after the chest and abdomen
  2. From the outer corner inward with soapy water
  3. Inner corner outward, new cloth area each eye Correct answer.
  4. Using the same part of the washcloth for both eyes

Explanation

The eye is cleansed from the inner corner outward, away from the tear duct, and a different area of the cloth is used for each eye. This prevents drainage from one eye being carried to the other.

Question 10Physical Care Skills: Activities of Daily Living

Which action is correct when providing catheter care?

  1. Hang the drainage bag on the side rail above the bladder
  2. Cleanse away from the meatus; bag below the bladder Correct answer.
  3. Cleanse from the drainage tubing toward the urinary meatus
  4. Disconnect the tubing from the bag to wash it daily

Explanation

Cleansing away from the meatus carries organisms away from the urinary opening, and the bag is kept below the bladder so urine cannot flow back into the bladder. The closed system is never disconnected for routine cleaning.

Question 11Physical Care Skills: Activities of Daily Living

A resident has weakness on the left side after a stroke. How should the NA help with dressing?

  1. Dress the weak side last and undress it first
  2. Dress the strong side first and undress it last
  3. Dress both sides at the same time
  4. Dress the weak side first and undress it last Correct answer.

Explanation

The general rule is to dress the affected side first and undress it last, which makes it easier to move the weak limb into the garment. The strong side does the work.

Question 12Physical Care Skills: Activities of Daily Living

Which action is correct when shaving a resident who takes a blood thinner?

  1. Use a disposable razor and shave against the hair growth
  2. Shave without lather to see the skin better
  3. Use an electric razor instead of a blade Correct answer.
  4. Use a straight razor after warming the face with a hot towel

Explanation

A resident who takes an anticoagulant bleeds easily, and a blade can cause serious bleeding. An electric razor is used instead, and shaving is done in the direction of hair growth.

Question 13Physical Care Skills: Activities of Daily Living

Which rule applies when performing range-of-motion exercises?

  1. Push through resistance to increase the range
  2. Bounce the joint gently at the end of the range
  3. Stop if there is pain and never force a joint Correct answer.
  4. Exercise only the unaffected side

Explanation

Range-of-motion exercise is stopped at the point of pain or resistance because forcing a joint can cause injury. Movements are slow and smooth, and the joint is supported throughout.

Question 14Physical Care Skills: Activities of Daily Living

Which action is correct when moving a resident from bed to a wheelchair?

  1. Lock the wheels; place the chair on the strong side Correct answer.
  2. Place the wheelchair beside the resident's weaker side
  3. Have the resident hold the NA around the neck
  4. Pull the resident up by the underarms

Explanation

The wheelchair is locked and placed on the resident's stronger side so the resident can use the stronger arm and leg to help. Holding around the neck or pulling by the underarms can injure both the resident and the NA.

Question 15Physical Care Skills: Activities of Daily Living

How should the NA comb a resident's tangled hair?

  1. From the scalp to the ends with quick, firm strokes
  2. From the ends upward, holding above the tangle Correct answer.
  3. With a fine-toothed comb while the hair is soaking wet
  4. Cut out the tangles without asking the resident

Explanation

Working from the ends of the hair upward, while holding the section above the tangle, prevents pulling at the scalp and breaking the hair. Wet hair is more fragile, and a fine comb makes tangles worse.

Question 16Physical Care Skills: Activities of Daily Living

Which technique is correct for a back massage?

  1. Massage downward toward the buttocks for a few seconds
  2. Massage directly over reddened areas of skin
  3. Massage upward from the lower back to the shoulders Correct answer.
  4. Use an alcohol-based lotion to dry the skin

Explanation

Massage strokes move from the lower back upward toward the shoulders to support venous return and comfort. Reddened areas are avoided because the skin there may already be damaged.

Question 17Physical Care Skills: Activities of Daily Living

How should the NA clean a resident's eyeglasses?

  1. With hot water and a paper towel
  2. By storing them face down on the nightstand
  3. Warm water and mild soap, dried with a soft cloth Correct answer.
  4. With household glass cleaner on plastic lenses

Explanation

Warm water with mild soap and a soft cloth cleans lenses without scratching them. Hot water and paper towels can damage plastic lenses, and glasses are stored with the lenses up.

Question 18Physical Care Skills: Activities of Daily Living

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

  1. Wash it in warm soapy water and let it air dry
  2. Store it in a sunny window to dry
  3. Turn it off, then wipe it with a soft dry cloth Correct answer.
  4. Leave it in the ear during bathing

Explanation

Hearing aids contain electronic parts, so they are turned off and wiped with a dry soft cloth and are never soaked in water. They are removed before bathing and stored in a safe, dry place.

Question 19Physical Care Skills: Activities of Daily Living

A resident drinks a 4-oz glass of juice. How many milliliters should the NA record?

  1. 60 mL
  2. 240 mL
  3. 120 mL Correct answer.
  4. 90 mL

Explanation

One ounce equals 30 mL, so 4 ounces equals 120 mL. Intake is recorded in milliliters so it can be compared with output and with the care plan.

Question 20Physical Care Skills: Activities of Daily Living

Which approach best helps a resident who has frequent incontinence?

  1. Check the brief once per shift
  2. Delay answering the call light during meals
  3. Offer the toilet every 2 hours and at set times Correct answer.
  4. Limit all fluids after the evening meal to prevent episodes

Explanation

Scheduled toileting, such as every 2 hours and before and after meals, helps the resident reach the toilet in time and preserves dignity. Restricting fluids or delaying a response to the call light causes dehydration and skin breakdown.

Question 21Physical Care Skills: Activities of Daily Living

The skin between a resident's toes is white and moist, and the resident reports burning. What should the NA do?

  1. Apply lotion between the toes and put on socks
  2. Trim the loose skin with nail scissors
  3. Dry the area carefully, keep it open, and report it Correct answer.
  4. Sprinkle powder between the toes and reapply the socks

Explanation

White, macerated skin between the toes with burning suggests a fungal infection and moisture trapped in the area. The NA dries the area, keeps the toes separated, avoids lotion between the toes, and reports to the nurse.

Question 22Physical Care Skills: Activities of Daily Living

Which action reduces the risk of aspiration after a meal?

  1. Give thin liquids through a straw to make swallowing easier
  2. Lay the resident flat in bed right after the meal
  3. Keep the resident upright for about 30 minutes Correct answer.
  4. Lower the head of the bed during the meal

Explanation

Staying upright for about 30 minutes after eating lets gravity help keep food down and reduces the chance of aspiration. Lying flat and drinking through a straw both increase the risk.

Question 23Physical Care Skills: Activities of Daily Living

A resident is placed in a side-lying position. Which action supports correct body alignment?

  1. Remove all pillows from the bed
  2. Place a pillow between the knees Correct answer.
  3. Cross the top leg over the bottom leg
  4. Place a pillow under the buttocks

Explanation

A pillow between the knees keeps the hips aligned and prevents the top leg from pulling the hip into rotation. Pillows are used to support alignment, not removed.

Question 24Physical Care Skills: Activities of Daily Living

A resident's hand is curled and the wrist is bent. Which action best supports the hand?

  1. Pull the fingers straight several times a day to stretch them
  2. Tie the hand to the side rail to keep it straight
  3. Place a rolled washcloth in the palm as ordered Correct answer.
  4. Tuck the hand under the resident's body for warmth

Explanation

A rolled washcloth or hand roll keeps the fingers and wrist in a functional position and helps prevent a contracture when it is ordered. Pulling on the fingers, tying the hand, or trapping it under the body can cause injury or skin breakdown.

Question 25Physical Care Skills: Activities of Daily Living

A resident's urine is dark and strong-smelling, and output was 200 mL in 8 hours. What should the NA do?

  1. Restrict fluids to reduce the odor
  2. Report the findings and offer fluids as allowed Correct answer.
  3. Wait until the end of the shift to report the findings
  4. Record the output as normal and continue care

Explanation

Dark, strong-smelling urine with low output suggests dehydration and must be reported so the nurse can assess the resident. Fluids are never restricted without a specific order.

Question 26Physical Care Skills: Activities of Daily Living

An unconscious resident needs mouth care. Which approach is correct?

  1. Turn the head to the side and clean the mouth with moistened swabs. Correct answer.
  2. Place the head flat and use a firm toothbrush with toothpaste.
  3. Sit the resident fully upright before starting mouth care.
  4. Give small sips of water to rinse the mouth before cleaning.

Explanation

A resident who is unconscious cannot swallow or protect the airway, so the head is turned to the side and the mouth is cleaned with moistened swabs while secretions drain. Suction equipment should be nearby, and no fluids are placed in the mouth.

Question 27Physical Care Skills: Activities of Daily Living

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

  1. Scrub the dentures with a stiff brush and scouring powder.
  2. Store the dentures dry in a covered cup at night.
  3. Clean the dentures with hot water and household bleach.
  4. Line the sink and use cool water while cleaning them. Correct answer.

Explanation

Dentures are fragile and can warp in heat, so the sink is lined with a towel and cool water is used in case they are dropped. When out of the mouth they are kept in a labeled cup of cool water.

Question 28Physical Care Skills: Activities of Daily Living

The nursing assistant's hands are visibly soiled after providing care. Which action is correct?

  1. Use an alcohol-based hand rub and continue care.
  2. Rinse the hands with water only and dry them.
  3. Wash the hands with soap and running water. Correct answer.
  4. Wipe the hands with a paper towel and put on gloves.

Explanation

When hands are visibly soiled, soap and running water are required because alcohol rubs do not remove dirt or organic material. Gloves never take the place of hand hygiene.

Question 29Physical Care Skills: Activities of Daily Living

Which action keeps a resident safe during a tub bath or shower?

  1. Add bath oil to the water so the skin stays soft.
  2. Check the water temperature before the resident gets in. Correct answer.
  3. Use water hot enough to relax tight muscles.
  4. Leave the resident alone briefly to get clean towels.

Explanation

The water is checked before the resident enters so it is warm, not hot, and cannot burn fragile skin. A resident in the tub or shower is never left alone, and bath oils are avoided because they make the surface slippery.

Question 30Physical Care Skills: Activities of Daily Living

Which action is correct when giving perineal care to a female resident?

  1. Wash from the urinary opening toward the rectum. Correct answer.
  2. Clean the area with hot water and pat dry with a rough towel.
  3. Wash from the rectum toward the urinary opening.
  4. Use the same washcloth for the front and back without rinsing it.

Explanation

Cleaning from front to back keeps stool bacteria away from the urinary opening and helps prevent urinary tract infection. A fresh part of the washcloth is used for each stroke, with warm water and gentle drying.

Question 31Physical Care Skills: Activities of Daily Living

A resident refuses to take a shower this morning. What should the nursing assistant do?

  1. Respect the refusal and report it to the nurse. Correct answer.
  2. Ask other residents to convince the resident to shower.
  3. Wait until the resident is asleep and give a bed bath.
  4. Tell the resident the shower cannot be skipped today.

Explanation

Residents have the right to refuse care, and the refusal is documented and reported so the team can look for a cause such as pain, fear, or fatigue. The assistant can offer choices, such as a bath instead of a shower or a later time.

Question 32Physical Care Skills: Activities of Daily Living

A resident is learning to walk with a walker. Where should the nursing assistant stand?

  1. Behind and to the side, holding the gait belt. Correct answer.
  2. Behind the resident, holding the back of the walker.
  3. Directly in front of the resident, facing them.
  4. At the resident's side, holding the arm above the elbow.

Explanation

Standing behind and slightly to the side lets the assistant support the resident with a gait belt while the resident controls the walker. Pulling on an arm can injure the resident and gives poor control of a fall.

Question 33Physical Care Skills: Activities of Daily Living

A resident is placed in Fowler's position. How is the resident positioned?

  1. Lying flat on the back with the legs raised above the heart.
  2. Sitting up with the head of the bed raised 45 to 60 degrees. Correct answer.
  3. Lying on the side with the knees drawn up to the chest.
  4. Lying on the abdomen with the head turned to one side.

Explanation

Fowler's position is a semi-sitting position in which the head of the bed is raised about 45 to 60 degrees, which aids breathing and eating. The other choices describe prone, side-lying, and Trendelenburg positions.

Question 34Physical Care Skills: Activities of Daily Living

A resident on a fluid intake record drinks very little during the day. Which action should the nursing assistant take?

  1. Wait until the resident asks for something to drink.
  2. Give large glasses of water at the end of the day.
  3. Offer small amounts of fluid often during the shift. Correct answer.
  4. Record only the fluids the resident finishes completely.

Explanation

Frequent small offerings make it easier for a resident to take enough fluid without feeling overwhelmed. Everything taken by mouth is recorded, and fluids are spread through the day rather than pushed at bedtime.

Question 35Physical Care Skills: Activities of Daily Living

How should the nursing assistant weigh a resident who can stand on a scale?

  1. Weigh the resident right after a meal and a drink.
  2. Weigh the resident at a different time each day.
  3. Use the same scale at about the same time of day. Correct answer.
  4. Round the weight to the nearest five pounds.

Explanation

Using the same scale, at about the same time, with similar clothing makes small weight changes meaningful. Weights are recorded accurately to the nearest pound or tenth of a kilogram.

Question 36Physical Care Skills: Activities of Daily Living

A resident has trouble falling asleep at night. Which action should the nursing assistant take?

  1. Wake the resident every two hours to check on them.
  2. Follow the resident's usual bedtime routine. Correct answer.
  3. Give the resident coffee or cola in the evening.
  4. Keep the television on for company during the night.

Explanation

Keeping the resident's usual bedtime routine and a quiet, dim environment supports sleep. Caffeine, bright light, and unnecessary waking all interfere with rest.

Question 37Physical Care Skills: Activities of Daily Living

A resident needs to use a bedpan. Which action is correct?

  1. Warm the pan, raise the head of the bed, and stay nearby. Correct answer.
  2. Slide the bedpan under the resident with the bed flat.
  3. Leave the resident alone on the bedpan for 30 minutes.
  4. Powder the rim so the bedpan slides into place easily.

Explanation

A warmed bedpan is more comfortable, and raising the head of the bed to a semi-sitting position allows normal elimination. The resident is never left alone on a bedpan, and skin is checked after it is removed.

Question 38Physical Care Skills: Activities of Daily Living

A resident with arthritis in both hands spills food while eating. Which item should the nursing assistant suggest?

  1. A plate guard and a spoon with a built-up handle. Correct answer.
  2. A knife and fork with straight, narrow handles.
  3. A straw and a sipper cup for every meal.
  4. A bowl with high sides and a short teaspoon.

Explanation

Built-up handles make utensils easier to grip with weak hands, and a plate guard keeps food on the plate so it can be scooped. The goal is to adapt the equipment so the resident can keep eating independently.

Question 39Physical Care Skills: Activities of Daily Living

When applying elastic compression stockings, which action is correct?

  1. Apply lotion to the legs before putting the stockings on.
  2. Apply them at bedtime after the legs have rested.
  3. Put them on in the morning before the resident is up. Correct answer.
  4. Roll them down to the ankle and pull them up by the top edge.

Explanation

Compression stockings are applied in the morning before the resident gets out of bed, while swelling is lowest. They are smoothed free of wrinkles, never rolled down, and the skin is checked at each removal.

Question 40Physical Care Skills: Activities of Daily Living

A resident can feed themselves but eats very slowly. Which action should the nursing assistant take?

  1. Feed the resident so the meal is finished on time.
  2. Allow extra time and sit with the resident. Correct answer.
  3. Take the tray away when the other residents finish.
  4. Give the resident a supplement instead of the meal.

Explanation

A resident who can eat independently should be allowed the time to do so, with the assistant nearby for encouragement and safety. Taking over feeding reduces self-care ability and dignity.

Question 41Physical Care Skills: Basic Nursing Skills

When should the nursing assistant perform hand hygiene?

  1. Only when gloves are not available
  2. Only at the start and end of a shift
  3. Only after contact with a resident who has an infection
  4. Before and after contact with each resident Correct answer.

Explanation

Hand hygiene is required before and after every resident contact, whether or not gloves are worn, because gloves do not replace handwashing and organisms are carried on hands between residents.

Question 42Physical Care Skills: Basic Nursing Skills

A resident has just finished drinking a cup of hot coffee. How long should the nursing assistant wait before taking an oral temperature?

  1. No waiting period is needed
  2. 30 minutes
  3. 15 minutes Correct answer.
  4. 5 minutes

Explanation

Hot or cold fluids, smoking, and chewing gum change the temperature inside the mouth, so the standard wait is about 15 minutes before an oral temperature is taken.

Question 43Physical Care Skills: Basic Nursing Skills

How should the nursing assistant count a radial pulse?

  1. Ask the resident to hold their breath
  2. Count for 10 seconds and multiply by 6
  3. Count the beats for a full minute Correct answer.
  4. Press firmly with the thumb

Explanation

Counting for a full minute gives the most accurate rate, especially when the rhythm is irregular; the radial pulse is felt with the pads of two or three fingers on the thumb side of the wrist.

Question 44Physical Care Skills: Basic Nursing Skills

Which action is correct when counting respirations?

  1. Count for 15 seconds and multiply by 4
  2. Keep fingers on the wrist during the count Correct answer.
  3. Tell the resident you are counting the breaths
  4. Ask the resident to breathe deeply and evenly

Explanation

A person can change breathing on purpose, so respirations are counted without telling the resident, often by keeping the fingers on the wrist as though still counting the pulse.

Question 45Physical Care Skills: Basic Nursing Skills

Which item should the nursing assistant record as fluid intake?

  1. A glass of water the resident drank Correct answer.
  2. Urine emptied from the catheter bag
  3. Vomit collected in an emesis basin
  4. Drainage from a wound dressing

Explanation

Intake is everything the resident takes in by mouth or tube, such as water, juice, soup, ice chips, and intravenous fluids; all other options are forms of output.

Question 46Physical Care Skills: Basic Nursing Skills

Where should the nursing assistant put soiled linens when making an unoccupied bed?

  1. On the chair beside the bed
  2. On the overbed table
  3. Straight into the hamper Correct answer.
  4. On the floor beside the bed

Explanation

Soiled linens are placed directly into the linen hamper without shaking, because shaking or setting them on furniture or the floor spreads microorganisms and contaminates surfaces.

Question 47Physical Care Skills: Basic Nursing Skills

Which removal order is correct when taking off personal protective equipment?

  1. Gloves first, mask last Correct answer.
  2. Mask first, gloves last
  3. Mask first, gown last
  4. Gown first, gloves last

Explanation

The most contaminated items come off first and the mask comes off last, so gloves are removed first and the mask is removed after leaving the room, handling it by the ties only.

Question 48Physical Care Skills: Basic Nursing Skills

How should a resident who is unconscious be positioned for mouth care?

  1. On the abdomen
  2. Sitting upright at a 90-degree angle
  3. Flat on the back
  4. Side-lying, head turned Correct answer.

Explanation

An unconscious resident is turned onto the side with the head turned toward the assistant so that secretions and fluid drain out of the mouth instead of being aspirated into the airway.

Question 49Physical Care Skills: Basic Nursing Skills

The nursing assistant uses a blood pressure cuff that is too small for the resident's arm. What is the likely result?

  1. The reading will not be affected
  2. The reading will be falsely high Correct answer.
  3. The reading will be falsely low
  4. The cuff will not inflate fully

Explanation

A cuff that is too small requires more pressure to compress the artery, so the reading comes out falsely high; a cuff that is too large gives a falsely low reading. The cuff must fit the arm circumference.

Question 50Physical Care Skills: Basic Nursing Skills

A pulse oximeter shows a reading of 88% on a resident breathing room air. What should the nursing assistant do?

  1. Ask the resident to walk around
  2. Report it to the nurse at once Correct answer.
  3. Record it as a normal finding
  4. Wait an hour and recheck it

Explanation

Normal oxygen saturation is about 95% to 100%, and a reading of 88% is below the expected range, so it is reported to the nurse right away rather than filed without comment.