Modules N-H

a,c,d,f,h,i,j,k

What type of incidents requires an incident report? (Mark all that apply)
Select one or more:
a. A resident falls
b. A resident refuses to take a shower
c. A mistake was made during resident care
d. Something is broken or damaged by a member of the health care team or the resident
e. A resident reports that her roommate did not sleep, but played the TV all night and kept her awake
f. Someone makes sexual advances or remarks to a member of the health care team or resident
g. Reports that another NA is abusive to the residents
h. Member of the health care team is injured on the job
i. Member of the health care team believes an exposure to blood and possible blood borne pathogens has occurred
j. There is an angry outburst by family members or staff
k. Resident states that some item of value is missing

a,b,d,g,h

When completing an incident report, the NA should include: (Mark all that apply)
Select one or more:
a. time of incident
b. where in the facility it took place
c. why it took place
d. who was present and exactly what happened
e. what you heard about the incident
f. your opinions about the incident
g. actions taken to help with the incident
h. any outcomes noted from actions taken
i. documentation in the residents medical record about the incident

Critical Thinking

Safely providing resident care in a variety of situations based on facts learned and bedside observations, or the ability to think on one's feet

a,c,d,f,g

What are critical thinking points?
a. What am I trying to do?
b. Who am I trying to help?
c. What problem or problems do I need to solve?
d. What information do I need and where can I get it?
e. Do I need to get the RN?
f. What basic concepts do I need to use?
g. What am I missing?

c

Which of the following should the nurse aide report to the nurse?
Select one:
a. The resident is crying after visiting with family members
b. The family shared their feelings with the resident
c. The family is upset after seeing the resident in the facility
d. The family perform unusual religious practices

b,d,e

Which of these factors will negatively affect a family member's decision to place their loved one in the facility where you work?
Select one or more:
a. Food looks appetizing and smells good
b. Strong smell of urine
c. Staff is friendly and asks to assist
d. Residents are still in the bed and undressed a 11 am
e. Signaling device light is on for more than 5 minutes

True

True or False: It is important to ask the family of an aphasic patient who was newly admitted about their likes and dislikes.

a,c

Which of the following questions can you answer?
Select one or more:
a. How did Mom sleep last night?
b. What are the result's of Mom's blood work?
c. Did Mom go to therapy yesterday?

Defecation

Process of emptying the rectum of feces

Fecal Impaction

Prolonged retention and accumulation of feces in the rectum

Prosthetic device

Replacement devices for lost body parts specially fitted for the patient

Urination

Process of emptying the bladder

Amputation

Surgical removal of body part

Orthotic device

Artificial device that replaces a body part and helps with function and/or appearance

Supportive device

Special equipment that helps a disabled or ill patient with movement

Adaptive device

Special equipment that helps a disabled or ill patient perform ADL's

Bowel training

Measures helpful for fecal impaction, constipation, and fecal incontinence

b

As healthcare providers, we should always remember:
a. it is quicker to bathe a patient than have a patient bathe self
b. to encourage a resident to be as independent as possible
c. to provide the care for a patient rather than letting him realize what he can't do
d. to maintain a strict schedule in delivering ADL's to all patients

a,d,e,f

What are the goals of restorative care? (Mark all that apply)
Select one or more:
a. maintaining and/or improving the patient's existing abilities
b. discouraging the patient from thinking about the future
c. do most of the care for the patient so that he/she can regain their strength
d. preventing further complications
e. move the patient toward increased independence
f. focuses on the whole person

d

Guidelines for assisting with bladder retraining include all the following except:
Select one:
a. running water in the sink
b. have the patient lean forward putting pressure on the bladder
c. regular exercise
d. limiting fluids

c

How long does bowel and bladder training take?
Select one:
a. 2-3 weeks
b. 4-6 weeks
c. 8-10 weeks
d. 3-6 months

c

What are footboards used for?
Select one:
a. keep the top sheet off the bed
b. prevent legs from rolling off the bed
c. help prevent plantar flexion (foot drop)
d. all the above

a,d,e,f

What are the goals of restorative care? (Mark all that apply)
Select one or more:
a. maintaining and/or improving the patient's existing abilities
b. discouraging the patient from thinking about the future
c. do most of the care for the patient so that he/she can regain their strength
d. preventing further complications
e. move the patient toward increased independence
f. focuses on the whole person

d

What are the signs and symptoms of fecal impaction?
Select one:
a. seepage of liquid stool
b. abdominal distention/cramping
c. rectal pain
d. all the choices

a,b,d,e,g,h,i,j,k

What is the NA's role in bowel and bladder training? (Mark all that apply)
Select one or more:
a. support explanation of training schedule to patient so others can't hear
b. keep accurate record of patterns/amounts
c. choose the patient's meal choices
d. answer call lights promptly
e. don't rush or scold
f. post the training schedule and progress in the patient's room
g. be positive and offer encouragement
h. assist to the bathroom
i. provide privacy
j. offer fluids, fiber foods, regular exercise and good peri-care
k. keep bedding clean

c

What type of incontinence may be related to the NA not responding to the signal device?
Select one:
a. stress incontinence
b. urge incontinence
c. functional incontinence
d. all of the choices

a,c,d

When are patients encouraged to urinate? (mark all that apply)
Select one or more:
a. one hour before meals
b. once a shift
c. every two hours between meals
d. when the patient wakes up
e. every two hours during the night

a,c,d

Question 12
Which of the following can be part of the bowel and bladder training?
a. encourage regular exercise
b. encourage foods high in protein
c. offer fluids per the schedule
d. responding to signal device quickly
e. decreasing fluid intake to cut down on accidents

True

True or False: The purpose of the cleansing enema is to clean the lower colon.

Basic Restorative care

care provided after resident's highest possible functioning is restored (rehabilitation) following illness or injury

Empathy

Being able to identify with and understand how a resident feels

Enema

The introduction of fluid into the colon to eliminate stool or feces or stimulate bowel activity

Functional Loss

Partial or complete loss of the function of a body part

Incontinence

the inability to control urination or defecation

Rehabilitation

Restoration of resident's highest possible functions following illness or injury

Friction

2 surfaces rub together

Eczema

Red itching areas one the surfaces of the skin

Epidermis

Outer layer of skin contains melanin, nerve endings, but no blood vessels

Dermis

layer of skin containing hair and nail follicles, sweat and oil glands, blood vessels, nerves and touch receptors

Dermatitis

Inflammation of the skin

Bony prominences

Areas of the body where the bone is close to the skin, such as the elbows, shoulder blades, and sacrum

Shearing

the skin moves in one direction and the underneath tissue remains fixed

Integumentary System

The largest organ and system in the body, responsible for providing a natural protective covering of the body

Melanin

Gives skin its primary color

Pressure points

Where the body bears much of the weight

Pressure ulcers

A serious wound caused by poor circulation, resulting from pressure, also called bedsores, decubitus ulcers, and pressure sores

Gangrene

A condition that results in necrosis or death of tissue

Shingles

Viral infection caused by varicella zoster (chicken pox)

Liver spots

Brown spots on the skin caused by aging

Psoriasis

Chronic inflammatory noncontagious, excessive reproduction of epidermal cells, causing circular patches which are scaly and itch

Cranial cravity

Contains the brain and 12 cranial nerves

Thoracic cavity

Contains the lungs, heart, and esophagus

Abdominal cavity

Contains the stomach, liver, kidneys, pancreas, spleen, gallbladder, small intestine, and most of the large intestine

Pelvic cavity

Contains the reproductive organs, lower colon, and the rectum

Malignant tumor

A cancerous tumor

Restorative-free care

An environment in which restraints are not kept or used for any reason

Restraint alternative

measures used instead of physical or chemical restraints

Restraint

A physical or chemical way to restrict voluntary movement or behavior

Chemical restraint

Any drug used to control actions of a resident for staff convenience

Soft cloth mitt restraints

A physical restraint that limits mobility of hands and use of fingers, frequently used for residents who could harm themselves by pulling at tubing, removing dressings, touching incisions, or scratching a wound

b

What is the use of unnecessary restraints considered?
Select one:
a. malpractice
b. false imprisionment
c. assault
d. negligence

a

When can restraints be used?
Select one:
a. to protect the resident during treatment and to keep them from injuring self or others
b. when the RN feels they are needed
c. when the health care team feels they are needed
d. for discipline and the convience of staff

b

Where are restraints tied?
Select one:
a. side rails
b. movable part of the bed frame
c. unmovable part of the bed frame
d. headboard or footboard

a,b,d,e,f,h,i,j,k,l

Which of the following are negative effects of restraints?
a. physical and psychological discomfort
b. pressure ulcers
c. diarrhea
d. pneumonia
e. reduced blood circulation
f. incontinence
g. constipation
h. weakness and muscle atrophy
i. poor appetite and malnutrition
j. depression
k. stress and anxiety
l. sleep disorders

a,c

Question 6
Which of the following would be considered a physical restraint?
a. the bed linens are tucked in very tight on the sides of the bed
b. the bed linens are tucked in very tight at the foot of the bed
c. all 4 side rails are raised
d. 3 side rails are raised

d

Who determines the need and orders restraints
a. RN
b. Health care team
c. ombudsman
d. MD

Stage 1

skin is intact, red, darkened or non-blanchable which is still present 30 minutes after pressure is relieved

Stage 2

skin has blister-like lesions,: partial-thickness skin loss involving the epidermis and the dermis

Stage 3

full thickness skin loss; infection and eschar (scab) may result

Stage 4

skin and fatty tissue destroyed, muscle and bone involved

a,c,d,f,h

A common cause of pressure ulcers includes:
a. shearing
b. ambulating every 2 hours
c. moisture
d. friction
e. high protein diet
f. pressure
g. trauma
h. incontinence

a,c,d,f

What changes due to aging are normal for the integumentary system?
a. folds, lines, wrinkles, and brown spots appear
b. skin becomes thicker, oilier, and less fragile
c. fatty layer decreases so person feels colder
d. hair thins and may gray
e. nails thicken
f. skin losses its elasticity

c

What is metastasis?
a. Cancer cells are eliminated
b. A patient is having radiation
c. Cancer cells have spread to other body parts
d. Cancer cells have decreased

a,c,f

What should the NA remember when caring for older adults? (mark all that apply)
Select one or more:
a. Older adults do not need complete bed baths every day
b. Massage any reddened areas to increase circulation
c. Lotion may be needed for moisture
d. The RN will do all skin observation
e. Rub skin thoroughly to dry and increase circulation
f. layer clothes for extra warmth
g. Limit fluids

d

Where can pressure ulcers develop on an obese woman?
Select one:
a. underneath the breasts
b. between the legs
c. between abdominal folds
d. all the choices

a,c,d,f,g,h,k,l,n

Which of the following are pressure points?
a. elbows
b. abdomen
c. shoulder blades
d. sacrum
e. throat
f. hips
g. knees
h. ankles
i. throat
j. wrist
k. toes
l. back of head
m. forehead
n. back of neck

b,d,e

Which of the following can prevent pressure ulcers?
a. keeping the resident on strict bed rest
b. turning the resident every 2 hours
c. allowing the resident to sleep all night uninterrupted
d. keeping a resident clean and dry
e. keeping the linens clean and dry
f. massaging any pressure sites

Fracture

Break in the bone

Osteoarthritis

non-inflammatory degeneration of the cartilage of the weight-bearing joints due to stress, with aches, stiffness, and limited motion, also known as DJD or degenerative joint disease

Extension

Straightening a body part

Flexsion

Bending a body part

Abduction

Moving a body part away from the midline

Arthritis

Inflammation of the joints

Bone Marrow

soft spongy inside part of the bone which produces RBC, WBC, and platelets

Bones

hard and rigid structures that make up the skeleton and form the framework of the body

Cardiac muscle

involuntary muscle of the heart

Dorsiflexion

bending the toes and foot upward at the ankle

Contracture

permanent shortening of muscle resulting in immovable joints, ROM exercises can help prevent

Joints

point where bones meet, consists of cartilage and connective tissue that conshions the bones allowing for movement of the area

Ligaments

Connects bone to bone

Muscle atrophy

Muscle mass decreases in size

Musculoskeletal system

Provides structure and movements of the body

Osteoporosis

Spongy type of bone that breaks easily

Plantar flexion

Bending the foot downward at the ankle, also known as foot drop

Rheumatoid arthritis

Systemic crippling disease causing deformities with stiff, painful, swollen joints

Skeletal muscles

Voluntary muscle that powers movement of the body

Smooth muscles

Involuntary muscle of the inner linings of organs

Tendons

Connects muscle to bone

Sprain

Stretched or torn ligaments or tendons

Compound fracture

Open fracture that penetrates the skin