CNA Self-Care and Independence Practice Test

25 practice questions

Choose an answer, then check it under Show answer.

1. Question 1 of 25Medium

   A nurse aide checks the fit of a resident's walker while the resident stands upright with arms resting comfortably at the sides. The top of the walker hand grips should align with the resident's:

   1. AA. waistline.
   2. BB. wrist creases.
   3. CC. mid-thigh area.
   4. DD. lower ribs.
   Show answer to question 1

   Answer: B. wrist creases.

   Proper walker height is verified when the hand grips align with the resident's wrist creases while arms hang relaxed at the sides. This alignment ensures the resident's elbows will be flexed at an optimal 15 to 30 degrees when holding the grips. Aligning the grips with the waistline makes the walker too tall, which causes shoulder strain and poor control.

2. Question 2 of 25Medium

   While performing active range-of-motion exercises of the upper extremities, a resident begins to breathe heavily and complains of sudden dizziness. What should the nurse aide do first?

   1. AA. Assist the resident to rest and check their vital signs
   2. BB. Offer the resident a large glass of ice water
   3. CC. Switch to passive exercises to reduce the resident's effort
   4. DD. Instruct the resident to finish the remaining exercises quickly
   Show answer to question 2

   Answer: A. Assist the resident to rest and check their vital signs

   If a resident shows signs of activity intolerance, such as dizziness or heavy breathing, the aide should immediately stop the exercise, ensure the resident is resting safely, and check vital signs to report to the nurse. Continuing any form of exercise under these conditions puts the resident at risk for a fall or cardiovascular distress.

3. Question 3 of 25Medium

   A nurse aide is assisting a resident who uses a rolling walker to ambulate. Which instruction should the nurse aide provide to promote safe movement?

   1. AA. Use the walker handles to pull up into a standing position from the chair
   2. BB. Keep both feet together while lifting the walker completely off the floor
   3. CC. Move the walker forward a short distance, then step the weaker foot ahead
   4. DD. Push the walker forward a full arm's length before taking any steps
   Show answer to question 3

   Answer: C. Move the walker forward a short distance, then step the weaker foot ahead

   Proper walker technique involves rolling the walker a short distance ahead, stepping the weaker foot into the frame, and following with the stronger foot. Pushing the walker too far ahead compromises balance, and pulling on the walker handles to stand can tip the device backward.

4. Question 4 of 25Medium

   A care plan directs the nurse aide to perform plantar flexion during foot and ankle exercises. Which action should the nurse aide take?

   1. AA. Pull the resident's toes upward toward the front of the leg
   2. BB. Turn the sole of the resident's foot inward toward the other foot
   3. CC. Rotate the resident's entire ankle gently in continuous circles
   4. DD. Bend the resident's foot downward pointing the toes toward the bed
   Show answer to question 4

   Answer: D. Bend the resident's foot downward pointing the toes toward the bed

   Plantar flexion is the movement of pointing the toes and bending the foot downward toward the sole of the foot. Pulling the toes upward toward the shin describes dorsiflexion. Turning the sole inward is inversion.

5. Question 5 of 25Medium

   A restorative care plan directs the nurse aide to walk a resident 50 feet twice daily using a gait belt. Halfway down the hall, the resident begins to sway and says, 'I feel too weak to keep going.' What should the nurse aide do?

   1. AA. Help the resident sit safely in a nearby chair or wheelchair right away
   2. BB. Instruct the resident to lean against the hallway wall while standing
   3. CC. Encourage the resident to walk quickly to finish the required distance
   4. DD. Hold the gait belt with both hands and pull the resident forward
   Show answer to question 5

   Answer: A. Help the resident sit safely in a nearby chair or wheelchair right away

   Resident safety takes priority over completing a distance goal, so the aide should immediately help the resident sit down in a chair or wheelchair if weakness or instability occurs. Forcing a tired resident to walk or lean against a wall creates a high risk for a fall.

6. Question 6 of 25Easy

   A nurse aide observes that a resident's fingers are tightly curled into the palm and cannot be straightened without pain. This condition is best described as a:

   1. AA. Contracture
   2. BB. Muscle spasm
   3. CC. Sprain
   4. DD. Strain
   Show answer to question 6

   Answer: A. Contracture

   A contracture is the permanent shortening of muscles, tendons, or ligaments that causes joint deformity and immobility, which range-of-motion exercises are designed to prevent. A muscle spasm is a temporary, involuntary twitch or cramp rather than a persistent structural shortening.

7. Question 7 of 25Medium

   A resident recovering from total hip replacement surgery has an abduction pillow placed between the legs. What is the main purpose of this device?

   1. AA. To raise the heels off the mattress to avoid pressure ulcers
   2. BB. To keep the legs separated to prevent hip dislocation
   3. CC. To prevent internal and external blood pooling in the calves
   4. DD. To keep the surgical knee bent at a sharp angle
   Show answer to question 7

   Answer: B. To keep the legs separated to prevent hip dislocation

   An abduction wedge or pillow keeps the resident's lower limbs apart, maintaining the hip joint in proper anatomical alignment and preventing dislocation of the prosthesis. Raising the heels is accomplished with heel protectors or elevation pillows rather than an abduction wedge.

8. Question 8 of 25Hard

   A resident's care plan says to walk with her 50 feet twice a day. Today she feels strong and asks to walk to the dining room, about 150 feet away. What should the aide do?

   1. AA. Walk her to the dining room since she feels strong
   2. BB. Tell her she will never be able to walk that far
   3. CC. Keep to the plan and report her request to the nurse
   4. DD. Let her walk there alone so she can test her limits
   Show answer to question 8

   Answer: C. Keep to the plan and report her request to the nurse

   The aide follows the care plan and reports the request so the nurse and therapist can decide whether to increase the distance. Her wish to do more is useful information for the team.

   Why the other options are wrong

   • AGoing beyond the care plan without approval could overtire or injure her.
   • BThis is discouraging and untrue, since the plan can change as she progresses.
   • DWalking alone without approval exposes her to a fall.

9. Question 9 of 25Medium

   A resident who is learning to use an adaptive dressing aid becomes discouraged and states, "This is taking too long; just do it for me." What is the best restorative response by the nurse aide?

   1. AA. Leave the room and tell the resident to call when the dressing is completed
   2. BB. Inform the resident that assistive devices are mandatory and must be mastered today
   3. CC. Offer encouragement, allow more time, and assist only with the steps the resident cannot complete
   4. DD. Take the device away and finish dressing the resident immediately to prevent agitation
   Show answer to question 9

   Answer: C. Offer encouragement, allow more time, and assist only with the steps the resident cannot complete

   Restorative care aims to build independence and self-worth by giving residents sufficient time and positive support while stepping in only for steps they cannot yet master. Taking over the dressing process entirely fosters learned helplessness and contradicts restorative nursing goals.

10. Question 10 of 25Medium

    A resident who spends most of the day in bed has a footboard positioned at the end of the mattress. This restorative device helps prevent which complication?

    1. AA. Plantar flexion contracture, known as foot drop
    2. BB. Deep vein thrombosis in the lower legs
    3. CC. Sacral skin breakdown and friction tears
    4. DD. External rotation of the knee joints
    Show answer to question 10

    Answer: A. Plantar flexion contracture, known as foot drop

    A footboard keeps the resident's feet in dorsiflexion, which prevents plantar flexion contractures (foot drop) that can permanently impair walking. While circulation and pressure relief are critical care goals, footboards specifically address joint and tendon alignment rather than deep vein thrombosis.

11. Question 11 of 25Medium

    A resident participating in a restorative program to regain independence successfully puts on his button-up shirt today without any help for the first time. How should the nurse aide respond?

    1. AA. Remove all adaptive equipment from the resident's closet immediately.
    2. BB. Complete the rest of dressing for the resident to save his energy.
    3. CC. Commend the resident and report the improvement to the charge nurse.
    4. DD. Advise the resident that staff assistance will no longer be provided.
    Show answer to question 11

    Answer: C. Commend the resident and report the improvement to the charge nurse.

    Functional improvements should be acknowledged with positive reinforcement and reported to the charge nurse so the resident's care plan can be updated to support greater independence. Discontinuing all staff assistance is inappropriate because restorative care requires gradual progress and ongoing safety monitoring.

12. Question 12 of 25Easy

    A resident with mild dementia becomes confused and stops while brushing her teeth. How should the nurse aide encourage the resident to continue independently?

    1. AA. Replace the toothbrush with mouthwash to finish quickly
    2. BB. Provide short, simple step-by-step directions to guide her
    3. CC. Tell her that oral care can be skipped until the evening
    4. DD. Take the toothbrush and complete the brushing for her
    Show answer to question 12

    Answer: B. Provide short, simple step-by-step directions to guide her

    Breaking a complex task into manageable steps and offering gentle verbal cues allows residents with cognitive changes to complete the activity themselves. Taking over the task immediately removes the resident's opportunity to maintain functional skills.

13. Question 13 of 25Hard

    During ambulation exercises, a resident who usually walks comfortably suddenly becomes diaphoretic, begins breathing rapidly, and clutches the hallway handrail. What do these signs most likely suggest?

    1. AA. An acute onset of severe pain or physical distress
    2. BB. Dehydration caused by a warm room temperature
    3. CC. Expected exertion from standard physical conditioning
    4. DD. Mild boredom and disinterest in continuing the walk
    Show answer to question 13

    Answer: A. An acute onset of severe pain or physical distress

    Sudden profuse sweating, rapid breathing, and clutching handrails are physiological and behavioral signs of acute pain or cardiovascular distress. These acute signs require immediate rest and nurse assessment rather than being dismissed as expected exertion or simple boredom.

14. Question 14 of 25Medium

    A nurse aide is assisting a resident with range of motion exercises. The care plan directs the aide to perform abduction of the resident's shoulder. Which movement should the aide perform?

    1. AA. Rotating the arm downward in a continuous circular pattern
    2. BB. Bending the arm at the elbow upward toward the resident's chest
    3. CC. Moving the arm inward and toward the midline of the body
    4. DD. Moving the arm outward and away from the midline of the body
    Show answer to question 14

    Answer: D. Moving the arm outward and away from the midline of the body

    Abduction is the movement of a body part away from the center or midline of the body. Moving the arm toward the body's midline is adduction. Bending the elbow toward the chest is flexion.

15. Question 15 of 25Easy

    A resident who had a left hip replacement uses a single-point cane. On which side should the resident hold the cane?

    1. AA. On the side that feels most natural
    2. BB. On the right side
    3. CC. On the left side
    4. DD. In both hands while walking
    Show answer to question 15

    Answer: B. On the right side

    The resident should hold the cane on the stronger, unaffected side (the right side) to provide balance and support for the opposite, weaker leg. Holding the cane on the affected side reduces stability and increases the risk of falls.

16. Question 16 of 25Easy

    A resident learning to walk with crutches asks where their body weight should rest when standing. What should the nurse aide tell the resident?

    1. AA. On the hands pressing down firmly on the handgrips
    2. BB. Across the forearms leaned against the vertical bars
    3. CC. On the underarms resting against the top pads
    4. DD. Against the upper chest pressed between both crutches
    Show answer to question 16

    Answer: A. On the hands pressing down firmly on the handgrips

    Body weight should be supported by the palms and hands on the handgrips to protect the nerves and blood vessels in the armpits. Resting weight directly on the underarm pads can compress the brachial plexus and lead to temporary or permanent nerve damage.

17. Question 17 of 25Hard

    A resident with lower-extremity paralysis is learning to transfer from a wheelchair to a bed using a sliding board. What safety instruction should the nurse aide give the resident?

    1. AA. Curl fingers underneath the edges of the board to grip it firmly
    2. BB. Leave the wheelchair unlocked so it shifts smoothly with the body
    3. CC. Slide across the board quickly in one single, continuous push
    4. DD. Keep hands flat on the board surface or push up from the seat
    Show answer to question 17

    Answer: D. Keep hands flat on the board surface or push up from the seat

    Keeping the palms flat on the board or pushing directly from the seating surfaces protects the resident's fingers from being crushed or pinched underneath the board as body weight shifts across it. Curling fingers under the board edges is a frequent cause of severe pinching and skin tears.

18. Question 18 of 25Medium

    Before a walk, the nurse aide notices that the rubber tip on a resident's cane is worn smooth. What should the aide do?

    1. AA. Have the resident walk only on carpeted areas today
    2. BB. Use the cane and report the tip at the end of the shift
    3. CC. Wrap tape around the tip to improve its grip
    4. DD. Take the cane out of use and report it for a new tip
    Show answer to question 18

    Answer: D. Take the cane out of use and report it for a new tip

    A worn rubber tip can slip and cause a fall. Damaged equipment is taken out of use and reported so it can be repaired or replaced before the resident walks with it.

    Why the other options are wrong

    • AA worn tip can still slip on carpet, and the problem is not fixed.
    • BUsing unsafe equipment for a whole shift puts the resident at risk of falling.
    • CTape is not a safe repair and can make the tip slide even more.

19. Question 19 of 25Easy

    What is the main goal of restorative care for a nursing home resident?

    1. AA. To finish daily care tasks for the resident as quickly as possible
    2. BB. To help the resident regain or keep as much function as possible
    3. CC. To prepare the resident for a transfer to a hospital setting
    4. DD. To take the place of physical therapy when no therapist is available
    Show answer to question 19

    Answer: B. To help the resident regain or keep as much function as possible

    Restorative care helps a person regain lost abilities or keep current abilities so the person stays as independent as possible. The nurse aide supports this goal by following the care plan and encouraging self-care.

    Why the other options are wrong

    • ADoing tasks quickly for the resident reduces independence and works against restorative goals.
    • CRestorative care focuses on function and independence, not on preparing for a hospital transfer.
    • DRestorative nursing supports therapy goals but does not replace services from a licensed therapist.

20. Question 20 of 25Hard

    A resident recovering from hip surgery must follow hip precautions that forbid bending forward at the waist. Which action best supports independent lower-body dressing?

    1. AA. Having the resident bend from the waist only while seated firmly in a sturdy chair
    2. BB. Instructing the resident to cross his legs tightly at the knee to reach his feet
    3. CC. Teaching the resident how to use a sock aid and a long-handled shoehorn
    4. DD. Dressing the resident's lower body completely to prevent accidental hip flexion
    Show answer to question 20

    Answer: C. Teaching the resident how to use a sock aid and a long-handled shoehorn

    Adaptive equipment such as sock aids and long-handled shoehorns enables residents to put on footwear without bending past 90 degrees at the hip. Crossing the legs at the knee or bending while seated violates common post-surgical hip precautions and risks joint dislocation. Completely dressing the resident avoids the safety risk but unnecessarily prevents the resident from developing self-care independence.

21. Question 21 of 25Easy

    A resident who had a stroke wants to feed himself, but food constantly spills because his hand trembles and his grip is weak. Which action by the nurse aide best supports the resident's independence?

    1. AA. Insist that the resident keep practicing with standard silverware
    2. BB. Provide an adaptive spoon with a built-up, weighted handle
    3. CC. Feed the resident the entire meal to prevent frustration and spills
    4. DD. Encourage the resident to eat only finger foods with his fingers
    Show answer to question 21

    Answer: B. Provide an adaptive spoon with a built-up, weighted handle

    Providing an adaptive utensil with a built-up or weighted handle accommodates the resident's weak grip and tremors, allowing him to maintain dignity and feed himself. Taking over and feeding the resident completely undermines his independence and restorative goals.

22. Question 22 of 25Easy

    What should the nurse aide inspect the resident's skin for after removing a prescribed wrist splint?

    1. AA. Changes in freckle patterns
    2. BB. Signs of dry cuticles
    3. CC. Excessive hair growth
    4. DD. Persistent redness or sores
    Show answer to question 22

    Answer: D. Persistent redness or sores

    Whenever an orthosis or splint is removed, the nurse aide must inspect the underlying skin for redness, pressure areas, or skin breakdown. While mild, temporary skin marks may appear, redness that does not fade indicates abnormal pressure and must be reported to the nurse.

23. Question 23 of 25Hard

    When observing a resident walking with axillary crutches, which action indicates that the resident needs additional safety instruction?

    1. AA. Resting body weight directly on the underarm pads while standing
    2. BB. Looking straight ahead down the hallway rather than at the floor
    3. CC. Keeping both elbows bent at roughly a thirty-degree angle
    4. DD. Bearing body weight primarily on the palms and handgrips
    Show answer to question 23

    Answer: A. Resting body weight directly on the underarm pads while standing

    Body weight must be supported by the hands and arms on the handgrips; resting weight directly on the axillary pads can compress nerves and blood vessels in the armpit, leading to permanent nerve damage. Bearing weight on the handgrips and keeping elbows slightly bent are correct techniques.

24. Question 24 of 25Hard

    To help prevent pressure injuries in a resident who sits in a wheelchair for extended periods, the nurse aide should encourage the resident to:

    1. AA. remain completely motionless to prevent skin friction.
    2. BB. cross their legs at the knees every two hours.
    3. CC. slide their hips forward toward the edge of the seat.
    4. DD. shift their weight and change position frequently.
    Show answer to question 24

    Answer: D. shift their weight and change position frequently.

    Chair-bound residents need frequent weight shifts, typically every 15 to 30 minutes, to relieve pressure on the tailbone and buttocks and promote circulation. Sliding forward increases shearing forces on the skin and poor posture, which increases rather than reduces the risk of tissue breakdown.

25. Question 25 of 25Hard

    A resident returning from the hospital after total hip replacement surgery has strict medical orders to avoid hip flexion greater than 90 degrees. Which bathroom adaptive device is essential to maintain this restriction during elimination?

    1. AA. A wall-mounted towel bar
    2. BB. A nonslip floor mat
    3. CC. A raised toilet seat
    4. DD. A low bedside commode
    Show answer to question 25

    Answer: C. A raised toilet seat

    A raised toilet seat increases the height of the commode surface so the resident's hips remain higher than the knees, preventing unsafe hip flexion past 90 degrees when sitting down. A low bedside commode would force the knees higher than the hips, directly violating the resident's post-surgical precautions.

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