When checking the residents urinary drainage bag, the nurse aide observes that the resident has had about 50 ccs (mls) of urine output in the last six hours. What should the nurse aide do first?
Begin offering the resident fluids to drink every 15 minutes.
Report the observation to the charge nurse immediately.
Ask if the resident is having any pain when urinating.
Check to see if the tubing is kinked or bent.
Correct Answer :
D. Check to see if the tubing is kinked or bent.
Related Questions
The nurse aide notices that a resident with dementia keeps walking over to the piano, pausing there, touching the piano, and then walking away only to return again. Which of the following is the best action for the nurse aide to take?
Take the resident back to the residents room.
Distract the resident by asking about the residents family.
Invite the resident to sit down at the piano with the nurse aide.
Ask the activity director to find something for the resident to do.
When a resident wears a restraint, the nurse aide must make sure the
resident is wearing an incontinent brief.
resident is checked once every two hours.
restraint is applied following the manufacturers instructions.
restraint is applied tightly and placed under the residents clothing.
A resident who is in isolation needs a temperature taken several times a day. Where is the appropriate place for the thermometer to be kept?
At the nurses station.
On the isolation cart outside the residents room.
In the dirty utility room.
In the residents room.
When a person is receiving end-of-life care, the residents care plan is likely to include
ways to best provide for the comfort of the resident.
exercises to help improve the residents strength.
frequent observation to help prevent confusion.
instructions for providing post-mortem care.
Which of the following is an observation often seen when a resident is impacted?
Liquid feces seeping out of the anus
Darkening of the residents urine
Many soft, formed stools
Bad breath odor
A resident, who is on a toileting schedule, asks to go to the bathroom frequently. The nurse aide should respond to the residents requests by
telling the resident that it is not time.
decreasing the residents fluid intake.
asking the resident to follow the schedule.
taking the resident to the bathroom as needed.
A nurse aide who is new to the unit, observes two residents go into a room and close the door. The nurse aide suspects that the two residents are going to have sex. What should the nurse aide do?
Check on the residents every few minutes.
Report the residents behavior to the charge nurse.
Ask the nurse if the residents should be medicated.
Tell the residents that sex is not allowed in the nursing home.
While performing range of motion exercises, the nurse aide notices that the residents elbow is stiff and will not bend. The nurse aide should
continue exercises but move onto another joint.
continue since stiff joints are a normal part of aging.
apply very gentle pressure to try to bend the elbow slightly.
suggest the resident see a physical therapist for the elbow.
Which statement is true about the effects of aging
The aging process can be reversed with good health care.
Bladder incontinence is a normal part of aging.
Joints tend to be less flexible as a person ages.
Sensitivity to pain increases with age.
The nurse aide is taking routine vital signs on a resident. The residents temperature is 101.4� Fahrenheit. The most appropriate response by the nurse aide is to
place a cool, wet washcloth to the residents forehead.
cover the resident with extra blankets.
record and report the change at the end of the shift.
report the temperature promptly.
A nurse aide is assisting a resident at mealtime. The resident grabs his throat and cannot speak. What should the nurse aide do first?
Try to get the resident to take a few sips of water through a straw.
Reach around from behind the resident to provide abdominal thrusts.
Pat the residents back and then reach in his mouth to remove the blockage.
Ask the resident to take a deep breath and cough.
A resident reports that his wrist watch is missing. The nurse aide should ask
if the resident thinks someone took it.
if the resident has checked the lost and found box.
who was assigned to the resident on the previous shift.
for permission to help look around the residents room.
Residents are most likely to feel the urge to have a bowel movement
after taking a nap.
after eating a meal.
just before bedtime.
during the shift change.
A nurse aide hears the charge nurse scream at a resident. The nurse aide goes to the resident to provide immediate protection of the resident. The nurse aide should also
call the police immediately.
ask if the nurse is feeling stressed about something.
report the situation to the charge nurses supervisor.
ask if any other staff have ever observed this behavior.
After reporting the observation of a red area on the residents hip, the nurse aide should expect that the
resident will be placed on short-term bed rest.
area will be covered with a protective dressing.
area will need frequent massage with a moisturizing lotion.
resident should be positioned to avoid pressure on the area.
The use of a physical restraint helps
control a residents behavior.
protect the resident from injury.
make staff members jobs easier.
decrease how often staff need to check the resident.
A resident says she is 5 feet 6 inches tall. When the nurse aide measures the residents height, the resident is 5 feet 4 inches. What should the nurse aide do?
Record the residents height as 5 feet 4 inches.
Record the residents height as 5 feet 6 inches.
Explain that older people shrink with aging.
Measure the resident again.
When weighing a resident, it is important to make sure the
residents last measured weight is available.
scale measures both pounds and kilograms.
resident is wearing light weight clothing such as pajamas.
scale is balanced or calibrated before helping the resident onto the scale.
The goal when removing gloves that are soiled is to
remove quickly since there is a risk of exposure to germs.
dispose of the gloves in a biohazard-safe trash can.
avoid contact with the outside of the gloves.
keep germs in the trash can area.
A resident says, I am not going to eat this food. It is poisoned, What is the best response by the nurse aide?
Offer to taste all the food first to prove it is not poisoned.
Report to the charge nurse that the resident is acting crazy.
Ask if there is something else the resident would like to eat.
Leave the resident alone because the resident will eat when hungry enough.
A resident must stay in bed for long periods of time. Which of the following actions will best prevent the resident from developing pressure ulcers?
Put hand rolls in the residents hands.
Avoid raising the head of the residents bed.
Turn and position the resident according to schedule.
Provide range of motion (ROM) exercises every two hours.
A resident whose husband died a few years ago, says, I have got to get dinner started. My husband will be home from work soon. What is the best way for the nurse aide to respond?
Offer to walk with the resident to the activity departments kitchen.
Remind the resident that the nursing home prepares her meals.
Ask the resident about her husbands favorite dinners.
Explain gently that the residents husband is dead.
Which of the following is the most appropriate schedule for residents who are incontinent to receive perineal care?
In the morning and at bedtime
At the beginning and near the end of a shift
Whenever the resident is soiled with urine or stool
Every two hours when the nurse aide checks on the resident
When moving a resident in bed, a lift or turning sheet may be used to help prevent
atrophy.
shearing.
infections.
contractures.
A resident with advance directives has a DNR order. This means that the resident
does not remember.
should not be restrained.
does not respond to instructions.
should not be resuscitated.
When providing foot care, the nurse aide observes an open sore on the residents foot. The nurse aide should
pat gently to dry and cover with a dry dressing before applying a sock.
stop the foot care immediately and ask the resident what happened.
report the skin opening to the charge nurse as soon as possible.
check the residents sock for any wound drainage.
A resident, who is usually alert and oriented, is having difficulty remembering where he is today. What should the nurse aide do first?
Increase the residents fluids since dehydration causes confusion.
Consider that some memory loss is a normal part of aging.
Ask where the resident believes he is.
Report the change to the charge nurse.
A nurse aide is asked to provide postmortem care to a resident who died of natural causes. Which of the following is the most appropriate practice to follow when providing postmortem care?
Wear gloves, a mask and a gown when providing care.
Use strict isolation precautions throughout care.
Wash hands and wear gloves throughout care.
Double bag all items removed from the room.
A resident has returned from the hospital after a hip replacement. The nurse aide should expect that the resident will be
dependent and need total care.
confined to bed for several weeks.
going to physical therapy to increase mobility.
receiving range of motion (ROM) exercises to hip.
The Health Insurance Portability and Accountability Act (HIPAA) is important to the nurse aide because it
allows residents to carry health care from the hospital to the nursing home.
provides for insurance coverage for residents and health care workers.
identifies protected health information that must remain confidential.
provides accountability for care offered across health care settings.