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A certified nursing assistant (CNA) is assisting a patient into a wheelchair. The nurse intervenes if the CNA has:

left the patient with the lap robe tucked underneath.

left the brakes of the wheelchair unlocked.

placed the patient's feet centered on the footrests.

placed slippers on the patient.

Answer and Explanation

The Correct Answer is B

A. Left the patient with the lap robe tucked underneath.

A lap robe is used for warmth and comfort; tucking it under does not pose a risk.

B. Left the brakes of the wheelchair unlocked.

Wheelchair brakes must be locked during transfers to prevent the chair from moving and causing a fall.

C. Placed the patient's feet centered on the footrests.

Feet should be properly placed to avoid dragging or injury.

D. Placed slippers on the patient.

This is appropriate as long as the slippers are non-skid, providing safe footing during transfer.

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Correct Answer is C

Explanation

A. Abducting the arm to a 90-degree angle from the side of the body

This is only partial abduction; full ROM involves more than 90 degrees.

B. Adducting the arm so that it lies next to the client's side

Adduction is part of the range, but not a complete indicator of full shoulder ROM.

C. Flexing the shoulder by raising the arm from a side position to a 180-degree angle

This demonstrates full shoulder flexion, from rest to above the head.

D. Circumducting the shoulder in a 180-degree half circle

Circumduction is a circular movement, but a 180° half-circle isn’t a full demonstration of the shoulder’s capacity.

A. cover the pin with several gauze pads and tape securely. B. assure the patient that such drainage is expected. C. notify the charge nurse of possible infection. D. wipe off drainage with a damp wash cloth.

Correct Answer is B

Explanation

A. Cover the pin with several gauze pads and tape securely:

This may trap moisture and increase infection risk. Pin sites need to be monitored and cleaned regularly.

B. Assure the patient that such drainage is expected:

Serous drainage is a normal finding after pin insertion. Reassurance is appropriate unless signs of infection are present.

C. Notify the charge nurse of possible infection:

This may be premature without signs of infection (e.g., purulent drainage, redness, fever).

D. Wipe off drainage with a damp wash cloth:

This is not a sterile technique and may introduce infection. Pin site care should follow sterile protocol.

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A certified nursing assistant (CNA) is assisting a patient into a wheelchair. The nurse intervenes if the CNA has:

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has been hospitalized and is performing active range-of-motion exercises. Which of the following body movements should indicate to the nurse that the client has full range of motion of the shoulder?

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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