CNA Activities of Daily Living Practice Test

Question 1

The resident is drowsy and cannot sit upright. Which is the safest position for oral care?

Accepted Answer

Side-lying. C (correct): The side-lying position prevents aspiration by allowing fluids to drain from the mouth rather than pool in the airway, making it the safest position when upright positioning is not possible. A (incorrect): The supine position (lying flat on the back) increases the risk of aspiration because fluids can flow into the airway. B (incorrect): The resident is described as unable to sit upright, so High Fowler's position is not possible. D (incorrect): The prone position (lying face down) is inappropriate for oral care and increases aspiration risk.

Question 2

A resident can brush their own hair but needs setup. What should the nurse aide do?

Accepted Answer

Provide the brush and encourage independence. B (correct): Providing setup assistance while encouraging the resident to complete the task independently supports both dignity and functional independence. A (incorrect): Since the resident is capable of brushing their own hair, doing it for them unnecessarily reduces independence and self-esteem. C (incorrect): This is not a professional response. If the nurse aide is too busy, they should suggest a time when they can return to help with setup. D (incorrect): Elderly residents need more time to complete ADLs and should never be rushed or have care skipped because of the pace at which they work.

Question 3

A nurse aide is assisting a resident with their bath. Which action by the nurse aide will maintain the resident's dignity?

Accepted Answer

Using a bath blanket to cover areas not being washed. B (correct): Covering exposed body parts with a bath blanket during bathing maintains the resident's privacy and dignity and also prevents them from getting cold. A (incorrect): Leaving the door open is disrespectful and violates the resident's privacy. The door should always be closed during personal care. C (incorrect): Elderly residents need more time to complete tasks. If timing is a concern, the nurse aide should schedule the bath earlier so the resident can be ready for breakfast without being rushed. D (incorrect): Telling a resident they should be bathing without assistance is disrespectful and can cause unnecessary stress. Independence should be encouraged in a supportive and dignified way.

Question 4

A nurse aide is assigned to assist a resident with toileting. The resident says, "I can do this myself. Please leave." What should the nurse aide do?

Accepted Answer

Respect the resident's request, but ensure the call light is within reach. Residents have the right to privacy and independence. The nurse aide should respect the resident's wishes while ensuring safety by placing the call light within reach. This allows the resident to call for help if needed. Independence should be encouraged whenever it is safe to do so. Insisting on staying (A) violates the resident's right to privacy and dignity. The nurse aide should not force assistance on a resident who is capable of performing a task independently. Leaving immediately without ensuring the call light is within reach (B) could put the resident at risk if they need assistance. Telling the resident that staff must observe all toileting (D) is not true and violates the resident's right to privacy. Staff do not need to observe all toileting unless there is a specific safety concern documented in the care plan.

Question 5

A resident coughs frequently during meals. What should the nurse aide do?

Accepted Answer

Place them in High Fowler's position and notify the nurse. D (correct): Frequent coughing during meals can be a sign of aspiration. Sitting the resident upright in High Fowler's position helps food enter the esophagus more easily and reduces aspiration risk. The nurse should be notified immediately to assess the resident. A, C (incorrect): Cutting the food into smaller pieces or providing clear liquids could actually worsen aspiration in some cases and does not address the underlying concern. These changes to a resident's diet must be ordered by a licensed provider. B (incorrect): The cough is occurring during eating and is likely related to a swallowing issue, not a respiratory problem. The nurse needs to assess the resident — a cough medication order is not the appropriate response.

Question 6

A resident tells the nurse aide, 'I don't want a male aide helping me shower.' What is the nurse aide's BEST response?

Accepted Answer

'I understand. I'll report your preference to the nurse/supervisor.'. C (correct): This response respects the resident's dignity, autonomy, and right to privacy while appropriately escalating the preference through the chain of command to find a solution. A (incorrect): While staffing may be a real constraint, using it to dismiss the resident's preference is manipulative and does not respect their rights. Accommodations should be attempted before telling the resident their preference cannot be honored. B (incorrect): Withholding bathing as a consequence of the resident's preference violates their rights and constitutes neglect. D (incorrect): Dismissing the resident's feelings as 'silly' is disrespectful and invalidating. Personal care preferences, especially around gender, are meaningful and must be honored whenever possible.

Question 7

A nurse aide is helping a resident get dressed for the day. The resident has weakness on the left side due to a stroke. Which action should the nurse aide take when putting on the resident's shirt?

Accepted Answer

Put the shirt on the left arm first, then the right arm. When dressing a resident with weakness on one side, the nurse aide should dress the weaker or affected side first. This reduces strain and discomfort for the resident. The phrase to remember is "weak side first" for dressing and "strong side first" for undressing. Dressing the stronger arm first (A) would require the resident to awkwardly maneuver the weaker arm into the sleeve, causing discomfort and potential injury. While resident preferences are important (C), there is a correct clinical technique for dressing a resident with one-sided weakness that the nurse aide should follow. Putting on both arms at the same time (D) is not a practical dressing technique and does not account for the resident's weakness.

Question 8

The nurse aide is helping a resident with mouth care. The resident wears dentures. Which action should the nurse aide take when cleaning the dentures?

Accepted Answer

Clean the dentures over a sink filled with water or lined with a towel. Dentures should be cleaned over a sink filled with water or lined with a soft towel. This prevents the dentures from breaking if they are dropped. Dentures are expensive to replace and the resident needs them to eat and speak properly. Hot water (B) can warp or damage dentures. Dentures should be cleaned with cool or lukewarm water. Dentures must be removed from the mouth for proper cleaning (C). Leaving them in place does not allow for thorough cleaning of all surfaces. Dentures should be soaked in a denture cleaning solution or plain water, not mouthwash (D). Mouthwash can damage denture materials and is not designed for overnight soaking.

Question 9

The nurse aide is helping a resident who uses a cane ambulate to the activity room. Where should the nurse aide position themselves while walking with the resident?

Accepted Answer

On the resident's weaker side and slightly behind. When assisting a resident who uses a cane, the nurse aide should walk on the resident's weaker side and slightly behind. This position allows the nurse aide to provide support if the resident loses balance on their weaker side while not interfering with the cane on the stronger side. Walking in front of the resident (A) blocks their path and does not allow the nurse aide to provide immediate support if the resident loses balance. Walking behind the resident (C) does not provide adequate support. The nurse aide would not be able to reach the resident quickly if they began to fall. The cane is typically used on the stronger side. If the nurse aide is also on the stronger side holding the resident's arm (D), this interferes with the proper use of the cane and does not support the weaker side.

Question 10

The nurse aide is caring for a patient who has had a stroke and is experiencing residual left-sided weakness. He needs minimal assistance with dressing. How should the CNA assist him?

Accepted Answer

Help him dress by standing on his weaker side. When helping a patient who has suffered a stroke and has unilateral weakness, the aide should assist the patient by standing on the patient’s weaker side to assist them with dressing. This helps ensure that if the patient were to become weak, you are on their weaker side to assist them. Putting on the shirt or getting another aide to dress him reduces the patient’s independence. It would be unsafe to leave a patient with unilateral weakness alone to dress.

Question 11

A nurse aide is preparing to give a bed bath to a resident. Which action demonstrates proper infection control technique?

Accepted Answer

Change the bath water when it becomes cool or soapy. Bath water should be changed when it becomes cool, soapy, or dirty. This maintains resident comfort and prevents the spread of microorganisms. Clean, warm water is necessary for effective hygiene and infection control. Using the same washcloth for the entire body (A) spreads microorganisms from one area to another. Different areas of the body require separate washcloths or the washcloth should be folded to expose a clean surface. The correct technique is to wash from the cleanest areas to the dirtiest areas (B). This prevents spreading microorganisms to cleaner body parts. Gloves should be worn throughout the bed bath procedure (D), not just for perineal care, to protect both the resident and the nurse aide from the transmission of microorganisms. Note: The CDC recommends glove use during bathing only if there is broken skin or a disease that can spread from contact. Follow your facility's protocol.

Question 12

The nurse aide is assisting a resident with eating breakfast. The resident begins to cough and appears to have difficulty swallowing. What should the nurse aide do first?

Accepted Answer

Stop feeding and report to the nurse immediately. Coughing and difficulty swallowing are signs of possible dysphagia, which increases the risk of aspiration. The nurse aide should stop feeding immediately and report these observations to the nurse. The nurse can then assess the resident and determine if a swallowing evaluation is needed. Continuing to feed a resident who is showing signs of swallowing difficulty (A) increases the risk of aspiration and choking. Giving liquids to a resident who is having difficulty swallowing (C) can cause aspiration. Thin liquids are often the most difficult to swallow safely. Encouraging the resident to swallow harder (D) does not address the underlying problem and could lead to aspiration.

Question 13

Which resident should NOT receive nail care from a nurse aide?

Accepted Answer

A resident with diabetes. B (correct): Diabetic residents have reduced circulation and slower wound healing, so nail care carries a high risk of injury or infection. Nail care for residents with diabetes must be performed by a nurse or podiatrist. A (incorrect): Nurse aides can assist residents with arthritis with nail care, taking extra care due to joint sensitivity. C (incorrect): Nurse aides can provide nail care to residents with limited vision with appropriate care and communication. D (incorrect): Nurse aides can assist residents with mild dementia with nail care, using a calm approach and clear step-by-step communication.

Question 14

A resident is on a mechanical soft diet. Which food item is appropriate?

Accepted Answer

Scrambled eggs. C (correct): Scrambled eggs are soft, moist, and require minimal chewing, making them an appropriate food for a resident on a mechanical soft diet. A (incorrect): Raw carrots are hard and crunchy and require significant chewing. They are not appropriate for a mechanical soft diet and pose a choking risk. B (incorrect): A whole apple has a firm texture and skin that requires biting and chewing. It is not appropriate for a mechanical soft diet. D (incorrect): Peanuts are hard, small, and difficult to chew, making them a choking hazard and inappropriate for a mechanical soft diet.

Question 15

A resident with dementia repeatedly tries to stand up without assistance. What should the nurse aide do?

Accepted Answer

Use a calm voice, stay with the resident, and notify the nurse about repeated unsafe attempts. B (correct): Staying with the resident and communicating calmly is both safe and therapeutic. Repeated unsafe attempts should be reported to the nurse so that a care plan intervention can be developed to address the behavior. A (incorrect): Moving the resident to their room alone increases fall risk and social isolation, which can worsen agitation in residents with dementia. C (incorrect): Threatening or shaming the resident is unethical, non-therapeutic, and violates the resident's rights. D (incorrect): Restraints require a physician's order and are considered a last resort after all other interventions have been exhausted. A nurse aide cannot independently apply a restraint.

Question 16

The nurse aide is helping a resident with dementia get ready for bed. The resident becomes agitated and refuses to put on pajamas. What should the nurse aide do?

Accepted Answer

Leave and return in a few minutes to try again. Residents with dementia may become agitated during care activities. The nurse aide should remain calm, stop the activity, and return in a few minutes to try again. A brief break often allows the resident to calm down and may make them more receptive to care. This approach respects the resident's dignity and reduces the risk of escalating the agitation. Firmly insisting (A) can increase agitation in a resident with dementia. This approach does not respect the resident's feelings and may lead to a combative situation. Forcing care on a resident (C) is never acceptable. This violates the resident's rights and is considered abuse. Describing the resident as "being difficult" (D) is not professional or accurate. The behavior is a symptom of dementia, not willful defiance. The nurse aide should try alternative approaches before reporting.

Question 17

A nurse aide is making an occupied bed. The resident is able to turn from side to side with assistance. Which action should the nurse aide take to maintain the resident's safety?

Accepted Answer

Raise the bed to a comfortable working height and use side rails appropriately. When making an occupied bed, the nurse aide should raise the bed to a comfortable working height to prevent back strain. Side rails should be used appropriately—raised on the side the resident is turned toward to prevent falls. This protects both the resident and the nurse aide. Lowering both side rails (A) increases the risk of the resident falling out of bed, especially when they are being turned to one side. Keeping the bed in the lowest position (B) requires the nurse aide to bend over, which can cause back injury. The bed should be raised to working height during the procedure. Asking the resident to hold the headboard (D) is not a safe technique. The headboard may not be secure, and this does not provide proper support for the resident during turning.

Question 18

A nurse aide is assisting a resident with a shower. The resident asks the nurse aide to leave the bathroom door open so it does not get too warm. What should the nurse aide do?

Accepted Answer

Keep the door closed to maintain the resident's privacy. The nurse aide must maintain the resident's privacy during bathing, even if the resident requests otherwise. Other people in the facility could see the resident undressed if the door is left open. The nurse aide should explain this to the resident and offer other solutions, such as adjusting the water temperature or using a fan. Leaving the door open (A) would expose the resident and violate their right to privacy and dignity, even if the resident made the request. Other residents and visitors could see them. Leaving the door slightly open (C) still compromises privacy. The resident could be seen by others passing by the bathroom. This is not a decision that requires the charge nurse's input (D). Maintaining privacy during personal care is a basic standard that the nurse aide should uphold.

Question 19

The nurse aide has taken the resident's oxygen saturation (SpO2) with a result of 89% on room air. The resident's baseline is usually in the mid-90s. What should the nurse aide do?

Accepted Answer

Report it to the nurse promptly. B (correct): An SpO2 of 89% is below the normal range of 95 to 100% for healthy adults and is significantly below this resident's established baseline of the mid-90s. This drop requires immediate reporting to the nurse for assessment. A (incorrect): Low oxygen saturation can be clinically serious even when the resident does not appear to be in obvious distress. Relying on outward symptoms alone is not safe practice. C (incorrect): Oxygen is a medication and must never be applied or adjusted without a direct order from a licensed provider. D (incorrect): Abnormal vital signs must be reported immediately, not held until the nurse makes rounds. A delay in care could allow the resident's condition to deteriorate.

Question 20

The nurse aide notices that a resident who normally walks independently is unsteady and almost falls while walking to the dining room. What should the nurse aide do?

Accepted Answer

Help the resident to a safe seat and report the change to the nurse. A change in a resident's ability to walk safely is a significant observation that must be reported to the nurse immediately. The nurse aide should first ensure the resident's safety by helping them to a seat, then report the change. The nurse can assess the resident and determine if there is an underlying cause. Telling the resident to be more careful (A) does not address the reason for the unsteadiness and does not ensure the resident's safety. This could be a sign of a medical problem. While documentation is important (C), the nurse aide must report this change to the nurse immediately. This is not a routine observation that can wait. It is not within the scope of practice of the nurse aide to restrict a resident to a wheelchair (D). This decision must be made by the nurse or physician after assessment.

Test Details

Activities of Daily Living Practice Test is Designed by Nursing Educators

Michele J. McCarthy

Kailey R.

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Common Questions We Always Get

What counts as Activities of Daily Living on the CNA exam?

Is this practice test like the real NNAAP exam?

How do I stop getting tricked by ‘two correct answers’?”

What are the most common ADL mistakes students make?”

What ADL topics are most likely to show up?”

Do I need to memorize steps, or understand the ‘why’?”

Is the CNA exam only written questions?”