1) Mention what is CNA?
A CNA stands for certified nursing assistant. It is a person who has received training to help patients under the close supervision of a licensed practical nurse or a registered nurse.
2) Mention how to become a qualified CNA?
To become a qualified CNA,
- Complete state approved education program
- Pass state approved education program.
- Check local regulations before enrolling since CNA training vary by state
- CNA programs last from 4 to 16 weeks
- Pass state specific examination
- Pass a state-specific examination to be fully certified
- Graduates can work up to four months without certification while waiting to take the exam
- Get your first job
- Certified nurse assistants can only practice under the supervision of licensed nurses
- It is illegal to offer their services as independent providers
- Some states mandate CNAs must fulfill education credits each year to maintain their qualifications.
3) Mention what are the job responsibilities of a CNA Nurse?
Job responsibility of a CNA nurse include,
- Provides patients personal hygiene like backrubs, shampoos, shaves, bedpans, urinals, baths, assisting travel to the bathroom, and so on.
- Other activities include serving meals, feeding patients, ambulating, turning, and positioning patients, etc.
- CNA should also give medical help like administering enemas, nonsterile dressings, douches, surgical preps, heat treatments, ice packs, sitz and therapeutic baths, applying restraints, etc.
- Restock rooms with necessary supplies and change bed sheets.
- Take patient vital signs- testing urine, weight check, recording intake and output information.
- Transporting patients, answering patients’ call lights and request, reporting observations of the patient to nursing supervisor
- Documentation and maintaining forms, logs, reports, and records
- By following policies and procedures maintains work operations like keeping patient information confidential
- Participate in educational opportunities, maintaining licensure, reading professional publications and so on.
- Serve hospital community by adhering to professional standards, hospital policies and procedures, federal, state, and local requirements, and jcaho
- summon emergency assistance in the hospital
4) Mention what are the common challenges a CNA may face?
A common challenges a CNA may face include,
- Dealing with difficult patients and their demeanor
- Managing smooth transition of shifts
- Avoiding conflicts with co-workers
- Lack of help from co-workers
- Convincing patient and politely denying unreasonable request
5) How you deal with a patient who is aggressive and resist for medication?
To deal with patient who is aggressive and resist for medication my first approach would be,
- I would make patient calm and administer the drug if that didn’t work then
- I would make sure that he is safe, and I would ask for help
6) You will have several patients to take care of? How do you prioritize which one you attend to first?
I would assess the list and organize them in order of urgency as per their medical needs.
7) What are all places a CNA can work?
A CNA can work at following places,
- Nursing Homes
- Home Health Care Agencies
- Assisted Living Facilities
- Staffing Agencies
- Doctor Offices/Practice Groups
- Day Care Centers and Schools
- Medical Clinics
- Urgent Care Centers
By federal law, CNA are mandatory at Nursing Homes.
8) Mention medical skills a CNA must possess?
A CNA must not require a highly sophisticated medical skills, but they should know in emergency, what to do like
- To perform cardiopulmonary resuscitation if a patient is having heart attack or breathing problem
- Should know how to use pressure to stop bleeding
- What to do when unconscious patient suddenly begins to vomit
9) Give details about the CNA licensing exam?
The CNA licensing exam is taken in two segments,
- The theoretical portion includes questions about patient procedures, protecting patient privacy and other information you covered in your lectures, textbooks, and workbooks. It is written portion of the licensing exam.
- The second part of the test is a clinical portion. Where you need to practically demonstrate all tasks on a model patient.
10) Mention what is the difference between CNA and Nursing assistant?
The difference between CNA and Nursing assistant is that CNA tends to provide bedside care to senescent patients. While medical assistants assist more with procedural or administrative preparation and housekeeping.
11) Mention what are the software a CNA will be using during their tenure?
- Billing software
- Health information medical history databases
- GE Healthcare Centricity EMR
- Charting software and MS office
12) Mention what are the medical apparatus a CNA will be using?
- Automated external defibrillators
- Electronic medical thermometers
- Heating or cooling pads
- compression packs
13) Mention what are the opportunities a CNA may have?
After few years of experience as CNA, he/she can advance in following fields
- LPN (Licensed Practical Nursing)
- RN (Registered Nursing)
- RN (Neonatal Nurse)
14) What are legal guidelines CNA must be aware of?
Laws are passed by local, state and federal governments. When CNA disobey a law, he is liable for fines, loss of certification and/or imprisonment. To avoid legal issues, CNA must avoid following things,
- Knowing and staying within their state’s scope of practice rules.
- Seek the advice of your supervisor if you’re asked to do tasks you have not been trained to do
- Carry out procedures and tasks only the way you are trained or taught. Do not go after any experiments.
- Keep yourself upto date with your skills, education, and in-service requirements
- In questionable situations, seek the advice of your supervisor.
- Understand your assignment and role very well
- Do not harm patients
- Know your facility policies and standard guidelines
15) Give 1-2 example for negligence CNA can do?
Example of negligence include,
- Administering drug without supervision
- You place a wrong medication tray that belongs to another patient with the same name
- You transfer a patient by yourself even though the care plans states two staff should be present
- You give a patient a bath without checking the water temperature first.
16) When your CNA license is liable for inactivation?
Your CNA license is liable for inactivation if you do not work for at least eight (8) hours, for pay, in the provision of nursing services with two (2) or more years break.
17) What is your five-year plan as a CNA?
As a CNA mention a plan like pursuing a bachelor degree in nursing or some advanced course related to CNA. This shows that you aspire for RN (registered nurse).
18) Mention what you do if you notice a doctor or nurse not doing their job?
When you see a doctor or nurse not doing their job, you should follow protocol and report the person through the proper channels.
19) What all things CNA needs to take care while transferring a patient from bed?
While transferring patient from bed, CNA must crosscheck following things,
- Can patient bear his weight? fully or partially
- If patient is cooperative use stand and pivot technique using a gait/transfer belt
(1 caregiver) -or- powered standing assist lift (1 caregiver)
- If the patient is not cooperative use full body sling lift and 2 caregivers to transfer patient.
- If patient have upper extremity strength then use gait/transfer belt until the patient is proficient in completing transfer independently
20) While doing a lateral side transfer for patient having different weights what will be your approach?
For lateral side transfer for patient having different weights, say for
- For patient < 100 pounds use a lateral sliding aid and 2 caregivers
- Patient having >200 pounds weight use a lateral sliding aid or mechanical lateral transfer device with 3 caregivers
21) Mention what all lateral sliding aid you can use to transfer the patient to bed?
Lateral sliding aid you can use to move patient are,
- Draw sheet or transfer cot with handles
- Low friction mattress covers
- Slide boards
- Gurneys with transfer devices
- Beds that convert to chairs
22) Mention what all precautions need to be taken care while using bath boards and transfer benches?
While using bath boards and transfer benches, following things need to be taken care of
- Use clothing or material between the resident’s skin and the board
- Look for devices that allow for water drainage and have height adjustable legs
- If a wheelchair is used, ensure wheels are locked. Make sure the transfer surfaces are at the same level
- Ensure that floor is dry while taking patient out of bath tub
23) Mention for what patient height adjustable shower gurney or lift bath cart with Waterproof top is used?
Height adjustable shower gurney or lift bath cart with Waterproof top is used for a patient who is unable to sit up.
24) Mention how would you classify a pressure sore?
A pressure sore is classified into 4 stages,
- Stage I: stage I pressure sore would appear as a reddened area that does not blanch (turn white) when pressed
- Stage II: stage II pressure sore involves a partial breakdown of the upper layer of skin, but does not extend all the way through the
- Stage III: stage III and stage IV ulcers extend all the way through the skin
- Stage IV: stage IV ulcers extend all the way down to muscles, tendons or bones
25) Mention what is the proper term for an infection that is transmitted during a medical procedure?
The proper term for an infection that is transmitted during a medical procedure is iatrogenic.
26) Mention what is the measurement of the pressure in a patient’s heart during contraction?
During contraction, the measurement of the pressure in a patient’s heart is referred as systolic blood pressure.
27) Mention what is the meaning of assault and battery in CNA practice?
In CNA practice,
- Assault is referred to physical violence or threat to use violence against someone.
- Battery is actually referred for physical violence or wrongful touching against someone.
28) Mention what is the best way to deal with the irritant patient?
The best way to deal with irritant patient is,
- Talk to them
- Inform them of what you will be doing
- Be kind and gentle
- Always check the room for any hazards or waste
- Be courteous and treat them with respect
- Be vigilant in monitoring what they are doing at all times of the procedure
29) Mention what should a CNA must do to assist during a code?
A CNA must do following things to assist during a code,
- Retrieve emergency equipment, including the code cart or intubation box. Perform other tasks that fall within a CNA’s scope of practice.
- Document the events
- Administer emergency medications as per the physician’s instructions
- Speak with the family and inform them about what is happening.
30) Mention what is the responsibility of a CNA when he is informed about an admission?
The responsibility of a CNA when he is informed about an admission is to,
- Prepare the room, bed, clothing and other necessary equipment.
- Complete the admission process.
- Make sure the patient’s medications have been received from the pharmacy and it’s
- Coordinate the patient’s care with the rest of the treatment team.
31) Mention what are some of the types of post-surgical care that a nursing assistant can be asked to provide for patients?
Some of the types of post-surgical care that a nursing assistant can be asked to provide for patients include
- Monitoring and recording of vital signs ( blood pressure, temperature, heart rate, and respiratory rate)
- Post-Operative Pain, make sure their pain is under control
- Carefully moving the patient as such tubes or drains are connected with patients body
- Fluid Intake/Output should be monitored
32) Mention what are the measure and methods practiced by CNA for handling Urinary drainage bag?
For handling Urinary drainage bag, CNA should practice following steps,
- Wear gloves before handling urinary sample or urinary drainage bag
- Empty bag into relevant container without touching tubing against container
- After emptying urine wipe drain with alcohol swab
- Close or protect drain
- Leave bag close to bed and should not touch floor (use barrier)
- Remove gloves and wash hands
33) Mention how should a CNA must deal resident who has a speech problem?
- Knock on the door, call out to the resident by name and begin conversation
- keep conversation to the point and brief
- Use simple direct questions
- Be patient and wait for answers
- Use communication tools like Notepads and pens, scrabble tiles, flash cards, pointing, picture boards and maybe charades
- Repeat it back to make sure you heard right what is said
34) Mention how a CNA can become LN (Licensed Nurse)?
A CNA can become LN (Licensed Nurse),
- Need as many as 200 hours of additional education in some areas like pediatrics, maternal medicine, and gerontology.
- Need experience in a hospital, clinic, or private practice that you can use toward your license
- Need to pass the national NCLEX-PN exam to work in a hospital setting
35) Mention how to record intake and output in a resident or patient?
To record intake and output in a resident or patient, follow the steps below.
- Locate liquid foods for the resident and record their intake
- Record liquid food intake in cubic centimeters or milliliters as per facility policy
- The output is measured by pouring the urine of the resident into a graduate
- While using a gloved hand to hold the graduate, use a gloveless hand to flush down the toilet
- Disinfect each and every appliance used during the test
- Record the urine output and report any form of the unusual characteristic to nurse.
36) Mention what is Heimlich maneuver?
Heimlich maneuver is a technique used when a person’s airway get chocked. In this technique you
- Reach around the victim from behind. Circle your hands around the victim’s stomach
- Make a fist with your dominant hand. The thumb of the fist should point into the stomach (just above the victim’s navel )
- Wrap your other hand firmly around this fist and give a good inward push by pressing the victim’s abdomen
- These thrusts should be repeated until either the item is removed, or the resident loses consciousness.
- Use less force if the victim is a child.
37) Being a CNA what is the correct way to sign your name?
( P.Jason ,CNA.) is the correct way to sign the name.
38) Mention what is the right way to correct an error made while charting on a resident’s chart?
The right method to correct an error made while charting on a resident’s chart is to draw one line through it, write the words “mistaken entry,” and then initial.
39) While measuring blood pressure what you need to check as a precaution?
As a precaution, while measuring blood pressure, you need to make sure that you don’t take a BP on an arm with an IV.
40) Mention what is a goal of hospice care?
A goal of hospice care is to provide comfort to terminally ill patients and their families
41) How should be a resident in a shower chair should be placed?
A resident in a shower chair should be placed facing the door of the shower stall.
42) Mention what are the complications that can develop due to immobility?
Complications that can develop due to immobility are,
- Blood clots
- Pressure sores
43) Mention whether STNA and CNA are same?
Yes, they both are same “STNA” stands for State Tested Nursing Assistant and “CNA” stands for Certified Nursing Assistant.
44) Explain how to apply wrist and ankle restraint?
To apply wrist and ankle restraint,
- Pad the bony areas of the restrained area.
- The padded portion should be applied at the ankle or wrists correspondingly
- The tie of the restraint should be pulled through the corresponding slit
- To avoid the tourniquet effect, use a half-bow knot in order to attach the other end to the movable side of the bed
Be careful while removing the restraints, because failing to follow them will be considered negligence.
45) Mention how to get the most accurate patient weight?
To get the most accurate patient weight, the nursing assistant should weigh the patient at the same time every day.
46) Being a nurse how you contribute to your patient?
- Offer them the best care and advice for their good health
- Provide them comfort and attention by listening to their concerns
- Ensuring that they are taking their medication regularly
47) What are the duties of a Vocational Nurse?
Duties of Vocational Nurse includes
- Provide medication regularly or intravenous fluid
- Observe patients and reporting any changes in patient’s condition
- Sterilize equipment and supplies
- Provide basic patient care like checking patient temperature, treating bedsores, dressing wounds, performing catheterization
- Answer patients call
- Collect samples of urine, blood and sputum and send samples for laboratory tests
- Assemble and sterilize equipment like catheters, tracheotomy tubes and oxygen suppliers
- Prepare the patient for tests, examinations and treatments
48) Explain what is the difference between LVN, RN and VN?
RN is a Registered Nurse and more responsible in respect of setting patient care than LVN. While, LVN is a Licensed Vocation Nurse, and can collect data on a patient and carries out clinical duties under the supervision of licensed physician or RN. Both has to pass a national licensing exam- for LVN it is NCLEX-PN and for RNs it is NCLEX-RN. Without holding the certificate of LVN one cannot work as vocational nurse.
49) What are the skills required for a Vocational Nurse?
Skills required for a Vocational Nurse is
- He/she should be a people’s person
- Always ready to serve people
- Good at communication and understanding people’s problem
- Must mentally prepare to do any work
- Must be detail oriented- observing, receiving and obtaining information from lead nurse, doctors and patients
50) What are the challenges that nurse have to face?
Some of the challenges that nurse have to face is
- Meeting patient expectation
- Work stress due to limited staff
- Time management
- Working in odd shift
- Conflict between staff members, patient and patient relatives
51) How to deal with a difficult patient?
To deal with a difficult patient, you have to take following things in consideration
• Don’t just hear patient, listen to them
• Seek the assistance of fellow staff member while dealing with a difficult patient
• Check the history of the patient if he/she is under any psychological treatment
• Report or record any uneven incident from the patient
• Inform the supervisor in case of threat or any abnormal behavior from the patient
• Try to figure out the cause that makes them restless or uncomfortable
52) Where vocational nurse can work?
Vocational nurse can work anywhere in
• In the hospital under supervision of LVN, RN or Doctors
• Community care facilities
• College or community health clinics
• Private homes
• Nursing homes
• Physician offices
• Outpatient care centers
53) Explain how to stay updated with the nursing profession?
To stay updated with the nursing profession, you have to
• Subscribe professional nursing journals and literature like American Journal of Nursing
• Registering with relevant forums and groups
• Attending seminars and vocational training program
• Learn about new technologies used in field online
54) Mention what are the general check-up does vocational nurse have to do?
General observation that vocational nurse have to do are
• Check for the vital sign in a patient, including apical pulse
• Height and Weight
• General appearance of skin and nails
• Hair masses and swelling of the scalp
• Pupil size, shape, symmetry and reaction to light
• Analysis of the lips appearance like color, ulceration, moisture, etc.
• Check inside the mouth like bleeding gums, dental caries, cracked or chipped teeth
• General appearance of the mouth and color of the sclera
• Abdominal tenderness or see for bowel sounds
• Curvature of the spine, posture, gait or motion problems
• Deformities and joint injuries
• Peripheral pulses
• edema and involuntary muscular movements
55) What vocational nurses don’t do?
Vocational nurses may NOT do
• Comprehensive assessments like complete medical analysis
• May not make a medical or nursing diagnosis
• May not assume responsibility for determining nursing interventions for specific patients
• May not independently determine or initiate a course of treatment
• May not perform endotracheal intubation
• May not administer emergency medication intravenously or via endotracheal tube
• May not apply casts
• May not cut a window or bivalve a cast even upon the order of a physician
• May not dispense medication
• May not remove an occlusion by aspiration or other means
• May not initiate or superimpose intravenous fluids into a peripheral site if the infusate contains medications
56) Explain when a vocational nurse can initiate intravenous fluids into a peripheral site?
A vocational nurse can initiate intravenous fluids into a peripheral site when
• LVN holds a valid post license certificate in intravenous therapy
• When the infusate is a solution of vitamins, electrolyte, nutrients, blood or blood products
• When administration is carried out under the supervision of a valid physician order
57) Can vocational nurses do medical screening exam?
The board of nursing of that states determines the practice for nursing. As far as medical screening exam is concerned, it is not under the scope of vocational nurses, regardless of having years of experience. Even if the physician wishes to delegate the assessment of the medical condition, vocational nurse can only perform the task that falls under the act 217.11.
58) Can a vocational nurse administer a sedation drugs?
The regulatory body for nurses does not give permission to vocational nurse to administer sedation drug intravenously or by any other route to the patient. However, regulatory board cannot supervise the physician practice.
59) Can a vocational nurse give directions to the patient on the phone?
Vocational nurse cannot give any direction or suggestion to the patient in an independent environment to safeguard patient.
60) Explain what is the procedure for a nurse to work with radiologic procedures?
The nurse who are willing to or intended to work with radiologic procedure has to register themselves with the regulatory board of that states by filling the form with documents like.
• Current licensure of a registered nurse
• The name and address of the practitioner or director of radiological services under whose guidance the radiologic procedure has to be performed
• Once received confirmation of registration, any change in the information shall be informed in 30 days
• The nurse has to practice according to the regulatory body of the nurse of that state
61) Can LVN nurse pronounce the patient’s death?
An LVN nurse are not allowed to pronounce patient’s death in hospital, however there are different laws for different states, and few facilities allow two RNs to pronounce patient death with a set protocol.
62) How would you deal with a doctor who is rude and demeaning to you?
- Discuss with the doctor straightway to find the reason
- Also, if there is anything that displeased him I would find out and rectify the situation
- If he goes rude once I would ignore it. Otherwise, I would notify to my supervisor
63) How would you handle patient who complains about everything?
- Make sure whether patient has some genuine reason and try convince them what we were doing is best for them
- Try to explain them your responsibility is not limited to one particular patient
- Ask them politely to stop being mean to you if they are getting unnecessarily on your nerves
- If issue cannot be resolved, approach your supervisor.
64) What is most rewarding about being a nurse?
The most rewarding about being a nurse is
- Taking care for people who are in pain and suffering
- See the happiness on the face of the patient when they recover from critical condition
- Interacting with patients and their families
- Assuring the patient how important the patient is
65) Explain what is the responsibilities of nurses?
Registered nurses primary responsibilities are
- Administering medications
- Managing intravenous lines
- Monitoring and observing patients conditions
- Maintaining records and communicating with doctors
- If necessary provide moral support to patients and relatives
- Giving direction patient and patient relative about medications
- Train other nurses
66) What is the most challenging part of being nurse?
The most difficult part of being nurse is
- You have to take care of many patients at the same time which cause much stress sometimes
- When you see your patient hopeless and suffering from pain
- When you cannot help patient to face a difficult situation
- When you have to work in shift
67) Where nurse practitioners can provide patient care?
The various field where nurse practitioners can provide their service are
- School health
- Women’s health
- Family and adult health
- Mental health
- Home Care
68) Can anyone see a nurse practitioner?
Yes, anyone who are interested in seeing a nurse practitioner can visit by asking their health care provider.
69) Mention the normal blood glucose level?
Normal blood glucose in a healthy person is between 4-8 millimoles per litre.
70) What patient is considered diabetic?
According to WHO, a diabetic person has blood sugar 7millimoles per litre or more and blood glucose after two hours of eating is 11.1 millimoles per litre
71) What are the duties of nursing assistance?
The duties of nursing assistance includes
- Skin care and bathing
- Mouth and Hair care
- Making beds
- Toileting assistance and catheter care
- Helping patient to walk who can’t
- Assisting with range of motion exercise
- Positioning bedridden patients regularly
- Safety awareness
- Reporting all changes to the nurse
- Observing, reporting and documentation
- Post-mortem care
72) What are hygiene procedures for unconscious patients?
For unconscious patients, nurse has to do following things
- At least every four hours oral care should be taken care of
- To prevent aspiration in the unconscious patient oral suctioning may be required
- A soft toothbrush or gauze padded tongue can be used to clean and mouth
- Patient handling in suitable position for drainage and to prevent perspiration.
73) What are the precaution nurse have to take while bathing patient on bed?
- During patient bed bath, bed should be in high position
- Side rails should be up after the patients bath for the patient who is confined to the bed
- Side rails help to prevent falls for the elderly patient
- Patients call light should be in reach of the patient
- No smoking is allowed surround the patient bed
- Wash hands after leaving the patient room
74) What are the methods by which medication can be administered?
Different methods for administering the medication is
- Gas Inhalation
75) Explain what are topical drugs?
The topical drugs are applied to the surface area of the body. The two purpose of topical drugs are
- Local Effect: The drug is used to relieve the patient from burning, itching or other skin conditions
- Systemic Effect: The drug is absorbed through the skin into the bloodstream
76) Explain what is the difference between Intradermal and Intravenous?
- Intradermal: Intradermal is the method of injecting drugs within the dermis layer of the skin.
- Intravenous: Intravenous is the method of administering the drug or fluid directly into the veins
77) What are the tips for administering Subcutaneous Injections?
While giving subcutaneous injections
- Injection should not contain fluid more than 1 ml
- Give at 45-90 degrees of angle
- It can be given at outermost part of the upper arm, abdomen, anterior part of the thigh, upper back, upper ventral or dorsogluteal area. The insertion site depends on the nature of medication and patient’s preference.
78) What is an air embolism?
An air embolism is a medical term used when any large air bubble trapped in blood vessel. At some instant of time, this air bubble could block the artery and cut off the blood supply to a particular part of the body. Death may occur if large bubble of gas becomes lodged in the heart.
79) What are the different types of burns?
Burns are categorised according to their severity; there are five types of burns
- First-degree burns: First-degree burn involves red, dry and painful blanch on the epidermis. It heals in 1 week without scarring
- Superficial or second degree burns: There is a blister formation and is very painful it includes the superficial dermis. It usually takes 10 to 14 days for healing
- Deep second degree burn: it is less painful than superficial dermis, but it takes more time to heal
- Third-degree burn: In this burn, you would observe a leather like texture due to destroyed collagen, and they do not heal spontaneously
- Fourth-degree burn: It extends beyond the skin to fat, tendon, muscle or bone. In such cases, you need amputation or complex reconstruction
80) Explain what is occlusive dressing?
Occlusive dressing is not used for treating wound for long terms, but it is used to provide immediate control of pressure and to stop bleeding from the wound. It provides a barrier between the wound and contamination agent like air and water.
81) Explain what is a skin graft?
Skin graft is a surgery where a fresh layer of skin from patient body is cut and placed it over the damaged skin of the patient. This method is usually used in treating patient having third-degree burn.