CSLB General Building (B) — All Questions

When giving medication through a G-tube (gastrostomy tube), the aide should:

• a.Mix all pills together and pour them in dry
• b.Flush the tube with water before and after, and give liquid or properly dissolved medications separately✓
• c.Push the medication in as fast as possible
• d.Give crushed enteric-coated tablets routinely

Enteral (G-tube) medications require flushing with water before and after and giving each drug separately to prevent clogging and interactions, using liquid forms or appropriately crushed/dissolved tablets. Enteric-coated and extended-release drugs generally should not be crushed, so the nurse or pharmacist is consulted.

A resident with diabetes has a blood glucose of 55 mg/dL and is shaky and sweating. This indicates hypoglycemia. The aide should FIRST:

• a.Follow protocol to give a fast-acting carbohydrate and notify the nurse✓
• b.Give the resident's insulin dose immediately
• c.Withhold all food and fluids
• d.Wait an hour and recheck

A glucose of 55 with shakiness and sweating signals hypoglycemia, which is treated with a fast-acting carbohydrate (such as juice) per protocol and prompt nurse notification. Giving insulin would dangerously lower the glucose further.

Insulin ordered on a sliding scale means the dose:

• a.Is always the same amount
• b.Is decided by the aide's judgment
• c.Varies based on the resident's current blood glucose reading per the ordered scale✓
• d.Should be given without checking glucose

Sliding-scale insulin dosing is determined by the resident's measured blood glucose matched to the physician's ordered scale, so glucose must be checked first. The aide follows the scale exactly and confirms the dose per policy, often with a nurse for this high-alert drug.

A resident is ordered a PRN pain medication. Which is the BEST example of correct PRN judgment by the aide?

• a.Give it every time on a fixed schedule regardless of pain
• b.Give it only if the resident is unconscious
• c.Withhold it even when the resident meets the ordered criteria
• d.Give it when the resident reports pain within the ordered dose and interval, then document the response✓

PRN medications are given only when the resident meets the ordered indication (such as reported pain) and within the allowed frequency, followed by documentation of effect. Giving PRN drugs on a fixed schedule or withholding them when criteria are met are both incorrect.

A resident develops hives, swelling of the lips, and difficulty breathing shortly after a new medication. The aide should:

• a.Recognize a possible severe allergic reaction, stop, get emergency help, and notify the nurse immediately✓
• b.Give another dose to build tolerance
• c.Wait to see if it worsens before telling anyone
• d.Document it at the end of the shift only

Hives, lip swelling, and breathing difficulty suggest a possible anaphylactic reaction, a medical emergency requiring immediate help and nurse notification. Prompt action can be lifesaving, and no further doses are given.

Geriatric (older adult) residents often need extra caution with medications because:

• a.Their bodies clear all drugs faster than younger adults
• b.Age-related changes can slow drug metabolism and increase sensitivity and side effects✓
• c.They never experience side effects
• d.They always need higher doses

Aging can reduce kidney and liver function and increase sensitivity, so older adults are more prone to drug accumulation and side effects such as dizziness and falls. The aide monitors closely and reports changes, since 'start low, go slow' often applies.

A resident receiving tube feedings is ordered a medication that must be given on an empty stomach. The aide should:

• a.Give it mixed into the ongoing feeding
• b.Skip the medication entirely
• c.Coordinate with the nurse to hold the feeding as ordered and flush the tube appropriately✓
• d.Give it faster to save time

Some medications require holding the tube feeding before and after to ensure absorption, which must be coordinated with the nurse and done with proper flushing. Mixing such a drug into a continuous feeding can reduce its effectiveness.

When should the aide notify the nurse about a resident's response to medication?

• a.Only if the resident dies
• b.Never, since the aide handles everything
• c.Only at the annual review
• d.Whenever there is an adverse reaction, no improvement, a refusal, or a value outside a hold parameter✓

The aide reports promptly for adverse reactions, lack of expected effect, refusals, or vital signs outside ordered parameters so the nurse can intervene. Timely communication is central to safe medication assistance within the aide's scope.

A resident's finger-stick glucose is 320 mg/dL before a meal. According to good practice, the aide should:

• a.Follow the ordered sliding-scale or protocol and notify the nurse of the high reading✓
• b.Give a fast-acting carbohydrate like juice
• c.Withhold all the resident's medications
• d.Ignore it because the resident feels fine

A glucose of 320 is elevated (hyperglycemia), so the aide follows the ordered insulin sliding scale or protocol and informs the nurse. Giving juice would be appropriate for low glucose, not high, so recognizing the direction of the imbalance is essential.

A resident who normally swallows pills easily is suddenly coughing and choking while taking oral medication. The aide should:

• a.Continue giving the remaining pills quickly
• b.Stop administration, ensure the airway is clear and the resident is safe, and notify the nurse✓
• c.Give water forcefully to push the pills down
• d.Lay the resident flat immediately and keep feeding pills

New coughing and choking may indicate a swallowing (aspiration) problem, so administration is stopped and the resident's safety and airway are the priority before notifying the nurse. Forcing more pills or fluids could worsen aspiration.