Client Rights — CNA practice questions

Restraints may be used:

1. For staff convenience when the unit is short-staffed and residents cannot be watched closely
2. Only with a current physician order, for a defined medical purpose, after less restrictive alternatives have failed
3. Routinely on residents with dementia who wander, since wandering is a widely recognized safety hazard
4. At the CNA's discretion whenever a resident's behavior looks unsafe, with the nurse told afterward

Answer: B — Only with a current physician order, for a defined medical purpose, after less restrictive alternatives have failed

A/C/D) Illegal. B) Correct.

When answering a call light, you should:

1. Tell the resident through the door to wait until you have finished the task you are already doing
2. Turn the light off on your way past and come back once the current round of care is complete
3. Respond promptly, knock and identify yourself, and find out what the resident needs before leaving
4. Send another staff member in your place without first checking what the resident needs

Answer: C — Respond promptly, knock and identify yourself, and find out what the resident needs before leaving

C) Correct - answering quickly, identifying yourself, and learning the need before leaving the room prevents falls from residents who try to get up alone and prevents delayed toileting or pain relief. A) and B) both delay care, and B) also cancels the signal without meeting the need. D) may be appropriate after the need is known, but passing it along unchecked risks sending someone who cannot help.

A resident tells the nurse aide that a family member has been taking money from her purse. The nurse aide should:

1. Advise the resident to keep the purse locked and check on it later in the week
2. Report the resident's statement to the nurse right away, quoting what she said
3. Ask the family member about the missing money at the next visit
4. Wait to see whether the resident repeats the story, since memory may be impaired

Answer: B — Report the resident's statement to the nurse right away, quoting what she said

B) Correct - suspected financial exploitation is reported through the chain of command immediately and charted in the resident's own words; the aide reports and does not investigate. A) offers a practical tip but leaves a mandated report unmade. C) is investigating and confronting, which is outside the aide's role and may endanger the resident. D) delays a mandated report based on the aide's own judgment of credibility; every allegation is reported.

During a procedure, you should provide privacy by:

1. Leaving the door slightly open so the nurse can see in and respond quickly if you need help
2. Closing the door, drawing the curtain, and exposing only the area being cared for
3. Asking a coworker and any visitors to stay and observe so the resident is never left unattended
4. Removing all of the resident's clothing at the start so the procedure is finished in one step

Answer: B — Closing the door, drawing the curtain, and exposing only the area being cared for

A) A cracked door still exposes the resident to hallway traffic; call for help by other means. B) Correct. C) Observers require the resident's permission. D) Expose only what you are working on, and keep the rest covered.

Which is NOT a resident right?

1. The right to refuse an offered treatment or a medication
2. The right to confidentiality of personal and medical information
3. Right to demand the CNA share other residents' information
4. The right to voice grievances without fear of retaliation

Answer: C — Right to demand the CNA share other residents' information

A/B/D) Protected rights. C) Correct — not a right; violates others' confidentiality.

You are about to give a bed bath. What should you do FIRST after gathering supplies?

1. Knock, identify yourself, explain the procedure, and provide privacy
2. Begin washing the face with a clean corner of the washcloth
3. Lower the side rails and raise the bed to a comfortable working height
4. Remove the gown and cover the resident with a bath blanket for warmth

Answer: A — Knock, identify yourself, explain the procedure, and provide privacy

A) Correct - knocking, introducing yourself, explaining what you are about to do and closing the door or curtain protects the resident's dignity and obtains her agreement before any care begins. B) washing the face is the correct first washing step, but it comes after the resident knows what is happening and is covered. C) raising the bed and lowering the rails is proper body mechanics, but it is done after the resident consents and privacy is provided. D) removing the gown before privacy is arranged exposes the resident.

A resident who wanders is placed alone in a room with the door held shut by a chair for two hours because staff are busy. This is BEST described as:

1. A safe alternative to a physical restraint
2. Reasonable use of environmental control during short staffing
3. Involuntary seclusion, a form of abuse
4. A restriction that is permitted if it is documented in the record

Answer: C — Involuntary seclusion, a form of abuse

C) Correct - separating a resident from others and confining the resident to a room against his or her will is involuntary seclusion, which federal rules classify as a form of abuse. A) is a common misconception; confining someone to a room is itself a restraint of freedom, not an alternative to one. B) staffing levels never justify confining a resident. D) documenting an improper practice does not make it lawful.

A resident wants to manage their own money. They have the right to:

1. Have the facility manage the account for them as a standard admission policy
2. Manage their own funds or designate any person they choose to do so
3. Hand the money to the CNA who cares for them for safekeeping
4. Have no say, because the facility decides how resident funds are held

Answer: B — Manage their own funds or designate any person they choose to do so

A) Violates OBRA. B) Correct. C) Boundary violation. D) Wrong.

A new resident brings a wedding ring, a quilt and family photographs to the facility. Which action by the nurse aide BEST supports the right to personal possessions?

1. Send all valuables home with the family, since the facility cannot be responsible for lost or stolen property
2. Store the items in a locked drawer at the nurses' station and bring them out during visits
3. Label every item with the resident's name and place them in the closet out of sight for safekeeping
4. Help the resident arrange the items in the room and follow facility policy for inventorying valuables

Answer: D — Help the resident arrange the items in the room and follow facility policy for inventorying valuables

D) Correct — residents may keep and use personal possessions, and the aide supports this by helping arrange them and following the inventory policy that protects them. A) removes a right in the name of liability; the decision belongs to the resident. B) makes the resident ask permission to use her own belongings. C) labeling is a good practice, but storing the items out of sight defeats the purpose of having them.

OBRA's Residents' Bill of Rights guarantees all EXCEPT:

1. The right to personal privacy during care, treatment, and visits with family
2. The right to be treated with dignity and to have personal preferences respected
3. The right to be free from physical and chemical restraints used for staff convenience
4. The right to refuse infection-control measures during a facility disease outbreak

Answer: D — The right to refuse infection-control measures during a facility disease outbreak

A) Personal privacy during care, treatment, and visits is guaranteed. B) Dignity and respect for personal preferences are guaranteed. C) Freedom from restraints used for discipline or staff convenience is guaranteed. D) Correct as the exception — resident rights are broad, but they do not include refusing public-health measures such as isolation during an outbreak, because those protect other residents and staff.

OBRA Resident Rights?

Federal rights for nursing-home residents: dignity, privacy, freedom from abuse, freedom from restraint, participation in own care, refuse treatment, manage own money, voice grievances.