Legal and Ethical Behavior — CNA practice questions

OBRA stands for:

1. Omnibus Budget Reconciliation Act of 1987
2. Office of Beneficiary Rights Administration
3. Older Beneficiaries' Rights Act of 1990
4. Omnibus Budget Recovery Amendment of 1990

Answer: A — Omnibus Budget Reconciliation Act of 1987

A) Correct — OBRA is the Omnibus Budget Reconciliation Act of 1987, the federal law that created nursing assistant training and competency requirements, the resident rights protections, and the standardized resident assessment used in long-term care. B) tempts because it sounds like a real federal office concerned with resident rights, but no such agency is the source of the nursing home reform requirements. C) uses the familiar words 'rights' and 'older' and a plausible year, yet OBRA is budget legislation, not a stand-alone rights act, and 1990 is the wrong year. D) recycles 'Omnibus Budget' correctly but substitutes 'Recovery Amendment' and 1990 for the actual title and year.

You see a coworker take a resident's watch. You should:

1. Speak to the coworker privately and ask her to put it back
2. Report what you saw to your supervisor immediately
3. Say nothing, since you did not see it clearly
4. Retrieve the watch later and return it to the room

Answer: B — Report what you saw to your supervisor immediately

A) Inadequate. B) Correct — financial abuse is reportable. C) Failure to report. D) Not your role.

The federal law setting nurse-aide training + competency requirements is:

1. HIPAA, the privacy rule
2. OBRA 1987, the reform act
3. OSHA, the workplace safety act
4. ADA, the disability act

Answer: B — OBRA 1987, the reform act

A) Privacy law. B) Correct — Omnibus Budget Reconciliation Act 1987 set 75-hr training minimum + competency exam. C) Workplace safety. D) Disability.

Threatening a resident with harm (without touching) is:

1. Battery
2. Fraud
3. Defamation
4. Assault

Answer: D — Assault

A) Requires contact. D) Correct. C) Reputation harm. B) Deception.

A resident asks the CNA to read a complex consent form to them and explain what to sign. The CNA should:

1. Read the form aloud and explain in plain words which line the resident should sign
2. Explain that this is not your job and leave the room
3. Sign the form as a witness on the resident's behalf so the procedure is not delayed
4. Notify the nurse — informed consent is the nurse's or provider's role

Answer: D — Notify the nurse — informed consent is the nurse's or provider's role

A) Reading and interpreting a consent form, including telling the resident where to sign, is teaching about a procedure and is outside the aide's scope. B) Refusing without getting anyone else involved abandons a resident who has an unmet need. C) Signing a consent for a resident is illegal and is never a witness role the aide holds. D) Correct — informed consent belongs to the nurse or provider, so the aide reports the request and stays with the resident.

What are the aide's duties as a mandated reporter of suspected abuse?

Report suspicion immediately to the charge nurse or supervisor. Do not investigate, do not delay, and document objective observations only.

What is a living will?

A type of advance directive in which a person states, in advance, what medical treatments they do or do not want if they become unable to make decisions for themselves.

Recertification?

Most states require ≥8 hr (often 12-24) of paid work as a CNA every 24 months OR retake the competency exam. Renewal requirements vary by state.

Confidentiality?

HIPAA applies. Don't discuss residents outside the care team or facility. Don't post anything to social media about work.