CNA Ethics and Professionalism 2 — Questions and Answers
Question 1: A resident with dementia, who is non-verbal, becomes agitated during care, pushing your hand away and moaning loudly. The resident's care plan states they can be 'resistant.' What is the most ethical first action for the CNA?
- Continue with the care quickly but gently, as this behavior is expected.
- Stop the care immediately, leave the room, and document the refusal.
- Stop the care, attempt to soothe the resident with a calm voice, and try to identify the cause of agitation. (Correct answer)
- Ask another CNA to help hold the resident still to complete the task safely.
Correct answer: Stop the care, attempt to soothe the resident with a calm voice, and try to identify the cause of agitation.
Ethical care requires recognizing that behavior is a form of communication, especially in non-verbal residents. Pushing away and moaning are clear signs of distress or refusal. The CNA's primary duty is to the resident's well-being (beneficence) and to do no harm (non-maleficence). Stopping the task, attempting to comfort the resident, and assessing for a cause (e.g., pain, fear, discomfort) respects their dignity and autonomy. Continuing, restraining, or simply abandoning care would be unethical.
Question 2: You overhear a fellow CNA telling a resident's family member that the resident's roommate has been diagnosed with a contagious illness. Which professional principle is most clearly being violated?
- Scope of Practice
- Beneficence
- Confidentiality (HIPAA) (Correct answer)
- Non-maleficence
Correct answer: Confidentiality (HIPAA)
Sharing a resident's diagnosis with anyone not directly involved in their care is a major breach of confidentiality. The Health Insurance Portability and Accountability Act (HIPAA) legally protects patients' health information. Even though the CNA may have good intentions, discussing one resident's health with another resident's family is a serious violation of privacy rights.
Question 3: A resident's family brings in a special herbal tea and asks you to give it to the resident every evening. The resident is on a fluid-restricted diet and takes several medications. What is the CNA's most appropriate action?
- Give the tea as requested to respect the family's wishes and cultural practices.
- Politely decline and explain to the family that CNAs cannot administer any substances not on the care plan.
- Accept the tea and report the request to the supervising nurse for assessment and approval. (Correct answer)
- Suggest the family give the tea to the resident themselves during their next visit.
Correct answer: Accept the tea and report the request to the supervising nurse for assessment and approval.
This situation involves a potential conflict between a family's request and the resident's prescribed plan of care. Herbal supplements can interact with medications or violate dietary restrictions. It is outside the CNA's scope of practice to make this clinical judgment. The correct and professional action is to escalate the request to the nurse, who can assess the tea for potential contraindications and make an informed decision, ensuring the resident's safety.
Question 4: A CNA is assigned to care for a resident who has been personally unpleasant and rude to them in the past. To act professionally, the CNA must:
- Ask the charge nurse to reassign them to a different resident.
- Provide care that meets the minimum standard but limit unnecessary interaction.
- Provide the same quality of care to this resident as they would to any other. (Correct answer)
- Inform the resident that their rudeness is unacceptable and will not be tolerated.
Correct answer: Provide the same quality of care to this resident as they would to any other.
Professionalism requires CNAs to provide care based on need, not personal feelings. All residents are entitled to the same high standard of care, regardless of their personality or behavior. While reassigning might be an option in extreme cases, the core ethical duty is to overcome personal bias and provide impartial, compassionate, and competent care.
Question 5: During a busy shift, a nurse is overwhelmed and asks you to change a sterile dressing on a resident's surgical wound, a task you have seen done but have not been trained for. Which of the following is the most ethical and responsible action?
- Attempt the dressing change carefully to help the overwhelmed nurse.
- Tell the nurse you will do it, but only if they supervise you the entire time.
- Politely state that this task is outside your scope of practice and you are not trained to do it. (Correct answer)
- Find another, more experienced CNA to do the dressing change instead.
Correct answer: Politely state that this task is outside your scope of practice and you are not trained to do it.
Performing a task that is outside your scope of practice, especially a sterile procedure, puts the resident at risk and exposes the CNA to legal and professional liability. The most ethical choice is to recognize your limitations and clearly, but respectfully, decline the task. This protects the resident from potential harm and upholds professional boundaries. It is the nurse's responsibility to perform the task or delegate it to another qualified licensed professional.
Question 6: A resident offers you a $50 bill as a 'thank you' for your hard work. What is the most appropriate response in this situation?
- Accept the gift, as refusing would be rude and might offend the resident.
- Politely refuse the gift, explaining that it is against facility policy and your professional code of conduct. (Correct answer)
- Suggest the resident use the money to buy a treat for all the staff on the unit.
- Take the money and report it to your supervising nurse immediately.
Correct answer: Politely refuse the gift, explaining that it is against facility policy and your professional code of conduct.
Accepting money or significant gifts from residents is unethical and against the policy of almost all healthcare facilities. It can blur professional boundaries and be seen as exploitation. The correct action is to politely and graciously decline, explaining that your good care is part of your job and that you are not allowed to accept such gifts. This maintains a professional relationship and avoids any potential conflicts of interest.
CNA Ethics and Professionalism 2
A resident with dementia, who is non-verbal, becomes agitated during care, pushing your hand away and moaning loudly.
The resident's care plan states they can be 'resistant.' What is the most ethical first action for the CNA?