CNA Mental Health and Social Services Needs 1 4

Question 1

A nursing assistant notices that a resident who was previously sociable has become withdrawn, stopped eating regularly, and made a comment about 'not being around much longer.' Which of the following actions is the MOST appropriate immediate response?

Accepted Answer

Document the behavioral changes and report them to the charge nurse immediately, including the resident's exact words

Answer

Behavioral changes combined with a statement suggesting the resident may not be alive in the future are potential warning signs of suicidal ideation. The CNA must report this immediately to the charge nurse, documenting exact words used, because the clinical team must assess suicide risk. Reassuring or redirecting is insufficient when safety may be at risk. CNAs should not attempt independent suicide risk assessments, and delaying reporting could have fatal consequences.

Question 2

A resident with major depressive disorder refuses to take a shower for the fifth consecutive day, stating, 'What's the point?' The CNA has tried encouragement without success. What is the BEST next step?

Accepted Answer

Document the refusal accurately, report to the nurse, and note the resident's exact statement

Answer

When a resident refuses care, CNAs must respect autonomy while ensuring the care team is informed. The statement 'What's the point?' is clinically significant — it may indicate worsening depression or hopelessness and needs nursing and possibly psychiatric evaluation. Forcing care violates patient rights, making threats is coercive and unethical, and involving other residents breaches confidentiality and is inappropriate.

Question 3

During a routine care interaction, an elderly resident confides to the CNA that their adult child has been taking money from their bank account without permission and has threatened to stop visiting if they 'tell anyone.' How should the CNA respond?

Accepted Answer

Report the disclosure to the charge nurse as a suspected case of financial and emotional elder abuse

Answer

What the resident describes — unauthorized access to finances and coercive threats — meets the criteria for financial and emotional elder abuse. CNAs are mandated reporters and must report suspected abuse to the charge nurse or supervisor immediately, regardless of the resident's request for confidentiality. Keeping it secret enables ongoing abuse; advising confrontation may escalate danger; and contacting the bank is outside the CNA's scope.

Question 4

A resident diagnosed with schizophrenia tells the CNA that the food is being poisoned by staff. The resident is refusing all meals and is becoming increasingly agitated. What is the MOST therapeutically appropriate CNA response?

Accepted Answer

Acknowledge the resident's feelings without reinforcing the delusion, and promptly report the refusal and agitation to the nurse

Answer

When a resident experiences psychotic symptoms such as paranoid delusions, the CNA should neither argue with nor reinforce delusional thinking. Acknowledging the resident's distress ('I can see you're upset') while redirecting and promptly reporting to the nurse is the safest, most therapeutic approach. The nurse must assess whether medication adjustment is needed and whether the food refusal poses a nutritional risk. Confronting or labeling the delusion is counterproductive and can escalate agitation.

Question 5

A CNA is assigned to assist a resident who has been newly diagnosed with terminal cancer and is displaying signs consistent with the bargaining stage of grief — repeatedly asking whether following a strict diet might reverse the diagnosis. Which response BEST supports the resident's psychosocial needs?

Accepted Answer

Listen actively and empathetically without making medical claims, and inform the nurse of the resident's emotional state

Answer

The CNA's role in end-of-life psychosocial care is to provide empathetic, non-judgmental listening and to communicate the resident's emotional needs to the interdisciplinary team. Making false promises about dietary interventions reversing a terminal diagnosis is dishonest and outside scope. Explaining grief stages to the resident is clinical counseling, not CNA role. Arranging dietary changes without clinical justification is inappropriate. The nurse and social worker need to know about the resident's state to arrange proper support, such as a chaplain or social worker visit.

CNA Practice Test

CNA Practice Test

CNA Mental Health and Social Services Needs 1 4