CNA Promoting Resident Independence and Choice 2

Question 1

A resident with dementia who is otherwise calm insists on wearing a heavy wool sweater on a very hot summer day. Which action by the CNA BEST promotes the resident's choice while ensuring their well-being?

Accepted Answer

Acknowledge the choice, find a much lighter sweater of a similar color, and offer it as an alternative.

Answer

This approach respects the resident's initial choice and feelings while gently redirecting them to a safer option. By offering a similar but more appropriate item, the CNA validates the resident's desire while protecting them from overheating. Forcing the resident or removing the item can cause agitation and disregards their autonomy.

Question 2

A resident has a legal guardian who has provided strict instructions for their daily care. The resident, who is alert and can express their preferences, tells you they would prefer to shower at night instead of the morning as the guardian stipulated. What is the CNA's most appropriate action?

Accepted Answer

Inform the nurse of the resident's expressed wish so it can be discussed with the resident and guardian.

Answer

Even with a legal guardian, the resident's preferences should be respected and communicated to the care team. The CNA's role is to observe, report, and advocate for the resident. Informing the nurse allows for a proper assessment and communication through the correct channels to see if the care plan can be adjusted to honor the resident's choice. Ignoring the resident's wish or the guardian's instructions is inappropriate.

Question 3

A resident who had a stroke has expressive aphasia, making it difficult to state their needs. They become visibly frustrated during morning care and begin refusing assistance. What is the CNA's BEST initial response?

Accepted Answer

Stop the task, make eye contact, and use a communication board or simple yes/no questions to determine the cause of their frustration.

Answer

Frustration in residents with aphasia often stems from the inability to communicate. The best approach is to pause, reduce pressure, and try alternative communication methods. Using a communication aid or simplifying questions to 'yes' or 'no' respects their struggle and empowers them to express their needs, which could be anything from pain to a desire to do the task differently. Proceeding without addressing the frustration can escalate the situation.

Question 4

Which of the following is an advanced application of promoting independence for a resident who frequently tries to stand from their wheelchair without assistance?

Accepted Answer

Engaging the resident in a scheduled activity like folding laundry while seated to provide purposeful engagement.

Answer

This is an example of using a restraint alternative that focuses on the root cause of the behavior. Often, residents try to stand out of boredom or a desire to be helpful. Providing a meaningful, seated activity addresses this need, promotes engagement, and reduces the unsafe behavior without using physical restraints. A lap belt or geri-chair are restraints, and simply reminding them does not address the underlying need.

Question 5

In a new 'person-centered' dining program, what is the CNA's MOST impactful role in promoting resident choice and independence?

Accepted Answer

Learning and honoring individual resident preferences for seating, meal choices, and the pace of the meal.

Answer

Person-centered dining moves away from an institutional, task-based model to one that prioritizes individual preferences and a social, home-like experience. The CNA's key role is to know each resident and actively facilitate their choices regarding who they sit with, what they eat (within their dietary plan), and when they are ready for the next course, thus promoting dignity and autonomy.

CNA Practice Test

CNA Practice Test

CNA Promoting Resident Independence and Choice 2