CNA Resident's Rights 5

Question 1

A resident with mild cognitive impairment refuses a prescribed medication, stating she doesn't want to take it anymore. The nurse tells the CNA to 'just put it in her pudding so she doesn't have to worry about it.' What is the CNA's most appropriate response?

Accepted Answer

Refuse to participate and report the nurse's instruction to the charge nurse or supervisor

Answer

Covertly administering medication without a resident's knowledge or consent is a form of chemical restraint and a violation of the resident's right to refuse treatment — regardless of cognitive status. It may also constitute abuse or neglect under state and federal law. The CNA must refuse to participate and immediately report the instruction up the chain of command. Family permission does not override the resident's own refusal rights.

Question 2

A resident requests that his roommate be moved out of their shared room because of a personal conflict. Under OBRA residents' rights provisions, which statement best reflects the facility's obligation?

Accepted Answer

The facility must take reasonable steps to resolve the conflict and accommodate the request if space permits, while following proper transfer notice procedures

Answer

OBRA grants residents the right to choose roommates and to request room changes, but this right is not absolute — it is subject to available space and must follow proper involuntary transfer/discharge procedures for the roommate being moved. The facility must make good-faith efforts to resolve conflicts and accommodate reasonable requests while protecting both residents' rights. The family has no decision-making authority over room assignments unless the resident lacks capacity.

Question 3

During a care conference, a resident's adult daughter insists on seeing her mother's medical records and demands that staff share updates about her mother's condition at every visit. The resident, who is fully cognitively intact, has never signed a HIPAA authorization for her daughter. What should the CNA do?

Accepted Answer

Refer the daughter to the charge nurse and follow the resident's documented disclosure preferences

Answer

A cognitively intact resident controls who may access their health information under HIPAA. Without an authorization signed by the resident, sharing medical information with family members — including adult children — violates the resident's privacy rights. The CNA should redirect the daughter to the charge nurse and consult the resident's documented disclosure preferences on file. Guardianship is not required; what is required is the resident's own consent. ADL data is still considered protected health information.

Question 4

A long-term care resident informs her CNA that she wants to participate in a research study being conducted in the facility. The administrator later tells staff that only residents whose families have given written consent are allowed to enroll. The resident's son has refused on her behalf. The resident is cognitively intact. Which statement is correct?

Accepted Answer

The resident has the right to make her own decision to participate since she is cognitively intact, and the son's refusal does not override her autonomous consent

Answer

A cognitively intact resident retains full autonomy over personal decisions, including participation in research studies. A family member — even a son with healthcare proxy status — cannot override the decisions of a competent adult. Proxy authority only activates when a resident lacks decision-making capacity. The facility policy requiring family consent for competent residents is inconsistent with residents' rights under OBRA and informed consent principles. The CNA should escalate this conflict to the ombudsman or supervisor.

Question 5

A resident has posted a handwritten sign on the inside of his door that reads 'Do Not Enter Without Knocking — This Means Everyone.' A housekeeper enters without knocking while the resident is dressing. Under residents' rights standards, this incident is best categorized as:

Accepted Answer

A violation of the resident's right to privacy and dignity, which should be documented and reported

Answer

Residents have an explicit right to privacy in their rooms, including during personal care and dressing. The resident's posted sign constitutes a clearly communicated privacy preference that all staff — including housekeeping — are obligated to respect. Entering without knocking while a resident is dressing violates both privacy and dignity rights under OBRA. Such incidents should be documented, reported to a supervisor, and addressed through staff education. The violation exists independent of whether the resident files a grievance.

CNA Practice Test

CNA Practice Test

CNA Resident's Rights 5