CNA Restorative Care and Rehabilitation 4

Question 1

A CNA is assisting a post-stroke patient in a restorative program who has left-sided hemiplegia. During ambulation training with a gait belt, the patient begins to fatigue and starts to fall. What is the CORRECT action for the CNA to take?

Accepted Answer

Step behind the patient, grasp the gait belt firmly, and ease the patient down to the floor in a controlled manner

Answer

When a patient begins to fall during ambulation, the CNA should never try to stop the fall completely — this risks injury to both patient and aide. The correct technique is to widen your stance for a base of support, grasp the gait belt firmly, and guide the patient to the floor in a controlled slide. Grabbing a hemiplegic arm can dislocate the shoulder. Letting go is negligent, and a rapid pivot to a chair risks losing control entirely.

Question 2

A restorative nursing program is implementing PROM (passive range of motion) for a resident with severe contractures in both knees. The CNA notices increased resistance and hears a faint clicking sound in the right knee mid-exercise. What should the CNA do FIRST?

Accepted Answer

Stop the exercise immediately and report the finding to the nurse before continuing

Answer

Clicking sounds (crepitus) combined with increased resistance during PROM may indicate joint pathology, a fracture risk, or soft tissue damage. The CNA must stop immediately and report to the nurse — continuing could cause serious injury. Forcing through resistance is never appropriate in PROM. Switching to the other limb delays necessary reporting, and end-of-shift documentation is not timely enough for a potential injury finding.

Question 3

During a restorative feeding program, a resident with dysphagia secondary to Parkinson's disease is on a nectar-thick liquid diet. The resident requests regular water, saying it 'tastes better.' The CNA knows the resident has the cognitive capacity to make decisions. What is the MOST appropriate response?

Accepted Answer

Inform the resident of the aspiration risks associated with thin liquids and refer the decision to the nurse and speech therapist before allowing it

Answer

This is a nuanced clinical-ethical situation. While cognitively intact residents do have the right to refuse or modify care, the CNA cannot independently override a dysphagia diet order — this requires a care conference, informed consent discussion with the interdisciplinary team (nurse, SLP), and possibly a modified diet or 'aspiration risk acknowledged' protocol. Simply providing thin liquid (Option B) bypasses the required clinical process. Outright refusal without explanation (Option C) violates dignity. Independently modifying the delivery method (Option D) exceeds the CNA's scope.

Question 4

A resident in a restorative program following a hip replacement is prescribed weight-bearing as tolerated (WBAT) on the right leg. The restorative CNA should recognize which of the following scenarios as a contraindication requiring immediate nursing notification?

Accepted Answer

The resident reports new, sharp groin pain on the operative side that was not present at the previous session

Answer

New sharp groin pain on the operative side following hip replacement is a red-flag symptom that may indicate prosthetic dislocation, deep vein thrombosis, or hardware failure — all of which are contraindications to continued weight-bearing and require immediate nurse notification. Mild fatigue is a normal variance that warrants a shorter session, not a medical alert. A modest blood pressure increase with positional change is physiologically expected. Increased assistance needs reflect functional decline and should be documented and reported, but do not constitute an emergency contraindication to stop immediately.

Question 5

A restorative CNA is working with a resident who had a right-hemisphere stroke and exhibits unilateral neglect of the left side. Which intervention BEST addresses unilateral neglect during activities of daily living (ADL) retraining?

Accepted Answer

Consistently position essential items (call light, water, food tray) on the resident's LEFT side to encourage scanning toward the neglected field

Answer

Unilateral neglect rehabilitation requires actively drawing the patient's attention toward the neglected hemispace. Placing items on the LEFT side encourages the resident to visually scan and cognitively engage with the neglected field, which is the therapeutic goal. Placing items on the right (Option B) accommodates the neglect rather than remediating it. Verbal cues alone (Option C) are insufficient without environmental restructuring. An eye patch (Option D) is a compensatory strategy sometimes used in vision therapy but is not within CNA scope and does not address the neurological neglect itself.

CNA Practice Test

CNA Practice Test

CNA Restorative Care and Rehabilitation 4