CNA Restraint Use and Alternatives to Restraints

Question 1

Under federal OBRA regulations, a physical restraint may only be applied to a resident when:

Accepted Answer

It is ordered by a physician and used as a last resort after alternatives have failed

Answer

OBRA regulations require a physician's order for physical restraints, and restraints must be the least restrictive intervention used only after alternatives have been tried and documented. Family requests or staffing issues are not acceptable justifications.

Question 2

A resident is in a vest restraint. How often should the nurse aide check on and release the restraint according to standard practice?

Accepted Answer

At least every two hours, with repositioning and range of motion offered

Answer

Residents in restraints must be monitored at least every two hours. The nurse aide must release the restraint, reposition the resident, provide range of motion exercises, offer toileting, and observe skin condition to prevent complications such as pressure injuries, poor circulation, and muscle contracture.

Question 3

Which of the following is considered an alternative to physical restraints that the care team should attempt first?

Accepted Answer

Placing the resident in a low bed with floor mats and a bed alarm

Answer

Restraint alternatives include bed alarms, low beds with floor mats, increased supervision, activity engagement, addressing unmet needs (pain, toileting), and environmental modifications. These must be tried and documented before a restraint order is sought.

Question 4

A nurse aide ties a bed sheet across a resident's lap to prevent her from sliding out of the wheelchair without a physician order. This is:

Accepted Answer

A form of illegal physical restraint that must be reported

Answer

Any device that restricts a resident's freedom of movement without a physician's order constitutes an unauthorized physical restraint, regardless of intent. This is a violation of OBRA regulations and the resident's rights, and must be reported immediately.

Question 5

While a resident is in a torso restraint, the nurse aide observes the resident is struggling to breathe. The nurse aide should:

Accepted Answer

Remove or loosen the restraint immediately and call the nurse

Answer

Respiratory distress is a life-threatening restraint complication. The nurse aide must immediately loosen or remove the restraint to restore breathing and call the nurse. Restraints must never impair breathing, and any sign of respiratory compromise requires immediate action.

CNA Practice Test

CNA Practice Test

CNA Restraint Use and Alternatives to Restraints