CNA Scope of Practice 2 — Questions and Answers
Question 1: A supervising nurse asks a CNA to administer an oral medication because the unit is short-staffed. What should the CNA do?
- Administer the medication to help the nurse
- Decline and explain that medication administration is outside a CNA's scope of practice (Correct answer)
- Crush the medication and mix it with food so the patient takes it
- Ask another CNA to administer it
Correct answer: Decline and explain that medication administration is outside a CNA's scope of practice
Medication administration requires a nursing or pharmacy license. A CNA must decline this request regardless of staffing pressures.
CNA scope of practice is defined by state law and does not include medication administration (with very limited exceptions in some states for specific oral medications with additional training). Administering medications without authorization puts the patient at risk and exposes the CNA to criminal liability, license revocation, and civil liability. The nurse must perform the task or escalate the staffing issue.
Question 2: Which of the following falls WITHIN the CNA's scope of practice?
- Changing a sterile wound dressing
- Performing a physical assessment
- Measuring and recording a patient's blood pressure (Correct answer)
- Adjusting a patient's oxygen flow rate
Correct answer: Measuring and recording a patient's blood pressure
Vital sign measurement, including blood pressure, is a core CNA skill performed and documented under nursing supervision.
Measuring and recording vital signs is a foundational CNA task. Sterile wound dressings, physical assessments, and oxygen flow adjustments require clinical judgment, specialized training, and nursing licensure. CNAs report vital sign measurements to the nurse, who interprets them in clinical context.
Question 3: A CNA is asked to perform a task they believe is outside their scope of practice. Who determines their scope?
- The supervising nurse on duty
- The facility administrator
- State law and the state nurse aide registry regulations (Correct answer)
- The patient's family
Correct answer: State law and the state nurse aide registry regulations
A CNA's scope of practice is defined by state law and the state's nurse aide training and competency evaluation program (NATCEP) regulations.
While facility policies must align with state law, the legal scope of CNA practice is established by state statute and administrative code. Individual supervisors or facilities cannot expand the CNA's scope beyond what is legally permitted. When in doubt, the CNA should consult the state's official CNA scope of practice guidance.
Question 4: What does it mean to 'work within your scope of practice'?
- Performing only the tasks you feel comfortable with on a given day
- Performing only tasks that are authorized by your training, certification, and state law (Correct answer)
- Following any instruction given by a licensed provider
- Completing as many tasks as possible to support the nursing team
Correct answer: Performing only tasks that are authorized by your training, certification, and state law
Scope of practice defines the legal boundaries of what a CNA is trained, certified, and authorized by law to perform.
Scope of practice is a legal construct protecting patients and providers. A CNA works within their scope by performing only those tasks covered by their NATCEP training, state certification, and facility orientation. Even if a CNA feels capable of a higher-level task, performing it without licensure is unauthorized practice and illegal.
Question 5: A CNA is assisting with a dressing change and the nurse steps out of the room. The patient asks the CNA to finish the dressing alone. What should the CNA do?
- Finish the dressing to avoid leaving the wound exposed
- Stop and wait for the nurse to return before proceeding (Correct answer)
- Ask another CNA to finish the dressing
- Call the physician for guidance
Correct answer: Stop and wait for the nurse to return before proceeding
Sterile dressing changes require nursing supervision. The CNA should maintain sterile field if possible, keep the patient comfortable, and wait for the nurse to return.
The CNA's scope does not expand because a licensed nurse is temporarily absent or because the task is partially completed. The CNA should safeguard the sterile field, reassure the patient, and wait for the nurse. Completing the dressing alone would constitute unauthorized practice, regardless of circumstances.
Question 6: A CNA notices a patient's IV site appears red and swollen. What is the appropriate action?
- Adjust the IV flow rate to relieve pressure at the site
- Remove the IV line to prevent further infiltration
- Notify the nurse immediately and do not touch the IV (Correct answer)
- Apply a warm compress and continue monitoring independently
Correct answer: Notify the nurse immediately and do not touch the IV
IV assessment and management are nursing responsibilities. The CNA should observe and report but must not manipulate IV equipment.
Redness and swelling at an IV site may indicate infiltration or phlebitis, requiring prompt nursing intervention. The CNA's role is to report the observation immediately and leave IV management to the nurse. Manipulating IV lines is outside the CNA's scope and could cause further harm to the patient.
CNA Scope of Practice 2
A supervising nurse asks a CNA to administer an oral medication because the unit is short-staffed.
What should the CNA do?