CNA Scope of Practice 2

Question 1

A registered nurse is busy with a critical patient and asks the CNA to apply a prescribed medicated cream to a resident's pressure injury that has broken the skin. The CNA has previously applied barrier creams for this resident. What is the CNA's most appropriate action?

Accepted Answer

Inform the nurse that applying medication to non-intact skin is outside the CNA scope of practice.

Answer

While CNAs may apply over-the-counter barrier creams to intact skin, applying any substance, especially a prescribed medicated one, to non-intact skin is considered a medication administration and wound care task. This requires a nurse's assessment and is outside the typical scope of practice for a CNA. The most appropriate action is to professionally and clearly state why the task cannot be performed.

Question 2

A resident with a well-established ostomy asks the CNA for advice on how to manage skin irritation around the stoma. The CNA has received facility-approved training in basic ostomy care. Which of the following responses is within the CNA's scope of practice?

Accepted Answer

"I can clean the area and apply the barrier powder as the care plan directs. I will also report the irritation to the nurse right away."

Answer

A CNA with specialized training can perform routine, established ostomy care, which includes emptying the bag, cleaning the skin, and applying barrier creams or powders as directed by the care plan. However, assessing the skin, diagnosing a condition (like an infection), recommending new products, or altering the ostomy appliance are all outside the CNA scope of practice. The correct action is to perform the allowed task and immediately report the observation to the nurse for assessment.

Question 3

During a medical emergency, a resident becomes unresponsive and stops breathing. Which of the following actions falls outside the CNA's scope of practice, even in this emergency?

Accepted Answer

Administering a family member's nitroglycerin tablet to the resident.

Answer

Administering medication, especially a prescription medication like nitroglycerin that does not belong to the resident, is strictly outside the CNA scope of practice, even in an emergency. CNAs are trained and expected to perform CPR, call for help, and assist the team by bringing equipment. However, medication administration requires a licensed nurse's order and assessment.

Question 4

A CNA is working in a state where, with additional certification and under specific circumstances, they are permitted to perform certain advanced tasks. Which of these tasks would most likely require this type of special certification?

Accepted Answer

Discontinuing a resident's indwelling urinary catheter.

Answer

While specific regulations vary by state, discontinuing (removing) an indwelling urinary catheter is an invasive procedure that is generally outside the standard CNA scope. Some states or facilities may allow a specially trained CNA to perform this task. The other tasks, such as assisting with inhalers (but not administering the medication independently), performing restorative exercises, and documenting I&O, are more commonly within the standard CNA role.

Question 5

A resident's family member asks the CNA to explain the side effects of the resident's new blood pressure medication. The most appropriate response for the CNA is to:

Accepted Answer

Explain that CNAs cannot provide medical education and offer to get the nurse.

Answer

Patient education, including explaining medication actions and side effects, is the responsibility of licensed nurses. A CNA's scope is to reinforce information already provided by the nurse, not to provide new education. Reading from a handout could lead to misinterpretation, and the other options are unprofessional and inappropriate. The correct action is to defer to the nurse.

CNA Practice Test

CNA Practice Test

CNA Scope of Practice 2