CNA The Nurse Aide's Role and Responsibilities 4

Question 1

A nurse aide is caring for a resident who becomes increasingly agitated and demands that the aide administer a higher dose of pain medication than prescribed. The aide knows the resident is in genuine discomfort. What is the most appropriate action?

Accepted Answer

Refuse the request and report the resident's pain level and request to the charge nurse immediately

Answer

Administering medications—in any dose—is outside the nurse aide's scope of practice. The correct action is to refuse the request and immediately escalate the resident's uncontrolled pain to the charge nurse, who can assess and adjust the care plan. Administering a placebo or contacting the pharmacy are also outside the aide's role and could cause harm or legal liability.

Question 2

During a shift, a nurse aide witnesses a co-worker (also a nurse aide) verbally belittling a cognitively impaired resident for having a toileting accident. The resident appears distressed but cannot reliably communicate what happened. What should the aide do FIRST?

Accepted Answer

Remove the resident from the situation if safe to do so, then report the incident to the supervisor

Answer

The immediate priority is the resident's safety and dignity. Removing the resident from the abusive situation (if safe) addresses the immediate harm. The incident must then be reported to a supervisor—nurse aides are mandatory reporters of abuse, neglect, and mistreatment. Waiting, confronting the co-worker without reporting, or charting without notifying the chain of command are all insufficient or inappropriate responses.

Question 3

A nurse aide is assigned to a resident whose care plan specifies passive range-of-motion (PROM) exercises to the right shoulder. While performing the exercises, the resident suddenly winces and reports sharp pain at 60 degrees of abduction. What is the correct response?

Accepted Answer

Stop the movement at the point of pain, position the resident comfortably, and report the finding to the nurse

Answer

PROM should never be performed through pain. The aide must stop at the point where pain begins, ensure the resident is comfortable, and immediately report this change in the resident's condition to the supervising nurse. Continuing through pain risks injury. Independently changing the exercise type or simply deferring without reporting are outside the aide's scope and neglect the duty to communicate changes in resident status.

Question 4

A resident's adult child arrives during visiting hours and insists on reviewing their parent's complete medical chart, stating they have 'always handled all the paperwork.' The resident has never been declared legally incompetent. How should the nurse aide respond?

Accepted Answer

Politely explain that chart access requires authorization and direct the family member to the charge nurse or administrator

Answer

A competent adult resident controls who may access their medical information under HIPAA. Unless the resident has designated that family member as their authorized representative (e.g., via healthcare proxy or HIPAA release), the aide cannot grant chart access. The aide should not make this determination independently—it must be escalated to the charge nurse or administration. Being an emergency contact does not confer the right to access medical records.

Question 5

A nurse aide notices that a resident's advance directive specifies 'do not resuscitate' (DNR), but while providing morning care the resident stops breathing and has no pulse. A family member present in the room screams at the aide to 'do something' and start CPR. What should the aide do?

Accepted Answer

Call for nursing staff immediately without initiating CPR, per the documented DNR order

Answer

A valid DNR order is a legally binding medical order that the nurse aide must honor. The aide should call for nursing staff immediately but not initiate CPR. Family verbal requests do not override a documented DNR. Asking for power of attorney documentation in an emergency is inappropriate and delays needed nursing response. The nurse or physician will manage the legal and clinical aspects of the situation.

CNA Practice Test

CNA Practice Test

CNA The Nurse Aide's Role and Responsibilities 4