CNA Care for Residents with Cognitive Impairment 2 — Questions and Answers
Question 1: A resident with dementia repeatedly asks where her husband is, not knowing he passed away years ago. What is the BEST response for the CNA?
- Tell her firmly that her husband is dead
- Say 'He's not here right now' and redirect her to a pleasant activity (Correct answer)
- Remind her every hour that her husband has passed
- Ignore her questions so she forgets about it
Correct answer: Say 'He's not here right now' and redirect her to a pleasant activity
Therapeutic fibbing or gentle redirection prevents unnecessary grief while keeping the resident calm and engaged.
Question 2: Which environment modification BEST reduces confusion and wandering at night for a resident with dementia?
- Keep the room completely dark to promote sleep
- Place a large illuminated clock and nightlight in the room (Correct answer)
- Lock the door from outside to prevent wandering
- Remove all furniture to reduce injury risk
Correct answer: Place a large illuminated clock and nightlight in the room
A visible clock and nightlight help orient the resident to time and surroundings, reducing nighttime confusion.
Question 3: A resident with Alzheimer's disease refuses to bathe and becomes agitated. What should the CNA do FIRST?
- Force the bath quickly to minimize distress
- Document the refusal and try again later using a different approach (Correct answer)
- Report immediately to the charge nurse and do nothing else
- Skip bathing for the week to avoid upsetting the resident
Correct answer: Document the refusal and try again later using a different approach
Documenting the refusal and trying a different approach later respects the resident's autonomy and uses person-centered care strategies.
Question 4: Which statement about sundowning in dementia residents is CORRECT?
- Sundowning only occurs in residents with severe dementia
- Sundowning refers to increased confusion and agitation in late afternoon or evening (Correct answer)
- Sundowning is caused by sleeping too much during the day and is always preventable
- Sundowning is a rare complication seen only in nursing homes
Correct answer: Sundowning refers to increased confusion and agitation in late afternoon or evening
Sundowning describes worsening confusion, restlessness, and agitation that typically occurs in the late afternoon or evening hours.
Question 5: When a cognitively impaired resident uses repetitive speech or actions, the CNA should PRIMARILY:
- Ask the charge nurse to prescribe sedatives
- Respond calmly and try to identify unmet needs behind the behavior (Correct answer)
- Tell the resident to stop immediately and firmly
- Restrain the resident to prevent self-harm
Correct answer: Respond calmly and try to identify unmet needs behind the behavior
Repetitive behaviors often signal an unmet need such as pain, hunger, or the need for reassurance.
Question 6: Which communication technique is MOST effective when speaking with a resident who has moderate dementia?
- Ask open-ended complex questions to stimulate thinking
- Use short, simple sentences and speak slowly and clearly (Correct answer)
- Speak rapidly to hold the resident's attention
- Use medical terminology so the resident feels respected
Correct answer: Use short, simple sentences and speak slowly and clearly
Short, simple sentences spoken slowly and clearly are easiest for residents with dementia to process and understand.
Question 7: A resident with dementia tries to leave the building, saying she needs to pick up her children from school. The CNA should:
- Unlock the exit and accompany her outside
- Validate her feelings, gently redirect her, and engage her in an activity (Correct answer)
- Lecture her about why she cannot leave
- Call her family immediately and wait without engaging the resident
Correct answer: Validate her feelings, gently redirect her, and engage her in an activity
Validating feelings and redirecting to an engaging activity is the safest and most therapeutic response to elopement attempts.
CNA Care for Residents with Cognitive Impairment 2
A resident with dementia repeatedly asks where her husband is, not knowing he passed away years ago.
What is the BEST response for the CNA?