CNA Care Of Cognitively Impaired Residents 4 3 — Questions and Answers
Question 1: A resident with dementia repeatedly tries to remove their catheter. What is the BEST initial intervention?
- Apply restraints immediately
- Notify the nurse and assess for discomfort or infection (Correct answer)
- Distract the resident with an activity
- Increase sedation medication
Correct answer: Notify the nurse and assess for discomfort or infection
Repeated attempts to remove a catheter may indicate pain or infection, so the nurse must be notified for assessment before other interventions.
Question 2: When providing personal care to a resident with Alzheimer's disease, the CNA should:
- Complete tasks as quickly as possible to minimize agitation
- Explain each step before performing it and allow extra time (Correct answer)
- Avoid talking to prevent overstimulation
- Ask family members to perform all hygiene tasks
Correct answer: Explain each step before performing it and allow extra time
Explaining each step and allowing extra time reduces anxiety and promotes cooperation in residents with Alzheimer's disease.
Question 3: A cognitively impaired resident wanders into another resident's room and becomes combative when redirected. The CNA should FIRST:
- Use physical force to return the resident to their room
- Speak calmly and use gentle redirection with a familiar activity or object (Correct answer)
- Lock the wandering resident's door
- Ignore the behavior and allow it to resolve on its own
Correct answer: Speak calmly and use gentle redirection with a familiar activity or object
Calm verbal redirection paired with a familiar distraction is the safest first response to combative wandering behavior.
Question 4: Which environment modification BEST helps prevent elopement in residents with dementia?
- Keeping all hallway lights off after 8 PM
- Installing door alarms and using camouflaged exit doors (Correct answer)
- Requiring residents to sign out at the nursing station
- Placing the resident in a locked seclusion room
Correct answer: Installing door alarms and using camouflaged exit doors
Door alarms and camouflaged exits are evidence-based environmental strategies to prevent elopement without using restrictive measures.
Question 5: A resident with dementia refuses to eat breakfast but was hungry an hour earlier. The BEST response is to:
- Document the refusal and remove the tray
- Force-feed the resident to maintain nutrition
- Offer small portions later and try favorite foods (Correct answer)
- Administer a feeding tube immediately
Correct answer: Offer small portions later and try favorite foods
Offering small portions of preferred foods later accommodates the fluctuating appetite and preferences common in dementia.
Question 6: Which statement BEST describes validation therapy when used with dementia residents?
- Correcting the resident's false beliefs with facts
- Acknowledging and respecting the resident's feelings and perceived reality (Correct answer)
- Keeping the resident focused only on present-day tasks
- Using distraction to redirect all confused statements
Correct answer: Acknowledging and respecting the resident's feelings and perceived reality
Validation therapy acknowledges the resident's emotional reality rather than correcting factual errors, reducing distress.
Question 7: A resident with moderate dementia becomes agitated every evening around 5 PM. This phenomenon is called:
- Confabulation
- Sundowning (Correct answer)
- Retrograde amnesia
- Delirium tremens
Correct answer: Sundowning
Sundowning refers to increased confusion and agitation in dementia patients that typically occurs in the late afternoon or evening.
CNA Care Of Cognitively Impaired Residents 4 3
A resident with dementia repeatedly tries to remove their catheter.
What is the BEST initial intervention?