CNA Regulatory Compliance & Legal Framework 3 — Questions and Answers
Question 1: A CNA applies a physical restraint on a resident without a physician's order to prevent a fall. This action could result in:
- A commendation for proactive safety measures
- Disciplinary action and potential legal liability for unlawful restraint (Correct answer)
- Approval if documented properly after the fact
- No consequences if the resident was not injured
Correct answer: Disciplinary action and potential legal liability for unlawful restraint
Applying restraints without a proper physician's order and informed consent constitutes unlawful restraint and exposes the CNA to discipline and liability.
Question 2: The Minimum Data Set (MDS) is used in long-term care facilities primarily to:
- Track employee attendance and performance
- Standardize comprehensive resident assessments for care planning and reimbursement (Correct answer)
- Document medication administration errors
- Report infection control data to the CDC
Correct answer: Standardize comprehensive resident assessments for care planning and reimbursement
The MDS is a federally mandated assessment tool used to evaluate residents' health and functional status, guide care planning, and determine Medicare/Medicaid reimbursement.
Question 3: Which of the following scenarios represents a HIPAA violation by a CNA?
- Discussing a resident's diet preferences with the dietitian
- Telling a resident's roommate about the resident's recent surgery (Correct answer)
- Documenting care provided in the medical record
- Reporting a change in condition to the charge nurse
Correct answer: Telling a resident's roommate about the resident's recent surgery
Sharing a resident's medical information with their roommate is an unauthorized disclosure that violates HIPAA privacy rules.
Question 4: State nurse practice acts govern CNAs by:
- Setting national uniform standards that override all state rules
- Defining the scope of practice and tasks CNAs are legally permitted to perform in that state (Correct answer)
- Only applying to licensed nurses, not nursing assistants
- Establishing CNA wage requirements
Correct answer: Defining the scope of practice and tasks CNAs are legally permitted to perform in that state
Each state's nurse practice act outlines the legal scope of practice for all nursing personnel, including CNAs, within that state.
Question 5: A resident asks the CNA to sign as a witness to their will. The CNA should:
- Sign the will if the resident appears mentally competent
- Decline and refer the resident to the social worker or administration (Correct answer)
- Sign only if a supervisor is present
- Refuse and document that the resident is confused
Correct answer: Decline and refer the resident to the social worker or administration
CNAs should not witness legal documents for residents, as this creates conflicts of interest and potential legal liability; the social worker or administrator should be notified.
Question 6: Under federal nursing home regulations, residents must be free from chemical restraints. A chemical restraint is defined as:
- Any medication given to treat a diagnosed psychiatric condition
- A medication used for discipline or staff convenience rather than to treat a medical condition (Correct answer)
- Antibiotics given to control infection
- Pain medication administered on a scheduled basis
Correct answer: A medication used for discipline or staff convenience rather than to treat a medical condition
Chemical restraints are drugs used to control behavior for staff convenience or discipline rather than to treat a legitimate medical or psychiatric condition.
Question 7: Which document gives a designated person the legal authority to make healthcare decisions for a resident who is no longer able to do so?
- A living will
- A durable power of attorney for healthcare (Correct answer)
- A facility admission agreement
- A DNR order
Correct answer: A durable power of attorney for healthcare
A durable power of attorney for healthcare designates a specific individual to make medical decisions when the resident lacks capacity to do so.
CNA Regulatory Compliance & Legal Framework 3
A CNA applies a physical restraint on a resident without a physician's order to prevent a fall.
This action could result in: