CNA Basic Restorative Services Competency Exam — Questions and Answers

Question 1: How much fluid should most residents consume daily to support healthy bladder and bowel function?

1,000 to 1,200 mL per day
Less than 500 mL per day
More than 3,000 mL per day
1,500 to 2,000 mL per day (Correct answer)

Correct answer: 1,500 to 2,000 mL per day

Most adults need approximately 1,500 to 2,000 mL (about 6–8 cups) of fluid daily to maintain healthy bladder and bowel function.

Question 2: When assisting a resident to stand from a chair, where should the aide stand?

To the side furthest from the resident's weak leg
In front of and slightly to the side of the resident (Correct answer)
Directly behind the resident
At arm's length in front of the resident

Correct answer: In front of and slightly to the side of the resident

Standing in front and slightly to the side allows the aide to hold the gait belt, guide the movement, and quickly respond if the resident loses balance.

Question 3: What constitutes a 'significant change' that would trigger a new MDS assessment?

A change in the resident's preferred meal time
A major decline or improvement in two or more areas of function that is not expected to resolve (Correct answer)
Any single missed restorative session
A temporary illness lasting less than 3 days

Correct answer: A major decline or improvement in two or more areas of function that is not expected to resolve

A significant change is defined as a major decline or improvement in two or more areas of function that is not expected to resolve without intervention.

Question 4: What does 'long-term goal' versus 'short-term goal' mean in restorative care planning?

Long-term goals describe the ultimate functional outcome; short-term goals are incremental steps to achieve it (Correct answer)
They are interchangeable terms with no practical distinction
Short-term goals always have a 1-day timeframe
Long-term goals are written by the physician; short-term by the aide

Correct answer: Long-term goals describe the ultimate functional outcome; short-term goals are incremental steps to achieve it

Long-term goals define the desired functional endpoint, while short-term goals break the path into measurable milestones that build toward the long-term outcome.

Question 5: What is the function of a dysphagia cup (nose-cutout cup)?

Provides a wider opening for residents with tremors
Measures the exact amount of fluid consumed per serving
Keeps hot beverages warm longer
Allows the resident to drink without tilting the head back, reducing aspiration risk (Correct answer)

Correct answer: Allows the resident to drink without tilting the head back, reducing aspiration risk

The nose cutout allows the cup to tilt without the resident tilting their head back, keeping the chin tucked and reducing the risk of aspiration during drinking.

Question 6: A resident with Parkinson's disease freezes mid-gait. Which technique often helps them resume walking?

Cue the resident to step over a real or imagined line on the floor (Correct answer)
Increase walker height to improve posture
Have the resident sit down and rest for 30 minutes
Physically push the resident forward

Correct answer: Cue the resident to step over a real or imagined line on the floor

Visual or auditory cues, such as stepping over a line or to a beat, help bypass the motor-freezing associated with Parkinson's disease.

Question 7: Which of the following is classified as a basic Activity of Daily Living (ADL)?

Bathing (Correct answer)
Managing finances
Using public transportation
Shopping for groceries

Correct answer: Bathing

Basic ADLs include self-care tasks such as bathing, dressing, grooming, toileting, eating, and mobility — all essential for physical self-maintenance.

Question 8: Which adaptive device helps a resident with severe arthritis open bottles and jars independently?

Built-up handle fork
Rocker knife
Plate guard
Dycem non-slip mat or jar opener with extended handle (Correct answer)

Correct answer: Dycem non-slip mat or jar opener with extended handle

A Dycem mat provides friction to stabilize containers, and jar openers with extended handles reduce the grip and torque needed, enabling independent use.

Question 9: What is the purpose of the interdisciplinary care plan in restorative services?

To document billing codes for Medicare
To coordinate goals and interventions across all disciplines to provide consistent, resident-centered care (Correct answer)
To list only nursing diagnoses and medical orders
To replace the physician's plan of treatment

Correct answer: To coordinate goals and interventions across all disciplines to provide consistent, resident-centered care

The interdisciplinary care plan integrates input from all team members — nursing, therapy, social work, dietary — to create cohesive, individualized goals and interventions.

Question 10: A family member asks the restorative aide to share the resident's care plan details. What should the aide do?

Refer the family to the nurse or social worker to ensure HIPAA-compliant information sharing (Correct answer)
Post the care plan in the resident's room for easy family access
Refuse to discuss anything about the resident's care
Share all details freely since the family member is listed as next of kin

Correct answer: Refer the family to the nurse or social worker to ensure HIPAA-compliant information sharing

Information sharing must comply with HIPAA and facility policy; the aide should direct family members to the appropriate licensed staff member rather than disclosing information independently.

Question 11: Before ambulating a resident for the first time after a period of bed rest, what should the restorative aide do first?

Dangle the resident at the bedside to assess for orthostatic hypotension (Correct answer)
Check blood pressure only while the resident is still lying down
Immediately stand the resident and begin walking
Apply a gait belt and begin walking without sitting up first

Correct answer: Dangle the resident at the bedside to assess for orthostatic hypotension

Dangling at the bedside allows the resident's cardiovascular system to adjust to positional changes and helps the aide assess for dizziness before standing.

Question 12: Which MDS section captures restorative nursing program participation?

Section N
Section O (Correct answer)
Section B
Section G

Correct answer: Section O

MDS Section O captures special treatments, procedures, and programs including restorative nursing services provided during the look-back period.

Question 13: Which gait pattern is used for a resident who can bear partial weight on both lower extremities with a walker?

Two-point or four-point gait (Correct answer)
Pivot transfer only
Non-weight-bearing gait
Swing-through gait

Correct answer: Two-point or four-point gait

Two-point or four-point gait allows partial weight-bearing on both legs and is used when residents have some strength bilaterally.

Question 14: What is the main benefit of a rollator (four-wheeled walker with a seat) over a standard walker?

It requires no safety training before use
It allows continuous walking without picking up the frame, and provides a rest seat (Correct answer)
It offers greater stability than a standard walker
It is appropriate for non-weight-bearing residents

Correct answer: It allows continuous walking without picking up the frame, and provides a rest seat

A rollator rolls continuously for a more natural gait pattern and includes a built-in seat for rest, but it requires cognitive ability and good hand brake control.

Question 15: What is the purpose of the 'problem statement' in a restorative care plan?

To document staff complaints about the resident
To justify the cost of the restorative program to the payer
To identify the specific functional deficit or risk that the restorative program will address (Correct answer)
To list all of the resident's medical diagnoses

Correct answer: To identify the specific functional deficit or risk that the restorative program will address

The problem statement identifies the functional challenge (e.g., 'impaired gait requiring two-person assist') that the restorative program is designed to address.

Question 16: Which sign most indicates that a resident may benefit from a scheduled toileting program?

The resident independently requests toileting every 2 hours
The resident has frequent incontinent episodes without awareness of the urge (Correct answer)
The resident's daily urine output exceeds 2,000 mL
The resident currently has an indwelling urinary catheter

Correct answer: The resident has frequent incontinent episodes without awareness of the urge

Frequent incontinent episodes without awareness suggest the resident cannot recognize or respond to the urge to void, making a scheduled program beneficial.

Question 17: A restorative aide is working with a resident on self-feeding. Which approach best reflects restorative philosophy?

Feed the resident quickly to save time
Allow only a nurse to assist with feeding
Encourage the resident to feed themselves as much as possible (Correct answer)
Skip the meal if the resident is uncooperative

Correct answer: Encourage the resident to feed themselves as much as possible

Restorative philosophy emphasizes enabling residents to perform tasks independently to the greatest extent possible.

Question 18: What does 'NWB' mean in a resident's mobility orders?

Non-weight-bearing (Correct answer)
Normal walking balance
Nighttime wandering behavior
Neuromuscular weakness baseline

Correct answer: Non-weight-bearing

NWB stands for non-weight-bearing, meaning the resident must not put any weight on the designated extremity during transfers and ambulation.

Question 19: A resident with severe knee arthritis who cannot fully straighten their elbows would benefit most from which walker modification?

Removing one side of the walker for easier grip
Lowering the walker handles to the lowest setting
Standard walker with no modifications
Platform walker (forearm walker) with forearm rests (Correct answer)

Correct answer: Platform walker (forearm walker) with forearm rests

A platform walker supports the forearms rather than the hands, eliminating the need to fully extend the elbows and reducing stress on arthritic wrists and elbows.

Question 20: Which of the following is the correct way to clean and store a resident's personal assistive device between uses?

Send devices to central supply after each use
Store all assistive devices in the common activity room
Clean per facility protocol, allow to dry, and store in the resident's room (Correct answer)
Share devices between residents after wiping with a dry cloth

Correct answer: Clean per facility protocol, allow to dry, and store in the resident's room

Personal assistive devices must be cleaned according to facility infection control protocols, properly dried, and stored in the resident's own room to prevent cross-contamination.

Question 21: Which type of walker provides the most stability for a resident with significant balance impairment?

Rolling (wheeled) walker
Hemi walker
Standard (pick-up) walker (Correct answer)
Quad cane

Correct answer: Standard (pick-up) walker

A standard pick-up walker offers maximum stability because all four legs are on the floor during weight-bearing, with no wheels that could roll unexpectedly.

Question 22: A resident using a cane should hold it on which side of the body?

The affected (weaker) side
Either side based on preference
The unaffected (stronger) side (Correct answer)
The dominant hand side always

Correct answer: The unaffected (stronger) side

Holding the cane on the unaffected side shifts weight away from the weaker leg and mimics the natural gait pattern, improving stability.

Question 23: What adaptive equipment might help a resident with limited hand grip strength eat independently?

Pureeing all foods regardless of swallowing ability
Built-up handle utensils (Correct answer)
A standard metal fork and knife
A straw for all foods

Correct answer: Built-up handle utensils

Built-up handle utensils have thicker grips that are easier to hold for residents with weak grip strength, arthritis, or neurological impairment.

Question 24: How far should a resident typically be able to ambulate before a restorative program is considered successful at the maintenance level?

Distance is irrelevant — frequency is the only measure
Exactly 100 feet is the universal standard
Only one lap around the unit per session
It depends on the individual resident's specific goals as documented in the care plan (Correct answer)

Correct answer: It depends on the individual resident's specific goals as documented in the care plan

Success is measured against each resident's individualized, measurable goals documented in the care plan, not a universal distance standard.

Question 25: If a restorative aide disagrees with a goal on the care plan, what is the appropriate action?

Change the intervention independently without informing the team
Ignore the goal and implement their preferred approach
Discuss the concern with the supervising nurse or bring it up at the next care plan meeting (Correct answer)
Refuse to participate in the resident's care

Correct answer: Discuss the concern with the supervising nurse or bring it up at the next care plan meeting

Professional concerns about care plan goals should be communicated to the supervising nurse or raised at the care planning meeting — never acted on unilaterally.

Question 26: What is the purpose of a reacher/grabber tool in restorative ADL training?

To perform strengthening exercises for the shoulder
To measure distance walked during ambulation training
To assist with wheelchair propulsion
To allow residents to pick up objects without bending, reaching overhead, or twisting (Correct answer)

Correct answer: To allow residents to pick up objects without bending, reaching overhead, or twisting

A reacher/grabber extends the resident's functional reach, enabling them to retrieve objects independently while avoiding unsafe positions such as excessive bending.

Question 27: Which footwear is safest for ambulation training in long-term care?

Non-slip, supportive, closed-toe shoes that fit properly (Correct answer)
Bare feet for better sensory feedback on the floor
Loose slippers for easy removal
Thick socks without shoes for comfort

Correct answer: Non-slip, supportive, closed-toe shoes that fit properly

Proper-fitting, non-slip, closed-toe shoes reduce the risk of falls and provide necessary support during ambulation training.

Question 28: How does a restorative nursing program positively impact a long-term care facility?

It increases the number of skilled therapy orders needed
It is primarily a social program with no clinical impact
It can improve MDS scores and quality indicators, positively affecting reimbursement (Correct answer)
It replaces the need for licensed nursing staff

Correct answer: It can improve MDS scores and quality indicators, positively affecting reimbursement

Effective restorative programs improve resident function, which positively affects MDS scoring, quality measures, and CMS reimbursement rates.

Question 29: What is the primary purpose of keeping a voiding diary in a bladder retraining program?

To track patterns of urination and incontinent episodes over time (Correct answer)
To monitor urinary catheter output and drainage
To document fluid intake restrictions for the dietary department
To replace the need for physician orders for toileting

Correct answer: To track patterns of urination and incontinent episodes over time

A voiding diary records the timing, amount, and continence status of each void to identify patterns and guide the retraining schedule.

Question 30: A restorative aide documents 'ROM x 5 reps bilateral UE PROM without complaints.' What does 'UE' stand for?

Upper extremities (Correct answer)
Unusual event
Unit evaluation
Unilateral exercise

Correct answer: Upper extremities

UE is standard medical abbreviation for upper extremities, referring to the arms and shoulder girdle.

Question 31: A resident voids 100 mL but reports not feeling empty. What is the nurse aide's most appropriate action?

Perform straight catheterization to check for residual urine
Reassure the resident they are fine and return at the next scheduled time
Document the concern and report it to the supervising nurse (Correct answer)
Administer a prescribed diuretic to increase output

Correct answer: Document the concern and report it to the supervising nurse

Complaints of incomplete emptying may indicate urinary retention and must be reported to the nurse for further clinical assessment.

Question 32: What is 'prompted voiding' in a restorative bladder program?

Reminding residents to void at set intervals and praising successful continence (Correct answer)
Catheterizing the resident every 4 hours to prevent accidents
Using medication to chemically stimulate the urge to void
Requiring residents to reach the bathroom independently without assistance

Correct answer: Reminding residents to void at set intervals and praising successful continence

Prompted voiding involves asking residents at scheduled intervals if they need to use the bathroom and providing positive reinforcement for continent voids.

Question 33: What is the correct placement of a gait belt when assisting a resident with ambulation?

Loosely around the hips for comfort
Around the resident's chest under the arms
Around the wrist for light guidance only
Snugly around the resident's waist over clothing, with two fingers fitting underneath (Correct answer)

Correct answer: Snugly around the resident's waist over clothing, with two fingers fitting underneath

The gait belt is placed snugly around the waist over clothing; it should be tight enough to stay in place but allow two fingers to slide underneath.

Question 34: What is the correct sequence when a resident with a right-sided weakness uses a cane to walk?

Cane and weak leg simultaneously, then strong leg
Strong left leg first, then cane, then weak right leg
Weak right leg first, then cane, then strong left leg
Cane forward first, then weak right leg, then strong left leg (Correct answer)

Correct answer: Cane forward first, then weak right leg, then strong left leg

The cane moves forward first to create a wide base of support, then the weaker leg advances, followed by the stronger leg.

Question 35: Which condition is a contraindication to performing ROM exercises on a specific joint?

History of a healed fracture 2 years ago
Mild arthritis with stiffness
Generalized muscle weakness
Recent fracture or joint dislocation at that site (Correct answer)

Correct answer: Recent fracture or joint dislocation at that site

A recent fracture or dislocation is a contraindication for ROM at that joint until cleared by the physician or therapist, as movement could worsen the injury.

Question 36: Which food is most likely to have a laxative effect and loosen stools in a bowel retraining program?

Prunes or prune juice (Correct answer)
Bananas
White rice
Cheese

Correct answer: Prunes or prune juice

Prunes and prune juice contain sorbitol and dietary fiber, which have a natural laxative effect that softens and loosens stools.

Question 37: How often should a wheelchair-dependent resident be repositioned to prevent pressure injuries?

Once per shift is sufficient
Every 30 minutes without exception
Only when the resident reports discomfort
At least every 1 to 2 hours or per the care plan (Correct answer)

Correct answer: At least every 1 to 2 hours or per the care plan

Regular repositioning every 1–2 hours or per the individualized care plan is standard practice to relieve sustained pressure on bony prominences.

Question 38: How often must care plans be reviewed and revised for long-term care residents under OBRA regulations?

Every 30 days regardless of resident status
Only annually at the resident's yearly review
Quarterly and whenever there is a significant change in condition (Correct answer)
Whenever a family member requests a meeting

Correct answer: Quarterly and whenever there is a significant change in condition

OBRA requires care plans to be reviewed and updated at least quarterly and whenever a significant change in the resident's condition occurs.

Question 39: A resident's MDS assessment shows a decline in ADL function. What is the restorative team's first step?

Notify the family and take no further action
Reduce the number of restorative sessions
Assess the cause of decline and update the care plan (Correct answer)
Immediately discharge to rehabilitation

Correct answer: Assess the cause of decline and update the care plan

When a decline is identified, the care team must assess contributing factors and revise the care plan accordingly to address the resident's current needs.

Question 40: What type of cushion is most appropriate for a resident at high risk for pressure injuries who uses a wheelchair?

No cushion — firm surfaces reduce skin breakdown
Pressure-redistributing cushion such as gel or air-filled cushion (Correct answer)
Folded blanket or towel for padding
Standard foam cushion from any office chair

Correct answer: Pressure-redistributing cushion such as gel or air-filled cushion

Pressure-redistributing cushions reduce peak pressure over bony prominences in the buttocks and tailbone, significantly lowering the risk of pressure injuries.

Question 41: Which of the following must be documented after every restorative nursing session?

Date, type of intervention, duration, resident's response, and the aide's signature (Correct answer)
Only the type of exercise performed
The supervising nurse's initials only
Only if the resident refused or had a problem

Correct answer: Date, type of intervention, duration, resident's response, and the aide's signature

Complete restorative documentation includes the date, intervention type, duration, the resident's response/tolerance, and the aide's identifying signature.

Question 42: When walking behind a resident who uses a walker, where should the restorative aide position themselves?

Directly in front of the resident to catch them if they fall forward
Alongside the resident holding their hand only
Several feet back to give the resident independence
Slightly behind and to one side of the resident, holding the gait belt (Correct answer)

Correct answer: Slightly behind and to one side of the resident, holding the gait belt

Positioning slightly behind and to one side while holding the gait belt allows the aide to support and respond quickly if the resident loses balance.

Question 43: What is 'cueing' in the context of restorative ADL training?

Demonstrating a skill for the resident to watch
Providing hands-on assistance for the entire task
Writing care notes in the resident's chart
Verbal, visual, or physical prompts that remind the resident to initiate or continue a task (Correct answer)

Correct answer: Verbal, visual, or physical prompts that remind the resident to initiate or continue a task

Cueing involves prompts that help the resident remember or initiate steps in a task, supporting independence without taking over the activity.

Question 44: What is a 'sit-to-stand' transfer?

Transferring a resident from bed to chair
Rolling a resident in bed
Moving a resident from a seated position to standing (Correct answer)
Sliding a resident from one wheelchair to another

Correct answer: Moving a resident from a seated position to standing

A sit-to-stand transfer is the specific movement of assisting a resident to rise from a chair or bed to a standing position before ambulation.

Question 45: What information should a nurse aide document after each toileting attempt in a bladder retraining program?

The time of the attempt, whether a void occurred, and the estimated or measured amount (Correct answer)
The resident's emotional state and level of cooperation only
Only incontinent episodes and the volume of leakage
Only successful voids where the resident remained continent

Correct answer: The time of the attempt, whether a void occurred, and the estimated or measured amount

Complete documentation includes the time of the attempt, whether the resident voided, and the amount, enabling the care team to evaluate program effectiveness.

Question 46: Which federal agency oversees the MDS assessment process and restorative nursing documentation requirements?

The Joint Commission (TJC)
Occupational Safety and Health Administration (OSHA)
Centers for Medicare & Medicaid Services (CMS) (Correct answer)
American Nurses Association (ANA)

Correct answer: Centers for Medicare & Medicaid Services (CMS)

CMS sets all federal standards for MDS completion, restorative nursing program requirements, and associated documentation in Medicare/Medicaid-certified facilities.

Question 47: What is overflow incontinence?

Leakage that occurs when the overfull bladder cannot empty properly and urine spills over (Correct answer)
Incontinence caused by a sudden urge that cannot be controlled in time
Incontinence related to physical or cognitive barriers that prevent reaching the toilet
Loss of bladder control during activities such as coughing, sneezing, or lifting

Correct answer: Leakage that occurs when the overfull bladder cannot empty properly and urine spills over

Overflow incontinence occurs when the bladder cannot empty completely, causing it to overfill and continuously leak small amounts of urine.

Question 48: In a scheduled toileting program, when should a resident be offered toileting assistance?

Only immediately following an observed incontinent episode
Only when the resident verbally requests to use the bathroom
At the scheduled time, regardless of whether the resident has already been incontinent (Correct answer)
Every 30 minutes throughout the entire day and night

Correct answer: At the scheduled time, regardless of whether the resident has already been incontinent

Scheduled toileting is offered at predetermined intervals regardless of whether the resident has been incontinent, in order to establish a predictable routine.

Question 49: What information should be included in a restorative nursing progress note?

Resident name/ID, date, intervention, duration, resident response, progress toward goal, and aide signature (Correct answer)
Family member comments about the resident's progress
Only the date and type of exercise
The aide's personal assessment of whether the program is working

Correct answer: Resident name/ID, date, intervention, duration, resident response, progress toward goal, and aide signature

A complete progress note documents all identifying information, the specific intervention, duration, the resident's response and tolerance, goal progress, and the responsible aide's signature.

Question 50: Which abbreviation commonly used in restorative documentation means 'as needed'?

QID
BID
NWB
PRN (Correct answer)

Correct answer: PRN

PRN (from Latin 'pro re nata') means 'as needed' and is used in orders and documentation to indicate an intervention performed only when a specific condition arises.

Question 51: What does 'pronation' of the forearm mean?

Rotating the palm to face upward
Bending the elbow
Straightening the elbow
Rotating the palm to face downward (Correct answer)

Correct answer: Rotating the palm to face downward

Pronation is the rotation of the forearm so the palm faces downward, while supination is rotation so the palm faces upward.

Question 52: What is a key indicator that a bowel retraining program is successful?

The resident has a regular, predictable bowel pattern without excessive straining or fecal incontinence (Correct answer)
The resident can manage their entire bowel care program without any staff assistance
The resident never experiences any episode of constipation again
The resident no longer requires any dietary modifications or fiber supplements

Correct answer: The resident has a regular, predictable bowel pattern without excessive straining or fecal incontinence

Success in bowel retraining is indicated by a regular, predictable bowel pattern achieved without significant straining or fecal incontinence episodes.

Question 53: What is the primary goal of a bladder retraining program in restorative care?

Reduce the frequency of documentation
Increase the resident's daily fluid intake
Eliminate the use of all incontinence products
Help the resident regain voluntary control over urination (Correct answer)

Correct answer: Help the resident regain voluntary control over urination

Bladder retraining aims to restore voluntary control over urination by gradually increasing the interval between voids.

Question 54: When ascending stairs with a resident who has left-sided weakness, which leg should go up first?

Both legs simultaneously with support
The weaker left leg goes up first
The stronger right leg goes up first (Correct answer)
The aide's leg goes up first to demonstrate

Correct answer: The stronger right leg goes up first

When ascending stairs, the stronger leg leads because it can support the body weight while the weaker leg steps up — 'up with the good.'

Question 55: How many repetitions are typically recommended per joint during a standard ROM exercise session?

10 to 15 repetitions only if tolerated
1 repetition is sufficient
3 to 5 repetitions (Correct answer)
20 to 30 repetitions

Correct answer: 3 to 5 repetitions

Standard restorative ROM protocols typically recommend 3 to 5 repetitions per joint to maintain flexibility without causing fatigue or injury.

Question 56: During ambulation, a resident begins to fall. What is the correct aide response?

Release the gait belt and call for help
Guide the resident to the floor in a controlled manner using the gait belt (Correct answer)
Quickly lower the resident to a nearby chair regardless of distance
Try to hold the resident up and prevent any contact with the floor

Correct answer: Guide the resident to the floor in a controlled manner using the gait belt

Attempting to stop the fall entirely risks injury to both the resident and aide; controlling the descent to the floor using the gait belt is the safest intervention.

Question 57: What must be true for restorative nursing minutes to count toward MDS Section O documentation?

The therapist must supervise each session in person
The program must have a care plan, measurable goals, and at least 15 minutes of service on 6 or more days in the 7-day look-back period (Correct answer)
The resident must receive services every day
A physician must sign off on each session

Correct answer: The program must have a care plan, measurable goals, and at least 15 minutes of service on 6 or more days in the 7-day look-back period

CMS requires restorative programs to have a care plan with measurable goals and at least 15 minutes on at least 6 of 7 days in the look-back period to qualify for MDS coding.

Question 58: What is a typical recommended starting interval for a timed voiding schedule in a bladder retraining program?

Once per nursing shift
Every 6 hours around the clock
Every 30 minutes throughout the day
Every 2 hours during waking hours (Correct answer)

Correct answer: Every 2 hours during waking hours

A 2-hour voiding interval is a common starting point in bladder retraining that can be gradually extended as the resident demonstrates improved continence.

Question 59: A restorative aide is performing PROM on a resident's shoulder and feels sudden resistance. What should the aide do?

Document the resistance and continue the session
Push through the resistance to achieve full range
Apply heat before continuing
Stop the movement immediately and report to the nurse (Correct answer)

Correct answer: Stop the movement immediately and report to the nurse

Sudden resistance during ROM may indicate pain, spasm, or injury; the aide must stop immediately and report to the supervising nurse to prevent harm.

Question 60: What is the restorative goal of a bowel and bladder retraining program?

Reduce the need for incontinence products entirely
Prevent all incontinence episodes permanently
Help the resident achieve the highest level of continence possible (Correct answer)
Replace medical treatment for urinary tract infections

Correct answer: Help the resident achieve the highest level of continence possible

Bowel and bladder retraining aims to maximize continence through scheduled toileting and habit training based on the resident's individual patterns.

Question 61: A resident reports feeling dizzy during ambulation. What is the first action?

Have the resident lie down on the hallway floor
Remove the gait belt to make the resident more comfortable
Continue walking slowly until the dizziness passes
Have the resident sit down or return to a chair immediately (Correct answer)

Correct answer: Have the resident sit down or return to a chair immediately

Dizziness during ambulation is a fall risk; the immediate priority is to safely seat the resident to prevent a fall and then notify the nurse.

Question 62: Which exercise is specifically used to strengthen the pelvic floor muscles to reduce urinary incontinence?

Bicep curls
Kegel exercises (Correct answer)
Straight leg raises
Shoulder shrugs

Correct answer: Kegel exercises

Kegel exercises involve contracting and relaxing the pelvic floor muscles, which strengthens sphincter control and can significantly reduce urinary incontinence.

Question 63: Which dietary change most directly supports bowel regularity in a restorative program?

Decreasing dairy product intake
Reducing overall protein consumption
Eliminating all fruits from the diet
Increasing dietary fiber and daily fluid intake (Correct answer)

Correct answer: Increasing dietary fiber and daily fluid intake

Fiber adds bulk to stool and adequate fluids keep stool soft, both of which are essential for promoting regular bowel movements.

Question 64: Before using any assistive device with a resident, what should the restorative aide verify?

The device was used by a previous resident without problems
The device is available in the supply room
A family member approves of the device
The device is ordered, properly fitted, in good repair, and the resident knows how to use it (Correct answer)

Correct answer: The device is ordered, properly fitted, in good repair, and the resident knows how to use it

Assistive devices must be ordered, correctly sized, in safe working condition, and the resident must be trained in their use before each session.

Question 65: What is the purpose of hand-over-hand technique in restorative ADL training?

To demonstrate a task without the resident touching anything
To hold the resident's hands to prevent unsafe movement
To restrain a combative resident during personal care
To guide the resident's hands through a task while allowing them to feel the movement pattern (Correct answer)

Correct answer: To guide the resident's hands through a task while allowing them to feel the movement pattern

Hand-over-hand guidance allows the resident to experience the correct movement pattern, building muscle memory for increased independence over time.

Question 66: What is the FIRST step when initiating a bowel retraining program for a long-term care resident?

Start a high-fiber diet supplement immediately
Assess the resident's current bowel patterns and elimination habits (Correct answer)
Schedule the resident for toileting every hour around the clock
Administer a laxative every morning to stimulate the bowel

Correct answer: Assess the resident's current bowel patterns and elimination habits

Before implementing any bowel program, the resident's current bowel patterns must be assessed to establish a baseline and individualize the care plan.

Question 67: Which principle should guide how long a restorative aide waits for a resident to complete an ADL step independently?

Ask the resident to rush to match the aide's schedule
Give the resident exactly 30 seconds per step
Allow as much time as the resident needs while the session schedule permits (Correct answer)
Complete the step after 5 seconds to maintain efficiency

Correct answer: Allow as much time as the resident needs while the session schedule permits

Restorative care requires patience; residents need adequate time to process and perform tasks, and rushing undermines the goal of building independence.

Question 68: What is the correct height adjustment for a standard walker?

Handles at hip level for maximum support
Handles at elbow height to allow full arm extension
Handles at the resident's wrist crease when standing with arms relaxed at sides (Correct answer)
Height is adjusted based on resident preference only

Correct answer: Handles at the resident's wrist crease when standing with arms relaxed at sides

Walker handles should align with the wrist crease when the resident is standing upright with arms relaxed, creating a slight elbow bend of 15–30 degrees during use.

Question 69: What type of urinary incontinence is characterized by a sudden, strong urge to urinate that cannot be suppressed?

Urge incontinence (Correct answer)
Functional incontinence
Overflow incontinence
Stress incontinence

Correct answer: Urge incontinence

Urge incontinence, also called overactive bladder, involves a sudden compelling urge to urinate that results in involuntary leakage before reaching the toilet.

Question 70: Dorsiflexion of the foot means:

Pointing the toes downward away from the shin
Rotating the foot outward
Rotating the foot inward
Moving the toes upward toward the shin (Correct answer)

Correct answer: Moving the toes upward toward the shin

Dorsiflexion refers to bending the foot upward so the toes point toward the shin, which is essential for safe walking and fall prevention.

CNA Basic Restorative Services Competency Exam

Assesses certified nursing assistant knowledge and skills in restorative care techniques, including ADL restoration, ambulation and mobility training, bowel and bladder retraining, and care planning documentation to help residents achieve their highest level of functional independence.

Questions

90 min

Time Limit

70%

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