CNA Basic Restorative Services Competency Exam — Questions and Answers

Question 1: What is the correct placement of a gait belt when assisting a resident with ambulation?

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

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

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

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 3: 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 4: 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
Document the concern and report it to the supervising nurse (Correct answer)
Reassure the resident they are fine and return at the next scheduled time
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 5: When assisting a resident to stand from a chair, where should the aide stand?

At arm's length in front of the resident
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

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 6: 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 7: Which position best promotes complete bladder emptying during voiding?

Sitting upright on the toilet or commode (Correct answer)
Semi-recumbent with the head of bed elevated 30 degrees
Lying flat on the back (supine)
Side-lying position with knees bent

Correct answer: Sitting upright on the toilet or commode

Sitting upright uses gravity to assist bladder emptying and allows the pelvic floor muscles to relax properly.

Question 8: When walking behind a resident who uses a walker, where should the restorative aide position themselves?

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

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

Apply a gait belt and begin walking without sitting up 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

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

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

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

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

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 12: When is a resident considered 'totally dependent' in an ADL per MDS guidelines?

The resident performs less than 50% of the task
The resident needs verbal reminders for every step
The resident requires any physical guidance
Staff perform the activity for the resident with no participation from the resident (Correct answer)

Correct answer: Staff perform the activity for the resident with no participation from the resident

MDS defines total dependence as staff performing the entire activity without any active participation from the resident.

Question 13: Which factor most commonly contributes to constipation in elderly residents in long-term care facilities?

Overuse of prescribed stool softeners
Excessive physical exercise and activity
Consuming too much dietary fiber
Inadequate fluid intake combined with reduced physical activity (Correct answer)

Correct answer: Inadequate fluid intake combined with reduced physical activity

Inadequate fluid intake and decreased physical activity are the most common contributors to constipation in elderly residents, as both slow bowel motility.

Question 14: Which of the following is the correct way to clean and store a resident's personal assistive device between uses?

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

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

Post the care plan in the resident's room for easy family access
Refer the family to the nurse or social worker to ensure HIPAA-compliant information sharing (Correct answer)
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 16: Which dietary change most directly supports bowel regularity in a restorative program?

Reducing overall protein consumption
Eliminating all fruits from the diet
Decreasing dairy product intake
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 17: What is overflow incontinence?

Leakage that occurs when the overfull bladder cannot empty properly and urine spills over (Correct answer)
Incontinence related to physical or cognitive barriers that prevent reaching the toilet
Incontinence caused by a sudden urge that cannot be controlled in time
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 18: What does 'SOAP' stand for in the context of clinical documentation?

Session, Outcome, Assistance, Position
Subjective, Objective, Assessment, Plan (Correct answer)
Status, Orders, Alerts, Physician
Signs, Observations, Actions, Progress

Correct answer: Subjective, Objective, Assessment, Plan

SOAP is a structured documentation format: Subjective (what the resident reports), Objective (measurable findings), Assessment (clinical interpretation), and Plan (next steps).

Question 19: What is the purpose of the interdisciplinary care plan in restorative services?

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

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 20: 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
Stop the movement immediately and report to the nurse (Correct answer)
Push through the resistance to achieve full range
Apply heat before continuing

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

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

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

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

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

It can improve MDS scores and quality indicators, positively affecting reimbursement (Correct answer)
It is primarily a social program with no clinical impact
It increases the number of skilled therapy orders needed
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 24: What does 'long-term goal' versus 'short-term goal' mean in restorative care planning?

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

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

History of a healed fracture 2 years ago
Generalized muscle weakness
Mild arthritis with stiffness
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 26: A resident reports pain of 7/10 during hip ROM exercises. What should the restorative aide do?

Stop the exercise, reposition the resident comfortably, and report to the nurse (Correct answer)
Encourage the resident to push through the pain
Reduce the repetitions to 1 and continue
Administer pain medication and continue

Correct answer: Stop the exercise, reposition the resident comfortably, and report to the nurse

Pain at 7/10 indicates significant discomfort; the aide must stop, ensure the resident's comfort, and notify the nurse before resuming any exercise.

Question 27: Which type of splint is commonly used in restorative programs to maintain hand function position?

Resting hand splint (Correct answer)
Dynamic extension splint
Compression glove
Wrist cock-up splint for active use

Correct answer: Resting hand splint

A resting hand splint holds the hand in a functional position to prevent contracture formation during periods of inactivity or at night.

Question 28: Which exercise is specifically used to strengthen the pelvic floor muscles to reduce urinary incontinence?

Straight leg raises
Bicep curls
Kegel exercises (Correct answer)
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 29: Which type of walker provides the most stability for a resident with significant balance impairment?

Standard (pick-up) walker (Correct answer)
Rolling (wheeled) walker
Hemi walker
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 30: A resident with Parkinson's disease freezes mid-gait. Which technique often helps them resume walking?

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

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.

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

35 min

Time Limit

70%

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