CNA Abuse, Neglect, and Mandatory Reporting — Questions and Answers
Question 1: A nurse aide witnesses a coworker yelling at a resident and calling them insulting names. This is an example of:
- Physical abuse
- Financial exploitation
- Verbal or emotional abuse (Correct answer)
- Passive neglect
Correct answer: Verbal or emotional abuse
Verbal or emotional abuse includes yelling, threatening, insulting, humiliating, or demeaning a resident. It causes psychological harm and is prohibited under federal law regardless of whether physical contact occurs.
Question 2: As a nurse aide, you are a mandatory reporter. This means you are legally required to report:
- Only abuse you personally commit
- Only abuse that leaves visible physical marks
- Any suspected or witnessed abuse, neglect, or exploitation of a resident, regardless of who committed it (Correct answer)
- Abuse only after consulting with the charge nurse and getting their approval to report
Correct answer: Any suspected or witnessed abuse, neglect, or exploitation of a resident, regardless of who committed it
Mandatory reporters must report any suspected, witnessed, or disclosed abuse — whether committed by staff, family, other residents, or anyone else. Waiting for supervisor approval or limiting reports to visible injuries violates mandatory reporting laws.
Question 3: A nurse aide notices a resident has unexplained bruises in various stages of healing and becomes very anxious when male staff enter the room. The nurse aide should:
- Assume the bruises are from the resident bumping into furniture
- Confront the coworker she suspects and ask if they know how the bruises happened
- Document the observations and report them to the charge nurse or supervisor immediately (Correct answer)
- Wait and see if more bruises appear before reporting to avoid making a false accusation
Correct answer: Document the observations and report them to the charge nurse or supervisor immediately
Unexplained injuries and behavioral changes consistent with fear are red flags for abuse. The nurse aide's obligation is to document and report observations immediately — not to investigate, confront staff, or wait for more evidence. The nurse aide is not responsible for proving abuse, only reporting suspicion.
Question 4: Which of the following best describes neglect in a long-term care setting?
- A deliberate act of hitting or pushing a resident
- Stealing money from a resident's personal fund
- Failure to provide necessary care such as food, hygiene, positioning, or medical attention (Correct answer)
- Making demeaning comments about a resident's appearance
Correct answer: Failure to provide necessary care such as food, hygiene, positioning, or medical attention
Neglect is the failure — intentional or unintentional — to provide care that meets a resident's basic needs, including nutrition, hygiene, repositioning, or medical follow-up. It differs from physical abuse (hitting) and financial exploitation (stealing).
Question 5: A resident tells a nurse aide, 'My daughter took all the money from my wallet last week and won't give it back.' The nurse aide should:
- Tell the resident this is a family matter and the facility cannot get involved
- Advise the resident to talk to their daughter directly and resolve it privately
- Report the disclosure to the charge nurse immediately, as this may be financial exploitation (Correct answer)
- Ask other staff whether they have noticed money missing from the resident before reporting
Correct answer: Report the disclosure to the charge nurse immediately, as this may be financial exploitation
Taking a resident's money or property without permission is financial exploitation — a form of abuse. The nurse aide must report this disclosure immediately to the charge nurse. Family relationship does not exempt someone from abuse reporting requirements.
Question 6: After reporting suspected abuse to the charge nurse, the nurse aide is told, 'Don't worry about it — that resident always makes things up.' The nurse aide should:
- Accept the charge nurse's judgment and take no further action
- Confront the suspected abuser directly to get to the truth
- Continue up the chain of command or report to the state abuse hotline if the concern is not addressed (Correct answer)
- Document nothing to avoid conflict with the supervisor
Correct answer: Continue up the chain of command or report to the state abuse hotline if the concern is not addressed
If a supervisor dismisses or ignores a report of suspected abuse, the nurse aide has a legal obligation to continue reporting up the chain of command — to the director of nursing, administrator, or directly to the state abuse hotline. Mandatory reporting duty is not discharged by telling one person who takes no action.
CNA Abuse, Neglect, and Mandatory Reporting
A nurse aide witnesses a coworker yelling at a resident and calling them insulting names.
This is an example of: