CNA Basic Restorative Services 1 2 — Questions and Answers

Question 1: What is the primary goal of restorative nursing care for a resident with limited mobility?

To do all tasks for the resident to save time
To maintain and restore the resident's highest possible level of function (Correct answer)
To keep the resident in bed to prevent falls
To administer medications that improve mobility

Correct answer: To maintain and restore the resident's highest possible level of function

Restorative nursing focuses on helping residents regain or maintain the maximum level of function they are capable of, promoting independence rather than dependence.

Restorative nursing care is a philosophy that emphasizes maintaining and restoring each resident's highest possible level of physical, mental, and psychosocial function. Rather than performing all tasks for residents, CNAs encourage and assist residents to do as much as they safely can for themselves. This approach reduces the negative effects of immobility, preserves muscle strength and joint flexibility, boosts self-esteem, and improves overall quality of life.

Question 2: When assisting a resident with range-of-motion exercises, the CNA should move each joint until the resident reports:

Severe pain
Mild discomfort or resistance (Correct answer)
No sensation at all
A popping sound

Correct answer: Mild discomfort or resistance

Range-of-motion exercises should be performed to the point of mild resistance or slight discomfort, never forcing the joint past that point to avoid injury.

During passive or assisted range-of-motion exercises, the CNA moves each joint through its full range slowly and gently. The exercise should stop when mild resistance or slight discomfort is felt. Forcing joints beyond their natural range can cause muscle tears, fractures, or joint damage — especially in residents with arthritis, contractures, or osteoporosis. The CNA should never cause pain, and any report of pain means the exercise must stop immediately.

Question 3: Contractures are a common complication of immobility. What does a contracture involve?

Weakening of the heart muscle
Permanent shortening and hardening of muscles and tendons causing joint deformity (Correct answer)
Fluid buildup in the joints
Loss of sensation in the extremities

Correct answer: Permanent shortening and hardening of muscles and tendons causing joint deformity

Contractures occur when muscles and tendons shorten and harden due to prolonged immobility, leading to fixed joint deformities that limit movement.

A contracture is a permanent shortening of a muscle or tendon that causes a joint to become fixed in a bent or straightened position. They develop when a body part is not moved through its full range of motion regularly. Common sites include the hands, wrists, elbows, hips, knees, and feet. Contractures are painful, limit function, and are difficult to reverse once established. Preventive measures include regular repositioning, range-of-motion exercises, and proper positioning with support devices.

Question 4: Which of the following is an example of an assistive device used in restorative care to promote independence with eating?

A Foley catheter
A built-up handled spoon (Correct answer)
A Hoyer lift
A sequential compression device

Correct answer: A built-up handled spoon

A built-up handled spoon has a wider grip that is easier for residents with limited hand strength or coordination to hold, promoting independent eating.

Assistive devices for eating include built-up handled utensils (thicker handles for easier gripping), plate guards that prevent food from sliding off, non-skid mats to stabilize dishes, rocker knives for one-handed cutting, and cups with special lids. These adaptive tools allow residents with physical limitations such as arthritis, weakness, or paralysis to eat independently. Encouraging self-feeding supports dignity, caloric intake, and fine motor function. A Hoyer lift is a transfer device, not an eating aid.

Question 5: A restorative nursing program requires a care plan. Who is responsible for developing this plan?

The CNA alone, based on direct observations
The interdisciplinary team including the nurse, therapist, and physician (Correct answer)
The resident's family only
The administrator of the facility

Correct answer: The interdisciplinary team including the nurse, therapist, and physician

The restorative care plan is developed by the interdisciplinary team, which may include nurses, physical therapists, occupational therapists, the physician, and input from the resident and family.

A restorative nursing care plan is created by the interdisciplinary team (IDT), which typically includes the attending physician, registered nurse, licensed practical nurse, physical therapist, occupational therapist, speech therapist (as needed), social worker, dietitian, and the CNA who provides direct care. The resident and family are also involved. The CNA's role is to carry out the plan consistently, document progress accurately, and report changes to the nurse. CNAs do not independently create care plans but contribute valuable observations to the planning process.

Question 6: When a resident is performing restorative exercises, the CNA should provide:

Minimal verbal interaction to avoid distraction
Encouragement and positive reinforcement throughout the activity (Correct answer)
Criticism when the resident does not perform correctly
Physical force to complete the full range of motion

Correct answer: Encouragement and positive reinforcement throughout the activity

Encouragement and positive reinforcement motivate residents to participate in restorative activities, which can be challenging and frustrating for them.

Emotional support is a critical component of restorative care. Residents may feel frustrated, embarrassed, or discouraged when they cannot perform tasks they once did easily. The CNA should offer consistent encouragement, celebrate small achievements, and provide positive reinforcement to build the resident's confidence and motivation. Using a kind and patient tone, explaining each step before doing it, and acknowledging the effort — even when progress is slow — helps residents remain engaged in their care and more likely to achieve functional goals.

CNA Basic Restorative Services 1 2

What is the primary goal of restorative nursing care for a resident with limited mobility?