CNA Legal & Ethical Behaviours 1 — Questions and Answers

Question 1: You observe your co-worker verbally abusing a resident. What should you do?

Report it to the charge nurse. (Correct answer)
Talk to her after work.
Do nothing, since words won’t hurt the resident.
Tell the resident’s family.

Correct answer: Report it to the charge nurse.

Verbal abuse of a resident is a serious form of elder abuse and a direct violation of professional ethics and resident rights. CNAs have a legal and ethical obligation to protect residents from harm. Reporting the incident immediately to the charge nurse, who is the direct supervisor, ensures that the situation is addressed promptly and appropriately through the proper chain of command.

Question 2: You observe your charge nurse holding a resident’s nose to get him to take his medications. You should

make an anonymous call to the family.
report the incident immediately to the D.O.N. (Correct answer)
do nothing. She is your supervisor.
discuss the incident with other CNAs.

Correct answer: report the incident immediately to the D.O.N.

Forcing medication by holding a resident's nose is a form of abuse and a violation of their rights, specifically the right to refuse treatment and freedom from abuse. When a supervisor, like a charge nurse, is involved in such an act, reporting it to the next level of authority, the Director of Nursing (D.O.N.), is crucial. This ensures the incident is investigated and appropriate action is taken to protect residents.

Question 3: You don't answer a call light because the patient is always hitting it accidentally. No responding is considered to be

breaking confidentiality.
unethical.
false imprisonment.
neglect or abuse. (Correct answer)

Correct answer: neglect or abuse.

Failing to respond to a patient's call light, regardless of perceived frequency or reason, is considered neglect. Patients rely on call lights for essential needs, safety, and comfort. Deliberately ignoring a call light deprives the patient of necessary care and attention, which can lead to harm, distress, or injury, thus constituting neglect or a form of abuse.

Question 4: After the end of the shift, some nurse aides go to a restaurant. Acceptable topics of conversation would include

surgical procedures.
their patients.
hospital politics.
the weather. (Correct answer)

Correct answer: the weather.

Discussing patients, their medical conditions, or sensitive hospital politics outside of a professional setting violates patient confidentiality (HIPAA) and professional ethics. CNAs have a legal and ethical responsibility to protect patient privacy. Acceptable topics of conversation among colleagues outside of work should be general and not involve any protected health information or confidential workplace details.

Question 5: The nurse aide reports directly to the

licensed nurse. (Correct answer)
staff development nurse.
physician.
administrator.

Correct answer: licensed nurse.

In most healthcare settings, the nurse aide works under the direct supervision of a licensed nurse (RN or LPN/LVN). The licensed nurse is responsible for delegating tasks, overseeing patient care, and ensuring the nurse aide performs duties within their scope of practice. This chain of command ensures proper patient care, accountability, and adherence to facility policies.

Question 6: What is the main purpose of continuing education for the nurse aide?

Facility compliance
Review of skills
Client safety (Correct answer)
Promotes teamwork

Correct answer: Client safety

Continuing education for nurse aides is primarily designed to ensure they maintain and update their knowledge and skills, which directly contributes to client safety. By staying current with best practices, new procedures, and safety protocols, CNAs can provide the highest quality of care and minimize risks to residents. This ongoing learning is vital for competent and safe patient care.

Question 7: Once a nurse aide’s name is placed on the abuse registry for neglect they may

petition the state nursing board for reinstatement. (Correct answer)
continue to work as long as they abuse no one else.
never be employed as a nurse aide again.
work only as a home health aide.

Correct answer: petition the state nursing board for reinstatement.

If a nurse aide's name is placed on the abuse registry for neglect, it typically means they are barred from working as a CNA. However, most states have a process where an individual can petition the state nursing board or equivalent regulatory body for reinstatement after a certain period, provided they meet specific criteria, such as demonstrating rehabilitation or completing additional training. This process allows for potential re-entry into the profession under strict conditions.

Question 8: A resident's call light

should be answered as quickly as possible. (Correct answer)
may be kept out of the resident's reach so they can rest.
should only be answered by the nurse aide assigned to that client.
may be answered when you have time.

Correct answer: should be answered as quickly as possible.

A resident's call light is their primary means of requesting assistance, whether for immediate needs like toileting, pain, or safety concerns. Promptly answering the call light is crucial for ensuring resident safety, comfort, and dignity. Delaying responses can lead to falls, increased discomfort, anxiety, or other negative outcomes, and is considered neglect.

Question 9: The client offers a nurse aide a twenty dollar bill as a thank you for all that the nurse aide has done. The nurse aide SHOULD

take the money not to offend the client.
ask the nurse in charge what to do.
politely refuse the money. (Correct answer)
take the money and buy something for the floor.

Correct answer: politely refuse the money.

Accepting money or gifts from clients can create a conflict of interest, compromise professional boundaries, and potentially lead to accusations of exploitation. Healthcare facilities typically have policies against staff accepting personal gifts of monetary value from residents. Politely refusing the money upholds professional ethics and maintains appropriate boundaries in the caregiver-client relationship.

Question 10: Patients can suddenly become combative and hit a nurse aide. If this happens, you should _____.

contact the family members to control the situation
immediately leave the patient and call for security
ask the nurse to call the doctor to get an order for restraints
back away from the patient and talk to them in a calm voice (Correct answer)

Correct answer: back away from the patient and talk to them in a calm voice

When a patient becomes combative, the immediate priority is to ensure safety for both the patient and the caregiver. Backing away creates physical space, reducing the risk of injury. Speaking calmly can help de-escalate the situation, as a calm voice can often soothe an agitated person and prevent further escalation, allowing time to assess the situation and call for additional help if needed.

Question 11: What are your legal and ethical responsibilities if you have access to medical records?

To only tell your family about a patient
To write everything down accurately
To keep all information confidential (Correct answer)
To share information with anyone who asks

Correct answer: To keep all information confidential

Medical records contain Protected Health Information (PHI) and are subject to strict confidentiality laws, such as HIPAA. Healthcare professionals, including CNAs, have a legal and ethical responsibility to protect this information and only share it with authorized personnel directly involved in the patient's care. Breaching confidentiality can lead to severe penalties, including fines and loss of licensure.

Question 12: A patient's chart is a legal document. If something is mistakenly written on the chart, the correct action is to

use correction ink to block out the mistake. Then write the correct information over it in blue or black ink. Add your initials, date, and time.
draw a single line through the mistake with blue or black ink. Write your initials, date, and time. Then write the correct information. (Correct answer)
use a black or blue marker to cover the mistake completely. Then follow with the correct information. Add your name and title, date, and time.
get a new chart page and copy everything, including all the correct information in blue or black ink. Write your name and title, date, and time.

Correct answer: draw a single line through the mistake with blue or black ink. Write your initials, date, and time. Then write the correct information.

A patient's chart is a legal document, and any corrections must be made in a way that preserves the original entry for legal and auditing purposes. Drawing a single line through the error makes it legible, while initialing and dating the correction ensures accountability. Using correction fluid or completely obscuring the mistake is unacceptable as it can be seen as an attempt to falsify records.

Question 13: It is okay to call a resident by a nickname if

The resident requests it (Correct answer)
The nickname is appropriate
The family uses that name
Everyone else calls them that

Correct answer: The resident requests it

Respecting a resident's personal preferences, including how they wish to be addressed, is fundamental to person-centered care and upholding their dignity. While a nickname might seem appropriate or be used by family, it is only acceptable for a CNA to use it if the resident explicitly requests or consents to it. This ensures the resident feels respected and comfortable in their care environment.

Question 14: A 22-year old with terminal brain cancer tells you that she has an Advanced Directive for her end-of-life care. You know this can mean any of the following EXCEPT

She can designate who can make her medical decisions.
She can choose to be a DNR patient.
Her family can direct the staff to keep her alive. (Correct answer)
Her Living Will can indicate her wishes.

Correct answer: Her family can direct the staff to keep her alive.

An Advanced Directive, such as a Living Will or Durable Power of Attorney for Healthcare, is a legal document that allows an individual to express their wishes for end-of-life care or designate a healthcare proxy. The purpose is to ensure the patient's wishes are followed, even if they become incapacitated. Therefore, the family cannot override a valid Advanced Directive to keep a patient alive if the directive states otherwise, as the patient's autonomy is paramount.

Question 15: The intentional attempt or threat to touch a person's body without the person's consent is

Battery
Defamation
Assault (Correct answer)
Slander

Correct answer: Assault

Assault is defined as the intentional act of making someone fear that they are about to be touched in an offensive, insulting, or physically injurious way. It is the threat or attempt to touch without consent, causing apprehension. Battery, in contrast, is the actual unlawful touching of another person without their consent.

Question 16: A famous athlete has been admitted into your facility. He is in a different unit. If you want to find out why he is there, what should you do?

Log on and quickly read his electronic health record.
Drop by the other unit to learn whatever you can.
Avoid temptation and just keep working. (Correct answer)
Ask a co-worker on the unit to give you an update.

Correct answer: Avoid temptation and just keep working.

Accessing a patient's medical records without a legitimate 'need to know' for their direct care is a violation of patient confidentiality (HIPAA). Even if the patient is a celebrity or on a different unit, curiosity does not justify accessing their private health information. CNAs have an ethical and legal responsibility to protect patient privacy and should only access records relevant to their assigned duties.

CNA Legal & Ethical Behaviours 1

You observe your co-worker verbally abusing a resident.
What should you do?