CNA Promoting Resident Independence and Choice — Questions and Answers
Question 1: What does 'restorative care' mean in the context of nursing assistant practice?
- Providing all care so the resident does not have to exert any effort
- Encouraging residents to maintain or regain their highest level of function and independence (Correct answer)
- Restoring the resident to their pre-illness state through surgery
- Performing physical therapy exercises on the resident
Correct answer: Encouraging residents to maintain or regain their highest level of function and independence
Restorative care is an approach that focuses on helping residents achieve and maintain their highest possible level of physical, mental, and psychosocial function. It includes encouraging residents to perform as much self-care as they are safely able to, rather than having the CNA do everything for them.
Question 2: A resident with mild dementia can still dress themselves with guidance. What should the CNA do?
- Dress the resident completely to save time
- Send the resident to occupational therapy and wait for their discharge
- Encourage the resident to dress themselves with step-by-step guidance and extra time (Correct answer)
- Document the resident as fully dependent for dressing
Correct answer: Encourage the resident to dress themselves with step-by-step guidance and extra time
Even residents with dementia should be encouraged to participate in self-care to the extent they are able. Laying out clothes in order, using simple one-step instructions, and allowing extra time promotes independence, preserves dignity, and can slow functional decline.
Question 3: When offering choices to a resident, which approach best supports autonomy?
- Making decisions for the resident based on the care plan alone
- Offering two or three clear options and letting the resident decide (Correct answer)
- Telling the resident what they will do without options to maintain efficiency
- Only offering choices to cognitively intact residents
Correct answer: Offering two or three clear options and letting the resident decide
Offering meaningful choices—such as which clothing to wear, preferred meal times, or bathing schedule—supports resident autonomy. Choices should be clear, realistic, and free from coercion. This approach respects the resident as an individual with preferences and rights.
Question 4: A resident wants to participate in their own wound dressing change. How should the CNA respond?
- Refuse because wound care is a nurse's responsibility only
- Allow the resident to do the entire dressing change unsupervised
- Encourage appropriate participation and involvement within the bounds of safety and scope of practice (Correct answer)
- Ignore the request and complete the dressing change without communicating
Correct answer: Encourage appropriate participation and involvement within the bounds of safety and scope of practice
While CNAs must follow the scope of practice and care plan, encouraging resident participation in appropriate aspects of their own care promotes independence. The CNA can describe what they are doing, involve the resident in monitoring, and encourage appropriate participation within safety guidelines.
Question 5: What is the CNA's role in supporting a resident's right to make healthcare decisions?
- Override decisions that the CNA believes are not in the resident's best interest
- Document that the resident refused care but provide the care anyway
- Respect refusals of competent residents and report concerns to the nurse (Correct answer)
- Only support decisions that the physician has approved in advance
Correct answer: Respect refusals of competent residents and report concerns to the nurse
CNAs support resident rights by providing information requested, notifying appropriate staff when a resident expresses concerns or wants to change their care plan, and never performing care that a competent resident has clearly refused. Residents have the legal right to accept or refuse treatment.
Question 6: Which action demonstrates a CNA encouraging a resident's independence during morning ADLs?
- Rushing through bathing to complete the morning assignment on time
- Performing all grooming tasks while the resident watches
- Allowing extra time for the resident to wash their own face independently (Correct answer)
- Documenting the resident as needing full assistance regardless of ability
Correct answer: Allowing extra time for the resident to wash their own face independently
Allowing the resident extra time to wash their face independently, even if it takes longer, directly promotes functional independence and dignity. This is the essence of a restorative care approach during activities of daily living.
CNA Promoting Resident Independence and Choice
What does 'restorative care' mean in the context of nursing assistant practice?