GNA - Geriatric Nursing Assistant Mental Health and Dementia Care Questions and Answers — Questions and Answers
Question 1: A resident with dementia becomes increasingly agitated and confused in the late afternoon. The GNA recognizes this behavior as sundowning. Which of the following interventions is most appropriate?
- Increase the lighting in the resident's room before dusk. (Correct answer)
- Encourage a long nap after lunch to ensure they are well-rested.
- Turn on the television to a lively program for distraction.
- Ask the resident to explain why they are feeling so upset.
Correct answer: Increase the lighting in the resident's room before dusk.
Closing curtains and increasing light before dusk can help minimize shadows and the confusion they may cause for a person with dementia experiencing sundowning. A full schedule or too much daytime napping can interfere with nighttime sleep and worsen sundowning, while loud distractions like television can increase agitation. Trying to reason with a resident who is confused is often ineffective.
Question 2: A GNA is caring for a resident with advanced dementia who is pacing the halls and appears distressed, repeatedly saying, "I need to go home! I need to go home!" Which communication technique is most therapeutic?
- Gently reminding the resident that this is their home now.
- Asking the resident to describe what their home is like. (Correct answer)
- Offering to walk them to their room to rest.
- Administering their prescribed PRN medication for anxiety.
Correct answer: Asking the resident to describe what their home is like.
This response uses validation therapy by acknowledging the resident's feelings and reality without directly correcting them. Asking about their home focuses on the emotion behind the words and allows the GNA to connect with the resident's experience. Reminding them that the facility is their home (reality orientation) can increase agitation in advanced dementia. While rest may be needed, it doesn't address the underlying emotional distress. Administering medication is not within the GNA's scope of practice without a nurse's direction.
Question 3: When assisting a resident with dementia who has become combative during morning care, which of the following actions should the GNA take first?
- Continue with the care task quickly to finish.
- Leave the resident alone to calm down.
- Stop the care task and step back to ensure safety. (Correct answer)
- Firmly tell the resident to stop the behavior.
Correct answer: Stop the care task and step back to ensure safety.
The immediate priority in any situation involving aggression or combativeness is the safety of both the resident and the caregiver. The GNA should stop the task that is causing the agitation and create a safe distance. Continuing the task or using a firm tone can escalate the behavior. Leaving a distressed resident entirely alone may not be safe or therapeutic.
Question 4: A resident with moderate dementia frequently wanders into other residents' rooms. Which of the following is the best initial approach for the GNA to manage this behavior?
- Apply a restraining device to keep the resident in their chair.
- Scold the resident for not respecting others' privacy.
- Redirect the resident by inviting them to a scheduled activity. (Correct answer)
- Lock the resident's door from the outside.
Correct answer: Redirect the resident by inviting them to a scheduled activity.
Redirecting a wandering resident to a purposeful and engaging activity is a recommended strategy. This approach addresses potential underlying causes like boredom without using restraints or punitive measures. Restraints and locking doors are illegal and unethical, and scolding is not a therapeutic response and can increase agitation.
Question 5: Which of the following is a key principle of providing care for a person with dementia?
- It is best to frequently change the daily routine to provide stimulation.
- Correcting all of the resident's misstatements will help their memory.
- Maintaining a consistent and predictable routine provides a sense of security. (Correct answer)
- Communicating primarily with the family to avoid confusing the resident.
Correct answer: Maintaining a consistent and predictable routine provides a sense of security.
Individuals with dementia thrive on consistency and predictability, which helps to reduce cognitive demands and anxiety. Establishing and maintaining a daily routine can provide a sense of security and stability. Frequent changes can be confusing and distressing. Constantly correcting a person with dementia is a form of reality orientation that can cause agitation, and direct communication with the resident should be maintained as much as possible.
Question 6: A GNA is trying to communicate with a resident who has a significant hearing impairment and dementia. Which action is most effective?
- Shouting the information so the resident can hear.
- Approaching the resident from behind to avoid startling them.
- Using simple sentences and gesturing or pointing. (Correct answer)
- Writing down complex instructions for them to read.
Correct answer: Using simple sentences and gesturing or pointing.
When communicating with a resident with both hearing impairment and dementia, using clear, simple sentences combined with non-verbal cues like gesturing is most effective. Shouting distorts sound and can be frightening. Approaching from the front is crucial to avoid startling the resident. Complex written instructions may be difficult for a person with dementia to process.
GNA - Geriatric Nursing Assistant Mental Health and Dementia Care Questions and Answers
A resident with dementia becomes increasingly agitated and confused in the late afternoon.
The GNA recognizes this behavior as sundowning.
Which of the following interventions is most appropriate?