Question 1

What are the most common signs of depression a CNA should observe and report in an elderly resident?

Accepted Answer

Common signs include persistent sadness, withdrawal from activities, changes in appetite or sleep, tearfulness, and expressions of hopelessness. CNAs should report these observations promptly to the nurse, as depression is often underdiagnosed in elderly populations.

Question 2

What is validation therapy, and when is it most appropriately used with dementia residents?

Accepted Answer

Validation therapy involves acknowledging and accepting the feelings and reality of a person with dementia rather than correcting or arguing with them. It is most appropriate when a resident is emotionally distressed, confused, or living in a past reality, as it reduces agitation and preserves dignity.

Question 3

What behavioral changes are typically observed during the early stage of Alzheimer's disease, and how should CNAs adjust care?

Accepted Answer

Early-stage Alzheimer's involves short-term memory loss, difficulty finding words, occasional confusion, and mood changes such as anxiety or depression. CNAs should promote independence, use simple clear communication, and provide gentle reminders while respecting the resident's dignity and existing abilities.

Question 4

What is sundowning, and which residents are most at risk for experiencing this phenomenon?

Accepted Answer

Sundowning refers to increased confusion, agitation, wandering, and behavioral disturbances that occur in the late afternoon or evening hours, most commonly in residents with dementia or Alzheimer's disease. The exact cause is not fully understood but may involve disruption to the internal body clock, fatigue, and reduced environmental light.

Question 5

What is reality orientation, and in which clinical situations is it most appropriately applied by a CNA?

Accepted Answer

Reality orientation involves consistently reminding a person of the current time, date, place, and situation to help them maintain connection to the present. It is most appropriate for residents with mild cognitive impairment or delirium where reorientation is possible and helpful, rather than for those with advanced dementia where it causes frustration.

CNA Certified Nursing Assistant Exam — Mental Health & Cognitive Impairment

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