Question 1

A CNA is caring for a resident with advanced dementia who insists her deceased mother is coming to pick her up for dinner. The resident is calm and smiling. Which approach best preserves the resident's dignity and emotional well-being?

Accepted Answer

Use validation therapy by acknowledging the resident's feelings rather than correcting her. Saying something like 'It sounds like you love your mother very much' enters her emotional reality and reduces distress without causing confusion or agitation.

Question 2

A CNA is assigned to care for a newly admitted resident who speaks only Mandarin. The resident's adult daughter offers to interpret during the care explanation. What is the most appropriate action for the CNA to take?

Accepted Answer

The CNA should politely decline family interpretation and request a professional medical interpreter, either in person or via telephone interpreter service. Using family members as interpreters compromises confidentiality, may introduce inaccuracies, and violates professional standards for informed care.

Question 3

A resident tells the CNA she does not want to take her blood pressure medication this morning, stating she feels fine and does not believe she needs it. How should the CNA respond?

Accepted Answer

The CNA should acknowledge the resident's right to refuse, avoid arguing or coercing her, and promptly report the refusal to the charge nurse so the licensed nurse can document it, counsel the resident on risks, and notify the physician if needed. Residents have the legal right to refuse any treatment.

Question 4

A nurse aide notices that a previously sociable resident has stopped attending group activities, often stays in bed past breakfast, and has barely touched her meals for the past week. The resident says, 'Nothing matters anymore.' Which action is most appropriate?

Accepted Answer

The CNA should report these observations to the charge nurse promptly and objectively, including the behavioral changes, appetite decline, withdrawal from activities, and the resident's verbal statement. These are classic signs of depression that require clinical assessment and possible intervention.

Question 5

A CNA arrives for the evening shift and finds a resident who was alert and oriented at lunch now appears confused, is pulling at her IV tubing, and does not recognize the CNA. The resident was diagnosed with dementia six months ago. What is the priority action?

Accepted Answer

The CNA should recognize this as a sudden change in mental status — a hallmark of delirium — which is different from the gradual decline of dementia. The charge nurse must be notified immediately, as delirium often signals an underlying medical emergency such as infection, medication reaction, or metabolic imbalance.

Psychosocial Care — Scenarios

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