22 Rights, Communication & Role Practice Questions & Answers

1. 1. A resident tells the nurse aide that she does not want her scheduled shower this morning. What should the aide do?

   • A.Record the shower as given and mention the refusal in the end-of-shift report.
   • B.Wait until the resident is drowsy after lunch, then give the shower while she is calm.
   • C.Explain that the shower schedule is set by the facility and help her into the chair.
   • D.Accept her decision, offer the shower at another time, and tell the nurse about it.✓ Answer

   A resident has the right to refuse care or treatment, so the refusal is honored, an alternative is offered, and the nurse is told so the reason can be explored and documented. Care is never forced, never timed to a moment of drowsiness, and never charted as given when it was not.

   Source: 42 CFR 483.10(c)(6) — right to request, refuse and/or discontinue treatmentReport a problem with this question

2. 2. A nurse aide is about to give perineal care to a resident in a semi-private room. Which action best protects the resident's personal privacy?

   • A.Leave the door partly open so another aide can be called if she feels weak.
   • B.Work with the curtain open so the resident's call light stays within her reach.
   • C.Close the door and the privacy curtain and cover all but the area being washed.✓ Answer
   • D.Ask the roommate's visitors to look toward the window while the care is done.

   Personal privacy is physical: the door and curtain are closed and the body is draped so only the part being cared for is exposed. Privacy protects the body from view, while confidentiality protects information about the resident, and the two are tested as separate rights.

   Source: 42 CFR 483.10(h)(1) — personal privacy during treatment and personal careReport a problem with this question

3. 3. A nurse aide takes a photo of a resident at the facility birthday party. Which action by the aide protects the resident's confidentiality?

   • A.Share the photo in a private group chat with the coworkers who care for him.
   • B.Post the photo without the resident's name, since an unnamed photo names no one.
   • C.Crop the resident's face out of the photo and then post it on her own page.
   • D.Delete the photo unless the resident has given written consent for its use.✓ Answer

   A photograph taken in the facility reveals that the person lives there, which is protected health information, so posting or sharing it without written consent breaks confidentiality even when no name appears. Cropping, a private group, or a friends-only setting does not make the disclosure lawful.

   Source: 42 CFR 483.10(h)(2)-(3) and HIPAA Privacy Rule, 45 CFR 164.502Report a problem with this question

4. 4. A resident tells the nurse aide that her wedding ring is missing from her bedside drawer. What should the aide do?

   • A.Report the missing ring to the charge nurse now so the facility can look into it.✓ Answer
   • B.Tell the resident that jewelry is easily misplaced and look again for it tomorrow.
   • C.Search the roommate's closet and drawers before telling anyone the ring is gone.
   • D.Leave a note for the evening shift to look for the ring during bedtime care.

   A resident has the right to keep and use personal possessions, and taking or using a resident's property is misappropriation, which the facility must investigate. The aide reports the loss to the nurse at once and does not search other residents' belongings or delay the report.

   Source: 42 CFR 483.10(e)(2) (personal possessions); misappropriation defined at 42 CFR 488.301Report a problem with this question

5. 5. The team is meeting to update a resident's care plan. Which action supports her right to take part in that planning?

   • A.Invite the resident to the meeting and ask which goals and daily routines she wants.✓ Answer
   • B.Hold the meeting with the family and give the resident a copy of the final plan.
   • C.Ask the resident's roommate which morning routines seem to work best for her.
   • D.Let the charge nurse set the goals and tell the resident about them afterward.

   A resident has the right to participate in developing and carrying out her person-centered care plan and to be told in advance of changes to it. Being handed a finished plan, or having a roommate or the nurse speak for her, is notice after the fact rather than participation.

   Source: 42 CFR 483.10(c)(2)-(3) — participation in person-centered care planningReport a problem with this question

6. 6. A resident wants to complain about the meals but fears the staff will be angry with him. He asks what the long-term care ombudsman does. Which answer is correct?

   • A.A state inspector who certifies nurse aides and enters findings on the registry.
   • B.An outside advocate who receives residents' complaints and works to resolve them.✓ Answer
   • C.A facility manager who runs care conferences and approves changes to care plans.
   • D.A hospital social worker who arranges transfers and discharge plans for residents.

   The long-term care ombudsman is an advocate from outside the facility who receives and works to resolve residents' complaints and may review a resident's records with consent. A resident may voice a grievance without fear of reprisal, and the ombudsman is an external channel rather than the aide's first stop for a change in condition.

   Source: Older Americans Act §712, Long-Term Care Ombudsman Program (42 U.S.C. 3058g); 42 CFR 483.10(j) grievancesReport a problem with this question

7. 7. A nurse aide shuts a resident alone in her room and props a chair against the door so she will stop walking in the hallway. Which term describes this?

   • A.Neglect, which is failing to give the services a resident needs to avoid harm.
   • B.Defamation, which is a false statement that damages the resident's reputation.
   • C.Misappropriation, which is using a resident's property without her permission.
   • D.Involuntary seclusion, which is a form of abuse in a long-term care facility.✓ Answer

   Separating a resident from others and confining her to an area against her will is involuntary seclusion, which federal rules classify as abuse, and blocking her exit is also false imprisonment. Wandering is managed by supervision and activity, never by confining the resident.

   Source: 42 CFR 483.5 (definition of involuntary seclusion); 42 CFR 483.12(a)Report a problem with this question

8. 8. A nurse aide sees the most senior aide on the unit slap a resident's hand during feeding. What should she do first?

   • A.Stay with the resident to keep her safe and report to the nurse right away.✓ Answer
   • B.Speak privately with the senior aide and warn her that this must not happen again.
   • C.Write the event in the resident's chart and raise it at the next staff meeting.
   • D.Watch the senior aide over the next few days to be sure of what she is seeing.

   A nurse aide is a mandated reporter, so the resident is protected first and the suspicion goes to the nurse immediately, no matter how senior or well liked the person suspected is. The aide does not investigate, confront the coworker, or wait to see whether it happens again.

   Source: 42 CFR 483.12(c)(1) — immediate reporting of alleged abuse (within 2 hours if serious bodily injury)Report a problem with this question

9. 9. The unit is short-staffed, and a nurse tells the aide to fasten a lap belt on a resident who wanders so he stays in his chair. What should the aide do?

   • A.Apply the lap belt and chart it as a safety device rather than as a restraint.
   • B.Seat the resident in a deep reclining chair that he is not able to rise from.
   • C.Ask the nurse for the physician's order and offer to walk with the resident.✓ Answer
   • D.Apply the lap belt and release it every two hours until the staffing improves.

   A resident has the right to be free of any restraint imposed for discipline or staff convenience, and a physical restraint requires a physician's order for a documented medical symptom and must be the least restrictive measure for the least time. Short staffing is never a reason to restrain, and calling a restraint a safety device or a deep chair does not change what it is.

   Source: 42 CFR 483.10(e)(1) and 42 CFR 483.12(a)(2) — freedom from restraints imposed for discipline or convenienceReport a problem with this question

10. 10. A resident who had a stroke understands what is said but cannot find words to answer. Which approach should the aide use?

    • A.Ask open-ended questions and wait in silence until he forms a full sentence.
    • B.Ask questions he can answer yes or no, and offer a picture board for choices.✓ Answer
    • C.Finish his sentences for him so that the conversation keeps moving along.
    • D.Speak louder and more slowly, because a stroke usually dulls the hearing.

    In expressive aphasia the resident understands language but cannot produce it, so questions answerable with yes or no and a picture or communication board let him take part without having to find words. Finishing his sentences takes away his voice, and a stroke of this kind does not impair hearing.

    Source: NNAAP Written (Oral) Examination Content Outline, Communication — adapting to speech impairmentReport a problem with this question

11. 11. A resident who wears a hearing aid keeps saying 'What?' during morning care. What should the aide do?

    • A.Check that the hearing aid is on, face the resident, and speak in a normal tone.✓ Answer
    • B.Stop speaking and write out every instruction, since the aid no longer helps.
    • C.Raise her voice and shout each word again toward the resident's better ear.
    • D.Take the hearing aid out and speak straight into the ear so the words carry.

    Shouting distorts speech and raises the pitch that hearing loss affects most, so the aide first makes sure the aid is switched on and working, then faces the resident in good light and speaks clearly in a normal tone. Removing the aid or giving up on speech takes away the resident's usable hearing instead of supporting it.

    Source: NNAAP Written (Oral) Examination Content Outline, Communication — hearing impairmentReport a problem with this question

12. 12. A nurse aide brings a lunch tray into the room of a resident who is blind. Which action is correct?

    • A.Move quietly so the resident is not startled, and touch her arm before speaking.
    • B.Cut the food, feed the resident, and read the menu aloud after the meal ends.
    • C.Rearrange the furniture so that the path to the bathroom is shorter for her.
    • D.State her own name on entering, describe where the foods are, and say goodbye.✓ Answer

    A resident who cannot see relies on sound and on a room that stays the same, so the aide announces herself on entering, describes the tray using clock positions, and says when she is leaving. Touching first startles the resident, moving furniture removes her learned map of the room, and feeding a person who can eat takes away her independence.

    Source: NNAAP Written (Oral) Examination Content Outline, Communication — visual impairmentReport a problem with this question

13. 13. At 4 p.m. a resident with dementia puts on her coat and says she must go home to cook supper for her children. What is the best response?

    • A.Tell her that supper is already cooked and that her family has called to cancel.
    • B.Ask about her children and walk with her toward the dining room for a snack.✓ Answer
    • C.Explain that her children are grown and that this facility is now her home.
    • D.Hang her coat in the closet and ask her to sit down until the feeling passes.

    A resident living in an earlier time cannot be argued back into the present, so the aide accepts the feeling behind the statement, asks about the children, and redirects her to a pleasant activity. Correcting her causes distress, inventing a phone call is dishonest, and taking her coat away provokes a struggle.

    Source: NNAAP Written (Oral) Examination Content Outline, Communication — residents with cognitive impairmentReport a problem with this question

14. 14. Which entry in a resident's record is an objective observation by the nurse aide?

    • A.The resident seemed depressed and did not enjoy the food served at lunch.
    • B.The resident says she feels sick to her stomach and wants no lunch today.
    • C.The resident refused lunch because she is angry with her roommate today.
    • D.The resident ate half of the lunch tray and drank 120 mL of milk.✓ Answer

    An objective entry records what the aide can see, hear or measure, such as the amount eaten and the millilitres taken, while wording like seemed depressed is an opinion and a stated cause is an assumption. What the resident reports about herself is subjective and belongs in the record in her own words inside quotation marks.

    Source: NNAAP Content Outline, Data Collection and Reporting; 42 CFR 483.70(i) accurate medical recordsReport a problem with this question

15. 15. The unit is busy and a coworker asks the aide to chart turns that are not yet done, so the records are finished before break. What should the aide do?

    • A.Enter the turns under the coworker's name and note that she performed them.
    • B.Record the turns in pencil so the entries can be changed if care is delayed.
    • C.Chart each turn after performing it, and let the coworker chart her own care.✓ Answer
    • D.Chart the turns now and carry them out before the end of the shift as planned.

    The medical record is a legal document, so an aide charts only care she gave herself and only after she has given it; an entry written in advance is false even if the care is done later. Charting for another worker or in pencil makes the record unreliable and can be treated as falsification.

    Source: 42 CFR 483.70(i)(1) — complete and accurately documented medical records; NNAAP Content OutlineReport a problem with this question

16. 16. A resident points to a cup of pills on the medication cart and asks the nurse aide to hand it to her. What should the aide do?

    • A.Set the cup on the overbed table so that she can take them when she wishes.
    • B.Tell her the nurse will bring her medicine and let the nurse know she asked.✓ Answer
    • C.Hand her the cup, because the nurse has already poured out the correct pills.
    • D.Crush the pills into applesauce and give them, since she swallows poorly.

    Giving, handing or leaving medication is administration, which is outside the nurse aide's scope unless the aide holds a separate medication aide certification, so the request goes to the licensed nurse. Crushing a tablet also changes how the drug is released and is a nursing decision, not an aide's.

    Source: 42 CFR 483.35 (nursing services) and state nurse practice acts — medication administration is a licensed functionReport a problem with this question

17. 17. A nurse delegates to the aide a task that the aide has never been trained to perform. What should the aide do?

    • A.Look the steps up in the facility procedure manual and do the task alone.
    • B.Perform the task and ask an experienced aide to watch her and correct her.
    • C.Tell the nurse she has not been trained for it and ask to be taught first.✓ Answer
    • D.Perform the task as described, since the nurse is responsible for delegating.

    A nurse may delegate only a task that is within the aide's training and scope, and the aide stays accountable for performing it correctly, so an untrained task is declined and returned to the nurse until training is given. Learning from a manual or from another aide on the spot does not replace documented training and competency.

    Source: 42 CFR 483.35(c)-(d) — nurse aide competency; 42 CFR 483.152 training and competency evaluationReport a problem with this question

18. 18. A resident's daughter asks the nurse aide what the doctor found in her mother's test results. What should the aide do?

    • A.Read the results out of the chart, since the daughter visits her mother daily.
    • B.Say the nurse can discuss results, and pass the daughter's question along to her.✓ Answer
    • C.Say that results are private and that no family member may ever be told them.
    • D.Give a general idea of the findings and suggest asking the doctor about them.

    Interpreting test results is outside the aide's scope, and health information may be shared only with people the resident has authorised, so the aide refers the question to the licensed nurse. Saying that no family member may ever be told is also wrong, because the resident herself decides who receives her information.

    Source: 42 CFR 483.10(h) confidentiality and 483.10(g) access to information; scope per 42 CFR 483.35Report a problem with this question

19. 19. A resident keeps a religious statue and prayer beads on her bedside table and prays before breakfast each day. How should the aide support this?

    • A.Ask the chaplain to keep the items and bring them at set prayer times.
    • B.Join the resident in her prayers so that she does not feel alone in them.
    • C.Move the items into the closet during care and put them back afterward.
    • D.Leave the items where she keeps them and give her care after she has prayed.✓ Answer

    Religious articles are the resident's personal property and her practice is part of her routine, so the aide leaves the items untouched and plans care around the time she prays. Handling or storing the items without permission and taking part in the prayers both impose the aide's judgement on the resident's beliefs.

    Source: 42 CFR 483.10(f)(2)-(3) self-determination and choice of activities; 483.10(e)(2) personal possessionsReport a problem with this question

20. 20. Using Maslow's hierarchy of needs, which resident need should the nurse aide meet first?

    • A.A chaplain visit for a resident who says that she has been feeling lonely.
    • B.Drinking water within reach for a resident who says she is thirsty.✓ Answer
    • C.A card group for a resident who wants to make friends on the unit.
    • D.Praise for a resident who dressed himself without any help this morning.

    Maslow places physical needs such as water, food, air and elimination at the base of the hierarchy, and they are met before needs for belonging or esteem. Thirst is a physical need, while a chaplain visit, a card group and praise address belonging and self-esteem higher up the pyramid.

    Source: Maslow's hierarchy of needs; NNAAP Content Outline, Emotional and Mental Health NeedsReport a problem with this question

21. 21. A dying resident holds the nurse aide's hand and says that she is frightened. What is the best response by the aide?

    • A.Sit down beside her, hold her hand, and listen to what is frightening her.✓ Answer
    • B.Describe what usually happens in the last hours so she knows what to expect.
    • C.Finish the care quickly and leave the room so that she is able to rest.
    • D.Tell her there is nothing to fear and that she will be feeling better soon.

    Presence and active listening are the therapeutic response, because they let the resident express fear and show she is not alone; touch and silence carry as much meaning as words. False reassurance closes the conversation, leaving the room abandons her, and describing the course of dying is outside the aide's role.

    Source: NNAAP Content Outline, Emotional and Mental Health Needs; Communication — therapeutic responseReport a problem with this question

22. 22. A resident with a terminal illness snaps at the aide, saying the staff are useless and the food is always cold. Which stage of grief does this suggest?

    • A.Acceptance, in which the resident grows calm and settles unfinished business.
    • B.Bargaining, in which the resident promises change in return for more time.
    • C.Denial, in which the resident insists that the diagnosis is a laboratory error.
    • D.Anger, in which the feeling is often aimed at the staff rather than the illness.✓ Answer

    In the anger stage described by Kubler-Ross the person turns the unfairness of the loss outward, so complaints about staff and food are usually about dying rather than about the meal. The aide does not take the outburst personally, stays calm, listens, and reports the change to the nurse.

    Source: Kubler-Ross five stages of grief (denial, anger, bargaining, depression, acceptance); NNAAP Content OutlineReport a problem with this question

Practice questions based on the NNAAP written content outline. Not affiliated with Credentia/Pearson VUE or any state nurse-aide registry, and not medical advice. Requirements vary by state. About CNA testing →