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CNA exam topic: abuse, neglect and reporting

19 exam-style questions with the answer and the exact rule from federal regulations or CDC guidance.

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1. A resident asks the nurse aide which specific types of issues they can include in a complaint filed with the State Survey Agency. Which list accurately reflects the examples provided in the regulation?Resident abuse, neglect, exploitation, misappropriation of resident property, non-compliance with advance directives, and requests for information regarding returning to the community. The rule lists these specific categories as examples of violations for which a resident may file a complaint.
   42 CFR § 483.10(g): “including but not limited to resident abuse, neglect, exploitation, misappropriation of resident property in the facility, non-compliance with the advance directives requirements and requests for information regarding returning to the community”
2. Which entity is authorized to place findings of abuse, neglect, or misappropriation of property on the state nurse aide registry?Only the State survey and certification agency. The regulation restricts the authority to add these specific findings exclusively to the State survey and certification agency.
   42 CFR § 483.156(b): “Only the State survey and certification agency may place on the registry findings of abuse, neglect, or misappropriation of property.”
3. What is the definition of 'sexual abuse' in the context of resident care?Non-consensual sexual contact of any type with a resident. The rule defines sexual abuse as non-consensual sexual contact of any type with a resident.
   42 CFR § 483.5: “Sexual abuse is non-consensual sexual contact of any type with a resident.”
4. According to the regulations, what is the maximum time limit for reporting an allegation that involves abuse or results in serious bodily injury?Within 2 hours. The regulation specifies a strict two-hour window for reporting allegations involving abuse or serious bodily injury.
   42 CFR § 483.12(c): “reported immediately, but not later than 2 hours after the allegation is made, if the events that cause the allegation involve abuse or result in serious bodily injury”
5. An individual on the nurse aide registry has not performed any nursing-related services for two years. Under what condition will the registry retain their entry rather than removing it?If the individual's registry entry includes documented findings of abuse, neglect, or misappropriation of property. Entries are typically removed after 24 months of inactivity, but they are retained if there are documented findings of abuse, neglect, or misappropriation.
   42 CFR § 483.156(c): “unless the individual's registry entry includes documented findings of abuse, neglect, or misappropriation of property.”
6. According to the definition of abuse, which of the following best describes the scope of actions considered abuse regarding a resident's well-being?Verbal abuse, sexual abuse, physical abuse, and mental abuse, including abuse facilitated through technology. The regulation lists these specific types of abuse, including those mediated by technology, as part of the definition.
   42 CFR § 483.5: “It includes verbal abuse, sexual abuse, physical abuse, and mental abuse including abuse facilitated or enabled through the use of technology.”
7. Which of the following best describes the scope of actions considered abuse regarding a resident's well-being?Deprivation of goods or services necessary to attain or maintain physical, mental, and psychosocial well-being. Abuse is defined broadly to include not just physical injury but also the withholding of necessary goods or services that support overall well-being.
   42 CFR § 483.5: “Abuse also includes the deprivation by an individual, including a caretaker, of goods or services that are necessary to attain or maintain physical, mental, and psychosocial well-being.”
8. A resident asks a nurse aide how to formally report a suspected case of neglect in the facility. According to the regulations, with which specific entity may the resident file this complaint?The State Survey Agency. The regulation directs residents to file complaints regarding suspected violations with the State Survey Agency.
   42 CFR § 483.10(g): “A statement that the resident may file a complaint with the State Survey Agency concerning any suspected violation of state or federal nursing facility regulations”
9. In addition to general abuse prevention, what specific care aspect must nurse aides address in training if they provide services to individuals with cognitive impairments?The care of the cognitively impaired. The regulation specifies that training for aides serving cognitively impaired residents must address the care of those individuals.
   42 CFR § 483.95(g): “For nurse aides providing services to individuals with cognitive impairments, also address the care of the cognitively impaired.”
10. You observe a colleague ignoring a resident's call light for an extended period, which you consider neglect. What is the required action regarding reporting this alleged violation?Immediately report the alleged violation to the administrator of the provider. The rule mandates immediate reporting of alleged violations such as neglect or abuse to the administrator, emphasizing prompt action over delay.
    42 CFR § 483.10(j): “Consistent with § 483.12(c)(1), immediately reporting all alleged violations involving neglect, abuse, including injuries of unknown source, and/or misappropriation of resident property, by anyone furnishing services on behalf of the provider, to the administrator of the provider;”
11. Under the regulations, what constitutes 'misappropriation of resident property'?Using a resident's belongings or money without their consent. The definition specifies that misappropriation involves the wrongful use of belongings or money without the resident's consent.
    42 CFR § 483.5: “Misappropriation of resident property means the deliberate misplacement, exploitation, or wrongful, temporary, or permanent use of a resident's belongings or money without the resident's consent.”
12. What action must a facility take regarding an employee who has been found guilty of abuse or neglect by a court of law?The facility must not employ or otherwise engage the individual. The regulation requires facilities to avoid employing individuals who have been found guilty of abuse or neglect by a court.
    42 CFR § 483.12(a): “Not employ or otherwise engage individuals who— (i) Have been found guilty of abuse, neglect, exploitation, misappropriation of property, or mistreatment by a court of law;”
13. Which of the following best describes the concept of 'neglect' as defined for nursing home regulations?The failure to provide necessary goods and services to avoid physical harm, pain, mental anguish, or emotional distress. Neglect is specifically defined as failing to provide essential goods and services needed to prevent harm or distress to the resident.
    42 CFR § 483.5: “Neglect is the failure of the facility, its employees or service providers to provide goods and services to a resident that are necessary to avoid physical harm, pain, mental anguish, or emotional distress.”
14. When a state survey agency places a finding of abuse against a nurse aide on the registry, what additional information must be included in the response?Any statement disputing the finding made by the nurse aide. The regulation requires that if a finding of abuse is included, the response must also include any statement disputing that finding made by the nurse aide.
    42 CFR § 483.156(a): “Must provide that any response to an inquiry that includes a finding of abuse, neglect, or misappropriation of property also include any statement disputing the finding made by the nurse aide, as provided under paragraph (c)(1)(ix) of this section.”
15. What action must the facility take regarding potential abuse or neglect while an investigation into an allegation is still ongoing?Prevent further potential abuse, neglect, exploitation, or mistreatment. The regulation requires proactive prevention of further harm during the active investigation period.
    42 CFR § 483.12(c): “Prevent further potential abuse, neglect, exploitation, or mistreatment while the investigation is in progress.”
16. According to the definition of abuse, what does the term 'willful' specifically require from the individual inflicting harm?The individual must have acted deliberately. The regulation clarifies that 'willful' refers to the deliberate nature of the action itself, rather than the specific intent behind causing harm.
    42 CFR § 483.5: “Willful, as used in this definition of abuse, means the individual must have acted deliberately, not that the individual must have intended to inflict injury or harm.”
17. A nurse aide was found to have misappropriated property. How long must this finding remain in the registry?Permanently, unless the finding was made in error, the individual was found not guilty in court, or the State is notified of the individual's death. Findings remain permanently in the registry unless specific exceptions apply, such as the finding being erroneous or the individual dying.
    42 CFR § 483.156(c): “This information must be included in the registry within 10 working days of the finding and must remain in the registry permanently, unless the finding was made in error, the individual was found not guilty in a court of law, or the State is notified of the individual's death.”
18. A resident reports a minor bruise on their arm that did not result in serious bodily injury. According to the reporting timeline rules, when must this allegation be reported to the facility administrator?Not later than 24 hours after the allegation is made. The rule specifies a 24-hour reporting window for allegations that do not involve abuse or serious bodily injury, distinguishing it from the stricter 2-hour limit for serious cases.
    42 CFR § 483.12(c): “not later than 24 hours if the events that cause the allegation do not involve abuse and do not result in serious bodily injury”
19. What topics must be included in the mandatory training for staff regarding resident interactions, in addition to reporting procedures?Dementia management and resident abuse prevention. The regulation lists dementia management and resident abuse prevention as specific topics that must be covered in staff training.
    42 CFR § 483.95(c): “(3) Dementia management and resident abuse prevention.”

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