More Practice Tests
You’ve studied the skills. You know how to take a blood pressure and bathe a resident perfectly. But if you don’t understand the legal and ethical rules of your profession, you could still fail the exam—or worse, put your license and your residents at risk.
The “Legal and Ethical Behaviours” domain isn’t just about memorizing laws; it’s about understanding how to protect the rights and dignity of the people you care for. This area accounts for a significant portion of your written exam, and missing these questions can sometimes be an automatic fail in certain states.
In this guide, we will break down the complex legal jargon into easy-to-understand concepts. We’ll cover everything from the Residents’ Bill of Rights to HIPAA, abuse reporting, and exactly what is within your scope of practice.
💡 Quick Stat: This domain makes up approximately 17% of your written exam—roughly 9 to 12 questions. Mastering this section is a “must-pass” priority.
Understanding Legal and Ethical Behaviours: Your Exam Blueprint
This topic covers the rules that govern your daily life as a Nursing Assistant. It bridges the gap between your clinical skills (the “how”) and your professional responsibilities (the “should” and “must”). Whether it is protecting a resident’s privacy or knowing when to refuse an unsafe assignment, this domain is the safety net of your career.
Where This Topic Fits in Your Exam
pie showData title "Legal and Ethical Behaviours on the CNA Exam" "Legal & Ethical (Domain)" : 17 "Other Exam Topics" : 83
Interpretation: While 17% might seem small, these questions are high-stakes. They often appear as scenario-based questions that test your judgment. You cannot simply memorize a definition; you must apply the law to a specific situation.
What You Need to Know Within Legal & Ethical Behaviours
flowchart TD
MAIN["🎯 Legal & Ethical Behaviours<br/><small>(17% of Exam)</small>"]
MAIN --> ST1["📌 Residents' Rights<br/><small>High Frequency</small>"]
MAIN --> ST2["📌 Abuse & Neglect<br/><small>High Frequency</small>"]
MAIN --> ST3["📋 HIPAA & Confidentiality<br/><small>High Frequency</small>"]
MAIN --> ST4["📋 Scope of Practice<br/><small>Medium Frequency</small>"]
MAIN --> ST5["📄 Informed Consent<br/><small>Medium Frequency</small>"]
MAIN --> ST6["📄 Documentation<br/><small>Medium Frequency</small>"]
MAIN --> ST7["📄 Advanced Directives<br/><small>Low Frequency</small>"]
style MAIN fill:#1976D2,color:#fff,stroke:#1565C0
style ST1 fill:#c8e6c9,stroke:#4CAF50
style ST2 fill:#c8e6c9,stroke:#4CAF50
style ST3 fill:#c8e6c9,stroke:#4CAF50
style ST4 fill:#fff3e0,stroke:#FF9800
style ST5 fill:#fff3e0,stroke:#FF9800
style ST6 fill:#fff3e0,stroke:#FF9800
style ST7 fill:#f5f5f5,stroke:#9e9e9eInterpretation: Focus your energy on the three green nodes: Residents’ Rights, Abuse & Neglect, and Confidentiality. These are the “Big Three” that appear most frequently.
📋 Study Strategy: Start your study session with Residents’ Rights. Almost every other legal concept (abuse, privacy, informed consent) is an extension of these rights.
High-Yield Cheat Sheet: Legal & Ethical at a Glance
Let’s visualize the core pillars you need to master.
mindmap
root((Legal & Ethical))
Residents' Rights
Dignity & Respect
Privacy (Body/Info)
Freedom from Abuse
Abuse & Neglect
PEASVN Types
Mandatory Reporting
Chain of Command
Confidentiality
HIPAA Rules
No Social Media
Verbal Privacy
Scope of Practice
RIGHT-O Delegation
Observe vs Assess
Refuse Unsafe Tasks
Documentation & Ethics
Chart Only What You Do
Objective Facts
Correcting ErrorsQuick Reference Summary
1. The Residents’ Bill of Rights
This is the heart of the CNA exam. Residents have the right to make their own choices (autonomy), be treated with dignity, and have their privacy protected (both their body and their medical records). You must always honor their refusal of care, even if you disagree.
2. Abuse, Neglect, and Exploitation
You are a mandated reporter. If you even suspect abuse, you must report it immediately to your nurse supervisor. Do not investigate yourself; just report and document the facts.
3. Confidentiality and HIPAA
Protected Health Information (PHI) includes everything from a resident’s diagnosis to their room number. Never discuss residents in public places (elevators, cafeterias) and never post photos on social media.
4. Scope of Practice and Delegation
Know your legal limits. CNAs provide care and observation, not assessment or medical judgment. If a nurse delegates a task that is unsafe or outside your training, you have the right and duty to refuse.
5. Legal Documentation and Ethics
If you didn’t chart it, you didn’t do it. Always document objectively (facts only), not subjectively (opinions). Never erase an error; draw a line through it, initial it, and write “error.”
How Legal & Ethical Behaviours Connect to Other Exam Topics
Legal standards aren’t isolated; they overlay everything you do. Understanding these connections helps you answer complex scenario questions.
flowchart TD
subgraph CORE ["Legal & Ethical Behaviours"]
A["Residents' Rights (Dignity)"]
B["Standard of Care (Negligence)"]
C["Privacy (HIPAA)"]
end
subgraph RELATED ["Connected Topics"]
D["Infection Control"]
E["Personal Care"]
F["Safety / Emergency"]
end
A -->|"Privacy during care"| E
B -->|"Precautions prevent negligence"| D
C -->|"Resident ID & Rights"| F
style CORE fill:#e3f2fd,stroke:#1976D2
style RELATED fill:#f5f5f5,stroke:#757575Why These Connections Matter
- Infection Control: Legally, failing to wash your hands isn’t just “gross”—it is negligence (a failure to provide the standard of care).
- Personal Care: Closing the curtain during perineal care is both an infection control measure AND a legal requirement for privacy/dignity.
- Safety: Using restraints without a doctor’s order is a violation of Residents’ Rights and can lead to charges of false imprisonment.
💡 Exam Tip: When a question mixes topics (e.g., a resident falls and you don’t wash your hands before helping them up), look for the legal violation first.
What to Prioritize: High-Yield vs. Supporting Details
You cannot study everything with equal intensity. Use this matrix to focus your time.
quadrantChart
title Study Priority Matrix
x-axis "Low Complexity" --> "High Complexity"
y-axis "Low Yield" --> "High Yield"
quadrant-1 "Master These"
quadrant-2 "Know Well"
quadrant-3 "Basic Awareness"
quadrant-4 "Review If Time"
"Mandatory Reporting": [0.25, 0.85]
"Scope of Practice": [0.35, 0.90]
"HIPAA": [0.20, 0.80]
"Residents' Rights": [0.75, 0.80]
"Informed Consent": [0.85, 0.70]
"Tort Law Details": [0.80, 0.30]Priority Table
| Priority | Concepts | Study Approach |
|---|---|---|
| 🔴 Must Know | Mandatory Reporting, Residents’ Rights (Dignity/Privacy), HIPAA, Scope of Practice (Observe vs. Assess), Informed Consent, Restraints, Advance Directives | Master completely. These concepts appear frequently. |
| 🟡 Should Know | Ombudsman role, Incident reports, Involuntary seclusion, Assault vs. Battery, Libel vs. Slander, Negligence vs. Malpractice | Understand well. Know the definitions and differences. |
| 🟢 Good to Know | Patient Self-Determination Act, Ethical dilemmas (boundaries), Whistleblower protection | Review basics. Recognize the terms if they appear. |
| ⚪ Awareness | OBRA ’87 specific sections, Tort reform, Employment law | Skim if time permits. Deep knowledge is rarely tested. |
Strategic Insight: Focus heavily on the “Red” items. If you know Scope of Practice and Residents’ Rights, you can logically deduce the answer to many “Yellow” questions.
Essential Knowledge: Legal & Ethical Deep Dive
Pillar 1: The Residents’ Bill of Rights
The Residents’ Bill of Rights isn’t just a suggestion; it is federal law (OBRA ’87). It guarantees that residents in long-term care facilities maintain their dignity and autonomy as individuals.
Key Concepts:
- Dignity and Respect: Residents must be treated politely at all times. They should not be treated like children, regardless of their mental state.
- Privacy: This covers their body (close curtains/doors during care) and their information (medical records).
- Freedom from Abuse: Residents have the right to be free from verbal, sexual, physical, and mental abuse.
- Grievances: Residents can complain without fear of retaliation. If they complain to you, you must report it to the nurse.
Exam Focus:
Questions often ask about the “right to refuse.” A resident can refuse a bath, medication, or food. The CNA’s role is to encourage (try to persuade) but never to force. If they refuse, you document it and report it to the nurse.
💡 Memory Tip: Use D.R.E.S.S. to remember the core themes.
- Dignity
- Respect
- Exercise rights
- Self-determination
- Security/Privacy
Pillar 2: Abuse, Neglect, and Exploitation
Recognizing and reporting abuse is one of the most critical duties of a CNA. Exploitation is the illegal misuse of a resident’s money or property.
Key Concepts:
- Types of Abuse: You need to recognize the signs.
- Physical: Unexplained bruises, fractures, burns.
- Sexual: Bruises in genital area, torn clothing, STDs.
- Emotional: Resident is withdrawn, fearful, or agitated.
- Neglect: Poor hygiene, bedsores, weight loss, dehydration.
- Financial: Missing checks, changes to will, missing belongings.
- Mandatory Reporting: You do not need proof to report. You only need suspicion.
Reporting Process:
flowchart LR
A[Suspect Abuse] --> B[Ensure Immediate Safety]
B --> C[Report to Nurse Supervisor<br/>IMMEDIATELY]
C --> D[Nurse Investigates/Reports to State]
D --> E[CNA Documents Facts<br/>Objectively]
style A fill:#ffcdd2,stroke:#c62828
style C fill:#c8e6c9,stroke:#2e7d32
style E fill:#bbdefb,stroke:#1565c0Exam Focus:
The exam will often test the chain of command. You always report to the Nurse Supervisor first. You do not call the police or the family yourself (unless instructed by the supervisor, or in an immediate life-threatening emergency where police/911 are needed alongside medical aid).
💡 Memory Tip: P.E.A.S.V.N. helps you recall the types of abuse.
- Physical
- Emotional
- Abuse (Sexual)
- Sexual
- Verbal
- Neglect
Pillar 3: Confidentiality and HIPAA
HIPAA (Health Insurance Portability and Accountability Act) protects a resident’s “Protected Health Information” (PHI).
Key Concepts:
- PHI: Includes name, diagnosis, room number, birth date, and medical condition.
- Verbal Privacy: Do not discuss residents in hallways, elevators, or the cafeteria. If you overhear others gossiping, you must stop them or report it.
- Social Media: Never take photos of residents, even if they are “cute” or “funny,” and even if you don’t use their name. This is a major violation and often leads to immediate termination.
Exam Focus:
Watch out for the “Family Trap.” A family member asks you, “How is Mom doing?” If you are not the assigned nurse, you generally should direct them to the nurse or say, “You can speak to the nurse at the desk.” Never give a medical update over the phone to someone you cannot verify.
Pillar 4: Scope of Practice and Delegation
Your “Scope of Practice” defines what you are legally allowed to do. Performing tasks outside this scope is illegal and can result in loss of your certification.
Key Concepts:
- Observation vs. Assessment: CNAs observe (I see a red rash) and report. RNs assess (I see a red rash that looks like a heat rash). CNAs cannot interpret data (e.g., saying “The pulse is irregular”—you report the rate and rhythm, the nurse determines irregularity).
- The 5 Rights of Delegation: Before accepting a task from an RN, check RIGHT-O.
Scope Decision Tree:
flowchart TD
A["Start: Assigned a Task"] --> B{"Is it an ADL<br/>(hygiene, feeding)?"}
B -- Yes --> C["Perform the task"]
B -- No --> D{"Was I taught this<br/>in CNA class?"}
D -- No --> E["REFUSE: Out of Scope"]
D -- Yes --> F{"Is it delegated by<br/>an RN/LPN?"}
F -- No --> E
F -- Yes --> G["Accept and Perform"]
style C fill:#c8e6c9,stroke:#4CAF50
style E fill:#ffcdd2,stroke:#c62828
style G fill:#fff3e0,stroke:#FF9800Exam Focus:
Tasks like inserting IVs, irrigating catheters, or adding medication to water are outside the CNA scope. Also, you can only accept delegation from an RN or LPN; you cannot accept tasks from a doctor or another CNA.
💡 Memory Tip: RIGHT-O
- Right Task
- Right Circumstances
- Right Person (You)
- Right Direction/Communication
- Right Supervision/Evaluation
Pillar 5: Legal Documentation and Ethics
Documentation is your legal proof that you did your job.
Key Concepts:
- Charting: Chart only what you do and see. Do not chart for someone else. If you forget to chart something, do not go back and add an entry to a previous time. Chart the current time and note “late entry.”
- Correcting Errors: Never use white-out or erase. Draw a single line through the error, write “error,” and initial it.
- Informed Consent: This is the process of explaining a procedure (risks/benefits) to a resident. CNAs cannot obtain informed consent; only doctors and nurses can.
Comparison: Types of Legal Terms
| Term | Definition | Intent | Example |
|---|---|---|---|
| Negligence | Failure to provide standard care, resulting in harm. | Unintentional | Forgetting to put side rails up and resident falls. |
| Malpractice | Negligence by a professional. | Unintentional | (Mostly applies to RNs/MDs, but CNAs can be negligent). |
| Assault | Threatening or causing fear of harmful contact. | Intentional | Threatening to restrain a resident if they don’t eat. |
| Battery | Unwanted harmful or offensive touching. | Intentional | Performing care on a resident after they said “Stop.” |
Exam Focus:
Informed consent questions are tricky. If a resident asks, “Why are you taking my blood?”, your answer is “The doctor ordered it to check your health.” You do not explain the medical reasons for the test (diagnosis).
💡 Memory Trick: “L” in Libel looks like a line on paper (Written). “S” in Slander looks like a mouth (Spoken).
Common Pitfalls & How to Avoid Them
Even well-meaning CNAs can fall into these legal traps.
⚠️ Pitfall #1: The “Good Samaritan” Trap
❌ THE TRAP: Thinking that providing emergency care (like giving medication you have at home) during a shift is helpful.
✅ THE REALITY: Performing tasks outside your scope of practice, even with good intentions, is illegal.
💡 QUICK FIX: “Scope of practice is a fence, not a suggestion. If I didn’t learn it in CNA school, I don’t do it.”
⚠️ Pitfall #2: The “Family Permission” Fallacy
❌ THE TRAP: Believing that a family member (who is not the legal guardian) can give consent for care or authorize the CNA to withhold information.
✅ THE REALITY: Consent comes from the resident (if competent) or the legal guardian. Spouses/children do not automatically have legal authority.
💡 QUICK FIX: “Check the chart for the legal decision-maker. ‘Husband’ does not automatically mean ‘Guardian’.”
⚠️ Pitfall #3: The “Nurse is Busy” Bypass
❌ THE TRAP: Failing to report a change in condition or abuse because the nurse “looks stressed” or “is busy.”
✅ THE REALITY: The CNA is the eyes and ears. Reporting is mandatory regardless of the nurse’s mood.
💡 QUICK FIX: “It’s not my job to decide if the nurse needs to know. It’s my job to tell them.”
⚠️ Pitfall #4: The “Social Media” Slip
❌ THE TRAP: Posting a picture of a “cute” resident party or a funny story about a shift (without names) on Facebook.
✅ THE REALITY: Any reference to a resident, even without names, is a HIPAA violation and ground for immediate dismissal.
💡 QUICK FIX: “If it happens in the facility, it stays in the facility. No phones in resident rooms.”
⚠️ Pitfall #5: The “I’ll Fix It” Documentation Mistake
❌ THE TRAP: Erasing a mistake in the chart and writing the correct entry.
✅ THE REALITY: You must never erase, use white-out, or scribble out entries. Draw one line through, write “error,” and initial.
💡 QUICK FIX: “One line and initial. The chart is a legal record of what actually happened, including my errors.”
🎯 Remember: Your actions on the floor are legally binding. When in doubt, stop and ask the nurse.
How This Topic Is Tested: Question Patterns
Recognizing the pattern is half the battle.
📋 Pattern #1: The “Who Do You Tell?” Scenario
WHAT IT LOOKS LIKE: A scenario describes a CNA witnessing an event (e.g., a family member yelling at a resident, or a bruise appearing). The question asks for the immediate next action.
EXAMPLE STEM:
“You enter a room and see a visitor shaking a resident violently. The visitor yells, ‘Stop wetting the bed!’ What should you do FIRST?”
SIGNAL WORDS: “First,” “Report,” “Who,” “Chain of command.”
YOUR STRATEGY:
- Ensure immediate safety (intervene if safe to do so).
- Identify that it is an abuse/neglect situation.
- Select “Report to the nurse supervisor immediately.”
⚠️ TRAP TO AVOID: Offering an immediate solution (like talking to the visitor) rather than reporting. The CNA’s role ends at reporting.
📋 Pattern #2: The “Scope Check” Question
WHAT IT LOOKS LIKE: Lists of tasks are provided. You must identify which one a CNA cannot perform or which one is outside the scope.
EXAMPLE STEM:
“Which of the following tasks is within the scope of practice for a nursing assistant?”
SIGNAL WORDS: “Scope,” “Assignment,” “Delegate,” “Cannot,” “Illegal.”
YOUR STRATEGY:
- Scan for assessment tasks (listening to bowel sounds, checking pupils = RN only).
- Scan for sterile procedures (catheter insertion, IV start = RN only).
- Look for ADLs (washing, feeding, dressing = CNA ok).
⚠️ TRAP TO AVOID: Including “Irrigating a nasogastric tube” or “Applying an elastic bandage” as distractors. These are often RN-only or require additional certification.
📋 Pattern #3: The “Informed Consent” Trap
WHAT IT LOOKS LIKE: A resident refuses care. The CNA must decide how to respond.
EXAMPLE STEM:
“A resident with dementia refuses to take their afternoon medication. The CNA’s best action is to:”
SIGNAL WORDS: “Refuses,” “Refusal,” “Consent,” “Rights.”
YOUR STRATEGY:
- Acknowledge the right to refuse (even if they have dementia).
- Do not force or hide medication.
- Report the refusal to the nurse.
⚠️ TRAP TO AVOID: “Explain that the doctor ordered it” (nagging) or “Crush it and put in pudding” (assault/battery).
🎯 Pattern Recognition Tip: If a question asks “Who is responsible?”, the answer is almost always the person who performed the task or the person delegating it, not the family member.
Key Terms You Must Know
| Term | Definition | Exam Tip |
|---|---|---|
| Assault | Intentional act that causes fear of immediate harmful or offensive contact. | Tested in scenarios of threatening residents. |
| Battery | Intentional harmful or offensive touching without consent. | Touching a resident who refused care. |
| Libel | Defamation via written or printed words. | Writing “Mrs. Smith is mean” in a note. |
| Slander | Defamation via spoken words. | Gossiping in the break room. |
| Negligence | Failure to provide the standard of care, resulting in harm. | Forgetting to lock wheelchair wheels. |
| Malpractice | Negligence by a professional. | Often appears as a distractor; CNAs commit negligence. |
| Mandated Reporter | Professional legally required to report suspected abuse. | You must report to the Nurse, not police (initially). |
| Scope of Practice | Tasks legally allowed for a specific role. | Stick to ADLs and observations. |
| Informed Consent | Permission given after full explanation of risks/benefits. | Only MD/RN/LPN can obtain this. |
| PHI | Protected Health Information (any data relating to health status). | Includes room numbers and diagnoses. |
| Ombudsman | Official appointed to investigate residents’ complaints. | They advocate for the resident, not the facility. |
Red Flag Answers: What’s Almost Always Wrong
When in doubt, eliminate answers that break these rules.
| 🚩 Red Flag | Example | Why It’s Wrong |
|---|---|---|
| Bypassing the Nurse | “Call 911 immediately” (for non-emergency) | CNA reports to the Nurse Supervisor; RN calls 911. |
| Diagnosing | “Assess the pain level” / “Check for infection” | Assessment is an RN/LPN function. |
| Forcing Care | “Hold the resident down” / “Explain that the doctor ordered it” | Residents have the right to refuse; forcing is battery. |
| Social Media | “Post the picture without names” | HIPAA violation. |
| Gossip/Opinions | “Tell the daughter that her father is difficult” | Unprofessional and violates dignity. |
| Altering Records | “Use white-out to fix the error” | Illegal. Never erase. |
Practice Application: If you see an answer that involves explaining a medical procedure, forcing care, or discussing a resident in an elevator, immediately cross it out.
Myth-Busters: Common Misconceptions
❌ Myth #1: “If a resident is confused, they can’t refuse care.”
✅ THE TRUTH: Even residents with dementia have the right to refuse. You must attempt to persuade (redirect) but cannot force care.
📝 EXAM IMPACT: Selecting an answer that forces treatment will result in a wrong answer.
❌ Myth #2: “It’s okay to gossip if I don’t use the resident’s name.”
✅ THE TRUTH: HIPAA covers Protected Health Information (PHI). Describing a condition or a room number can identify a person.
📝 EXAM IMPACT: Answers that involve discussing residents in break rooms are always wrong.
❌ Myth #3: “I am not liable if I follow the nurse’s orders.”
✅ THE TRUTH: CNAs are responsible for their own actions. If a nurse orders you to do something illegal, you are legally obligated to refuse.
📝 EXAM IMPACT: Choosing “Follow the nurse’s orders” when the order is unsafe is a guaranteed exam failure.
❌ Myth #4: “Restraints are necessary to keep residents from wandering.”
✅ THE TRUTH: Restraints are a last resort for medical necessity, not for staff convenience.
📝 EXAM IMPACT: Selecting restraint usage for wandering is a high-probability wrong answer.
❌ Myth #5: “Living Wills mean ‘Do Not Treat’.”
✅ THE TRUTH: Living Wills specify specific treatments the resident does not want (e.g., CPR). It does not mean “stop all care.” Hygiene and comfort continue.
📝 EXAM IMPACT: Withholding a meal or bath from a resident with a Living Will is neglect.
💡 Bottom Line: The law protects the resident first. Your convenience or opinion comes second.
Apply Your Knowledge: Practice Scenarios
Scenario #1: The Social Media Post
Situation: You see a coworker take a selfie with a resident who has just recovered from a stroke and post it on Instagram, saying, “So happy he is better!” No name is used.
Think About:
- Does the lack of a name make it okay?
- Is this a violation of the resident’s privacy?
Key Principle: Confidentiality/HIPAA.
See Application: This is a violation. Even without a name, the resident is identifiable to people who know him. You must report this to the nurse supervisor.
Scenario #2: The “Difficult” Daughter
Situation: A resident’s daughter yells at you in the hallway, “My mother is thirsty! Why haven’t you given her water?” Other residents can hear.
Think About:
- Should you argue back?
- Should you explain her mother’s medical condition in the hallway?
Key Principle: Professional Boundaries & Privacy.
See Application: Do not argue back. Do not provide medical info in the hallway (Privacy). Say, “I understand your concern. Let’s step into the conference room/private area to discuss this.”
Scenario #3: The Missing Money
Situation: While making a bed, you find a $20 bill under the mattress.
Think About:
- The resident has dementia and might not remember it.
- Can you keep it as a “tip”?
Key Principle: Honesty/Exploitation.
See Application: Keeping it is theft/exploitation. You must report it to the nurse so it can be secured in the facility safe or valuables cabinet.
Frequently Asked Questions
Q: Can a CNA accept a gift from a resident?
Small, non-monetary gifts (cookies, a handmade card) are usually acceptable per facility policy. However, money or expensive items must be politely refused to avoid ethical conflicts (exploitation). Always check the specific facility Employee Handbook.
📝 Exam Tip: If asked on an exam, “Refuse money/expensive gifts” is the safest answer.
Q: What exactly is “Involuntary Seclusion”?
Involuntary seclusion is separating a resident from others against their will. Examples include locking them in a room, putting them in a hallway chair and ignoring them, or using chemical restraints to make them sleep all day. It is prohibited by federal law.
📝 Exam Tip: “Time out” in a room is generally considered seclusion for adults.
Q: If I make a mistake in charting, can I use white-out?
Absolutely not. Never use correction fluid, erase, or scribble. Draw a single line through the error, write “error” or “mistake” next to it, and initial. Document the correct entry as a new entry with the current time.
📝 Exam Tip: The chart is a legal document. Altering it is a crime (tampering with a medical record).
Q: What should I do if I suspect a coworker is stealing from a resident?
This is exploitation (a type of abuse). Do not confront the coworker directly. Report immediately to the nurse supervisor.
📝 Exam Tip: Confronting the abuser can put you in danger and tamper with the investigation. Stick to the chain of command.
Q: Are side rails considered restraints?
Yes, specifically raising all four side rails restricts freedom of movement and is considered a restraint. Using 2 or 3 may also be considered a restraint depending on state law and the resident’s condition.
📝 Exam Tip: Restraints require a doctor’s order and specific documentation.
Q: Can I tell a family member about a resident’s condition over the phone?
No. You cannot verify who is on the phone or if they have authorization. Direct all medical questions to the nurse or refer to the authorized contact list.
📝 Exam Tip: Verifying identity over the phone is difficult; protecting privacy is the priority.
Recommended Study Approach for Legal and Ethical Behaviours
This domain requires you to think differently than you do for clinical skills. It requires logic and rule-application.
Phase 1: Build Foundation (1.5 Hours)
Focus Areas:
- Residents’ Bill of Rights (Focus on Dignity, Privacy, Refusal).
- Scope of Practice (ADLs vs. Assessment).
Activities:
- Create flashcards for the D.R.E.S.S. and P.E.A.S.V.N. acronyms.
- Read the “Bill of Rights” summary in your textbook.
- Define “Negligence,” “Assault,” and “Battery” in your own words.
Phase 2: Deepen Understanding (1.5 Hours)
Focus Areas:
- Abuse Reporting (The Chain of Command).
- HIPAA and Confidentiality.
- Informed Consent.
Activities:
- Practice the “Who do you tell?” scenarios. If you suspect abuse, who is the first person you tell? (Nurse Supervisor).
- Review the comparison tables for Legal Terms (Negligence vs. Malpractice).
- Audit your social media habits (mental check of what is okay vs. not okay).
Phase 3: Apply & Test (1.5 Hours)
Focus Areas:
- Scenario-based application.
- Pattern recognition.
Activities:
- Take 20-30 practice questions specifically on Legal/Ethical topics.
- Look for the “Red Flags” in the wrong answers (e.g., “Ignore the resident,” “Argue back”).
- Review the “Scope Decision Tree” logic for every delegation question.
Phase 4: Review & Reinforce (30 Minutes)
Focus Areas:
- Pitfalls and Myths.
- Documentation rules.
Activities:
- Review the “Common Pitfalls” section one last time.
- Memorize the “One line and initial” rule for chart errors.
✅ You’re Ready When You Can:
- [ ] Explain the difference between “Assault” and “Battery.”
- [ ] Identify exactly who to report suspected abuse to (Nurse Supervisor).
- [ ] List three tasks that are OUTSIDE the CNA scope of practice.
- [ ] Explain why you can’t discuss a resident in an elevator.
- [ ] Describe the correct way to fix a charting error.
- [ ] State the rule regarding a resident’s right to refuse care.
🎯 Study Tip: Don’t memorize the laws word-for-word. Memorize the principle behind them (e.g., “Protect the resident”) and apply that logic to the question.
Skills Test Connection
Legal concepts aren’t just for the written exam; they are graded during your skills test!
| Skill | Written Exam Connection | What to Know |
|---|---|---|
| Handwashing | Infection Control / Negligence | Failing to wash hands is negligence and a breach of Standard Precautions. |
| Perineal Care | Privacy & Dignity | You must explain the procedure, close curtains/doors, and cover the resident (drape). |
| Transferring (Hoyer Lift) | Safety / Negligence | Not using a gait belt or safety bar is negligent. Forcing a transfer is battery. |
| Feeding a Resident | Scope of Practice | Do not feed a resident who is lying down (aspiration risk). If they refuse, do not force. |
| Vital Signs | Documentation | Record what you see. Do not add “normal” if you didn’t take it. |
| Catheter Care | Privacy / Infection | Maintaining dignity (privacy) and preventing infection (Standard of Care) are legal duties. |
Study Integration: When you practice your skills, verbalize the legal steps out loud. For example, say, “I am closing the curtain to provide privacy,” before starting perineal care. This builds the habit for both the skills test and the real world.
Wrapping Up: Your Legal & Ethical Action Plan
You now have a comprehensive understanding of the legal and ethical responsibilities required of a CNA. We’ve covered the Residents’ Bill of Rights, the critical nature of abuse reporting, the strict rules of HIPAA, and the boundaries of your scope of practice.
Remember, these laws exist to protect the resident, but they also protect you. By following these rules, you ensure that you are providing the highest standard of care while keeping your license safe.
Your next step is to take the Readiness Checklist above and ensure you can check every box. Once you do, move on to practice questions to test your application of these rules.
You have the knowledge. Now, go apply it with confidence and integrity!
🌟 Final Thought: “Ethics is knowing the difference between what you have a right to do and what is right to do.” — Potter Stewart
More Practice Tests
CNA Practice Test
Basic Nursing Skills
Basic Restorative Skills
Personal Care Skills
Activities of Daily Living
Infection Control
Safety & Emergency Procedures
Communication Skills
Member of a Healthcare Team
Emotional & Mental Health Needs
Legal and Ethical Behaviours – (you are here)
Priorities and Priority Setting
Data Collection and Reporting
Care of Cognitively Impaired Residents
End of Life Care
Patient Rights