Certified Nursing Assistant (CNA) Exam: Legal and Ethical Behavior Concepts
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Overview
This chapter covers the legal and ethical limits of the nurse aide's job. Questions often ask whether an action is within the aide's role and how to name a type of wrongdoing.
Nurse aides work within a limited scope of practice. They do not give medicine, change orders or the care plan, or do tasks they were not trained for. They politely refuse tips and gifts, and they keep resident information private, including never posting about residents on social media.
Negligence is a careless failure to give proper care that causes harm. Neglect is failing to provide the care a resident needs, such as leaving a resident wet for hours. Threats to withhold food or care are mental abuse, and taking a resident's money, even to 'borrow' it, is misappropriation of property.
Federal rules require state-approved training of at least 75 clock hours, including at least 16 hours of supervised practical training. Confirmed findings of abuse, neglect, or misappropriation are recorded in the state nurse aide registry. After 24 consecutive months without paid nursing-related work, a new training and competency evaluation program or a new competency evaluation program is required.
Key concepts
Scope of practice
The tasks a nurse aide is trained and allowed to do; giving medicine and changing orders are outside it.
Memory tipNot trained or not allowed? Tell the nurse.
Negligence
An unintended failure to give the care a careful, trained person would give, which causes harm.
Memory tipCareless, not on purpose.
Neglect
Failing to provide the goods and services a resident needs to avoid harm, pain, or distress.
Memory tipNeeded care not given.
Misappropriation
Taking or using a resident's money or belongings without consent, even for a short time.
Memory tip'Borrowing' is still taking.
Training minimum
A state-approved nurse aide training program must have at least 75 clock hours, including at least 16 hours of supervised practical training.
Memory tip75 total, 16 supervised.
Source: 42 CFR 483.152 · as of 2026
Nurse aide registry
The state list of individuals who passed the competency evaluation, including any confirmed findings of abuse, neglect, or misappropriation.
Memory tipFindings follow the aide on the registry.
Source: 42 CFR 483.156 · as of 2026
24-month rule
After 24 consecutive months with no paid nursing or nursing-related work, a new training and competency evaluation or a new competency evaluation is required.
Memory tipTwo years off → retrain or retest.
Source: 42 CFR 483.35(d) · as of 2026
Often tested
- Aides do not give medicine; report requests to the nurse.
- Politely refuse tips.
- Threats to withhold food are mental abuse.
- Never post residents' photos on social media.
3 sample questions
Verified practice questions from this unit.
Question 1. A resident asks the nurse aide for a pain pill from the medicine cart. What should the aide do?
- ① Give the resident one pill from the cart
- ② Tell the resident pain pills are not allowed
- ③ Give the resident a pill from the aide's own purse
- ④ Tell the nurse about the request
▼ Show answer and explanation▲ Hide answer and explanation
Answer: ④ Tell the nurse about the request
Key point: Aides don't give medicine; tell the nurse
Nurse aides do not give medications. Report the request and the resident's pain to the nurse, who will assess the resident.
Wrong choices
- Give the resident one pill from the cart: Giving medicine is not part of the nurse aide's role.
- Tell the resident pain pills are not allowed: Only the nurse and doctor decide about medicine.
- Give the resident a pill from the aide's own purse: Giving any medicine is outside the aide's role and unsafe.
Question 2. Which is an example of neglect?
- ① Encouraging a resident to drink water
- ② Helping a resident walk to the dining room
- ③ Leaving a resident in a wet, soiled bed for hours
- ④ Respecting a resident's choice to skip an activity
▼ Show answer and explanation▲ Hide answer and explanation
Answer: ③ Leaving a resident in a wet, soiled bed for hours
Key point: Neglect = failing to provide needed care
Neglect is failing to provide the goods and services a resident needs to avoid harm, pain, or distress, such as not giving toileting help, food, water, or repositioning. Report any neglect you see.
Wrong choices
- Encouraging a resident to drink water: This is good care.
- Helping a resident walk to the dining room: This is good care.
- Respecting a resident's choice to skip an activity: This respects the resident's rights.
Question 3. A resident offers the aide a $20 tip for good care. What should the aide do?
- ① Accept it and share it with coworkers
- ② Accept it but give the resident extra attention
- ③ Accept it so the resident is not offended
- ④ Politely refuse the money
▼ Show answer and explanation▲ Hide answer and explanation
Answer: ④ Politely refuse the money
Key point: Politely refuse tips and gifts
Accepting money or gifts from residents can look like taking advantage of them. Politely thank and refuse the tip, and tell the nurse if the resident insists.
Wrong choices
- Accept it and share it with coworkers: Sharing does not make accepting money acceptable.
- Accept it but give the resident extra attention: This is still accepting money and creates unfair care.
- Accept it so the resident is not offended: Accepting money from residents is not allowed.
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