Certified Nursing Assistant (CNA) Exam Emotional and Mental Health Needs Summary

Dementia makes it hard to follow and remember information. Approach from the front, use the resident's name, speak calmly, and use short, simple sentences with one step at a time. Give the resident time to respond.

Wrong choices

• Give several instructions at once to save time: Several steps at once are confusing for a person with dementia.
• Speak quickly so the resident keeps up: Fast speech is harder to follow.
• Use long explanations so nothing is missed: Long explanations are hard to follow and remember.

Upset behavior in dementia often comes from fear, pain, or confusion. Stay calm, speak softly, make sure she is safe, and redirect her or try again later. Report the behavior to the nurse. Never argue, force care, or isolate her.

Wrong choices

• Argue with the resident until she agrees to the bath: Arguing makes the resident more upset.
• Finish the bath quickly while holding her arms: Holding a resident down for care can be abuse.
• Leave her alone in a locked room to calm down: Locking a resident in a room is involuntary seclusion.

Any talk about not wanting to live or harming oneself must be taken seriously. Do not leave the resident alone, listen calmly, and report to the nurse immediately.

Wrong choices

• Change the subject to something cheerful: Changing the subject ignores a serious warning sign.
• Tell the resident he does not really mean it: This dismisses his feelings and may stop him from talking.
• Promise to keep it a secret: A statement about not wanting to live must be reported; it cannot be kept secret.

Sundowning means more confusion, pacing, or agitation late in the day. A calm, quiet setting, a regular routine, and daytime activity can help. Report changes to the nurse.

Wrong choices

• Sleeping all day in a sunny room: Sundowning is a behavior change, not daytime sleep.
• Waking up early each morning feeling rested: Waking rested is not a dementia behavior.
• A sunburn from sitting outside: Sundowning has nothing to do with the sun's rays.

Signs of depression include loss of interest in activities, withdrawal, sadness, poor appetite, and changes in sleep. Depression is common and treatable, so report these changes to the nurse.

Wrong choices

• A resident enjoys talking with visitors: Enjoying visits is a healthy sign.
• A resident asks for an extra blanket on a cold night: Wanting to be warm is a normal comfort need.
• A resident takes a short nap after lunch: A short nap is normal.

Anger often comes from fear, pain, or loss of control. Stay calm, do not take it personally, listen, and answer his needs. Make sure everyone is safe, and report the behavior to the nurse.

Wrong choices

• Walk away and refuse to care for him: Leaving without arranging care can be neglect.
• Tell the resident he will get no dinner if he keeps yelling: Threats like this are a form of abuse.
• Yell back so the resident knows it is not acceptable: Yelling back makes things worse and is unprofessional.

Arguing with a person with dementia about facts rarely helps. Respond to the feeling behind the words, for example, 'You love taking care of your family. Tell me about them.' Then gently redirect her to a calm activity.

Wrong choices

• Tell her firmly that her children are grown and she is confused: Correcting her often upsets her and does not help her remember.
• Ignore her until she stops talking: Ignoring her leaves her feelings unmet and can increase distress.
• Lock the door to her room so she cannot leave: Locking her in is involuntary seclusion, a form of abuse.

Several instructions at once overwhelm a person with dementia. Give one step at a time. Approaching from the front, using the resident's name, and using simple words are all helpful.

Wrong choices

• Calling the resident by name: Using the name helps get attention and shows respect.
• Using simple, familiar words: Simple words are easier to understand.
• Approaching from the front so the resident can see you: Approaching from the front avoids startling the resident.

Maslow's hierarchy puts physical needs (air, water, food, rest, elimination) at the base. Next come safety, then love and belonging, then self-esteem, and finally self-actualization. Basic physical needs must be met first.

Wrong choices

• The need for safety and security: Safety comes right after physical needs.
• The need for self-esteem: Self-esteem is near the top of the hierarchy.
• The need for love and belonging: Love and belonging come after physical and safety needs.

Alzheimer's disease is the most common cause of dementia. It is progressive, meaning it gets worse over time, and it affects memory, thinking, behavior, and the ability to do daily tasks. It is not a normal part of aging.

Wrong choices

• It only affects memory and nothing else: It also affects judgment, behavior, language, and daily skills.
• It can be cured with rest: There is no cure; rest does not reverse it.
• It is a normal part of aging for everyone: Alzheimer's is a disease, not normal aging.