Communication & CultureQuestion 29 of 200

A nonverbal resident with end-stage dementia grimaces, moans, and guards the abdomen during repositioning. The CNA should interpret this as:

a.Normal behavior, no action needed
b.Attention-seeking
c.Possible pain; stop care, ensure safety, and report to the nurse for assessment using a tool such as PAINAD
d.Hunger

Explanation

Nonverbal cues—grimacing, moaning, guarding, withdrawal, tense posture—are valid pain indicators in cognitively impaired residents, assessed with tools such as PAINAD or FLACC. The CNA must stop nonessential activity, ensure safety, and notify the nurse for assessment and analgesic decision. Ignoring (a) or mischaracterizing (b, d) leads to undertreated pain, a recognized quality-of-care deficiency under CMS F-tags.

Law Reference: ANA scope and standards (nonverbal observation)

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