Certified Nursing Assistant Examination (CNA) Restorative Care, Rehabilitation, and End-of-Life Care Syllabus

Restorative Care, Rehabilitation, and End-of-Life Care syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Restorative Care, Rehabilitation, and End-of-Life Care in Certified Nursing Assistant Examination (CNA), not a summary of it.

1. 1

   Restorative and Rehabilitative Care

   4 topics

   • Principles of restorative care
     • Promoting independence and self-care
     • Preventing decline and complications
   • Supporting therapy goals
     • Reinforcing PT/OT/speech exercises
     • Use of adaptive and assistive devices
   • Bowel, bladder, and ambulation retraining
   • Encouraging activity and quality of life
2. 2

   Care of the Older Adult

   3 topics

   • Normal changes of aging
     • Physical changes by body system
     • Psychosocial changes and adjustment
   • Promoting safety and independence in the elderly
   • Preventing common complications of immobility
3. 3

   End-of-Life and Palliative Care

   4 topics

   • The dying process and hospice philosophy
     • Physical signs of approaching death
     • Comfort and palliative measures
   • Emotional and spiritual support
     • Stages of grief
     • Supporting residents and families
   • Advance directives and patient wishes
     • Living wills and DNR orders
     • Respecting end-of-life choices
   • Postmortem care
     • Providing dignified care after death
     • Handling personal belongings

Restorative Care, Rehabilitation, and End-of-Life Care flashcards for Certified Nursing Assistant Examination (CNA)

24 of 51 cards from the Restorative Care, Rehabilitation, and End-of-Life Care deck — real questions with worked answers.

1. What is the primary goal of restorative care?

   To help a resident regain or maintain the highest possible level of function and independence, preventing further decline after illness or injury.

2. How does restorative care differ from rehabilitation?

   Rehabilitation is intensive, therapist-directed treatment to restore function after illness/injury; restorative care is the ongoing nursing maintenance that keeps and reinforces those gains in daily life.

3. What is an ADL, and give examples relevant to restorative care.

   Activities of Daily Living are basic self-care tasks: bathing, dressing, grooming, toileting, transferring, eating, and ambulating.

4. What does the principle of 'use it or lose it' mean in restorative care?

   Unused muscles and abilities atrophy and decline; consistent activity preserves function, so residents should perform as much self-care as possible.

5. Why should a nursing assistant let a resident do a task slowly themselves rather than do it for them?

   Promoting independence preserves function, dignity, and self-esteem; doing tasks for residents fosters dependence and disuse.

6. What is the nursing assistant's role in supporting a resident's therapy (PT/OT/ST) goals?

   Reinforce and practice the exercises and techniques the therapist prescribes during everyday care, encourage the resident, and report progress or problems to the nurse.

7. What is a prosthesis versus an orthosis?

   A prosthesis is an artificial device that replaces a missing body part (e.g., artificial leg); an orthosis (brace/splint) supports, aligns, or protects an existing body part.

8. What is the difference between active and passive range-of-motion (ROM) exercises?

   Active ROM is performed by the resident themselves; passive ROM is performed for the resident by the caregiver when the resident cannot move the joint.

9. What is bladder retraining (bladder training)?

   A program to restore normal urinary control using a scheduled toileting routine, gradually lengthening the time between voiding to regain continence.

10. What is bowel retraining?

    Establishing a regular pattern of bowel elimination, often by toileting at the same time daily (commonly after a meal) and providing fluids and fiber to promote regularity.

11. Why is offering the bedpan or toileting after meals helpful in bowel retraining?

    It takes advantage of the gastrocolic reflex, in which eating stimulates peristalsis and the urge to defecate.

12. What is a toileting schedule and how often is it typically offered?

    A planned routine of taking the resident to the toilet at set intervals (commonly every 2 hours) to prevent incontinence episodes.

13. What is ambulation, and what is gait training?

    Ambulation is walking; gait training is teaching or relearning how to walk safely, often with an assistive device after injury, surgery, or illness.

14. On which side of a resident with weakness (hemiplegia) should the nursing assistant stand and the cane be held?

    The caregiver stands on the weak (affected) side for support; the cane is held on the strong (unaffected) side.

15. When transferring a weak resident, do you move them toward the strong side or weak side?

    Move toward the resident's strong (unaffected) side, which leads the transfer and bears weight.

16. List three ways a nursing assistant can encourage quality of life and activity.

    Encourage participation in hobbies and group activities, support social/family connections, and offer choices to maintain a sense of control and purpose.

17. Why is offering choices important to a resident's quality of life?

    Choices preserve dignity, autonomy, and self-esteem, giving the resident a sense of control over their own life.

18. Name three normal changes of aging in the integumentary (skin) system.

    Skin becomes thinner, drier, and less elastic; wrinkles form; and there is decreased subcutaneous fat, making skin fragile and easily injured.

19. Name two normal changes of aging in the musculoskeletal system.

    Loss of muscle mass and strength, and decreased bone density (bones become brittle), with stiffer joints and reduced flexibility.

20. What are two normal age-related changes in the cardiovascular system?

    The heart muscle pumps less efficiently and blood vessels narrow/stiffen, leading to reduced circulation and a tendency toward higher blood pressure.

21. What are common normal age-related sensory changes?

    Decreased vision (including presbyopia and reduced night vision), hearing loss (especially high pitches), and reduced senses of taste, smell, and touch.

22. Is confusion or dementia a normal part of aging?

    No. Some mild slowing of memory/recall can occur, but confusion and dementia are NOT normal aging and should be reported.

23. What is the difference between a normal age change and a disease/disability?

    Normal age changes happen gradually to everyone and don't necessarily impair function; diseases/disabilities are abnormal, cause illness or loss of function, and require treatment.

24. List three ways to promote safety for an elderly resident at risk of falls.

    Keep the call light and personal items within reach, ensure non-skid footwear and clear walkways, and keep the bed in the lowest locked position.

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