This 25-question CNA practice test covers the category Communication. The questions are designed to test your ability to communicate clearly and respectfully with residents, families, and the healthcare team, using both verbal and nonverbal skills. You’ll be challenged on active listening, empathy, cultural sensitivity, professional boundaries, and how to respond appropriately to residents’ concerns, questions, and changes in condition.
Each question reflects common scenarios and topics you may encounter on the actual Certified Nursing Assistant exam in 2025, giving you the chance to assess your understanding of the Communication category. You’ll see situations involving speaking with residents who have dementia or hearing loss, using interpreters or communication aids, reporting to the nurse, and documenting important information. All our questions and rationales have been reviewed by an experienced registered nurse (RN).
If you would like to practice questions from other exam categories, please try our comprehensive and free CNA practice test.
1. Question
A resident is telling a CNA a story, but the CNA is standing by the door, repeatedly checking their watch. This non-verbal communication is telling the resident that the CNA is:
- Interested and has plenty of time.
- In a hurry and not focused on the resident.
- Waiting for the resident to ask a question.
- Concerned about the resident’s health.
Show Rationale
Correct: B.
Body language is a powerful form of communication. Checking a watch and standing by the door (a “closed” posture) signals impatience and disinterest.
2. Question
A resident is non-verbal and uses a picture board to communicate. The CNA is assisting with morning hygiene and points to the picture of a toothbrush, but the resident shakes their head “no.” What should the CNA do?
- Ignore the resident and perform mouth care anyway.
- Leave the room and let the resident finish their own care.
- Make an angry face until the resident complies.
- Respect the resident’s response and ask if they would prefer it later.
Show Rationale
Correct: D.
Shaking their head is a clear form of non-verbal communication. The resident has the right to refuse care, and the CNA must respect this, document it, and try again later.
3. Question
When communicating with a resident who is blind, what is the most important action for the CNA to take when entering the room?
- Touch the resident’s arm to get their attention.
- Turn on all the lights in the room.
- Announce their name and purpose.
- Speak in a very loud voice.
Show Rationale
Correct: C.
A person who is blind cannot see someone approaching. Announcing yourself first prevents startling or frightening the resident and orients them to who is in the room.
4. Question
A resident with dementia is anxiously repeating, “I have to go home, I have to go home!” Which response from the CNA uses validation therapy?
- “You can’t go home; this is your home now.”
- “Your home is far away. Why don’t we watch TV instead?”
- “It sounds like you miss your home. Tell me what your home is like.”
- “If you are quiet, you can go home tomorrow.”
Show Rationale
Correct: C.
Validation therapy involves acknowledging the resident’s feelings and entering their reality instead of arguing or correcting. This response validates their feeling (“miss your home”) and redirects them to a calm conversation.
5. Question
A resident with expressive aphasia (difficulty speaking) is struggling to say something, pointing, and becoming frustrated. What is the CNA’s best action?
- Be patient and ask simple “yes” or “no” questions.
- Finish the resident’s sentence for them.
- Tell the resident to “just spit it out.”
- Leave the room and come back when the resident has calmed down.
Show Rationale
Correct: A.
Expressive aphasia is frustrating for the resident. The CNA’s role is to be patient, reduce pressure, and try to narrow down the need with simple, close-ended questions.
6. Question
How can a CNA best demonstrate “active listening” to a resident?
- By finishing the resident’s sentences so they don’t have to.
- By not making eye contact, so the resident doesn’t feel uncomfortable.
- By planning the rest of their assigned tasks while the resident talks.
- By nodding and summarizing what was said.
Show Rationale
Correct: D.
Active listening involves giving the resident your full attention and using non-verbal cues (nodding, eye contact) and verbal cues such as asking clarifying questions or summarizing.
7. Question
A resident who is hard of hearing has a hearing aid, but it is whistling. This most likely means:
- The hearing aid is not inserted correctly.
- The battery is low.
- The resident has water in their ear.
- The hearing aid is broken and needs to be replaced.
Show Rationale
Correct: A.
A high-pitched whistling or feedback sound usually occurs when the amplified sound from the hearing aid leaks out and is picked up again by its own microphone. This is most often caused by a poor fit, improper insertion, or earwax buildup.
8. Question
A resident’s family member is very angry and yells at the CNA about their dissatisfaction with the care received. What is the CNA’s most professional response?
- Yell back at the family member to defend their job.
- Tell the family member they are “not allowed to talk to staff that way.”
- Listen calmly, apologize for their frustration, and ask the nurse to speak with them.
- Let the family member know that they are short-staffed.
Show Rationale
Correct: C.
The CNA’s role is to de-escalate. This is achieved by listening without arguing, acknowledging the person’s feelings (empathy), and escalating the concern to the nurse, who can address it further.
9. Question
A resident with dementia is resisting care and becoming agitated. What is the best communication strategy for the CNA to implement?
- Use a loud, firm voice to gain control.
- Speak calmly and use simple, one-step directions.
- Threaten to take away a privilege, like watching TV.
- Perform the care as quickly as possible, ignoring the agitation.
10. Question
A resident tells the CNA, “I’m having sharp pain in my chest.” This is an example of:
- Subjective information.
- Objective information.
- A behavioral issue.
- Cardiac arrest.
Show Rationale
Correct: A.
Subjective information (or symptoms) is what the resident reports feeling, such as pain, nausea, or dizziness. It cannot be directly measured by the CNA.
11. Question
A resident has severe arthritis and is struggling to use the call light button with their fingers. What should the CNA do?
- Move the resident to a room closer to the nurse’s station so they can yell for help.
- Schedule check-ins every hour or so to see if the resident needs anything.
- Set up a two-way monitor so the staff can see the resident at all times.
- Inform the nurse that the resident needs an adaptive “touch-pad” or “easy-call” device.
Show Rationale
Correct: D.
The call light is a safety line. If the resident cannot physically use the standard button, the CNA must recognize this barrier and report it so that a more appropriate, adaptive call system can be provided.
12. Question
Which of the following is an example of an objective observation?
- “The resident must not be feeling well today.”
- “The resident’s skin is cool and clammy.”
- “The resident’s daughter is very annoying.”
- “The resident’s cough sounds bad.”
Show Rationale
Correct: B.
Objective information is factual, measurable, or observable using the five senses (sight, smell, touch, hearing). “Cool and clammy” is something the CNA can feel (touch). The other options are opinions or judgments (“depressed,” “annoying,” “bad”).
13. Question
What is a major barrier to effective communication?
- Using medical jargon and abbreviations.
- Speaking in a calm, clear tone.
- Sitting at eye level with the resident.
- Asking open-ended questions.
Show Rationale
Correct: A.
Using terms like “NPO,” “VS,” “ambulate,” or “CHF” (jargon) is confusing to residents who are not medical professionals. This creates a barrier to comprehension. The CNA should use plain language when communicating with residents.
14. Question
A CNA is documenting care and makes a mistake in the paper chart. What is the correct procedure?
- Use correction fluid (Wite-Out) to cover the mistake.
- Scribble over the mistake so it cannot be read.
- Draw a single line through the error, write “error,” and initial it.
- Use a red pen to mark an “X” through the entire entry and start over.
Show Rationale
Correct: C.
In a legal document like a medical chart, entries must never be erased or obliterated. The correct method allows the original entry to be seen, shows it was an error, and identifies who made the correction.
15. Question
What is the most appropriate way for the CNA to answer the facility’s phone?
- Identify your location, your name, and where to direct the call.
- State your name and have the caller identify the resident’s name and birth date.
- Have the caller identify themselves and who they are trying to reach.
- Have them hold and transfer the call to the receptionist or nurse.
Show Rationale
Correct: A.
Proper phone etiquette in a professional setting includes identifying your location (unit/station/facility), your name, and offering assistance.
16. Question
The CNA needs to use the resident’s in-room comm-box (intercom) to speak to the nurse. The CNA knows this conversation is:
- Not private, and can be overheard by others.
- Completely confidential.
- A HIPAA-compliant way to report abnormalities.
- Only to be used for emergencies.
Show Rationale
Correct: A.
An intercom system is not a private channel. The CNA must never share confidential resident information over the intercom, as staff, other residents, or visitors could hear it.
17. Question
A resident is very upset, speaking in a language the CNA does not understand, and is clutching at their chest. What should the CNA do?
- Leave the room to find an interpreter.
- Attempt to guess what the problem is through gestures.
- Give the resident a piece of paper and a pen.
- Stay with the resident and immediately call for the nurse.
Show Rationale
Correct: D.
Agitation combined with pointing to the chest could signal a medical emergency (like chest pain or trouble breathing). The CNA must stay with the resident for safety and immediately notify the nurse to assess the situation. Finding an interpreter is secondary to a potential emergency.
18. Question
The CNA needs to chart the care given to a resident. Which charting entry is factual and legal?
- “Resident was obnoxious and angry during their bath.”
- “Resident had a large BM at 10:00. Hygiene care provided.”
- “Resident ate better today and is in a good mood.”
- “Resident’s daughter complained about the food again.”
Show Rationale
Correct: B.
Legal charting must be objective, factual, and specific. (B) provides exact details (time, description, and action taken) without any personal opinions, judgments (“obnoxious”), or interpretations (“good mood”).
19. Question
When providing an end-of-shift report to the next CNA, which information is most critical to include?
- “Mr. Jones’s daughter is visiting and isn’t in a good mood.”
- “Mr. Jackson only ate half his dinner, so he may want a snack later.”
- “Mrs. Chen has been sleeping a lot more recently.”
- “Mrs. Smith’s care plan was changed to ‘two-assist’ for all transfers.”
Show Rationale
Correct: D.
The shift report must contain factual, up-to-date information that affects resident safety and care. A change in transfer status (assist level) is a critical safety detail the next CNA must know.
20. Question
A male resident tells a female CNA, “You have a great body, I’d like to take you out.” What is the CNA’s most appropriate response?
- Laugh and say, “You’re just a sweet-talker.”
- Firmly and calmly state, “Please don’t talk to me that way.”
- Ignore the comment and hope he doesn’t say it again.
- Glare at the resident and tell him he’s being disrespectful.
Show Rationale
Correct: B.
The CNA must set professional boundaries. The comment must be addressed directly, professionally, and calmly to stop the behavior. Ignoring it (C) may be seen as acceptance, while (A) and (D) are unprofessional.
21. Question
A CNA is caring for a resident who has receptive aphasia. This means the resident:
- Can only understand simple yes/no questions.
- Repeats the words that are said to them.
- Cannot speak at all.
- Has difficulty understanding spoken or written language.
Show Rationale
Correct: D.
Receptive aphasia (Wernicke’s aphasia) affects the ability to receive and process language. The resident can hear or read the words but cannot make sense of them. They may be able to speak fluently, though their speech may be nonsensical.
22. Question
A resident with dementia is trying to “go to work,” and is packing a bag. The resident is calm but insistent. What is the best action for the CNA?
- Tell the resident they are retired and don’t have a job.
- Physically stop the resident from packing.
- Engage and redirect the resident by saying, “Let’s go to the cafeteria to have lunch first.”
- Make a joke and tell the resident they can have the CNA’s job if they want to work.
Show Rationale
Correct: C.
Do not argue with the resident (A) or use force (B). The best approach is to join their reality (not deny it) and then gently redirect them to a different, acceptable activity.
23. Question
A new resident is crying and says, “I feel so alone and scared.” What is the most empathetic response from the CNA?
- “Don’t worry, you’ll make friends soon.”
- “I’ll go get the activity director. They can find you a new hobby.”
- “You shouldn’t feel scared, this is a very nice place.”
- “This is a big change. I’m here to listen if you want to talk.”
Show Rationale
Correct: D.
Empathy involves acknowledging the resident’s feelings as valid without “fixing” them or dismissing them. This response validates their feeling (“big change”) and offers support (comfort and listening).
24. Question
A resident asks the CNA why they need to keep taking a specific medication. What is the CNA’s best response?
- Tell the resident you will get the nurse so they can answer that question.
- Tell the resident that the medication will make them feel better.
- Find the medication bottle so they can read it.
- Tell the resident that if the doctor ordered it, it must be necessary.
Show Rationale
Correct: A.
It is outside the CNA’s scope of practice to discuss medication purposes, effects, or side effects. All such questions must be referred to the licensed nurse.
25. Question
When a CNA reports information to the nurse, they should:
- Give their opinion about what the problem is.
- Report only objective facts and observations.
- Wait until the end of the shift to report everything at once.
- Tell the other CNAs first to see what they think.
Show Rationale
Correct: B.
When reporting to the nurse, the CNA must provide clear, concise, and factual information (e.g., “The resident’s blood pressure is 90/50,” not “The resident is acting different”). The nurse will use these facts to make a clinical assessment.