This 25-question CNA practice test covers the category Emotional and Mental Health Needs. The questions are designed to test your ability to support residents’ emotional well-being, respond to challenging behaviors, and promote a sense of respect, safety, and belonging. You’ll be assessed on recognizing signs of emotional distress, using therapeutic communication, maintaining professional boundaries, and helping residents cope with loss, loneliness, confusion, or fear.
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 Emotional and Mental Health Needs category. You’ll see situations involving residents with depression, anxiety, dementia, or other mental health conditions, as well as questions about abuse and neglect reporting, person-centered care, and supporting residents’ rights and dignity. 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 new resident stays in their room, has a poor appetite, and is frequently tearful. When the CNA tries to talk to them, the resident says, “Just leave me alone.” These behaviors are most likely signs of:
- Aphasia.
- Depression.
- Dementia.
- Anxiety.
Show Rationale
Correct: B.
Social withdrawal, tearfulness, loss of appetite, and apathy are classic signs of depression, which is common in new residents adjusting to their surroundings.
2. Question
A male resident with dementia begins to take off his clothes in the public dayroom. What should the CNA do first?
- Calmly and quietly lead the resident back to their private room.
- Yell at the resident to stop immediately.
- Put a blanket over the resident and ignore the behavior.
- Announce to the other residents that the resident is confused.
Show Rationale
Correct: A.
The CNA’s first priority is to protect the resident’s dignity and privacy. Moving them to a private area de-escalates the situation and removes the public audience.
3. Question
What is the primary therapeutic purpose of group activities in a long-term care facility?
- To keep residents busy so they do not get into trouble.
- To replace the need for physical therapy.
- To make the facility look busy for visitors.
- To give residents a chance for social interaction.
Show Rationale
Correct: D.
Group activities are designed to meet the residents’ social needs, prevent isolation, promote a sense of belonging, and increase self-esteem by allowing them to participate successfully.
4. Question
A resident who recently had a leg amputated is very angry, withdrawn, and refuses to look at the residual limb. The CNA understands this behavior is:
- A sign the resident is seeking attention.
- A normal part of grieving their loss.
- A medication side effect that will pass.
- A sign of post-traumatic stress disorder.
Show Rationale
Correct: B.
A person grieving the loss of a body part often goes through stages of grief, including anger and denial (refusing to look at it). This is a normal emotional response.
5. Question
A resident with paranoia accuses the CNA of stealing their favorite sweater, which is hanging in the closet. How should the CNA respond?
- “I did not steal it! How dare you accuse me!”
- “It’s right there in your closet. Why would you lie?”
- “Let’s look and see if we can find it together.”
- “You just didn’t see it because your eyesight isn’t great.”
Show Rationale
Correct: C.
Do not argue with a paranoid delusion. Instead, “join” the resident in their reality and help them solve the problem (e.g., by looking for the item), which builds trust and de-escalates the situation.
6. Question
A resident is constantly pacing, wringing their hands, and asking the same question repeatedly. The CNA recognizes these behaviors as signs of:
- Anxiety.
- Anger.
- A stroke.
- Schizophrenia.
Show Rationale
Correct: A.
Repetitive motions (hand-wringing, pacing) and an inability to settle are physical manifestations of anxiety. The resident may be seeking reassurance.
7. Question
A CNA notices a resident is hoarding crackers, sugar packets, and napkins from the dining room in their drawers. What is the CNA’s best action?
- Throw all the hoarded items away when the resident is occupied.
- Ask the resident if they are not getting enough to eat.
- Tell the resident it is against policy to take items from the dining room.
- Report the behavior to the nurse, as it may signal anxiety or insecurity.
Show Rationale
Correct: D.
Hoarding is often a coping mechanism for anxiety, fear, or a past trauma (like living through the Great Depression). It requires compassion and building trust to manage appropriately.
8. Question
A resident tells the CNA, “The man on the television is sending me secret messages that I’m in danger.” This resident is experiencing:
- An auditory hallucination.
- A delusion of persecution.
- Disorganized thinking.
- Spiritual distress.
Show Rationale
Correct: B.
This is a delusion (a false, fixed belief) and specifically one of persecution (believing one is being threatened or harmed).
9. Question
A resident with dementia is sitting calmly. A loud alarm suddenly sounds, and the resident starts screaming and crying, trying to climb out of the chair. This behavior is called:
- A catastrophic reaction.
- Sundowning.
- A manic episode.
- A temper tantrum.
Show Rationale
Correct: A.
A catastrophic reaction is a severe, sudden, and disproportionate emotional outburst in response to a minor or overwhelming trigger (like a loud noise or too much activity).
10. Question
A resident with Alzheimer’s becomes combative and tries to hit the CNA during a shower. What is the CNA’s first priority?
- Hold the resident’s arms down firmly to finish the shower.
- Tell the resident, “You hit me, so you lose your shower privileges.”
- Yell for help.
- Step back from the resident’s reach to protect themselves.
Show Rationale
Correct: D.
The immediate priority is safety. The CNA must stop the procedure and move to a safe distance to prevent injury to both themselves and the resident.
11. Question
A resident is clinically depressed and does not want to get out of bed. What is the most therapeutic approach?
- “Let’s try just sitting on the edge of the bed for a minute.”
- “If you don’t get up, you will develop bed sores.”
- “If you stay in bed, you can’t have breakfast.”
- “Your daughter will be very upset to find you in bed when she arrives.”
Show Rationale
Correct: A.
This response validates the resident’s feelings while encouraging a small, achievable step. This “breaking down” of tasks can help overcome the apathy of depression. Guilt or threats are not therapeutic.
12. Question
How can a CNA best promote a resident’s self-esteem and independence during personal care?
- By laying out the resident’s outfit so they aren’t overwhelmed with choices.
- By letting the resident perform tasks on their own.
- By doing everything for the resident so they look perfect.
- By leaving the room and giving the resident privacy.
Show Rationale
Correct: B.
Choice and participation are key to self-esteem. Allowing the resident to make decisions (what to wear) and do what they can (wash their face) gives them a sense of control and purpose.
13. Question
A resident is staring at the wall and says, “There is a very large spider on that wall! Get it!” The CNA looks and sees nothing. What is the best response?
- “That sounds scary. Let me check the wall for you.”
- “No, there isn’t. You are hallucinating.”
- “That’s just a spot on the paint. Don’t worry.”
- “Let me go get the maintenance man to spray for pests.”
Show Rationale
Correct: A.
This response validates the resident’s feeling (fear) without agreeing with the hallucination. Arguing (A), dismissing (C), or playing along (D) is not therapeutic.
14. Question
A resident with dementia is “rummaging” through another resident’s bedside table. What is the CNA’s best action?
- Scold the resident and tell them, “Stop that!”
- Alert the other resident so they can start hiding their items.
- Report the resident to the nurse for stealing.
- Calmly redirect the resident and offer them another activity.
Show Rationale
Correct: D.
Rummaging is a common, anxiety-driven behavior in dementia. The best approach is to redirect the resident’s energy to a safe, approved activity, like a box of their own items to sort.
15. Question
A resident with dementia is found wandering the hall, trying to get out of a locked door. They keep repeating, “I have to get my children from school.” This resident is:
- Lying to the staff to get outside.
- Experiencing a memory from their past as if it were real.
- Having a psychotic episode.
- A high fall risk.
Show Rationale
Correct: B.
This is a common behavior in dementia. The resident is not lying; they are “time-traveling” and believe they are living in a different time by recalling past memories.
16. Question
A resident who used to enjoy bingo now refuses to leave their room, stating, “They all think I’m stupid.” This is a sign of:
- Normal aging.
- A hearing problem.
- Low self-esteem.
- Self-pity.
Show Rationale
Correct: C.
The resident’s statement reflects a negative self-perception (low self-esteem), which can lead to social withdrawal.
17. Question
A resident with dementia is usually calm but becomes very agitated and restless every day around 3:00 PM when the staff is changing shifts. This agitation is likely related to:
- The noise and increased activity of shift change.
- The resident not receiving an afternoon nap.
- The resident needing extra attention.
- The resident not liking the 3:00 PM staff.
Show Rationale
Correct: A.
People with dementia are very sensitive to their environment. The noise, confusion, and new faces of a shift change can be a “trigger” that causes agitation.
18. Question
A resident with mild confusion frequently asks what day it is. What can the CNA do to implement reality orientation?
- Tell the resident once and then ignore them if they ask again.
- Remind the resident constantly what day it is, even if they don’t ask.
- Write each day on the large white board in their room.
- Give the resident a copy of the monthly activities.
Show Rationale
Correct: C.
Reality orientation is a technique used for mild confusion. It involves providing cues and prompts to dates, times, and locations.
19. Question
A resident who is usually pleasant throws his spoon and yells, “This is garbage! I can’t live like this!” This outburst is most likely a sign of:
- The resident being spoiled.
- Frustration and a sense of powerlessness.
- A worsening mental health condition.
- The resident simply not liking the food.
Show Rationale
Correct: B.
This behavior is an outward expression of a deeper emotional problem. The resident is most likely not just angry about the food, but about their loss of independence, loss of health, and lack of control.
20. Question
A resident’s daughter is visiting and sitting by the bedside, crying. What is the most supportive action the CNA can take?
- “Why don’t we go outside so you don’t upset your mother?”
- Offer the daughter a tissue and listen if she talks.
- Turn on upbeat music to lighten the mood.
- Pretend not to notice so she won’t feel embarrassed.
Show Rationale
Correct: B.
The CNA’s role is to support the whole family unit. This simple, empathetic gesture provides comfort and “permission” for the family member to express their emotions without judgment.
21. Question
A resident is newly admitted to the facility. They tell the CNA, “I’m not sick. My family is just leaving me here for a few days to rest.” The CNA knows this is a long-term admission. The resident is using the coping mechanism of:
- Denial.
- Anger.
- Bargaining.
- Acceptance.
Show Rationale
Correct: A.
Denial is the first stage of grief and coping. The resident is unable to accept the reality of their situation (long-term admission) and is protecting themselves from the emotional pain.
22. Question
A resident with dementia is screaming and crying. What is the first thing the CNA should do?
- Find the charge nurse immediately.
- Close the resident’s door so they don’t disturb others.
- Give the resident a PRN (as-needed) anxiety medication.
- Speak calmly and try to find the cause of the distress.
Show Rationale
Correct: D.
The resident is trying to express a need (pain, hunger, fear, needing to use the toilet, etc.). The CNA’s first job is to investigate the cause in a calm, non-threatening way.
23. Question
What is the best environment for a resident who is easily agitated or over-stimulated?
- The main activity room so that they can be distracted.
- Their room, with the television on at all times.
- The nurses’ station, where they can be watched.
- The library where they can sit by the window.
Show Rationale
Correct: D.
Agitation is often caused by over-stimulation (too much noise, light, or activity). The best intervention is to reduce these stimuli by providing a calm, quiet, and simple environment.
24. Question
A resident with severe, late-stage dementia insists it is 1950 and she is waiting for her husband to get home from work. What is the best approach?
- Remind the resident that it is 2025 and their husband passed away.
- Ask the resident to tell you more about her husband.
- Show the resident a calendar to prove she is wrong.
- Ignore the resident and change the subject.
Show Rationale
Correct: B.
This is validation therapy. For severe dementia, reality orientation (A or C) is cruel and ineffective. Validation involves “entering the resident’s reality” and discussing the feelings behind their words, which is calming.
25. Question
A resident has severe anxiety and often has panic attacks. When the CNA sees the resident breathing rapidly and looking afraid, the CNA should:
- Tell the resident to “just calm down.”
- Dim the lights and leave the resident alone to rest.
- Turn on the TV to a game show to distract them.
- Speak in a calm voice and encourage slow, deep breaths.
Show Rationale
Correct: D.
Leaving a resident during a panic attack increases their anxiety. The CNA’s most important role is to provide a calm, safe presence and gently coach them through it.