Free CNA Practice Test
End-of-Life Care
22 NNAAP-style questions, one at a time — just like exam day. Score and full explanations at the end.
Free CNA practice test on end-of-life care — Kubler-Ross stages of grief, signs of approaching death, hospice and palliative care, comfort measures, post-mortem care, and spiritual support. Covers the "Emotional, Spiritual, and Cultural Needs" NNAAP block.
Need a refresher first? Read our free End-of-Life Care study guide before taking the test.
Exam-simulator mode: picking an answer saves it and automatically moves you to the next question. You will not see right/wrong until you finish — just like the real NNAAP.
Question 1 of 22.Which is the FIRST stage of grief according to Kubler-Ross?
Prefer to read? All 22 questions with answers
Which is the FIRST stage of grief according to Kubler-Ross?
- Anger
- Denial (correct answer)
- Bargaining
- Acceptance
Kubler-Ross described five stages: denial, anger, bargaining, depression, acceptance. They do not always occur in order and not every person passes through every stage.
A dying resident says 'I'm scared.' The BEST response is:
- You'll be fine
- Sit with the resident, listen, and acknowledge the feeling: 'Tell me what's scaring you.' (correct answer)
- Change the subject
- Walk away
Presence, active listening, and gentle acknowledgment of fear are far more therapeutic than reassurance. Encourage spiritual or family support per the resident's wishes.
Hospice care focuses on:
- Curing the disease
- Comfort and quality of life for terminally ill residents and their families (correct answer)
- Aggressive treatment
- Long-term rehabilitation
Hospice is comfort-focused care for residents with a terminal prognosis (typically 6 months or less). Palliative care can be offered alongside curative care, while hospice is specifically end-of-life.
Which is a sign that death is approaching (hours to days)?
- Strong appetite
- Mottled extremities, Cheyne-Stokes breathing, decreased urine output, drop in BP (correct answer)
- High energy
- Improved alertness
Late-stage signs include mottled, cool extremities; Cheyne-Stokes (irregular, shallow then rapid) breathing; death rattle (oral secretions); decreased urine output; falling blood pressure; and decreasing responsiveness.
Which is true about hearing at end of life?
- Hearing is the first sense lost
- Hearing is believed to be the LAST sense to fade — always speak gently and assume the resident hears you (correct answer)
- Hearing returns fully at death
- Hearing is irrelevant
Hearing is widely believed to remain even when the dying person cannot respond. Always speak calmly, identify yourself, explain care, and avoid disturbing conversation at the bedside.
Which is appropriate post-mortem care?
- Leave the body in place for hours
- Provide privacy, position the body in proper alignment, close the eyes, place dentures, follow facility policy, and treat the body with dignity (correct answer)
- Rush the family out
- Remove all linens immediately
Post-mortem care: provide privacy, close eyes (gently hold for a moment), replace dentures, position body in alignment, place pillows under the head, follow facility and family wishes, and document.
Which is the BEST way to support a dying resident's family?
- Avoid them
- Allow them to be present, offer chairs and water, provide privacy, listen without judgment, and respect spiritual practices (correct answer)
- Tell them to leave
- Discuss other residents with them
Family support at end of life includes presence, privacy, comfort items, listening, accommodating spiritual practices and rituals, and respecting cultural mourning customs.
Which symptom is part of the 'death rattle'?
- Crying
- Gurgling sound from secretions in the throat as the resident loses the ability to swallow (correct answer)
- Loud snoring
- Laughter
The death rattle is gurgling from oral and pharyngeal secretions as swallowing and cough reflexes are lost. Repositioning, side-lying with head slightly elevated, and oral suction at the nurse's direction may help.
Which is a CNA's role in spiritual care?
- Convince the resident of a religion
- Allow space for the resident's chaplain, clergy, or religious practices, and notify the nurse of spiritual concerns (correct answer)
- Avoid the topic entirely
- Argue about beliefs
CNAs support — but do not lead — spiritual care. Notify the nurse of the resident's spiritual preferences, allow uninterrupted time for clergy visits, and respect rituals (such as removing the body in a specific way).
Which is an example of culturally sensitive end-of-life care?
- Treating all families the same regardless of culture
- Asking about and accommodating religious and cultural practices around the body, presence of family, and prayer (correct answer)
- Imposing the CNA's beliefs
- Ignoring family customs
Different cultures and religions have specific practices regarding who handles the body, how it is prepared, family presence, and burial timing. Always ask and accommodate wherever possible.
Which is true about pain management in hospice?
- Pain medications must be withheld
- Pain control is a priority; the CNA reports pain promptly so the nurse can medicate per orders (correct answer)
- Pain is part of dying and must be tolerated
- Only the family can give pain medicine
Comfort is the focus of hospice. CNAs observe and report pain promptly using a 0-10 scale or behavioral signs (facial grimacing, guarding, restlessness, moaning) so the nurse can medicate.
A resident has a DNR order. The CNA's role is to:
- Begin CPR if the resident stops breathing
- Honor the order — call for the nurse, provide comfort, do NOT begin CPR (correct answer)
- Call 911
- Ask the family for permission
A DNR is a physician's order that must be followed exactly. The CNA stays with the resident, calls for the nurse, and provides comfort but does not begin CPR.
Which is appropriate skin care at end of life?
- Vigorous massage of pressure areas
- Frequent gentle repositioning, careful skin care, moisture barriers, and avoidance of unnecessary procedures (correct answer)
- No skin care needed
- Hot baths daily
End-of-life skin care focuses on comfort: gentle repositioning every 2 hours, moisture barriers, soft sheets, and minimization of procedures. The skin becomes fragile and prone to breakdown.
Which is the CNA's role when a resident dies?
- Pronounce death
- Notify the nurse immediately, stay with the resident, and follow facility policy (correct answer)
- Call the family
- Move the body alone
A licensed nurse or physician pronounces death. The CNA notifies the nurse, stays with the resident, supports the family, and follows facility policy. The nurse contacts the physician and family.
Which is the BEST environment for a dying resident?
- Bright lights, loud TV, busy hallway
- Quiet, dim lighting, soft music if desired, family at the bedside, gentle voices (correct answer)
- Cold and dark
- Crowded with strangers
A calm, quiet environment with low lighting, soft music (per preference), family presence, and gentle care is most comforting. Avoid loud conversation, unnecessary procedures, and abrupt movements.
Which is true about advance directives at end of life?
- They are optional and can be ignored
- They are legal documents that direct care and must be followed (correct answer)
- They expire at admission
- Only doctors can write them
Advance directives — living wills, healthcare POAs, and DNR orders — must be followed exactly. The CNA's role is to know which residents have them and ensure care reflects them.
Which is true about feeding a dying resident?
- Force-feed regardless of refusal
- Offer food and fluids as tolerated; never force; provide oral care for comfort if the resident cannot eat (correct answer)
- Withhold all care
- Insert a feeding tube without consent
At end of life, appetite naturally decreases. Offer small amounts as tolerated, never force. Frequent oral care with swabs and lip balm provides comfort even when the resident cannot drink.
Which is a normal change in skin color near death?
- Bright pink
- Mottled (blue-purple patches), pale, or waxy appearance in the extremities (correct answer)
- No change
- Sunburned
Mottling — blue-purple patches on the legs, feet, and hands — is a common sign of impending death as circulation slows. Skin becomes cool, pale, or waxy.
The Kubler-Ross stage in which the resident says 'If I can just live until my grandchild graduates...' is:
- Denial
- Anger
- Bargaining (correct answer)
- Acceptance
Bargaining involves making promises or seeking more time, often with God or a higher power, in exchange for a delay of death.
Which is true about a resident in a coma at end of life?
- You can speak freely as if they cannot hear
- Always speak gently, explain care, and avoid sensitive conversation — hearing may persist (correct answer)
- Touch is not important
- Skip oral care
Always assume hearing persists. Explain procedures, introduce yourself, and avoid distressing conversation at the bedside. Touch is comforting; gentle care continues until the end.
Which family expression is a normal response to a recent death?
- Crying, shock, anger, or numbness (correct answer)
- Laughter only
- Indifference
- Eating heartily
Grief reactions vary widely — crying, shock, numbness, anger, withdrawal, or even momentary laughter are all normal. The CNA's role is to support without judgment.
Which post-mortem detail is correct?
- Strip the bed and leave the body uncovered
- Provide privacy, cover the body with a clean sheet, allow family time, label per facility policy (correct answer)
- Discard personal belongings
- Open all curtains
Treat the body with dignity: provide privacy, allow family time, cover with a clean sheet, secure personal belongings for the family, and follow facility identification and transport policies.
FAQ: End-of-Life Care on the CNA Exam
How many end-of-life care questions are on the actual NNAAP exam?
The NNAAP written exam has 60 scored questions distributed across eight content areas. End-of-Life Care is one of the most heavily tested categories, with several questions appearing on every form of the exam. Drilling these questions repeatedly until you can explain why each correct answer is correct is the best way to lock in the material.
What should I do if I miss several questions on this end-of-life care practice test?
Re-read the corresponding free study guide (linked above and below) before retaking the test. Take notes on the exact concept you missed — for example, 'I confused contact and droplet precautions' — and review the explanations until the pattern is clear. Most students need 2 to 3 cycles of test, review, and retake before consistently scoring above 80%.
Are these questions identical to the real CNA exam?
No. The actual NNAAP, Prometric, Headmaster, and PSI exams are confidential and only the official testing vendors have access to live items. Our questions are written by us to mirror NNAAP style, difficulty, and content distribution based on the publicly available NNAAP content outline. Performing well here is a strong predictor of passing the real test.
Do I have to pay or sign up to take this practice test?
No. Every practice test, study guide, and resource on freecnatraining.org is 100% free, with no signup or paywall. Most other CNA practice test sites charge $30 to $100 per month for access; we are funded by our nursing-school directory and keep the study material free for students.