CNA Certification (Written Exam) flashcards

Total fluid intake is calculated by adding all liquids and liquid foods (like soup, ice cream, gelatin) consumed during a given period, usually recorded in milliliters (mL).

• Add all liquid amounts consumed to get total intake
• Soup, gelatin, ice cream count as fluid intake
• 1 oz = approximately 30 mL for conversions

Memory trick: 'Add it all up, drop by drop!'

RACE is the fire response sequence: Rescue, Alarm, Confine, Extinguish. Rescue is always the first step to protect anyone in immediate danger.

• R = Rescue people in danger first
• A = Alarm to alert others
• C = Confine by closing doors
• E = Extinguish only if safe

Memory trick: Race to rescue first, then sound the alarm.

Federal law prohibits discharging or transferring a resident simply because they change from private pay to Medicaid; discharge must meet specific legal criteria.

• Payment source change is not valid grounds for discharge
• Valid reasons include medical necessity, danger, or nonpayment when able to pay
• Proper notice alone does not legalize an improper discharge

Memory trick: Switching to Medicaid? Can't kick them out for that.

PASS is the technique for using a fire extinguisher: Pull the pin, Aim at the base, Squeeze the handle, Sweep side to side.

• Pull pin to unlock the extinguisher
• Aim at the base, not the flames
• Sweep is the final step after squeezing

Memory trick: Pull, Aim low, Squeeze, Sweep it clean

A DNR is a legal medical order indicating that a resident does not want CPR performed if their heart stops or they stop breathing.

• DNR orders must be honored by all staff, including CNAs
• Notify the nurse immediately even when following a DNR
• Overriding a valid DNR can result in legal liability

Memory trick: 'DNR means Do Not Rescue with CPR.'

A seal check involves inhaling and exhaling to detect air leaks, confirming the N95 respirator fits properly before entering an airborne precaution room.

• Performed every time the mask is donned
• Detects gaps around nose and edges of mask
• Essential for airborne precautions like TB

Memory trick: Breathe in, breathe out — feel for the leak before you're about.

The average normal oral body temperature is 98.6°F (37°C), with a normal range of roughly 97.6°F–99.6°F.

• Average oral temp = 98.6°F/37°C
• Normal range approx 97.6°F-99.6°F
• Rectal temps run about 1°F higher; axillary about 1°F lower

Memory trick: '98.6 is the magic number' for oral temps.

Respecting a resident's cultural, religious, and personal preferences, including modesty, is essential to person-centered care.

• Residents have the right to request same-gender caregivers when possible
• Facility should attempt reasonable accommodation
• Report cultural needs to the care team

Memory trick: Respect the request, don't dismiss the culture.

A drop in blood pressure that occurs when a person changes from lying or sitting to standing, often causing dizziness or fainting.

• BP checked lying, sitting, then standing for comparison
• Symptoms include dizziness, lightheadedness, fainting
• Increases fall risk, especially in elderly residents

Memory trick: 'Stand up fast, blood pressure drops, dizziness stops you in your tracks.'

Residents have the legal right to file complaints about care or treatment without fear of retaliation, and facilities must address them promptly.

• Complaints must be reported, not dismissed
• No retaliation is allowed against the resident
• Ombudsman can also be contacted for unresolved issues

Memory trick: Voice it, don't silence it.

Signs posted on the door of a resident under transmission-based precautions to alert anyone entering of the required PPE and precaution type.

• Sign posted outside/on the door, not inside
• Specifies PPE required (mask, gown, gloves, etc.)
• Applies to droplet, contact, and airborne precautions

Memory trick: See the sign before you step in.

Skin turgor is tested by gently pinching the skin; if it remains 'tented' rather than snapping back quickly, it may indicate dehydration.

• Poor turgor = skin stays tented after pinching
• A sign of dehydration, especially in elderly residents
• Should be reported to the nurse for further assessment

Memory trick: 'Tent stays up? Fluids are low — report it now!'

A urine collection method that reduces contamination by cleansing the perineal area and collecting the middle portion of the urine stream.

• Cleanse front to back for females to prevent contamination
• Let the initial stream pass before collecting
• Collect specimen in a sterile container without touching the inside

Memory trick: 'Clean, catch the middle, keep it sterile'

RACE is the sequence for responding to a healthcare fire: Rescue, Alarm, Confine, Extinguish.

• R = Rescue people in danger first
• A = Activate the alarm
• C = Confine fire by closing doors
• E = Extinguish only if safe and trained

Memory trick: Run to Rescue, Alert, Close doors, Extinguish

Reduced appetite and fluid intake are natural, expected changes in the dying process and should not be forced.

• Normal part of body shutting down
• Offer comfort measures like ice chips, not forced feeding
• Report changes to the nurse

Memory trick: Dying body needs less, not more.

After a needlestick injury, the exposed area should be washed immediately with soap and water, followed by prompt reporting and follow-up care.

• Wash immediately with soap and water
• Report to supervisor right after first aid
• Follow facility exposure control plan for testing and treatment

Memory trick: Wash first, report next — protect yourself before the paperwork.

An abnormal breathing pattern with cycles of rapid, shallow breaths followed by periods of apnea, commonly seen near the end of life.

• Sign of the body's systems slowing down before death
• Should be reported to the nurse, not treated as an emergency
• Comfort care continues; no CPR or resuscitation attempts needed unless directed

Memory trick: Breathe fast, then stop — Cheyne-Stokes is the body's final rhythm.

Competent residents have the legal right to refuse any care, treatment, or medication offered to them.

• Applies even if refusal may harm the resident's health
• Aide must document and report refusals to the nurse
• Refusing care is not the same as neglect by staff

Memory trick: 'My Body, My Choice' — document, don't force.

Hospice care provides comfort, dignity, and symptom relief for terminally ill residents rather than curative treatment.

• Focus is comfort, not cure
• Manages pain and symptoms
• Supports emotional/spiritual needs of resident and family

Memory trick: Hospice = comfort, not cure.

A technique describing food positions on a plate using clock-face numbers to promote independent eating.

• 12 o'clock is top of plate, 6 o'clock is bottom
• Helps promote independence and dignity
• Should be used consistently at each meal

Memory trick: Plate is a clock—tell the time of the food.

The correct method of washing hands with soap and water, including friction over all hand surfaces for at least 20 seconds.

• Wet hands, apply soap, scrub 20 seconds
• Include between fingers, under nails, backs of hands
• Use paper towel to turn off faucet

Memory trick: Scrub every nook, like reading a book, for 20 seconds it took.

Hand hygiene must be performed before and after contact with every resident, and after glove removal, as part of standard precautions.

• Applies to ALL residents regardless of diagnosis
• Before contact, after contact, and after gloves
• Reduces cross-contamination between residents

Memory trick: Before you touch, after you touch, after gloves you clutch

A fall-prevention practice requiring visible warning signage and restricted access whenever floors are wet to reduce slip risk.

• Wet floor signs must be clearly visible
• Block access if possible until floor dries
• Applies to spills, mopping, and weather tracked-in water

Memory trick: See wet, set the sign — silence isn't a safety plan.

The correct sequence for putting on PPE is gown, mask, goggles/face shield, then gloves, ensuring gloves cover gown cuffs.

• Gown first for full body coverage
• Mask/respirator second, fitted snugly
• Gloves last to overlap gown cuffs

Memory trick: Gown, Mask, Goggles, Gloves - GMGG keeps you safe

Total fluid output combines all sources (urine, emesis, drainage) after converting all measurements to the same unit, typically milliliters.

• 1 ounce = 30 mL for conversions
• Add all output sources together for the shift total
• Report unusually high or low output to the nurse

Memory trick: 'Convert first, then add it all up'

Residents have the right to privacy during personal care, including having doors and curtains closed and being addressed respectfully.

• Always knock and announce before entering
• Close doors/curtains during bathing, toileting, or dressing
• Privacy is a core resident right under nursing home regulations

Memory trick: 'Knock, cover, care.'

The use of medication to control a resident's behavior or movement for staff convenience, rather than to treat a diagnosed condition, which is prohibited without proper justification.

• Must be tied to a diagnosed medical need, not convenience
• Requires physician order and, often, consent
• Violates resident's right to be free from unnecessary restraints

Memory trick: Meds for meds' sake, not to make life easy for staff.

Scope of practice defines the tasks a nurse aide is legally permitted to perform; invasive procedures like catheter insertion are reserved for licensed nurses.

• CNAs cannot insert catheters, give injections, or administer most medications
• Performing tasks outside scope can lead to legal liability
• Always notify the nurse when a task requires licensed skills

Memory trick: 'If it's invasive, it's not mine.'

The first Kübler-Ross stage where a person refuses to believe or accept a terminal diagnosis as a coping mechanism.

• Protects the person from immediate emotional pain
• Nurse aide should listen without arguing
• Part of the five stages: denial, anger, bargaining, depression, acceptance

Memory trick: DABDA — Denial comes first, like closing your eyes to bad news.

Residents have the right to receive care without discrimination based on race, ethnicity, religion, disability, or other protected characteristics.

• Discriminatory refusal of care violates resident rights
• Applies regardless of language or accent
• Staff must report discriminatory behavior observed

Memory trick: Care for all, no bias at all.

A living will expresses wishes about specific treatments (like ventilators), while a DNR order specifically addresses resuscitation; they are not interchangeable.

• Living will ≠ DNR order
• Without a DNR, staff must attempt CPR
• Advance directives must be clearly documented and specific

Memory trick: No DNR? Do CPR.

Immediate flushing of eyes, nose, or mouth with water or saline following exposure to blood or body fluids to reduce infection risk, followed by reporting per protocol.

• Flush immediately for several minutes
• Report exposure promptly per facility policy
• Follow up with occupational health/testing as required

Memory trick: Splash in the eye? Flush, don't delay.

The final Kübler-Ross stage where the person comes to terms with the loss and often expresses peace or gratitude.

• Final of five stages
• Marked by calmness and resolution
• Does not mean the person is no longer sad, just at peace

Memory trick: Acceptance = peace at the end.

Use short, simple, one-step instructions and allow extra time for the resident to respond.

• Break tasks into single steps
• Use calm, simple language
• Avoid overwhelming with too many choices

Memory trick: One step, one thought, keep it slow.

A stool specimen must be collected without urine contamination, typically by having the resident urinate first, then collecting stool in a clean container like a specimen hat.

• Urine contamination can alter stool test results
• Use a specimen hat or clean bedpan, not the toilet directly
• Label and transport specimens promptly per facility policy

Memory trick: 'Pee first, then poop pure'

A safety device applied around a resident's waist to provide a secure grip for the caregiver during transfers and ambulation, reducing fall risk.

• Applied snugly over clothing, not bare skin
• Used to guide, not lift, the resident
• Check for adequate strength/balance before transfer

Memory trick: Belt it before you move it — grip the belt, not the body.

Informed consent for medical procedures must be obtained by the physician or licensed practitioner performing the procedure, not by nurse aides.

• Requires explanation of risks, benefits, alternatives
• Outside nurse aide scope of practice
• Resident must have decision-making capacity to consent

Memory trick: Doctor explains, resident decides—aide just abides.

The apical pulse is heard using a stethoscope over the apex of the heart, at the fifth intercostal space, left midclavicular line.

• Measured with a stethoscope, not fingers
• Used for infants, children, and residents with irregular pulses
• Counted for a full 60 seconds

Memory trick: 'Apex is under the left breast, count a full minute test.'

Handwashing with soap and water should last at least 20 seconds to effectively remove pathogens.

• 20 seconds is the standard minimum
• Sing 'Happy Birthday' twice as a timer
• Applies to soap and water washing, not just sanitizer

Memory trick: Twice through 'Happy Birthday' keeps germs away.

PPE removal order is gloves, goggles/face shield, gown, then mask, with hand hygiene performed between steps as needed.

• Gloves removed first (most contaminated)
• Mask removed last (protects airway)
• Hand hygiene after glove removal and after all PPE off

Memory trick: Glove, Goggle, Gown, Guard your face last

An oral temperature above about 99.6°F is considered elevated and should be reported to the nurse right away.

• Normal oral temperature averages 98.6°F (range ~97.6-99.6°F)
• Fever indicates possible infection or illness
• Nurse aides report abnormal vitals; they do not diagnose or medicate

Memory trick: 'Above normal? Alert the nurse fast!'

Consistent conditions—same scale, same time of day, and similar clothing—are required to obtain accurate and comparable weight readings.

• Weigh at the same time of day, ideally before breakfast
• Use the same scale each time for consistency
• Note similar clothing/footwear to avoid skewed results

Memory trick: 'Same scale, same time, same clothes, true trend'

Increased confusion, restlessness, or agitation in dementia residents that typically occurs in the late afternoon or evening.

• Common in moderate to severe dementia
• Triggered by fatigue, low light, or disrupted routine
• Managed with lighting, routine, and calm environment

Memory trick: As the sun goes down, confusion goes up — keep lights on and routines steady.

Nonverbal behaviors such as eye contact vary widely by culture and should not be misinterpreted using one's own cultural norms.

• Avoiding eye contact can signal respect in many cultures
• Personal space norms also vary by culture
• Avoid assuming negative intent behind cultural differences

Memory trick: Different culture, different cues—don't assume.

A respiratory rate above 20 breaths per minute in an adult is considered abnormal and should be reported promptly.

• Normal adult respiration: 12-20 breaths/min
• Rates above 20 = tachypnea, below 12 = bradypnea
• Shallow, rapid breathing may indicate respiratory distress

Memory trick: '12 to 20 keeps breathing serene — above that, report the scene!'

Basic care of hearing aids includes checking battery function, cleanliness, and proper fit before assuming device failure.

• Dead batteries are a common cause of malfunction
• Clean earwax buildup can also block sound
• Report persistent problems to the nurse

Memory trick: Battery first, blame last.

HIPAA requires that a resident's protected health information only be discussed with authorized individuals in private, appropriate settings.

• Applies to verbal, written, and electronic information
• Overheard conversations in public areas are violations
• Only share information on a 'need to know' basis for care

Memory trick: 'Loose lips in the lobby lose your license.'

A set of infection control measures used to reduce the spread of respiratory pathogens through droplets when coughing or sneezing.

• Cover mouth/nose with tissue or sleeve, not bare hands
• Dispose of tissue immediately
• Perform hand hygiene after coughing or sneezing

Memory trick: Sleeve, not hands, stops the germ bands.

Respirations should be counted without the resident's knowledge to avoid altering the natural breathing pattern.

• Often counted right after pulse while still holding wrist
• Count for 30 seconds and multiply by 2, or a full minute if irregular
• Normal adult rate is 12-20 breaths per minute

Memory trick: 'Sneaky breath count keeps it accurate'

All blood and body fluids from all residents are treated as potentially infectious, regardless of diagnosis.

• Applies to every resident, not just known infections
• Reduces risk of undiagnosed infections spreading
• Foundation for all other precaution types

Memory trick: Treat every fluid like it's contagious — better safe than sorry.

Keeping the call light within a resident's reach allows them to request help rather than attempt unsafe movement alone.

• Call light should always be within reach
• Reduces attempts at unassisted transfers
• Part of comprehensive fall risk reduction plan

Memory trick: A light within reach means less chance of a fall breach.

Always approach a resident with dementia from the front, identify yourself, and speak calmly to reduce fear and confusion.

• Sudden movement or touch can startle a confused resident
• Approach from the front within their line of sight
• Use a calm, reassuring tone of voice

Memory trick: Front, Friendly, Familiar voice — approach like you're greeting a friend.

Beds should be kept in the lowest position with wheels locked whenever the resident is not receiving direct care, to reduce fall injury risk.

• Lowest position reduces injury severity from falls
• Wheels must always be locked
• Call light within reach after every care task

Memory trick: Low bed, locked wheels, light within reach

During a fire, residents closest to the fire or in immediate danger are evacuated first, regardless of mobility status.

• Proximity to danger determines evacuation order
• Facility fire plans specify evacuation zones
• Staff should follow facility-specific fire evacuation policies

Memory trick: Closest to the flame, first to be saved.

Nurse aides must immediately report any allegation or suspicion of sexual abuse to a supervisor or authority; they must not investigate or confront the accused themselves.

• Mandatory reporters must act immediately
• No independent investigation by aide
• Delay or confrontation is inappropriate

Memory trick: Hear it, report it—now, not later.

Fire extinguishers are classified by the type of fire they are designed to fight: A (ordinary combustibles), B (flammable liquids), C (electrical), and K (kitchen grease).

• Class A: wood, paper, cloth
• Class B: liquids and gases
• Class C: electrical equipment
• Class K: cooking oils and fats

Memory trick: C is for Cords - use it on electrical shock hazards.

Normal pulse oximetry readings range from 95% to 100%. Readings below 95% should be reported to the nurse.

• Normal SpO2: 95%-100%
• Below 90% is often considered critical
• Always report abnormal readings promptly

Memory trick: '95 to stay alive' — below that, report it!

A stepwise method of removing contaminated gloves so the outer, soiled surface never contacts bare skin, preventing cross-contamination.

• Peel first glove from outside, ball it into the palm of the other gloved hand
• Slide ungloved finger under second glove at wrist to remove from inside
• Discard immediately and perform hand hygiene

Memory trick: Outside stays outside — peel from the inside to keep hands clean.

For a conscious choking infant, rescuers alternate 5 back blows and 5 chest thrusts rather than abdominal thrusts used in adults.

• 5 back blows between shoulder blades
• 5 chest thrusts with two fingers on breastbone
• Never perform abdominal thrusts on infants
• Avoid blind finger sweeps

Memory trick: Back and chest, never the belly, for babies it's best.

A communication technique that acknowledges the resident's feelings and reality rather than correcting or arguing with confused statements.

• Avoid arguing about facts
• Redirect gently to reduce distress
• Validate emotions behind the statement

Memory trick: Feel first, facts later.