Written Exam
Multiple-choice test assessing theoretical knowledge.
Getting Started with Your CNA Exam
Free knowledge base
CNA Certification (Written Exam) — key terms, tricks & tips
Everything from the course in one searchable place: 330 entries. Use it to review before a practice test or look up a word you forgot.
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Skills Exam
Practical test demonstrating care procedures.
Getting Started with Your CNA Exam
Multiple-Choice
Question format where you select one best answer.
Getting Started with Your CNA Exam
Pretest Questions
Unscored questions used for future exam development.
Getting Started with Your CNA Exam
Content Categories
Broad areas of knowledge covered on the exam.
Getting Started with Your CNA Exam
Critical Thinking
Applying knowledge to solve problems or make decisions.
Getting Started with Your CNA Exam
Passing Score
Minimum score required to pass the exam.
Getting Started with Your CNA Exam
CNA Written Exam: Format & Structure
To remember the two parts of the exam, think: 'Knowledge is Written, Skills are Shown.'
Getting Started with Your CNA Exam
CNA Written Exam: Format & Structure
For California, the written exam (NNAAP) typically has 60 multiple-choice questions, with 10 of those being 'pretest' questions that do not count towards your score. You have 90 minutes to complete the exam. The passing score is 70%.
Getting Started with Your CNA Exam
CNA Written Exam: Format & Structure
Underestimating the importance of time management during the exam.
Getting Started with Your CNA Exam
CNA Written Exam: Format & Structure
Focusing only on memorization without understanding how to apply the information.
Getting Started with Your CNA Exam
CNA Written Exam: Format & Structure
Not reviewing the specific content outline or percentage breakdown for your state's exam.
Getting Started with Your CNA Exam
Active Learning
Engaging with material through critical thinking and application.
Getting Started with Your CNA Exam
Passive Learning
Absorbing information without active engagement or processing.
Getting Started with Your CNA Exam
Active Recall
Retrieving information from memory without external cues.
Getting Started with Your CNA Exam
Spaced Repetition
Reviewing material at increasing intervals to improve retention.
Getting Started with Your CNA Exam
Study Plan
A structured schedule outlining study topics and times.
Getting Started with Your CNA Exam
Mock Exam
A practice test simulating the actual exam conditions.
Getting Started with Your CNA Exam
Test Anxiety
Excessive worry or fear related to taking an exam.
Getting Started with Your CNA Exam
Effective Study Strategies for CNA Success
For 'Active Learning,' remember ACT: Apply, Create, Teach. These actions make learning stick!
Getting Started with Your CNA Exam
Effective Study Strategies for CNA Success
The NNAAP exam often includes scenario-based questions. Practice applying your knowledge to realistic patient situations, not just memorizing facts.
Getting Started with Your CNA Exam
Effective Study Strategies for CNA Success
Cramming all your studying into the last few days before the exam.
Getting Started with Your CNA Exam
Effective Study Strategies for CNA Success
Only rereading notes or highlighting without actively testing your knowledge.
Getting Started with Your CNA Exam
Effective Study Strategies for CNA Success
Ignoring practice questions or not reviewing why answers were correct/incorrect.
Getting Started with Your CNA Exam
Perineal Care
Cleaning the genital and anal areas to prevent infection and odor.
Mastering Activities of Daily Living (ADLs)
Aspiration
Inhaling food, fluid, or foreign material into the lungs; a risk during oral care.
Mastering Activities of Daily Living (ADLs)
Dignity
The state of being worthy of honor or respect; maintained during all care.
Mastering Activities of Daily Living (ADLs)
Standard Precautions
Infection control practices used for all residents, regardless of diagnosis.
Mastering Activities of Daily Living (ADLs)
Skin Breakdown
Damage to the skin, often caused by pressure, moisture, or friction.
Mastering Activities of Daily Living (ADLs)
Axillae
The underarm or armpit area.
Mastering Activities of Daily Living (ADLs)
Call Light
A device used by residents to signal for assistance from staff.
Mastering Activities of Daily Living (ADLs)
Foreskin
The retractable fold of skin covering the tip of an uncircumcised penis.
Mastering Activities of Daily Living (ADLs)
Assisting with Bathing and Personal Hygiene
WASH: W-Water temp checked, A-All supplies ready, S-Safety first (no falls), H-Hygiene (clean to dirty, front to back).
Mastering Activities of Daily Living (ADLs)
Assisting with Bathing and Personal Hygiene
The California NNAAP exam emphasizes specific steps for perineal care for both male and female residents, and the importance of wiping front to back to prevent UTIs. Memorize the sequence of washing areas during a bed bath.
Mastering Activities of Daily Living (ADLs)
Assisting with Bathing and Personal Hygiene
Forgetting to check the water temperature, leading to burns or discomfort for the resident.
Mastering Activities of Daily Living (ADLs)
Assisting with Bathing and Personal Hygiene
Not explaining the procedure or asking for consent, which violates resident rights and dignity.
Mastering Activities of Daily Living (ADLs)
Assisting with Bathing and Personal Hygiene
Wiping from back to front during perineal care, significantly increasing the risk of urinary tract infections (UTIs).
Mastering Activities of Daily Living (ADLs)
Hemiparesis
Weakness or partial paralysis on one side of the body.
Mastering Activities of Daily Living (ADLs)
Adaptive clothing
Garments designed to make dressing easier for individuals with disabilities.
Mastering Activities of Daily Living (ADLs)
Gait belt
A safety device used to assist residents with transfers and ambulation.
Mastering Activities of Daily Living (ADLs)
Independence
The ability to perform activities without relying on others.
Mastering Activities of Daily Living (ADLs)
Privacy
The state of being free from public attention; essential during personal care.
Mastering Activities of Daily Living (ADLs)
Dressing and Grooming Techniques
W.E.A.K. D.R.E.S.S. - Weak side first to DRESS. Strong side first to UNDRESS.
Mastering Activities of Daily Living (ADLs)
Dressing and Grooming Techniques
On the California NNAAP exam, pay close attention to the sequence for dressing a resident with a weak side. The skill 'Dressing with a Weak Arm' specifically tests putting the garment on the weak arm first and removing it from the strong arm first. Also, remember to offer choices and ensure privacy.
Mastering Activities of Daily Living (ADLs)
Dressing and Grooming Techniques
Rushing the resident or doing everything for them, which reduces their independence.
Mastering Activities of Daily Living (ADLs)
Dressing and Grooming Techniques
Forgetting to provide privacy or offer clothing choices, disrespecting the resident's dignity.
Mastering Activities of Daily Living (ADLs)
Dressing and Grooming Techniques
Not dressing the weak side first, which can cause discomfort or injury to the resident with hemiparesis.
Mastering Activities of Daily Living (ADLs)
Incontinence
Involuntary loss of urine or feces.
Mastering Activities of Daily Living (ADLs)
Urinary Tract Infection (UTI)
Bacterial infection in the urinary system.
Mastering Activities of Daily Living (ADLs)
Bladder Training
Scheduled toileting to improve bladder control.
Mastering Activities of Daily Living (ADLs)
Bedpan
Receptacle for elimination while in bed.
Mastering Activities of Daily Living (ADLs)
Urinal
Container for male urination, often handheld.
Mastering Activities of Daily Living (ADLs)
Briefs
Disposable absorbent undergarments (adult diapers).
Mastering Activities of Daily Living (ADLs)
Toileting and Incontinence Care
P.R.I.V.A.C.Y. for Toileting: P-Privacy, R-Respond, I-Independence, V-Verify needs, A-Assist, C-Clean, Y-You're done!
Mastering Activities of Daily Living (ADLs)
Toileting and Incontinence Care
The NNAAP exam often emphasizes the importance of wiping from front to back during perineal care, providing privacy, and responding promptly to call lights. Look for questions testing these specific procedural steps.
Mastering Activities of Daily Living (ADLs)
Toileting and Incontinence Care
Delaying response to a call light for toileting needs.
Mastering Activities of Daily Living (ADLs)
Toileting and Incontinence Care
Forgetting to provide privacy during toileting or brief changes.
Mastering Activities of Daily Living (ADLs)
Toileting and Incontinence Care
Wiping from back to front during perineal care, leading to infection.
Mastering Activities of Daily Living (ADLs)
Dysphagia
Difficulty or discomfort in swallowing.
Mastering Activities of Daily Living (ADLs)
Dehydration
Insufficient fluid in the body.
Mastering Activities of Daily Living (ADLs)
Intake and Output (I&O)
Measurement of all fluids consumed and excreted.
Mastering Activities of Daily Living (ADLs)
Adaptive equipment
Specialized tools to assist with daily tasks.
Mastering Activities of Daily Living (ADLs)
Pocketing food
Holding food in the cheeks without swallowing.
Mastering Activities of Daily Living (ADLs)
Diet order
Physician's instructions for a resident's diet.
Mastering Activities of Daily Living (ADLs)
Feeding and Nutritional Support
Remember 'S.A.F.E. M.E.A.L.': **S**it at eye level, **A**llow time, **F**luids often, **E**ncourage independence, **M**outh care, **E**levate head, **A**lways report, **L**ook for issues.
Mastering Activities of Daily Living (ADLs)
Feeding and Nutritional Support
The NNAAP exam often emphasizes safety and resident rights during feeding. Look for questions about preventing aspiration, respecting resident preferences, and reporting changes. Memorize the 45-60 degree upright position for feeding.
Mastering Activities of Daily Living (ADLs)
Feeding and Nutritional Support
Rushing a resident during mealtime, which increases the risk of choking and aspiration.
Mastering Activities of Daily Living (ADLs)
Feeding and Nutritional Support
Not checking the resident's diet order or allergies before offering food.
Mastering Activities of Daily Living (ADLs)
Feeding and Nutritional Support
Leaving a resident unattended while they are eating, especially if they have swallowing difficulties.
Mastering Activities of Daily Living (ADLs)
Vital Signs
Measurements indicating essential body functions.
Essential Basic Nursing Skills for CNAs
Temperature
Measure of body heat production and loss.
Essential Basic Nursing Skills for CNAs
Pulse
Heartbeat felt at an artery; indicates heart rate.
Essential Basic Nursing Skills for CNAs
Respiration
Process of breathing; inhalation and exhalation.
Essential Basic Nursing Skills for CNAs
Blood Pressure
Force of blood against arterial walls.
Essential Basic Nursing Skills for CNAs
Systolic Pressure
Top number in BP; heart contracts.
Essential Basic Nursing Skills for CNAs
Diastolic Pressure
Bottom number in BP; heart relaxes.
Essential Basic Nursing Skills for CNAs
Sphygmomanometer
Device used to measure blood pressure.
Essential Basic Nursing Skills for CNAs
Measuring and Interpreting Vital Signs
TPR + BP: 'Take Patient's Regular Blood Pressure' helps remember the four main vital signs.
Essential Basic Nursing Skills for CNAs
Measuring and Interpreting Vital Signs
The NNAAP exam often includes scenarios where you must identify the correct site for a specific temperature measurement (e.g., 'rectal temperature is most accurate') or recognize a normal vital sign range for an adult. Memorize the normal adult ranges for all four vital signs.
Essential Basic Nursing Skills for CNAs
Measuring and Interpreting Vital Signs
Not waiting long enough after a resident has eaten, drunk, or smoked before taking an oral temperature.
Essential Basic Nursing Skills for CNAs
Measuring and Interpreting Vital Signs
Using an incorrectly sized blood pressure cuff, which can lead to inaccurate readings.
Essential Basic Nursing Skills for CNAs
Measuring and Interpreting Vital Signs
Failing to report abnormal vital signs or significant changes to the nurse promptly.
Essential Basic Nursing Skills for CNAs
Intake (I)
All fluids consumed by a resident.
Essential Basic Nursing Skills for CNAs
Output (O)
All fluids excreted by a resident.
Essential Basic Nursing Skills for CNAs
Milliliter (mL)
Standard unit for fluid measurement.
Essential Basic Nursing Skills for CNAs
Graduated Cylinder
Container used to measure fluid volume.
Essential Basic Nursing Skills for CNAs
Fluid Balance
Relationship between fluid intake and output.
Essential Basic Nursing Skills for CNAs
Strict I&O
Precise measurement of all intake/output.
Essential Basic Nursing Skills for CNAs
Edema
Swelling caused by excess fluid retention.
Essential Basic Nursing Skills for CNAs
Accurate Intake, Output, and Measurements
I-O-W-H: In-Out-Weight-Height. Remember the order of importance for these measurements in a resident's care plan.
Essential Basic Nursing Skills for CNAs
Accurate Intake, Output, and Measurements
The California NNAAP exam frequently tests on fluid conversions. Memorize that 1 ounce (oz) equals 30 milliliters (mL), and ice chips are recorded as half their volume when melted. You must correctly convert and calculate I&O totals.
Essential Basic Nursing Skills for CNAs
Accurate Intake, Output, and Measurements
Forgetting to convert ice chips to half their volume when recording intake.
Essential Basic Nursing Skills for CNAs
Accurate Intake, Output, and Measurements
Not measuring at eye level when using a graduated cylinder, leading to inaccurate readings.
Essential Basic Nursing Skills for CNAs
Accurate Intake, Output, and Measurements
Failing to document immediately, which can lead to forgotten or incorrect entries.
Essential Basic Nursing Skills for CNAs
Specimen
A sample of bodily fluid or tissue for analysis.
Essential Basic Nursing Skills for CNAs
Contamination
Introduction of unwanted substances, making a sample unusable.
Essential Basic Nursing Skills for CNAs
Clean-catch
Urine collection method to minimize external bacterial contamination.
Essential Basic Nursing Skills for CNAs
Midstream
The middle portion of urine collected during voiding.
Essential Basic Nursing Skills for CNAs
24-hour urine
Collection of all urine over a full 24-hour period.
Essential Basic Nursing Skills for CNAs
Sputum
Mucus coughed up from the lungs, not saliva.
Essential Basic Nursing Skills for CNAs
Expectorate
To cough or spit out phlegm from the respiratory tract.
Essential Basic Nursing Skills for CNAs
Specimen Collection and Documentation
L.A.S.T. for Specimen Success: Label Immediately, Avoid Contamination, Safety First, Transport Promptly.
Essential Basic Nursing Skills for CNAs
Specimen Collection and Documentation
On the NNAAP exam, pay close attention to scenarios involving labeling and proper collection technique for urine specimens. Keywords like 'immediately,' 'sterile,' and 'avoid contamination' are crucial. Remember that the specimen container, not the lid, is labeled.
Essential Basic Nursing Skills for CNAs
Specimen Collection and Documentation
Labeling the specimen lid instead of the container itself.
Essential Basic Nursing Skills for CNAs
Specimen Collection and Documentation
Delaying labeling, leading to potential mix-ups or incorrect information.
Essential Basic Nursing Skills for CNAs
Specimen Collection and Documentation
Allowing urine or toilet paper to contaminate a stool specimen.
Essential Basic Nursing Skills for CNAs
Specimen Collection and Documentation
Collecting saliva instead of true sputum from the lungs.
Essential Basic Nursing Skills for CNAs
Observation
Noticing and interpreting information about a resident's condition.
Essential Basic Nursing Skills for CNAs
Objective Observation
Factual, measurable, and verifiable information, seen or heard by anyone.
Essential Basic Nursing Skills for CNAs
Subjective Observation
Information based on what the resident states, their feelings or symptoms.
Essential Basic Nursing Skills for CNAs
Reporting
Verbal communication of observations to the nursing staff (RN/LPN).
Essential Basic Nursing Skills for CNAs
Documentation
The written record of observations, care provided, and resident responses.
Essential Basic Nursing Skills for CNAs
Continuity of Care
Seamless, uninterrupted care across different caregivers and shifts.
Essential Basic Nursing Skills for CNAs
Charting
Another term for documentation, usually in the resident's medical record.
Essential Basic Nursing Skills for CNAs
Observation, Reporting, and Documentation
O.R.D.E.R.: Observe, Report, Document, Every time, Right now!
Essential Basic Nursing Skills for CNAs
Observation, Reporting, and Documentation
The California NNAAP exam emphasizes accurate and timely reporting of changes in condition, especially for vital signs and pain. Pay close attention to what constitutes an 'immediate' report.
Essential Basic Nursing Skills for CNAs
Observation, Reporting, and Documentation
Delaying reporting of significant changes in a resident's condition.
Essential Basic Nursing Skills for CNAs
Observation, Reporting, and Documentation
Documenting observations before they actually occur ('charting ahead').
Essential Basic Nursing Skills for CNAs
Observation, Reporting, and Documentation
Using personal opinions or judgments instead of factual descriptions in documentation.
Essential Basic Nursing Skills for CNAs
Acute pain
Sudden, short-term pain, often related to injury or illness.
Essential Basic Nursing Skills for CNAs
Chronic pain
Persistent pain lasting six months or longer.
Essential Basic Nursing Skills for CNAs
Non-pharmacological
Treatments not involving medication, like massage or heat.
Essential Basic Nursing Skills for CNAs
Pain scale
Tool (e.g., 0-10, FACES) to measure pain intensity.
Essential Basic Nursing Skills for CNAs
Subjective pain
Pain as experienced and reported by the individual.
Essential Basic Nursing Skills for CNAs
Objective pain cues
Observable signs of pain, like grimacing or guarding.
Essential Basic Nursing Skills for CNAs
Distraction
Technique to shift focus away from pain, e.g., music.
Essential Basic Nursing Skills for CNAs
Pain Management and Comfort Measures
P.A.I.N. = P-osition, A-sk, I-ntervene, N-otify. This helps remember the steps!
Essential Basic Nursing Skills for CNAs
Pain Management and Comfort Measures
On the California NNAAP exam, be prepared to identify both verbal and non-verbal signs of pain. You must also know to report pain to the nurse and be able to list at least two non-pharmacological comfort measures a CNA can provide, such as repositioning or back rub.
Essential Basic Nursing Skills for CNAs
Pain Management and Comfort Measures
Assuming a resident isn't in pain just because they don't verbalize it; always look for non-verbal cues.
Essential Basic Nursing Skills for CNAs
Pain Management and Comfort Measures
Delaying reporting pain to the nurse, especially new or worsening pain.
Essential Basic Nursing Skills for CNAs
Pain Management and Comfort Measures
Attempting to administer pain medication or suggesting specific doses, which is outside the CNA's scope of practice.
Essential Basic Nursing Skills for CNAs
Range of Motion (ROM)
Movement of a joint to its fullest extent.
Promoting Resident Independence: Restorative Skills
Contracture
Permanent shortening of a muscle or joint.
Promoting Resident Independence: Restorative Skills
Active ROM
Resident performs exercises independently.
Promoting Resident Independence: Restorative Skills
Active-Assistive ROM
Resident moves with some CNA assistance.
Promoting Resident Independence: Restorative Skills
Passive ROM
CNA moves the resident's joint entirely.
Promoting Resident Independence: Restorative Skills
Flexion
Bending a joint or limb.
Promoting Resident Independence: Restorative Skills
Extension
Straightening a joint or limb.
Promoting Resident Independence: Restorative Skills
Abduction
Moving a limb away from the body's midline.
Promoting Resident Independence: Restorative Skills
Adduction
Moving a limb toward the body's midline.
Promoting Resident Independence: Restorative Skills
Range of Motion (ROM) Exercises
P-A-A: Passive (CNA moves), Active-Assistive (CNA helps), Active (Resident moves). Think of it as a spectrum of help!
Promoting Resident Independence: Restorative Skills
Range of Motion (ROM) Exercises
For the California NNAAP exam, pay close attention to the critical steps for performing ROM, especially supporting the joint and not causing pain. The exam often tests your ability to identify the correct type of ROM based on a resident's ability.
Promoting Resident Independence: Restorative Skills
Range of Motion (ROM) Exercises
Forcing a joint past the point of pain or resistance, which can cause injury.
Promoting Resident Independence: Restorative Skills
Range of Motion (ROM) Exercises
Not supporting the limb properly, leading to instability or discomfort.
Promoting Resident Independence: Restorative Skills
Range of Motion (ROM) Exercises
Performing ROM too quickly or roughly, which can be painful for the resident.
Promoting Resident Independence: Restorative Skills
Range of Motion (ROM) Exercises
Failing to communicate with the resident about the procedure or their comfort level.
Promoting Resident Independence: Restorative Skills
Ambulation Aid
Device assisting walking, providing support and balance.
Promoting Resident Independence: Restorative Skills
Cane
Walking aid for minimal support, held on the stronger side.
Promoting Resident Independence: Restorative Skills
Walker
Walking aid offering more stability than a cane.
Promoting Resident Independence: Restorative Skills
Weight-bearing
Ability to support body weight on a limb.
Promoting Resident Independence: Restorative Skills
Non-skid footwear
Shoes with soles designed to prevent slipping.
Promoting Resident Independence: Restorative Skills
Fatigue
Extreme tiredness or exhaustion.
Promoting Resident Independence: Restorative Skills
Assisting with Ambulation Aids
WALK SAFE: W-Walker forward, A-Aid adjusted, L-Look ahead, K-Keep clear path, S-Stronger side, A-Always use gait belt, F-Feet non-skid, E-Observe for Exhaustion.
Promoting Resident Independence: Restorative Skills
Assisting with Ambulation Aids
The California NNAAP exam often emphasizes the correct placement of the gait belt (over clothing, snug but not tight, buckle off-center) and the importance of checking the resident's feet for non-skid footwear before ambulation.
Promoting Resident Independence: Restorative Skills
Assisting with Ambulation Aids
Forgetting to use a gait belt when assisting with ambulation, even if the resident uses an aid.
Promoting Resident Independence: Restorative Skills
Assisting with Ambulation Aids
Not checking the ambulation aid for proper height adjustment or damage before use.
Promoting Resident Independence: Restorative Skills
Assisting with Ambulation Aids
Allowing the resident to pull on the walker or cane to stand up, which can cause it to tip.
Promoting Resident Independence: Restorative Skills
Body Mechanics
Efficient use of the body to prevent injury.
Promoting Resident Independence: Restorative Skills
Supine Position
Lying on the back.
Promoting Resident Independence: Restorative Skills
Lateral Position
Lying on the side.
Promoting Resident Independence: Restorative Skills
Fowler's Position
Head of bed elevated 45-60 degrees.
Promoting Resident Independence: Restorative Skills
Draw Sheet
Small sheet used for repositioning residents in bed.
Promoting Resident Independence: Restorative Skills
Mechanical Lift
Equipment used for non-weight-bearing resident transfers.
Promoting Resident Independence: Restorative Skills
Proper Positioning and Transfers
LIFT: Lock wheels, Identify resident ability, Find help if needed, Transfer safely.
Promoting Resident Independence: Restorative Skills
Proper Positioning and Transfers
On the California NNAAP exam, you must demonstrate correct application of a gait belt and safe transfer techniques, including locking wheels and proper body mechanics. Pay attention to resident safety and communication.
Promoting Resident Independence: Restorative Skills
Proper Positioning and Transfers
Forgetting to lock bed/wheelchair brakes before a transfer.
Promoting Resident Independence: Restorative Skills
Proper Positioning and Transfers
Attempting to lift a resident alone who is too heavy or unable to assist.
Promoting Resident Independence: Restorative Skills
Proper Positioning and Transfers
Not using a gait belt when appropriate for transfers.
Promoting Resident Independence: Restorative Skills
Proper Positioning and Transfers
Twisting your back instead of pivoting your feet during a transfer.
Promoting Resident Independence: Restorative Skills
Pressure Injury
Localized damage to skin/tissue from pressure.
Promoting Resident Independence: Restorative Skills
Bony Prominence
Area where bone is close to the skin surface.
Promoting Resident Independence: Restorative Skills
Shear
Skin layers slide over bone, tearing blood vessels.
Promoting Resident Independence: Restorative Skills
Friction
Skin rubs against a surface, causing abrasion.
Promoting Resident Independence: Restorative Skills
Non-blanchable
Redness that doesn't turn white when pressed.
Promoting Resident Independence: Restorative Skills
Repositioning
Changing a resident's body position regularly.
Promoting Resident Independence: Restorative Skills
Barrier Cream
Protective ointment for skin against moisture.
Promoting Resident Independence: Restorative Skills
Preventing Pressure Injuries and Skin Breakdown
Remember 'SKIN': **S**urface (pressure relief), **K**eep turning, **I**ncontinence management, **N**utrition.
Promoting Resident Independence: Restorative Skills
Preventing Pressure Injuries and Skin Breakdown
The California NNAAP exam emphasizes identifying risk factors, proper repositioning techniques (e.g., using pillows for support), and reporting skin changes. Memorize the 2-hour repositioning rule for bed-bound residents and 1-hour for chair-bound.
Promoting Resident Independence: Restorative Skills
Preventing Pressure Injuries and Skin Breakdown
Dragging residents instead of lifting them, which causes shear and friction.
Promoting Resident Independence: Restorative Skills
Preventing Pressure Injuries and Skin Breakdown
Not checking skin during repositioning, missing early signs of breakdown.
Promoting Resident Independence: Restorative Skills
Preventing Pressure Injuries and Skin Breakdown
Ignoring incontinence, allowing prolonged moisture exposure to the skin.
Promoting Resident Independence: Restorative Skills
Hand Hygiene
Washing hands with soap/water or using alcohol-based hand rub.
Ensuring Safety and Preventing Infection
PPE
Personal Protective Equipment; barriers protecting against infection.
Ensuring Safety and Preventing Infection
Donning
The process of putting on personal protective equipment.
Ensuring Safety and Preventing Infection
Doffing
The process of safely removing personal protective equipment.
Ensuring Safety and Preventing Infection
ABHR
Alcohol-Based Hand Rub; hand sanitizer with at least 60% alcohol.
Ensuring Safety and Preventing Infection
Visibly Soiled
Hands that clearly have dirt, blood, or other contaminants on them.
Ensuring Safety and Preventing Infection
Gown
Protective clothing worn to shield skin and clothing from splashes.
Ensuring Safety and Preventing Infection
N95 Respirator
A type of mask that filters at least 95% of airborne particles.
Ensuring Safety and Preventing Infection
Hand Hygiene and Personal Protective Equipment (PPE)
Remember the 5 moments for hand hygiene with 'B-B-A-A-A': Before Patient, Before Aseptic, After Body Fluids, After Patient, After Around Patient.
Ensuring Safety and Preventing Infection
Hand Hygiene and Personal Protective Equipment (PPE)
The California exam emphasizes the proper sequence for donning and doffing PPE. Memorize the order: Donning (Gown, Mask, Goggles, Gloves) and Doffing (Gloves, Goggles, Gown, Mask) is a frequently tested sequence.
Ensuring Safety and Preventing Infection
Hand Hygiene and Personal Protective Equipment (PPE)
Forgetting to perform hand hygiene after removing gloves, which can lead to self-contamination.
Ensuring Safety and Preventing Infection
Hand Hygiene and Personal Protective Equipment (PPE)
Touching clean surfaces or your face with contaminated gloves or hands.
Ensuring Safety and Preventing Infection
Hand Hygiene and Personal Protective Equipment (PPE)
Using alcohol-based hand rub when hands are visibly soiled or after caring for a C. difficile patient (soap and water is required).
Ensuring Safety and Preventing Infection
Hand Hygiene and Personal Protective Equipment (PPE)
Removing PPE in the wrong order, especially taking off a gown before gloves, which can spread contamination.
Ensuring Safety and Preventing Infection
Transmission-Based Precautions
Additional measures for specific infectious agents.
Ensuring Safety and Preventing Infection
Contact Precautions
Used for infections spread by direct or indirect contact.
Ensuring Safety and Preventing Infection
Droplet Precautions
Used for infections spread by large respiratory droplets.
Ensuring Safety and Preventing Infection
Airborne Precautions
Used for infections spread by small airborne particles.
Ensuring Safety and Preventing Infection
AIIR
Airborne Infection Isolation Room, for airborne diseases.
Ensuring Safety and Preventing Infection
Standard & Transmission-Based Precautions
My CNA is 'S.A.F.E.': Standard, Airborne, Droplet, Contact, and Everyone (all patients).
Ensuring Safety and Preventing Infection
Standard & Transmission-Based Precautions
The NNAAP exam often presents scenarios where you must choose the correct precaution. Look for keywords like 'tuberculosis' (Airborne), 'C. diff' (Contact), or 'influenza' (Droplet). Remember, Standard Precautions are always applied first.
Ensuring Safety and Preventing Infection
Standard & Transmission-Based Precautions
Failing to apply Standard Precautions to ALL patients.
Ensuring Safety and Preventing Infection
Standard & Transmission-Based Precautions
Confusing the type of PPE needed for different Transmission-Based Precautions (e.g., surgical mask for airborne).
Ensuring Safety and Preventing Infection
Standard & Transmission-Based Precautions
Forgetting that Transmission-Based Precautions are always used IN ADDITION to Standard Precautions, not instead of them.
Ensuring Safety and Preventing Infection
Fall Risk Assessment
Evaluating factors that increase a patient's likelihood of falling.
Ensuring Safety and Preventing Infection
Bed Alarm
An electronic device that alerts staff when a patient leaves their bed.
Ensuring Safety and Preventing Infection
Orthostatic Hypotension
A sudden drop in blood pressure upon standing, causing dizziness.
Ensuring Safety and Preventing Infection
Incident Report
A formal document detailing an unexpected event, like a fall.
Ensuring Safety and Preventing Infection
Ambulation
The act of walking or moving about.
Ensuring Safety and Preventing Infection
Fall Prevention Strategies and Interventions
Remember 'SAFE': **S**afety first, **A**ssist as needed, **F**loor clear, **E**nvironment optimized.
Ensuring Safety and Preventing Infection
Fall Prevention Strategies and Interventions
The California NNAAP exam frequently emphasizes the importance of using gait belts correctly and ensuring the patient's environment is free of hazards. Memorize the steps for applying a gait belt and positioning a patient for ambulation.
Ensuring Safety and Preventing Infection
Fall Prevention Strategies and Interventions
Failing to put the bed in the lowest position after care, increasing the distance a patient could fall.
Ensuring Safety and Preventing Infection
Fall Prevention Strategies and Interventions
Not ensuring the call light is within reach, leading patients to try and get up unassisted.
Ensuring Safety and Preventing Infection
Fall Prevention Strategies and Interventions
Ignoring minor spills or clutter, which can quickly become major fall hazards.
Ensuring Safety and Preventing Infection
RACE procedure
Acronym for fire response: Rescue, Alarm, Contain, Extinguish/Evacuate.
Ensuring Safety and Preventing Infection
PASS procedure
Acronym for using a fire extinguisher: Pull, Aim, Squeeze, Sweep.
Ensuring Safety and Preventing Infection
Fire alarm
Device that signals the presence of fire.
Ensuring Safety and Preventing Infection
Fire extinguisher
Portable device to put out small fires.
Ensuring Safety and Preventing Infection
Evacuation plan
Facility's detailed strategy for moving people to safety during an emergency.
Ensuring Safety and Preventing Infection
Containment
Actions taken to prevent fire/smoke spread.
Ensuring Safety and Preventing Infection
Fire Safety: RACE and PASS Procedures
RACE: Run Away, Call Everyone, Close Everything, Extinguish/Escape. PASS: Pin, Aim, Spray, Sweep.
Ensuring Safety and Preventing Infection
Fire Safety: RACE and PASS Procedures
The NNAAP exam frequently tests the exact order of the RACE and PASS procedures. Memorize 'Rescue, Alarm, Contain, Extinguish/Evacuate' and 'Pull, Aim, Squeeze, Sweep' precisely. Pay attention to scenarios where you must decide whether to extinguish or evacuate.
Ensuring Safety and Preventing Infection
Fire Safety: RACE and PASS Procedures
Attempting to fight a fire that is too large or spreading, putting yourself and others at risk.
Ensuring Safety and Preventing Infection
Fire Safety: RACE and PASS Procedures
Forgetting to activate the fire alarm or call for help before attempting to extinguish a fire.
Ensuring Safety and Preventing Infection
Fire Safety: RACE and PASS Procedures
Aiming a fire extinguisher at the flames instead of the base of the fire.
Ensuring Safety and Preventing Infection
Choking
Airway obstruction, preventing breathing.
Ensuring Safety and Preventing Infection
Heimlich Maneuver
Abdominal thrusts to dislodge airway obstruction.
Ensuring Safety and Preventing Infection
Airway Obstruction
Blockage preventing air from entering lungs.
Ensuring Safety and Preventing Infection
Cyanosis
Bluish discoloration due to lack of oxygen.
Ensuring Safety and Preventing Infection
CPR
Cardiopulmonary resuscitation for cardiac arrest.
Ensuring Safety and Preventing Infection
Choking Prevention and Intervention
CHOKE: C-Cough (encourage), H-Heimlich (perform), O-Observe (signs), K-Know (risks), E-Emergency (call for help).
Ensuring Safety and Preventing Infection
Choking Prevention and Intervention
The California NNAAP exam emphasizes knowing the correct hand placement for the Heimlich maneuver (abdominal thrusts) – above the navel and below the sternum – and the importance of asking 'Are you choking?' before intervening.
Ensuring Safety and Preventing Infection
Choking Prevention and Intervention
Not asking 'Are you choking?' before performing the Heimlich maneuver on a conscious resident.
Ensuring Safety and Preventing Infection
Choking Prevention and Intervention
Ignoring subtle signs of difficulty swallowing, leading to a choking incident.
Ensuring Safety and Preventing Infection
Choking Prevention and Intervention
Performing abdominal thrusts on an infant or a pregnant/obese resident without modification.
Ensuring Safety and Preventing Infection
Resident Rights
Legal and ethical protections for individuals in long-term care.
Upholding Resident Rights and Ethics
OBRA '87
Federal law establishing resident rights in nursing homes.
Upholding Resident Rights and Ethics
Advocacy
Supporting or speaking up for a resident's best interests.
Upholding Resident Rights and Ethics
Self-determination
The right to make one's own choices and decisions.
Upholding Resident Rights and Ethics
Chain of Command
The official hierarchy for reporting issues within a facility.
Upholding Resident Rights and Ethics
Retaliation
Punishment for reporting wrongdoing; illegal in healthcare.
Upholding Resident Rights and Ethics
Understanding and Protecting Resident Rights
REMEMBER: 'CPR' for Resident Rights: Choice, Privacy, Respect. Always think of CPR when caring for residents!
Upholding Resident Rights and Ethics
Understanding and Protecting Resident Rights
California CNAs must be aware that the state has specific regulations (Title 22) that reinforce and sometimes expand upon federal resident rights. The exam may include questions about a resident's right to receive visitors, participate in activities, and be free from involuntary seclusion.
Upholding Resident Rights and Ethics
Understanding and Protecting Resident Rights
Assuming a resident's preferences based on their age or condition, rather than asking them directly.
Upholding Resident Rights and Ethics
Understanding and Protecting Resident Rights
Discussing a resident's personal information or care details in public areas.
Upholding Resident Rights and Ethics
Understanding and Protecting Resident Rights
Not reporting a subtle sign of disrespect or potential rights violation because it 'didn't seem serious enough'.
Upholding Resident Rights and Ethics
Abuse
Intentional harm, confinement, or punishment causing injury or anguish.
Upholding Resident Rights and Ethics
Neglect
Failure to provide necessary care, leading to harm or illness.
Upholding Resident Rights and Ethics
Mandated Reporter
Legally required to report suspected abuse or neglect.
Upholding Resident Rights and Ethics
Physical Abuse
Causing bodily injury through hitting, pushing, or other force.
Upholding Resident Rights and Ethics
Emotional Abuse
Causing mental anguish through threats, humiliation, or harassment.
Upholding Resident Rights and Ethics
Sexual Abuse
Any non-consensual sexual contact with a resident.
Upholding Resident Rights and Ethics
Financial Abuse
Misusing or stealing a resident's money or property.
Upholding Resident Rights and Ethics
Recognizing and Reporting Abuse and Neglect
ABC: Always Be Careful (to) Report Concerns!
Upholding Resident Rights and Ethics
Recognizing and Reporting Abuse and Neglect
California law requires CNAs to report suspected abuse or neglect to their supervisor immediately, and if the supervisor does not act or is involved, to the facility administrator or the California Department of Public Health (CDPH). Know the CDPH reporting hotline number.
Upholding Resident Rights and Ethics
Recognizing and Reporting Abuse and Neglect
Trying to investigate the abuse yourself instead of reporting immediately.
Upholding Resident Rights and Ethics
Recognizing and Reporting Abuse and Neglect
Confronting the alleged abuser, which can escalate the situation or put you at risk.
Upholding Resident Rights and Ethics
Recognizing and Reporting Abuse and Neglect
Delaying reporting because you are unsure or want to gather more 'proof.'
Upholding Resident Rights and Ethics
Recognizing and Reporting Abuse and Neglect
Reporting to a coworker or someone not in the direct chain of command.
Upholding Resident Rights and Ethics
Confidentiality
Keeping private information secret.
Upholding Resident Rights and Ethics
HIPAA
Federal law protecting patient health information.
Upholding Resident Rights and Ethics
PHI
Protected Health Information; identifiable health data.
Upholding Resident Rights and Ethics
Breach
Unauthorized disclosure of sensitive information.
Upholding Resident Rights and Ethics
Need-to-know
Access to info only if necessary for care.
Upholding Resident Rights and Ethics
Confidentiality, HIPAA, and Privacy
Think of HIPAA as 'Hand In Private And Protected' information. It's like a secret handshake for your patient's data!
Upholding Resident Rights and Ethics
Confidentiality, HIPAA, and Privacy
The California exam emphasizes HIPAA compliance. Memorize that PHI includes any identifiable health information and that unauthorized disclosure is a serious offense. Keywords to spot: 'patient rights,' 'privacy,' 'confidentiality,' 'HIPAA violation.'
Upholding Resident Rights and Ethics
Confidentiality, HIPAA, and Privacy
Discussing resident information in public areas like hallways or elevators.
Upholding Resident Rights and Ethics
Confidentiality, HIPAA, and Privacy
Leaving resident charts or care plans visible to unauthorized individuals.
Upholding Resident Rights and Ethics
Confidentiality, HIPAA, and Privacy
Sharing information with family members without confirming authorization.
Upholding Resident Rights and Ethics
Scope of Practice
Legal limits of duties a CNA can perform.
Upholding Resident Rights and Ethics
Professional Boundaries
Limits separating professional from personal relationships.
Upholding Resident Rights and Ethics
Delegation
Assignment of duties by a licensed nurse.
Upholding Resident Rights and Ethics
Activities of Daily Living (ADLs)
Basic self-care tasks like bathing, dressing, eating.
Upholding Resident Rights and Ethics
Supervision
Monitoring and guidance by a licensed nurse.
Upholding Resident Rights and Ethics
Nurse Practice Act
State law defining legal scope for nursing roles.
Upholding Resident Rights and Ethics
CNA Scope of Practice and Professional Boundaries
SCOPE: S-State laws, C-Competence, O-Orders (nurse's), P-Prohibited (never do), E-Ethical. Always check these before acting!
Upholding Resident Rights and Ethics
CNA Scope of Practice and Professional Boundaries
The California NNAAP exam frequently tests your understanding of what CNAs CANNOT do. Memorize key prohibited actions like administering medications, performing sterile procedures, or diagnosing conditions.
Upholding Resident Rights and Ethics
CNA Scope of Practice and Professional Boundaries
Performing a task because 'another CNA does it' without confirming it's within your scope and delegated.
Upholding Resident Rights and Ethics
CNA Scope of Practice and Professional Boundaries
Sharing personal problems or details with residents, blurring professional lines.
Upholding Resident Rights and Ethics
CNA Scope of Practice and Professional Boundaries
Accepting significant gifts or money from residents, which can lead to exploitation or favoritism.
Upholding Resident Rights and Ethics
Dementia
Progressive decline in cognitive function affecting memory, thinking, and behavior.
Effective Communication and Psychosocial Support
Validation
Acknowledging and respecting a person's feelings and reality, even if different from yours.
Effective Communication and Psychosocial Support
Redirection
Guiding a person's attention from a distressing topic to a more positive one.
Effective Communication and Psychosocial Support
Person-centered care
Care focused on the individual's unique history, preferences, and abilities.
Effective Communication and Psychosocial Support
Reminiscence therapy
Using past events or familiar objects to stimulate memory and conversation.
Effective Communication and Psychosocial Support
Aphasia
Difficulty with language, affecting speaking, understanding, reading, or writing.
Effective Communication and Psychosocial Support
Sundowning
Increased confusion, agitation, and restlessness in late afternoon/evening.
Effective Communication and Psychosocial Support
Communicating with Residents with Dementia
To communicate with DEMENTIA, remember SLOW: Speak Simply, Listen, Observe, Validate.
Effective Communication and Psychosocial Support
Communicating with Residents with Dementia
The California NNAAP exam emphasizes person-centered care and validating feelings. Be prepared for scenarios where you must choose the response that respects the resident's dignity and perceived reality, rather than correcting them or arguing.
Effective Communication and Psychosocial Support
Communicating with Residents with Dementia
Arguing with a resident about their perception of reality.
Effective Communication and Psychosocial Support
Communicating with Residents with Dementia
Asking multiple questions at once or using complex sentences.
Effective Communication and Psychosocial Support
Communicating with Residents with Dementia
Ignoring non-verbal cues of discomfort or unmet needs.
Effective Communication and Psychosocial Support
Hearing Loss
Partial or total inability to hear sounds.
Effective Communication and Psychosocial Support
Vision Loss
Partial or total inability to see.
Effective Communication and Psychosocial Support
Assistive Devices
Tools that help people with disabilities perform tasks.
Effective Communication and Psychosocial Support
Lip-reading
Understanding speech by observing lip movements.
Effective Communication and Psychosocial Support
Non-verbal Cues
Communication through body language, gestures, expressions.
Effective Communication and Psychosocial Support
Orientation
Awareness of one's surroundings and position.
Effective Communication and Psychosocial Support
Environmental Adaptations
Modifications to surroundings for safety and function.
Effective Communication and Psychosocial Support