LACNA Candidate Information Bulletin
Karla Zellmer
TXCNA CIB - 090120 Candidate Information Bulletin
State of Texas
C E R T I F I E D N U R S E A I D E E V A L U A T I O N P R O G R A M
The Texas Health and Human Services Commission (HHSC) has contracted with Prometric, a nationally recognized leading provider of assessment services to regulatory agencies and national associations. Prometric will develop, score and report the results of the Nurse Aide Examination required for certification and placement on the Texas Nurse Aide Registry.
This bulletin describes the procedures for becoming a Texas CNA and being listed on the Registry.
To Become a Certified Nurse Aide in Texas
1 Complete the Texas Nurse Aide Application in the portal available on www.prometric.com/nurseaide/tx.
2 Prepare for your tests, using the content outlines in this bulletin--Page 11.
3 Take your tests at your scheduled test site. Be sure to bring the necessary identification with you to the test site--Page 6.
4 Once you have passed both tests, you will be placed on the Texas Nurse Aide Registry --Page 10.
To Get Answers not Provided in this Bulletin
Direct all questions and requests for information about the testing process to:
Prometric, Attention TX Nurse Aide 7941 Corporate Drive Nottingham, MD 21236 Phone: 800.488.5787 Email: txcna@prometric.com www.prometric.com/nurseaide/tx
For questions and requests for information about the Nurse Aide Registry and statespecific regulations:
Texas Health and Human Services Commission (HSSC) TX Nurse Aide Registry Mail E-414 PO Box 149030 Austin, TX 78714-9030 Phone: 512.438.2050
Copyright © 2020 Prometric LLC
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Eligibility to Test Requirements
Eligibility for taking the Competency Evaluation Program testing is established by meeting one of the following eligibility routes:
Route New Nurse Aide Candidate applying under this eligibility route must:
· Complete a Texas-approved training course within the last 24 months.
Receive email from Prometric confirming that your training program coordinator has uploaded your course completion information.
· Logon and complete the application in the TX Nurse Aide portal found online at
www.prometric.com/nurseaide/tx .
· Submit required exam fees to Prometric and schedule your exam
appointments.
· Pass the Clinical Skills exam and Written or Oral exam within 24 months of
completing your training. You will have three attempts to pass the Clinical Skills exam and three attempts to pass the Written or Oral exam before you are required to re-train.
Route 5528 Nurse Aides with Expired Status If you have NOT performed nursing or nursing related duties in a health care setting and completed 24 hours of in-service education during the twenty-four (24) months since registration or renewal, your nurse aide registration has expired.
· To renew your registration, you must take the skills and written or oral examinations.
· To apply, call HHSC at 512.438.2050 or complete form NAR-5528 and submit to HHSC for authorization to test.
The form is available at: https://hhs.texas.gov/doing-businesshhs/licensing-credentialing-regulation/nurse-aide-registry/narforms
NOTE: If you HAVE performed nursing or nursing related duties in a health care setting during the twenty-four (24) months and completed 24 hours of in-service education since registration or renewal, you do not need to re-test. Call HHSC at 512.438.2050 or have your employer complete form NAR-5506 and submit to HHSC.
The form is available at https://hhs.texas.gov/doing-business-hhs/ licensing-credentialing-regulation/nurse-aide-trainingcompetencyevaluation-program-natcep/natcep-curriculum-forms
Route 5511 Nurse Aides with Equivalent Military Training Candidate applying under this eligibility route must have:
· Completed military training of 100 hours or more on or after July 1, 1989, equivalent to civilian nurse aide training.
· To apply, call HHSC at 512.438.2017 or complete form or complete form 5511-NATCEP and submit to HHSC for authorization to test.
The form is available at: https:// hhs.texas.gov/doing-businesshhs/licensing-credentialing-regulation/nurse-aide-trainingcompetency-evaluation-program-natcep/natcep-curriculum-forms
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Route 5512 (RN/LVN Graduate) Candidate applying under this eligibility route must: · Complete a state-accredited school of nursing in any state within the past twenty-four (24) months. To apply, call HHSC at 512.438.2017 or complete form 5512-NATCEP and submit to HHSC for authorization to test. The form is available at: https://hhs.texas.gov/doing-business-hhs/ licensingcredentialing-regulation/nurse-aide-trainingcompetency-evaluation-programnatcep/natcep-curriculum-forms Route 5513 (RN/LVN Student) Candidate applying under this eligibility route must have:
· Completed basic nursing training within the past twenty-four (24)
months.
· To apply, call HHSC at 512.438.2017 or complete form 5513-
NATCEP and submit to HHSC for authorization to test. The form is available at: https://hhs.texas.gov/doing-business-hhs/ licensing-credentialing-regulation/nurse-aide-trainingcompetencyevaluation-program-natcep/natcep-curriculum-forms Route 5510 (Out-of-State Training) Candidate applying under this eligibility route must have:
· Completed an approved training program in another state within the past twenty-four (24) months. To apply, call HHSC at (512) 4382017 or complete form 5510-NATCEP and submit to HHSC for authorization to test.
The form is available at: https://hhs.texas.gov/doingbusiness-hhs/licensingcredentialing-regulation/nurseaide-training-competency-evaluation-programnatcep/natcep-curriculum-forms
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Scheduling Your Tests
The Certified Nurse Aide (CNA) Competency Evaluation Program consists of a Clinical Skills Test and a Written/Oral Test. You must pass both tests to become a CNA.
You must complete a Texas Certified Nurse Aide Examination Application in the portal found at www.prometric.com/nurseaide/tx. Complete the form clearly and accurately. Payment for testing will need to accompany the application or it will be considered incomplete.
Social Security number. If you do not have a Social Security number at the time you complete the registration form, you will not be allowed to test.
Admission to Test Letter When the exam application and payment is completed, you will be able to schedule your exams at any convenient testing centers or via remote proctoring (Written/Oral exams only) on dates and times that work for your schedule. You will be emailed an Admission to Test Letter (ATT) that will include the test site location as well as the start time of the exam.
Note Texas requires that a candidate complete testing within 24 months of the
training completion date.
Status Emails You will receive a status email from Prometric throughout the registration, application, payment, and scheduling process. These emails will provide instructions for the next steps in the process.
Written/Oral Exams Written/Oral Exams are administered in four different types of locations. The specific options available to each candidate will appear in the TX Nurse Aide portal for selection at scheduling:
· Computer-Based Testing (CBT) locations open multiple days/week to candidates from any profession.
· Regional Testing Sites open to nurse aide candidates from any training program
· In-Facility Testing (IFT) sites open to nurse aide candidates with preapproval from the site
· Live Remote Proctoring available to any candidate with the required computer, internet, and space requirements (testing at home, school, etc.).
Clinical Skills Exams Clinical Skills Exams are administered in two different types of locations. The specific options available to candidates will appear in the TX Nurse Aide portal for selection at scheduling:
· Regional Testing Sites open to nurse aide candidates from any training program
· In-Facility Testing (IFT) sites open to nurse aide candidates with preapproval from the site
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Fee Information
Testing fees are paid to Prometric when the application is processed and must be paid with 3rd party/employer check, cashier's check, money order, credit card or voucher.
Fees are as follows:
Test Options
Newly Trained Tester
Written and Clinical Skills
Oral English/Spanish and Clinical Skills (includes Reading Comprehension Exam) Lapsed/Other Candidate Written and Clinical Skills
Oral English/Spanish and Clinical Skills (includes Reading Comprehension Exam) Re-tester
Written Test ONLY
Oral Test ONLY (Oral includes Reading Comprehension Exam) Clinical Skills Test ONLY
Fees Fee
$125 $135
Fee $125 $135
Fee $35 $45
$90
Important Print your name on money orders, certified checks, or company
checks. Testing fees are nonrefundable and nontransferable.
Special Test Considerations ADA Accommodation. HHSC complies with the provisions of the Americans with Disability Act as amended. If you need testing accommodations for the state exam, please indicate the specific request(s) when you complete your application in Prometric's portal. All candidates who are requesting accommodations because of a disability must provide appropriate documentation of their condition and how it is expected to affect their ability to take the test under standard conditions. Test accommodations are individualized and considered on a case-by-case basis. Accommodation requests must be submitted 6 weeks prior to the exam date for approval. Contact HHSC at 512.438.2017 if you need assistance.
The Clinical Skills and Written/Oral tests are written so as not to exceed a sixthgrade reading level, as required by the Texas Competency Evaluation Program..
English as a Second Language (ESL). The Texas Nurse Aide Competency Exam is offered in English and Spanish. Translators are not permitted and translation dictionaries may not be used during the exam administration. Information about taking the exam in an oral format is available on Page 7. All candidates testing by way of Oral Exam are required to also pass a Reading Comprehension exam.
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Rescheduling a Test Appointment
Rescheduling fees will apply as follows:
· $25 fee if you reschedule 5-29 days before your test.
If you reschedule less than 5 days before your test you will lose your test fee and be considered a no show for the exam. In order to reschedule you will need to pay the entire test fee again. There is no charge for rescheduling 30 or more days before your appointment.
If Absent or Late If you miss your test, or are late and are not allowed to test, you will be considered a "no show" and will need to reschedule your exam. You will be required to pay the exam fee of the exam(s) in order to be scheduled to test.
Emergency Closing If a test administration is canceled due to weather conditions or other major incidents, you will be rescheduled for another appointment without additional cost.
Taking Your Tests
You should arrive at least 30 minutes before your scheduled test appointment. This allows time for you to sign in and for staff to verify your identification.
What to Bring to the Test Site You must bring all the following items with you to the test site.
· Authorization to Test (ATT) Letter. You must present the original letter
sent to you by Prometric via email.
· Government-issued Photo Identification with Signature (such as a
driver's license, passport, or Texas ID card). This identification must be current (non-expired) and must have both a photograph and a signature.
· A second form of Identification with Signature (such as a school ID card,
facility ID, or library card). ID that is cracked, torn or may have been tampered with will not be accepted and you may not be admitted to test.
Important If you fail to bring all of the required documents listed on your
testing appointment email, you will not be allowed to test.
What to Wear on Test Day
If you are taking the Clinical Skills Test, you are required to wear flat, nonskid, closed-toed shoes. It is suggested that a uniform or scrubs be worn on the day of testing. You should also have a watch with a secondhand.
Clinical Skills Test Overview
The Clinical Skills test is a timed test. You will be scored on five skills. While performing three assigned skills, you will also be scored on two additional skills - Handwashing and Indirect Care. Indirect Care is care related to resident rights, communication with the resident, resident safety and comfort, and infection control. The outline shown on Page 12 is a list of the possible tasks you might be asked to perform during the Clinical Skills Test. Each test form has its own time limit based on the combination of skills being asked to perform. The instruction card you will be given will advise you of your time limit.
To pass the Clinical Skills test, you must pass all five skills. You are not required to perform the skill perfectly, but you are required to demonstrate competency of the
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skill. Each skill has a list of checkpoints. The Nurse Aide Evaluator (NAE) will watch you perform the skill and compare your performance to the checkpoints for the skill. A Clinical Skills Checklist is located online at www.prometric.com/nurseaide/la.
Once you are at the test site, listen carefully to the instructions given by the NAE. You will be given an instruction sheet to refer to during testing that lists the skills you are to perform. The test will take place in a clinical laboratory, with someone acting as a resident or with a mannequin.
The rules for the Clinical Skills test allow you to make corrections while performing a skill. You must tell the NAE that you are making a correction during the skill. Once you have completed a skill and have indicated to the NAE that you are done with the skill, you may not go back to correct a previous skill.
The NAE who administers the Clinical Skills test is not permitted to teach, coach, or discuss your results or performance with you.
Written Test Overview
You will take the Written Test on a computer at the test site or via remote proctoring. You do not need computer experience to take the test. You will use a computer mouse to select answers. Before you begin the test, you will have the chance to answer several practice questions to make sure you know how to use the computer.
The Written Test consists of 60 multiple-choice questions that evaluate your nurse aide knowledge and skills. You will have 90 minutes to take the test. The content outline shown on Page 12 is the basis for the Knowledge Test. The outline lists all topics covered in the test and the approximate percentage of questions asked about each topic.
Oral Test Overview
The Written test can be taken in an Oral form. During an Oral test, you will hear the questions read to you while reading and answering questions on the computer. You may replay questions as many times as needed. If you would like to take the Oral test, you must select this option on the application form. This request cannot be made on the day of testing.
Besides the multiple choice knowledge portion of the test that is the same as taken by all nurse aide candidates, the Oral test has an additional section of exam questions on Reading Comprehension. The Reading Comprehension Test has approximately 15 questions. This test is used to find out if candidates have the reading skills a nurse aide who works in a nursing facility needs.
Candidates must pass both the Reading Comprehension section and the Oral test section on the same day in order to pass the Oral test. Candidates will be given a separate score for each section. Each time a candidate takes the Oral test, she/he will be required to take the Reading Comprehension section, even if it was passed in a previous attempt.
Practice Exam
A Nurse Aide Practice Exam is available online at www.prometric.com/nurseaide/tx. The practice exam is created in the same format and uses the same question types as the actual certification exam. The practice exam will also help you become familiar with the computer-based testing process.
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During the practice exam, you will get immediate feedback to correct and incorrect responses as well as overall feedback at the end of the session. The practice exam will list rational statements and reference listings for further study.
The Written Nurse Aide Practice Exam contains 50 questions. The fee for each practice exam is $10. A super pack of all 3 practice exams is available for $25 and is payable online using a credit or debit card at the time you purchase the practice exam.
The Clinical Skills Readiness Test allows you to prepare for your skills exam by testing your knowledge of the skills you will need to perform on the day of testing. There are 6 tests available with 3-4 skills in each. The fee for each Clinical Skill Readiness test is $5 to $7 with a super pack of all skills available for $25. The fee is payable online using a credit or debit card at the time you purchase the practice exam.
Sample Test
A Nurse Aide Certification Sample Test is located on Page 14 of this bulletin. The sample test is intended to help you become familiar with the exam format. How well you do on this sample test does not predict your results on your actual test.
Test Site Regulations
The following regulations will be observed at each test site. If you do not follow these rules, it will result in the disqualification of your test. Prometric reserves the right to audiotape and videotape any testing session.
References · No reference materials, papers or study materials are allowed at the test center.
If you are found with these or any other aids, you will not be allowed to continue the test and your answers will not be scored.
Personal Items · Prometric is not responsible for personal items brought to the test center. It is
recommended that personal items not be brought into the test site. Note the following:
· Electronic equipment is not permitted in the testing area. This includes cell
phones, pagers, cameras, recording devices, etc. All of these items will be collected by the Nurse Aide Evaluator (NAE) or proctor.
· Other personal items--purses, briefcases, etc.--are not permitted in the testing
area. Note: It is recommended that purses not be brought to the test center. Access to purses will not be allowed during testing.
Restroom Breaks · If you leave the testing room while an exam is taking place, you must sign out/in
on the roster and you will lose exam time.
· You will not have access to any personal items during this break. · You are not allowed to use any electronic devices or phones during breaks.
Visitors · No guests, visitors, children or family members are allowed at the test center.
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Misconduct or Disruptive Behavior
Weapons
If you engage in any disruptive or offensive behaviors, you will be dismissed from the examination. If dismissed, your test results will be invalid and the details of the misconduct will be reported to HHSC. Examples are: giving or receiving help, cell phones ringing in the test center, resident actors talking, prompting or moving when not directed to do so, taking part in an act of impersonation, removing test materials or notes from the testing room, using rude or offensive language and behavior that delays or interrupts testing.
· Weapons are not allowed at the test center.
Your Test Results
Important Every time you enter the test room, you will be asked to turn your
pockets inside out to confirm that you have no prohibited items. The test site administrator will collect any materials that violate the rules.
If Questions Arise. Test site employees are not allowed to answer any questions about the test content. If you do not understand a question on the test, you should answer the question to the best of your ability.
Copyrighted Questions. All test questions are the property of Prometric LLC and are protected by copyright. Federal law provides severe civil and criminal penalties for the unauthorized reproduction, distribution, or exhibition of copyrighted materials.
Written/Oral Test Since your test is given on computer, you will get a score report emailed to you on the same day. The score report will list either pass or fail. Test site employees cannot discuss your results with you.
Clinical Skills Test Your score report will be emailed to you shortly after the completion of your test. You must pass all five skills to pass the Clinical Skills test. The nurse giving the Clinical Skills test is not allowed to discuss your results with you.
Passing Candidates Once you pass both the Clinical Skills Test and Written/Oral Test, your information will be provided to HHSC for entry in the Texas Nurse Aide Registry. Results are confidential and are not given out over the phone.
Unsuccessful Candidates If you were unsuccessful in either test and remain eligible to retest, you need to go to the Exam Scheduling portal on www.prometric.com/nurseaide/tx to submit payment and schedule a retest.
Candidates can log onto the TX Nurse Aide portal at www.prometric.com/nurseaide/tx using their username and password at any time to access their exam result history and review score reports.
Important You may only take the Clinical Skills Test and/or the Knowledge Test
three times each in 24 months. If you are unable to pass both tests in the allotted attempts, you will be required to retrain before retesting.
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Appeals Process
Our goal is to provide a quality test and a standard testing experience for every candidate. If you are dissatisfied with either and believe we can correct the problem, we would like to hear from you. We provide an opportunity for general comments at the end of your test. Our personnel will review your comments, but you will not receive a direct response.
If you are requesting a response about test content, registration, scheduling or test administration (testing site procedures, equipment, personnel, etc.), please submit an appeal in writing within 60 days of your test date. Your appeal must provide your name, the test title, the date you tested and the details of your concern, including all relevant facts.
The Appeals Committee will review your concern and send you a written response with acknowledgement of receipt within 10 business days.
Certified Nurse Aide Registry
After you successfully pass the Competency Evaluation Program -- both the Clinical Skills Test and the Written/Oral Test -- you will be placed on the Texas Nurse Aide Registry. Your Nurse Aide Registry certificate is valid for two years from the time of issue.
Registry Verification Before an individual can be hired as a nurse aide, the employer must verify successful completion of the NATCEP.
Nurse aides with findings of resident abuse, neglect, and/or misappropriation of resident property will remain on the Registry with the findings placed in their record. This information will be disclosed to the health facilities that call to verify a person's standing. Findings placed on the Registry are permanent and will be removed only when:
· The findings have been made in error; · An individual has been found not guilty in a court of law; or · The state is informed of a registrant's death.
A nurse aide under investigation for resident abuse, neglect and/or misappropriation of resident property is given a hearing and has an opportunity to rebut findings in the Registry. Only validated findings are placed on the Registry. This is public information.
Moving out of state If you are a nurse aide moving from Texas to another state, you must contact the Registry of that state to see if your CNA status can be transferred to that state as requirements vary from state to state. You must complete the Reciprocity process of the state you wish to transfer to.
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Examination Content Outlines
The Competency Examination consists of two tests, a Written (Knowledge) test, and a performance-based Clinical Skills test. You must pass both the Written and Clinical Skills test within 12 months of completing your nurse aide training.
Written (Knowledge) Test Content Outline
60 questions--90 minute time limit
The following outline gives an overview of the content of Written Test. The test will include questions on the subjects contained in this outline.
I. Role of the Nurse Aide - 20% A. Personal responsibility 1. Reporting requirements 2. Promotion of personal health and safety 3. Promotion and protection of resident rights 4. Time management and work prioritization 5. Workplace standards, including ethical and unethical behaviors 6. Nurse Aide Registry B. Nurse aide as a member of the health care team 1. Job responsibilities of the nurse aide, including duties and limitations 2. Interdisciplinary team member roles 3. Teamwork principles (e.g., collaboration, cooperation, sharing information, customer service) 4. The care planning process and implementation 5. Nurse aide's responsibility to provide care according to the care plan C. Interpersonal relations/communication skills 1. Communication principles 2. Communication types 3. Factors affecting communication 4. Therapeutic communication techniques D.
II. Promotion of Safety - 22% A. Potential hazards in the healthcare environment B. Common injuries of residents (e.g., skin tears and shearing, falls, spills, burns, bruises) C. Risks related to common injuries D. Safety and comfort 1. Comfort needs of the resident 2. Accident prevention including fall prevention protocols 3. Restraint techniques and alternatives 4. Legal implications in the use of restraints 5. Risk factors for elopement (resident leaving without staff knowledge) E. Safety devices (e.g., wanderguard, alarms) F. Infection prevention and control 1. Maintaining a clean environment 2. Factors that contribute to spread of disease-causing organisms 3. Signs and symptoms of infections 4. Practices that decrease the risk of exposure to disease-causing organisms
G. Emergencies 1. Emergency and disaster response protocols 2. Immediate life-safety techniques 3. Evacuation procedures
H. Fire prevention and safety
III.
Promotion of Function and Health of
Residents - 20% A. Personal care skills
1. Feeding 2. Bathing 3. Perineal care, including catheter 4. Foot/nail care 5. Mouth care 6. Skin care 7. Toileting 8. Grooming 9. Dressing/undressing B. Health maintenance/restoration 1. Promoting circulation and skin integrity
(e.g., specialized mattresses, chair cushions, positioning) 2. Nutrition and hydration 3. Sleep and rest needs 4. Elimination (bowel and bladder) 5. Mobility, including bed mobility 6. Effects of immobility 7. Care and use of assistive devices C. Age-related changes 1. Cognitive (e.g., memory) changes 2. Psychosocial (e.g., relationships) changes 3. Physical changes Psychosocial needs of residents 1. Fundamental human needs (e.g., Maslow's Hierarchy of Needs) 2. Emotional support strategies 3. Intervention strategies to assist residents in coping with losses and adjustments to nursing home placement (e.g., control, autonomy, privacy)
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IV. Basic Nursing Care Provided by the Nurse Aide - 24% A. Routine, chronic, non-life threatening situations 1. Observation and reporting of physical changes 2. Observation and reporting of behavioral changes B. Acute emergency situations 1. Chest pain 2. Cardiac arrest 3. Respiratory distress 4. Difficulty swallowing 5. Choking/aspirations 6. Vomiting 7. Seizures 8. Changes in mobility, speech, or other potential signs of stroke 9. Diabetic situations 10. Sudden onset of confusion or agitation 11. Changes in level of consciousness 12. Falls 13. Bleeding 14. Burns
V. Providing Specialized Care for Residents with Changes in Health - 14 % A. Physical problems 1. Common physical impairments and related care 2. Providing for safety, care, and comfort of residents with physical impairments 3. Impact of impairment on resident safety, care, and comfort B. Psychological problems 1. Common psychological impairments and related care (e.g., confusion, anxiety, depression, delirium, phobias, addiction) 2. Special considerations for the safety, care, and comfort of residents with psychological impairments C. Care of the dying resident and post-mortem care 1. Grief process 2. Responding to the emotional needs of the resident, other residents, family and caregivers in the grief process 3. Factors influencing responses to grief (e.g., spiritual beliefs, culture, past experience) 4. Physical changes and needs as death approaches 5. Post-mortem care procedures
Clinical Skills
The following is a list of the clinical skills that you may be asked to perform during the Clinical Skills test. A checklist for these skills may be found online at www.prometric.com/nurseaide/la.
Handwashing Note: Your handwashing technique is evaluated at the beginning of the test. This skill is not prompted, which means you will not be told to wash your hands. Nursing aides are expected to know to wash their hands before and after physical contact (touching) with the resident.
I. Clinical Skills List A. Ambulate the resident using a transfer/gait belt B. Assist resident needing to use a bedpan C. Change bed linen while the resident remains in bed D. Change resident's position to a supported side-lying position E. Dress a resident who has a weak arm F. Empty contents of resident's urinary drainage bag, and measure and record urine output on an Intake and Output (I&O) form G. Feed a resident who is sitting in a chair H. Measure and record a resident's radial pulse I. Measure and record a resident's respirations J. Provide catheter care to a female resident who has an indwelling urinary catheter K. Provide foot care to a resident who is sitting in a chair L. Provide mouth care to a resident who has a denture M. Provide mouth care to a resident who has teeth N. Provide perineal care to a female resident who is incontinent of urine O. Provide resident hand and nail care P. Provide resident a partial bed bath and back rub Q. Provide resident with passive range of motion (ROM) exercises to one elbow and wrist R. Provide resident with passive range of motion (ROM) exercises to one shoulder S. Provide resident with passive range of motion (ROM) exercises to one hip, knee, and ankle T. Transfer the resident from the bed into a wheelchair using a pivot technique and a transfer/gait belt
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Nurse Aide Certification Sample Test
Notice: This Sample Test is provided as a courtesy to individuals who are preparing to take a Prometric Nurse Aide Competency Examination. You are reminded that how well you do on these practice questions, does not predict results on your actual examination.
Directions: This test contains 50 questions. Each question has four suggested answers, (A), (B), (C) or (D). For each question, choose the ONE that best answers it.
1. A resident often carries a doll with her, treating it like her baby. One day she is wandering around crying that she can't find her baby. The nurse aide should
(A) ask the resident where she last had the doll.
(B) ask the activity department if they have any other dolls.
(C) offer comfort to the resident and help her look for her baby.
(D) let the other staff know the resident is very confused and should be watched closely.
2. A nurse aide is asked to change a urinary drainage bag attached to an indwelling urinary catheter. The nurse aide has never done this before. The best response by the nurse aide is to
(A) change the indwelling catheter at the same time.
(B) ask another nurse aide to change the urinary drainage bag.
(C) change the bag asking for help only if the nurse aide has problems.
(D) ask a nurse to watch the nurse aide change the bag since it is the first time.
3. Before feeding a resident, which of the following is the best reason to wash the resident's hands?
(A) The resident may still touch his/her mouth or food.
(B) It reduces the risk of spreading airborne diseases.
(C) It improves resident morale and appetite. (D) The resident needs to keep meal routines.
4. Which of the following is a job task performed by the nurse aide?
(A) Participating in resident care planning conferences
(B) Taking a telephone order from a physician (C) Giving medications to assigned residents (D) Changing sterile wound dressings
5. Which of the following statements is true about range of motion (ROM) exercises?
(A) Done just once a day (B) Help prevent strokes and paralysis (C) Require at least ten repetitions of each
exercise (D) Are often performed during ADLs such as
bathing or dressing
6. While the nurse aide tries to dress a resident who is confused, the resident keeps trying to grab a hairbrush. The nurse aide should
(A) put the hairbrush away and out of sight. (B) give the resident the hairbrush to hold. (C) try to dress the resident more quickly. (D) restrain the resident's hand.
7. A resident who is lying in bed suddenly becomes short of breath. After calling for help, the nurse aide's next action should be to
(A) ask the resident to take deep breaths. (B) take the resident's vital signs. (C) raise the head of the bed. (D) elevate the resident's feet.
8. A resident who has cancer is expected to die within the next couple of days. Nursing care for this resident should focus on
(A) helping the resident through the stages of grief.
(B) providing for the resident's comfort. (C) keeping the resident's care routine, such
as for bathing. (D) giving the resident a lot of quiet time and
privacy.
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9. While giving a bedbath, the nurse aide hears the alarm from a nearby door suddenly go off. The nurse aide should
(A) wait a few minutes to see if the alarm stops.
(B) report the alarm to the charge nurse immediately.
(C) make the resident being bathed safe and go check the door right away.
(D) stop the bedbath and go check on the location of all assigned residents.
10. Gloves should be worn for which of the following procedures?
(A) Emptying a urinary drainage bag (B) Brushing a resident's hair (C) Ambulating a resident (D) Feeding a resident
11. When walking a resident, a gait or transfer belt is often
(A) worn around the nurse aide's waist for back support.
(B) used to keep the resident positioned properly in the wheelchair.
(C) used to help stand the resident, and then removed before walking.
(D) put around the resident's waist to provide a way to hold onto the resident.
12. Which of the following statements is true about residents who are restrained?
(A) They are at greater risk for developing pressure sores.
(B) They are at lower risk of developing pneumonia.
(C) Their posture and alignment are improved. (D) They are not at risk for falling.
13. A resident has diabetes. Which of the following is a common sign of a low blood sugar?
(A) Fever (B) Shakiness (C) Thirst (D) Vomiting
14. When providing foot care to a resident it is important for the nurse aide to
(A) remove calluses and corns. (B) check the feet for skin breakdown. (C) keep the water cool to prevent burns. (D) apply lotion, including between the toes.
15. When feeding a resident, frequent coughing can be a sign the resident is
(A) choking. (B) getting full. (C) needs to drink more fluids. (D) having difficulty swallowing.
16. When a person is admitted to the nursing home, the nurse aide should expect that the resident will
(A) have problems related to incontinence. (B) require a lot of assistance with personal
care. (C) experience a sense of loss related to the
life change. (D) adjust more quickly if admitted directly
from the hospital.
17. A resident gets dressed and comes out of his room wearing shoes that are from two different pairs. The nurse aide should
(A) tease the resident by complimenting the resident's sense of style.
(B) ask if the resident realizes that the shoes do not match.
(C) remind the resident that the nurse aide can dress the resident.
(D) ask if the resident lost some of his shoes.
18. A resident's wife recently died. The resident is now staying in his room all the time and eating very little. The best response by the nurse aide is to
(A) remind the resident to be thankful for the years he shared with his wife.
(B) tell the resident that he needs to get out of his room at least once a day.
(C) understand the resident is grieving and give him chances to talk.
(D) avoid mentioning his wife when caring for him.
19. When a resident refuses a bedbath, the nurse aide should
(A) offer the resident a bribe. (B) wait awhile and then ask the resident
again. (C) remind the resident that people who smell
don't have friends. (D) tell the resident that nursing home policy
requires daily bathing.
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20. When a resident is combative and trying to hit the nurse aide, it is important for the nurse aide to
(A) show the resident that the nurse aide is in control.
(B) call for help to make sure there are witnesses.
(C) explain that if the resident is not calm a restraint may be applied.
(D) step back to protect self from harm while speaking in a calm manner.
21. During lunch in the dining room, a resident begins yelling and throws a spoon at the nurse aide. The best response by the nurse aide is to
(A) remain calm and ask what is upsetting the resident.
(B) begin removing all the other residents from the dining room.
(C) scold the resident and ask the resident to leave the dining room immediately.
(D) remove the resident's plate, fork, knife, and cup so there is nothing else to throw.
22. Which of the following questions asked to the resident is most likely to encourage conversation?
(A) Are you feeling tired today? (B) Do you want to wear this outfit? (C) What are your favorite foods? (D) Is this water warm enough?
23. When trying to communicate with a resident who speaks a different language than the nurse aide, the nurse aide should
(A) use pictures and gestures. (B) face the resident and speak softly when
talking. (C) repeat words often if the resident does not
understand. (D) assume when the resident nods his/her
head that the message is understood.
24. While walking down the hall, a nurse aide looks into a resident's room and sees another nurse aide hitting a resident. The nurse aide is expected to
(A) contact the state agency that inspects the nursing facility.
(B) enter the room immediately to provide for the resident's safety.
(C) wait to confront the nurse aide when he/she leaves the resident's room.
(D) check the resident for any signs of injury after the nurse aide leaves the room.
25. Before touching a resident who is crying to offer comfort, the nurse aide should consider
(A) the resident's recent vital signs. (B) the resident's cultural background. (C) whether the resident has been sad
recently. (D) whether the resident has family that visits
routinely.
26. When a resident is expressing anger, the nurse aide should
(A) correct the resident's misperceptions. (B) ask the resident to speak in a kinder tone. (C) listen closely to the resident's concerns. (D) remind the resident that everyone gets
angry.
27. When giving a backrub, the nurse aide should
(A) apply lotion to the back directly from the bottle.
(B) keep the resident covered as much as possible.
(C) leave extra lotion on the skin when completing the procedure.
(D) expect the resident to lie on his/her stomach.
28. A nurse aide finds a resident looking in the refrigerator at the nurses' station at 5 a.m. The resident, who is confused, explains he needs breakfast before he leaves for work. The best response by the nurse aide is to
(A) help the resident back to his room and into bed.
(B) ask the resident about his job and if he is hungry.
(C) tell him that residents are not allowed in the nurses' station.
(D) remind him that he is retired from his job and in a nursing home.
29. Which of the following is true about caring for a resident who wears a hearing aid?
(A) Apply hairspray after the hearing aid is in place.
(B) Remove the hearing aid before showering. (C) Clean the earmold and battery case with
water daily, drying completely. (D) Replace batteries weekly.
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30. Residents with Parkinson's disease often require assistance with walking because they
(A) become confused and forget how to take steps without help.
(B) have poor attention skills and do not notice safety problems.
(C) have visual problems that require special glasses.
(D) have a shuffling walk and tremors.
31. A resident who is inactive is at risk of constipation. In addition to increased activity and exercise, which of the following actions helps to prevent constipation?
(A) Adequate fluid intake (B) Regular mealtimes (C) High protein diet (D) Low fiber diet
32. A resident has an indwelling urinary catheter. While making rounds, the nurse aide notices that there is no urine in the drainage bag. The nurse aide should first
(A) ask the resident to try urinating. (B) offer the resident fluid to drink. (C) check for kinks in the tubing. (D) obtain a new urinary drainage bag.
33. A resident who is incontinent of urine has an increased risk of developing
(A) dementia. (B) urinary tract infections. (C) pressure sores. (D) dehydration.
34. When cleansing the genital area during perineal care, the nurse aide should
(A) cleanse the penis with a circular motion starting from the base and moving toward the tip.
(B) replace the foreskin when pushed back to cleanse an uncircumcised penis.
(C) cleanse the rectal area first, before cleansing the genital area.
(D) use the same area on the washcloth for each washing and rinsing stroke for a female resident.
35. Which of the following is considered a normal age-related change?
(A) Dementia (B) Contractures (C) Bladder holding less urine (D) Wheezing when breathing
36. A resident is on a bladder retraining program. The nurse aide can expect the resident to
(A) have a fluid intake restriction to prevent sudden urges to urinate.
(B) wear an incontinent brief in case of an accident.
(C) have an indwelling urinary catheter. (D) have a schedule for toileting.
37. A resident who has stress incontinence
(A) will have an indwelling urinary catheter. (B) should wear an incontinent brief at night. (C) may leak urine when laughing or coughing. (D) needs toileting every 1-2 hours throughout
the day.
38. The doctor has told the resident that his cancer is growing and that he is dying. When the resident tells the nurse aide that there is a mistake, the nurse aide should
(A) understand that denial is a normal reaction.
(B) remind the resident the doctor would not lie.
(C) suggest the resident ask for more tests. (D) ask if the resident is afraid of dying.
39. A slipknot is used when securing a restraint so that
(A) the restraint cannot be removed by the resident.
(B) the restraint can be removed quickly when needed.
(C) body alignment is maintained while wearing the restraint.
(D) it can be easily observed whether the restraint is applied correctly.
40. When using personal protective equipment (PPE) the nurse aide correctly follows Standard Precautions when wearing
(A) double gloves when providing perineal care to a resident.
(B) a mask and gown while feeding a resident that coughs.
(C) gloves to remove a resident's bedpan. (D) gloves while ambulating a resident.
41. To help prevent resident falls, the nurse aide should
(A) always raise siderails when any resident is in his/her bed.
(B) leave residents' beds at the lowest level when care is complete.
(C) encourage residents to wear larger-sized, loose-fitting clothing.
(D) remind residents who use call lights that they need to wait patiently for staff.
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42. As the nurse aide begins his/her assignment, which of the following should the nurse aide do first?
(A) Collect linen supplies for the shift
(B) Check all the nurse aide's assigned
residents
(C) Assist a resident that has called for
assistance to get off the toilet
48.
(D) Start bathing a resident that has physical
therapy in one hour
43. Which of the following would affect a nurse aide's status on the state's nurse aide registry and also cause the nurse aide to be ineligible to work in a nursing home?
(A) Having been terminated from another facility for repeated tardiness
(B) Missing a mandatory infection control inservice training program
(C) Failing to show for work without calling to report the absence
(D) Having a finding for resident neglect
44. To help prevent the spread of germs between patients, nurse aides should
(A) wear gloves when touching residents. (B) hold supplies and linens away from their
uniforms. (C) wash hands for at least two minutes after
each resident contact. (D) warn residents that holding hands spreads
germs.
45. When a sink has hand-control faucets, the nurse aide should use
(A) a paper towel to turn the water on. (B) a paper towel to turn the water off. (C) an elbow, if possible, to turn the faucet
controls on and off. (D) bare hands to turn the faucet controls both
on and off.
46. When moving a resident up in bed who is able to move with assistance, the nurse aide should
(A) position self with knees straight and bent
at waist.
(B) use a gait or transfer belt to assist with the
repositioning.
(C) pull the resident up holding onto one side
of the drawsheet at a time.
(D)
bend the resident's knees and ask the
resident to push with his/her feet.
47. The resident's weight is obtained routinely as a way to check the resident's
(A) growth and development. (B) adjustment to the facility. (C) nutrition and health. (D) activity level.
Which of the following is a right that is included in the Resident's Bill of Rights?
(A) To have staff available that speak different languages on each shift
(B) To have payment plan options that are based on financial need
(C) To have religious services offered at the facility daily
(D) To make decisions and participate in own care
49. Which of the following, if observed as a sudden change in the resident, is considered a possible warning sign of a stroke?
(A) Dementia (B) Contractures (C) Slurred speech (D) Irregular heartbeat
50. Considering the resident's activity, which of the following sets of vital signs should be reported to the charge nurse immediately?
(A) Resting: (B) After eating: (C) After walking exercise: (D) While watching television:
98.6°-98-32 97.0°-64-24 98.2°-98-28 98.8°-72-14
1 C 2 D 3 A 4 A 5 D 6 B 7 C 8 B 9 C 10 A 11 D 12 A 13 B
Answer Key
14 B
27 B
15 D
28 B
16 C
29 B
17 B
30 D
18 C
31 A
19 B
32 C
20 D
33 C
21 A
34 B
22 C
35 C
23 A
36 D
24 B
37 C
25 B
38 A
26 C
39 B 40 C 41 B 42 C 43 D 44 B 45 B 46 D 47 C 48 D 49 C 50 A
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