Nursing Aid Exam

nursing assistant/
nurse aide
exam
NURSE 4ED [FIN].indd 1 8/19/09 9:49:39 AM

Other Titles of Interest from
l e a r n i n g e xp r e s s
Becoming a Nurse
Healthcare Career Starter, 2nd edition
Spanish/English Terms for Nurses

Nursing
ASSISTANT/
NursE
AIDE
EXAM
4th Edition
N e w Y o r k

Copyright © 2009 LearningExpress, LLC.
All rights reserved under International and Pan-American Copyright Conventions.

Published in the United States by LearningExpress, LLC, New York.
Library of Congress Cataloging-in-Publication Data:
Nursing assistant/nurse aide exam.—4th ed.

p. : cm.
Includes bibliographical references and index.
ISBN 978-1-57685-699-4
1. Nurses’ aides—Examinations—Study guides. I. LearningExpress (Organization)
[DNLM: 1. Nurses’ Aides—Examination Questions. WY 18.2 N974 2009]
RT84.N864 2009
610.7306’98—dc22
200917462
Printed in the United States of America

987654321
Fourth Edition
ISBN 978-1-57685-699-4
Regarding the Information in This Book

We attempt to verify the information presented in our books prior to publication. It is always a good idea,
however, to double-check such important information as minimum requirements, application and testing
procedures, and deadlines, as such information can change from time to time.
For more information or to place an order, contact LearningExpress at:

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List of Contributors
Marlene Beck, RN, MSN is a Nursing Instructor at the Bridgeport Hospital School of Nursing. She has had
extensive experience as a manager and educator. In her current position, she has been instrumental in curriculum
development, teaching, and clinical supervision. Previously, she was Administrative Manager of Organization,
Development, and Education at Bridgeport Hospital/Yale New Haven Healthcare System. In this role, she devel-
oped and implemented the first Certified Nursing Assistant program for the hospital. She lives in Seymour,
Connecticut.
Patricia Mulrane is a freelance writer with a Bachelor of Arts in Print Media. She began her publishing career in
1994 and is currently Marketing Director for Peter Lang Publishing/USA, a scholarly press in New York City. She
lives in Brooklyn, New York.
Mary E. Muscari, PhD, CPNP, APRN-BC started out as a diploma nursing graduate and continued her education
to become an advanced practice nurse, educator, and writer. She has written several books and numerous articles,
and continues to practice nursing. Dr. Muscari also presents at numerous conferences, inspiring other nurses to
find their passions and enhance their careers.
Johanna Rubin, BS, RN works for the New York Harbor HealthCare System as a Compliance Officer, displaying
expertise in clinical service education. Her clients include doctors, nurses, and nursing assistants. She is also an
instructor at Franklin Career Institute, where she trains beginning nursing assistants.
Caren Silhavey, RN, MSN, CURN is a Nursing Instructor at the Bridgeport Hospital School of Nursing, Bridge-
port, Connecticut. Prior to that, she was a Staff Development Instructor in the Organizational Development
and Education Department at Bridgeport Hospital, where she taught and coordinated both the Clinical Care
Provider program (extended Nursing Assistant) and the Certified Nursing Assistant Program. She lives in Strat-
ford, Connecticut.

–list of contributors–
National Occupational Competency Testing Institute (NOCTI) is a recognized leader in occupational compe-
tency testing and has developed and validated over 250 written exams and performance assessments that measure
the skills of entry-level and experienced workers. A non-profit institute, NOCTI has created hundreds of custom-
ized workplace-related assessments for major corporations such as Disney, Toyota, GTE, and 3M.
Helen S. Wilson, BSN, RN, is currently an instructor and coordinator of the Certified Nursing Assistant Program
at Franklin Career Institute in Hempstead, New York. Previously, she taught the Certified Nursing Assistant
programs at Suburban Technical (Hempstead, New York) and Allen School for Nursing Assistants (Queens, New
York) and the Licensed Practical Nurse program at VEEB in Uniondale, New York. Before retiring, she served as
a Nursing Administrator and Supervisor at the Veterans Affairs Extended Care Facility (Queens, New York). She
resides in Uniondale, New York.
vi

Contents
chapter 1 The Nursing Assistant/Nurse Aide Exam 1

chapter 2 The LearningExpress Test Preparation System 11
chapter 3 Nursing Assistant/Nurse Aide Practice Exam 1 29
chapter 8 Nursing Assistant/Nurse Aide Practical Skills Exam 99
chapter 9 Certification Requirements and Trends 105
chapter 10 Important Resources 111
appendix Nursing Assistant/Nurse Aide Practice Exam Question Outline 131
vii

1
the nursing
c h a p t e r
assistant/nurse
aide exam
c ha pt er SU MMARY
This chapter introduces you to the certification process for nursing
assistants and shows you how to use this book to help you prepare
for the exam to become a Certified Nursing Assistant (CNA).
H ealthcare knowledge progresses rapidly. Therefore, states now require minimum practice standards
for persons entering the healthcare professions, including nursing assistants/nurse aides (NA).
Those requirements include formal training and a recognized certification process. But certification
is more than just a required process; it is also long overdue, formal recognition for a group of healthcare profes-
sionals who provide hands-on care for the ill and the elderly.
Prior to 1987, there were no standards in nursing homes and the quality of care was in question. As the
public began to hear horrible stories in the media about the abuse and mistreatment of residents in nursing
homes, the government decided to step in and take action. The result was the Omnibus Budget and Reform Act
(OBRA), which required the implementation of standards for nursing homes that receive federal funds such as
Medicare or Medicaid. The act also emphasized residents’ rights, registered nurse (RN) presence, and improved
food and medical services for patients, along with better maintenance and housekeeping. Due to these new stan-
dards, states now individually regulate the training and testing of certified nursing assistants (CNAs). In August
2008, the National Council of State Boards of Nursing (NCSBN) became the exclusive owner of the National
Nurse Aide Assessment Program (NNAAP) and the Medication Aide Certification Examination (MACE).

–the nursing assistant/nurse aide exam–
NCSBN develops examination programs and admin- Career O utlook and

isters them through a contract with a national testing Ea r ni ng Potential
service.
The information in this book is based on the According to the U.S. Bureau of Labor Statistics, nurs-
national standards for CNAs, but each state specifies ing assistants held approximately 1.4 million jobs in
the amount of training, and what certification and 2006. About 53 percent of nursing assistants worked
practical skills exams CNAs must pass. Therefore, you in nursing and residential care facilities, while another
will also need to contact state or local agencies to find 29 percent worked in hospitals. Job opportunities are
out about the specific requirements in your state. excellent since they will arise from a combination of
employment growth and the need to replace many
workers who leave the occupation each year. Overall
C h a r a c t e r i s t i c s o f N ursing employment is expected to grow about 28 percent
A s s i s t a n t s / N u r s e Ai d es between 2006 and 2016, faster than the average for all
occupations. Home health aide jobs are expected to
Nursing assistants work in hospitals, long-term care grow faster than other aides due to both consumers’
facilities, and home care, often having more contact preference for home care and agencies’ cost cutting.
with patients than other members of the staff. Their Long-term care jobs for nursing assistants are expected
duties depend upon their workplaces, but the job to grow faster than average through 2016 in response
emphasis is always on the patient’s physical and emo- to the health needs of an aging population. The
tional well-being, including reporting observations of median hourly wage for nursing assistants was $10.67
changes in patient health status to the nurse. The work in 2006, with an hourly salary range of less than $7.78
can be challenging, especially when dealing with dif- to more than $14.99.
ficult patients, but most CNAs get great satisfaction
from their work. Common characteristics for this
profession include dedication, patience, compassion, Finding Out about
and reliability. Another key element is the ability to Certification Requirements
communicate and work well with others. CNAs must
also be physically able to perform a job that may Your first step in becoming a CNA is obtaining your
require standing for a good portion of their eight- state’s education and certification requirements. You
hour day, as well as lifting and moving heavy objects can do this a number of ways:
and equipment.
CNAs must participate in regular inservice edu- 1. Call your state’s nurse aide registry; each state’s
cation and performance reviews as mandated by contact information is listed at the end of this
OBRA. OBRA requires long-term care facilities to chapter.
provide a minimum of 12 hours of inservice each year 2. Contact your state or local health department;
that may consist of new skills or a review of existing most phone books list these agencies in their
skills, depending upon the facilities’ need. OBRA also blue (government) pages.
mandates retraining and the passing of a competency 3. Talk to the healthcare facility or employment
exam for CNAs who have not worked for two con- agency where you wish to work, since they will
secutive years. often guide you through the education and cer-
tification process.

Chapter 9 will give you an overview of some of ■ Military Nurse Aide: Persons who had equivalent
the current trends in CNA certification to help pre- nurse aide training and experience in a military
pare you on what to expect. service.
OBRA laws require that state registries be kept Lapsed or Expired Certification: Persons who are
■
for CNAs. Thus, these agencies are valuable resources. applying back to the state in which they were
They can provide you with information on certifica- originally certified and whose certification has
tion dates, reports of abuse and neglect, and lapse lapsed or expired (and usually who have not had
periods. You may want to contact your state registry at their certificate revoked in any state and are not
some point before you seek certification. listed on any state’s nurse aide abuse registry).
Eligibility for Certification Some states allow reciprocity for a person who is
Eligibility varies by state; however, most states have already certified as a CNA. Reciprocity means that you
multiple eligibility options. The following list repre- are asking your new state to recognize the certification
sents most types of eligibility, but you should check you received from your original certifying state. If you
with your state for its requirements. are already a CNA in good standing (no abuse or revo-
cation incidents) in another state, check with your
■ New Nursing Assistant: Persons who have never present state’s nurse aide registry.
been certified as a nursing assistant/nurse aide. Most healthcare facilities require that CNAs have
These candidates must complete a state-approved a high school diploma or GED; however, some states
nursing assistant education program prior to tak- allow persons to become CNAs at age 16. Many states
ing the exam. require that you submit to a criminal background
■ Nursing Student: Nursing students who have suc- check and/or caregiver background check, and that
cessfully completed a fundamentals of nursing you not have any exclusionary convictions on record
course through a state-approved nursing program or substantiated findings on another state registry or
within one year of applying to take the examina- licensing board.
tion, and those who have successfully completed Some states allow hospitals and other agencies to
the fundamentals course and are currently employ nursing assistants prior to their being certi-
enrolled in a nursing program. fied. Typically, the nursing assistant may be employed
■ Graduate Nurse: A person who has graduated for up to four months (120 days) while studying to
from a state-approved nursing program and who achieve certification. Check with your nurse aide
is waiting to take the state nursing licensing registry to see if your state has this option.
examination.
■ Foreign Graduate Nurse: A person who graduated
a nursing program in a foreign country and who Education and Training
is currently a nurse in that country.
Nursing Assistant in Another State: A person cur-
■ Training programs consist of 75 to 150 hours of edu-
rently certified as a nurse aide in another state cation that includes lectures and hands-on skills prac-
who is listed in that other state’s nurse aide regis- tice, as well as supervised experience in a healthcare
try (and usually who has not had their certificate setting. These programs are offered at vocational
revoked in any state and is not listed on any schools, community colleges, and some free-standing
state’s nurse aide abuse registry). private training facilities. Many long-term care facili-
ties also offer nursing assistant education. And many of

these institutions also offer refresher courses for nurs- placement service to get information about
ing assistants whose certification lapsed or expired. training.
You may be able to complete an online CNA Contact the local community college and ask if
■
preparation course, provided that you receive nurse they have a program.
aide experience and your state allows this type of pro- ■ Browse the Yellow Pages of your phone book.
gram to sit for the certification exam. Online pro-
grams allow you to study at your own pace and If allowed by your state, you may be able to plan
complete the program at your convenience, although on your own. Whether you train on your own or take
most can be finished in six to eight weeks. a course, obtain a textbook and other materials that
CNA training programs include education on the can enhance your knowledge and assist you in learn-
signs and symptoms of common diseases, as well as: ing your skills. You can purchase these at your local
bookstore or from an online bookstore. You can also
communication skills
■ look for them in your local library.
■ patient/resident rights
■ legal and ethical issues
■ the role of the nursing assistant/nurse aide How to Use This Book
■ infection control
■ bathing and dressing patients Many state and local agencies require a written exam
■ helping patients in and out of bed consisting of approximately 70 multiple-choice ques-
■ range of motion exercises tions as part of the certification process for CNAs.
■ taking vital signs—temperature, pulse, respira- This book contains five practice written exams, based
tions, and blood pressure on the national standards, that contain questions
feeding patients
■ about the skills you will use as a CNA. The written
■ measuring fluid intake and urinary output portion of the nursing assistant exam consists of
■ setup and storage of medical equipment multiple-choice questions, while the clinical portion
has you performing five on-the-job skills. Some of the
skills tested include:
Yo u r C NA P re p Pl a n
n Handwashing—this will always be one of the five
Once you know what you must do in order to be certi- skills in some states.
fied in your state, begin your CNA prep plan. First, Personal Care Skills—client bathing, grooming,
n
you need to find an appropriate training program. You dressing, toileting, skin care, nutrition, and more
can do this several ways: n Basic Nursing Skills—providing a safe and/or
clean environment, recognizing abnormal signs
■ Do a web search for “nursing assistant programs or symptoms of diseases and conditions, commu-
in [your state].” nicating with clients, understanding basic princi-
■ Contact the hospital, home healthcare agency, or ples of infection and control, and more
long-term care facility where you plan to work, n Mental Health and Social Service Needs—
and ask which programs they recommend. psychosocial characteristics of populations,
Go to a local career counseling center, state
■ identification of developmental tasks associated
employment agency, or private healthcare job with aging, behavior management, and more

n Basic Restorative Devices—use of assistive you will perform as a CNA. You may be asked to per-
devices, range of motion, client transfer, bowel form tasks like these either during a state certification
and bladder training, and care and use of pros- exam or by a prospective employer during a job inter-
thetic devices view. You should practice these tasks and become
n Client’s Rights—privacy, grievances, client and proficient enough to perform them under pressure
family group participation, physical and chem- with an examiner or your potential employer watch-
ical restraints, personal possessions, and more ing you closely. Carefully practicing these skills will
Employability Skills—acquiring and maintaining
n help you sell yourself to your employer and will put
a job you ahead of other people applying for the same posi-
tion. Keep in mind that the best-trained person is
Even if your state or agency doesn’t require a usually the one who is selected for the position.
written exam, you will find that these practice exams Here are the steps to take to become a CNA:
are a valuable way to review and solidify your skills.
Once you have completed your course of study, 1. Contact your local or state health department
you are ready to take the first practice exam in this or your state’s nurse aide registry. The list of
book. Each practice exam contains 70 multiple-choice registries follows.
questions on all aspects of the job. Allow yourself 2. Contact local employment agencies for
enough time to complete the entire exam in one sit- employment opportunities.
ting, approximately two and a half hours. 3. Take your CNA course and/or use study guides
Each practice exam has an answer key at the end, and textbooks to prepare for certification.
which not only tells you the right answer, but also 4. Take the first practice exam in this book and
explains why that answer is right. In general, you score it. Review your weakest areas.
should count yourself successful when you can score 5. Continue to review and take practice exams.
at least 75%. If you don’t get that score on the first Score yourself on each exam to see how pre-
practice exam, don’t panic! First, review the answer pared you are for the actual certification exam.
explanations to see where you went wrong. Then, see 6. Once you feel confident to take the exam, go to
which areas you did well in and which areas gave you www.pearsonvue.com and find the Candidate
more trouble. Go back to your textbook or other Handbook for your state. Read it and follow
training materials to review your weakest areas. Then the instructions. You will be scheduled for test-
take the second practice exam. You should find that ing once you submit your examination applica-
your score improves. Continue this process—review- tion, required documents and examination fee.
ing, taking a practice exam, more reviewing—until If your state is not listed, contact your state’s
you have completed all five practice exams in this nurse aide registry or health department.
book. That way you will be well prepared for any state 7. Take the certification exam and pass it!
certification exam you may have to take. 8. Present your certificate and resumes to your
Practice with the exams in this book is not a prospective employers. This shows you are
guarantee that you will pass a state certification ready to start a job and have the initiative to
exam—or get a job as a CNA. But it certainly does advance once you are hired.
bring you closer to those goals!
In addition to the practice written exams, this If you faithfully follow these steps, you will be
book also includes a sample performance assessment well on your way to a successful career as a certified
in Chapter 8. This is a sample of the kind of job tasks nursing assistant.

S t a t e N u r s i n g A s s i sta nt/ COLORADO

Colorado State Board of Nursing
N u r s e A i d e R e g i stri es 1560 Broadway, Suite 670
Denver, CO 80202
Phone: 303-894-2816
ALABAMA Fax: 303-894-2815
Alabama Certified Nurse Aide Registry
Alabama Department of Public Health CONNECTICUT
Division of Healthcare Facilities Connecticut Department of Public Health
RSO Tower, Suite 600 410 Capitol Avenue, MS 12MQA
201 Montgomery Street P.O. Box 340308
Montgomery, AL 36104 Hartford, CT 06134
Phone: 334-206-5159 Phone: 860-509-7607
Fax: 334-206-5219 Fax: 860-509-7596
ALASKA DELAWARE
Alaska Nurse Aide Registry Division of Long Term Care Residents Protection
Department of Commerce and Economic Development 3 Mill Road, Suite 308
Division of Corporations, Business and Professional Wilmington, DE 19806
Licensing Phone: 302-577-6666
550 W. 7th Avenue, Suite 1500 Fax: 302-577-6661
Anchorage, AK 99501
Phone: 907-269-8169 DISTRICT OF COLUMBIA
Fax: 907-269-8196 Pearson VUE/DC Nurse Aide Registry
P.O. Box 13785
ARIZONA Philadelphia, PA 19101
Arizona State Board of Nursing Phone: 800-475-8291
Nursing Assistant Registration Program
4747 N. 7th Street, Suite 200 FLORIDA
Phoenix, AZ 85014 Department of Health
Phone: 602-889-5150 MQA/CNA Program
Fax: 602-889-5155 4052 Bald Cypress Way, Bin C13
Tallahassee, FL 32399
ARKANSAS Phone: 850-245-4567
Arkansas Nurse Aide Registry Fax: 850-488-4281
Department of Human Services
Office of Long Term Care GEORGIA
P.O. Box 8059, Mail Slot 405 Georgia Health Partnership
Little Rock, AR 72203 Nurse Aide Registry
Phone: 501-682-8484 P.O. Box 7000
Fax: 501-682-8551 McRae, GA 31055
Phone: 800-414-4358
CALIFORNIA
Department of Health Services HAWAII
Licensing and Certification Program Department of Commercial and Consumer Affairs
Aide and Technician Certification Section Professional and Vocational Licensing Division
P.O. Box 997416 P.O. Box 3469
Sacramento, CA 95899 Honolulu, HI 96801
Phone: 916-327-2445 Phone: 808-734-2101, ext. 122
Fax: 916-552-8787

IDAHO MAINE
Idaho Nurse Aide Registry Registry of CNAs
Division of Medicaid 442 Civic Center Drive
Department of Health and Welfare #11 State House Station
P.O. Box 83720 Augusta, ME 04333
Boise, ID 83720 Phone: 207-287-9310
Phone: 208-334-6620 / 800-748-2480 Fax: 207-287-9325
Fax: 206-334-6629
MARYLAND
ILLINOIS Maryland Nurse Aide Registry
Department of Public Health 4140 Patterson Avenue
Education and Training Section Baltimore, MD 21215
525 W. Jefferson Phone: 410-585-1990 / 877-847-0626
Springfield, IL 62761
Phone: 217-785-5133 / 217-782-3070 (Auto line) MASSACHUSETTS
Nurse Aide Registry Program
INDIANA 99 Chauncy Street, 2nd Floor
State Department of Health Boston, MA 02111
Division of Long Term Care Phone: 617-753-8143
2 N. Meridian Street, Section 4B
Indianapolis, IN 46204 MICHIGAN
Phone: 800-246-8909 Michigan Department of Community Health
Fax: 317-233-7750 Bureau of Health Professionals
P.O. Box 30670
IOWA Lansing, MI 48909
Department of Inspections and Appeals Phone: 514-241-0554
Health Facilities Division
Lucas State Office Building MINNESOTA
Des Moines, IA 50319 Division of Compliance Monitoring
Phone: 515-281-4963 / 515-281-4077 Nursing Assistant Registry
P.O. Box 64501
KANSAS St. Paul, MN 55164
Department of Health and Environment Phone: 651-215-8705
1000 SW Jackson Street, Suite 330
Topeka, KS 66612 MISSISSIPPI
Phone: 785-296-6877 Mississippi State Department of Health
Bureau of Health Facilities
KENTUCKY Licensure and Certification
Kentucky Nurse Aide Registry P.O. Box 1700
312 Whittington Parkway, Suite 300-A Jackson, MS 39211
Louisville, KY 40222 Phone: 601-364-1100
Phone: 888-530-1919 Fax: 601-364-5052
Fax: 502-696-3949
MISSOURI
LOUISIANA Missouri Department of Health and Senior
Louisiana Nurse Aide Registry Services
5647 Superior Drive P.O. Box 570
Baton Rouge, LA 70808 Jefferson City, MO 65102
Phone: 225-295-8575 Phone: 573-526-8528 / 573-522-6203
Fax: 225-295-8578 Fax: 573-526-7656

MONTANA NEW YORK

Department of Public Health and Human Services Prometric
P.O. Box 202953 Attn: New York Nurse Aide Registry
2401 Colonial Drive, 2nd Floor 1260 Energy Lane
Helena, MT 59620-2953 St. Paul, MN 55108
Phone: 406-444-4980 Phone: 800-805-9128 (candidate services) / 800-321-6443
(to check on status)
NEBRASKA
Nebraska Health and Human Service System NORTH CAROLINA
Department of Regulatory and Licensure and North Carolina Department of Health and Human
Credentialing Division Services
P.O. Box 94986 Division of Health Service Regulation
Lincoln, NE 68509 Healthcare Personnel Registry Section
Phone: 402-471-0537 2719 Mail Service Center
Raleigh, NC 27619
NEVADA Phone: 919-855-3969
Nevada State Board of Nursing
2500 W. Sahara Avenue, Suite 207 NORTH DAKOTA
Las Vegas, NV 89102 North Dakota Department of Health
Phone: 702-486-5800 Division of Health Facilities
Fax: 702-486-5803 600 E. Boulevard Avenue, Department #301
Bismarck, ND 58505
NEW HAMPSHIRE Phone: 701-328-2352
New Hampshire Board of Nursing Fax: 701-328-1890
21 S. Fruit Street, Suite 16
Concord, NH 03301 OHIO
Phone: 603-271-6282 Department of Health
Fax: 603-271-6605 Nurse Aide Registry
246 N. High Street
NEW JERSEY Columbus, OH 43215
Division of Long Term Care Systems Phone: 614-752-9500 / 800-582-5908
Department of Health and Senior Services
P.O. Box 367, 120 South Stockton Street OKLAHOMA
Trenton, NJ 08625 State Department of Health
Phone: 609-633-9171 Nurse Aide Registry
Fax: 609-633-9060 / 609-633-9087 1000 NE 10th Street, Room 11
Oklahoma City, OK 73117
NEW MEXICO Phone: 405-271-4085
New Mexico Nurse Aide Registry Fax: 405-271-1130
2040 South Pacheco Street
2nd Floor, Room 413 OREGON
Santa Fe, NM 87505 Oregon State Board of Nursing
Phone: 505-476-9039 17938 SW Upper Boones Ferry Road
Fax: 505-476-9026 Portland, OR 97224
Phone: 971-67-0685
Fax: 971-673-0684

PENNSYLVANIA VERMONT
Pearson VUE Vermont State Board of Nursing
Pennsylvania Nurse Aide Registry Office of Professional Regulation
P.O. Box 13785 National Life Building, North Floor 2
Philadelphia, PA 19101 Montpelier, VT 05620
Phone: 717-772-3815 / 800-852-0518 Phone: 802-828-1505
RHODE ISLAND VIRGINIA

Rhode Island Department of Health Virginia Board of Nursing
Office of Health Professionals Regulation Nurse Aide Registry
3 Capitol Hill, Room 105 9960 Maryland Drive, Suite 300
Providence, RI 02908 Richmond, VA 23233
Phone: 401-222-5888 Phone: 804-367-4515
Fax: 401-222-3352 Fax: 804-527-4455
SOUTH CAROLINA WASHINGTON

Pearson VUE DSHS Aging and Adult Services Administration
South Carolina Nurse Aide Registry OBRA Nursing Assistant Registry
P.O. Box 13785 P.O. Box 45600
Philadelphia, PA 19101 Olympia, WA 98504
Phone: 800-475-8290 Phone: 360-725-2570
Fax: 360-493-2581
SOUTH DAKOTA
Board of Nursing WEST VIRGINIA
Nurse Aide Section Office of Health Facility
4305 S. Louise Avenue, Suite 201 Licensure and Certification
Sioux Falls, SD 57106 Capitol and Washington Street
Phone: 605-362-2760 1 Davis Square, Suite 101
Fax: 605-362-2768 Charleston, WV 25301
Phone: 304-558-0050
TENNESSEE
State of Tennessee Department of Health WISCONSIN
Nurse Aide Registry Wisconsin Department of Health Services
227 French Landing, Suite 501 Division of Quality Assurance
Heritage Place, Metrocenter 1 W. Wilson Street
Nashville, TN 37243 Madison, WI 53701
Phone: 615-532-5171 / 800-778-4504 Phone: 608-261-8319
Fax: 615-248-3601 Fax: 608-264-6340
TEXAS WYOMING
Nurse Aide Registry Wyoming State Board of Nursing
P.O. Box 149030 / Mail Code E-414 1810 Pioneer Avenue
Austin, TX 78714 Cheyenne, WY 82002
Phone: 512-231-5829 / 800-452-3934 Phone: 307-777-7601
Fax: 512-834-7674
UTAH
Health Technology Certification Center
550 East 300 South
Kaysville, UT 84037
Phone: 801-547-9947

The
2
c h a p t e r
LearningExpress
Test Preparation
System
c ha pt er Summa ry
Taking a nursing assistant certification exam can be tough, and
your career in healthcare depends on your passing the exam.
The LearningExpress Test Preparation System, developed exclusively
for LearningExpress by leading test experts, gives you the discipline
and attitude you need to succeed.
P assing the CNA certification exam is a rite of passage to your new career, and it allows you to use the
CNA credential after your name. Passing may mean more job security and a better salary, and it may
be the boost to inspire you to further your nursing career.
Like all good things, passing the exam does not come easily. You do have to work for it. But you don’t have
to work alone. The LearningExpress Test Preparation System is here to help. In just ten easy-to-follow steps, you
will learn everything you need to prepare for the exam and help you perform your best. You’ll be in control. Being
a “good test-taker” requires more than just knowing your material. It means being prepared.
Here is how the LearningExpress Test Preparation System works: Ten easy steps lead you through everything
you need to know and do to get ready to master your exam. Each step includes both reading about the step and
one or more activities. It is important that you do the activities along with the reading, or you won’t be getting
the full benefit of the system.
Step 1: Know the Potential Test-Taking Blockers

Step 2: Get Information
11

–the learningexpress test preparation system–
Step 3: Conquer Test Anxiety Take ownership of your career. While others may
Step 4: Make a Plan help you, it ultimately remains up to you to pass
Step 5: Learn to Manage Your Time the certification exam.
Step 6: Learn to Use the Process of Elimination Not preparing for the exam: Don’t be over-confi-
■
Step 7: Know When to Guess dent. Even straight-A students can fail exams if
Step 8: Reach Your Peak Performance Zone they have not prepared.
Step 9: Get Your Act Together Preparing at the last minute: Everyone is pressed
■
Step 10: Do it! for time these days, but you need to make ade-
quate time to prepare for your exam. Weeks are
If you have several hours, you can work through better than days, and days are better than hours.
the whole LearningExpress Test Preparation System in Squeezing several weeks of studying into one
one sitting. Otherwise, you can break it up and do just night only increases test anxiety. Save that last
one or two steps a day for the next several days. It is up night for a quick review and a good night’s sleep.
to you—remember, you are in control. ■ Not practicing: The more you practice nursing
assistant exam questions, the better you’ll be at
answering the ones on your certification exam.
Step 1: K n o w t h e P otential Use and reuse the practice exams in this book.
Te s t - Ta k i n g B l o c k ers You will increase your comfort level and keep get-
ting better at answering multiple-choice ques-
Activities: Think about tests you had difficulty with tions and performing job-related tasks.
in the past. Then take a look at the list of test-taking
blockers and see how many of them applied to you
back then. Now make your own list from the sugges- Step 2: Get Information
tions for correcting them, place it on your desk or
refrigerator, and start making changes. Activities: Read Chapter 1, “The Nursing Assistant
For example, if you were a negative thinker, write, Exam,” and use the suggestions there to find out
“Think Positive: I WILL pass my certification exam!” about your certification requirements.
Knowledge is power. Therefore, first, you have to find
Part A: Test-Taking Blockers out everything you can about the nursing assistant
Test taking is challenging because of the many pitfalls exam. Once you have your information, the next steps
that can keep you from doing your best. will show you what to do with it.
■ Having a negative attitude: Thinking that you will Part A: Straight Talk about the
do poorly can actually cause you to fail. Think Nursing Assistant Exam
positive. Stand in front of a mirror and say, “I will Why do you have to take this exam? One of the major
pass my nursing assistant certification exam!” objectives of OBRA was to better the quality of care
Post signs around your home and car that say, “I given to residents of long-term care facilities. Thus,
WILL pass!” Write your name with the letters OBRA requires that all nursing assistants who wish to
CNA after it. work in a long-term care facility complete a training
Not taking ownership of your career: Teachers
■ program and pass an exam to ensure they have the
don’t fail students; students fail on their own. necessary knowledge and skills to provide adequate
12

care. Individual states may or may not require certifi- Step 3: Conquer Test Anxiety
cation to work in acute care facilities (such as hospi-
tals), so you need to check your state’s requirements Activity: Take the Test Anxiety Quiz on page 14.
before embarking on the certification process. Having complete information about the exam is the
It is important for you to remember that your first step in getting control of the exam. Next, you have
score on the written exam does not determine how to overcome one of the biggest obstacles to test suc-
smart you are or even whether you will make a good cess: test anxiety. Test anxiety can not only impair your
nursing assistant. There are all kinds of things a writ- performance on the exam itself; it can even keep you
ten exam like this can’t test: whether you are likely from preparing! In this step, you will learn stress man-
to show up late or call in sick a lot, whether you can agement techniques that will help you succeed on
be patient with a trying client, or whether you can be your exam. Learn these strategies now, and practice
trusted with confidential information about people’s them as you complete the exams in this book so that
health. Those kinds of things are hard to evaluate on a they will be second nature to you by exam day.
written exam. Meanwhile, it is easy to evaluate whether
you can correctly answer questions about the job Combatting Test Anxiety
duties of a nurse aide. The first thing you need to know is that a little test
This is not to say that correctly answering the anxiety is a good thing. Everyone gets nervous before
questions on the written exam is not important! The a big exam, and if that nervousness motivates you to
knowledge tested on the exam is knowledge you will prepare thoroughly, so much the better. Many well-
need to do your job, and your ability to enter the pro- known people throughout history have experienced
fession you have trained for depends on your passing anxiety or nervousness—from performers such as
this exam. And that’s why you are here—to achieve actor Sir Laurence Olivier and singer Aretha Franklin
control over the exam. to writers such as Charlotte Brontë and Alfred Lord
Tennyson. In fact, anxiety probably gave them a little
Part B: What’s on the Test extra edge—just the kind of edge you need to do well,
The certification exam tests the skills, knowledge, and whether on a stage or in an examination room.
attitudes needed to perform as a nursing assistant. Stop here and complete the Test Anxiety Quiz on
These areas include communications, client rights, legal page 14 to find out whether your level of test anxiety
and ethical issues, the healthcare team, grooming and is something you should worry about.
dressing, hygiene, hydration and nutrition, elimination,
comfort, rest and sleep, infection control and hand- Stress Management before the Test
washing, safety, emergencies, therapeutic and technical If you feel your level of anxiety rising in the weeks
procedures, data collection and reporting, prevention, before the test, here is what you need to do to bring the
self-care and independence, mental health and emo- level down again:
tional needs, and spiritual and cultural needs.
The passing score varies by state, but the range is n Get prepared. There’s nothing like knowing what
usually from 70 to 80 percent on the written exam. to expect and being prepared for it to put you in
The acceptable score on the clinical skills portion of control of test anxiety. That’s why you are reading
the exam also varies by state from 70 to 100 percent. this book. Use it faithfully, and remind yourself
Check with your state agency to obtain information that you are better prepared than most of the
about its specific requirements. people taking the test.
13

Test Anxiety Quiz
You need to worry about test anxiety only if it is extreme enough to impair your performance. The following
questionnaire will provide a diagnosis of your level of test anxiety. In the blank before each statement, write
the number that most accurately describes your experience.
0 = Never
1 = Once or twice
2 = Sometimes
3 = Often
I have gotten so nervous before an exam that I simply put down the books and didn’t study for it.
I have experienced disabling physical symptoms such as vomiting and severe headaches because I was
nervous about an exam.
I have simply not showed up for an exam because I was scared to take it.
I have experienced dizziness and disorientation while taking an exam.
I have had trouble filling in the little circles because my hands were shaking too hard.
I have failed an exam because I was too nervous to complete it.
Total: Add up the numbers in the blanks above.
Your Test Stress Score

Here are the steps you should take, depending on your score. If you scored:
■ Below 3, your level of test anxiety is nothing to worry about; it’s probably just enough to give you that lit-
tle extra edge.
■ Between 3 and 6, your test anxiety may be enough to impair your performance, and you should practice
the stress management techniques in this section to try to bring your test anxiety down to manageable
levels.
■ Above 6, your level of test anxiety is a serious concern. In addition to practicing the stress management
techniques listed in this section, you may want to seek additional, personal help. Call your local high
school or community college and ask for the academic counselor. Tell the counselor that you have a level
of test anxiety that sometimes keeps you from being able to take the exam. The counselor may be willing
to help you or may suggest someone else you should talk to.
14

n Practice self-confidence. A positive attitude is a ing through the park, or whatever makes you feel
great way to combat test anxiety. This is no time good. Now close your eyes and imagine you are
to be humble or shy. Stand in front of the mirror actually there. If you practice in advance, you will
and say to your reflection, “I’m prepared. I’m full find that you only need a few seconds of this exer-
of self-confidence. I’m going to ace this test. I cise to experience a significant increase in your
know I can do it.” If you hear it often enough, you sense of well-being.
will come to believe it.
Fight negative messages. Every time someone
n When anxiety threatens to overwhelm you right
starts telling you how hard the exam is or how it there during the exam, there are still things you can do
is almost impossible to get a high score, start tell- to manage the stress level.
ing them your self-confidence messages. If the
someone with the negative messages is you, tell- ■ Repeat your self-confidence messages. You
ing yourself you don’t do well on exams or you should have them memorized by now. Say them
just can’t do this, don’t listen. silently to yourself, and believe them!
Visualize. Imagine yourself reporting for duty on
n Visualize one more time. This time, visualize
■
your first day as a certified nursing assistant. yourself moving smoothly and quickly through
Think of yourself helping patients and making the test answering every question correctly and
them more comfortable. Imagine coming home finishing just before time is up. Like most visual-
with your first paycheck. Visualizing success can ization techniques, this one works best if you
help make it happen—and it reminds you of why have practiced it ahead of time.
you are working so hard to pass the exam. n Find an easy question. Skim over the test until
n Exercise. Physical activity helps calm down your you find an easy question, and answer it. Getting
body and focus your mind. Besides, being in good even one circle filled in gets you into the
physical shape can actually help you do well on test-taking groove.
the exam. Go for a run, lift weights, go n Take a mental break. Everyone loses concentra-
swimming—and do it regularly. tion once in a while during a long test. It is nor-
mal, so you shouldn’t worry about it. Instead,
Stress Management on Test Day accept what has happened. Say to yourself, “Hey,
There are several ways you can bring down your level I lost it there for a minute. My brain is taking a
of test anxiety on test day. They will work best if you break.” Put down your pencil, close your eyes, and
practice them in the weeks before the test, so you do some deep breathing for a few seconds. Then
know which ones work best for you. you will be ready to go back to work.
■ Deep breathing. Take a deep breath while you Try these techniques ahead of time, and see if
count to five. Hold it for a count of one, then let they work for you!
it out for a count of five. Repeat several times.
■ Move your body. Try rolling your head in a circle.
Rotate your shoulders. Shake your hands from Step 4: Make a Plan
the wrist. Many people find these movements
very relaxing. Activity: Construct a study plan.
■ Visualize again. Think of the place where you are Maybe the most important thing you can do to get
most relaxed: lying on the beach in the sun, walk- control of yourself and your exam is to make a study
15

plan. Too many people fail to prepare simply because many pieces, how do you begin? Do you need to read
they fail to plan. Spending hours poring over sample the directions and see the diagram? Would you rather
test questions the day before the exam not only raises hear someone read the directions to you—telling you
your level of test anxiety, but also will not replace care- which part connects to another? Or do you draw your
ful preparation and practice over time. own diagram?
Don’t fall into the cram trap. Take control of The three main learning methods are visual,
your preparation time by mapping out a study auditory, and kinesthetic. Determining which type of
schedule. On pages 26 and 27 are two sample sched- learner you are will help you create tools for studying.
ules, based on the amount of time you have before
you take the written exam. If you are the kind of Visual learners need to see the information in the
person who needs deadlines and assignments to form of maps, pictures, text, or math problems.
motivate you for a project, here they are. If you are Outlining notes and important points in colorful
the kind of person who doesn’t like to follow other highlighters and taking note of diagrams and pic-
people’s plans, you can use the suggested schedules tures may be key in helping you study.
to construct your own.
Auditory learners retain information when they can
Even more important than making a plan is
hear directions, the spelling of a word, a math theo-
making a commitment. You can’t review everything
rem, or poem. Repeating information aloud or lis-
you learned in your nursing assistant course in one
tening to your notes on a tape recorder may help.
night. You need to set aside some time every day for
Many auditory learners also find working in study
study and practice. Try for at least 20 minutes a day.
groups or having someone quiz them is beneficial.
Twenty minutes daily will do you much more good
than two hours on Saturday—divide your test prepa- Kinesthetic learners must do! They might need to
ration into smaller pieces of the larger work. In addi- draw diagrams, write directions or build a model.
tion, making study notes, creating visual aids, and Rewriting notes on index cards or making margin
memorizing can be quite useful as you prepare. Each notes in your textbooks also helps kinesthetic
time you begin to study, quickly review your last les- learners to retain information.
son. This act will help you retain all you have learned
and help you assess whether you are studying effec- Mnemonics
tively. You may realize you are not remembering some Mnemonics are memory tricks that help you remem-
of the material you studied earlier. Approximately one ber what you need to know. The three basic principles
week before your exam, try to determine the areas that in the use of mnemonics are imagination, association,
are still most difficult for you. and location. Acronyms (words created from the first
Don’t put off your study until the day before the letters in a series of words) are common mnemonics.
exam. Start now. A few minutes a day, with half an One acronym you may already know is HOMES, for
hour or more on weekends, can make a big difference the names of the Great Lakes (Huron, Ontario, Mich-
in your score. igan, Erie, and Superior). ROY G. BIV reminds people
of the colors in the spectrum (Red, Orange, Yellow,
Learning Styles Green, Blue, Indigo, and Violet). Depending on the
Each of us absorbs information differently. Whichever type of learner you are, mnemonics can also be color-
way works best for you is called your dominant learn- ful or vivid images, stories, word associations, or catchy
ing method. If someone asks you to help them con- rhymes such as “Thirty days hath September . . .”
struct a bookcase they just bought that may be in created in your mind. Any type of learner, whether
16

visual, auditory, or kinesthetic, can use mnemonics to n Keep track of your place on the answer sheet. If
help the brain store and interpret information. you skip a question, make sure that you also skip
the question on the answer sheet. Check yourself
every 5–10 questions to make sure that the num-
Step 5: Learn to Manage ber of the question still corresponds with the
Your Time number on the answer sheet.
Don’t rush. Though you should keep moving,
n
Activities: Practice these strategies as you take the rushing won’t help. Try to keep calm and work
sample tests in this book. methodically and quickly.
Steps 5, 6, and 7 of the LearningExpress Test Prepara-
tion System put you in charge of your exam by show-
ing you test-taking strategies that work. Practice these Step 6: Learn to Use the
strategies as you take the sample tests in this book, and Process of Elimination
then you will be ready to use them on test day.
First, you will take control of your time on the Activity: Complete worksheet on Using the Process
exam. Most nursing assistant exams have a time limit, of Elimination (see page 20).
which may give you more than enough time to com- After time management, your next most important
plete all the questions—or may not. It is a terrible tool for taking control of your exam is using the pro-
feeling to hear the examiner say, “Five minutes left,” cess of elimination wisely. It is standard test-taking
when you are only three-quarters of the way through wisdom that you should always read all the answer
the test. Here are some tips to keep that from happen- choices before choosing your answer. This helps you
ing to you. find the right answer by eliminating wrong answer
choices. And, sure enough, that standard wisdom
n Follow directions. If the directions are given applies to your nursing assistant exam, too.
orally, listen to them. If they are written on the Let’s say you are facing a question that goes
exam booklet, read them carefully. Ask questions like this:
before the exam begins if there’s anything you
don’t understand. If you are allowed to write in Which of the following lists of signs and
your exam booklet, write down the beginning symptoms indicates a possible heart attack?
time and the ending time of the exam. a. headache, dizziness, nausea, confusion
Pace yourself. Glance at your watch every few
n b. dull chest pain, sudden sweating, difficulty
minutes, and compare the time to how far you breathing
have gotten in the test. When one-quarter of the c. wheezing, labored breathing, chest pain
time has elapsed, you should be a quarter of d. difficulty breathing, high fever, rapid pulse
the way through the test, and so on. If you are
falling behind, pick up the pace a bit. You should always use the process of elimination
n Keep moving. Don’t spend too much time on on a question like this, even if the right answer jumps
one question. If you don’t know the answer, skip out at you. Sometimes the answer that jumps out isn’t
the question and move on. Circle the number of right after all. Let’s assume, for the purpose of this
the question in your test booklet in case you have exercise, that you are a little rusty on your signs and
time to come back to it later. symptoms of a heart attack, so you need to use a little
17

intuition to make up for what you don’t remember. choice b on your answer sheet. If you have the time to
Proceed through the answer choices in order. be extra careful, you could compare your check mark
answer to your question-mark answers to make sure
n Start with choice a. This one is pretty easy to that it is better.
eliminate; none of these signs and symptoms is It is good to have a system for marking good,
likely to indicate a heart attack. Mark an X next bad, and maybe answers. We recommend this one:
to choice a so you never have to look at it
again. X = bad
n On to choice b. “Dull chest pain” looks good, 3 = good
though if you are not up on your cardiac signs ? = maybe
and symptoms, you might wonder if it should be
“acute chest pain” instead. “Sudden sweating” and If you don’t like these marks, devise your own
“difficulty breathing”? Check. And that’s what system. Just make sure you do it long before test day—
you write next to choice b—a check mark, meanwhile you are working through the practice exams
ing “good answer, I might use this one.” in this book—so you are comfortable using it during
Choice c is a possibility. Maybe you don’t really
n the test.
expect wheezing in a heart attack victim, but you
know “chest pain” is right, and let’s say you are Key Words
not sure whether “labored breathing” is a sign of Often, identifying key words in a question will help
cardiac difficulty. Put a question mark next to c, you in the process of elimination. Words such as
meaning “well, maybe.” always, never, all, only, must, and will often make state-
n Choice d is also a possibility. “Difficulty breath- ments incorrect. Here is an example of an incorrect
ing” is a good sign of a heart attack. But wait a statement:
minute. “High fever?” Not really. “Rapid pulse?”
Well, maybe. This doesn’t really sound like a heart When a nursing assistant is preparing to ambulate a
attack, and you have already got a better answer client, making sure the client is wearing proper foot-
picked out in choice b. If you are feeling sure of wear will always prevent them from falling.
yourself, put an X next to this one. If you want to
be careful, put a question mark. Now your ques- The word always in this statement makes it
tion looks like this: incorrect. Nursing assistants must also take other
measures, in addition to providing proper footwear,
Which of the following lists of signs and when ambulating a resident, such as proper body
symptoms indicates a possible heart attack? mechanics and providing support to the client.
X a. headache, dizziness, nausea, confusion Words like usually, may, sometimes, and most
3 b. dull chest pain, sudden sweating, may make a statement correct. Here is an example of
difficulty breathing a correct statement:
? c. wheezing, labored breathing, chest pain
? d. difficulty breathing, high fever, rapid Clients of healthcare facilities and hospitals may need
pulse help with tasks such as being fed and bathed.
You have just one check mark, for a good answer. The word may makes this statement correct.
If you are pressed for time, you should simply mark There are clients in facilities who may be too ill or
18

weak to perform daily tasks such as feeding and bath- guesser, complete the Your Guessing Ability worksheet
ing themselves. on page 21.
Even when you think you are absolutely clueless
about a question, you can often use the process of
elimination to get rid of at least one answer choice. If Step 8: Reach Your Peak
so, you are better prepared to make an educated guess, Perfor ma nc e Zo n e
as you will see in Step 7. More often, you can eliminate
choices until you have only two possible answers. Activity: Complete the Physical Preparation
Then you are in a strong position to guess. Checklist.
Try using your powers of elimination on the ques- To get ready for a challenge like a big exam, you have
tions in the worksheet on the following page, Using the to take control of your physical, as well as your mental,
Process of Elimination. The questions are not about state. Exercise, proper diet, and rest in the weeks prior
healthcare work; they are just designed to show you to the test will ensure that your body works with,
how the process of elimination works. The answer rather than against, your mind on test day and during
explanations for this worksheet show one possible way your preparation.
you might use the process to arrive at the right answer.
Exercise
If you don’t already have a regular exercise program
Step 7: Know When to Guess going, the time during which you are preparing for an
exam is actually an excellent time to start one. And if
Activity: Complete worksheet on Your Guessing you are already keeping fit—or trying to get that
Ability (see page 21). way—don’t let the pressure of preparing for an exam
Armed with the process of elimination, you are ready fool you into quitting now. Exercise helps reduce stress
to take control of one of the big questions in test tak- by pumping feel-good hormones called endorphins
ing: Should I guess? The answer is Yes. Some exams into your system. It also increases the oxygen supply
have what’s called a “guessing penalty,” in which a frac- throughout your body, including your brain, so you
tion of your wrong answers is subtracted from your will be at peak performance on test day.
right answers—but nursing assistant exams don’t tend A half hour of vigorous activity—enough to
to work like that. The number of questions you answer raise a sweat—every day should be your aim. If you
correctly yields your raw score. So you have nothing to are really pressed for time, every other day is OK.
lose and everything to gain by guessing. Choose an activity you like and get out there and do it.
The more complicated answer to the question Jogging with a friend always makes the time go faster,
“Should I guess?” depends on you—your personality and or take a portable music player.
your “guessing intuition.” There are two things you need But don’t overdo it. You don’t want to exhaust
to know about yourself before you go into the exam: yourself. Moderation is the key.
1. Are you a risk-taker? Diet

2. Are you a good guesser? First of all, cut out the junk. Go easy on caffeine and
nicotine, and eliminate alcohol from your system at
You will have to decide about your risk-taking least two weeks before the exam. What your body
quotient on your own. To find out if you are a good needs for peak performance is simply a balanced diet.
19

Using the Process of Elimination
Use the process of elimination to answer the following questions.

1. Ilsa is as old as Meghan will be in five years. 3. Smoking tobacco has been linked to
The difference between Ed’s age and Meghan’s a. increased risk of stroke and heart attack.
age is twice the difference between Ilsa’s age b. all forms of respiratory disease.
and Meghan’s age. Ed is 29. How old is Ilsa? c. increasing mortality rates over the past ten
a. 4 years.
b. 10 d. juvenile delinquency.
c. 19
d. 24 4. Which of the following words is spelled
correctly?
2. “All drivers of commercial vehicles must carry a a. incorrigible
valid commercial driver’s license whenever b. outragous
operating a commercial vehicle.” c. domestickated
According to this sentence, which of the d. understandible
following people need NOT carry a
commercial driver’s license?
a. a truck driver idling his engine while waiting
to be directed to a loading dock
b. a bus operator backing her bus out of the
way of another bus in the bus lot
c. a taxi driver driving his personal car to the
grocery store
d. a limousine driver taking the limousine to
her home after dropping off her last
passenger of the evening

Answers
Here are the answers, as well as some suggestions as to how you might have used the process of elimination
to find them.
1. d. You should have eliminated choice a right off choice c in the same way and be left with
the bat. Ilsa can’t be four years old if Meghan choice d.
is going to be Ilsa’s age in five years. The 2. c. Note the word not in the question, and go
best way to eliminate other answer choices is through the answers one by one. Is the truck
to try plugging them in to the information driver in choice a “operating a commercial
given in the problem. For instance, for vehicle”? Yes, idling counts as “operating,” so
choice b, if Ilsa is 10, then Meghan must be he needs to have a commercial driver’s
5. The difference between their ages is 5. The license. Likewise, the bus operator in choice b
difference between Ed’s age, 29, and is operating a commercial vehicle; the ques-
Meghan’s age, 5, is 24. Is 24 two times 5? No. tion doesn’t say the operator has to be on the
Then choice b is wrong. You could eliminate street. The limo driver in choice d is operating
20

Using the Process of Elimination (continued)
a commercial vehicle, even if it doesn’t have the rate at which people die, you might keep
a passenger in it. However, the driver in this choice as a possibility, but you would still
choice c is not operating a commercial vehi- be able to eliminate two answers and have
cle, but his own private car. only two to choose from.) And choice d is
3. a. You could eliminate choice b simply because plain silly, so you could eliminate that one,
of the presence of the word all. Such abso- too. You are left with the correct choice, a.
lutes hardly ever appear in correct answer 4. a. How you used the process of elimination here
choices. Choice c looks attractive until you depends on which words you recognized as
think a little about what you know—aren’t being spelled incorrectly. If you knew that the
fewer people smoking these days, rather correct spellings were outrageous, domesti-
than more? So how could smoking be cated, and understandable, then you were
responsible for a higher mortality rate? (If home free.
you didn’t know that mortality rate means
Your Guessing Ability

The following are ten really hard questions. You are not supposed to know the answers. Rather, this is an assessment
of your ability to guess when you don’t have a clue. Read each question carefully, as if you were expected to answer
it. If you have any knowledge of the subject, use that knowledge to help you eliminate wrong answer choices.
1. September 7 is Independence Day in 4. American author Gertrude Stein was born in

a. India. a. 1713.
b. Costa Rica. b. 1830.
c. Brazil. c. 1874.
d. Australia. d. 1901.
2. Which of the following is the formula for 5. Which of the following is NOT one of the Five
determining the momentum of an object? Classics attributed to Confucius?
a. p = MV a. I Ching
b. F = ma b. Book of Holiness
c. P = IV c. Spring and Autumn Annals
d. E = mc2 d. Book of History
3. Because of the expansion of the universe, the 6. The religious and philosophical doctrine that
stars and other celestial bodies are all moving holds that the universe is constantly in a
away from each other. This phenomenon is struggle between good and evil is known as
known as a. Pelagianism.
a. Newton’s first law. b. Manichaeanism.
b. the big bang. c. neo-Hegelianism.
c. gravitational collapse. d. Epicureanism.
d. Hubble flow.
21

Your Guessing Ability (continued)
7. The third Chief Justice of the U.S. Supreme How Did You Do?
Court was You may have simply gotten lucky and actually known
a. John Blair. the answer to one or two questions. In addition, your
b. William Cushing. guessing was probably more successful if you were
c. James Wilson. able to use the process of elimination on any of the
d. John Jay. questions. Maybe you didn’t know who the third Chief
Justice was (question 7), but you knew that John Jay
8. Which of the following is the poisonous
was the first. In that case, you would have eliminated
portion of a daffodil?
choice d and, therefore, improved your odds of
a. the bulb
guessing right from one in four to one in three.
b. the leaves
According to probability, you should get two-
c. the stem
and-a-half answers correct, so getting either two or
d. the flowers
three right would be average. If you got four or more
9. The winner of the Masters golf tournament in right, you may be a really terrific guesser. If you got
1953 was one or none right, you may be a really bad guesser.
a. Sam Snead. Keep in mind, though, that this is only a small
b. Cary Middlecoff. sample. You should continue to keep track of your
c. Arnold Palmer. guessing ability as you work through the sample
d. Ben Hogan. questions in this book. Circle the numbers of ques-
10. The state with the highest per capita personal tions you guess on as you make your guess; or, if you
income in 1980 was don’t have time while you take the practice tests, go
a. Alaska. back afterward and try to remember which questions
b. Connecticut. you guessed at. Remember, on a test with four
c. New York. answer choices, your chance of guessing correctly is
d. Texas. one in four. So keep a separate “guessing” score for
each exam. How many questions did you guess on?
Answers How many did you get right? If the number you got
Check your answers against the following correct right is at least one-fourth of the number of questions
answers. you guessed on, you are at least an average guesser—
1. c. maybe better—and you should always go ahead and
2. a. guess on the real exam. If the number you got right
3. d. is significantly lower than one-fourth of the number
4. c. you guessed on, you would be safe in guessing any-
5. b. way, but maybe you would feel more comfortable if
6. b. you guessed only selectively, when you can eliminate
7. b. a wrong answer or at least have a good feeling about
8. a. one of the answer choices.
9. d. Remember, even if you are a play-it-safe person
10. a. with lousy intuition, you are still safe guessing every
time.
22

Eat plenty of fruits and vegetables, along with protein held. Do you know how to get to the testing site? Do
and carbohydrates. you know how long it will take to get there? If not,
Make sure to eat a healthy breakfast the day make a trial run, preferably on the same day of the
of the exam. Be sure to include protein, complex week at the same time of day. Make note, on the Final
carbohydrates, and some fat. Complex carbohydrates, Preparations worksheet on page 25, of the amount of
such as whole-grain toast or oatmeal, help you feel time it will take you to get to the exam site. Plan on
energized throughout the day. arriving at least 10–15 minutes early so you can get the
lay of the land, use the bathroom, and calm down.
Rest Then figure out how early you will have to get up that
You probably know how much sleep you need every morning, and make sure you get up that early every
night to be at your best, even if you don’t always get day for a week before the exam.
it. Make sure you do get that much sleep, though, for
at least a week before the exam. Moderation is Gather Your Materials
important here, too. Extra sleep will just make you The night before the exam, lay out the clothes you will
groggy. wear and the materials you have to bring with you to
If you are not a morning person and your exam the exam. Plan on dressing in layers; you won’t have
will be given in the morning, you should reset your any control over the temperature of the examination
internal clock so that your body doesn’t think you are room. Have a sweater or jacket you can take off if it is
taking an exam at 3 a.m. You have to start this process warm. Use the checklist on the Final Preparations
well before the exam. The way it works is to get up half worksheet on page 25 to help you pull together what
an hour earlier each morning, and then go to bed half you will need.
an hour earlier that night. Don’t try it the other way
around; you will just toss and turn if you go to bed Don’t Skip Breakfast
early without having gotten up early. The next morn- Even if you don’t usually eat breakfast, do so on exam
ing, get up another half an hour earlier, and so on. morning. A cup of coffee doesn’t count. Don’t eat
How long you will have to do this depends on how late doughnuts or other sweet foods, either. A sugar high
you are used to getting up. will leave you with a sugar low in the middle of the
exam. A mix of protein and complex carbohydrates is
best: Cereal with milk, or eggs with whole-grain toast,
Step 9: Get Your Act Together will do your body a world of good.
Activity: Complete the Final Preparations worksheet.

You are in control of your mind and body; you are in Step 10: Do It!
charge of test anxiety, your preparation, and your test-
taking strategies. Now it is time to take charge of Activity: Ace the nursing assistant exam!
external factors, like the testing site and the materials Fast forward to exam day. You are ready. You made
you need to take the exam. a study plan and followed through. You practiced
your test-taking strategies while working through
Find Out Where the Test Is and Make this book. You are in control of your physical, men-
a Trial Run tal, and emotional states. You know when and where
The testing agency or your nursing assistant instructor to show up and what to bring with you. In other
will notify you when and where your exam is being words, you are better prepared than most of the
23

other people taking the nursing assistant exam with And then do it. Go into the exam, full of confi-
you. You are psyched. dence, armed with test-taking strategies you have
Just one more thing. . . When you are done with practiced until they are second nature. You are in
the exam, you deserve a reward. Plan a celebration. control of yourself, your environment, and your per-
Call up your friends and plan a party, or have a nice formance on the exam. You are ready to succeed. So
dinner for two—whatever your heart desires. Give do it. Go in there and ace the exam. And look for-
yourself something to look forward to. ward to your future career as a nursing assistant!
24

Final Preparations
Getting to the Exam Site
Location of exam site:
Date:
Departure time:
Do I know how to get to the exam site? Yes No (If no, make a trial run.)
Time it will take to get to exam site
Things to Lay Out the Night Before
Clothes I will wear
Sweater/jacket
Watch
Photo ID
Four #2 pencils
Other Things to Bring/Remember
25

Schedule A: The 30-Day Plan
If you have at least a month before you take the nursing assistant exam, you have plenty of time to prepare—as
long as you don’t waste it! If you have less than a month, turn to Schedule B.
Time Preparation
Days 1–3 Skim over a textbook or the written materials from your training program, particularly
noting any areas you expect to be emphasized on the exam or any areas you don’t
remember well.
Day 4 Take the first practice exam in Chapter 3.
Day 5 Score the first practice exam. Based on this exam, identify your strongest and weakest
areas. Pick two areas that you will concentrate on before you take the second
practice exam.
Days 6–8 Study the two areas you identified as your weak points. Don’t worry about the other areas.
Days 9–10 Take the second practice exam in Chapter 4.
Day 11 Score the second practice exam. Identify one area to concentrate on before you take the
third practice exam.
Days 12–16 Study the one area you identified for review. In addition, review both practice exams you
have taken so far, with special attention to the answer explanations.
Day 17 Take the third practice exam.
Day 18 Once again, identify one area to review, based on your score on the third practice exam.
Days 19–20 Study the one area you identified for review.
Days 21–23 Take an overview of all your training materials, consolidating your strengths and
improving on your weaknesses.
Days 24–25 Review all the areas that have given you the most trouble in the three practice exams you
have taken so far.
Day 26 Take the fourth practice exam in Chapter 6. Note how much you have improved!
Days 27–28 Review any areas in which you still feel unsure.
Day 29 Take the final practice exam.
Day before Relax. Do something unrelated to the exam and go to bed at a reasonable hour.
the exam
26

Schedule B: The 10-Day Plan
If you have two weeks or less before you take the exam, you may have your work cut out for you. Use this 10-day
schedule to help you make the most of your time.
Time Preparation
Day 1 Take the first practice exam in Chapter 3 and score it using the answer key at the end.
Identify which skill areas need the most work, based on your exam score.
Day 2 Review one area that gave you trouble on the first practice exam.
Day 3 Review another area that gave you trouble on the first practice exam.
Day 4 Take the second practice exam in Chapter 4 and score it.
Day 5 If your score on the second practice exam doesn’t show improvement on the two areas
you studied, review them. If you did improve in those areas, choose a new weak area to
study today.
Day 6 Take the third practice exam in Chapter 5 and score it.
Day 7 Choose your weakest area from the third practice exam to review.
Day 8 Review any areas that you have not yet reviewed in this schedule.
Day 9 Take the fourth practice exam in Chapter 6 and score it.
Day 10 Use your last study day to brush up on any areas that are still giving you trouble and then
take the fifth practice exam.
Day before Relax. Do something unrelated to the exam and go to bed at a reasonable hour.
the exam
27

Nursing
3
c h a p t e r
Assistant/Nurse
Aide Practice
Exam 1
c ha pt er Summa ry
This is the first of five practice exams in this book based on the
National Nurse Aide Assessment Program (NNAAP) written exam.
Use this first test to identify your areas of strength and weak-
ness.
I f you a re required to take a written exam in order to be certified, the exam you take is likely to be very
much like this one, based on the NNAAP. This exam has 70 multiple-choice questions covering the range
of duties performed by a certified nursing assistant:
n Physical Care Skills—activities of daily living, basic nursing skills, restorative skills
n Psychosocial Care Skills—emotional‑ and mental-health needs, spiritual and cultural needs
n Role of the Nurse Aide—communication, client rights, legal and ethical behavior as a member of the
healthcare team
As with the NNAAP, this exam is not divided into these sections; you may find questions on very different
topics right next to each other.
Normally you would have two hours to complete a test like this, but for now, don’t worry about timing. Just
answer all of the questions at one sitting. The answer sheet you should use for filling in your answers is on the
next page. After the exam is an answer key, with all the answers explained. These explanations will help you see
29

–nursing assistant/nurse aide practice exam 1–
your areas of strength and weakness. Then you will the question types. The chart will help you understand
know which parts of your training materials to study which kinds of questions are most difficult for you, so
before you take the second practice exam. You can you can focus on those skills for next time. Generally,
refer to the Appendix (page 131) for a breakdown of a score of 75% or higher is considered passing.
30

–nursing assistant/nurse aide answer sheet–
Practice Exam 1

1. a b c d 25.

a b c d 49.

a b c d

2. a b c d

26. a b c d

50. a b c d

3. a b c d

27. a b c d

51. a b c d
4. a b c d

28. a b c d

52. a b c d

5. a b c d

29. a b c d

53. a b c d
6. a b c d

30. a b c d 54. a b c d

7. a b c d

31. a b c d

55. a b c d

8. a b c d

32. a b c d 56. a b c d

9. a b c d

33. a b c d

57. a b c d

10.
a b c d 34. a b c d

58. a b c d

11. a b c d

35. a b c d

59. a b c d

12. a b c d 36. a b c d

60. a b c d

13. a b c d

37. a b c d

61. a b c d

14. a b c d

38. a b c d

62. a b c d

15. a b c d

39. a b c d

63. a b c d

16. a b c d

40. a b c d 64. a b c d

17. a b c d

41. a b c d

65. a b c d

18. a b c d

42. a b c d 66. a b c d

19. a b c d

43. a b c d

67. a b c d

20. a b c d

44. a b c d

68. a b c d

21. a b c d

45. a b c d

69. a b c d

22. a b c d

46. a b c d

70. a b c d

23. a b c d

47. a b c d

24. a b c d

48. a b c d
31

Practice Exam 1 6. The proper medical abbreviation for before

meals is
1. When assisting a client in learning how to use a a. p.c.
cane, the nurse aide stands b. b.i.d.
a. approximately two feet directly behind the c. a.c.
client. d. t.i.d.
b. about one foot from the client’s weak side.
c. about one foot from the client’s strong side. 7. A client diagnosed with hypertension will most
d. slightly behind the client on the client’s weak likely have a history of
side. a. low blood pressure.
b. high blood pressure.
2. When working with a client who has urinary c. low blood sugar.
retention, the nurse aide can expect that the d. high blood sugar.
client will
a. urinate large volumes. 8. A patient who has difficulty chewing or
b. be unable to urinate. swallowing will need what type of diet?
c. urinate frequently. a. clear liquid
d. be incontinent of urine. b. low residue
c. bland
3. Aging-related hearing changes result in older d. mechanical soft
clients gradually losing their ability to hear
a. high-pitched sounds. 9. An elderly resident with Alzheimer’s disease
b. low-pitched sounds. cannot find her room. How can the nurse aide
c. slow sounds. help the client feel more independent?
d. rapid sounds. a. Tell her to stay in the room.
b. Have her roommate secretly watch her.
4. The best way to safely identify your patient is by c. Place a familiar object on the client’s door.
a. asking his name. d. Write the room number on a piece of paper.
b. calling his name and waiting for his
response. 10. How often should a patient’s intake and output
c. checking the bed plate. records be totaled?
d. checking the name tag. a. once each shift
b. twice a day
5. A client is on a bowel and bladder training c. every four hours
program and has not had a bowel movement in d. every 12 hours
three days. The nurse aide should
a. report it to the charge nurse.
b. give the client an enema.
c. offer the client prune juice.
d. encourage the client to drink more fluids.
33

11. Which of the following should the nursing 16. How often should clients be repositioned
assistant observe and record when admitting a during an eight-hour shift?
client? a. q1h
a. freckles b. q2h
b. wrinkles c. q3h
c. short nails d. q4h
d. bruises
17. Which of the following is the correct procedure
12. When responding to a client on the intercom, for serving a meal to a client who must be fed?
the nursing assistant should say a. Serve the tray along with all the other trays,
a. “Hello, who is calling, please?” and then come back to feed the client.
b. “What is it that you want?” b. Bring the tray to the client last; feed after
c. “This is [nursing assistant name and you have served all the other clients.
position], can I help you?” c. Bring the tray into the room when you are
d. “Please hold; I’ll have the nurse answer your ready to feed the client.
call.” d. Have the kitchen hold the tray for one hour.
13. Which of the following things should the nurse 18. The most serious problem that wrinkles in the
aide do to familiarize new clients with their bedclothes can cause is
surroundings? a. restlessness.
a. Demonstrate the location and use of the call b. sleeplessness.
light. c. decubitus ulcers.
b. Explain that the TV is not to be used. d. bleeding and shock.
c. Instruct family to leave the room after the
aide is finished with the admission. 19. Restorative care begins
d. Raise the bed to the high position and raise a. as soon as possible.
the safety rails. b. when the client is ready.
c. when the client is discharged.
14. When arranging a client’s room, the nursing d. when the client is diagnosed as terminally ill.
assistant should do all of the following
EXCEPT 20. Before placing a client in Fowler’s position, the
a. checking the placement of the call bell. nurse aide should
b. adjusting the back rest as directed. a. open the window.
c. administering the client’s medications. b. explain the procedure to the client.
d. adjusting the lighting as appropriate. c. check with the client’s family.
d. remake the bed.
15. When assisting a client out of bed, the nurse
aide should always
a. employ body mechanic techniques.
b. get another nurse aide to assist.
c. raise the bed to its maximum height.
d. lower all safety rails.
34

21. During hand washing, the nurse aide 26. When assisting a client with eating, one of the
accidentally touches the inside of the sink while first things the nurse aide should do is
rinsing the soap off. The next action is to a. cut the food into bite-size pieces.
a. allow the water to run over the hands for b. wash his own hands and the client’s hands.
two minutes. c. butter the client’s bread.
b. dry the hands and turn off the faucet with d. provide the client with privacy.
the paper towel.
c. repeat the wash from the beginning. 27. A patient has a new cast on her right arm.
d. repeat washing, but for half the time. While caring for her, it is important to first
observe for
22. How should a nurse aide dress for a job a. pulse above the cast.
interview? b. color and hardness of the cast.
a. wearing a clean t-shirt and casual slacks c. warmth and color of fingers.
b. wearing a nurse aide uniform d. signs of crumbling at the cast end.
c. wearing a business suit, dress, or pants and
dress shirt 28. Encouraging a client to take part in activities of
d. wearing formal attire daily living (ADLs) such as bathing, combing
hair, and feeding is
23. An ambulatory client is newly admitted. Before a. done only when time permits.
leaving the client alone, the nurse aide should b. the family’s responsibility.
a. ask if the client is hungry. c. necessary for rehabilitation.
b. inspect the client’s skin. d. a violation of client rights.
c. assess the client’s intake and output.
d. make sure the client knows how to use the 29. In caring for a confused elderly man, it is
call bell. important to remember to
a. keep the bedrails up except when you are at
24. When lifting a heavy object, the correct method the bedside.
would be to bend at the b. close the door to the room so that he does
a. waist, keeping your legs straight. not disturb other patients.
b. waist, rounding your shoulders. c. keep the room dark and quiet at all times to
c. knees, keeping your back straight. keep the patient from becoming upset.
d. knees and waist. d. remind him each morning to shower and
shave independently.
25. When should nurse aides wash their hands?
a. after eating 30. Before assisting a client into a wheelchair, the
b. before using the bathroom first action would be to check if the
c. after client care a. client is adequately covered.
d. before cleaning a bedpan b. floor is slippery.
c. door to the room is closed.
d. wheels of the chair are locked.
35

31. A client has a weak left side. When transferring 35. As an afternoon snack, the kitchen sent a
the client from the bed to the wheelchair, the diabetic client a container of chocolate ice
nurse aide should stand cream. The nursing assistant should first
a. on the right side. a. substitute diet soda for the ice cream.
b. in front of the client. b. hold the afternoon snack and report to the
c. on the left side. charge nurse.
d. behind the client. c. call the kitchen and report the error.
d. allow the client to have half of the ice cream.
32. While making rounds at 5:30 a.m., a nurse aide
finds a patient lying on the floor. What should 36. When assisting a client who is using the
the nurse aide do first? commode, it is important to
a. Call 911. a. leave the call light within reach.
b. Perform CPR. b. lock the door to promote privacy.
c. Call for help. c. stand next to the client until the client is
d. Assess the client’s pulse and respirations. finished.
d. restrain the client to prevent a fall.
33. When moving a wheelchair onto an elevator,
the nurse aide should stay 37. Ensuring adequate circulation to tissues is a
a. behind the chair and pull it toward the aide. major factor in preventing skin breakdown.
b. behind the chair and push it away from the This can be accomplished by doing all of the
aide. following EXCEPT
c. in front of the client to observe the client’s a. positioning the patient every four hours.
condition. b. using mechanical aids.
d. at the side of the wheelchair while opening c. giving backrubs.
the door. d. performing active or passive ROM exercises.
34. The Foley bag must be kept lower than the 38. The purpose of cold applications is usually to
client’s bladder so that a. speed the flow of blood to the area.
a. urine will not leak out, soiling the bed. b. prevent heat exhaustion.
b. urine will not return to the bladder, causing c. prevent or reduce swelling.
infection. d. prevent the formation of scar tissue.
c. the bag will be hidden and the client will not
be embarrassed. 39. The hot water bottle is an example of a
d. the client will be more comfortable in bed. a. local dry heat application.
b. generalized dry heat application.
c. local moist heat application.
d. generalized moist heat application.
36

40. Clients receiving an enema are usually placed 45. When giving information to the charge nurse
a. on the right side. for an incident report, the nurse aide should
b. on the left side. a. write in the client’s chart that an incident
c. flat on the back. occurred.
d. in a semisitting position. b. keep the report in her personal file.
c. state the facts clearly.
41. A female client’s perineal area should be d. give her opinions as to the cause of the
cleansed before which specimen is collected? incident.
a. 24-hour urine specimen
b. midstream clean-catch urine specimen 46. All long-term-care nurse aides must be
c. pediatric routine urine specimen competency evaluated and must complete a
d. routine urine specimen distinct educational course. These requirements
are set by
42. The most common site for counting the pulse a. OBRA.
is the b. OSHA.
a. carotid artery. c. CDC.
b. femoral artery. d. FDA.
c. brachial artery.
d. radial artery. 47. A resident is blind. It is important not to
a. leave the door completely opened.
43. When counting respirations, the nurse aide b. rearrange the furniture.
should c. announce yourself before entering the room.
a. wait until after the client has exercised. d. explain the location of food on the plate,
b. not tell the patient what he is going to do. using the face of the clock to assist.
c. count five respirations and then check his
watch. 48. When family members visit a client, the visitors
d. have the client count respirations while the should
aide takes her pulse. a. stay in the day room.
b. stay a short while so as not to tire the client.
44. Which of the following is NOT the nurse aide’s c. be expected to help with care.
responsibility when caring for clients who have d. be allowed privacy with the client.
urinary catheters?
a. inserting the catheter 49. A resident asks, “If I need help during the
b. ensuring that the catheter drains properly night, who will be there?” The nursing assistant
c. preventing infection should respond,
d. recording urinary output a. “Don’t worry, you’ll be okay.”
b. “Just yell; someone will hear you.”
c. “Your roommate will probably ring the call
bell.”
d. “There are people here all night to help you.”
37

50. Which of the following is a client’s right? 55. A goal for an extended care facility (ECF)
a. having personal information kept resident is that she not swear at the nurses or
confidential aides. When she calls an aide by his name, the
b. obtaining private duty staff if desired appropriate action is to
c. knowing what is wrong with the client’s a. smile and give the appropriate reward.
roommate b. continue whatever task that is being done.
d. treating the staff any way he or she pleases c. tease the resident about not swearing.
d. tell all of the staff that she didn’t swear.
51. A resident often cries while she is receiving her
p . m . care. What should the nurse aide do? 56. An agitated resident must be turned every two
a. Tell her to stop crying. hours all night long. The first action of the
b. Ignore her and continue with her care. nurse aide when waking up this resident is to
c. Tell her jokes to make her laugh. a. turn on the light.
d. Tell her that it’s all right to cry, and that the b. speak quietly and calmly.
aide is there for her if she wants to talk. c. touch her shoulder.
d. shout her name.
52. When providing denture care, the nurse aide
must 57. If a client objects to certain food for religious
a. wash them in boiling water. or cultural reasons, the appropriate action
b. hold them under warm running water. would be to
c. dunk them in and out of cool water. a. tell him to wait for the next meal.
d. place them on a towel in the sink with cool b. offer to substitute something different for
water. him.
c. call the dietician the next day.
53. Sexuality in long-term-care clients may include d. tell him he needs to eat what is on his tray.
all of the following except
a. needing private time with a partner. 58. The client’s religion forbids eating pork. Bacon
b. caring about one’s physical appearance. is being served for breakfast. The most
c. engaging in public fondling. appropriate response is to
d. desiring sexual interaction. a. encourage the client to eat it because she
needs protein.
54. A client is scheduled for a partial bed bath. This b. tell the client it is all right since her doctor
means that the nurse aide must wash the ordered the diet.
client’s c. call the kitchen for a tray without bacon.
a. face, neck, ears, arms, and hands. d. tell the client that restrictions are not as
b. face, axillae, hands, and buttocks. important as her health.
c. face, hands, axillae, and legs.
d. face, hands, axillae, genitals, and buttocks.
38

59. Which type of communication can often be 64. A patient turns on the call light when he needs
most powerful? to urinate. The appropriate action is to
a. written a. ignore the light, since he is not the aide’s
b. verbal own client.
c. silent b. announce on the intercom that there are two
d. tactile patients ahead of him.
c. answer the call light and get the urinal.
60. A client refuses to allow the nurse aide to bathe d. answer the call light when the aide has the
her. The nurse aide tells the client that she will time.
not be allowed to eat lunch or go to bingo if she
does not have her bath. This is an example of 65. A client is on CMR and in the prone position.
a. rehabilitation. The nurse aide finds the client vomiting bright
b. discipline. red blood. The nurse aide should first
c. verbal abuse. a. clean up the vomit.
d. physical abuse. b. place the client in the side-lying position.
c. provide the client with an emesis basin.
61. On entering a room, an aide notices that the d. call the charge nurse.
client is not breathing. The aide’s first action
should be to 66. When performing catheter care, the nurse aide
a. call for help. should wash the catheter
b. lay the client down on his back. a. toward the meatus.
c. give four quick breaths. b. with Betadine soap.
d. give 8–10 abdominal thrusts. c. away from the meatus.
d. with alcohol.
62. A client’s dentures are lost. The first action
should be to 67. A nurse aide who applies restraints on a client
a. notify the administrator. without directions from the charge nurse may
b. look for them. be accused of
c. notify the doctor. a. slander.
d. notify the charge nurse. b. battery.
c. false imprisonment.
63. Nursing assistants are responsible for d. negligence.
a. planning client care.
b. doing tasks assigned by the charge nurse. 68. H.S. care is care that is given
c. performing without ever asking for help. a. before meals.
d. comparing assignments with coworkers. b. before bedtime.
c. after meals.
d. upon awakening.
39

69. The best food choices for a geriatric client with 70. A client’s family wants to talk about the client’s
no teeth would include impending death, but the client does not want
a. hamburger, french fries, corn, and ice cream. to talk about it. The family should be
b. baked chicken, dressing, green beans, and encouraged to
coconut macaroons. a. carry on the conversation away from the
c. spare ribs, macaroni and cheese, coleslaw, client.
and fruit cocktail. b. talk freely in front of the client in order to
d. baked fish, whipped potatoes, spinach help the client to accept it.
soufflé, and tapioca. c. wait until the client dies to talk about it.
d. force the client to talk about it with them.
40

Answers 17. c. An aide should not bring the tray into the
room until he has time to feed the client.
1. d. Standing slightly behind the client at her 18. c. The most serious problem that wrinkles in
weak side better enables the nurse aide to the bedclothes can cause patients are
prevent falls. decubitus ulcers, or decubiti.
2. b. Urinary retention means that the client 19. a. Restorative care begins as early as possible to
cannot urinate. This problem should be prevent further disability.
reported to the nurse as soon as it is noted. 20. b. Caregivers should always explain procedures
3. a. Age-related hearing loss, also called presbycu- first, so b is the correct answer.
sis, results in older persons gradually losing 21. c. The aide has contaminated her hands and
their ability to hear high-pitched sounds. must start over.
4. d. A confused patient may answer to any name 22. c. First impressions are critical, so nurse aides
or lie down in any bed. should wear business attire.
5. a. The nurse aide should report this problem, as 23. d. New clients should always know how to call
nurse aides cannot do any of the interventions for help before being left alone.
on their own. 24. c. Keeping the back straight forces the body to
6. c. The proper medical abbreviation for before use the strong leg muscles.
meals is a.c. 25. c. Nurse aides should wash their hands after
7. b. Hypertension is the medical term for high client care to prevent cross-contamination.
blood pressure, so the client will most likely 26. b. Always remember to consider infection
have this problem in his history, although it control.
may now be controlled with medication. 27. c. A new cast may cut off circulation. Choice c
8. d. A mechanical soft diet is easy to chew, reminds the nurse aide to check for
swallow, and digest. circulatory impairment.
9. c. A familiar object can enable the client to find 28. c. Rehabilitation should always be part of the
her room on her own, helping her feel more care plan.
independent. 29. a. Make sure to follow agency policy.
10. a. Input and output are totaled once per shift, as 30. d. Before assisting a patient into a wheelchair,
well as every 24 hours. check to see if the wheels of the chair are
11. d. Bruising may be due to accidents, abuse, locked.
medications, or illness, and should be 31. c. Assist the client at the client’s weak side.
recorded and reported. 32. d. Assess pulse and breathing first. The client
12. c. Always give your name and position when may have fainted.
answering the call bell, and politely ask the 33. a. The nurse aide must stay behind the chair to
client what she wants. control it and move it backward to prevent
13. a. Make sure clients know how to call for help. the wheels from falling into the door opening.
14. c. Nursing assistants are not allowed to 34. b. Raising the bag above the bladder level can
administer medications. lead to backflow of the urine, with its
15. a. Always use proper body mechanics when bacteria, into the bladder.
moving clients. 35. b. The nursing assistant should report this
16. b. Clients should be turned every two hours to error to the charge nurse, who in turn will
prevent decubiti. contact the kitchen and obtain the correct
nourishment.
41

36. a. The client should always have access to a 53. c. As long-term-care providers, nursing assis-
means to get help when needed. tants must respect the resident’s right to sex-
37. a. The patient must be positioned every two uality. However, engaging in public fondling
hours to prevent skin breakdown due to poor is inappropriate and may infringe on other
circulation. residents’ rights.
38. c. The purpose of cold applications is usually to 54. d. Partial bed baths are generally given before
prevent or reduce swelling. breakfast due to incontinence to help the
39. a. A hot water bottle applied by itself is local dry client feel comfortable and clean.
heat. 55. a. The nurse aide should positively reinforce the
40. b. Placing the patient on the left side allows resident’s appropriate behavior, so smiling
better entry into the colon. and rewarding her good behavior is the best
41. b. The clean-catch specimen requires cleaning action.
the perineum. 56. b. Do not startle the resident, as this may agitate
42. d. The other sites are rarely used by the nursing her. The aide should speak as he enters the
assistant. room.
43. b. Telling the patient that the aide is watching 57. b. Consideration of cultural or religious beliefs
her breathing will cause her to slightly change is important to all patients.
her breathing pattern. 58. c. The other answers do not address the
44. a. Nurse aides are not responsible for catheter resident’s right to practice her religion.
insertion. 59. c. Listening to someone shows that you are very
45. c. An incident report becomes a permanent interested in what he or she is saying.
part of the legal record. Make sure the facts 60. c. Threatening to withhold activities and food is
are clear. verbally abusive.
46. a. OBRA stands for the Omnibus Budget and 61. a. Always call for help first in an emergency.
Reform Act. 62. d. The first step for any lost belongings is always
47. b. Never rearrange the furniture in a blind to notify the charge nurse.
patient’s room after the patient settles into it. 63. b. Nursing assistants work under the supervi-
This can cause falls. sion of practical and registered nurses and
48. d. The family members should expect and be perform the tasks assigned them.
allowed private time with their loved one. 64. c. Answer any call light as soon as possible.
49. d. To make clients feel safe, assure them that 65. b. Placing the client in the side-lying position
help is there if needed. prevents aspiration of the vomitus.
50. a. Clients have a right to confidentiality. 66. c. You should follow the clean-to-dirty princi-
51. d. It is normal for a person to have moments of ple, with the meatus considered cleaner than
sadness, and it is important for the patient to the catheter tubing.
know that the nurse aide cares. 67. c. Applying restraints without an order or
52. d. Dentures are expensive. The towel prevents without consent can be considered false
breakage if dropped, and cool water prevents imprisonment.
warping. 68. b. H.S. is the abbreviation for hour of sleep.
69. d. Of the choices listed, only d is a soft diet.
70. a. If the client does not want to talk about
death, the family should be allowed to talk
privately, away from the client.
42

Nursing
4
c h a p t e r
Assistant/Nurse
Aide Practice
Exam 2
c ha pt er Summa ry
This is the second of five practice exams in this book based on the
This exam will give you more practice with the kinds of questions
you are likely to see on the exam.
L i ke the fi rst exam in this book, the exam in this chapter follows the NNAAP exam for certified nurs-
ing assistants. Now that you have taken one exam, you should be more comfortable with the format. If
you followed the advice of this book and went back to your training materials to brush up on the areas
you had trouble with in the first exam, you will probably do better on the second exam.
When you finish the exam, check your answers against the answer key that follows the exam. Read the
explanations carefully; they will help you see why you missed the questions you did. You can also use the expla-
nations to help you brush up on areas that give you trouble. Then refer to the chart in the Appendix (page 131)
to see which kinds of questions were the most difficult for you. You should also go back to review your training
materials and textbook, focusing on these areas in particular, before you take the third practice exam.
43

Practice Exam 2

1. a b c d 25.

a b c d 49.

a b c d

2. a b c d

26. a b c d

50. a b c d

3. a b c d

27. a b c d

51. a b c d
4. a b c d

28. a b c d

52. a b c d

5. a b c d

29. a b c d

53. a b c d
6. a b c d

30. a b c d 54. a b c d

7. a b c d

31. a b c d

55. a b c d

8. a b c d

32. a b c d 56. a b c d

9. a b c d

33. a b c d

57. a b c d

10.
a b c d 34. a b c d

58. a b c d

11. a b c d

35. a b c d

59. a b c d

12. a b c d 36. a b c d

60. a b c d

13. a b c d

37. a b c d

61. a b c d

14. a b c d

38. a b c d

62. a b c d

15. a b c d

39. a b c d

63. a b c d

16. a b c d

40. a b c d 64. a b c d

17. a b c d

41. a b c d

65. a b c d

18. a b c d

42. a b c d 66. a b c d

19. a b c d

43. a b c d

67. a b c d

20. a b c d

44. a b c d

68. a b c d

21. a b c d

45. a b c d

69. a b c d

22. a b c d

46. a b c d

70. a b c d

23. a b c d

47. a b c d

24. a b c d

48. a b c d
45

Practice Exam 2 6. The purpose of correctly positioning the client

is to
1. When should postmortem care be performed? a. prevent skin breakdown.
a. after the family views the body b. maintain function of joints and muscles.
b. immediately after the doctor pronounces the c. increase comfort.
patient dead d. all of the above
c. when rigor mortis sets i n
d. after the body goes to the morgue 7. A surgical bed should be left in what position?
a. Fowler’s position
2. A walker may be used if the client can b. lowest horizontal position
a. support some weight. c. semi-Fowler’s position
b. use her hands well. d. highest position
c. balance without help.
d. walk independently. 8. The preferred way to remove a bedpan from a
client who is unable to lift her buttocks is to
3. A cane should be used on a. use a mechanical lifting device.
a. the affected (weak) side of the body. b. have another nursing assistant lift the client.
b. the unaffected (strong) side of the body. c. turn the client to the side while holding
c. the side with the strongest arm. the pan.
d. the weak side one day, and the strong side d. slowly slide the pan from under the client.
the next day.
9. After shaving a patient with a safety razor, the
4. A nurse aide is collecting linens for a bed nurse aide should
change and drops a sheet on the floor. What a. cover it before discarding.
should the nurse aide do? b. wrap it in a paper towel and drop it into the
a. Ignore it and leave it on the floor. trash can.
b. Place it back on the linen cart. c. dispose of it in a sharps container.
c. Discard it in the soiled linen hamper. d. place it in the patient’s drawer for reuse.
d. Use it anyway.
10. When a client complains that his dentures are
5. When applying a cold treatment to a patient, it hurting, the appropriate action is to
is important to observe the patient closely for a. encourage him to wear the dentures more
signs of often.
a. redness. b. report the complaint to the charge nurse.
b. dizziness. c. report the complaint to the physician.
c. fainting. d. put the dentures on the bedside table.
d. cyanosis.
47

11. A nurse aide notices that a water pitcher has 16. A client’s vital signs are as follows:
spilled onto the floor. The best action for the 118/80-98.8-80-30. Which finding should be
aide to perform is to reported at once?
a. wipe it up immediately. a. blood pressure
b. cover it with a towel. b. temperature
c. notify the charge nurse. c. pulse
d. contact housekeeping. d. respiration
12. Upon entering a room, the nurse aide notices 17. All of the following can cause an inaccurate
that a patient is not breathing. The aide’s first oral temperature reading EXCEPT
action is to a. drinking a hot cup of tea ten minutes before
a. call for help. the reading.
b. lay the patient down on his back. b. using an electronic thermometer.
c. give four quick breaths. c. failing to shake down a glass thermometer.
d. give ten abdominal thrusts. d. vigorous exercise prior to the reading.
13. A patient is on bed rest, wearing a TED hose. 18. Diastolic blood pressure is determined by
How often should the hose be r emoved? a. listening for the first clear sound.
a. never b. listening for the last clear sound.
b. q2h c. subtracting the lower number from the top.
c. at least twice a day d. adding the top and bottom numbers.
d. q6h
19. All of the following are correct when
14. Decubitus ulcers can be prevented by measuring blood pressure, EXCEPT
a. changing the client’s position frequently. a. do not assess blood pressure in an arm with
b. placing an egg-crate mattress on top of the an IV running.
mattress. b. do not take the blood pressure in the same
c. increasing the patient’s vitamin C arm as where a person had a mastectomy.
consumption. c. use the biggest cuff possible to get an
d. both a and b accurate reading.
d. make sure the room is quiet so you can hear
15. The first step in getting a client up to walk is to before taking blood pressures.
a. sit the client on the side of the bed.
b. put the client’s slippers on. 20. The first step in performing any procedure
c. check the activity order. is to
d. tell the client that he will be getting up. a. explain the procedure.
b. gather needed equipment.
c. perform proper handwashing.
d. provide privacy.
48

21. Which of the following best destroys all 26. If a client cannot speak English, the nurse aide
bacteria? should
a. soaking in alcohol a. have the family interpret.
b. washing with bleach b. ask the charge nurse to arrange for an
c. sterilizing interpreter.
d. scrubbing in hot water c. call the doctor to talk to the client.
d. tell the client that she cannot answer the
22. In the event of a fire in a client’s room, the question.
nurse aide should first
a. notify the charge nurse. 27. The accepted way to identify a client is to
b. turn in a fire alarm. a. check the bed name and number.
c. get the client to a safe place. b. check the identification band.
d. use a fire extinguisher. c. ask the client’s name.
d. call the client by name.
23. Safe use of oxygen therapy includes
a. always setting the flow meter at 2–3 liters per 28. Which of the following best describes nail care?
minute. a. Nail care is not needed for the elderly.
b. using wool blankets only. b. Use scissors for all nail care.
c. cleansing the nasal prongs each shift with c. All clients need nail care.
alcohol. d. Check with the charge nurse for nail-care
d. posting a “no smoking” sign on the door. instructions.
24. During CPR, the client should be lying 29. When performing perineal care on a male
a. flat on a hard surface. client, always
b. with head and shoulders elevated. a. clean the scrotum first.
c. with feet raised on a pillow. b. retract the foreskin if uncircumcised.
d. flat on the bed to prevent injuries. c. clean from front to back.
d. hold the penis at a 90-degree angle.
25. A procedure manual is a
a. written set of instructions on how to 30. Back rubs aid in all of the following EXCEPT
perform procedures. a. improving posture.
b. set of directions needed to complete a nurse b. improving circulation.
aide’s job description. c. increasing one-to-one interaction.
c. book of directions for administering d. relaxing the client.
medications.
d. book listing the procedures a nurse aide has 31. A client’s elbows are dry and red. The nurse
been assigned to do. aide should
a. report this to the charge nurse.
b. apply lotion to the elbows.
c. apply elbow protectors.
d. perform range of motion exercises.
49

32. A decubitus ulcer can be caused by all of the 37. Which of the following provides identification
following EXCEPT of clients in long-term care facilities?
a. poor nutrition. a. identification bracelet
b. pressure on the skin. b. photograph
c. poor circulation. c. identification bracelet and photograph
d. cotton clothing. d. calling clients by name
33. The nursing assistant shampoos a client’s hair 38. Before transferring a client from the bed to a
to improve all of the following EXCEPT wheelchair, the nurse aide should sit her on the
a. circulation to the client’s scalp. edge of the bed for a few minutes to
b. the client’s general appearance. a. rearrange her gown or clothing.
c. the client’s sense of well-being. b. prevent orthostatic hypotension.
d. the rate of the client’s hair growth. c. position and secure the wheelchair.
d. rest and remove the transfer belt.
34. When removing a soiled gown from a client
who has an IV, the best action is to 39. The client’s religion forbids eating meat. Beef
a. remove the opposite arm from the gown stew is being served for lunch. The nurse aide
first. should
b. have the nurse remove the IV needle. a. tell the client to eat it because she needs
c. disconnect the bag and tubing. protein.
d. slip the gown over the IV solution bag. b. tell the client it is all right since her doctor
ordered the diet.
35. If a client does not eat all the food on his tray, c. ask the nurse to call the kitchen.
the first thing an aide should do is d. tell the client that religious restrictions are
a. notify the charge nurse. not as important as her health.
b. ask the client why he has not finished.
c. remove the tray. 40. It is important to remember that dying patients
d. urge the client to eat all the food. a. have the same needs for care as other
patients.
36. The client states that a mistake has been made: b. need to be by themselves in a quiet room.
There is salt on her tray, although the doctor c. do not need to be consulted regarding their
has ordered a low-salt diet. The nurse aide care.
should d. are usually in pain.
a. explain this means no salt when preparing
food. 41. Dying patients and their families
b. tell the client not to use the salt. a. always pass through five stages of dying in
c. check the diet order with the charge nurse. order.
d. call the kitchen for a new tray. b. always accept death before it occurs.
c. may go back and forth among the five stages.
d. must go through all stages of dying before
they die.
50

42. Which of the following is a sign of dementia in 47. A client with dementia makes sexual advances
an elderly client? toward another client who has dementia. The
a. refusing to eat a meal nurse aide should
b. not knowing who she is a. allow it; OBRA states that clients must be
c. having frequent seizures allowed to fulfill sexual needs.
d. complaining of headaches b. ask them to keep their sexual activity in a
private place.
43. Clients with Alzheimer’s disease may have all of c. ignore it so as not to embarrass them.
the following characteristics EXCEPT d. tell the charge nurse, since a client with
a. physical wasting away. dementia is unable to give consent.
b. memory loss.
c. wandering. 48. A client hits a nurse aide during lunch. The
d. irritability. appropriate response is to
a. call the charge nurse for help.
44. When a client turns on the call light every few b. continue to feed her.
minutes, the appropriate response is to c. apply a restraint.
a. ask the client not to call so often. d. yell at her to stop hitting.
b. stop by the room more often.
c. place the call light out of reach. 49. A resident is confined to her bed. What might
d. tell the client how busy the staff is. keep her from getting pressure sores?
a. a plastic draw sheet
45. The doctor writes an order for “do not b. a foot board
resuscitate” (DNR). What does this mean? c. body lotion
a. Put the client on a machine if she stops d. an air mattress
breathing.
b. The client needs to be kept alive. 50. If the client is in traction, the nurse aide should
c. CPR will not be performed. never
d. Start CPR immediately if the client stops a. monitor affected skin temperature.
breathing. b. give a total bed bath.
c. change the position of weights.
46. How a client reacts to illness and disability is d. monitor distal pulses.
most dependent on his
a. age and stage of life. 51. Security for a client’s dentures includes
b. spouse’s support. a. keeping them in a tissue in a dresser drawer.
c. income and level of education. b. placing them in a labeled denture cup.
d. support system and life history. c. insisting the resident wear the dentures.
d. placing an identifying mark on the dentures.
51

52. If family members bring new clothes in for an 57. Maintaining good interpersonal relationships
ECF resident, the nurse aide should depends on
a. put them in the resident’s dresser drawers. a. agreeing with the crowd.
b. label them with the resident’s name. b. communicating clearly with others.
c. ask the family to remove an equal number of c. following orders without question.
old clothes. d. avoiding contact after work hours.
d. make sure the charge nurse sees the clothes.
58. If a nursing assistant does not know how to
53. The charge nurse instructs the nurse aide to complete an assignment, he should
clean an ECF resident’s closet. The nurse aide a. ask another nursing assistant.
should b. ask the client for his preference.
a. ask the family to do it. c. contact the charge nurse for help.
b. get another nurse aide to do it. d. utilize a procedure manual.
c. enlist help from the client.
d. have the client do it. 59. Reporting what the client tells you is an
example of
54. Before dressing an ECF resident, the nurse aide a. subjective observation.
should b. objective observation.
a. check the order. c. primary observation.
b. choose the client’s clothes. d. secondary observation.
c. close the door.
d. report to the charge nurse. 60. Incontinence means that the patient is
a. unable to make decisions.
55. Confidentiality refers to b. unable to speak.
a. never sharing client information. c. experiencing a disorder that comes with
b. the client’s right to privacy. aging.
c. not documenting information in the client’s d. in need of medical attention.
chart.
d. the client’s right to have insurance. 61. Failure to raise the side rails on the bed of a
confused client is an act of
56. During a . m . care, the nurse aide nicks a a. malpractice.
resident while shaving him. What should she b. negligence.
do first? c. overt commission.
a. Report it to the charge nurse. d. breaking a criminal law.
b. Do nothing.
c. Apply pressure and stop the bleeding. 62. During a job interview, it is important to tell
d. Place a bandage on it. the interviewer about
a. qualifications.
b. childcare needs.
c. scheduling problems.
d. salary expectations.
52

63. When a nurse aide cannot work due to illness, 67. If a nurse aide sees another employee hit a
the nurse aide should client, the nurse aide should
a. arrange for someone to cover his or her shift. a. tell the employee to stop.
b. contact the supervisor as soon as possible. b. keep an eye out to see if it happens again.
c. call the charge nurse one hour before the c. tell another nurse aide.
shift begins. d. report it to the charge nurse immediately.
d. wait until the charge nurse calls to find out
where the aide is. 68. Which statement about mouth care for
unconscious residents is correct?
64. What is the main goal of OBRA? a. Unconscious residents may be able to hear
a. to provide a safe environment for residents you speaking to them during mouth care.
of extended-care and hospice facilities. b. Unconscious residents can both swallow
b. to provide prompt payment of care costs for and spit.
residents covered by Medicare and Medicaid. c. Unconscious residents do not need to be
c. to make sure that healthcare providers meet observed for mouth sores.
the requirements nationwide by passing a d. Unconscious residents have very moist gum
competency and skill test to provide quality tissue.
care.
d. to shorten the hospital stay of patients who 69. A hearing impaired client has the right to all of
can be attended at home by a nurse aide. the following EXCEPT
a. written notes.
65. The client asks to see a priest. The nurse aide b. an interpreter.
should c. assistance with hearing aids.
a. ask the charge nurse to call a priest. d. purchase of the most expensive hearing aid.
b. tell the client to see if a priest walks by his or
her door. 70. When documenting a client’s vital signs, the
c. call the doctor. nurse aide makes a mistake. The nurse aide
d. tell the client to call herself. should
a. cover the mistake with heavy black marker.
66. When caring for a client who has just been b. cover the mistake with correction fluid.
placed on NPO, the nurse aide should first c. make a single line over it, write “error” and
a. encourage the client not to think about food initial it.
and water. d. ignore it.
b. encourage the client to eat and drink.
c. remove the water pitcher and all items of
food and drink.
d. give the client meticulous mouth care.
53

Answers 15. c. Always make sure the resident is allowed to

get up first.
1. b. Postmortem care needs to be done before 16. d. The respiratory rate of this client is elevated.
rigor mortis sets in so that the patient’s 17. b. Electronic thermometers are commonly used
appearance can be maintained. for assessing temperature.
2. a. A resident must be able to support some 18. b. The diastolic blood pressure occurs when the
weight before using a walker. heart muscle relaxes. It is the bottom number
3. b. If the cane is not used on the strong side, the of the reading and is the last sound heard
resident may fall. before silence.
4. c. To prevent contamination and the spread of 19. c. Use a cuff that fits. If the cuff is too large, you
microorganisms, the sheet should be put in will get a reading that is too low.
the soiled linen hamper. 20. c. Infection control (handwashing) is always the
5. d. Cyanosis is an indication of poor circulation, first step in a procedure.
which could lead to tissue death. The nurse 21. c. Only sterilizing destroys bacteria.
aide should stop the treatment and report it 22. c. Always get the client to safety first.
to the charge nurse. 23. d. Choice a is wrong because the flow is set by
6. d. Correctly positioning a patient should the physician. Choice b is wrong because
prevent skin breakdown, increase comfort, wool can cause sparks, and c is wrong
and maintain the function of joints and because alcohol causes drying. Therefore,
muscles. only choice d is correct.
7. d. The bed should be level with the stretcher. 24. a. The client should be lying flat on a hard sur-
This makes a transfer safer. face to assure adequate compressions and
8. c. Turning the resident is the easiest method, blood flow.
and it is important to hold the pan to prevent 25. a. A procedure manual is a written set of
spilling the contents. instructions on how to perform procedures.
9. c. Sharps containers are puncture resistant. 26. b. It is mandatory to provide a certified inter-
They are used to prevent contact with blood preter to clients not fluent in English.
borne p athogens. 27. b. Only an identification band is a definitive
10. b. Always bring such complaints to the charge way to identify the patient. A confused
nurse. patient may answer to any name.
11. a. Take care of spills immediately, or a patient 28. c. All residents need nail care. The nursing
may be injured while waiting for house- assistant should be able to obtain informa-
keeping. tion needed from the care plan.
12. a. Call for help to activate the facility’s emer- 29. b. Material may build up under the foreskin in
gency medical services. Early activation uncircumcised males unless the foreskin is
increases the client’s chances for survival. retracted for cleaning.
13. c. To allow normal blood flow to the lower 30. a. Back rubs are not used to improve posture.
extremities, the hose should be removed 31. a. Report this to the charge nurse, since there
twice a day. are many reasons for redness.
14. d. While choices a and b are correct, there is no 32. d. Poor circulation, poor nutrition, and pressure
data to suggest that choice c is correct. on the skin all can cause decubitus ulcers.
54

33. d. Shampooing can improve circulation to the 48. a. Obtaining assistance is the only correct way
client’s scalp, the client’s general appearance, to deal with abuse by a resident.
and the client’s sense of well-being, but not a 49. d. An air mattress relieves pressure. Air pressure
client’s hair growth rate. alteration reduces pressure against the body
34. a. Remove the sleeve from the arm without to prevent circulation impairment.
tubing first. 50. c. Position of weights in traction is ordered by a
35. b. The patient may not be eating due to per- doctor. Therefore, the nursing assistant
sonal dislike of the food. Asking first allows should never change the position of weights
the nurse aide to request a replacement if the without an order.
problem is this simple. 51. b. Every resident with dentures must have a
36. c. Any diet question must be answered before labeled denture cup to ensure security of the
the resident eats. costly dentures.
37. c. Both identification bracelets and photo- 52. b. All residents have the right to their own per-
graphs are used for identification purposes in sonal possessions. Labels allow the aide to
long-term care facilities. better provide protection.
38. b. Orthostatic hypotension is the light-headed 53. c. The client has a legal right to decide what to
feeling we all get when we rise too fast. keep and what to throw away, but may need
39. c. The other answers do not address the resi- assistance in the cleaning process.
dent’s right to practice religion or her right to 54. c. Close the door to promote privacy.
choice. 55. b. Confidentiality refers to the client’s right to
40. a. Not all dying patients have the same privacy.
problems, but they have all the same care 56. c. The first step is to stop the bleeding in order
needs as anyone else. to ensure the patient’s comfort.
41. c. Because each dying resident has unique 57. b. Clear communications are key to good inter-
emotional needs, each person will go through personal relationships.
the stages at different times and in a different 58. c. Asking for help from a supervisor is a critical
order. component to career growth.
42. b. Memory loss is a sign of dementia. 59. a. Subjective observation comes from what the
43. a. Memory loss, wandering, and irritability are client tells you; objective comes from what
all signs of Alzheimer’s disease. you see, feel, or smell.
44. b. Patients who use their call bell frequently are 60. d. Incontinence is generally due to a medical
usually afraid they will be ignored if they problem. It is important to adhere to a bowel/
don’t call often. Stopping in frequently reas- bladder training program.
sures them. 61. b. Negligence is an unintentional act of injury.
45. c. “Do not resuscitate” means that no attempts 62. a. You need to “sell” yourself during the inter-
will be made to resuscitate the patient. view. Ask about benefits and your personal
46. d. A person’s total environment always affects needs after you get the job.
everything that person does and thinks. 63. b. Contact a supervisor as soon as possible, so
47. d. Clients with dementia are not able to give that a replacement can be found in a timely
consent; therefore, nurse aides have a manner.
responsibility to protect clients from sexual 64. c. All healthcare providers must be responsible
advances. for their actions.
55

65. a. It is a client’s right to have clergy available as 68. a. The last sense to leave is hearing. Speak with
requested. kindness and be aware of what you say.
66. c. NPO means nothing by mouth, so removing 69. d. The client has the right to assistance with
all food and water will reduce temptations. hearing aids, but there is no right that per-
67. d. Tell the charge nurse immediately when you tains to getting expensive options.
suspect abuse. You are legally obligated to 70. c. Charting errors are corrected by using a single
report it, and you want to do so as soon as black line through the error, marking it with
possible to prevent further abuse. the word “error,” and initialing it.
56

Nursing
5
c h a p t e r
Assistant/Nurse
Aide Practice
Exam 3
c ha pt er SU MMARY
This is the third of five practice exams in this book based on the
Use this test to identify which types of questions are still giving
you problems.
Y ou are now beginning to be very familiar with the format of the nursing assistant exam. Your prac-
tice test-taking experience will help you most, however, if you have created a situation as close as
possible to the real one.
For this third exam, simulate taking the real test. Find a quiet place where you will not be disturbed. Have
several sharpened pencils and a good eraser nearby. Complete the test in one sitting, setting a timer or a stop-
watch. You should have plenty of time to answer all of the questions when you take the real exam, but you want
to work quickly without rushing.
As before, the answer sheet you should use is on the next page. Following the exam is an answer key, with
all the answers explained. These explanations will help you see where you need to concentrate further study. Once
you have reviewed the answer explanations and referred to the question-type breakdown in the Appendix (page
131), you will know which parts of your training materials you need to concentrate on before you take the fourth
exam.
57

Practice Exam 3

1. a b c d 25.

a b c d 49.

a b c d

2. a b c d

26. a b c d

50. a b c d

3. a b c d

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30. a b c d 54. a b c d

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32. a b c d 56. a b c d

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57. a b c d

10.
a b c d 34. a b c d

58. a b c d

11. a b c d

35. a b c d

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12. a b c d 36. a b c d

60. a b c d

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61. a b c d

14. a b c d

38. a b c d

62. a b c d

15. a b c d

39. a b c d

63. a b c d

16. a b c d

40. a b c d 64. a b c d

17. a b c d

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65. a b c d

18. a b c d

42. a b c d 66. a b c d

19. a b c d

43. a b c d

67. a b c d

20. a b c d

44. a b c d

68. a b c d

21. a b c d

45. a b c d

69. a b c d

22. a b c d

46. a b c d

70. a b c d

23. a b c d

47. a b c d

24. a b c d

48. a b c d
59

Practice Exam 3 6. The nursing assistant notes that a client’s

respiratory rate is zero. The nursing assistant
1. Inactivity and immobility may cause all of the should
following EXCEPT a. resume the client’s normal care.
a. skin breakdown. b. wait 10 minutes and check the client’s
b. permanent contractures. respirations again.
c. increased intestinal peristalsis. c. inform the client’s family that the client is
d. secretions remaining in the lungs. dead.
d. contact the charge nurse immediately.
2. The nurse aide knows that the term “up ad lib”
means the client 7. After a client dies, the client’s spouse wishes to
a. is not permitted out of bed. share his emotions. The nurse aide should
b. is independent with balanced periods of rest a. listen and try to provide comfort.
and activity. b. change the subject.
c. is out of bed at mealtime only. c. tell the spouse to contact a counselor.
d. will need assistance for all activities of daily d. send him to the charge nurse.
living.
8. An example of a special device to help prevent
3. When lifting a patient, it is important to use contractures is a(n)
good body mechanics. The nurse aide should a. handroll.
a. keep the patient at arm’s length. b. doppler.
b. bend at the knees. c. air mattress.
c. twist at the waist. d. manometer.
d. move the patient rapidly.
9. Falsely stating that a coworker took a client’s
4. A common sign of approaching death is money is an example of
a. increased appetite. a. negligence.
b. normal or elevated vital signs. b. assault.
c. severe, unceasing pain. c. defamation.
d. decreased body functions. d. hoarding.
5. Tuberculosis is a disease of the 10. Hemiplegia refers to

a. throat. a. paralysis on one side of the body.
b. colon. b. paralysis of both legs.
c. lungs. c. paralysis of both arms.
d. kidney. d. paralysis of all four extremities.
61

11. The most accurate method of measuring body 16. Which of the following is an intake-and-output
temperature is problem that the nurse aide must report?
a. rectal. a. The client states that he is not hungry.
b. oral. b. The client requests a bedpan.
c. axial. c. The client has not voided in eight hours.
d. feeling the forehead. d. The client’s eight-hour output is 600 cc.
12. Which of the following sets of vital signs 17. A client’s water pitcher holds 500 cc. The
should be reported immediately? pitcher is full at the beginning of the shift, and
a. T–98.6, P–60, R–14, BP–120/60 empty halfway through the shift. The nurse
b. T–102.4, P–100, R–32, BP–180/100 refills it, and the client drinks half of the
c. T–99.6, P–80, R–16, BP–132/70 pitcher by the end of the shift. The total water
d. T–97.6, P–82, R–20, BP–110/60 intake for this client at the end of the shift is
a. 250 cc.
13. A client consumed 180 cc of tea, 60 cc of soup b. 500 cc.
and 120 cc of ice cream. What is her total fluid c. 750 cc.
intake? d. 1,000 cc.
a. 180 cc
b. 240 cc 18. The nurse aide finds a damaged piece of
c. 360 cc equipment. The nurse aide should
d. 400 cc a. dispose of it immediately.
b. use it until new equipment arrives.
14. A client is placed on strict I&O after surgery. c. report it immediately.
The nurse aide should d. repair it herself and then use it.
a. keep the client NPO.
b. record the client’s entire solid food intake. 19. After caring for a confused client, the nurse
c. record the client’s fluid intake only. aide fails to pull up the safety rails, and the
d. record the client’s fluid intake and urine client falls out of the bed and fractures a hip.
output. This is called
a. abuse.
15. Which of the following would be included in a b. negligence.
client’s output record? c. battery.
a. urine, food eaten, and IV solutions d. assault.
b. urine, emesis, and bleeding
c. liquids taken in during the shift 20. A nursing assistant is giving foot care to a
d. bowel movements only resident. What should he NOT do?
a. Remove corns.
b. Soak the resident’s feet in warm water.
c. Check for skin breakdown.
d. Clean under the toes using an orangewood
stick.
62

21. When restraints are in use, the nurse aide 26. The nurse aide notices that a client has an open
should report all of the following EXCEPT red area on her coccyx that is draining. The
a. the type of device being used. nurse aide should
b. the time the restraint was released. a. wash the area with soap and water and apply
c. unusual observations about the client’s skin. alcohol.
d. the aide’s experience with restraints. b. ask another nursing assistant to look at it
and give his opinion.
22. The pulse located in the neck is called the c. check it again at the same time the next day.
a. apical pulse. d. tell the charge nurse so she can check it.
b. femoral pulse.
c. radial pulse. 27. A nursing assistant is ambulating a client in the
d. carotid pulse. hallway. Suddenly, the client complains of chest
pain and shortness of breath. The nurse aid
23. A client complains of numbness on one side of should first
the body. The client’s grip is weak and speech is a. walk the client back to the client’s bed
slurred. The nurse aide should immediately.
a. call the doctor because the client had a CVA. b. get the sphygmomanometer and take the
b. check the blood pressure to verify it is a client’s blood pressure.
CVA. c. stay with the client and call for help.
c. check the client later to see if it may be a d. help the client to the floor and go find a
CVA. phone to call 911.
d. report it to the charge nurse immediately
because it may be a CVA. 28. A client finishes drinking a glass of cold water
just as the nurse aide arrives to take the client’s
24. When providing perineal care to a female rectal temperature. The nurse aide should
patient, it is important to wash from the front a. wait 15 minutes before taking the
to the back to avoid spreading bacteria found temperature.
in the resident’s b. give the client some warm water to counter
a. pancreas. the effect of the cold.
b. vulvus. c. report this to the charge nurse.
c. meatus. d. take the client’s rectal temperature as
d. rectum. planned.
25. The order “vital signs q.i.d.” means to record 29. Which of the following observations should be
vital signs reported immediately?
a. four times per day. a. T–98.2, P–88, R–20
b. twice per day. b. yellow-colored urine
c. morning and evening. c. bluish tint to lips and skin
d. once per shift. d. skin that is warm and dry to the touch
63

30. Microorganisms can be spread by direct and 34. A client begins to choke during feeding. The
indirect contact. An example of indirect client is conscious but unable to speak or
contact is cough. The nurse aide should
a. bathing the patient. a. shake the client and ask if the client is okay.
b. using contaminated blood. b. call the physician.
c. touching objects or dirty instruments. c. administer abdominal thrusts.
d. breathing dust particles in the air. d. sweep your finger in the client’s mouth to
check for obstruction.
31. Which statement about handwashing is
correct? 35. The nurse aide should tell the licensed nurse
a. The faucet is clean and may be touched if a patient with does not finish
when washing hands. the food on his tray.
b. Wash at least two inches above the wrist. a. stroke
c. Hands can be washed in any temperature b. cancer
water. c. diabetes
d. Hand sanitizers never substitute for d. Alzheimer’s disease
handwashing.
36. Which of the following tasks is NOT within the
32. The nursing assistant finds a client lying on the job description of the nurse aide?
floor. The nursing assistant should first a. providing the resident with ROM
a. run out of the room and get help. b. shaving the resident
b. help her up into a chair. c. applying a sterile dressing to an open wound
c. gently shake her and ask if she is okay. d. recording vital signs
d. call 911.
37. Giving good oral care to a client includes all of
33. Which statement about use of fire extinguishers the following except
is correct? a. wearing gloves.
a. Any fire extinguisher can be used on any fire. b. handling and storing dentures carefully.
b. Each extinguisher should be used for the c. using dental floss.
correct type of fire. d. removing oxygen before brushing.
c. Nurse aides are not responsible for using fire
extinguishers. 38. To prevent infection in a client with an
d. Fire extinguishers should not be used indwelling catheter, the nurse aide should
around patients. a. keep the drainage bag higher than the
bladder.
b. do perineal care from front to back as
needed.
c. let the tubing make a U loop below the bed.
d. do perineal care every other night.
64

39. A client is on a clear fluid diet. The client’s 44. When clients are in a healthcare institution, they
lunch tray may consist of can expect their treatment to conform to the
a. tea, broth, and gelatin. a. Infection Control Manual.
b. coffee, milk and soup. b. Patient’s Bill of Rights.
c. milk, soup and ice cream. c. Policy and Procedure Manual.
d. coffee, broth and crackers. d. Physician’s Code of Ethics.
40. Which statement about injuries to clients and 45. A conversation about a client in the hospital’s
staff members is correct? elevator violates the
a. Injuries should be treated and reported on a. client’s right to privacy.
an incident report. b. client’s right to medical care.
b. Injuries to staff can be ignored if they are c. client’s right to review his records.
minor. d. client’s right to ask questions.
c. Injuries should be reported only if they are
major. 46. A client constantly makes sexual remarks to
d. Injuries should be treated but do not need to staff. When discussing this at a team meeting,
be reported. the staff decides to instruct staff to call the
client by name and tell the client,
41. Lying on a job application is an example of a. “You are making me blush.”
a. tort. b. “Your comments are not acceptable.”
b. malpractice. c. “You are quite a character.”
c. fraud. d. “You should be ashamed of yourself.”
d. negligence.
47. Which of the five senses would best detect a
42. While shaving a client, the nurse aide rash?
accidentally nicks the client. The nurse aide a. sight
should b. smell
a. put alcohol on the nick. c. touch
b. report it to the charge nurse. d. hearing
c. report it to the physician.
d. ignore it, since it is just a nick. 48. The best way a nurse aide can clean an infant’s
eyes is with a(n)
43. When witnessing another aide hitting an a. cotton swab lubricated with petroleum jelly.
irritable client, the nurse aide should b. moist cotton ball, wiping from the inner to
a. tell the aide to stop. the outer corner.
b. observe the aide for a few days. c. alcohol wipe, using circular motions.
c. report it to the charge nurse. d. hot towel, wiping from the outer to the inner
d. ignore it; the client is irritable. corner.
65

49. A client who is hard of hearing repeatedly turns 54. While providing personal care for a client, the
her light on. When responding to this client’s nurse aide should
call light, the nurse aide should a. uncover the client completely so that she can
a. listen carefully to determine her needs. work quickly.
b. talk loudly so that she can hear. b. uncover only the area she is working on.
c. train her to use the call light less often. c. keep the client completely covered and work
d. tell the charge nurse that the client is under the covers.
attention seeking. d. leave the curtain open at all times.
50. Another employee asks the nurse aide what is 55. When providing morning (a.m.) care for the
wrong with a newly admitted client. What client, the nurse aide should
should the nurse aide do? a. let the client do as much as he is able to.
a. Tell the employee, since information can be b. do everything for the client so it is done
shared with coworkers. correctly.
b. Discuss the situation with the charge nurse c. care only for clients who are the same sex.
before talking to the other employee. d. work as quickly as possible.
c. Wait until break time to discuss the client
with the other employee. 56. A client with left-sided weakness should be
d. Tell the other employee that aides are not taught to
allowed to talk about the clients. a. put his right arm into his shirt first.
b. put his left arm into his shirt first.
51. Most hospital stays are c. put both arms in the shirt at the same time.
a. one w
eek. d. wear a hospital gown to make dressing
b. a few days. easier.
c. two days.
d. as long as necessary. 57. It is important not to shake linens to prevent
the spread of what type of m
icroorganisms?
52. When caring for a female client, how should a. bacteria
the nurse aide address her? b. fungi
a. “Ma’am” c. rickettsiae
b. “Miss” d. fomite
c. by her first name
d. by her surname 58. If a client objects to certain food for religious
or cultural reasons, the nurse aide should
53. A client is on a low sodium diet. The nurse aide a. tell him to consult with his doctor.
notes that the client received bacon on the b. offer to get something different for him.
breakfast tray. The nurse aide should c. tell him he will have to speak to the dietician
a. remove the bacon from the tray. tomorrow.
b. instruct the client not to eat the bacon. d. tell him he will be given a tube feeding if he
c. take the breakfast tray to the charge nurse. won’t eat.
d. take the breakfast tray back to the dietician.
66

59. A terminally ill resident refuses his bath and 63. The older adult likes to feel positive about
throws a water basin across the room. Which herself by sharing past achievements and
stage of dying does this behavior represent? experiences. The best way the nurse aide can
a. denial encourage this is by
b. anger a. pairing the older adult with another talkative
c. bargaining resident.
d. acceptance b. encouraging frequent rest periods to save
energy for socializing.
60. A terminally ill resident begs, “Please just let c. listening to the older adult’s past
me live long enough to see my granddaughter.” experiences.
Which state of dying does this behavior d. telling the older adult that aides are too busy
represent? to listen to stories.
a. denial
b. anger 64. When caring for a client who is anxious, the
c. bargaining nurse aide should do all of the following
d. acceptance EXCEPT
a. remain calm.
61. An important thing the nurse aide can do for a b. make the client stay still.
dying client is to c. provide a quiet atmosphere.
a. leave her alone to allow for privacy. d. use simple, easy to understand words.
b. give physical and emotional support.
c. encourage her to believe that a miracle may 65. A client asks the nurse aide if she could have a
occur. few minutes to pray before her bath. The best
d. force her to eat three meals a day to keep up response by the nurse aide would be to
her strength. a. tell her that her bath comes first.
b. allow her some private time to pray.
62. What is most important to show the client in c. tell her to wait until clergy visits.
his new room? d. start bathing her.
a. the television remote control
b. how to lower and raise the bed 66. During orientation to a new job, a nursing
c. the location of the call bell and how to use it assistant realizes that the work shift ends at
d. where to store personal belongings 3:30 p.m. and not 3:00 p.m. as previously
thought. The nursing assistant’s child needs to
be picked up every day at 3:15 p.m. The nursing
assistant should
a. discuss this with the charge nurse as soon as
possible.
b. ask another nursing assistant to cover after
3:00 p.m.
c. leave early, as no one is likely to notice.
d. come in 15 minutes earlier in the morning.
67

67. The best definition of a certified nursing 69. When giving a bed bath, the nurse aide should
assistant is a a. put the bed in the low position.
a. graduate nurse who is registered and b. cover the resident with a bath blanket.
licensed by the state to practice nursing. c. wash the perineal area from back to front.
b. licensed person who provides education d. place dirty towels and linens on the floor.
about special diets.
c. person who transcribes the physician’s 70. An indwelling catheter drains the bladder of
orders for patient care. a. feces.
d. person who is certified to give care under the b. emesis.
direct supervision of a registered or licensed c. urine.
practical nurse. d. blood.
68. When the nurse aide shows genuine interest

and concern for the client, this is an example of
a. honesty.
b. caring.
c. teamwork.
d. accuracy.
68

Answers 16. c. Failure to void (urinate) may indicate kidney

failure.
1. c. Intestinal peristalsis decreases with inactivity 17. c. A full water pitcher at 500 plus a half pitcher
and immobility. at 250 equals 750 cc of water.
2. b. “Up ad lib” is an activity order suggesting the 18. c. Reporting damage to equipment immediately
client can perform ADLs independently with will prevent an accident.
periods of rest as needed. 19. b. Negligence is an unintentional wrong.
3. b. It is important to use the large muscles in the 20. d. Only a podiatrist or a nurse can remove
legs and thighs to prevent back injury. corns.
4. d. As circulation slows, body functions decrease. 21. d. The aide’s experience is not part of the cli-
5. c. Tuberculosis most commonly affects the ent’s record.
lungs. A person with tuberculosis in the lungs 22. d. The carotid pulse is located in the neck.
can spread it to others through droplets in 23. d. These are all signs of a possible CVA (stroke),
respiratory secretions. and the nurse aide should report this to the
6. d. A respiratory rate of zero may signal charge nurse immediately to prevent further
approaching death; contact the charge nurse damage to the client.
immediately. 24. d. Bacteria from the rectum could cause urinary
7. a. Caring for the family is part of the job, and tract infections.
thus the nursing aide should comfort the 25. a. “Q.i.d.” means four times per day.
spouse. 26. d. An opening in the skin predisposes the client
8. a. A handroll is placed in the palm of the hand to infection and must be checked by the
to prevent the hand and fingers from con- nurse.
tracting in the flexed position. 27. c. Do not leave the client in an emergency, and
9. c. Defamation is harming a person’s reputation chest pain and dizziness may signal a myocar-
by words that you say (slander) or write dial infarction (heart attack).
(libel) intentionally. 28. d. Take the client’s rectal temperature as
10. a. Hemiplegia refers to paralysis of one side of planned, since the cool water would affect the
the body; paraplegia refers to paralysis of the oral, not rectal, reading.
legs or lower body; quadriplegia refers to 29. c. Bluish discoloration (cyanosis) indicates a
paralysis of all four extremities. low oxygen level in the body. The condition
11. a. The rectal temperature method is considered can be life threatening.
the most accurate, as the thermometer is in 30. c. Objects such as bed linens, dishes, and dirty
direct contact with membranes. instruments harbor microorganisms.
12. b. A temperature of 102.4° F is elevated. The 31. b. Hands should be washed at least up to two
patient’s pulse indicates tachycardia. The inches above the wrist.
patient also has hypertension. 32. c. Shaking and shouting helps determine if the
13. c. Ice cream is a fluid, so the client’s total intake client is conscious and oriented.
is 360 cc. 33. b. Different extinguishers are used on various
14. d. I&O refers to fluid intake and urinary output, types of fires.
as well as other outputs. 34. c. Abdominal thrusts can dislodge the
15. b. Urine, emesis, and bleeding are all considered obstruction.
output.
69

35. c. A diabetic’s blood sugar is controlled by diet 54. b. Covering the areas that the nirse aide is not
and medication. Any food not eaten will working on will allow privacy and keep the
affect the blood sugar level. body warm.
36. c. Only a licensed RN or LPN may perform 55. a. Encouraging independence allows clients
sterile p
rocedures. to feel self-worth by participating in their
37. d. Oxygen does not interfere with oral hygiene. own care.
38. b. Always wipe from front to back to prevent 56. b. The client should put the weak arm in the
rectal germs from entering the vagina or uri- shirt first.
nary tract. 57. d. Fomites are found in or on some hospital
39. a. Clear fluids are see-through. equipment.
40. a. Minor and major injuries must be 58. b. Consideration of cultural or religious beliefs
documented. is important to all clients.
41. c. Fraud denotes deception. 59. b. The client is in the anger stage of dying, and
42. b. Report it to the charge nurse; all injuries the nurse aide should acknowledge the cli-
must be reported immediately. ent’s anger and allow him to talk about it.
43. c. Abuse must be reported immediately. 60. c. In bargaining, clients want to “make a deal” with
44. b. The Patient’s Bill of Rights is a written state- someone who may be able to control their fate.
ment that includes the rights clients are enti- The nurse aide should offer realistic support.
tled to when receiving healthcare. 61. b. Physical and emotional support are vital to
45. a. Conversations regarding a client should never terminal clients.
take place in a public area such as an elevator. 62. c. Providing a means to call a nurse is important
This violates the client’s right to privacy. to avoid injury and meet the client’s needs.
46. b. The staff must tell the client that the behavior 63. c. Listening tells the clients you are interested in
is inappropriate. what they have to say.
47. a. Rashes are best detected by observation. 64. b. Forcing an anxious client to stay still may
48. b. Infants’ eyes are cleaned from inner to outer increase the client’s anxiety level.
to prevent the spread of infection. A moist 65. b. Respecting a client’s spiritual needs is an
cotton ball is soft and will not injure the eye. important aspect of the client’s care.
49. a. Listening builds trust, and continuous call 66. a. Being honest and up-front with your supervi-
bell ringing may have an underlying reason, sor is the best approach.
such as loneliness. 67. d. This is the only correct definition of a certi-
50. d. The Patient Bill of Rights assures that clients’ fied nursing assistant. The nursing assistant is
confidential information is shared only when always under the direct supervision of a
necessary for the client’s care. licensed nurse.
51. d. Hospital stays vary based on the patient’s 68. b. Nursing is caring. It is an attitude of interest
specific diagnosis and procedure. and concern.
52. d. Clients should be addressed by their sur- 69. b. Privacy and warmth are in accordance with
names (e.g., Ms. Smith). This shows that the the Patient’s Bill of Rights.
aide respects the client’s dignity. 70. c. A catheter inserted in the bladder drains urine
53. c. The client should not have the bacon; the from the body.
charge nurse is responsible for contacting the
dietician about the error.
70

Nursing
6
c h a p t e r
Assistant/Nurse
Aide Practice
Exam 4
c ha pt er SU MMARY
This is the fourth of five practice exams in this book based on the
Use this test and the question breakdown in the Appendix (p. 131)
to identify which types of questions are still giving you problems.
T hi s i s the second-to-the-last sample National Nurse Aide Assessment Program (NNAAP) written
exam in this book. It is not any harder than the other three have been. It is simply another representa-
tion of what you might expect for the real test. Just as when you go to take the real test, there shouldn’t
be anything here to surprise you. That’s the idea for the real test, too—that you won’t be surprised, so you won’t
be unprepared.
71

Practice Exam 4

1. a b c d 25.

a b c d 49.

a b c d

2. a b c d

26. a b c d

50. a b c d

3. a b c d

27. a b c d

51. a b c d
4. a b c d

28. a b c d

52. a b c d

5. a b c d

29. a b c d

53. a b c d
6. a b c d

30. a b c d 54. a b c d

7. a b c d

31. a b c d

55. a b c d

8. a b c d

32. a b c d 56. a b c d

9. a b c d

33. a b c d

57. a b c d

10.
a b c d 34. a b c d

58. a b c d

11. a b c d

35. a b c d

59. a b c d

12. a b c d 36. a b c d

60. a b c d

13. a b c d

37. a b c d

61. a b c d

14. a b c d

38. a b c d

62. a b c d

15. a b c d

39. a b c d

63. a b c d

16. a b c d

40. a b c d 64. a b c d

17. a b c d

41. a b c d

65. a b c d

18. a b c d

42. a b c d 66. a b c d

19. a b c d

43. a b c d

67. a b c d

20. a b c d

44. a b c d

68. a b c d

21. a b c d

45. a b c d

69. a b c d

22. a b c d

46. a b c d

70. a b c d

23. a b c d

47. a b c d

24. a b c d

48. a b c d
73

Practice Exam 4 6. The nurse aide, a member of the healthcare

team, can participate in the nursing process
1. The charge nurse asks the nurse aide to place a except for
client in the Fowler’s position after the client a. collecting data.
eats breakfast. How should the aide position b. planning the care.
the client? c. making observations.
a. lying with the head of the bed elevated at a d. carrying out selected interventions.
90-degree angle
b. sitting with the feet elevated at a 45-degree 7. When using crutches, the client’s weight must
angle rest on the
c. lying flat on her side a. armpit.
d. lying flat on her abdomen b. knees.
c. hand rests.
2. How many stages of death were identified by d. shoulders.
Dr. Elizabeth Kubler-Ross?
a. four 8. How often should a client be repositioned if he
b. five cannot move himself?
c. eight a. every hour
d. two b. every two hours
c. every three hours
3. A cane should be used on d. every four hours
a. the affected side.
b. the unaffected side. 9. A client who had a CVA is going through a self-
c. either side, depending on how the client care/grooming program. The main goal of this
feels. program is for the client to
d. the weak side one day and the strong side a. be discharged sooner.
the next. b. gain independence.
c. learn to accept the disability.
4. All of the following factors contribute to lack of d. improve his body image.
appetite EXCEPT
a. decreased activity. 10. The goal of bladder training is to
b. bad dentures. a. gain voluntary control of urination.
c. increased exercise. b. stop using a catheter.
d. decreased saliva. c. prevent skin problems caused by
incontinence.
5. Atrophy i s d. prevent urinary tract infections from
a. contracture. indwelling catheters.
b. orthotic.
c. muscle wasting.
d. a fracture.
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11. A resident sometimes chokes while eating. The 16. One nurse aide is assigned vital signs, while
nursing assistant should another is assigned bathing. This is an example
a. instruct his roommate to watch him eat. of which type of nursing?
b. feed him to prevent problems. a. primary
c. use the Heimlich maneuver between bites. b. secondary
d. observe him while he eats. c. team
d. modular
12. If a client complains of a burning, tingling area
on her skin, the aide should first 17. Gloves must be worn when
a. rub the area well with lotion. a. providing peri-care.
b. report the complaint to the licensed nurse. b. making beds.
c. keep an eye on the area for a few days. c. washing a resident’s hair.
d. use cornstarch on the area. d. feeding a patient.
13. When changing a pillowcase, a nurse aide 18. While the nurse aide was caring for a client for
should not hold the pillow under his chin four hours, the client asked to be taken to the
because this would bathroom every 15 minutes. The nurse aide’s
a. tear the pillowcase. best action is
b. drop the pillowcase. a. leaving the client on a padded bedpan.
c. dampen the pillowcase. b. placing the client in bed with a waterproof
d. spread bacteria. under-pad.
c. giving the client some time to rest.
14. A nonsterile dressing is one that is d. discussing this with the charge nurse.
a. wet.
b. dry. 19. An elderly resident becomes confused and
c. clean. begins to wander. The nurse aide should
d. new. a. restrain her to prevent injuries.
b. orient her to time and place.
15. When asked to clean a resident’s eye, the nurse c. tell her family about the behavior.
aide should d. report her behavior to the charge nurse.
a. clean it from the outer corner to the inner
corner. 20. The Hoyer lift is used for all of the following
b. clean it with hydrogen peroxide. purposes EXCEPT
c. use a clean surface of the cloth each time he a. preventing injuries to healthcare workers.
wipes. b. supporting ambulatory clients.
d. clean the eye with exudates first. c. moving clients who are heavy.
d. moving clients who are weak.
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21. When performing active range-of-motion 27. When having a client sit up and dangle his legs
exercises for a resident, the nurse aide should before walking, the nurse aide should observe
a. move the joints until the resident feels pain. for all of the following EXCEPT
b. keep the body exposed to prevent a. cheerfulness.
overheating. b. sudden paleness.
c. have the client do as much as she can. c. excessive sweating.
d. minimize proper body mechanics. d. increased respirations.
22. Using a broad base of support means 28. When the nurse aide is transferring a client
a. keeping the feet comfortably apart. from the bed to the wheelchair, she should
b. keeping knees locked in place. always
c. holding objects away from the body. a. unlock the brakes on the wheelchair.
d. holding feet and hands as far from the body b. lock the brakes on the wheelchair first.
as possible. c. use a Hoyer lift.
d. put socks on the client first.
23. If a client is in traction, the nursing assistant
should NOT 29. Before any transfer, the nurse aide should do all
a. give a complete bed bath. of the following EXCEPT
b. monitor affected skin color. a. have the nurse’s approval.
c. change the position of the weights. b. know the proper procedure.
d. monitor all possible distal pulses. c. use a transfer belt if needed.
d. check with the client’s physician.
24. When the nurse aide is moving the client up in
bed, the pillow goes 30. The pulse located in the wrist is called the
a. on the chair, out of the way. a. carotid pulse.
b. at the foot of the bed, out of the way. b. apical pulse.
c. at the head of the bed, to protect the head. c. femoral pulse.
d. anywhere the client wants it. d. radial pulse.
25. Dangling a client’s legs over the side of the bed 31. A patient is scheduled for an ECG. This
is done to stands for
a. make sure she is able to sit up first. a. electroencephalogram.
b. give her time to put on her shoes. b. electrocardiogram.
c. prevent decubitus ulcers. c. elastic shock.
d. prevent orthostatic hypotension. d. endoscopic gastrostomy.
26. Walking with a client is safest if done with a 32. Which of the following sets of vital signs
a. transfer belt. should be reported immediately?
b. wheelchair a few steps behind him. a. T–98.2 P–122 R–20 BP–84/40
c. Hoyer lift. b. T–99.0 P–72 R–16 BP–134/82
d. nurse or doctor ready for emergencies. c. T–98.8 P–66 R–14 BP–100/62
d. T–98.6 P–90 R–18 BP–120/70
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33. A piece of linen that is placed beneath the 39. A resident with a paralyzed left arm may be
client from shoulders to thighs is called able to feed herself if she uses a
a. an underpad. a. plate guard.
b. a spread. b. arm brace.
c. a drawsheet. c. sling.
d. a sheet. d. bib.
34. Which bedmaking procedure is used when the 40. Which statement about residents with mental
client remains in the bed? retardation is generally correct?
a. occupied bedmaking procedure a. They should be treated like children.
b. unoccupied bedmaking procedure b. They cannot walk or talk.
c. circle bedmaking procedure c. They learn at a slower pace.
d. procedure using only fitted sheets d. They are suspicious of new people.
35. Which complication may happen if a post-op 41. A diabetic client has had her leg amputated.
client does not take in adequate fluids? Her need for sexuality will
a. constipation a. be more important for a while.
b. blood clots b. be less important for a while.
c. infection c. disappear forever.
d. foot drop d. be unaffected.
36. Which type of client is most likely to have 42. Clients with Alzheimer’s disease may show
problems as a result of poor nail care? which of the following symptoms?
a. a cancer client a. high fever accompanied by chills
b. a diabetic client b. clear memory of the recent and distant past
c. a stroke client c. chest pains and difficulty breathing
d. a mentally retarded client d. physical and mental decline
37. When performing mouth care for a client with 43. If a client is upset and is yelling, the nurse aide
right-sided weakness, the nurse aide should should respond by
a. pay special attention to the left side of her a. saying sternly, “Quiet down!”
mouth. b. offering to call her doctor.
b. let her do as much of it as she can. c. shutting her door for privacy.
c. do the mouth care for her. d. calmly sitting down with the client and
d. tell her to do it herself. listening.
38. A trochanter roll is used t o 44. A common sign of depression is

a. keep the arm straight. a. attending activities daily.
b. keep the patient on the side. b. laughing and smiling.
c. keep the hip in alignment. c. decreased appetite.
d. keep the leg flexed. d. socializing with friends.
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45. A client who has just been told she is dying asks 49. A young, permanently handicapped resident
the nurse aide to help her make a list of things tends to be very quiet and act as if nothing
she wants to do before she dies. The nurse aide matters. The nurse aide can best show respect
should for her by
a. tell her to wait for her family to help her. a. including her in the plan of care.
b. tell her that the list is not necessary. b. serving her dinner first.
c. help her make the list. c. calling her by her first name.
d. tell her not to worry because she has plenty d. doing the client’s care for her.
of time.
50. An example of using body language while
46. To assist a client with his psychological needs, communicating is
the nurse aide should a. using gestures and facial expressions.
a. be a good listener and show empathy. b. writing the message on paper.
b. assure the client that everything will be okay. c. sharing your feelings and concerns.
c. maintain the client’s confidentiality. d. offering your advice and opinions.
d. encourage the client to talk to his roommate.
51. A nurse aide smiles and nods her head while
47. A Catholic client refuses to eat meat on Fridays. sitting with a client. This type of nonverbal
Her lunch one Friday consists of a roast beef communication best demonstrates
sandwich and a salad. The nurse aide should a. encouragement for the client to continue
first talking.
a. tell the client to eat only the salad. b. displeasure at having to listen to the client.
b. offer to get her a meatless lunch. c. agreement with everything that the client
c. ask family members to bring in something says.
else. d. lack of available work for the nurse aide.
d. request that a priest come and speak with
her. 52. Barriers to effective communication include
a. reflection.
48. A nurse aide enters a room and finds a patient b. clarification.
having sex with his wife. What should the nurse c. assuming.
aide do? d. listening.
a. Ask him to stop.
b. Step out of the room quietly and close 53. A client’s best friend asks the nurse aide what is
the door. wrong with the client. The nurse aide’s best
c. Report it to the charge n
urse. response is
d. Discuss it with another nurse aide. a. “I’m sorry, I’m not allowed to discuss him
with you.”
b. “You really should ask the charge nurse for
that information.”
c. “I’ll tell you, but keep it confidential.”
d. “I’m really not sure what is wrong with him.”
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54. A client who is alert and oriented refuses his 58. A former union leader was the victim of an
bath. The best response from the nurse aide is industrial accident and is now a resident. To
a. “You must take a bath every day, even if you maintain this resident’s dignity, the nurse aide
don’t want to.” may suggest that the client
b. “I doubt your roommate would appreciate a. read industrial magazines.
the smell.” b. serve on the resident council.
c. “Can you tell me why you don’t feel like c. watch business-oriented movies.
bathing today?” d. relax and play bingo.
d. “Is there something wrong with taking a
bath?” 59. A client’s daughter wants to help with her
mother’s care. The nurse aide should
55. An example of false imprisonment is a. allow her to do whatever she care she wants
a. using restraints without a doctor’s order or to do.
the client’s consent. b. tell her she cannot perform any care for her
b. closing the door to the client’s room. mother.
c. treating the client differently because of his c. let her do the bathing and dressing only.
religious beliefs. d. have her do whatever the nurse agrees to.
d. refusing to answer a call light that rings
frequently. 60. It is important to remember that a client in the
last stage of a terminal illness should
56. Another nurse aide is not providing adequate a. be left alone to grieve.
care for the residents. The nurse aide who b. be offered care to meet her physical and
notices this should emotional needs.
a. keep a list of activities not performed. c. be cared for only by relatives and close
b. tell all the other staff members. friends.
c. complete the inadequate care himself. d. not be offered any choices about her care.
d. report this to the charge nurse immediately.
61. Allowing clients to dress in their personal
57. A nurse aide notes a bright red rash on a client. clothing
This type of observation is termed a. decreases clothing costs.
a. subjective. b. improves client well-being.
b. objective. c. makes it easier to dress clients.
c. primary. d. enhances infection control.
d. secondary.
80

62. A young postoperative client has his door 67. A healthcare team includes all of the following
closed and the nurse aide needs to check his except
vital signs. The nurse aide should a. nurse aides.
a. knock on the door and wait for the client to b. registered nurses.
respond. c. receptionists.
b. assume he does not want to be disturbed d. physical therapists.
and leave him alone.
c. immediately open the door and walk in. 68. In order to keep their jobs, nurse aides will
d. knock and enter without need for a need to follow institutional guidelines that may
response. include all of the following EXCEPT
a. reporting to work on time.
63. A restraint may be used on a resident for b. following a dress code.
a. discipline. c. reporting to the charge nurse.
b. staff convenience. d. performing tasks without training.
c. roommate r equest.
d. safety. 69. Staff who are supervised by an RN a re
a. administration.
64. A client insists on wearing a striped blouse and b. physicians.
plaid pants. The nurse aide should c. assistive personnel.
a. help her choose a more appropriate outfit. d. residents.
b. tell her that she will look uncoordinated.
c. respect her clothing choice. 70. During a job interview, the nurse aide should
d. select an outfit for her. never
a. ask about possibilities for advancement.
65. Failure to perform service for which a person is b. make negative comments about former
trained is called supervisors.
a. discrimination. c. ask about job responsibilities.
b. malpractice. d. talk about his own strengths and weaknesses.
c. slander.
d. false imprisonment.
66. After assisting a client to the bedside commode,

the nurse aide should
a. leave the curtain open so she can see the
client.
b. provide privacy with the curtain pulled.
c. make the client’s bed while she is sitting on
the commode.
d. tell the client that she can use the commode
only once a shift.
81

Answers 15. c. Use a clean portion of the cloth each time

you wipe to prevent contamination.
1. a. Clients in Fowler’s position are lying with 16. d. In modular nursing, each member of the
the head of the bed elevated at a 60- to team carries out the same assigned task for all
90-degree angle. This helps prevent aspira- patients and residents.
tion after eating. 17. a. Peri-care is preformed in a body area con-
2. b. According to Dr. Kubler-Ross, there are five taminated by organisms, so you need to wear
stages of death: denial, anger, bargaining, gloves to protect yourself and other clients.
depression, and acceptance. 18. d. The charge nurse needs to assess whether this
3. b. This position will provide balance and a normal behavior for this client or if some-
support for the client. The cane should be thing is wrong.
properly fitted. 19. d. All unusual behavior should be reported for
4. c. Increased exercise burns calories, thereby evaluation.
increasing the patient’s appetite. 20. b. The Hoyer lift moves heavy or weak clients and
5. c. Muscle wasting can be prevented by provid- those with mobility issues, while at the same
ing the patient with range of motion time preventing healthcare worker injuries.
exercises. 21. c. Active range-of-motion exercises require that
6. b. The planning phase of the nursing process can the client do the exercises independently.
be done only by the registered nurse. 22. a. A broad base of having the feet 12 inches
7. c. Proper instructions for hand placement pre- apart will allow the center of gravity to assist
vent nerve damage, which may cause paraly- in the transfer.
sis to the arm. 23. c. Changing the position of weights requires a
8. b. This is the maximum time a resident should doctor’s order.
be left in one position. Frequent turning pro- 24. c. The pillow provides safety and prevents the
motes good circulation. client from striking her head on the bed.
9. b. The main goal is independence, which should 25. d. Sitting the resident on the side of the bed
improve the client’s sense of self and body allows the blood to drain to the lower extrem-
image. ities and prevents the client from fainting.
10. a. While all of these are outcomes, the main 26. a. The transfer belt provides a lift mechanism
goal of bladder training is to promote a regu- and prevents the client from falling while
lar pattern of continence. walking.
11. d. Observing the patient helps to prevent aspi- 27. a. Sudden paleness, excessive sweating, and
ration, while still allowing the client some increased respirations are signs of potential
independence in feeding himself. problems that should be reported
12. b. This may be an indication of a serious condi- immediately.
tion and should be reported immediately. 28. b. Locking the brakes will prevent the chair
13. d. Inhaling the bacteria can cause infection to from rolling and the client from falling.
the healthcare worker. 29. d. Nurse aides do not report directly to
14. c. A clean dressing is nonsterile but promotes physicians.
protection to the skin. An adhesive bandage is 30. d. Though all of the listed options are pulse
an example of a clean dressing. points, the radial pulse is located at the wrist
and is most commonly used.
82

31. b. An electrocardiogram may also be called an 47. b. The nurse aide should make every effort to
EKG. It is the apparatus used in respect the client’s religious needs.
electrocardiography. 48. b. You should respect the patient’s sexuality
32. a. The pulse indicates tachycardia and the BP is rights and leave the room.
abnormally low. These vital signs need to be 49. a. Including the client in her plan of care helps
reported immediately. the client maintain dignity and feel a sense of
33. c. The drawsheet saves on bed changes and can independence.
be used as a lift sheet to move the client in bed. 50. a. Gestures, facial expressions, and posture are
34. a. When the client is bedridden, the bed sheets all examples of body language.
need to be changed with the client in bed. This 51. a. Head nodding and smiling while someone is
is called an occupied bedmaking procedure. speaking to you demonstrates interest and
35. a. Constipation is a common post-op complica- says, “Tell me more.”
tion from the effects of anesthesia. Not taking 52. c. Making assumptions can lead to conflict and
in adequate fluids will increase the risk of this confusion.
complication. 53. b. Confidentiality is important, and the charge
36. b. Poor nail care can lead to infection in the dia- nurse can explain that to visitors.
betic client. Diabetic clients require licensed 54. c. Asking the question will help determine if
personnel to provide nail care. there are any underlying physical or psycho-
37. b. Encourage as much independence as possible. logical reasons why the client chooses not to
38. c. The trochanter roll prevents external bathe.
rotation. 55. a. False imprisonment is the act of restraining
39. a. A plate guard enables the client to better get another person.
the food off the plate with one hand. 56. d. Inadequate care may result in client neglect
40. c. In many mentally retarded clients, learning is and should be reported right away.
slower than normal, but it still occurs and 57. b. Objective information is what the nurse aide
should be encouraged. sees, smells, and feels.
41. b. The diabetic patient needs time to accept the 58. b. Since the resident is a former leader, the resi-
amputation and realize that it does not need dent may feel better if feeling useful and
to affect sexuality. involved.
42. d. The Alzheimer’s patient suffers from physical 59. d. The nurse will evaluate the client’s condition
and mental decline. and the daughter’s abilities, then decide what
43. d. Calm the patient down and allow her to voice the daughter can safely do for her mother.
her concerns in a constructive way. 60. b. Terminally ill clients have physical and emo-
44. c. Lack of appetite may be caused by many dis- tional needs that need to be met.
eases, especially depression. 61. b. Personal clothing enhances the client’s sense
45. c. The nurse aide does not know when the of well-being.
patient may die. Allow her to die with dignity 62. a. Always knock on a closed door and wait for a
and respect her wishes. response to ensure client privacy.
46. a. Listening and empathy form the foundation 63. d. Restraints should be used only when a resi-
for developing a sense of trust with clients, dent’s safety is involved. A restraint must be
and trust is critical to their psychological ordered by the physician.
well-being.
83

64. c. As long as it is a safe choice, allow the client 69. c. LPNs and CNAs are assistive personnel. The
to make personal choices. RN is responsible for delegating assignments
65. b. Malpractice is the failure to give service for to qualified staff.
which one is trained. 70. b. Saying negative comments about another
66. b. As long as the client is safe, provide privacy person during a job interview will only cast
while on the commode. a negative image upon the interviewee. Keep
67. c. The healthcare team is the group of caregiv- the interview positive.
ers involved in providing care to patients.
68. d. Nurse aides should not perform tasks for
which they have not been adequately trained.
84

Nursing
7
c h a p t e r
Assistant/Nurse
Aide Practice
Exam 5
c ha pt er SU MMARY
This is the fifth and final nursing assistant exam. By the time you
finish this exam, you should be prepared for the real thing.
T hi s i s the last sample National Nurse Aide Assesment Program (NNAAP) written exam in this book.
For this last test, pull together all the tips you have been practicing since the first test. Give yourself the
time and the space to work, perhaps in an unfamiliar location such as a library, since you won’t be tak-
ing the real test in your living room. In addition, draw on what you have learned from reading the answer expla-
nations. Remember the types of questions that tripped you up in the past, and when you are unsure, try to
consider how those answers were explained.
When you are done, check your answers and refer to the Appendix (page 131) to find out on which
sections you may need a final review. Most of all, relax. You have worked hard and have every right to be
confident—good luck!
85

Practice Exam 5

1. a b c d 25.

a b c d 49.

a b c d

2. a b c d

26. a b c d

50. a b c d

3. a b c d

27. a b c d

51. a b c d
4. a b c d

28. a b c d

52. a b c d

5. a b c d

29. a b c d

53. a b c d
6. a b c d

30. a b c d 54. a b c d

7. a b c d

31. a b c d

55. a b c d

8. a b c d

32. a b c d 56. a b c d

9. a b c d

33. a b c d

57. a b c d

10.
a b c d 34. a b c d

58. a b c d

11. a b c d

35. a b c d

59. a b c d

12. a b c d 36. a b c d

60. a b c d

13. a b c d

37. a b c d

61. a b c d

14. a b c d

38. a b c d

62. a b c d

15. a b c d

39. a b c d

63. a b c d

16. a b c d

40. a b c d 64. a b c d

17. a b c d

41. a b c d

65. a b c d

18. a b c d

42. a b c d 66. a b c d

19. a b c d

43. a b c d

67. a b c d

20. a b c d

44. a b c d

68. a b c d

21. a b c d

45. a b c d

69. a b c d

22. a b c d

46. a b c d

70. a b c d

23. a b c d

47. a b c d

24. a b c d

48. a b c d
87

Practice Exam 5 6. A client complains of a sore spot in her calf.

The nurse aide should
1. It is important to practice standard precautions a. massage her legs with lotion.
when b. ask the nurse to check the client
a. dressing a patient. immediately.
b. feeding a patient. c. have the client walk to relieve the cramp.
c. providing oral hygiene. d. assess the soreness every hour for a few
d. ambulating a patient. hours.
2. What position should a patient be in to receive 7. An example of possible contamination through

an enema? direct contact is
a. supine a. cleaning a bedpan.
b. Fowler’s b. touching used linens.
c. prone c. being sneezed on.
d. left Sim’s d. using a doorknob.
3. Which of the following lists only items that 8. A nurse aide finds smoke and flames coming
would be included in fluid intake? from a resident’s room. The nurse aide should
a. milk, ham sandwich, ice cream bar first
b. water, mashed potatoes, gelatin a. attempt to get the resident out of the room
c. milk, custard, soup and close the door.
d. orange juice, soft-boiled egg, toast b. get the fire extinguisher and put out the fire.
c. take away the resident’s cigarettes.
4. The nurse aide must use a stethoscope to d. pull the fire alarm.
determine the
a. apical pulse rate. 9. To place a client in good alignment, the nurse
b. carotid pulse rate. aide should
c. popliteal pulse rate. a. keep the client’s joints well lubricated.
d. brachial pulse rate. b. keep the client as straight as possible.
c. keep the bed linens wrinkle free.
5. Another name for urination is d. ambulate the client at least twice a day.
a. defecation.
b. voiding. 10. When dressing a client with left-sided
c. wetting the bed. weakness, it is important for the nurse aide to
d. flatus. begin dressing him
a. on the right side.
b. on the left side.
c. when he is lying flat in bed.
d. as he lies on either side.
89

11. Which of the following conditions needs to be 16. A resident is walking back and forth in the hall.
reported immediately to the charge nurse? The nurse aide should
a. rash that appears suddenly a. restrain the resident.
b. warm, dry, and pink skin b. walk with the resident.
c. tough skin on the feet c. place the resident in a locked room.
d. scarred skin d. continue to observe the client.
12. A nurse aide is making rounds at 1:00 a . m . She 17. When transferring a client, the client becomes
finds a patient lighting a cigarette. Assuming weak and begins to fall. The nurse aide’s first
smoking is allowed in the facility, what should action is to
she do? a. hold the transfer belt and lean against the
a. Scold him and tell him never to smoke wall.
unsupervised again. b. call for help.
b. Remain with the patient until he finishes c. grasp the belt and lower the client to the
smoking. floor.
c. Tell another c oworker. d. hold the client tightly to prevent falling.
d. Call the charge nurse to supervise.
18. The best way to measure accurate daily weights
13. A client with a broken hip needs an enema. The is to
best bedpan to use would be a a. weigh the client without clothing.
a. fracture pan. b. weigh the client fully clothed.
b. plastic pan. c. weigh the client at the same time each day.
c. pediatric pan. d. weigh the client after breakfast.
d. metal pan.
19. A client is sitting in her room with a doll in her
14. Which of the following is true about visually arms, stating, “My baby is sick.” What should
challenged clients? the nurse aide do?
a. They prefer to eat alone. a. Tell her not to worry because the baby will
b. They use a “clock” system to find their food. be fine.
c. They prefer to be fed. b. Tell her that the aide will call the baby’s
d. They need liquid diets. doctor.
c. Ask her if she is upset with her doll.
15. Before ambulating a client who has a Foley d. Tell her the baby is not real.
catheter, the nurse aide should first
a. clamp off the catheter and disconnect it. 20. Padded side rails are used to
b. let the bag dangle between the client’s legs. a. keep the client in bed.
c. carry the bag below bladder level. b. protect the client from injury.
d. hide the bag in a pillow case. c. provide additional warmth.
d. remind the client of home.
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21. A nurse aide is recording the output of a 26. If a resident begins to choke while being fed
resident who has a Foley catheter. She sees that and is unable to speak, the nurse aide should
the urine bag is empty. What should she do call for help and begin doing
first? a. back blows.
a. Irrigate the catheter. b. mouth-to-mouth ventilations.
b. Check for kinks in the tube. c. a finger sweep.
c. Replace the drainage bag. d. abdominal thrusts.
d. Replace the catheter.
27. When making a bed, the nurse aide should
22. In the middle of lunch, a client stands up, place the soiled linen
clutching her neck and unable to speak. The a. on the bedside table.
nurse aide should first b. on the floor.
a. call for help. c. in a laundry bag.
b. offer her a drink of water. d. in a red plastic bag.
c. hit her on the back.
d. perform the Heimlich maneuver. 28. The ABCs of emergency care stand for
a. airway, breathing, circulation.
23. A client has not had a bowel movement in five b. action before calling.
days. He may also complain of c. airway before circulation.
a. nausea. d. action, benefits, contact.
b. headache.
c. leg cramps. 29. When forcing fluids, the nurse aide should
d. chest pain. offer
a. clear fluids only.
24. A client who is weak and unsteady needs to b. at least 5,000 cc of fluid per shift.
urinate. The nurse aide can safely leave him c. fluids every hour.
alone to use a d. high-calorie fluids.
a. commode.
b. toilet. 30. When caring for a hearing-impaired client, the
c. bedpan. nursing assistant should do all of the following
d. urinal. EXCEPT
a. stand or sit facing the client.
25. For a client who is classified as wound-and- b. speak clearly and softly.
skin isolation, the soiled linen should be c. raise your voice.
a. placed in the linen hamper. d. use simple words and sentences.
b. discarded.
c. bagged before removing from the room. 31. Security for a client’s dentures includes
d. taken directly to the laundry. a. keeping them in a tissue in a dresser drawer.
b. placing them in a labeled denture cup.
c. insisting the client wear the dentures.
d. placing an identifying mark on the dentures.
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32. While caring for a client, a nurse aide 37. When bathing a client, the nurse aide
accidentally gets blood in her eyes. The nurse recognizes which of the following as the first
aide should first sign of a pressure sore?
a. rinse them out with clear water. a. redness
b. call 911. b. swelling
c. report the incident to the charge nurse. c. numbness
d. document it. d. pain
33. A client drinks four ounces of juice. The nurse 38. Nurse aides should wash their hands in all of
aide would document this as the following situations EXCEPT
a. 4 ounces. a. before going to the bathroom.
b. four ounces. b. after each client contact.
c. one cup. c. before eating.
d. 120 cc. d. after changing dressings.
34. When using client restraints, the nurse aide 39. While bathing a resident, the nursing assistant
should notices a rash on the resident’s legs. The
a. observe for skin irritation. nursing assistant should
b. disallow the client to drink. a. ignore it if the resident does not complain.
c. release the restraints every four hours. b. wash it to see if it disappears.
d. leave the client alone to rest. c. rub it with alcohol to dry it out.
d. notify the charge nurse of the rash.
35. Which of the following vital signs should be
reported immediately? 40. The nursing assistant should tell clients
a. T–98.6, P–70, R–14, BP–120/60 a. how to dress.
b. T–95.4, P–40, R–10, BP–80/40 b. how to call for help.
c. T–98.8 “R,” P–60, R–20, BP–132/70 c. that things will get better.
d. T–97.6 “ax”, P–78, R–16, BP–110/60 d. that there is nothing to worry about.
36. Examples of client abuse include all of the 41. A client begins to have a seizure while the nurse
following EXCEPT aide is bathing him. The nurse aide should
a. forcing a client’s fingers off the side rails. a. hold him down to prevent him from falling.
b. deliberately leaving the call bell out of reach. b. put a tongue depressor in his mouth.
c. turning the lights out against the client’s c. protect him from injuring himself.
wishes. d. run out of the room and get help.
d. using gloves when providing peri-care.
42. Sputum is best collected
a. just before bedtime.
b. in the afternoon.
c. upon awakening in the morning.
d. anytime.
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43. To change direction, a nurse aide should 48. Which of the following is an example of a
a. turn her whole body by moving her feet. client’s delusion?
b. twist from the waist. a. seeing demons
c. move her body in sections. b. feeling imaginary bugs crawl on his arms
d. move her body very slowly. c. thinking that the CIA is secretly watching
him
44. When repositioning a heavy client, the nurse d. hearing voices demand that he escape from
aide should the facility
a. attempt to move the client alone.
b. let the family move the client. 49. Reality orientation techniques include all of the
c. get another aide to help. following EXCEPT
d. move the client later. a. labeling items in the client’s room.
b. putting up calendars and clocks.
45. To help a client into a wheelchair, the nurse c. using familiar items in the client’s room.
aide should position the chair d. reminding a client that his spouse is
a. at the side of the bed, facing the head of deceased.
the bed.
b. at the foot of the bed. 50. A young resident with muscular dystrophy
c. at the head of the bed. talks about wanting a boyfriend. This feeling is
d. at the side of the bed, facing the foot of best described as
the bed. a. normal.
b. hopeless.
46. Transferring a client from a bed to a stretcher c. unrealistic.
requires that the nurse aide use d. confused.
a. proper body mechanics.
b. a Hoyer lift. 51. A nurse aide walks in a client masturbating in
c. a minimum of three coworkers. his bathroom. The nurse aide should
d. a mobility mattress. a. insist that the client stop.
b. ask the client why he is engaging in this
47. Which statement about dressing residents is behavior.
correct? c. report it to the charge nurse.
a. Dressing is a waste of time for a d. allow the client privacy.
handicapped resident.
b. Residents are used to dressing in front of 52. When providing postmortem care, the nurse
others. aide must
c. Residents care about what they wear. a. ensure that a family member is present.
d. Residents like the nurse aide to dress them. b. have a coworker assist her.
c. wear gloves.
d. contact the funeral director for instructions.
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53. Which statement about bathing unconscious 58. When giving a client a bath, the nurse aide
clients is correct? should do all of the following EXCEPT
a. Unconscious clients may be able to hear you a. ensuring the client’s privacy.
speaking to them during the bath. b. checking the water temperature.
b. Unconscious clients can turn in bed when c. gathering all supplies before starting.
asked. d. performing a mental status exam.
c. Unconscious clients do not need to be
observed for decubiti. 59. A client who is eating poorly should be offered
d. Unconscious clients have very moist skin. a. vitamin pills.
b. tube feeding.
54. A client wants to know what is wrong with his c. clear broth.
roommate. The nurse aide’s best response is d. dietary supplements.
a. “It is really nothing for you to worry about.”
b. “I’ll check with his doctor for you.” 60. What are the signs of death?
c. “Sorry, I can’t share that information with a. convulsions
you.” b. loss of consciousness
d. “You can call his doctor and ask yourself.” c. no respirations, pulse, or blood pressure
d. no response when you call the patient
55. The care plan includes all of the following
EXCEPT 61. On Good Friday, a Catholic client is served
a. the nursing diagnosis. chicken and requests a meatless meal. The
b. short- and long-term g oals. nurse aide should
c. cost of the hospital s tay. a. offer to get another meal within the client’s
d. scheduled appointments for the resident. diet.
b. call the client’s priest for a dispensation.
56. A ten-month-old baby cries and pulls at his left c. tell the client that it is all right since she is in
ear. The nurse aide should the hospital.
a. give the baby ear drops. d. tell her the aide will check with the dietician
b. put a warm cloth on the baby’s ear. for the next day’s meal.
c. give the baby a bottle.
d. report it to the charge nurse. 62. A client is observing the Islamic holy month of
Ramadan by fasting from sunup to sundown.
57. A client is hard of hearing and repeatedly turns The most appropriate action for the nurse aide
her call light on. The nurse aide should would be to
a. take time to listen to her to determine her a. contact the dietician for a special tray.
needs. b. report this to the charge nurse.
b. talk loudly to her since she is hard of c. find out what the client may eat and drink.
hearing. d. inform the client that she must eat her
c. unplug the call light. prescribed diet.
d. tell the supervisor that the client is
uncooperative.
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63. An ECF resident tells the nurse aide something 67. A resident refuses to go to physical therapy one
about her family in confidence. The nurse aide morning. The nurse aide reports this to the
a. can tell any staff member. charge nurse, who discusses this with the
b. ethically cannot tell anyone else. resident. The resident states that she will go to
c. can tell the charge nurse only. physical therapy the next day. The nurse aide
d. can tell anyone who does not know the understands that the resident
resident. a. has the right to refuse treatment.
b. should not be given choices in his therapy.
64. A nurse aide observes a client falling in the c. does not have the right to refuse therapy.
hallway. It is important that the nurse aide d. can refuse therapy only with the doctor’s
report permission.
a. what the nurse aide thinks happened.
b. exactly what the nurse aide observed. 68. A person admitted to a hospital or extended-
c. nothing, if this is not the nurse aide’s client. care facility can be expected to be treated
d. what may have happened that day. according to the
a. State Hospital Association.
65. A client’s daughter offers the nurse aide $50 to b. Caregiver’s Bill of Rights.
thank her for caring for the client. The nurse c. Patient’s Bill of Rights.
aide should d. Physician’s Association.
a. accept it to be polite.
b. politely refuse it. 69. The nurse aide is told to bring a client by
c. use the money for the client. wheelchair to the X-Ray Department and
d. report this to the charge nurse. covers the client with a robe, blanket, and
slippers. The nurse aide has maintained the
66. An elderly resident recently cared for her client’s
husband until he died. The nurse aide a. right to confidentiality.
recognizes that this client needs to b. right to privacy.
a. keep busy to keep her mind off her husband. c. right to nursing-care plans.
b. have adequate time alone to grieve for her d. right to refuse.
husband.
c. meet other men to find a new partner. 70. Nurse aides need to identify themselves with
d. keep from crying to avoid getting more their names and title of CNA before giving any
upset. care to clients. This is an example of the
patient’s right to
a. considerate and respectful care.
b. privacy.
c. identification of healthcare workers.
d. be informed of hospital policies.
95

Answers 15. c. A nurse aide cannot disconnect the bag with-

out an order, but still must ensure that the
1. c. When coming in contact with oral mucosa, it bag remains below the bladder level.
is possible to come in contact with 16. d. The nurse aide should continue to observe
blood-borne pathogens. Infection control the client. This type of repetitive behavior
must be implemented. cannot cause harm.
2. d. The correct answer is left Sim’s. This allows 17. c. Grasp the transfer belt and lower the resident
better irrigation of the colon. to the floor along your bent leg.
3. c. Only choice c lists liquids only. 18. c. Weighing the client at the same time each day
4. a. Only a stethoscope can “hear” the apical provides the best assessment of weight loss or
pulse. gain.
5. b. Voiding means urinating. 19. c. Asking the resident if she’s upset with her
6. b. The nurse aide should report client com- doll can make her aware that it is not real,
plaints as soon as possible, and a sore calf may and help her cope with what is bothering her.
be a sign of a thrombus (blood clot), which 20. b. Padded side rails prevent clients, especially
can have serious complications. clients who are confused, from injuring
7. c. Sneezing is an example of direct contact with themselves on the bed rails.
potential contamination from client secre- 21. b. The nurse aide should always make sure there
tions that come directly from the client. are no kinks that could prevent urine flow. All
8. a. Always try to rescue the victim first if possi- other choices are not in the nurse aide’s range
ble; then call the fire department. of responsibilities.
9. b. Proper body alignment means that the client 22. d. Hands at the throat is a universal sign of
is kept as straight as possible to promote cir- choking. The nurse aide should perform the
culation and prevent contractions. Heimlich maneuver and call for help. Never
10. b. When a client has one-sided weakness, it is leave the patient unattended.
important to begin dressing the client on the 23. a. Abdominal fullness can cause nausea.
affected side to ease dressing and minimize 24. c. Keep the client in bed to prevent a fall, but
pain. allow privacy while voiding.
11. a. Of the choices listed, only a is an acute 25. a. Wound-and-skin isolation means high
change. likelihood of linen contamination, but
12. b. Most facilities are smoke free; however, according to Standard Precautions, all linen is
depending on the situation, smoking may be considered potentially infective.
permitted. It is the responsibility of the nurse 26. d. Abdominal thrusts are always the first step for
aide to remain with the patient and put the airway obstructions.
cigarette out in the proper r eceptacle. 27. c. Soiled linen should be directly placed in
13. a. Choose a fracture pan so that the client will laundry bags to prevent contamination.
have a minimal distance to lift his hips. 28. a. ABC stands for airway (open airway), breath-
14. b. Visually impaired clients can feed themselves ing (mouth to mouth), and circulation (chest
if they can visualize their food on a plate, and compressions).
the “clock” system helps them do this. 29. c. Offer fluids every hour to better ensure that
the client is taking in an adequate amount.
96

30. c. Speaking slowly and clearly will help a 47. c. Self-esteem promotes wellness. We all want to
hearing-impaired client to understand. look nice and care about our personal
Simple words and sentences will also help. appearances.
31. b. Every resident with dentures must have a 48. c. A delusion is a faulty belief; a hallucination is
labeled denture cup to ensure security of the a faulty sensory perception.
costly dentures. 49. d. Constantly reminding the client about loss
32. a. The nurse aide should rinse her eyes with will only depress him.
water immediately, then report it to the nurse 50. a. All patients need to feel wanted and to share
for safety. their feelings with another person. This is
33. d. Fluid intake is documented in the metric normal behavior.
system, and four ounces equals 120 cc. 51. d. The client has a right to privacy.
34. a. Restraints can cause skin irritations, so all 52. c. Standard precautions must be used during
restrained body parts must be observed for postmortem care. Wearing gloves is manda-
irritations. tory. The body continues to be infectious fol-
35. b. This patient’s vital signs are all very low. lowing death.
36. d. Using gloves for peri-care is a standard 53. a. The last sense to leave is hearing. Speak with
precaution, not client abuse. kindness and be aware of what you say.
37. a. Redness is usually the first sign of a pressure 54. c. The response reflects confidentiality for all
ulcer (Stage 1). clients as well as an appropriate, nonoffensive
38. a. Wash hands after going to the bathroom. response to the roommate.
39. d. All changes must be reported to the charge 55. c. The plan ensures that nursing care is consis-
nurse. tent with the patient’s needs, and progresses
40. b. The call bell system should be explained to toward self-care.
the resident to keep a line of communication 56. d. Report all changes to the charge nurse,
open. regardless of the client’s age.
41. c. Do not restrain the patient. Move all 57. a. Listening carefully to the client’s needs
furniture and equipment away to protect him encourages communication and builds trust.
from injury. 58. d. Mental status exams are not performed by
42. c. It is best to collect sputum in the morning. nurse aides.
This way, there are more bacteria in the 59. d. Dietary supplements are high in the neces-
specimen. sary vitamins and minerals.
43. a. Moving the whole body prevents twisting the 60. c. In death, the body shuts down and there are
back muscles and an injury. no vital signs.
44. c. To prevent self-injury, the nurse aide should 61. a. It is important to accommodate religious
get another aide to assist in moving the client. needs of the client.
45. d. Proximity of the bed to the chair will allow 62. c. It is important to accommodate the client’s
easier client transfer and the client will be cultural and religious beliefs in her health
facing the front of the room. care regimen. This begins with assessing the
46. a. Body mechanics promote good client’s cultural and religious needs.
musculoskeletal alignment. 63. b. Anything told in confidence cannot be
revealed.
97

64. b. All incidents need to be described exactly as 68. c. All clients are treated according to the
observed. Patient’s Bill of Rights.
65. b. Nurse aides should not accept monetary gifts 69. b. All clients have the right to privacy and
from clients and their families. should be properly covered at all times.
66. b. Residents have a right to be alone to grieve 70. c. The identification of healthcare workers
after the death of a loved one. allows the patient to know the identity of
67. a. Residents can refuse treatment because of the physicians, nurses, and others involved in their
Patient’s Bill of Rights. care.
98

Nursing
8
c h a p t e r
Assistant/Nurse
Aide Practical
Skills Exam
c ha pt er Summa ry
For most states’ certification requirements, you will be asked to
complete a performance evaluation—a hands-on test of your
practical skills as well as a written or oral exam. This chapter gives
a sample of the variety of job tasks you will be asked to perform.
A s pre v i ously note d , state requirements vary, and this chapter looks at the probable scenario. In
order to be certified as a nursing assistant, you will be asked to perform five job-related skills. Hand-
washing will most likely be one of the skills, while the other four will be randomly selected from a
list of nurse aide skills. A measurement skill, such as measuring urinary output, will probably be included in these
remaining four skills, and you will be required to record that measurement. You will perform these skills in a
hospital/nursing home-like setting while being observed by the evaluator. A volunteer will act as the client.
Each skill is broken down into steps, and some of these are critical steps that must be completed to pass the
skill. However, you must also successfully complete an adequate number of steps to pass each skill, and you must
pass all five skills to pass the entire skills exam. You will be expected to know and perform these steps; directions
will not be provided.
Equipment will be provided, and you may not be allowed to use your own equipment. The evaluator will
not give you instructions or answer any questions during the skill performance, so ask questions before you
begin. If you think you made a mistake during a skill performance, tell the evaluator at that time. You will be
allowed to correct the steps that you did incorrectly—one time. There are some exceptions to this, and some
99

–nursing assistant/nurse aide practical skills exam–
corrections will not receive credit. Also, once you Evaluation Criteria
begin a new skill, you will not be allowed to go back ■ Introduce yourself and address the client by title
and redo a previous one. and surname.
This chapter provides you with several job-related ■ Make sure paper towels are within reach and ready
skills you might be asked to perform: handwashing; to use—you do not want to touch the ‘dirty’ paper
counting the radial pulse; counting respirations; mea- towel container with your freshly cleaned hands.
suring blood pressure; donning and removing gown ■ Turn on the water at the sink—be careful, no
and gloves, or Personal Protective Equipment (PPE); splashing.
measuring urinary output; positioning on side; and Wet your hands and wrists thoroughly.
■
transferring from bed to wheelchair. Each skill list con- ■ Apply soap.
tains tips and evaluation criteria. Practice these skills, ■ Lather and rub fingers, hands, and wrists for at
using a friend or family member as your client, and least 15 seconds.
review the skills list after you are done to make sure you Clean your fingernails by rubbing the tips of your
■
did not miss any steps. You should utilize your nurse fingers against the palm of the opposite hand.
aide textbook to practice other job-related skills, espe- ■ Rinse fingers, hands, and wrists thoroughly; keep
cially those in which you need improvement. You your hands lower than your elbows and your fin-
should also contact your state’s nurse aide registry to gertips pointed down.
acquire a list of testable skills and expected steps. The ■ Dry hands thoroughly with clean paper towel and
registry office will be able to tell you how much time is dispose of paper towel. Dispose of paper towel in a
allowed for each skill performance. waste container without contaminating yourself.
Practice, practice, practice. Have a nurse or nurse Turn off the faucet with another clean paper
■
aide observe you with the skill step-list in hand to make towel, and dispose of that paper towel in a waste
sure you are performing the skills correctly, step-by- container without contaminating yourself.
step. Practice first for accuracy. Once you know you can
perform the steps correctly, practice to ensure that you
can complete the skills in the required time frame. Sa mpl e Sk i l l : Ra d i al Pu lse
S a m p l e S k i l l : H a n dwa shi ng Tips:

1. You should count the radial pulse for one full
minute. Bring a watch with a second hand.
Tips: 2. Do not use your thumb to count the pulse.
1. Handwashing is the single most important
method of preventing the spread of infection. Evaluation Criteria
2. When washing your hands, make sure to clean ■ Introduce yourself and address the client by title
under the fingernails, and between the fingers. and surname.
3. Do not wear nail polish or artificial nails for Wash your hands (see the Handwashing section).
■
the skills exam, and keep your nails trimmed ■ Explain the procedure to the client, speaking in a
short. Avoid wearing rings and bracelets. clear, slow manner. Make sure to maintain eye
4. Do not touch the inside of the sink at any time contact whenever possible.
during handwashing. Locate the client’s radial pulse by placing two fingers
■
over the radial artery (on the inside of the wrist).
100

■ Count the pulse for a full minute. 2. The diastolic pressure is the lower number and
■ Wash your hands (see the Handwashing section). is created when the heart muscle relaxes.
■ Record the client’s pulse rate. 3. If you cannot find the brachial artery, have the
client hyperextend his arm and try again.
4. Use the correct size cuff, or the blood pressure
S a m p l e S k i l l : R e spi ra ti ons measurement will not be accurate.
Evaluation Criteria
Tips: ■ Introduce yourself and address the client by title
1. The respiratory rate may be affected by fever, and surname.
pain, fear, disease, and other factors. Wash your hands (see the Handwashing section).
■
2. People can control their respirations to some ■ Explain the procedure to the client, speaking in a
extent (e.g., holding one’s breath). clear, slow manner. Make sure to maintain eye
3. Do not tell the client that you are measuring contact whenever possible.
her respiratory rate, because that will affect the Clean ear pieces and diaphragm/bell of
■
reading. Instead, take it immediately after you stethoscope with an alcohol wipe.
measure her radial pulse. This is one time it is ■ Position client’s arm with the palm up and upper
acceptable to perform a task without telling the arm exposed.
client what you are going to do. Find the brachial artery at the bend of the elbow,
■
4. Count respirations by watching the rise and fall on the inner aspect of the arm.
of the chest, and/or by placing your hand ■ Place the correct size blood pressure cuff snugly
against the person’s chest and feeling for the on the client’s upper arm with the arrow over the
rise and fall. brachial artery.
Locate the radial pulse (see the Radial Pulse
■
Evaluation Criteria section).

■ Introduce yourself and address the client by title ■ Inflate the cuff to no more than 30 mm Hg more
and surname. than where the pulse is felt.
Wash your hands (see the Handwashing section).
■ Deflate the cuff.
■
■ Explain the procedure to the client, speaking in a ■ Locate the brachial artery again, using your
clear, slow manner. Make sure to maintain eye fingertips.
contact whenever possible. Put the stethoscope in your ears and place the
■
Count respirations for a full minute.

■ diaphragm/bell over the brachial artery.
■ Wash your hands (see the Handwashing section). ■ Inflate the cuff to no more than 30 mm Hg more
■ Record respiratory rate. than where the pulse is felt.
Deflate cuff slowly and note the first sound that
■
you hear (systolic).

S a m p l e S k i l l : B l o od Pressure ■ Note the last sound you hear (diastolic).
■ Remove the cuff.
■ Wash hands (see the Handwashing section).
Tips: ■ Record blood pressure reading, both systolic and
1. The systolic pressure is the top number and is diastolic.
pressure caused when the heart muscle contracts.
101

Sa m p l e S k i l l : M e asuring Sample S kill: P ositioning on

U r i n a r y O u t p ut Si de (La tera l Positio n )
Tips: Tips:
1. Some people who are critically ill need to have 1. Make sure you have supportive devices ready
their urinary output measured hourly. before positioning client.
2. If a client uses the regular toilet, the client can 2. The lateral position is used for people with
use a “commode hat” to collect the urine for back pain, those in casts, and those who cannot
measuring. reposition themselves.
3. Make sure to hold the measuring container at
eye level to determine the amount. Evaluation Criteria
■ Introduce yourself and address the client by title
Evaluation Criteria and surname.
■ Introduce yourself and address the client by title ■ Wash your hands (see the Handwashing section).
and surname. ■ Explain the procedure to the client, speaking in a
■ Wash your hands (see the Handwashing section). clear, slow manner. Make sure to maintain eye
■ Explain the procedure to the client, speaking in a contact whenever possible.
clear, slow manner. Make sure to maintain eye ■ Provide privacy by closing the curtain or door.
contact whenever possible. ■ Lower the head of the bed.
■ Put on clean gloves before touching the bedpan. ■ Raise side rail on the side toward which the client
■ Pour the contents of the bedpan into a measuring will be turned.
container. Do not spill or splash urine. ■ Slowly roll client as one unit onto his side, toward
■ Measure urine at eye level with the container the raised side rail.
securely placed on a flat surface. ■ Place a pillow under his head for support.
After measuring urine, empty the measuring
■ ■ Make sure client is not lying on the arm that is on
container. the bed, and support the top arm with a support-
■ Rinse the measuring container and pour rinse ive device.
contents into the toilet. ■ Place supportive device behind the client’s back.
Rinse the bedpan and pour rinse contents into
■ ■ Flex the client’s top knee and place supportive
the toilet. device between the client’s legs; make sure the
■ Remove gloves. Dispose of gloves in a waste con- knee and ankle are supported.
tainer without contaminating yourself. ■ Lower the bed.
Wash hands (see the Handwashing section).
■ ■ Make sure the call bell is within reach.
■ Record urine output. ■ Wash hands (see the Handwashing section).
102

S a m p l e S k i l l : Persona l ■ Untie the gown at the neck and waist.

P ro t e c t i v e E q u i p m ent (PPE)— ■ Remove the gown without touching the outside
D o n n i n g a n d R emoving of the gown.
G o w n a n d Gl oves Hold the gown away from your body and turn it
■
inward to keep it inside out.

■ Dispose of gown in a waste container without
Tips: contaminating yourself.
1. PPE includes gowns, gloves, masks, and protec- Wash hands (see the Handwashing section).
■
tive eyewear.
2. Gloves must be intact and fit properly.
3. If you are allergic to latex, use gloves made Sample Skill: Transferring
from another synthetic material. Client from B ed to
4. If you touch a contaminated surface with your W heel c hair
gloves, your gloves become contaminated.
5. Gowns are used when you are likely to soil your
uniform with bodily fluids and for certain Tips:
types of isolation. 1. A transfer belt is used to assist weak or
unsteady persons with transferring, walking,
Evaluation Criteria and standing. Many facilities require nurse
■ Introduce yourself and address the client by title aides to use these when transferring clients.
and surname. 2. Always plan in advance when transferring cli-
Wash your hands (see the Handwashing section).
■ ents. Know your client’s specific limitations.
3. Wheelchairs should be checked to make sure
Donning the gown and gloves they have no broken or missing parts.
■ Unfold gown. 4. Make sure to lock the brakes before transfer-
■ With back opening of gown facing you, place ring clients into and out of wheelchairs.
arms through each of the sleeves.
■ Fasten the neck ties. Evaluation Criteria
■ Secure the gown at your waist, and make sure ■ Introduce yourself and address the client by title
your clothing is covered as much as possible. and surname.
■ Put on gloves, making sure the cuffs of the gloves Wash your hands (see the Handwashing section).
■
overlap the cuffs of the gown. ■ Explain the procedure to the client, speaking in a
clear, slow manner. Make sure to maintain eye
Removing the gown and gloves. contact whenever possible.
■ Use one gloved hand to remove the opposite Provide privacy by pulling the curtain or shutting
■
glove at the palm. the door.

■ Slip the fingers from your ungloved hand under ■ Position the wheelchair at the head of the bed,
the cuff of the remaining glove and remove the facing the foot of the bed.
glove, turning it inside out as you proceed. Make sure foot rests are removed or folded up.
■
■ Dispose of gloves in a waste container without ■ Make sure to lock the wheelchair brakes.
contaminating yourself.
103

■ Assist the client into a sitting position with her ■ Assist the client to turn to stand in front of the
feet flat on the floor. Make sure the client is wear- wheelchair, making sure her legs are against the
ing shoes before the client attempts to stand. wheelchair.
Securely apply the transfer belt over the client’s
■ Lower the client into the wheelchair.
■
clothing before assisting her to stand. ■ Position the client so that her hips touch the back
■ Instruct the client on the transfer process and of the chair, assuring that she is not sitting on any
provide her with a signal for when to begin objects that may cause pressure to her skin.
standing (e.g., “Stand on three”). Remove the transfer belt.
■
■ Stand facing the client during transfer. ■ Position footrests in the down position and assist
■ Count to three to alert the client to begin standing. the client in placing her feet on them.
■ On “three,” slowly help the client to stand by Make sure the client’s call bell is within reach.
■
grasping the transfer belt on both sides with an ■ Wash hands (see the Handwashing section).
upward grasp. Maintain the stability of the
client’s legs.
104

9
Certification
c h a p t e r
Requirements
and trends
c ha pt er Summa ry
This chapter provides an overview of state certification and licens-
ing requirements for nursing assistants. It will also help you keep
abreast of the trends—what’s new in healthcare certification.
A lthoug h there i s no national organization for the certification of nursing assistants, there is a
certification exam that is utilized by several states. The National Nurse Aide Assessment Program
(NNAAP) is the largest nursing assistant certification examination in the United States. The National
Council of State Boards of Nursing (NCSBN) develops the examination program and administers it with a test
service.
State Certification and Training
Since OBRA (Omnibus Budget and Reform Act) was passed in 1987, the federal government has been setting
regulations and creating standards for the quality of nursing home care. Specific guidelines and standards were
prescribed—one major change was the training and testing of nursing assistants/nurse aides. In many states,
nurse aides are required to go through a minimum of 75 hours of training approved by the federal government
to be certified. Most programs are between 75 and 150 hours and vary by state. Some states have created their
105

–certification requirements and trends–
own standards for nursing assistants. These standards ■ Nursing Assistants in another state can apply for
include the minimum training requirements as well as reciprocity. These are persons currently certified as
a written exam of multiple-choice questions and a nurse aide in another state and listed in that other
clinical/practical evaluations. Most healthcare facili- state’s nurse aide registry (and usually who have not
ties now require nurse aides to have a high school had their certificate revoked in any state or been
diploma or GED and pass a state-approved program. listed on any state’s nurse aide abuse registry).
Nurse aides completing these programs must obtain Military Nurse Aides have equivalent nurse aide
■
certification within four months of being hired at a training and experience in a military service.
healthcare facility. Once you pass the written exam, ■ Lapsed or Expired Certification pertains to persons
you will be placed on your state’s registry for nurse who are applying back to the state in which they
aides. Your certification is then valid for 24 months. were originally certified and whose certification
After being certified, CNAs are usually required to has lapsed or expired (and usually who have not
earn 12 continuing-education credits annually, often had their certificate revoked in any state or been
through inservice training. listed on any state’s nurse aide abuse registry).
Eligibility for Certification Training Programs

Most states have multiple eligibility options to meet Nursing assistant training programs prepare students
the needs of nursing assistants with various back- for employment as nursing assistants in hospitals,
grounds. The following list represents most types of long-term care facilities, hospices, home health agen-
eligibility, but you should check with your state’s nurse cies, and other healthcare agencies. Programs average
aide registry for its requirements. a total of 120 hours of combined classroom and clini-
cal education, allowing those who complete the pro-
■ New Nursing Assistants are persons who have gram to sit for the certification exam.
never been certified as a nursing assistant/nurse
aide. These candidates must complete a state- Content is similar from one program to the next and
approved nursing assistant education program typically includes:
prior to taking the exam.
Nursing Students include those who have suc-
■ ■ Overview of the Healthcare System
cessfully completed a nursing fundamentals ■ The Healthcare Team
course through a state-approved nursing program ■ The Role of the Nursing Assistant
within one year of applying to take the examina- ■ Working with Coworkers and Supervisors
tion, and those who have successfully completed ■ Work Ethic
the fundamentals course and are currently ■ Problem Solving and Conflict Management
enrolled in a nursing program. ■ Client and Resident Rights
Graduate Nurses are nurses who graduated

■ ■ Violations of Criminal and Civil Law
from a state-approved nursing program and ■ Medical Terminology
who are waiting to take the state nursing licens- ■ Effective Communications
ing examination. ■ Human Growth and Development
Foreign Graduate Nurses graduated a nursing

■ ■ The Human Body and Common Disorders:
program in a foreign country and are currently ■ The Integumentary System (Skin, Hair and
nurses in that country. Nails)
■ The Respiratory System
106

■ The Cardiovascular System Dressing Clients with One-Sided Weakness

■
■ The Digestive System ■ Feeding Clients
■ The Endocrine System ■ Measuring Urinary Output
■ The Hematologic System ■ Urinary Catheter Care
■ The Musculoskeletal System ■ Ostomy Care
■ The Nervous System ■ Administering Enemas
■ The Sensory System ■ Administering Hot and Cold Applications
■ The Immunologic System ■ Assisting with Dressing Changes
■ Admissions and Discharges ■ Ambulating Clients Using a Transfer Belt
■ Infection Control ■ Positioning Clients
■ Client Safety and Restraint ■ Transferring Clients from Bed to Wheelchair
■ Workplace Safety (Wheelchair to Bed)

■ Positioning ■ Passive Range of Motion Exercises
■ Nutrition and Feeding ■ Using Personal Protective Equipment
■ Urinary and Bowel Elimination ■ Postmortem Care
■ Basic First Aid
■ Basic Emergency Care A major part of the job of being a CNA involves
■ Death and Dying being able to manipulate patients physically in order
■ Specific Populations to clean them and help them change their clothes,
■ Older Adults exercise, or use the bathroom. The clinical part of the
■ Children training programs helps to determine if a student is
■ Mothers and Newborns capable of performing these tasks.
■ Persons with Disabilities Training programs are given in a number of
■ Persons with Mental Illness settings, including both public and private vocational-
■ Surgical Clients technical schools, community colleges, public-health
■ Home Health Clients agencies, and for-profit and not-for-profit healthcare
■ Hospice Clients agencies, such as visiting nurse associations. Since
hands-on clinical experience is usually required,
Nursing assistant students also learn and practice job- schools that do not have their own healthcare services
related skills: often affiliate with a healthcare facility. Then the
course work is given in the school and the clinical
■ Handwashing and Hand Hygiene work is performed in the healthcare facility or in a
■ Vital Signs: Blood Pressure, Temperature, Pulse, home setting served by a healthcare agency.
and Respiration In the states that require certification, there are
Measuring Height and Weight
■ usually a large number of locations that offer training
■ Oral Care programs. In Illinois, for example, there are some 300
■ Denture Care approved CNA training programs. Agencies that offer
■ Fingernail Care training programs often hire the people they have
■ Foot Care trained, so they are good places to sign up for a train-
■ Perineal Care ing program that may lead to a job offer when you
■ Bed Baths complete the course.
■ Applying Knee-High Stockings
107

Each program has its own admission require- Why Certification?

ments. But, like program content, requirements tend
to be similar among programs: The main reason behind the trend to CNA certifica-
tion is the growth of home healthcare. Home-based
■ Minimum age of 16 or 18 years, depending on healthcare has been on the increase because of cost-
program saving measures in the health industry: Patients are
Completion of COMPASS, ACT, or ASSET test
■
being encouraged to leave relatively expensive hospi-
before entering program (these test your verbal, tal-based care to complete their recuperations in
reading and numerical skills). Minimum scores lower-cost alternative settings, including short-term
are set by the training program. and long-term care facilities, as well as the home.
Ability to pass a national criminal background
■
Nursing assistants work in a wide variety of healthcare
check and a caregiver background check. (Certain settings, including skilled-nursing facilities, doctors’
convictions may limit a student’s ability to partic- offices, hospices, board-and-care retirement facilities,
ipate in clinical experiences or be employed in acute-care hospitals, clinics, rehabilitation hospitals,
healthcare facilities. Examples include convictions psychiatric hospitals, facilities for the developmentally
related to drugs, theft, violence, disorderly con- disabled, and daycare facilities. But the delivery of
duct, domestic abuse, theft, and fraud.) services in patient homes is what has increased aware-
■ Physical exam (certain vaccinations may be ness on the part of state and national authorities, lead-
required) ing to the increase of requirements for certification.
Certification offers assurance that nursing
Other possible requirements: assistants, who have such immediate, important, and
intimate contact with elderly or disabled persons,
■ High school diploma or GED have been properly trained to deal with the many
■ Health insurance and varied tasks they will have to perform. It is also
■ Ability to lift heavy weight and stand for long important to healthcare agencies that, in addition to
periods providing care for the patient, CNAs be able to
acknowledge the psychosocial needs of the patient’s
family. The federal government, which is often the
Exams funding source for home healthcare under the Medi-
care program, also wants to know that its funds are
Training programs usually conclude with a written (or being spent for high-quality services.
oral) examination that determines whether the student
is qualified to receive certification. Some institutions
that offer training make up their own examinations, Emphasis on
while others may use an exam prepared by a company Interpersonal Skills
that specializes in developing tests. Tests typically range
from 50 to 150 questions and are in sections that relate While it has always been important for healthcare
directly to the subject areas covered in the training, professionals of all kinds to be able to make patients
such as patient-care procedures, emergency procedures, feel safe and comfortable, these skills become even
or observation and charting. Usually a candidate must more crucial when care is being delivered in the
achieve a passing grade in each of the sections, and not patient’s own home or in long-term care. Thus, many
just overall, in order to qualify for certification. training programs are now emphasizing interpersonal
108

skills more than ever before. In the sample training reason for this is the increased need for home care of
programs shown earlier in this chapter, you can see the elderly—patients are being moved out of hospi-
that interpersonal skills, such as Effective Communica- tals and nursing homes to lower healthcare costs. In
tion and Client and Resident Rights, are emphasized. 2006, more than 787,000 people were employed as
home health aides and most were employed in
home-health agencies, nursing facilities, hospitals,
Combining CNA and Home visiting-nurse associations, residential-care facilities,
Health Aide Certification and temporary-help firms. Full-time aides work
about 40 hours per week, while many aides work part
The trend to certification is also spurred by the fact time. The actual job can be difficult both physically
that the training programs for nursing assistants typi- and emotionally; it includes a good portion of stand-
cally include the training requirements for the job ing, lifting, changing bed linens, and dealing with
of home health aide (HHA), as well. HHA training uncooperative clients. Generally, a home health aide
follows a federally mandated 75-hour curriculum. works independently and with a variety of patients.
The federal mandate is there because home-healthcare Supervisors visit sporadically, and the aide is always
agencies are eligible for Medicare funds for the ser- given explicit instructions pertaining to schedule and
vices they provide to the elderly. patient care.
Since CNAs can perform medical tasks beyond In Massachusetts, persons entering home health
what HHAs are trained to do, someone who has train- aide programs are often encouraged to undergo dual
ing and certification in both job categories is obvi- training and become CNAs in order to improve their
ously of greater value to the agency doing the hiring. employment opportunities.
The employer is better off hiring one person who can In some states, such as Illinois, people who
perform two different jobs, even if that one person’s want to become home health aides are required to
salary is a little higher than that of a person with one take the same training program as CNAs. The HHA
certification. training is included within the program as part of the
A representative of one major home-healthcare CNA training. As a result, the certification that fol-
agency in Austin, Texas, reported that the Sunday lows the successful completion of the CNA training
newspaper usually contains almost a full page of ads and the passage of the written competency examina-
from home-healthcare agencies calling for people to tion serves as a dual certification for home health
work as home health aides. However, she noted that aides as well.
most of these ads want CNAs to fill these positions The good news for people who want to become
because they have skills that go beyond those required nursing assistants is that the growth of healthcare in
of a home health aide. alternative settings ensures that workers will be needed.
The home health aide profession is growing CNAs can look forward to good job prospects for the
faster than average and should continue growing. The foreseeable future.
109

10
c h a p t e r
important
Resources
c ha pt er Summa ry
This chapter identifies numerous healthcare organizations and
services—potentially valuable resources in your search for the
right job.
W he ther you are just beginning a career in healthcare or you are just wondering how to find a
job, the resources in this chapter can give you valuable information. Included here is contact
information for professional organizations, job placement services, home health and hospice
organizations, and state nurses’ associations.
Professional Associations
Professional associations are made up of experts in the nursing field. Both members and the people who run
these organizations are actively working in, and on the behalf of, the fields they represent. Above all, they are great
sources of information on possible careers, education and training programs, and professional requirements such
as certification and licensure. In most cases, if these folks don’t have the information you need, they can tell you
who will.
111

–important resources–
In addition, many professional associations offer American Assembly for Men in Nursing
job placement or referral services. Many publish news- P.O. Box 130220
Birmingham, AL 35213
letters, magazines, books, and other publications, as Phone: 205-956-0146
well as multimedia products such as videos and CD- Website: www.aamn.org
ROMs. Many also sponsor seminars, workshops, and
other educational forums. All of these efforts can help American Association of Critical-Care Nurses
101 Columbia
interested individuals keep up on current happenings Aliso Viejo, CA 92656
in a given field. Phone: 949-362-2050
Website: www.aacn.org
American Association of Diabetes Educators

N u r s i n g A s s i s ta nt 200 W. Madison Street, Suite 800
O rg a n i z a t i o ns Chicago, IL 60606
Phone: 800-338-3633
National Association of Health Care Assistants Website: www.aadenet.org
1201 L Street NW
Washington, DC 20005 American Association of Legal Nurse Consultants
Phone: 202-454-1288 / 800-784-6049 401 N. Michigan Avenue
Website: www.nahcacares.org Chicago, IL 60611
Phone: 877-402-2562
National Network of Career Nursing Assistants Website: www.aalnc.org
Website: www.cna-network.org
American Association of Neuroscience Nurses
Nursing Assistant Resources 4700 W. Lake Avenue
Website: www.nursingassistants.net Glenview, IL 60025
Phone: 888-557-2266
Website: www.aann.org
N a t i o n a l Nu r sing American Association of Nurse Anesthetists

O rg a n i z a t i o n s 222 South Prospect Avenue
Park Ridge, IL 60068
Academy of Medical-Surgical Nurses Phone: 847-692-7050
East Holly Avenue, Box 56 Website: www.aana.com
Pitman, NJ 08071
Phone: 866-877-2676 American Association of Nurse Attorneys
Website: www.medsurgnurse.org P.O. Box 515
Columbus, OH 43216-0515
Air & Surface Transport Nurses Association Phone: 877-538-2262
7995 East Prentice Avenue, Suite 100 Website: www.taana.org
Greenwood Village, CO 80111
Phone: 303-770-1614 / 800-897-NFNA (6362) American Association of Occupational Health
Website: www.astna.org Nurses
2920 Brandywine Road, Suite 100
American Academy of Ambulatory Care Nursing Atlanta, GA 30341
East Holly Avenue, Box 56 Phone: 770-455-7757
Pitman, NJ 08071 Website: www.aaohn.org
Phone: 800-262-6877
Website: www.aaacn.org
112

American Association of Spinal Cord Injury Nurses American Public Health Association
801 18th Street, NW 800 I Street, NW
Washington, DC 20006 Washington, DC 20001
Phone: 202-416-7704 Phone: 202-777-APHA (2742)
Website: www.aascin.org Website: www.apha.org
American College of Nurse Midwives American Society of Ophthalmic Registered

8403 Colesville Road, Suite 1550 Nurses
Silver Spring, MD 20910 P.O. Box 193030
Phone: 240-485-1800 San Francisco, CA 94119
Website: www.midwife.org Phone: 415-561-8513
Website: www.asorn.org
American College of Nurse Practitioners
1501 Wilson Boulevard, Suite 509 American Society of Pain Management Nurses
Arlington, VA 22209 P.O. Box 15473
Phone: 703-740-2529 Lenexa, KS 66285
Website: www.acnpweb.org Phone: 888-34ASPMN (342-7766)
Website: www.aspmn.org
American Holistic Nurses’ Association
323 N. San Francisco Street, Suite 201 American Society of Perianesthesia Nurses
Flagstaff, AZ 86001 10 Melrose Avenue, Suite 110
Phone: 800-278-2462 Cherry Hill, NJ 08003
Website: www.ahna.org Phone: 877-737-9696
Website: www.aspan.org
American Medical Informatics Association
4915 St. Elmo Avenue, Suite 401 American Society of Plastic and Reconstructive/
Bethesda, MD 20814 Surgical Nurses
Phone: 301-657-1291 7794 Grow Drive
Website: www.amia.org Pensacola, FL 32514
Phone: 800-272-0136
American Nephrology Nurses’ Association Website: www.aspsn.org
East Holly Avenue, Box 56
Pitman, NJ 08071 Association for Radiologic & Imaging Nursing
Phone: 888-600-2662 7794 Grow Drive
Website: www.annanurse.org Pensacola, FL 32514
Phone: 866-486-2762
American Nurses Association Website: www.arinursing.org
8515 Georgia Avenue, Suite 400
Silver Spring, MD 20910 Association of Community Health Nurse
Phone: 800-274-4ANA (4262) Educators
Website: www.nursingworld.org 10200 West 44th Avenue, Suite 304
Wheat Ridge, CO 80033
American Organization of Nurse Executives Phone: 303-422-0769
1 North Franklin Street, 32nd Floor Website: www.achne.org
Chicago, IL 60606
Phone: 312-422-2800 Association of Occupational Health Professionals
Website: www.aone.org 109 VIP Drive, Suite 220
Wexford, PA 15090
American Psychiatric Nurses Association Phone: 800-362-4347
1555 Wilson Boulevard, Suite 530 Website: www.aohp.org
Arlington, VA 22209
Phone: 866-243-2443
Website: www.apna.org
113

Association of Pediatric Hematology/Oncology Emergency Nurses’ Association

Nurses 915 Lee Street
4700 W. Lake Avenue Des Plaines, IL 60016
Glenview, IL 60025 Phone: 800-900-9659
Phone: 847-375-4724 Website: www.ena.org
Website: www.apon.org
Endocrine Nurses Association
Association of periOperative Registered Nurses P.O. Box 211068
2170 South Parker Road, Suite 400 Milwaukee, WI 53221
Denver, CO 80231 Phone: 414-421-3679
Phone: 800-755-2676 Website: www.endo-nurses.org
Website: www.aorn.org
Home Healthcare Nurses Association
Association of Nurses in AIDS Care 228 Seventh Street, SE
3538 Ridgewood Road Washington, DC 20003
Akron, OH 44333 Phone: 202-547-7424
Phone: 800-260-6780 Website: www.nahc.org
Website: www.anacnet.org
Hospice and Palliative Nurses Association
Association of Rehabilitation Nurses One Penn Center West, Suite 229
4700 W. Lake Avenue Pittsburgh, PA 15276
Glenview, IL 60025 Phone: 412-787-9301
Phone: 800-229-7530 Website: www.hpna.org
Website: www.rehabnurse.org
Infusion Nurses Society
Association of Women’s Health, Obstetric and 315 Norwood Park South
Neonatal Nurses Norwood, MA 02062
2000 L Street, NW, Suite 740 Phone: 781-440-9408
Washington, DC 20036 Website: www.ins1.org
Phone: 800-673-8499
Website: www.awhonn.org International Association of Forensic Nurses
1517 Ritchie Highway, Suite 208
Association for Professionals in Infection Control Arnold, MD 21012
and Epidemiology 410-626-7805
1275 K Street NW, Suite 1000 Website: www.iafn.org
Washington, DC, 20005
202-789-1890 International Nurses Society on Addictions
Website: www.apic.org P.O. Box 163635
Columbus, OH 43216
Dermatology Nurses’ Association Phone: 877-646-8672
15000 Commerce Parkway, Suite C Website: www.intnsa.org
Mt. Laurel, NJ 08054
Phone: 800-454-4362 International Organization of Multiple Sclerosis
Website: www.dnanurse.org Nurses
P.O. Box 450
Developmental Disabilities Nurses Association Teaneck, NJ 07666
P.O. Box 536489 Phone: 201-487-1050
Orlando, FL 32853 Website: www.iomsn.org
Phone: 800-888-6733
Website: www.ddna.org
114

International Society of Nurses in Genetics National Association of Pediatric Nurse

461 Cochran Road Practitioners
Box 246 20 Brace Road, Suite 200
Pittsburgh, PA 15528 Cherry Hill, NJ 08034
Phone: 414-344-1414 Phone: 856-857-9700
Website: www.isong.org Website: www.napnap.org
National Association for Associate Degree National Association of School Nurses

Nursing 8484 Georgia Avenue, Suite 420
7794 Grow Drive Silver Spring, MD 20910
Pensacola, FL 32514 Phone: 240-821-1130
Phone: 877-966-6236 Website: www.nasn.org
Website: www.noadn.org
National Black Nurses Association
National Association for Practical Nurse 8630 Fenton Street, Suite 330
Education and Service Silver Spring, MD 20910
1940 Duke Street, Suite 200 Phone: 301-589-3200
Alexandria, VA 22314 Website: www.nbna.org
Phone: 703-933-1003
Website: www.napnes.org National Federation of Licensed Practical Nurses
605 Poole Drive
National Association of Clinical Nurse Specialists Garner, NC 27529
2090 Linglestown Road, Suite 107 Phone: 919-779-0046
Harrisburg, PA 17110 Website: www.nflpn.org
Phone: 717-234-6799
Website: www.nacns.org National Gerontological Nurses Association
7794 Grow Drive
National Association of Hispanic Nurses Pensacola, FL 32514
1455 Pennsylvania Avenue, NW, Suite 400 Phone: 800-723-0560
Washington, DC 20004 Website: www.ngna.org
Phone: 202-387-2477
Website: www.thehispanicnurses.org National League for Nursing
61 Broadway, 33rd Floor
National Association of Nurse Massage Therapists New York, NY 10006
28 Lowry Drive Phone: 800-669-1656
P.O. Box 232 Website: www.nln.org
West Milton, OH 45383
Phone: 800-262-4017 National Student Nurses’ Association
Website: www.nanmt.org 45 Main Street, Suite 606
Brooklyn, NY 11201
National Association of Nurse Practitioners in Phone: 718-210-0705
Women’s Health Website: www.nsna.org
505 C Street, Northeast
Washington, DC 20002 North American Nursing Diagnosis Association
Phone: 202-543-9693 P.O. Box 157
Website: www.npwh.org Kaukauna, WI 54130
Phone: 920-344-8670
National Association of Orthopedic Nurses Website: www.nanda.org
401 N. Michigan Avenue, Suite 2200
Chicago, IL 60611
Phone: 800-289-6266
Website: www.orthonurse.org
115

Nursing Division of the American Association of Transcultural Nursing Society

Mental Retardation Madonna University
501 3rd Street, NW Suite 200 36600 Schoolcraft Rd.
Washington, DC 20001 Livonia, MI 48150
Phone: 800-424-3688 Phone: 888-432-5470
Website: www.aamr.org Website: www.tcns.org
Oncology Nursing Society Wound, Ostomy and Continence Nurses Society

125 Enterprise Drive 15000 Commerce Parkway, Suite C
Pittsburgh, PA 15275 Mt. Laurel, NJ 08054
Phone: 866-257-4ONS (4667) Phone: 888-224-9626
Website: www.ons.org Website: www.wocn.org
Respiratory Nursing Society

309 E. Lee Avenue
Vinton, VA 24179 State and Territorial N urses
Website: www.respiratorynursingsociety.org Assoc i a ti ons
Society for Vascular Nursing Alabama State Nurses Association
203 Washington Street 360 North Hull Street
PMB 311 Montgomery, AL 36104
Salem, MA 01970 Phone: 334-262-8321
Phone: 888-536-4786 Fax: 334-262-8578
Website: www.svnnet.org Website: www.alabamanurses.org
Society of Gastroenterology Nurses and Alaska Nurses Association

Associates 3701 East Tudor Road, Suite 208
401 North Michigan Avenue Anchorage, AK 99507
Chicago, IL 60611 Phone: 907-274-0827
Phone: 800-245-7462 Fax: 907-272-0292
Website: www.sgna.org Website: www.aknurse.org
Society of Otorhinolaryngology and Head-Neck Arizona Nurses Association

Nurses 1850 E. Southern Avenue, Suite #1
202 Julia Street Tempe, AZ 85282
New Smyrna Beach, FL 32168 Phone: 480-831-0404
Phone: 386-428-1695 Fax: 480-839-4780
Website: www.sohnnurse.com Website: www.aznurse.org
Society of Pediatric Nurses Arkansas Nurses Association

7794 Grow Drive 1123 S. University Avenue, #1015
Pensacola, FL 32514 Little Rock, AR 72204
Phone: 800-723-2902 Phone: 501-244-2363
Website: www.pedsnurses.org Fax: 501-244-9903
Website: www.arna.org
Society of Urologic Nurses and Associates
East Holly Avenue, Box 56 ANA California
Pitman, NJ 08071 1121 L Street, Suite 409
Phone: 888-827-7862 Sacramento, CA 95814
Website: www.suna.org Phone: 916-447-0225
Fax: 916-442-4394
Website: www.anacalifornia.org
116

Colorado Nurses Association Idaho Nurses Association

1221 South Clarkson Street, Suite 205 3525 Piedmont Road
Denver, CO 80210 Building Five, Suite 300
Phone: 303-757-7483 Atlanta, GA 30305
Fax: 303-757-8833 Phone: 888-721-8904
Website: www.nurses-co.org Fax: 404-240-0998
Website: www.idahonurses.org
Connecticut Nurses Association
377 Research Parkway, Suite 2D Illinois Nurses Association
Meriden, CT 06450 105 West Adams Street, Suite 2101
Phone: 203-238-1207 Chicago, IL 60603
Fax: 203-238-3437 Phone: 312-419-2900, ext. 229
Website: www.ctnurses.org Fax: 312-419-2920
Website: www.illinoisnurses.com
Delaware Nurses Association
5586 Kirkwood Highway Indiana State Nurses Association
Wilmington, DE 19808 2915 North High School Road
Phone: 302-998-3141 / 302-998-3142 Indianapolis, IN 46224
Fax: 302-998-3143 Phone: 317-299-4575
Website: www.denurses.org Fax: 317-297-3525
Website: www.indiananurses.org
District of Columbia Nurses Association
5100 Wisconsin Avenue, N.W., Suite 306 Iowa Nurses Association
Washington, DC 20016 1501 42nd Street, Suite 471
Phone: 202-244-2705 West Des Moines, IA 50266
Fax: 202-362-8285 Phone: 515-225-0495
Website: www.dcna.org Fax: 515-225-2201
Website: www.iowanurses.org
Florida Nurses Association
P.O. Box 536985 Kansas State Nurses Association
Orlando, FL 32853 1109 SW Topeka Blvd.
Phone: 407-896-3261 Topeka, KS 66612
Fax: 407-896-9042 Phone: 785-233-8638
Website: www.floridanurse.org Fax: 785-233-5222
Website: www.nursingworld.org/snas/ks
Georgia Nurses Association
3032 Briarcliff Road, NE Kentucky Nurses Association
Atlanta, GA 30329 1400 South First Street
Phone: 404-325-5536 P.O. Box 2616
Fax: 404-325-0407 Louisville, KY 40201
Website: www.georgianurses.org Phone: 502-637-2546
Fax: 502-637-8236
Guam Nurses Association Website: www.kentucky-nurses.org
P.O. Box CG
Hagatna, GUAM 96932 Louisiana State Nurses Association
Phone: 671-477-6877 5713 Superior Drive, Suite A-6
Fax: 671-477-6877 Baton Rouge, LA 70816
Phone: 225-201-0993 / 800-457-6378
Hawaii Nurses Association Fax: 225-201-0971
677 Ala Moana Boulevard, Suite 301 Website: www.lsna.org
Honolulu, HI 96813
Phone: 808-531-1628
Fax: 808-524-2760
Website: www.hawaiinurses.org
117

ANA-Maine Montana Nurses Association

P.O. Box 3000, PMB #280 20 Old Montana State Highway
York, ME 03909 Clancy, MT 59634
Phone: 207-799-6350 Phone: 406-442-6710
Website: www.anamaine.org Fax: 406-442-1841
Website: www.mtnurses.org
Maryland Nurses Association
21 Governor’s Court, Suite 195 Nebraska Nurses Association
Baltimore, MD 21244 P.O. Box 82086
Phone: 410-944-5800 Lincoln, NE 68501
Fax: 410-944-5802 Phone: 402-475-3859
Website: www.marylandrn.org Fax: 402-475-3961
Website: www.NebraskaNurses.org
Massachusetts Association of Registered Nurses
P.O. Box 285 Nevada Nurses Association
Milton, MA 02186 P.O. Box 34660
Phone: 617-990-2856 Reno, NV 89533
Website: www.marnonline.org Phone: 775-747-2333
Fax: 775-329-3334
Michigan Nurses Association Website: www.nvnurses.org
2310 Jolly Oak Road
Okemos, MI 48864 New Hampshire Nurses Association
Phone: 517-349-5640, ext. 14 210 N. State Street, Suite 1-A
Fax: 517-349-5818 Concord, New Hampshire 03301
Website: www.minurses.org Phone: 603-225-3783
Fax: 603-228-6672
Minnesota Nurses Association Website: www.NHnurses.org
1625 Energy Park Drive
St. Paul, MN 55108 New Jersey State Nurses Association
Phone: 651-646-4807 / 800-536-4662 1479 Pennington Road
Fax: 651-647-5301 Trenton, NJ 08618-2661
Website: www.mnnurses.org Phone: 609-883-5335, ext. 10
Fax: 609-883-5343
Mississippi Nurses Association Website: www.njsna.org
31 Woodgreen Place
Madison, MS 39110 New Mexico Nurses Association
Phone: 601-898-0670 P.O. Box 29658
Fax: 601-898-0190 Santa Fe, NM 87592-965
Website: www.msnurses.org Phone: 505-471-3324
Fax: 877-350-7499
Missouri Nurses Association Website: www.nmna.org
1904 Bubba Lane
P.O. Box 105228 New York State Nurses Association
Jefferson City, MO 65110 11 Cornell Road
Phone: 573-636-4623 / 888-662-MONA (6662) Latham, NY 12110
Fax: 573-636-9576 Phone: 518-782-9400, ext. 279
Website: www.missourinurses.org Fax: 518-782-9530
Website: www.nysna.org
118

North Carolina Nurses Association South Carolina Nurses Association

103 Enterprise Street 1821 Gadsden Street
Box 12025 Columbia, SC 29201
Raleigh, NC 27605 Phone: 803-252-4781
Phone: 919-821-4250 Fax: 803-779-3870
Fax: 919-829-5807 Website: www.scnurses.org
Website: www.ncnurses.org
South Dakota Nurses Association
North Dakota Nurses Association P.O. Box 1015
531 Airport Road, Suite D Pierre, SD 57501
Bismarck, ND 58504 Phone: 605-945-4265
Phone: 701-223-1385 Fax: 605-945-4265
Fax: 701-223-0575 Website: www.sdnursesassociation.org
Website: www.ndna.org
Tennessee Nurses Association
Ohio Nurses Association 545 Mainstream Drive, Suite 405
4000 East Main Street Nashville, TN 37228
Columbus, OH 43213 Phone: 615-254-0350
Phone: 614-237-5414, ext. 1020 Fax: 615-254-0303
Fax: 614-237-6081 Website: www.tnaonline.org
Website: www.ohnurses.org
Texas Nurses Association
Oklahoma Nurses Association 7600 Burnet Road, Suite 440
6414 North Santa Fe, Suite A Austin, TX 78757
Oklahoma City, OK 73116 Phone: 512-452-0645
Phone: 405-840-3476 Fax: 512-452-0648
Fax: 405-840-3013 Website: www.texasnurses.org
Website: www.oklahomanurses.org
Utah Nurses Association
Oregon Nurses Association 4505 South Wasatch Boulevard, #135
18765 SW Boones Ferry Road Salt Lake City, UT 84124
Tualatin, OR 97062 Phone: 801-272-4510
Phone: 503-293-0011 Fax: 801-293-8458
Fax: 503-293-0013 Website: www.utahnurses.org
Website: www.oregonrn.org
Vermont State Nurses Association
Pennsylvania State Nurses Association 100 Dorset Street, Suite 13
2578 Interstate Drive, Suite 101 South Burlington, VT 05403
Harrisburg, PA 17110 Phone: 802-651-8886
Phone: 717-657-1222 / 888-707-7762 Fax: 802-651-8998
Fax: 717-657-3796 Website: www.vsna-inc.org
Website: www.panurses.org
Virgin Islands State Nurses Association
Rhode Island State Nurses Association P.O. Box 3617
67 Park Place Christiansted, US Virgin Islands 00822
Pawtucket, RI 02860 Phone: 340-713-0293
Phone: 401-305-3330
Fax: 401-305-3332 Virginia Nurses Association
Website: www.risnarn.org 7113 Three Chopt Road, Suite 204
Richmond, VA 23226
Phone: 804-282-1808 / 804-282-2373
Fax: 804-282-4916
Website: www.virginianurses.com
119

Washington State Nurses Association post your credentials, ask politely for referrals, or
575 Andover Park West, Suite 101 respond to specific job listings.
Seattle, WA 98188-3321
Phone: 206-575-7979
American Association of Managed Care Nurses, Inc.
Fax: 206-575-1908
Job Placement Services
Website: www.wsna.org
4435 Waterfront Drive, Suite 101
Glen Allen, VA 23060
West Virginia Nurses Association
Phone: 804-527-9698
405 Capitol Street, Suite 600
Fax: 804-747-5316
Charleston, WV 25301
Website: www.aamcn.org
Phone: 304-342-1169 / 800-400-1226
Fax: 304-346-1861
American Nursing Services
Website: www.wvnurses.org
Phone: 800-444-NURS (6877)
Website: www.american-nurse.com
Wisconsin Nurses Association
6117 Monona Drive
American Public Health Association CareerMart
Madison, WI 53716
(online only)
Phone: 608-221-0383
Website: www.apha.org/career
Fax: 608-221-2788
Website: www.wisconsinnurses.org
CompHealth
4021 South 700 East, Suite 300
Wyoming Nurses Association
Salt Lake City, UT 84107
PMB 101
Phone: 801-264-6400 / 800-453-3030
2816 Dogwood Avenue
Fax: 801-264-6464
Gillette, WY 82716
Website: www.comphealth.com
Phone: 800-795-6381
Website: www.wyonurse.org
Department of Health and Human Services
200 Independence Avenue SW
Washington, DC 20201
Placement Services and Phone: 202-619-0257 / 877-696-6775
For 24-hour Job Information: 912-757-3000
Job Searches Website: www.hhs.gov/jobs
Many organizations nationwide provide employment Department of Veterans Affairs

services for healthcare workers. In fact, it is a growing 810 Vermont Avenue NW
Washington, DC 20420
field precisely because the number of jobs is grow-
Phone: 202-273-5400
ing so fast. The following list covers just a few of the Website: www.va.gov
organizations and government agencies nationwide
working to identify available jobs in healthcare, link NurseWeek.com
Website: www.Nurseweek.com
candidates to employers and vice versa, or aid in the
actual hiring process. NursingJobs.com
If you have access to a computer, make the Inter- 12400 High Bluff Drive
net part of your job-hunting process. Both private San Diego, CA 92130
Phone: 877-435-2131
industry and government bureaus sponsor career- and
Website: www.nursingjobs.com
employment-related websites such as www.career-
builder.com and www.monster.com. We have also
included some pertinent website listings here. You also
can visit online forums and discussion groups that are
frequented by healthcare professionals, where you can
120

Nurse Web Search—The Nurse Directory Pacific Home Health

Website: www.nursewebsearch.com/nursing_ 4155 Tudor Centre Drive, Suite 103
employment.htm Anchorage, AK 99508
Phone: 907-729-2492
NurseZone Fax: 907-729-2489
12235 El Camino Real, Suite 200
San Diego, CA 92130 Arizona
Phone: 877-585-5010 Arizona Association for Home Care
Fax: 888-458-0197 2302 North Third Street
Website: www.NurseZone.com Phoenix, AZ 85004
Phone: 602-712-9812
Fax: 602-252-5265
Homecare Organizations by State Arkansas

HomeCare Association of Arkansas
One of your best bets in finding a job is one of the 411 South Victory, Suite 205
Little Rock, AR 72201
more than 80,000 home-healthcare providers operat-
Phone: 501-376-2273
ing in the United States as of 2009. The National Asso- Fax: 501-376-7107
ciation for Home Care (NAHC) defines homecare
organizations as home-health agencies, homecare- Home Health Professionals
P.O. Box 704
aide organizations, and hospices. Types of homecare
Blytheville, AR 72316
agencies include visiting-urse associations (VNAs), Phone: 870-762-1825
public government-agencies, proprietary for-profit Fax: 870-762-2299
agencies, private not-for-profit agencies, and hospital-
Arkansas Hospital Association
based agencies.
419 Natural Resources Drive
Members of the NAHC are featured in the follow- Little Rock, AR 72205
ing state-by-state listing of homecare organizations. Phone: 501-224-7878
Fax: 501-224-0519
Website: www.arkhospitals.org
Alabama
Home Care Association of Alabama California
P.O. Box 3238 California Association for Health Services at
Montgomery, AL 36109 Home
Phone: 334-395-9949 / 800-934-4312 3780 Rosin Court, Suite 190
Fax: 334-395-9959 Sacramento, CA 95834
Website: www.homecarealabama.org Phone: 916-641-5795
Fax: 916-641-5881
Lanier Home Health Services Website: www.cahsah.org
1806 44th Street
Valley, AL 36854 Area Administrator, San Diego Home Health &
Phone: 334-756-1950 Hospice
Fax: 334-756-1970 Kaiser Foundation Hospital Home Health
E-mail: dveal@lanierhospital.com 10992 San Diego Mission Road, 3rd Floor
San Diego, CA 92108
Alaska Phone: 619-641-4663
Alaska Home Care Association Fax: 619-641-4110
4155 Tudor Centre Drive, Suite 103
Anchorage, AK 99508
121

Colorado Florida
Home Care Association of Colorado Associated Home Health Industries of Florida, Inc.
7853 East Arapahoe Road, Suite 2100 1331 East Lafayette Street, Suite C
Englewood, CO 80112 Tallahassee, FL 32301
Phone: 303-694-4728 Phone: 850-222-8967
Fax: 303-694-4869 Fax: 850-222-9251
Website: www.hcaconline.org Website: www.ahhif.org
Northwest Colorado VNA/HQ MedSouth Home Health

940 Central Park Drive, Suite 101 112 W. Virginia Avenue
Steamboat Springs, CO 80487 Bonifay, FL 32425
Phone: 970-879-1632 Phone: 850-547-5549
Fax: 970-870-1326 Fax: 850-657-5458
Connecticut Georgia
Connecticut Association for Home Care, Inc. Georgia Association for Home Health Agencies, Inc.
110 Barnes Road 2100 Roswell Road
PO Box 90 Suite 200C - PMB 1107
Wallingford, CT 06492 Marietta, GA 30062
Phone: 203-265-9931 Phone: 770-565-4531
Fax: 203-949-0031 Fax: 770-565-1739
Website: www.cthomecare.org Website: www.gahha.org
New England Home Care Healthfield, Inc.

136 Berlin Road 6666 Powers Ferry Road
Cromwell, CT 06416 Atlanta, GA 30339
Phone: 860-632-3928 Phone: 770-951-6106
Fax: 860-632-3536 Fax: 770-541-3776
Delaware Georgia Association of Community Care

Delaware Association of Home and Community Providers
Care 168 North Johnston Street, Suite 304
Home Health Corp of America Dallas, GA 30132
260 Chapman Road, #200 Phone: 770-445-6640
Commonwealth Building Fax: 770-445-3893
Newark, DE 19702 Website: www.gaccp.org
St. Francis Hospital Home Health Care Program Englewood Home Health Care
Seventh and Clayton Streets P.O. Box 1743
PO Box 2500 Albany, GA 31702
Wilmington, DE 19805 Phone: 229-435-2109
Phone: 302-575-8231 Fax: 229-435-0729
Fax: 302-575-8239
Georgia Home Care Association
Delaware Hospice Association 168 North Johnston Street, Suite 304
3515 Silverside Road, Suite 100 Dallas, GA 30132
Wilmington, DE 19810 Phone: 770-445-3180
Phone: 302-478-5707 / 800-838-9800 Fax: 770-445-3893
Fax: 302-479-2586 Website: www.gahca.org
122

Nursing Care Inc. Indiana

205 Boulevard NE Indiana Association for Home and Hospice
Gainesville, GA 30501 Care, Inc.
Phone: 770-536-0484 8604 Allisonville Road, Suite 260
Fax: 770-536-3003 Indianapolis, IN 46250
Phone: 317-844-6630
Hawaii Fax: 317-575-8751
Healthcare Association of Hawaii Website: www.ind-homecare.org
932 Ward Avenue, Suite 430
Honolulu, HI 96814 St. Margaret Mercy Home Care
Phone: 808-521-8961 5454 Hohman Avenue
Fax: 808-599-2879 Hammond, IN 46320
Website: www.hahc.org Phone: 219-933-6663
Fax: 219-933-2641
CareResource Hawaii
680 Iwilei Road, Suite 660 Iowa
Honolulu, HI 96817 Iowa Association for Home Care
Phone: 808-599-4999 1520 High Street, Suite 203-B
Fax: 808-531-2832 Des Moines, IA 50309
Website: www.careresourcehawaii.org Phone: 515-282-3965
Fax: 515-282-8034
Idaho
Idaho Association of Home Health Agencies Visiting Nurse Association
10400 Overland Road, Suite 144 611 North 2nd Street
Boise, ID 83709 Clinton, IA 52732
Phone: 208-362-8190 Phone: 563-242-7165
Fax: 208-562-1366 Fax: 563-242-7197
Guardian Home Care Kansas

119 South Valley Drive, Suite C Kansas Home Care Association
Nampa, ID 83686 1512 B Legend Trail Drive
Phone: 208-461-1600 Lawrence, KS 66047
Phone: 785-841-8611
Illinois Fax: 785-749-5414
Illinois Home Care Council Website: www.kshomecare.org
1926 Waukegan Road, Suite 1
Glenview, IL 60025 Community Home Health
Phone: 847-657-6960 100 W. 8th
Fax: 847-657-6963 Onaga, KS 66521
Website: www.ilhomecare.org Phone: 785-889-7200
Fax: 785-889-4808
Tom Galluppi
Resurrection Home Health Services Kentucky
4930 W Oakton Street Kentucky Home Health Association
Skokie, IL 60077 154 Patchen Drive, Suite 90
Phone: 847-568-8524 Lexington, KY 40517
Fax: 847-568-8537 Phone: 859-268-2574
Fax: 859-269-1124
Website: www.khha.org
123

Visiting Nurse Association/JHHS Massachusetts

101 W Chestnut Street Home & Health Care Association of
Louisville, KY 40202 Massachusetts
Phone: 502-581-8702 31 James Avenue, Suite 780
Fax: 502-585-7600 Boston, MA 02116
Phone: 617-482-8830
Louisiana Fax: 617-426-0509
HomeCare Association of Louisiana Website: www.mass-homehealth.org
233-A East Main Street
New Iberia, LA 70562 VNA of Greater Lowell
Phone: 337-560-9610 P.O. Box 1965
Fax: 337-560-9606 Lowell, MA 01853
Website: www.hclanet.org Phone: 978-459-9343
Fax: 978-441-0007
Southland HH of Shreveport
8870 Youree Drive, Suite 110 Massachusetts Council for Home Care Aide
Shreveport, LA 71115 Services
Phone: 318-798-1755 31 New Chardon Street
Fax: 318-798-1754 Boston, MA 02114
Phone: 617-227-6641
Maine Fax: 617-227-1190
Home Care Alliance of Maine
20 Middle Street Merrimack Valley Hospice
Augusta, ME 04330 360 Merrimack Street, Bldg #9
Phone: 207-623-0345 Lawrence, MA 01843
Fax: 207-623-7141 Phone: 978-552-4701
Website: www.homecarealliance.org Fax: 978-552-4730
SMMC Visiting Nurses Michigan

72 Main Street Michigan Home Health Association
Kennebunk, ME 04043 2140 University Park Drive, Suite 220
Phone: 207-985-1000 / 800-794-3546 Okemos, MI 48864
Fax: 207-985-6715 Phone: 517-349-8089
Website: www.smmcvisitingnurses.org Fax: 517-349-8090
Website: www.mhha.org
Maryland/District of Columbia Airway Oxygen

Maryland National Capital Homecare Association 2935 Madison SE
6919 Baltimore National Pike, Suite F Grand Rapids, MI 49548
Frederick, MD 21702 Phone: 877-632-0730, ext. 208
Phone: 301-473-9801 Fax: 616-452-7404
Fax: 301-473-9803
Minnesota
Gentiva Health Services Minnesota HomeCare Association
1227 25th Street, N.W. 1711 West County Road B, Suite 211S
Washington, DC 20037 St. Paul, MN 55113
Phone: 703-340-1633 Phone: 651-635-0607
Fax: 651-635-0043
Website: www.mnhomecare.org
124

Fairview Home Care and Hospice Marcus Daley Home Care and Hospice
2450 26th Avenue S. 1200 Westwood Drive
Minneapolis, MN 55406 Hamilton, MT 59840
Phone: 612-721-2491 Phone: 406-363-6503
Fax: 612-728-2400 Fax: 406-363-2866
Mississippi Nebraska
Mississippi Association for Home Care Nebraska Association of Home and Community
P. O. Box 1468 Health Agencies
Ridgeland, MS 39158 7421 Forbes Drive
Phone: 601-853-7533 Lincoln, NE 68516
Fax: 601-853-7582 Phone: 402-489-1117
Website: www.mahc.org Fax: 402-489-1117
Website: www.nebraskahomecare.org
Gilbert Home Health
605 2nd Avenue, North #203 Saint Francis Medical Center Home Care Services
Columbus, MS 39701 2116 W. Faidley Avenue
Phone: 662-327-9669 Grand Island, NE 68802
Fax: 662-239-2015 Phone: 308-398-5470
Fax: 308-398-5363
Missouri
Missouri Alliance for Home Care Nevada
2420 Hyde Park Road, Suite A Home Health Care Association of Nevada
Jefferson City, MO 65109 Washoe Home Care
Phone: 573-634-7772 780 Kuenzli, Suite 200
Fax: 573-634-4374 Reno, NV 89502
Website: www.homecaremissouri.org
Colonial Home Care
John Knox Village Home Health 5516 Boulder Highway
400 Northwest Murray Road #2-F PMB185
Lee’s Summit, MO 64081 Las Vegas, NV 89122
Phone: 816-524-1133 Phone: 702-733-8498
Fax: 816-524-9177 Fax: 702-733-8498
Missouri Hospital Home Health Council New Hampshire

P.O. Box 60 Home Care Association of New Hampshire
Jefferson City, MO 65102 8 Green Street
Phone: 573-893-3700 Concord, NH 03301
Fax: 573-893-2809 Phone: 603-225-5597
Fax: 603-225-5817
Montana Website: www.homecarenh.org
Montana Hospital Association: An Association of
Montana Health Care Providers Rockingham VNA & Hospice
P.O. Box 5119 137 Epping Road
Helena, MT 59604 Exeter, NH 03079
Phone: 406-442-1911 Phone: 603-893-2900
Fax: 406-443-3894 Fax: 603-382-6246
Website: www.mtha.org
125

New Jersey New York State Association of Health Care

The Home Care Association of New Jersey Providers, Inc.
14 Washington Road, Suite 211 99 Troy Road, Suite 200
Princeton Junction, NJ 08550 East Greenbush, NY 12061
Phone: 609-275-6100 Phone: 518-463-1118
Fax: 609-936-9349 Fax: 518-463-1606
Website: www.homecarenj.org Website: www.nyshcp.org
VNA of Central Jersey, Inc. New York Nursing Care

141 Bodman Place 527 Townline Road, Suite 302
Redbank, NJ 07701 Hauppauge, NY 11788
Phone: 732-747-1204 Phone: 631-979-2200
Fax: 732-224-0843 Fax: 631-979-2265
New Jersey Hospital Association Health Care Association of New York State
760 Alexander Road One Empire Drive
P.O. Box 1 Rensselaer, NY 12144
Princeton, NJ 08543 Phone: 518-431-7600
Phone: 609-275-4000 Fax: 518-431-7915
Fax: 609-275-4265 Website: www.hanys.org
Website: www.njha.com
Home Care Council of New York City
New Mexico 25 West 43rd Street, 3rd Fl
New Mexico Association for Home and Hospice New York, NY 10036
Care Phone: 646-366-0860
3200 Carlisle Boulevard, NE, Suite 117 Fax: 646-366-0864
Albuquerque, NM 87110
Phone: 505-889-4556 North Carolina
Fax: 505-889-4928 Association for Home Care and Hospice of North
Website: www.nmahc.org Carolina, Inc.
3101 Industrial Drive
Lovelace Sandia Home Care Raleigh, NC 27609
5403 Gibson SE Phone: 919-848-3450
Albuquerque, NM 87108 Fax: 919-848-2355
Phone: 505-872-6500 Website: www.homeandhospicecare.org
Fax: 505-872-6547
Piedmont Home Care
New York P.O. Box 1624
Home Care Association of New York State, Inc. Lexington, NC 27293
194 Washington Avenue, Suite 400 Phone: 336-248-8212
Albany, New York 12210 Fax: 336-248-4937
Phone: 518-426-8764
Fax: 518-426-8788 The Carolinas Center for Hospice and End of Life
Website: www.hcanys.org Care
2400 Weston Parkway
VNA of Hudson Valley, Inc. Cary, NC 27513
100 South Bedford Road Phone: 919-677-4115
Mount Kisco, NY 10549 Fax: 919-677-4199
Phone: 914-666-7616, ext. 187 Website: www.carolinasendoflifecare.org
Fax: 914-666-9514
126

North Dakota May House Call

North Dakota Association for Home Care P.O. Box 940
c/o APT, Inc. Antlers, OK 74523
P.O. Box 2175 Phone: 580-298-3947
Bismarck, ND 58502 Fax: 580-298-2443
Phone: 701-224-1815
Fax: 701-224-9824 Oregon
Website: www.aptnd.com/ndahc Oregon Association for Home Care
1249 Commercial Street SE
MeritCare Home Care Salem, OR 97302
1711 S. University Drive Phone: 503-364-2733
Fargo, ND 58103 Fax: 503-399-1029
Phone: 701-280-4027 Website: www.oahc.org
Fax: 701-280-4030
E-mail: marcia.sjulstad@meritcare.com Cascade Home Care
2500 NE Neff Road
Ohio Bend, OR 97701
Ohio Council for Home Care Phone: 541-388-7796
1395 East Dublin-Granville Road, Suite 350 Fax: 541-318-4955
Columbus, OH 43229
Phone: 614-885-0434 Pennsylvania
Fax: 614-885-0413 Pennsylvania Homecare Association
Website: www.homecareohio.org 20 Erford Road, Suite 115
Lemoyne, PA 17043
SOMC Home Health Services Phone: 717-975-9448
727 8th Street Fax: 717-975-9456
Portsmouth, OH 45662 Website: www.pahomecare.org
Phone: 740-356-4663
Fax: 740-353-5956 Abington Memorial Hospital Home Care
2510 Maryland Road, Suite 250
Ohio Hospice & Palliative Care Organization Willow Grove, PA 19090
555 Metro Place North, Suite 650 Phone: 215-481-5800
Dublin, OH 43017 Fax: 215-481-5850
Phone: 614-763-0036
Fax: 614-763-0050 Rhode Island
Website: www.ohpco.org Alan Tavares Rhode Island Partnership for Home
Care, Inc.
Hospice of the Western Reserve 334 East Avenue
300 E 185th Street Pawtucket, RI 02860
Cleveland, OH 44119 Phone: 401-722-9090
Phone: 216-383-2222 Fax: 401-728-6509
Fax: 216-383-3730
VNA Rhode Island
Oklahoma 622 George Washington Highway
Oklahoma Association for Home Care Lincoln Mall
8108 NW Tenth, Suite C3 Lincoln, RI 02865
Oklahoma City, OK 73127 Phone: 401-335-2493
Phone: 405-495-5995 Fax: 401-335-9030
Fax: 405-495-5993
Website: www.oahc.com
127

South Dakota North Central Texas Home Care, Inc.

South Dakota Association of Healthcare 5608 Malvey, Suite 300
Organizations Fort Worth, TX 76107
3708 Brooks Place Phone: 800-648-0854
Sioux Falls, SD 57106 Fax: 817-377-0948
Phone: 605-361-2281
Fax: 605-361-5175 Utah
Website: www.sdaho.org Utah Association for Home Care
1327 South 900 East
Avera Sacred Heart Health Care Services Salt Lake City, UT 84105
501 Summit Phone: 801-466-7210
Yankton, SD 57078 Website: www.ua4hc.org
Phone: 605-668-8312
Fax: 605-665-0170 Applegate HomeCare & Hospice
1740 Combe Road, Suite 1
Tennessee Ogden, UT 84403
Tennessee Association for Home Care, Inc. Phone: 801-621-4027
131 Donelson Pike Fax: 801-627-6226
Nashville, TN 37214
Phone: 615-885-3399 Vermont
Fax: 615-885-4191 Vermont Assembly of Home Health Agencies
Website: www.tahc-net.org 10 Main Street
Montpelier, VT 05602
UT Medical Center Home Health Phone: 802-229-0579
2220 Southerland Avenue, Suite 102 Fax: 802-223-6218
Knoxville, TN 37919 Website: www.vnavt.com
Phone: 865-544-6200
Fax: 865-544-6240 Rutland Area VNA and Hospice
P.O. Box 787
Tennessee Hospital Association Home Care Rutland, VT 05702
Alliance Phone: 802-775-0568
500 Interstate Boulevard South Website: www.ravanah.org
Nashville, TN 37210
Phone: 615-256-8240
Fax: 615-242-4803 Virginia
Virginia Association for Home Care
Vanderbilt Home Care Services 8001 Franklin Farms Drive, Suite 110
Vanderbilt University Medical Center Richmond, VA 23229
2120 Belcourt Avenue Phone: 804-285-8636 / 800-755-8636
Nashville, TN 37212 Fax: 804-288-3303
Phone: 615-936-0336 Website: www.vahc.org
Texas Carilion Home Care Services

Texas Association for Home Care 1917 Franklin Road, Suite C
3737 Executive Center Drive, Suite 268 Roanoke, VA 24014
Austin, TX 78731 Phone: 540-224-4800
Phone: 512-338-9293 Fax: 540-982-5785
Fax: 512-338-9496
Website: www.tahc.org
128

Virginia Hospital and Health Care Association Panhandle Home Health

P.O. Box 31394 1161-2 Winchester Avenue
Richmond, VA 23294 Martinsburg, WV 25401
Phone: 804-965-1249 Phone: 304-263-5680
Fax: 804-965-0475 Fax: 304-267-1532
Website: www.vhha.com
Wisconsin
Virginia Hospital and Health Care Association Wisconsin Homecare Organization
P.O. Box 31394 5610 Medical Circle, Suite 33
Richmond, VA 23294 Madison, WI 53719
Phone: 804-965-1216 Phone: 608-278-1115
Fax: 804-965-0475 Fax: 608-278-4009
Website: www.wishomecare.org
Washington
Home Care Association of Washington Wyoming
P.O. Box 2016 Home Health Care Alliance of Wyoming
Edmonds, WA 98020 1515 S Spruce Street
Phone: 425-775-8120 Casper, WY 82601
Fax: 425-771-9588 Phone/Fax: 307-237-7042
Website: www.hcaw.org
Central Wyoming Home Care
Group Health Cooperative Home & Community 401 East Main
Services Riverton, WY 82501
1600 E. John Street Phone: 307-857-0599
M/S CMB-140 Fax: 307-857-2778
Seattle, WA 98122
Phone: 206-326-4828
Fax: 206-326-4555
West Virginia
West Virginia Council of Home Care Agencies, Inc.
Route 1 Box 190
Elk Fork Road
Middlebourne, WV 26149
Phone: 304-758-4312
129

Appendix:
Nursing Assistant/
Nurse Aide
Practice Exam
Question Outline
You can use the charts on the pages that follow to assess the areas in which you need more study. The column on
the left indicates the topics tested, and the right column indicates the question numbers in that topic.
131

–appendix–
Nursing Assistant/Nurse Aide Practice Exam 1

Physical Care Skills
Topic Question Numbers
Activities of Daily Living 2, 5, 8, 10, 17, 31, 52, 54, 68, 69
n Hygiene
n Dressing and Grooming

n Nutrition and Hydration
n Elimination
n Rest/Sleep/Comfort
Basic Nursing Skills 3, 4, 6, 7, 11, 15, 16, 21, 24, 25, 26,
n Infection Control 27, 30, 32, 33, 34, 35, 36, 37, 38, 39,
n Safety/Emergency 40, 41, 42, 43, 45, 47, 61, 62, 65, 66
n Therapeutic/Technical Procedures
n Data Collection and Reporting
Restorative Skills 1, 18, 19

n Prevention
n Self-Care/Independence
Psychosocial Care Skills
Emotional and Mental Health Needs 9, 47, 49, 51, 53, 55, 56, 70
Spiritual and Cultural Needs 57, 58

Role of the Nurse Aide
Communication 12, 13, 20, 23, 59, 64
Client Rights 28, 29, 46, 48, 50
Legal and Ethical Behavior 45, 60, 67
Member of the Healthcare Team 14, 22, 44, 63
132

–appendix–

Activities of Daily Living 8, 28, 29, 30, 33, 35, 60

n Hygiene

n Elimination

n Safety/Emergency 34, 36, 37, 38, 50, 56, 59, 64, 66
Restorative Skills 2, 3, 6, 14, 15, 32, 49

n Prevention
Emotional and Mental Health Needs 41, 42, 43, 46

Communication 26, 44, 57, 58, 59, 68
Client Rights 40, 45, 51, 52, 53, 54, 55, 67, 69
Legal and Ethical Behavior 47, 48, 61, 70
Member of the Healthcare Team 62, 63
133

–appendix–

Activities of Daily Living 13, 16, 24, 35, 37, 39, 53, 70
n Hygiene

n Elimination
Basic Nursing Skills 2, 3, 4, 5, 6, 10, 11, 12, 14, 15,

n Infection Control 17, 18, 20, 22, 23, 25, 26, 27, 28,
n Safety/Emergency 29, 30, 31, 32, 33, 34, 38, 42, 47, 48, 57

n Prevention
Emotional and Mental Health Needs 7, 59, 60, 61, 63, 64

Communication 46, 49, 52, 62
Client Rights 21, 44, 45, 54, 55, 69
Legal and Ethical Behavior 19, 40, 41, 43, 50
Member of the Healthcare Team 36, 51, 66, 67, 68
134

–appendix–

Activities of Daily Living 4, 33, 34, 35, 36, 61

n Hygiene

n Elimination
n Safety/Emergency 29, 30, 31, 32, 38, 57
Restorative Skills 3, 7, 9, 10, 37, 39

n Prevention
Emotional and Mental Health Needs 40, 41, 42, 43, 44, 45, 46, 48, 58
Spiritual and Cultural Needs 47

Communication 49, 50, 51, 52, 54
Client Rights 53, 60, 62, 64, 66
Legal and Ethical Behavior 55, 56, 63, 65
Member of the Healthcare Team 6, 16, 59, 67, 68, 69, 70
135

–appendix–

Activities of Daily Living 2, 3, 5, 10, 14, 20, 21, 23

n Hygiene

n Elimination
Basic Nursing Skills 1, 4, 6, 7, 8, 11, 12, 13, 15, 17, 18, 22, 25,
n Infection Control 26, 27, 28, 29, 32, 33, 34, 35, 37, 38, 39,
n Safety/Emergency 41, 42, 43, 44, 45, 46, 52, 60
n Prevention
Emotional and Mental Health Needs 19, 47, 48, 49, 50, 51, 66

Communication 30, 40, 53, 54, 55, 56, 57
Client Rights 31, 36, 58, 59, 67, 68, 69, 70
Legal and Ethical Behavior 63, 64, 65
Member of the Healthcare Team 60
136

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nursing assistant/

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All rights reserved under International and Pan-American Copyright Conventions.

Library of Congress Cataloging-in-Publication Data:

Nursing assistant/nurse aide exam.—4th ed.

Printed in the United States of America

Regarding the Information in This Book

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chapter 1 The Nursing Assistant/Nurse Aide Exam 1

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NCSBN develops examination programs and admin- Career O utlook and

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■ legal and ethical issues

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S t a t e N u r s i n g A s s i sta nt/ COLORADO

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MONTANA NEW YORK

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RHODE ISLAND VIRGINIA

SOUTH CAROLINA WASHINGTON

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Step 1: Know the Potential Test-Taking Blockers

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Your Test Stress Score

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1. Are you a risk-taker? Diet

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Use the process of elimination to answer the following questions.

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Your Guessing Ability

1. September 7 is Independence Day in 4. American author Gertrude Stein was born in

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Activity: Complete the Final Preparations worksheet.

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Location of exam site:

Time it will take to get to exam site

Things to Lay Out the Night Before

Clothes I will wear

Other Things to Bring/Remember

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Schedule A: The 30-Day Plan

Days 9–10 Take the second practice exam in Chapter 4.

Day 17 Take the third practice exam.

Day 29 Take the final practice exam.

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chapter 1 The Nursing Assistant/Nurse Aide Exam 1

Days 9–10 Take the second practice exam in Chapter 4.

Day 17 Take the third practice exam.

Day 29 Take the final practice exam.

5. Tuberculosis is a disease of the 10. Hemiplegia refers to

38. A trochanter roll is used t o 44. A common sign of depression is