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Minnesota

NURSINGASSISTANT/HOMEHEALTH AIDE

to test

BEFORE JULY 1, 2013

click here

to test ON orAFTER JULY 1, 2013

click herewritten (or oral) examination& skills evaluation

CANDIDATE HANDBOOK

PEARSON VUE

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Stock #0624-00 1/11

minnesotaNURsing assistant/

home health aide

CandidateHandbook

January 2011

QUICK REFERENCE

TABLE OFCONTENTS

PRINT

seaRCH

DoCUment

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QuiCk RefeRenCe

MiNNesotA DepArtMeNt of HeAltHNursing Assistant Registry

PO Box 64501St. Paul, MN 55164-0501

(800) 397-6124 (in Minnesota)

(651) 215-8705Hours of Operation 9:00 a.m. 3:00 p.m.

(Central Time Zone)

Call the Minnesota Department of Health to:

Obtain inormation on oicial regulations and

guidelines or nursing assistants/home health aides Update your name or address on the Registry

Update your employment inormation

Obtain inormation regarding test sites andapproved training programs

peArsoN VUe

Minnesota Nursing Assistant/Home Health Aide Program

PO Box 13785Philadelphia, PA 19101-3785(800) 274-0504

Hours of OperationMonday through Friday 9:00 a.m. 5:00 p.m.

(Eastern Time Zone)

Call Pearson VUE to:

Change your current address or name prior toexamination results being sent to the Registry

Request a duplicate Score Report

Obtain inormation regarding an examination

Go to Pearson VUEs website atwww.pearsonvue.com to:

Download a Candidate Handbook

View the Nurse Aide Practice Written Examination

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table of Contents

Quck rnc.............................insidefontcover

inducn........................................................1

National Nurse Aide Assessment Program ............... 1

NNAAP Exam Overview.................................... 1

Nurse Aide/Home Health Aide Combined Program 2

Exam Overview .................................................... 3

eg..................................................................3

Eligibility Routes ...................................................... 3

Acan and schdung.............................4

Filling Out an Application ....................................... 4Exam Fees ................................................................. 5

Exam Scheduling ...................................................... 6

Walk-in Testing .................................................... 6

Special Exam Requests and Services ......................... 7

Telecommunication Devices

or the Dea (TDD) .............................................. 7

Cancan..........................................................7

Weather Emergencies ................................................ 7

Reunds .................................................................... 7

exam Da..................................................................8

Checking In .............................................................. 8

What to Bring .......................................................... 8

Proper Identiication ................................................. 9

Testing Policies ......................................................... 9

Lateness ................................................................ 9

Electronic Devices ................................................ 9Study Aids ............................................................ 9

Eating/Drinking/Smoking................................... 10

Misconduct .......................................................... 10

Guests/Visitors ..................................................... 10

Use o Restrooms ................................................. 10

Security and Cheating ......................................... 10

th Wn ( oa) exam............................ 10

Written Exam .......................................................... 10

Oral Exam ............................................................... 11

NNAAp Wn ( oa) examCnn oun.............................................12

NA/HHA Wn ( oa) examCnn oun.............................................13

continued on next page

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Pearson VUE and ARC do not discriminate on the basis o age, sex, race, creed,

disabling condition, religion, national origin, or any other protected characteristics.

Copyright 2011 Pearson Education, Inc., or its afliates. All Rights Reserved.

NNAAP Written Exam Content Outline and Practical Skills ListingCopyright 2010 National Council o State Boards o Nursing, Inc. (NCSBN). All rights reserved.

sam Qun................................................ 14

s-amn adng ...................... 15-18

th sk evauan.........................................19

What to Expect ....................................................... 19

Setting ................................................................. 19

Who Will Act as a Client? ................................... 19

Candidate Volunteer Requirements ..................... 19

The Tasks ............................................................... 20Recording a Measurement ....................................... 21

Sample o Recording Sheetor Measurement Skills ....................................... 22

Tips or the Skills Evaluation.............................. 23

sk lng.....................................................24-39

sc rng..................................................40

Exam Results .......................................................... 40

Written (or Oral) ................................................ 30

Skills Evaluation ................................................. 40

Failing ..................................................................... 40How to Read a Failing Score Report ....................... 41

Sample o a Failing Score Report ............................. 41

Passing .................................................................... 42

Duplicate Score Report/Handscored Results .......... 42

th rg...........................................................42

Change o Address or Name ................................... 42

Change o Employment .......................................... 43

Updating the Registry ............................................ 43

Lost Certiicate ....................................................... 44

Lapsed Certiication ............................................... 44

MN NA/HHAfqun akd qun.................. 45-50

Andx

Appendix A: Request or Duplicate Score Reportor Handscored Answer Sheet Form

Appendix B: Request or Duplicate Certiicate Form

Appendix C: Change o Address or Name BeoreReceipt o Certiicate Form

Appendix D: Nursing Assistant Registry Update Form

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1

intRoduCtion

is handbook is designed or candidates seeking a nursingassistant or a nursing assistant/home health aide certication

in Minnesota. It describes the process o applying or the

National Nurse Aide Assessment Program (NNAAP) or

the Nurse Aide/Home Health Aide (NA/HHA) Combined

Program and taking the NNAAP or the NA/HHAExamination. It should be kept for future reference.

e Minnesota Department o Health has contracted with

Pearson VUE, a nationally recognized leading provider o

assessment services to regulatory agencies and national

associations, to develop, score, and report the results o the

competency examination required or certication and

placement on the Minnesota Nursing Assistant Registry.

NAtioNAl NUrse AiDe AssessMeNt

prorAM (NNAAp)

e Nursing Home Reorm Act, adopted by Congress aspart o the Omnibus Budget Reconciliation Act o 1987

(OBRA 87), was designed to improve the quality o care

in long-term health care acilities and to dene training

and evaluation standards or nurse aides who work in such

acilities. Each state is responsible or ollowing the terms

o this ederal law.

e National Nurse Aide Assessment Program (NNAAP)

is an examination program designed to determine minimal

competency to become a certied nursing assistant in your

state. e NNAAP was developed by the National Council

o State Boards o Nursing, Inc., (NCSBN) to meet the nurs-ing assistant evaluation requirement o ederal and state laws

and regulations. Pearson VUE is the authorized administra-

tor o the NNAAP in your state.

e NNAAP Examination is an evaluation o nursing

assistant-related knowledge, skills, and abilities. eNNAAP Examination is made up o both a Written (or

Oral) Examination and a Skills Evaluation. e purpose

o the NNAAP Examination is to test that you under-

stand and can saely perorm the job o an entry-level

nursing assistant.

e Minnesota Department o Health is responsible or

establishing the content o the examination, determining

the passing score or the examination, and deciding who

is eligible to take the examination.

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2

NNAAP Exam Overview

e two (2) parts o the NNAAP Examination, the

Written (or Oral) Examination and the Skills Evaluation,will be administered on the same day. You must pass both

parts in order to receive a certicate and be listed on the

Minnesota Nursing Assistant Registry.

e NNAAP Written Examination consists o seventy

(70) multiple-choice questions written in English. Sampleexamination questions are provided in this handbook.

An Oral Examination may be taken in place o the Written

Examination. e Oral Examination consists o sixty (60)

multiple-choice questions, and (10) multiple-choice read-

ing comprehension questions provided on a cassette tape.

You will be asked to listen to a cassette tape. o the Oral

Examination and ollow along in the test booklet as the

questions are read aloud on the tape. To request an Oral

Examination, you must complete Part II: Examination

Types and Feeson your application as well as contact your

Technical College to schedule an examination. Please notethat the Oral Examination is available on a cassette tape.

At the Skills Evaluation you will be asked to perorm ve

(5) randomly selected NNAAP skills. You will be rated on

these skills by an Evaluator. A complete listing o the skills

is shown on pages 24 to 39.

See The Written (or Oral) Exam and The Skills Evaluation

sections o this handbook or more details about the

NNAAP Examination.

NUrse AiDe/HoMe HeAltH AiDe

(NA/HHA) CoMbiNeD prorAMTogether with the Minnesota Department o Health

and subject matter experts rom the state o Minnesota,

Pearson VUE has developed a testing program called the

NA/HHA Combined Program. is program provides a

certicate as both a home health aide and a nursing assis-tant. e NA/HHA examination is a measure o home

health aide and nursing assistant related knowledge, skills,

and abilities.

e examination or the NA/HHA Combined Program

consists o the NA/HHA Written Examination togetherwith the NNAAP Skills Evaluation. In order to be eligible

to take the NA/HHA Examination, you must have suc-

cessully completed a state-approved nursing assistant/

home health aide training program.

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As an alternative to taking the entire NA/HHAExamination, candidates who are currently on theNursing Assistant Registry may achieve nursing assistant/home health aide certication by proving that they have:

previously completed a seventy-ive (75) hour state-approved nursing assistant training program,

successully passed both parts o the NNAAPExamination (see the description in the section

National Nurse Aide Assessment Program), completed an approved home health aide training

program, then taking and passing the NA/HHAWritten Examination.

Exam Overview

e NA/HHA Written Examination consists o seventy(70) multiple-choice questions written in English. Samplequestions are provided in this handbook.

An Oral Examination may be substituted or the NA/HHAWritten Examination. e Oral Examination consists osixty (60) multiple-choice questions, and (10) multiple-choice reading comprehension questions. To request anOral Examination, you must complete Part II: ExaminationTypes and Feeson your application as well as contact yourTechnical College to schedule an examination. e OralExamination is available on a cassette tape.

At the Skills Evaluation you will be asked to perorm ve(5) randomly selected nursing assistant/home health aideskills. You will be rated on these skills by an Evaluator. Acomplete listing o the skills is shown on pages 24 to 39.

See The Written (or Oral) Exam and The Skills Evaluationsections o this handbook or more details about the partso the examination or the NA/HHA Combined Program.

eligibility

eliibility roUtesYou are eligible to apply to take the NNAAP Exam-inationor the NA/HHA Examination or certication as a nurs-

ing assistant or a nursing assistant/home health aide in

Minnesota i you qualiy under one o the ollowing routes:

1 Nursing Assistant CandidateYou have completed a state-approved nursing assis-

tant training program within the past two (2) years.

You must take the NNAAP Written (or Oral)

Examination and the Skills Evaluation.

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2 Nursing Assistant/Home Health Aide Candidate

You have completed a state-approved nursing assistant/home health aide training program within the past

two (2) years. You must take the NA/HHA Written

(or Oral) Examination and the Skills Evaluation.

3 Home Health Aide Candidate

Prove you have previously completed a state-approved

nursing assistant training program, have taken and

passed the NNAAP Examination (both the Written

(or Oral) Examination and the Skills Evaluation), are

on the Minnesota Nursing Assistant Registry, and later

completed an approved home health aide program and

are now seeking home health aide certiication. Youare required to take only the NA/HHA Written (or

Oral) Examination. (Home health aide candidates do

N need to take the Skills Evaluation.)

4 Test-Out Candidate

(applies to nursing assistant candidates only)You are a candidate who does not meet any o the

three (3) eligibility routes listed above. Examples are:

1) i you trained in another country; 2) i you have

not taken a nursing assistant training program; 3) i

you have not worked as a nursing assistant in the last

two (2) years; 4) i you are rom another state and do

not qualiy or reciprocity in Minnesota or are not in

current status on transerring Registry; or 5) i you are

a student nurse or graduate nurse candidate. For these

candidates, the training program code or the applica-

tion is 77777.

appliCation andsCHeduling

filliN oUt AN AppliCAtioNYou must complete a Minnesota Nursing Assistant/

Home Health Aide Application beore taking the NNAAP

or NA/HHA Examination.

You may get an application rom your nursing assis-

tant/home health aide training program or test site.

You are responsible or completing the application,

however, you may ask someone rom your nurs-

ing assistant/home health aide training program

4

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or assistance in completing the application. I you

need additional help or have any questions about the

application, please contact a Pearson VUE CustomerService Representative at (800) 274-0504.

Minnesota requires you to provide your Social

Security number on this application. Your Social

Security number will become your nursing assistant

certiicate number and will be used or identiica-

tion purposes. Your Social Security number willbe kept private. Prospective employers who provide

your Social Security number to the Registry receive

veriication o your status on the Registry. Failure to

provide your Social Security number may result in

mis-identiication. You are also required by 42 CFR 483.156 to pro-

vide certain other identiying inormation on the

application, such as your name, address, birth date,

and telephone number. Your name and address

are public. The other inormation, except or your

Social Security number, will become public ateryou receive your Certiicate. I you do not supply

adequate identiying inormation, you may not be

eligible or placement on the Registry.

Bring your completed application, required documents

(see What to Bring), and appropriate ee together in

one envelope to the test site on the day you are sched-

uled or testing. (PLEASE NE: Some test sites

require ees and paperwork to be submitted PRIR

to the test date. Please contact your individual test site

to determine when these items are required.)

I your application is incomplete or incorrect, yourscore will be withheld until you supply Pearson VUE

with the requested inormation.

I you have any questions concerning the application,

you may call Pearson VUE at (800) 274-0504.

eAM feesYou will be required to submit two (2) ees or testing:

1. Administrative Fee

You will be required to pay the Technical College a

ee or administering the examination. Contact your

local Technical College to determine how much thisee is and the method o payment.

2. NNAAP and NA/HHA Examination Fees

The ees listed below have been established or the

NNAAP and NA/HHA Examinations in Minnesota.

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examination type fees

NNAAP Written Examination& Skills Evaluation

both $59

NNAAP Oral Examination& Skills Evaluation

both $59

NA/HHA Written

Examination& Skills Evaluation

both $59

NA/HHA Oral Examination& Skills Evaluation

both $59

Written (or Oral) ExaminationNLNNAAP orNA/HHA

re-test $40

Skills Evaluation NL re-test $19

You must pay for both theWritten (or Oral) Examination

and the Skills Evaluation the first time you take

either the NNAAP or the NA/HHA Examination.Under ederal laws and Medicare/Medicaid nursing acil-

ity regulations, nursing homes are required to pay the

National Nurse Aide Assessment Program ee and the

college ee or their nursing assistant employees, including

individuals required to re-test.

Payment must be made in the orm o a money order or

certied check, a check issued by a Technical College, or

a state-approved voucher made payable to Pearson VUE

Processing Center. Even i it is rom your employer, the

payment must display your name so it can be applied

to your examination. I you are not currently employedat a nursing home, you may pay the ee yoursel.

Personal checks and cash will not be accepted. Fees are

non-reundable and non-transerable once submitted to

Pearson VUE because they cover the administrative costs

o registration and testing.eAM sCHeDUliN

Walk-in Testing

Walk-in testing is N available at all test sites.

Contact your individual test site to determine if walk-

in testing is available at that test site.To take the NNAAP or NA/HHA Examination, you

must arrive at the test site with appropriate ees, proper

identication, and required documents and materials (see

What to Bring).6

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speCiAl eAM reQUests AND serViCes

e Minnesota Department o Health and Pearson

VUE certiy that they comply with the provisions o theAmericans with Disabilities Act (42 U.S.C. 12101 et seq.).

I you have a disability, you may ask or special arrange-

ments or testing when you apply. All requests must be

approved in advance by the Technical College. Be sure to

explain the specic type o help you need. You may also

enclose proo o the need (diagnosed disability) rom your

health care provider. Evaluators administering the Skills

Evaluation will be prepared to meet the needs o nursing

assistant/home health aide candidates who have disabling

conditions.

Any candidate requesting special testing arrangementsmay be required to submit documentation o the disability

to the Technical College. Contact your Technical College

or more inormation concerning special examination

requests and services.

Telecommunication Devicesfor the Deaf (TDD)

Pearson VUE is equipped with Telecommunication Devices

or the Dea (TDD) to assist dea and hearing-impaired

candidates. TDD calling is available during all Pearson VUE

hours through a special toll-ree number, (866) 274-4777.is TDD phone option is or the express use o individuals

equipped with compatible TDD machinery.

CanCellation

WeAtHer eMereNCiese examination will be delayed or cancelled only in

the case o severe weather or a natural disaster. I severe

weather or a natural disaster makes the test site inaccessible

or unsae, the examination will be delayed or cancelled.

refUNDsOnce payment o exam ees is received, N REFUNDS

WILL BE ISSUED.

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exaM day

CHeCiN iNYou must arrive 30 minutes prior to your scheduled timeor BOTH the written examination and or the skills evalu-ation. I you are late or the written examination you willnot be allowed to test and your ees will not be reunded.

I you missed your written examination and are scheduledor a skills evaluation, please arrive 30 minutes prior to yourscheduled time. Skills Evaluation test times are approximate.

You will be required to check in or both the writtenexamination and or the skills evaluation. You will berequired to present proper identication.

WHAt to briNYou MUS have the ollowing items with you when you

take either the NNAAP Examination or the NA/HHA

Examination. Please check with your individual test-

ing site for required materials:

A completed application (for new candidates).

Failing Score Report rom the Written (or Oral)

Examination.

Proo o completion o a nursing assistant and/or

home health aide training program approved by the

Minnesota Department o Health (for EligibilityRoutes 1, 2, and 3 only).

Two (2) orms o oicial, signature-bearing identii-

cation (one orm o which must be photo-bearing),

such as Drivers License, Passport, State-issued

identiication card. Photocopies of identification

will N be accepted.

Three (3) No. 2 pencils (sharpened).

Watch with a second hand.

Eraser.

Your Social Security number*.

Examination ees (made payable toPearson VUE Processing Center).

Test site ees (as required by the Technical College).No other materials will be allowed.

*Minnesota requires you to provide your Social Security

number. Your Social Security number will become your nurs-ing assistant certiicate number and is used or identiication

purposes. Your Social Security number will be kept private.

Prospective employers who provide your Social Security num-

8

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ber to the Registry receive veriication o your status on the

Registry. Failure to provide your Social Security number may

result in mis-identiication.You are also required by 42 CFR 483.156 to provide certain

identiying inormation on the application, such as your name,

address, birth date, and telephone number. Your name and

address are public. e other identiying inormation, except or

your Social Security number, will become public ater you receive

your Certicate. I you do not supply adequate identiying inor-

mation, you may not be eligible or placement on the Registry.

proper iDeNtifiCAtioN

Candidates are required to bring two (2) orms o current,

not expired, ofcial signature bearing identication to thetest site. One orm o identication must be photo bearing.

Photo copies will NOT be accepted. Examples o proper

identication include current, not expired:

Driver's license

Passport State-issued identiication card

Alien registration card

Signed Social Security Card

Credit Card

testiN poliCiese ollowing policies are observed at each test site.

Lateness

I you arrive late or your examination, you will N

be admitted to the examination room and you will be

responsible or the entire examination ee.

Electronic Devices

Cellular phones, beepers, or any other electronic devicesare not permitted to be used and must be turned o dur-ing testing, and there is no place or storage o personal

belongings at the test sites.

Study Aids

You are not permitted to take personal belongings suchas briecases, large bags, study materials, extra books, orpapers into the examination room. Any such materials

brought into the examination room will be collected andreturned to you when you have completed the examination.Pearson VUE is not responsible or lost or misplaced items.

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Eating/Drinking/Smoking

You are not permitted to eat, drink, or smoke during the

examination.Misconduct

I you are discovered causing a disturbance o any kind orengaging in any kind o misconduct, you will be dismissedrom the examination and reported to your state licensing

agency. Decisions regarding disciplinary measures are theresponsibility o this agency.

Guests/Visitors

No guests, visitors, pets, or children are allowed at thetest site.

Use of RestroomsYou must ask permission to use the restroom duringtesting. e Evaluator will collect your answer sheet andtest booklet. e time out and time in will be noted. Noadditional testing time will be granted.

security and cheatingI you give help or receive help during any examination,the examination will be stopped. e incident will bereported to the Minnesota Department o Health orreview, and your examination will not be scored.

Please note that all examination questions, each orm o theexamination, and all other examination materials are copy-righted by, the property o, or licensed to Pearson VUE.Consequently, any distribution o the examination contentor materials through any orm o reproduction, or throughoral or written communication, is strictly prohibited and

punishable by law. Anyone who removes or tries to removeexamination materials or information from the test site willbe prosecuted.

tHe WRitten

(oR oRal) exaM

WritteN eAM

Ater all candidates have been registered, the Evaluator

will hand out materials and give instructions or taking

the Written Examination. e NNAAP and NA/HHA

Written Examinations have sixty (70) multiple-choice

questions a piece. You will have two (2) hours to complete

either examination. You will be told when teen (15)

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minutes are let to nish. You will not be permitted to

work beyond the time allotted or the examination.

Complete your answer sheet careully by lling in onlyone (1) square on the answer sheet or each question.

Markings in the test booklet will not be accepted as

answers. Your answers must appear on the separate

answer sheet. Sample questions or the Written (or Oral)

Examination are located on page 14.

orAl eAM

An Oral Examination is available upon request as an alter-

native to either the NNAAP Written Examination or the

NA/HHA Written Examination. both the NNAAP and

NA/HHA Oral Examination consist o two (2) parts, andyou must pass both parts to pass the Oral Examination.

e rst part o the Oral Examination has sixty (60) mul-

tiple choice questions. Each o these questions is read twice.

As each question is read, you will be asked to choose the

correct answer and mark it on your answer sheet.

e second part o the Oral Examination has ten (10)

multiple-choice questions. ese questions test your abil-

ity to speak a minimum amount o English by recognizing

common words use by nurse aides in long-term care acili-

ties. Each word is read three (3) times. You are asked to

match the word you hear on the tape to the written wordin the test booklet. As you nd the match, mark your

answer on the answer sheet.

e Oral Examination takes two (2) hours to complete.

You will be told when teen (15) minutes remain. Fill

in only one (1) square on the answer sheet or each ques-tion. Markings in the test booklet will not be accepted

as answers. Your answers must appear on the separate

answer sheet. Sample questions or the Oral Examination

are located on page 17.

Both oral examinations contain questions on the same

subject matter ound on the Written Examinations or

which they are substituted.

To request an Oral Examination, you must complete

Part II: Examination Types and Fees on your application

as well as contact your Technical College to schedule

an examination. Please note that the Oral Examination isavailable on a cassette tape.

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2011 WRitten (oR oRal)exaM Content outline

e revised 2011 NNAAP Examination Content Outline

is based on the ndings rom the 2009Job Analysis

of Nurse Aides published by NCSBN in spring 2010.

e examination content outline will go into eect

January 2011.

e NNAAP written examination is comprised o 70

multiple-choice items; 10 are pretest items (non-scored)

on which statistical inormation will be collected. e

NNAAP oral examination is comprised o 60 multiple-

choice items and 10 reading comprehension (word recog-nition) items. e candidate is allowed to choose between

a written and an oral examination.

# of% of questions

I. Physical Care Skills the exam in the exam

A. Activities o Daily Living ........ 14% ............81. Hygiene2. Dressing and Grooming3. Nutrition and Hydration4. Elimination5. Rest/Sleep/Comort

B. Basic Nursing Skills .................39% ............ 24

1. Inection Control2. Saety/Emergency3. Therapeutic/Technical Procedures4. Data Collection and Reporting

C. Restorative Skills ...................... 7% .............41. Prevention2. Sel Care/Independence

II. Psychosocial Care Skills

A. Emotional and

Mental Health Needs ..............11% .............6B. Spiritual and Cultural Needs ....2% ..............2

III. Role of the Nurse Aide

A. Communication....................... 8% .............5

B. Client Rights ........................... 7% .............4

C. Legal and Ethical Behavior ...... 3% .............2

D. Member o theHealth Care Team ................... 9% .............5

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na/HHa WRitten(oR oRal) exaM

Content outline

e NA/HHA Written Examination is comprised oseventy (70) multiple-choice questions. An OralExamination may be substituted or the NA/HHA

Written Examination. e NA/HHA Oral Examinationis also comprised o seventy (70) multiple-choicequestions.

% ofI. Physical Care Skills the exam

A. Activities o Daily Living ..................................10%

1. Hygiene2. Dressing and Grooming3. Nutrition and Hydration4. Elimination5. Rest/Sleep/Comort

B. Basic Nursing Skills ..........................................27%

1. Inection Control2. Saety/Emergency3. Therapeutic/Technical Procedures4. Data Collection and Reporting

C. Restorative Skills ...............................................7%1. Prevention

2. Sel Care/Independence

II. Psychosocial Care Skills

A. Emotional and Mental Health Needs ..............7-8%

B. Spiritual and Cultural Needs.............................3%

III. Role of the Home Health Aide

A. Communication ................................................5%

B. Client Rights .....................................................5%

C. Legal and Ethical Behavior................................3%

D. Member o the Health Care Team .................. 7-8%

total 75%

IV. Unique Duties of the Home Health Aide

A. Meal Planning and Preparation .........................5%

B. Care o Inants, Children, and Adolescents,Those With Special Needs ................................5%

C. Saety and Home Management ..........................7%D. Care o the Client in the Home .........................8%

total 25%

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saMple Questions

e ollowing questions are samples o the kinds oquestions that you will nd on the Written (or Oral)

Examination. Check your answers to these questions in

the box below.

1. he clients call light should always be placed:

(A) on the bed(B) within the clients reach(C) on the clients right side(D) over the side rail

2. Which of the following items is used in theprevention and treatment of bedsores or

pressure sores?(A) rubber sheet(B) air mattress(C) emesis basin(D) restraint

3. When caring for a dying client, the nurse aide

should:(A) keep the clients room dark and quiet(B) allow client to express his eelings(C) change the subject i client talks about death(D) contact the clients minister, priest or rabbi

4. What does the abbreviation ADL mean?

(A) Ad Lib(B) As Doctor Likes(C) Activities o Daily Living(D) Ater Daylight

5. After giving a client a back rub, the nurse aideshould always note:(A) the last time the client had a back rub(B) any change in the clients skin(C) clients weight(D) amount o lotion used

6. How should the nurse aide communicate witha client who has a hearing loss?(A) ace the client when speaking(B) repeat the statement(C) shout so that the client can hear(D) use a high-pitched voice

CorrectAnswers

1.B2.B3.B4.C5.B6.A

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self-assessMentReading test

e two-part Sel-Assessment Reading Test that appears

below will help you decide i you should consider taking the

Oral Examination instead o the Written Examination. To

complete the reading test, ollow the instructions provided

below and select the answer to each question. When youhave completed the reading test, you will be able to deter-

mine the number o questions you answered correctly.

pArt 1: VoCAbUlAry

1. Circle the best answer to each question.2. When you have inished, check your answers using

the answer key on page 18.

3. Count up the number o correct answers.

4. I your score is less than 17, you may have diiculty

reading the Written Examination and should con-sider taking the Oral Examination.

1. ou go to a doctor when you _____.(A) eel sleepy (D) need money(B) need socks (E) need clothes(C) eel sick

2. A person who flies an airplane is its _____.(A) pilot (D) surgeon(B) steward (E) director(C) mother

3. ou use a _____ to write.

(A) bow (D) carpenter(B) calculator (E) needle(C) pencil

4. o EI a room means to _____ it.(A) enter (D) read(B) leave (E) interrupt

(C) orget5. A wedding is a joyous _____.

(A) ocus (D) occasion(B) vehicle (E) civilization(C) balloon

6. o REUIRE something means to _____ it.(A) need (D) understand(B) have (E) hear(C) orget

go to next page

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7. ou _____ something to find its length.(A) slice(B) lock(C) measure(D) orce(E) tape

8. Soup is served in a _____.(A) plate(B) bowl

(C) ork(D) chair(E) closet

9. o accompany someone means to _____.(A) disagree with him(B) work or him(C) go with him(D) speak to him(E) choose him

10. A nursing home resident receives _____ from thestaff.(A) quality

(B) ame(C) interruption(D) care(E) work

11. Medicine is used to _____ pain.(A) widen

(B) conjure(C) enliven(D) increase(E) relieve

12. o DRENCH the flowers means to ____ them.(A) steam(B) drink(C) touch(D) soak(E) anger

13. A bicycle is a means of _____.(A) nourishment(B) transportation(C) prediction(D) collision(E) walking

14. When someone speaks in a whisper,it may be difficult to _____.(A) deceive(B) understand(C) righten(D) estimate

(E) regulate go to next page

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self-assessMentReading test

pArt 2: CoMpreHeNsioN

In this part o the reading test you will be provided with a

series o brie paragraphs. You are to read each paragraph and

then answer the questions that appear ater the paragraph.

There are many dierent kinds o ish. All ish livein water. They use their tails and ins to swim.

15. Fish live in _____.

(A) cups(B) houses(C) air(D) water(E) ountains

16. Fish use their _____ to swim.

(A) tails(B) heads(C) gills(D) lungs(E) loats

Maria grew up on a arm. She loved the work onthe arm. She knew when all o the crops had tobe planted. She would like a job on a arm or in alower garden.

17. Maria has had experience as a _____.

(A) guide(B) armer(C) driver(D) nurse(E) teacher

18. She would like to work in _____.

(A) an oice(B) a library(C) a garden(D) a hospital(E) a supermarket

19. As a child Maria lived _____.

(A) in the city(B) in an apartment(C) on a arm(D) in a large house(E) on the beach go to next page

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Carolyn has a good job. She is a nurse in a large hos-pital. Every day she can help many people. She enjoys

this very much. She also makes a good salary. Eachmonth she can pay her bills and save some money.

20. Carolyn works in a _____.(A) hospital

(B) doctors oice(C) garage(D) school(E) library

21. ne of the things Carolyn enjoys is _____.(A) working in an oice

(B) helping people(C) reading books(D) working late hours(E) driving a car

22. With her salary she can pay her bills and _____.(A) buy urniture(B) give to charity(C) save money(D) buy new clothes(E) pay or college

This completes theSelf-Assessment Reading Test.

Answers

1. C 7. C 13. B 19. C2. A 8. B 14. B 20. A

3. C 9. C 15. D 21. B

4. B 10. D 16. A 22. C

5. D 11. E 17. B

6. A 12. D 18. C

If your score is less than 17, you may have difficulty

reading the Written Examination and should consider

taking the Oral Examination in place of the WrittenExamination.

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tHe skills evaluation

WHAt to epeCt

Setting

e Skills Evaluation is set up to resemble an actual care-

giving situation. e Skills Evaluation area will look similar

to your work setting. It will have all the equipment neces-sary to perorm the assigned skills. e Skills Evaluation

will be administered by a Nurse Aide Evaluator. Beore

your skills evaluation begins, the evaluator will show you

where equipment is located and answer questions about

operating the equipment.

Please arrive 30 minutes early. est times are approxi-

mate. Please plan to spend the day.

Who Will Act as a Client?

e part o the client will be played by a candidate who

volunteers to act as a weakened elderly person. While youperorm the skills, speak to the candidate volunteer as you

would speak to an actual client in a nurse aide work setting.

You are encouraged to speak to the candidate volunteer not

only because it is part o quality care, but also because it will

help you to relax as you perorm the skills.

Candidate Volunteer Requirements

You will need to act as a candidate volunteer or another

nurse aides Skills Evaluation and play the role o a nursing

home patient (client). e evaluator will give you verbal

instructions that will describe how you should act in per-

orming the role o the client.

You must wear at, slip-on, non-skid shoes, a loose-

tting top with short sleeves that can be rolled up to the

shoulder, or tank top, and loose tting pants that can

be rolled up. You will be required to put a gown on over

your clothing. In no case may candidates remove clothingdown to undergarments.

Prior to beginning the exam, you should inorm the evalu-

ator o any ood or latex allergy or sensitivity to skin soaps

or lotion. Any limitations to range o motion must also

be communicated to the evaluator prior to the start o theskills examination.

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For inection control purposes, you should not come to the

test site with open areas/sores on the skin. Candidates with

any open areas or sores on their skin should reschedule theirskills test to a later date ater their skin ully heals.

tHe tAss

e NNAAP Skills List contains all o the skills that you

may be asked to demonstrate during the Skills Evaluation.

Each skill represents a task that you will be asked to per-orm in your job and has been broken down into a series

o steps.

See pages 24-39 for the complete skills listing.

A step that is highlighted in bold typeis called aCritical

Element Step. Critical Element Steps are important stepsthat must be perormed correctly in order or you to pass

the skill. I you leave out a Critical Element Step or do

not perorm a Critical Element Step properly, you will not

pass the skill. However, i you perorm only the Critical

Element Step correctly in a skill, you do not automati-cally pass that skill. You must also correctly demonstrate

enough steps to meet the passing standard (or cut score)

or each skill.

Beore your Skills Evaluation begins, the Nurse Aide

Evaluator will give you an instruction card that will list the

ve (5) skills selected or you to perorm. Hand-washing willalways be one o the skills to be perormed. e remaining

our (4) skills are randomly chosen rom the complete set o

skills listings on pages 24 to 39 o this handbook. You are

strongly encouraged to perorm the skills in the order they

are listed on the instruction card.I you make a mistake, say so, and you will be instructed

to tell the evaluator which step(s) is to be corrected and

then to perorm the step(s). You will not have to redo the

entire skill, just the steps you wish to correct. ere are,

however, some exceptions to this rule. I you ail to put

on gloves or take them o when it is required to do so and

the evaluator reminds you to do so, or inection control

purposes, then you will not receive credit or attempting to

correct this step. I you wish to correct an order-dependent

step (a step stating that an action should be perormed

before or after another step) and you ail to saywhen thecorrected step should be perormed, you will not receive

credit or the correction.

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Once you begin a new skill, you may not go back to

correct a previous skill. e Nurse Aide Evaluator will

not answer questions during the Skills Evaluation andwill not tell you whether you perormed a skill correctly.

You may not receive help rom anyone during the Skills

Evaluation. I you do have any questions, please ask them

beore the Skills Evaluation begins.

One (1) o the our (4) randomly-selected skills will include

a measurement skill (see the section below, Recording AMeasurement, or more inormation regarding measure-

ment skills).

You must successfully complete five (5) out of the five (5) skills

in the skill form to pass the Skills Evaluation.

When you have completed your skills evaluation, theevaluator will direct you to wash your hands. Although

this will not eect your examination results, for the pur-

poses of infection control, you must wash your hands.

reCorDiN A MeAsUreMeNt

e NNAAP Skills Evaluation requires every candidate

to perorm one measurement skill, such as blood pressure,

radial pulse, respirations, urine output, or weight. You

will be given a special orm, called a Recording Sheet or

Measurement Skills, to write down, or record, the measure-

ment. For example, i perorming theMeasures and RecordsBlood Pressureskill, you will write the complete systolic anddiastolic pressures o your blood pressure reading in a box

labeled Candidate Results.

On the ollowing page is a copy o the recording sheet that

will be used during the skills exam. e candidate mustrecord his/her results in the Candidate Results box on this

sheet. is sheet will be used to record the results o the

ollowing measurement skills:

Measures and Records Blood Pressure

Measures and Records Weight o

Ambulatory Client

Measures and Records Urinary Output

Counts and Records Radial Pulse

Counts and Records Respirations

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22

Date

Test Site ID

CANDIDATE NAME

CANDIDATE ID

EVALUATOR NAME

EVALUATOR ID

SKILL TESTED

Evaluator must check one box

next to the skill being tested.

I Blood Pressure I Respirations

I Oral Temperature I Urine Output

I Radial Pulse I Weight

RECORDING SHEET FOR

MEASUREMENT SKILLS

TM

CANDIDATE EVALUATORRESULTS RESULTS

SAMPLE

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Tips for the Skills Evaluation

You will be expected to perorm the skills as you

would in a nursing home setting. When water isrequired, you must use running water. All candidates

will be required to perorm the Washes Hands skill.

The evaluator will inorm you ater you have washed

your hands or the irst time that you should just tell

him or her when you would wash your hands during

your perormance o the rest o the skills, rather than

actually washing them or each skill. For all steps

other than hand-washing, you must actually perorm

the skill in order to receive credit. You may not simply

tell the evaluator what you would do or simulating a

step. For example, you may not simply tell the evalua-tor that you would wash the client. You must actually

demonstrate washing the client. You may not simply

tell the evaluator that you would eed the client. You

must actually demonstrate eeding the client.

Ater you have introduced yoursel to the client or

the irst time, it is not necessary or you to introduce

yoursel each time you begin a new skill.

To receive ull credit or a measurement skill, you

must accurately make the required measurement and

then write that measurement on the Recording Sheet

for Measurement Skills. The evaluator will provide theRecording Sheet to you at the test site. A sample o the

Recording Sheet is shown on page 22 o this hand-

book. You are encouraged to become amiliar with the

Recording Sheet beore your scheduled test date.

You must know how to operate both a standing anda non-digital bathroom scale and must know how to

set both types o scales to zero.

You may not bringany o your own equipment to

the test site (i.e. transer/gait belt).

It is important or you to place the call signal withinthe clients reach whenever you leave the client.

Where the word client appears, it refers to the person

receivingcare.

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skills listing

e 24 skills that ollow are arranged in alphabeticalorder, except or the Washes Hands skill. Washes Hands

is listed rst as a reminder o the importance o perorm-

ing this skill beore all other skills. e numbered lines

below each skill are the steps needed to perorm that skill.

Critical Element Steps are in bold type.

WasHes Hands

1 Address client by name and introduces sel to clientby name

2 Turns on water at sink

3 Wets hands and wrists thoroughly4 Applies soap to hands

5 Lathers all surfaces of wrists, hands, and ngers,producing friction for at least 15 (fteen) seconds

6 Cleans ngernails by rubbing ngertips against palms

o the opposite hand7 Ater lathering or at least 15 seconds, rinses all

suraces o wrists, hands, and ngers keeping handslower than the elbows and the ngertips down

8 Uses clean, dry paper towel to dry all suraces ohands, wrists, and ngers then disposes o paper towel

into waste container9 Uses clean, dry paper towel to turn o aucet then

disposes o paper towel into waste container or usesknee/oot control to turn o aucet

10 Does not touch inside o sink at any time

applies one knee-HigH elastiC stoCking

1 Explains procedure, speaking clearly, slowly,and directly, maintaining ace-to-ace contactwhenever possible

2 Privacy is provided with a curtain, screen, or door

3 Client is in supine position (lying down in bed) whilestocking is applied

4 Turns stocking inside-out

5 Places oot o stocking over toes, oot, and heel

6 Pulls top o stocking over oot, heel, and leg

7 Moves oot and leg gently and naturally, avoidingorce and over-extension o limb and joints

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8 Finishes procedure with no twists or wrinklesand heel of stocking (if present) is over heel andopening in toe area (if present) is either over orunder toe area

9 Signaling device is within reach and bed is in lowposition

10 Washes hands

assists to aMbulate using tRansfeR belt1 Explains procedure, speaking clearly, slowly, and

directly, maintaining ace-to-ace contact wheneverpossible

2 Before assisting to stand, candidate ensures client iswearing shoes

3 Beore assisting to stand, bed is at a sae level

4 Beore assisting to stand, checks and/or locks bedwheels

5 Beore assisting to stand, client is assisted to sittingposition with eet at on the oor

6 Beore assisting to stand, applies transer belt securelyover clothing/gown

7 Beore assisting to stand, provides instructionsto enable client to assist in standing includingprearranged signal to alert client to begin standing

8 Stands acing client positioning sel to ensure saety o

candidate and client during transer. Counts to three(or says other prearranged signal) to alert client tobegin standing

9 On signal, gradually assists client to stand by graspingtranser belt on both sides with an upward grasp(candidates hands are in upward position), andmaintaining stability o clients legs

10 Walks slightly behind and to one side o client or adistance o ten (10) eet, while holding onto the belt

11 Ater ambulation, assists client to bed and removestranser belt


13 Washes hands

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assists WitH use of bedpan

1 Explains procedure speaking clearly, slowly, and directly,

maintaining ace-to-ace contact whenever possible2 Privacy is provided with a curtain, screen, or door

3 Beore placing bedpan, lowers head o bed

4 Puts on clean gloves beore handling bedpan

5 Places bedpan correctly under clients buttocks

6 Removes and disposes o gloves (without contaminatingsel) into waste container and washes hands

7 Ater positioning client on bedpan and removinggloves, raises head o bed

8 Toilet tissue is within reach

9 Hand wipe is within reach and client is instructed to

clean hands with hand wipe when nished10 Signaling device within reach and client is asked to

signal when nished

11 Puts on clean gloves beore removing bedpan

12 Head o bed is at beore bedpan is removed

13 Avoids overexposure o client14 Removes, empties, and rinses bedpan and pours rinse

into toilet

15 Ater rinsing bedpan, places bedpan in designateddirty supply area

16 Ater placing bedpan in designated dirty supply area,

removes and disposes o gloves (without contaminatingsel) into waste container and washes hands


Cleans uppeR oR loWeR dentuRe

1 Puts on clean gloves beore handling dentures

2 Sink is lined and/or sink is partially lled with waterbeore denture is held over sink

3 Rinses denture in tepid/moderate temperaturerunning water beore brushing them

4 Applies toothpaste to toothbrush5 Brushes suraces o denture

6 Rinses suraces o denture under tepid/moderatetemperature running water

7 Beore placing denture into cup, rinses denture cup

and lid8 Places denture in denture cup with tepid/moderate

temperature water and places lid on cup

9 Rinses toothbrush and places in designated toothbrushbasin/container

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10 Maintains clean technique with placement otoothbrush and denture

11 Sink liner is removed and disposed o appropriatelyand/or sink is drained

12 Ater rinsing equipment and disposing o sinkliner, removes and disposes o gloves (withoutcontaminating sel) into waste container and washeshands

Counts and ReCoRds Radial pulse*

1 Explains procedure, speaking clearly, slowly, anddirectly, maintaining ace-to-ace contact wheneverpossible

2 Places ngertips on thumb side o clients wrist to

locate radial pulse3 Count beats or one ull minute

4 Signaling device is within reach

5 Washes hands

6 After obtaining pulse by palpating in radial artery

position, records pulse rate within plus or minus 4beats of evaluators reading

* Count or one ull minute.

Counts and ReCoRds RespiRations*

1 Explains procedure (or testing purposes), speaking

clearly, slowly, and directly, maintaining ace-to-acecontact whenever possible

2 Counts respirations or one ull minute


4 Washes hands

5 Records respiration rate within plus or minus 2breaths of evaluators reading

* Count or one ull minute. For testing purposes youmay explain to the client that you will be counting therespirations.

donning and ReMoving ppe(goWn and gloves)

1 Picks up gown and unolds

2 Facing the back opening o the gown places armsthrough each sleeve

3 Fastens the neck opening

4 Secures gown at waist making sure that back oclothing is covered by gown (as much as possible)

5 Puts on gloves

6 Cus o gloves overlap cus o gown

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7 With one gloved hand, grasps the other glove at thepalm, pulls glove o

8 Slips ngers rom ungloved hand underneath cu oremaining glove at wrist, and removes glove turning itinside out as it is removed

9 Disposes o gloves into designated waste containerwithout contaminating sel

10 Ater removing gloves, unastens gown at neck and

waist11 Removes gown without touching outside o gown

12 While removing gown, holds gown away rom body,turns gown inward and keeps it inside out

13 Disposes o gown in designated container withoutcontaminating sel

14 Washes hands

dResses Client WitH affeCted (Weak)RigHt aRM

1 Explains procedure, speaking clearly, slowly, and



3 Asks which top he/she would like to wear and dresseshim/her in top o choice

4 While avoiding overexposure o client, removes gown

rom the unaected side rst, then removes gownrom the aected side

5 Assists to put the right (aected/weak) arm throughthe right sleeve of the top before placing garmenton left (unaected) arm

6 While putting on items, moves body gently andnaturally, avoiding orce and over-extension o limbsand joints

7 Finishes with clothing in place

8 Disposes o gown into soiled linen container

9 Signaling device is within reach and bed is in low

position10 Washes hands

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feeds Client WHo Cannot feed self

1 Explains procedure to client, speaking clearly,

slowly, and directly, maintaining ace-to-ace contactwhenever possible

2 Beore eeding, candidate picks up name card romtray and asks client to state name

3 Before feeding client, client is in an upright sittingposition (45-90 degrees)

4 Places tray where it can be easily seen by client

5 Clients hands are cleaned with hand wipe beorebeginning eeding

6 Candidate sits acing client during eeding

7 Tells client what oods are on tray and asks what client

would like to eat rst8 Using spoon, oers client one bite o each type o ood

on tray, telling client the content o each spoonul

9 Oers beverage at least once during meal

10 Makes sure clients mouth is empty beore oeringnext bite o ood or sip o beverage

11 At end o meal, clients mouth is wiped and hands arecleaned with hand wipe

12 Removes ood tray and places tray in designated dirtysupply area

13 Signaling device is within clients reach

14 Washes hands

gives Modified bed batH(faCe and one aRM, Hand andundeRaRM)




3 Removes gown while keeping client covered

4 Beore washing, checks water temperature or saety

and comort and asks client to veriy comort o water5 Puts on clean gloves beore washing client

6 Beginning with eyes, washes eyes with wet washcloth(no soap), using a dierent area o the washcloth oreach eye, washing inner aspect to outer aspect thenproceeds to wash ace

7 Dries ace with towel8 Exposes one arm and places towel underneath arm

9 Applies soap to wet washcloth

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10 Washes arm, hand, and underarm, keeping rest obody covered

11 Rinses and dries arm, hand, and underarm12 Moves body gently and naturally, avoiding orce and

over-extension o limbs and joints

13 Puts clean gown on client

14 Empties, rinses, and dries basin

15 Ater rinsing basin, places basin in designated dirty

supply area

16 Disposes o used gown and linen into soiled linencontainer

17 Avoids contact between candidate clothing and usedlinens

18 Ater placing basin in designated dirty supply area,and disposing o used linen, removes and disposeso gloves (without contaminating sel) into wastecontainer and washes hands


Makes an oCCupied bed(Client does not need assistanCe totuRn)

1 Explains procedure, speaking clearly, slowly, anddirectly, maintaining ace-to-ace contact whenever

possible2 Privacy is provided with a curtain, screen, or door

3 Lowers head o bed beore moving client

4 Client is covered while linens are changed

5 Loosens top linen rom the end o the bed

6 Raises side rail on side to which client will move andclient moves toward raised side rail

7 Loosens bottom used linen on working side andmoves bottom used linen toward center o bed

8 Places and tucks in clean bottom linen or ttedbottom sheet on working side and tucks under client

9 Beore going to other side, client moves back ontoclean bottom linen

10 Raises side rail then goes to other side o bed

11 Removes used bottom linen

12 Pulls and tucks in clean bottom linen, nishing with

bottom sheet ree o wrinkles13 Client is covered with clean top sheet and bath

blanket/used top sheet has been removed

14 Changes pillowcase

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15 Linen is centered and tucked at oot o bed

16 Avoids contact between candidates clothing and used

linen17 Disposes o used linen into soiled linen container andavoids putting linen on oor


19 Washes hands

MeasuRes and ReCoRds blood pRessuRe*


2 Beore using stethoscope, wipes bell/diaphragm andearpieces o stethoscope with alcohol

3 Clients arm is positioned with palm up and upper armis exposed

4 Feels or brachial artery on inner aspect o arm, atbend o elbow

5 Places blood pressure cu snugly on clients upper arm,with sensor/arrow over brachial artery site

6 Earpieces o stethoscope are in ears and bell/diaphragmis over brachial artery site

7 Candidate does one o the ollowing: a. Inates cubetween 160 mm Hg to 180 mm Hg. (I beat heard

immediately upon cu deation, completely deatecu.) Re-inate cu to no more than 200 mm Hg.OR b. Inates cu 30 mm Hg beyond where radial orbrachial pulse was last heard or elt

8 Deates cu slowly and notes the rst sound(systolic reading), and last sound (diastolic reading)(I rounding needed, measurements are rounded UP tothe nearest 2 mm o mercury)

9 Removes cu


11 Washes hands

12 After obtaining reading using BP cu andstethoscope, records both systolic and diastolicpressures each within plus or minus 8 mm ofevaluators reading

* is is a one-step blood pressure procedure. However, ia candidate correctly perorms a two-step blood pressure

procedure that includes step 7b, the candidate will not bepenalized and will be given credit or step 7.

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MeasuRes and ReCoRds uRinaRy output

1 Puts on clean gloves beore handling bedpan

2 Pours the contents o the bedpan into measuringcontainer without spilling or splashing urine outsideo container

3 Measures the amount o urine at eye level withcontainer on at surace

4 Ater measuring urine, empties contents o measuring

container into toilet

5 Rinses measuring container and pours rinse into toilet

6 Rinses bedpan and pours rinse into toilet

7 Ater rinsing equipment, and beore recordingoutput, removes and disposes o gloves (without

contaminating sel) into waste container and washeshands

8 Records contents of container within plus or minus25 ml/cc of evaluators reading

MeasuRes and ReCoRds

WeigHt of aMbulatoRy Client1 Explains procedure, speaking clearly, slowly, and


2 Candidate ensures client has shoes on beore walkingto scale

3 Sets scale to zero beore weighing client

4 While client steps onto scale, candidate stands next toscale and assists client, i needed, onto center o scale,then determines clients weight

5 While client steps o scale, candidate stands next

to scale and assists client, i needed, o scale beorerecording weight

6 Records weight based on indicator on scale. Weightis within plus or minus 2 lbs of evaluators reading(If weight recorded in kg weight is within plus orminus 0.9 kg of evaluators reading)

7 Washes hands

peRfoRMs passive Range of Motion(pRoM) foR one knee and one ankle

1 Explains procedure, speaking clearly, slowly, anddirectly, maintaining ace-to-ace contact whenever

possible


3 Instructs client to inorm nurse aide i pain isexperienced during exercise

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4 Supports leg at knee and ankle while perorming rangeo motion or knee

5 Bends the knee and then returns leg to clients normalposition (extension/exion) (AT LEAST 3 TIMESunless pain is verbalized)

6 Supports oot and ankle close to the bed whileperorming range o motion or ankle

7 Pushes/pulls oot toward head (dorsiexion), and

pushes/pulls oot down, toes point down (plantarexion) (AT LEAST 3 TIMES unless pain isverbalized)

8 While supporting the limb, moves joints gently,slowly, and smoothly through the range of motion,discontinuing exercise if client verbalizes pain


10 Washes hands

peRfoRMs passive Range of Motion(pRoM) foR one sHouldeR



3 Instructs client to inorm nurse aide i pain is

experienced during exercise4 Supports clients arm at elbow and wrist while

perorming range o motion or shoulder

5 Raises clients straightened arm rom side positionupward toward head to ear level and returns armdown to side o body (extension/exion) (AT LEAST3 TIMES unless pain is verbalized)

6 Moves clients straightened arm away rom the sideo body to shoulder level and returns to side o body(abduction/adduction) (AT LEAST 3 TIMES unlesspain is verbalized)

7 While supporting the limb, moves joint gently,slowly, and smoothly through the range of motion,discontinuing exercise if client verbalizes pain


9 Washes hands

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positions on side




3 Beore turning, lowers head o bed

4 Raises side rail on side to which body will be turned

5 Slowly rolls onto side as one unit toward raised siderail

6 Places or adjusts pillow under head or support

7 Client is positioned so that client is not lying on arm

8 Supports top arm with supportive device

9 Places supportive device behind clients back

10 Places supportive device between legs with top kneeexed; knee and ankle supported


12 Washes hands

pRovides CatHeteR CaRe foR feMale



3 Beore washing checks water temperature or saetyand comort and asks client to veriy comort o water

4 Puts on clean gloves beore washing

5 Places linen protector under perineal area beorewashing

6 Exposes area surrounding catheter while avoidingoverexposure o client


8 While holding catheter near meatus withouttugging, cleans at least four inches of catheternearest meatus, moving in only one direction, away

from meatus, using a clean area of the cloth foreach stroke

9 While holding catheter near meatus withouttugging, rinses at least four inches of catheternearest meatus, moving only in one direction, awayfrom meatus, using a clean area of the cloth for

each stroke10 While holding catheter near meatus without tugging,

dries our inches o catheter moving away rom meatus

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12 Ater rinsing basin, places basin in designated dirty

supply area13 Disposes o used linen into soiled linen container and

disposes o linen protector appropriately

14 Avoids contact between candidate clothing and usedlinen

15 Ater disposing o used linen and cleaning

equipment, removes and disposes o gloves (withoutcontaminating sel) into waste container and washeshands


pRovides fingeRnail CaRe on one Hand1 Explains procedure, speaking clearly, slowly, and


2 Beore immersing ngernails, checks water

temperature or saety and comort and asks client toveriy comort o water

3 Basin is in a comortable position or client

4 Puts on clean gloves beore cleaning ngernails

5 Fingernails are immersed in basin o water

6 Cleans under each ngernail with orangewood stick

7 Wipes orangewood stick on towel ater each nail

8 Dries ngernail area

9 Candidate eels each nail and les as needed

10 Disposes o orangewood stick and emery board intowaste container (or testing purposes)

11 Empties, rinses, and dries basin12 Ater rinsing basin, places basin in designated dirty

supply area

13 Disposes o used linen into soiled linen container

14 Ater cleaning nails and equipment, and disposing o

used linen, removes and disposes o gloves (withoutcontaminating sel) into waste container and washeshands


35

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pRovides foot CaRe on one foot




3 Beore washing, checks water temperature or saetyand comort and asks client to veriy comort o water

4 Basin is in a comortable position or client and on

protective barrier

5 Puts on clean gloves beore washing oot

6 Clients bare oot is placed into the water


8 Lits oot rom water and washes oot, including

between the toes9 Foot is rinsed, including between the toes

10 Dries oot, including between the toes

11 Applies lotion to top and bottom o oot, removingexcess (i any) with a towel

12 Supports oot and ankle during procedure13 Empties, rinses, and dries basin

14 Ater rinsing basin, places basin in designated dirtysupply area

15 Disposes o used linen into soiled linen container

16 Ater cleaning oot and equipment, and disposing o

used linen, removes and disposes o gloves (withoutcontaminating sel) into waste container and washeshands


36

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pRovides MoutH CaRe




3 Beore providing mouth care, client is in uprightsitting position (45-90 degrees)

4 Puts on clean gloves beore cleaning mouth

5 Places clothing protector across chest beore providingmouth care

6 Moistens toothbrush

7 Applies toothpaste to toothbrush

8 Cleans mouth (including tongue and surfaces of

teeth) using gentle motions9 Maintains clean technique with placement o

toothbrush

10 Holds emesis basin to chin while client rinses mouth

11 Wipes mouth and removes clothing protector

12 Empties, rinses, and dries basin13 Places used toothbrush in basin


15 Disposes o clothing protector appropriately

16 Ater placing basin in designated dirty supply area,

and disposing o used linen, removes and disposeso gloves (without contaminating sel) into wastecontainer and washes hands


37

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pRovides peRineal CaRe (peRi-CaRe)foR feMale



3 Beore washing checks water temperature or saetyand comort and asks client to veriy comort o water

4 Puts on clean gloves beore washing perineal area

5 Places pad/linen protector under perineal area beorewashing

6 Exposes perineal area while avoiding overexposure oclient

7 Applies soap to wet washcloth8 Washes genital area, moving from front to back,

while using a clean area of the washcloth for eachstroke

9 Using clean washcloth, rinses soap from genitalarea, moving from front to back, while using a

clean area of the washcloth for each stroke10 Dries genital area moving rom ront to back with

towel

11 Ater washing genital area, turns to side, then washesand rinses rectal area moving rom ront to back usinga clean area o washcloth or each stroke. Dries withtowel

12 Repositions client



15 Disposes o used linen into soiled linen container anddisposes o linen protector appropriately

16 Avoids contact between candidate clothing and usedlinen

17 Ater disposing o used linen, and placing usedequipment in designated dirty supply area, removesand disposes o gloves (without contaminating sel)into waste container and washes hands


38

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39

tRansfeRs fRoM bed to WHeelCHaiRusing tRansfeR belt



3 Beore assisting to stand, wheelchair is positionedalong side o bed, at head o bed, and acing the oot

o the bed4 Beore assisting to stand, ootrests are olded up or

removed

5 Beore assisting to stand, bed is at a sae level

6 Before assisting to stand, locks wheels on

wheelchair7 Beore assisting to stand, checks and/or locks bedwheels

8 Beore assisting to stand, client is assisted to a sittingposition with eet at on the oor

9 Beore assisting to stand, candidate ensures client is

wearing shoes10 Beore assisting to stand, applies transer belt securely

over clothing/gown

11 Beore assisting to stand, provides instructions toenable client to assist in transer including prearrangedsignal to alert when to begin standing

12 Stands acing client positioning sel to ensure saety ocandidate and client during transer. Counts to three(or says other prearranged signal) to alert client tobegin standing

13 On signal, gradually assists client to stand by grasping

transer belt on both sides with an upward grasp(candidates hands are in upward position) andmaintaining stability o clients legs

14 Assists client to turn to stand in ront o wheelchairwith back o clients legs against wheelchair

15 Lowers client into wheelchair

16 Positions client with hips touching back o wheelchairand transer belt is removed

17 Positions eet on ootrests


19 Washes hands

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40

sCoRe RepoRting

eAM resUltsWritten (or Oral) Exam

Ater you nish the Written (or Oral) Examination, the

Nurse Aide Evaluator will ax your answer sheet or scor-

ing. You will receive an ofcial Score Report on that day.

e Score Report will indicate whether you have passedor ailed the Written (or Oral) Examination. Results will

not be given over the phone.

Skills Evaluation

e Nurse Aide Evaluator will also ax your Skills Evaluation

results or scoring. Ater the Nurse Aide Evaluator evaluatesyour perormance, he or she will ax the Skills Evaluation

answer sheet or scoring. You will receive an ofcial Score

Report on that day. e Score Report will indicate whether

you have passed or ailed the Skills Evaluation.

Due to inrequent technical difculties, Score Reports

may not be received at the test center on the day o testing.I this happens your answer sheet will be mailed overnight

to Pearson VUE or handscoring. Your Score Report will

then be mailed to you within 5-7 business days rom the

receipt o materials. For questions regarding delayed Score

Reports, please contact Pearson VUE at (800) 274-0504.

fAiliNI you ail either the Skills Evaluation or the Written (or

Oral) Examination, you must re-take only the part you

ailed. You must bring your ailing Score Report and

new examination ees made payable to Pearson VUEProcessing Center to the test site on the day o testing.

You should contact the Technical College to determine

the amount o the administration ee.

I you ail either the Skills Evaluation or the Written (or

Oral) Examination three (3) times, you MUS take or

re-take a state-approved training program beore you re-

test. You will be required to complete a new application

orm, pay new examination and administration ees, and

take the entire NNAAP or NA/HHA Examination again.

I you do not pass both the Skills Evaluation and the

Written (or Oral) Examination and then you completean approved training program, the testing process starts

over. Both the Skills Evaluation and the Written (or Oral)

Examination must be taken and passed ater completion o

the training program.

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41

HoW to reAD A fAiliN

sCore report

I you do not pass the Skills Evaluation, you willreceive a Failing Score Report. e score report will

list the ve (5) skills that you perormed and a score o

Satisfactoryor Unsatisfactoryor each skill. Any skill with

an Unsatisactory result is considered a ailed skill. You

must receive a Satisactory result on all ve (5) skills inorder to pass the Skills Evaluation.

Use your ailing Score Report as an aid in studying to

re-take the Skills Evaluation. A ailed skill will show the

reason or the ailure. You may not have perormed the

steps o a skill correctly, or you may have orgotten a step,

especially a Critical Element Step.

e ailing Score Report will list steps that were missed or

incorrectlook or numbers printed directly under a skill

marked Unsatisactory. A list o all the skills and the steps

needed or each skill can be ound in this handbook. Find

the skill you ailed, and study the steps, especially stepslisted as Unsatisactory on the score report.

In the below, a candidate received a result o Unsatisactory

on the skill Washes Hands. e numbers 1, 5, and 10

printed below the skill reer to steps that were missed or

perormed incorrectly. To study or re-taking the SkillsEvaluation, this candidate should turn to the Skills

Listing in this handbook, look or the Washes Hands skill,

and review all the steps, especially steps 1, 5, and 10.

Minnesota NNAAP Examination Results

Exam: Skills Result: Fail

Skills Performance:

Washes Hands Unsatisfactory1, 5, 10

Provides Fingernail Care SatisfactoryOn One Hand

Measures and Records SatisfactoryBlood Pressure

Puts One Knee-High SatisfactoryElastic Stocking on Client

Measures and Records SatisfactoryWeight of Ambulatory Client

A sample of a Failing Score Report

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42

pAssiN

Once you have passed both the Skills Evaluation and

the Written (or Oral) Examination, you will receive aCerticate. Your name will be submitted to the Minnesota

Department o Health or placement on the Minnesota

Nursing Assistant Registry. You must successully pass both

parts within two (2) years o completing the training pro-

gram in order to be eligible or certication. Pearson VUE

will mail you your nursing assistant/ home health aide

Certicate approximately ten (10) business days ater you

have successully completed testing. I you do not receive

your Certicate within thirty (30) days o testing, contact

Pearson VUE at (800) 274-0504.

Your score is valid or twenty-our (24) months rom thedate o testing.

DUpliCAte sCore report/

HANDsCoreD resUlts

I you lose your Score Report or need a duplicate ScoreReport, or would like the handscored results o your

Written (or Oral) Examination or Skills Evaluation,

use the Request for Duplicate Score Report or Handscored

Answer Sheet Form in the back o this handbook.

gRievanCe pRoCess

oVerVieW

Each candidate has a right to le a grievance to complain

or contest the results o their Nurse Aide Examination.No grievance will be investigated i it is not received in

writing within thirty (30) days o testing.

proCess

All grievances must be in writing. e candidate must

provide as much detail as possible in the grievance letter

and orward it to the Minnesota Nurse Aide Registry

within 30 days o their exam date.

Ater receipt o the grievance letter, Minnesota Nurse

Aide Registry will review and ollow up with each com-

plaint. Inormation will be obtained rom the test siteand Pearson VUE. e Registry determinations are nal;

there is no appeal process.

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43

tHe RegistRy

CHANe of ADDress or NAMeI your address or name changes between the time you

apply or the examination and the time you receive your

Certicate, you must inorm Pearson VUE so that you

may receive your Score Report, your Certicate, and any

other correspondences that may be relevant to the certica-tion process. You may inorm Pearson VUE by using the

Change of Address or Name Before Receipt of Certificate Form

ound at the back o this handbook. Name changes must be

accompanied by ofcial documentation, such as a divorce

decree, marriage certicate, or other ofcial notice.I you change your address or name afteryou have passed the

examination and received your Certicate, please complete

Section A o the Nursing Assistant Registry Update Form

at the back o this handbook and mail it to the Minnesota

Department o Health, Nursing Assistant Registry, or contact

the Registry at (800) 397-6124 to obtain an update orm.

CHANe of eMployMeNtI your place o employment has changed, you must com-

plete Section A o the Nursing Assistant Registry Update

Form located in the back o this handbook. Ater youcomplete Section A, your new employer must complete

Section B o the orm and mail it to the Minnesota

Department o Health, Nursing Assistant Registry.

Please note that i you work or a temporary agency,

Section B MUS be completed by the certied nurs-

ing acility at which you work. is orm CANN be

completed by a temporary agency.

I a twenty-our (24) month period goes by in which you

are not employed (part-time or ull-time) as a nursing assis-

tant, your status changes. You then have two (2) choices:

a) You may re-take the NNAAP Examination. You havethree (3) chances to pass it. I you pass the examination,

you will again be eligible to have your name placed

on the Nursing Assistant Registry. I you ail all three

(3) times, you must enroll in a state-approved nursing

assistant training program, complete the program,and register again or testing; or

b) You may enroll in a state-approved nursing assistant

training program, complete the program, and

register again or testing.

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44

It is your responsibility to keep the Registry inormed o

any changes in employment.

Any updates to the Registry or questions regarding yourstatus must be sent to:

Minnesota Department of HealthNursing Assistant Registry

PO Box 64501St. Paul, MN 55164-0501

UpDAtiN tHe reistry

Once you receive your Certicate, you are responsible or pro-

viding the Registry with updated inormation (or example,

changes in name, address, and place o employment). Please

check your Social Security number, name, and address whenyou receive your Certicate rom Pearson VUE to veriy that

the Registry has the correct inormation.

I you need to inorm the Registry o a name or address

change, or a change o employment see sections Change of

Address or Nameand/or Change of Employment or more

inormation.

lost CertifiCAte

I you lose your Certicate, you may receive another

copy by sending in the Request for Duplicate Certificate

Form ound in the back o this handbook and a $15certied check or money order payable to Pearson VUE

Processing Center.

Do not make any changes to your Certicate. Any altera-

tion to the Certicate will result in loss o certication.

lApseD CertifiCAtioNUnder ederal requirements, certication as a nursing

assistant becomes invalid ater a lapse o twenty-our

(24) consecutive months or more in the perormance o

paid nursing-related services. It is critical to update your

employment history. In addition, ailure to inorm theRegistry o an address change may jeopardize your certi-

cation status.

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45

MiNNesotA NA/HHA CertifiCAtioN freQUeNtly AseD QUestioNs

UESTON ANSWER

How do Ibecome aNursingAssistant?

You must successully complete astate-approved nurse aide trainingprogram and pass both portions othe examination within two (2) years

o training at an approved testing site. You may also test without trainingi you trained in another country, iyou have not taken a nursing assis-tant training program, i you havenot worked as a nursing assistant in

the last two (2) years; i you are romanother state and do not qualiy orreciprocity in Minnesota; or i youare a student nurse or graduate nursecandidate. Please check or eligibilityrequirements in the candidate hand-

book under Eligibility. You must pass both the writtenand skills portions o the NNAAPexamination. .

May I

Perorm theDuties o aNurse AideBeore I AmCertiied?

I you are currently attending an

approved training program andemployed in a nursing home orcertiied boarding care home, youhave 120 days in which to completethe training and become certiied.During that period, a student may

not perorm any duty or which theyhave not been trained and checkedby the instructor.

I you are not enrolled in anapproved training course, you maynot perorm any nurse aide duties

until you become certiied.

How DoI Arrangeor SpecialAccomno-

dations?

Special requests must be submit-ted and approved prior to testing.Documentation rom your physicianor other qualiying proessional must

be included with the request. Pleasereer to the Special Exam Requestsand Services section o the candidatehandbook or details.

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46

MiNNesotA NA/HHA CertifiCAtioN freQUeNtly AseD QUestioNs

UESTON ANSWER

How do Idecide whichexam to take?

Initially, both the Written andSkills exams must be scheduledtogether.

An Oral Examination in English

may be substituted or the Writtenexamination.

Minnesota-approved curriculumsoer Nursing Assistant and NursingAssistant/Home Health Aide pro-gra

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Documents