nursing assistant - nurse aid exam, 2ed

NURSING ASSISTANT/NURSE AIDE

EXAM

NURSINGASSISTANT/NURSEAIDE EXAM

N E W Y O R K

2nd Edition

Copyright © 2002 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.—2nd ed.

p. cm.

1. Nurses’ aides—Examinations—Study guides. I. LearningExpress (Organization)

RT84 .N864 2002

610.73'06'98—dc21

2002003582

Printed in the United States of America

9 8 7 6 5 4 3 2 1

Second Edition

ISBN 1-57685-418-3

For more information or to place an order, contact LearningExpress at:

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Or visit us at:

www.learnatest.com

Marlene Beck, RN, MSN is a Nursing Instructor at the Bridgeport Hospital School of Nursing. She has had exten-

sive experience as a manager and an educator. In her current position at the school of nursing, 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 Sys-

tem. In this role, she developed 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.

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 was the Coordinator of the Clinical Care

Provider Program (extended Nursing Assistant) and the Certified Nursing Assistant Program. She lives in Strat-

ford, Connecticut.

National Occupational Competency Testing Institute (NOCTI) is a recognized leader in occupational compe-

tency testing and has developed and validated more than 250 written exams and performance assessments that

measure the skills of entry-level and experienced workers. A nonprofit institute, NOCTI has created hundreds of

customized workplace-related assessments for such major corporations as Disney, Toyota, GTE, and 3M.

List of Contributors

v

CHAPTER 1: The Nursing Assistant/Nurse Aide Exam 1

CHAPTER 2: The LearningExpress Test Preparation System 9

CHAPTER 3: Nursing Assistant/Nurse Aide Practice Exam 1 25





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 125

Contents

vii

NURSING ASSISTANT/NURSE AIDE

EXAM

IN T H I S DAY and age of professionalism, many careers that years ago didn’t require much expertise now

require not only formal training, but also some type of recognized certification. This is particularly true

for many healthcare professions, including nursing assistant/nurse aide (NA).

Prior to 1987, there were no standards in nursing homes and the quality of care was in question. As the pub-

lic began to hear horrible stories in the media of 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 standards, states

now individually regulate the training and testing of Certified Nursing Assistants (CNAs).

The information in this book is based on the national standards for CNAs, but each state specifies the

amount of training, and what certification and practical skills exams CNAs must pass. Therefore, you will also

need to contact state or local agencies to find out about the specific requirements in your state.

C H A P T E R

The NursingAssistant/NurseAide Exam

CHAPTER SUMMARYThis 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).

1

1

� Finding Out aboutCert i f icat ion Requirements

If you want to become a CNA, the first step is to con-

tact your local community or state health agency to

obtain certification requirements. You can find these

agencies listed in the blue (government) pages of your

phone book. You can also contact an employment

agency or the healthcare facility you want to work for,

since they will often be able to guide you through the

training and certification requirements. To give you an

idea of what to expect, see Chapter 9 for an outline of

some of the current trends in CNA certification.

OBRA laws also require that a state registry be

kept for CNAs. Information such as dates of certifica-

tion, reports of abuse and neglect, and lapse periods

are available in these registries. Turn to page 4 for a list

of registries by state.

� Educat ion and Training

Healthcare facilities usually require CNAs to have a

high school diploma or GED and to pass a state-

approved training program that consists of anywhere

from 75 to 150 hours of training. You can be hired

without being certified, but you must receive certifica-

tion within four months after your hire date. While the

duties of a nursing assistant vary depending on the

workplace, the job emphasis is always on the physical

and emotional well-being of the patient. While a day in

the life of a CNA is not easy, especially when dealing

with a difficult patient, most CNAs get great satisfac-

tion from their work. Common characteristics for

someone considering this profession are dedication,

patience, reliability, and compassion. Another key ele-

ment to the job is the ability to communicate and work

well with others. A CNA must also be physically able to

perform the job—such as standing for a good portion

of an eight-hour day and lifting and moving objects

and equipment. As a CNA, your training will consist of

learning to perform the following basic duties:

■ communicating with the patient and others on

the job■ bathing and dressing the patient (general skin

care and hygiene)■ helping patients out of bed■ setting up and storing medical equipment■ taking vital signs—pulse, blood pressure, temper-

ature, and respiration■ feeding the patient■ changing bed linens■ cleaning bedpans and measuring urine output■ answering patients’ calls and delivering messages

� Career Out look and Earning Potent ial

The nursing assistant profession, on the whole, is

growing faster than average. Nurse aides held about

1.4 million jobs in 1998, and that number is expected

to increase by almost 25% by 2008. While job pros-

pects are good, the salaries tend to be low. Hourly

wages range from about $6.00 to $12.00, depending on

which part of the country you live in. Salaries in the

Northeast are highest, while the South is lower paying.

If you have five years of experience or more, your pay

increases by a few dollars per hour. Paid holidays, hos-

pital and medical benefits, extra pay for overtime, and

pension plans are available to many hospital and some

nursing home employees.

Once you know what you have to do to be certi-

fied in your state, you can begin to plan your CNA

study program. Go to a local job counseling center,

state employment agency, or private healthcare job

placement service to get information about how to get

the training you need to become a CNA. Many health-

care agencies will provide you with the training you

need. Or you may be able to prepare on your own and

–THE NURSING ASSISTANT/NURSE AIDE EXAM–

2

simply go in to demonstrate your competence by tak-

ing a written exam, demonstrating your skills in a

practical exam, or both. Whether you are involved in a

training class or working on your own, you should be

using textbooks and other materials that will train you

in the most important skills a CNA needs. Such books

will be available in public libraries and college book-

stores; job search agencies may also have some supple-

mental materials available.

� How to Use This Book

Many state and local agencies require a written exam

consisting of approximately 70 multiple-choice ques-

tions as part of the certification process for CNAs. This

book contains five practice written exams, based on

the national standards, that contain questions about all

the skills you will use as a CNA. The written portion of

the nursing assistant exam consists of multiple-choice

questions, while the clinical portion has the test taker

performing five on-the-job skills. Some of the skills

tested include:

■ Personal Care Skills—such as client bathing,

grooming, dressing, toileting, skin care, nutrition,

and more■ Basic Nursing Skills—such as providing a safe

and/or clean environment, recognizing abnormal

signs or symptoms of diseases and conditions,

communicating with clients, understanding basic

principles of infection and control, and more■ Mental Health and Social Service Needs—such as

psychosocial characteristics of populations, iden-

tification of developmental tasks associated with

aging, behavior management, and so on■ Basic Restorative Devices—use of assistive

devices, range of motion, client transfer, bowel

and bladder training, and care and use of pros-

thetic devices

■ Client’s Rights—such as privacy, grievances,

client and family group participation, physical

and chemical restraints, personal possessions, and

more■ Employability Skills—such as acquiring a job and

maintaining a job

Even if your state or agency doesn’t require a

written exam, you will find that these practice exams

are a valuable way to review and solidify your skills.

Once you have completed your course of study,

you are ready to take the first practice exam in this

book. Each practice exam contains 70 multiple-choice

questions on all aspects of the job. Allow yourself

enough time to complete the entire exam at one sit-

ting, approximately two-and-a-half hours.

Each practice exam has an answer key at the end,

which not only tells you the right answer, but also

explains why that answer is right. In general, you

should count yourself successful when you can score at

least 75%. If you don’t get that score on the first prac-

tice exam, don’t panic! First, review the answer expla-

nations to see where you went wrong. Then, see which

areas you did well in and which areas gave you more

trouble. Go back to your textbook or other training

materials to review your weakest areas. Then take the

second practice exam. You should find that your score

improves. Continue this process—reviewing, taking a

practice exam, more review—until you have com-

pleted all five practice exams in this book. That way

you will be well prepared for any state certification

exam you may have to take.

Practice with the exams in this book is not a

guarantee that you will pass a state certification

exam—or get a job as a CNA. But it certainly does

bring you closer to those goals than if you had not

studied and prepared!

In addition to the practice written exams, this

book also includes a sample performance assessment

in Chapter 8. This is a sample of the kind of job tasks

you will perform as a CNA. You may be asked to per-


3

form tasks like these either during a state certification

exam or by a prospective employer during a job inter-

view. You should practice these tasks and become pro-

ficient enough to perform them under pressure with

an examiner or your potential employer watching you

closely. Carefully practicing these skills will help you

sell yourself to your employer and will put you ahead

of other people applying for the same position. Keep in

mind that the best-trained person is usually the one

who is selected for the position.

Here are the steps to take to become a CNA:

1. Contact local employment agencies or the state

health office to find out about certification stan-

dards. (A list of state registries follows.)

2. Contact local employment agencies for employ-

ment opportunities.

3. Take your CNA course and/or use study guides

and textbooks to prepare for certification.

4. Take the first practice exam in this book and

score it. Review your weakest areas.

5. Continue to review and take practice exams.

Score yourself on each exam to see how prepared

you are for the actual certification exam.

6. Once you feel confident, contact your state or

local agency to set a date for taking the certifica-

tion exam.

7. Take the certification exam and pass it!

8. Show prospective employers your certificate.

This shows you are ready to start a job and have

the initiative to advance once you are hired.

If you faithfully follow these steps, you will be

well on your way to a successful career as a certified

nursing assistant.

Nursing Assistant StateRegistries

ALABAMA Department of Public HealthDivision of License and Certification434 Monroe StreetMoffitt BuildingMontgomery, AL 36130-3017334-261-6505

ALASKADivision of Occupational LicensingAlaska State Board of Nursing3601 C Street, #722Anchorage, AK 99503907-561-2878

ARIZONAArizona State Board of Nursing1651 East Morten, Suite 150Phoenix, AZ 85020520-255-5455

ARKANSASDepartment of Human ServicesDivision of Medical ServicesMail Slot 405, P.O. Box 8059Little Rock, AR 72203-8059501-682-8484

CALIFORNIADepartment of Health ServicesDivision of Licensing and CertificationP.O. Box 942732Sacramento, CA 94234-7320916-327-2445

COLORADODepartment of Regulatory AgenciesState Board of Nursing1560 Broadway, #670Denver, CO 80202303-894-2816

CONNECTICUTAssessment Systems, Inc.Processing Center Suite 3003 Bala Plaza WestBala Cynwyd, PA 19004-3481800-274-2900


4

DELAWAREDivision of Public HealthHealth Facilities Licensing and Certification3 Mill Road, Suite 308Wilmington, DE 19800302-577-6666

DISTRICT OF COLUMBIADepartment of Consumer and Regulatory Affairs614 H Street NW, #1003Washington, DC 20001202-727-7190

FLORIDAAgency for Health Care Administration2727 Mahen DriveTallahassee, FL 32308904-488-8401

GEORGIAGeorgia Nurse Aide RegistryGeorgia Department of Human Resources2 Peachtree Street, NW, 21st FloorAtlanta, GA 30303-3167404-657-5730

HAWAIINurse Assistant Competency TestingAmerican Red Cross, Hawaii Chapter4155 Diamond Head RoadHonolulu, HI 96816-4417808-734-2101Fax: 808-734-8318

IDAHOIdaho Board of NursingP.O. Box 83720Boise, ID 83720-0061208-334-3110

ILLINOISDepartment of Public Health Education525 West JeffersonSpringfield, IL 62761217-782-3070

INDIANAState Board of Health1330 West MichiganP.O. Box 1964Indianapolis, IN 46206-1964317-383-6612 or 317-633-0639

IOWADepartment of Inspections and AppealsHealth Facilities DivisionLucas State Office BuildingDes Moines, IA 50319-0083515-281-4963

KANSASDepartment of Health and EnvironmentHealth Occupation Credential Unit109 SW 9th Street, Suite 400BTopeka, KS 66612-2218913-296-6877

KENTUCKYCabinet for Human ResourcesDivision of Licensing and Regulation274 East Main StreetCHR Building, 4th Floor EastFrankfort, KY 40621502-564-2800

LOUISIANABoard of Examiners for Nursing HomeAdministrators5615 Corporate Boulevard, Suite 8DBaton Rouge, LA 70808504-925-4591

MAINEDepartment of Human Resources—CNA RegistryState House Station 1135 Anthony AvenueAugusta, ME 04333207-287-3707

MARYLANDMaryland CNA RegistryPsychological CorporationP.O. Box 839963San Antonio, TX 78283-9963800-622-3231

MASSACHUSETTSDepartment of Public HealthDivision of Health Care Quality10 West StreetBoston, MA 02111617-727-5860

MICHIGANHealth Management Associates120 North Washington Square, #905Lansing, MI 48933517-371-9091 or 800-748-0252


5

MINNESOTAMinnesota Department of HealthFacility and Provider Compliance DivisionNurse Assistant Registry393 North Dunlap StreetP.O. Box 64501St. Paul, MN 55164-0501612-643-2176 or 800-397-6124

MISSISSIPPIMississippi Board of Nursing239 North Lamar, #401Jackson, MS 39201601-359-6182

MISSOURIHealth Education UnitDivision of AgingP.O. Box 1337Jefferson City, MO 65102314-571-3082 or 314-526-5686 (voice mail)

MONTANADepartment of HealthLicensing and Certification BureauCogswell Building, Room C-211Helena, MT 59620406-444-2037

NEBRASKADepartment of HealthBureau of Health Facility Standards301 Centennial Mall SouthP.O. Box 95007Lincoln, NE 68509-5007402-471-0537

NEVADAState Board of Nursing1755 East Plumb Lane, Suite 260Reno, NV 89502702-786-2778 or 702-739-0129

NEW MEXICODepartment of HealthLicensing and CertificationP.O. Box 26110Santa Fe, NM 87501505-827-4206Fax: 505-827-4203

NEW HAMPSHIRENew Hampshire Board of NursingDivision of Public Health Services6 Hazen DriveConcord, NH 03301603-271-6282 or 603-271-6599

NEW JERSEYAssessment Systems, Inc.Processing Center, Suite 3003 Bala Plaza WestBala Cynwyd, PA 19004-3481800-274-2900

NORTH CAROLINADepartment of Health and Human ServicesDivision of Facility ServicesNurse Aide Training and Registry Administration2709 Mail Service CenterRaleigh, NC 27699-2709919-733-2786Voice Response System: 919-715-0562www.ncnar.org

NORTH DAKOTANorth Dakota Department of Health Division ofEmergency Health Services600 E Blvd Avenue, Department 301Bismarck, ND 58505-0200701-328-2388Fax: 701-328-1890E-mail: [email protected]

OHIODepartment of HealthNurse Aide UnitP.O. Box 118Columbus, OH 43266-0118800-582-5908 or 614-752-9500

OKLAHOMAOklahoma State Department of Health1000 NE 10th StreetOklahoma City, OK 73117-1299800-695-2157

OREGONBoard of Nursing, Program Executive800 Northeast Oregon Street, Suite 465Portland, OR 97232503-731-4745


6

PENNSYLVANIADepartment of HealthDivision of Long Term CareP.O. Box 90, Room #526Harrisburg, PA 17108717-787-1816

RHODE ISLANDDepartment of HealthDivision of Professional Regulation3 Capitol Hill, Room 104Providence, RI 02098401-277-2827

SOUTH CAROLINADepartment of Health and Environment2600 Bull StreetColumbia, SC 29201803-737-7207

SOUTH DAKOTABoard of Nursing3307 S. Lincoln AvenueSioux Falls, SD 57105605-367-5940Fax: 605-367-5945

TENNESSEEDepartment of Health283 Plus Park BoulevardNashville, TN 37247-0530615-367-6344

TEXASDepartment of Human ServicesNurse Aide RegistryP.O. Box 149030, Mail Code Y-977Austin, TX 78714-9030512-834-6670

UTAHNurse Aide Registry550 East 300 SouthKaysville, UT 84037801-547-9947

VERMONTVermont Board of Nursing109 State StreetSecretary of State OfficeMontpelier, VT 05609-1106802-828-2819

VIRGINIADepartment of Health ProfessionalsBoard of Nursing6606 West Broad Street, 4th FloorRichmond, VA 23230-1717804-662-7310

WASHINGTONDepartment of Social and Health ServicesOBRA Nursing Assistant RegistryP.O. Box 45600Olympia, WA 98504-5600360-438-7925

WEST VIRGINIAHealth Facility Licensure and Certification1900 Kanawha Boulevard East, Building #3Charleston, WV 25305304-558-0050

WISCONSINDepartment of Health and Social ServicesBureau of Quality Compliance1 West Wilson StreetP.O. Box 2569Madison, WI 53701608-267-2374

WYOMINGState Board of Nursing2020 Carey Street, Suite 110Cheyenne, WY 82002307-777-7601


7

FI R S T, T H E B A D news: Taking the nursing assistant exam is no picnic, and neither is getting ready for

it. Your future career as a nursing assistant depends on passing the test, but there are all sorts of pit-

falls that can keep you from doing your best on this all-important exam. Here are some of the obsta-

cles that can stand in the way of your success:

■ Being unfamiliar with the format of the exam■ Being paralyzed by test anxiety■ Leaving your preparation to the last minute■ Not preparing at all!■ Not knowing vital test-taking skills: how to pace yourself through the exam, how to use the process of

elimination, and when to guess■ Not being in tip-top mental and physical shape■ Messing up on test day by arriving late at the test site, having to work on an empty stomach, or shivering

through the exam because the room is cold

C H A P T E R The LearningExpressTest PreparationSystemCHAPTER SUMMARYTaking 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.

2

9

What’s the common denominator in all these

test-taking pitfalls? One word: control. Who’s in con-

trol, you or the exam?

Now the good news: The LearningExpress Test

Preparation System puts you in control. In just nine

easy-to-follow steps, you will learn everything you

need to know to make sure that you are in charge of

your preparation and your performance on the exam.

Other test-takers may let the test get the better of them;

other test-takers may be unprepared or out of shape—

but not you. You will have taken all the steps you need

to take to get a high score on the nursing assistant

exam.

Here’s how the LearningExpress Test Preparation

System works: Nine easy steps lead you through every-

thing you need to know and do to get ready to master

your exam. Each of the steps listed below 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. Get Information

Step 2. Conquer Test Anxiety

Step 3. Make a Plan

Step 4. Learn to Manage Your Time

Step 5. Learn to Use the Process of Elimination

Step 6. Know When to Guess

Step 7. Reach Your Peak Performance Zone

Step 8. Get Your Act Together

Step 9. Do It!

If you have several hours, you can work through

the whole LearningExpress Test Preparation System in

one sitting. Otherwise, you can break it up and do just

one or two steps a day for the next several days. It is up

to you—remember, you are in control.

� Step 1: Get Information

Activities: Read Chapter 1, “The Nursing Assistant

Exam,” and use the suggestions there to find out

about your certification requirements.

Knowledge is power. Therefore, first, you have to find

out everything you can about the nursing assistant

exam. Once you have your information, the next steps

will show you what to do about it.

Part A: Straight Talk about theNursing Assistant ExamWhy do you have to take this exam, anyway? Because

an increasing number of people, particularly elderly

people, need to be cared for. And, since more and more

people need these services, there is growing concern

about the quality of care the patients get. One way to

try to ensure quality of care is to test the people who

give that care to find out if they have been well trained.

And that’s why your state or the agency you want to

work for may require you to take a written exam.

It is important for you to remember that your

score on the written exam does not determine how

smart you are or even whether you will make a good

nursing assistant. There are all kinds of things a writ-

ten exam like this can’t test: whether you are likely

to show up late or call in sick a lot, whether you can

be patient with a trying client, or whether you can be

trusted with confidential information about people’s

health. Those kinds of things are hard to evaluate on a

written exam. Meanwhile, it is easy to evaluate whether

you can correctly answer questions about the job

duties of a nursing assistant/nurse aide.

This is not to say that correctly answering the

questions on the written exam is not important! The

knowledge tested on the exam is knowledge you will

need to do your job, and your ability to enter the pro-

fession you have trained for depends on your passing

this exam. And that’s why you are here—to achieve

control over the exam.

–THE LEARNINGEXPRESS TEST PREPARATION SYSTEM–

10

Part B: What’s on the TestIf you haven’t already done so, stop here and read

Chapter 1 of this book, which gives you an overview of

the written exam. Chapter 1 also suggests ways to find

out about certification requirements in your state.

At this point, you may also want to skip ahead to

Chapter 9 to uncover some of the trends in healthcare

licensing requirements. Later, you will have the oppor-

tunity to take the sample practice exams in Chapters 3

through 7. Chapter 8 will help you go through the clin-

ical skills area of the test.

� Step 2: Conquer Test Anxiety

Activity: Take the Test Anxiety Quiz on page 12.

Having complete information about the exam is the

first step in getting control of the exam. Next, you have

to overcome one of the biggest obstacles to test success:

test anxiety. Test anxiety cannot only impair your per-

formance on the exam itself; it can even keep you from

preparing! In this step you will learn stress manage-

ment techniques that will help you succeed on your

exam. Learn these strategies now, and practice them as

you complete the exams in this book so that they will

be second nature to you by exam day.

Combating Test AnxietyThe first thing you need to know is that a little test anx-

iety is a good thing. Everyone gets nervous before a big

exam—and if that nervousness motivates you to pre-

pare thoroughly, so much the better. Many well-known

people throughout history have experienced anxiety or

nervousness—from performers such as actor Sir Lau-

rence Olivier and singer Aretha Franklin to writers

such as Charlotte Brontë and Alfred Lord Tennyson. In

fact, anxiety probably gave them a little extra edge—

just the kind of edge you need to do well, whether on

a stage or in an examination room.

Stop here and complete the Test Anxiety Quiz on

the next page to find out whether your level of test

anxiety is something you should worry about.

Stress Management Before the TestIf you feel your level of anxiety getting the best of you

in the weeks before the test, here is what you need to

do to bring the level down again:

■ Get prepared. There’s nothing like knowing what

to expect and being prepared for it to put you in

control of test anxiety. That’s why you are reading

this book. Use it faithfully, and remind yourself

that you are better prepared than most of the

people taking the test.■ Practice self-confidence. A positive attitude is a

great way to combat test anxiety. This is no time

to be humble or shy. Stand in front of the mirror

and say to your reflection, “I’m prepared. I’m full

of self-confidence. I’m going to ace this test. I

know I can do it.” If you hear it often enough, you

will come to believe it.■ Fight negative messages. Every time someone

starts telling you how hard the exam is or how it

is almost impossible to get a high score, start

telling them your self-confidence messages above.

If the someone with the negative messages is you,

telling yourself you don’t do well on exams or you

just can’t do this, don’t listen.■ Visualize. Imagine yourself reporting for duty on

your first day as a certified nursing assistant.

Think of yourself helping patients and making

them more comfortable. Imagine coming home

with your first paycheck. Visualizing success can

help make it happen—and it reminds you of why

you are working so hard to pass the exam.■ Exercise. Physical activity helps calm down your

body and focus your mind. Besides, being in good

physical shape can actually help you do well on

the exam. Go for a run, lift weights, go swim-

ming—and do it regularly.

Stress Management on Test DayThere are several ways you can bring down your level

of test anxiety on test day. They will work best if you


11

Test Anxiety Quiz

You only need to worry about test anxiety 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 accu-

rately 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 Anxiety 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 is probably just enough to give you that little extra

edge.

■ Between 3 and 6, your test anxiety may be enough to impair your performance, and you should practice the stress

management techniques listed 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 col-

lege 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 an exam. The counselor may be willing to help you or may suggest someone else

you should talk to.

12

practice them in the weeks before the test, so you know

which ones work best for you.

■ Deep breathing. Take a deep breath while you

count to five. Hold it for a count of one, then let

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

the wrist. Many people find these movements

very relaxing.■ Visualize again. Think of the place where you are

most relaxed: lying on the beach in the sun, walk-

ing through the park, or whatever makes you feel

good. Now close your eyes and imagine you are

actually there. If you practice in advance, you will

find that you only need a few seconds of this

exercise to experience a significant increase in

your sense of well-being.

When anxiety threatens to overwhelm you right

there during the exam, there are still things you can do

to manage the stress level.

■ Repeat your self-confidence messages. You

should have them memorized by now. Say them

quietly to yourself, and believe them!■ Visualize one more time. This time, visualize

yourself moving smoothly and quickly through

the test answering every question correctly and

finishing just before time is up. Like most visuali-

zation techniques, this one works best if you have

practiced it ahead of time.■ Find an easy question. Skim over the test until

you find an easy question, and answer it. Getting

even one circle filled in gets you into the test-

taking groove.■ Take a mental break. Everyone loses concentra-

tion once in a while during a long test. It is nor-

mal, so you shouldn’t worry about it. Instead,

accept what has happened. Say to yourself, “Hey,

I lost it there for a minute. My brain is taking a

break.” Put down your pencil, close your eyes, and

do some deep breathing for a few seconds. Then

you will be ready to go back to work.

Try these techniques ahead of time, and see if

they don’t work for you!

� Step 3: Make a Plan

Activity: Construct a study plan.

Maybe the most important thing you can do to get

control of yourself and your exam is to make a study

plan. Too many people fail to prepare simply because

they fail to plan. Spending hours poring over sample

test questions the day before the exam not only raises

your level of test anxiety, but it also will not replace

careful preparation and practice over time.

Don’t fall into the cram trap. Take control of your

preparation time by mapping out a study schedule. On

the following pages are two sample schedules, based on

the amount of time you have before you take the writ-

ten exam. If you are the kind of person who needs

deadlines and assignments to motivate you for a proj-

ect, here they are. If you are the kind of person who

doesn’t like to follow other people’s plans, you can use

the suggested schedules here to construct your own.

Even more important than making a plan is

making a commitment. You can’t review everything

you learned in your nursing assistant course in one

night. You need to set aside some time every day for

study and practice. Try for at least 20 minutes a day.

Twenty minutes daily will do you much more good

than two hours on Saturday—divide your test prepa-

ration into smaller pieces of the larger work. In addi-

tion, making study notes, creating visual aids, and

memorizing can be quite useful as you prepare. Each

time you begin to study, quickly review your last les-

son. This act will help you retain all you have learned

and help you assess if you are studying effectively. You

may realize you are not remembering some of the


13

material you studied earlier. Approximately one week

before your exam try to determine the areas that are

still most difficult for you.

Don’t put off your study until the day before the

exam. Start now. A few minutes a day, with half an

hour or more on weekends, can make a big difference

in your score.

Learning StylesEach of us absorbs information differently. Whichever

way works best for you is called your dominant learning

method. If someone asks you to help them construct a

bookcase they just bought, that may be in many pieces,

how do you begin? Do you need to read the directions

and see the diagram? Would you rather hear someone

read the directions to you—telling you which part con-

nects to another? Or do you draw your own diagram?

The three main learning methods are visual,

auditory, and kinesthetic. Determining which type of

learner you are will help you create tools for studying.

Visual Learners need to see the information in the

form of maps, pictures, text, words, or math exam-

ples. Outlining notes and important points in col-

orful highlighters and taking note of diagrams and

pictures may be key in helping you study.

Auditory Learners retain information when they can

hear directions, the spelling of a word, a math the-

orem, or poem. Repeating information aloud or lis-

tening to your notes on a tape recorder may help.

Many auditory learners also find working in study

groups or having someone quiz them is beneficial.

Kinesthetic Learners must do! They need to draw dia-

grams, write directions, etc. Rewriting notes on

index cards or making margin notes in your text-

books also helps kinesthetic learners to retain

information.

MnemonicsMnemonics are memory tricks that help you remem-

ber what you need to know. The three basic principles

in the use of mnemonics are imagination, association,

and location. Acronyms (words created from the first

letters in a series of words) are common mnemonics.

One acronym you may already know is HOMES, for

the names of the Great Lakes (Huron, Ontario, Michi-

gan, Erie, and Superior). ROY G. BIV reminds people

of the colors in the spectrum (Red, Orange, Yellow,

Green, Blue, Indigo, and Violet). Depending on the

type of learner you are, mnemonics can also be color-

ful or vivid images, stories, word associations, or catchy

rhymes such as “Thirty days hath September . . . ” cre-

ated in your mind. Any type of learner, whether visual,

auditory, or kinesthetic, can use mnemonics to help

the brain store and interpret information.

� Step 4: Learn to Manage Your Time

Activities: Practice these strategies as you take the

sample tests in this book.

Steps 4, 5, and 6 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

strategies as you take the sample tests in this book, and

then you will be ready to use them on test day.

First, you will take control of your time on the

exam. Most nursing assistant exams have a time limit,

which may give you more than enough time to com-

plete all the questions—or may not. It is a terrible feel-

ing to hear the examiner say, “Five minutes left,” when

you are only three-quarters of the way through the test.

Here are some tips to keep that from happening to

you.

■ Follow directions. If the directions are given

orally, listen to them. If they are written on the

exam booklet, read them carefully. Ask questions

before the exam begins if there’s anything you

don’t understand. If you are allowed to write in

your exam booklet, write down the beginning

time and the ending time of the exam.


14

■ Pace yourself. Glance at your watch every few

minutes, and compare the time to how far you

have gotten in the test. When one-quarter of the

time has elapsed, you should be a quarter of

the way through the test, and so on. If you are

falling behind, pick up the pace a bit.■ Keep moving. Don’t dither around on one ques-

tion. If you don’t know the answer, skip the

question and move on. Circle the number of the

question in your test booklet in case you have

time to come back to it later.■ Keep track of your place on the answer sheet. If

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-

ber of the question still corresponds with the

number on the answer sheet.■ Don’t rush. Though you should keep moving,

rushing won’t help. Try to keep calm and work

methodically and quickly.

� Step 5: Learn to Use theProcess of El iminat ion

Activity: Complete worksheet on Using the Process

of Elimination (see page 17).

After time management, your next most important

tool for taking control of your exam is using the

process of elimination wisely. It is standard test-taking

wisdom that you should always read all the answer

choices before choosing your answer. This helps you

find the right answer by eliminating wrong answer

choices. And, sure enough, that standard wisdom

applies to your nursing assistant exam, too.

Let’s say you are facing a question that goes like

this:

Which of the following lists of signs and symp-

toms indicates a possible heart attack?

a. headache, dizziness, nausea, confusion

b. dull chest pain, sudden sweating, difficulty

breathing

c. wheezing, labored breathing, chest pain

d. difficulty breathing, high fever, rapid pulse

You should always use the process of elimination

on a question like this, even if the right answer jumps

out at you. Sometimes the answer that jumps out isn’t

right after all. Let’s assume, for the purpose of this

exercise, that you are a little rusty on your signs and

symptoms of a heart attack, so you need to use a little

intuition to make up for what you don’t remember.

Proceed through the answer choices in order.

■ Start with answer a. This one is pretty easy to

eliminate; none of these signs and symptoms is

likely to indicate a heart attack. Mark an X next to

choice a so you never have to look at it again.■ On to choice b. “Dull chest pain” looks good,

though if you are not up on your cardiac signs

and symptoms you might wonder if it should be

“acute chest pain” instead. “Sudden sweating” and

“difficulty breathing”? Check. And that’s what

you write next to answer b—a check mark, mean-

ing “good answer, I might use this one.”■ Choice c is a possibility. Maybe you don’t really

expect wheezing in a heart attack victim, but you

know “chest pain” is right, and let’s say you are

not sure whether “labored breathing” is a sign of

cardiac difficulty. Put a question mark next to c,

meaning “well, maybe.”■ Choice d is also a possibility. “Difficulty breath-

ing” is a good sign of a heart attack. But wait a

minute. “High fever?” Not really. “Rapid pulse?”

Well, maybe. This doesn’t really sound like a heart

attack, and you have already got a better answer

picked out in choice b. If you are feeling sure of

yourself, put an X next to this one. If you want to


15

be careful, put a question mark. Now your ques-

tion looks like this:

Which of the following lists of signs and symp-

toms indicates a possible heart attack?

X a. headache, dizziness, nausea, confusion

✓ b. dull chest pain, sudden sweating, difficulty

breathing

? c. wheezing, labored breathing, chest pain

? d. difficulty breathing, high fever, rapid pulse

You have got just one check mark, for a good

answer. If you are pressed for time, you should simply

mark answer b on your answer sheet. If you have got

the time to be extra careful, you could compare your

check mark answer to your question-mark answers to

make sure that it is better.

It is good to have a system for marking good,

bad, and maybe answers. We recommend this one:

X = bad

✓ = good

? = maybe

If you don’t like these marks, devise your own

system. Just make sure you do it long before test day—

while you are working through the practice exams in

this book—so you won’t have to worry about it during

the test.

Key WordsOften, identifying key words in a question will help

you in the process of elimination. Words such as

always, never, all, only, must, and will often make state-

ments incorrect. Here is an example of an incorrect

statement:

When a nursing assistant is preparing to ambulate a

client, making sure the client is wearing proper

footwear will always prevent them from falling.

The word always in this statement makes it

incorrect. Nursing assistants must also take other

measures, in addition to providing proper footwear,

when ambulating a resident, such as proper body

mechanics and providing support to the client.

Words like usually, may, sometimes, and most may

make a statement correct. Here is an example of a cor-

rect statement:

Clients of healthcare facilities and hospitals may need

help with tasks such as being fed and bathed.

The word may makes this statement correct.

There are clients in facilities who may be too ill or weak

to perform daily tasks such as feeding and bathing

themselves.

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

so, you are better prepared to make an educated guess,

as you will see in Step 6. More often, you can eliminate

answers until you have only two possible answers.

Then you are in a strong position to guess.

Try using your powers of elimination on the

questions in the following worksheet, Using the Process

of Elimination. The questions are not about healthcare

work; they are just designed to show you how the

process of elimination works. The answer explanations

for this worksheet show one possible way you might

use the process to arrive at the right answer.

� Step 6: Know When to Guess

Activity: Complete worksheet on Your Guessing

Ability (see page 18).

Armed with the process of elimination, you are ready

to take control of one of the big questions in test tak-

ing: Should I guess? The first and main answer is Yes.

Some exams have what’s called a “guessing penalty,” in

which a fraction of your wrong answers is subtracted

from your right answers—but nursing assistant exams


16

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.

The difference between Ed’s age and Meghan’s

age is twice the difference between Ilsa’s age

and Meghan’s age. Ed is 29. How old is Ilsa?

a. 4

b. 10

c. 19

d. 24

2. “All drivers of commercial vehicles must carry a

valid commercial driver’s license whenever

operating a commercial vehicle.”

According to this sentence, which of the

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

3. Smoking tobacco has been linked to

a. increased risk of stroke and heart attack

b. all forms of respiratory disease

c. increasing mortality rates over the past ten

years

d. juvenile delinquency

4. Which of the following words is spelled cor-

rectly?

a. incorrigible

b. outragous

c. domestickated

d. understandible

1. d. You should have eliminated answer a off the

bat. Ilsa can’t be four years old if Meghan is

going to be Ilsa’s age in five years. The best

way to eliminate other answer choices is to

try plugging them in to the information given

in the problem. For instance, for answer b, if

Ilsa is 10, then Meghan must be 5. The differ-

ence in their ages is 5. The difference

between Ed’s age, 29, and Meghan’s age, 5,

is 24. Is 24 two times 5? No. Then answer b

is wrong. You could eliminate answer c in the

same way and be left with answer d.

2. c. Note the word not in the question, and go

through the answers one by one. Is the truck

driver in choice a “operating a commercial

vehicle”? Yes, idling counts as “operating,”

so he needs to have a commercial driver’s

license. Likewise, the bus operator in answer

b is operating a commercial vehicle; the

question doesn’t say the operator has to be

on the street. The limo driver in choice d is

operating a commercial vehicle, even if it

doesn’t have a passenger in it. However, the

cabbie in answer c is not operating a com-

mercial vehicle, but his own private car.

3. a. You could eliminate answer b simply because

of the presence of the word all. Such

absolutes hardly ever appear in correct

AnswersHere are the answers, as well as some suggestions as to how you might have used the process of elimination to find them.

17

answer choices. Choice c looks attractive

until you think a little about what you know—

aren’t fewer people smoking these days,

rather than more? So how could smoking be

responsible for a higher mortality rate? (If you

didn’t know that mortality rate means the rate

at which people die, you might keep this

choice as a possibility, but you would still be

able to eliminate two answers and have only

two to choose from.) And choice d is plain

silly, so you could eliminate that one, too. You

are left with the correct choice, a.

4. a. How you used the process of elimination

here depends on which words you recog-

nized as being spelled incorrectly. If you

knew that the correct spellings were outra-

geous, domesticated, and understandable,

then you were home free.

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, just as if you did expect 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

a. India

b. Costa Rica

c. Brazil

d. Australia

2. Which of the following is the formula for deter-

mining the momentum of an object?

a. p = MV

b. F = ma

c. P = IV

d. E = mc2

3. Because of the expansion of the universe, the

stars and other celestial bodies are all moving

away from each other. This phenomenon is

known as

a. Newton’s first law

b. the big bang

c. gravitational collapse

d. Hubble flow

4. American author Gertrude Stein was born in

a. 1713

b. 1830

c. 1874

d. 1901

5. Which of the following is NOT one of the Five

Classics attributed to Confucius?

a. the I Ching

b. the Book of Holiness

c. the Spring and Autumn Annals

d. the Book of History

6. The religious and philosophical doctrine that

holds that the universe is constantly in a strug-

gle between good and evil is known as

a. Pelagianism

b. Manichaeanism

c. neo-Hegelianism

d. Epicureanism

7. The third Chief Justice of the U.S. Supreme

Court was

a. John Blair

b. William Cushing

c. James Wilson

d. John Jay

Using the Process of Elimination (continued)

Your Guessing Ability

18

8. Which of the following is the poisonous portion

of a daffodil?

a. the bulb

b. the leaves

c. the stem

d. the flowers

9. The winner of the Masters golf tournament in

1953 was

a. Sam Snead

b. Cary Middlecoff

c. Arnold Palmer

d. Ben Hogan

10. The state with the highest per capita personal

income in 1980 was

a. Alaska

b. Connecticut

c. New York

d. Texas

AnswersCheck your answers against the correct answers

below.

1. c.

2. a.

3. d.

4. c.

5. b.

6. b.

7. b.

8. a.

9. d.

10. a.

How Did You Do?You may have simply gotten lucky and actually known the

answer to one or two questions. In addition, your guessing

was probably more successful if you were able to use the

process of elimination on any of the questions. Maybe you

didn’t know who the third Chief Justice was (question 7),

but you knew that John Jay was the first. In that case, you

would have eliminated answer d and therefore improved

your odds of guessing right from one in four to one in three.

According to probability, you should get two and a

half answers correct, so getting either two or three right

would be average. If you got four or more right, you may be

a really terrific guesser. If you got one or none right, you may

be a really bad guesser.

Keep in mind, though, that this is only a small sample.

You should continue to keep track of your guessing ability

as you work through the sample questions in this book. Cir-

cle the numbers of questions you guess on as you make

your guess; or, if you don’t have time while you take the

practice tests, go back afterward and try to remember

which questions you guessed at. Remember, on a test with

four answer choices, your chance of guessing correctly is

one in four. So keep a separate “guessing” score for each

exam. How many questions did you guess on? How many

did you get right? If the number you got right is at least one-

fourth of the number of questions you guessed on, you are

at least an average guesser—maybe better—and you

should always go ahead and guess on the real exam. If the

number you got right is significantly lower than one-fourth

of the number you guessed on, you would, frankly, be safe

in guessing anyway, but maybe you would feel more com-

fortable if you guessed only selectively, when you can elim-

inate a wrong answer or at least have a good feeling about

one of the answer choices.

Frankly, even if you are a play-it-safe person with

lousy intuition, you are still safe guessing every time.

Your Guessing Ability (continued)

19

don’t tend to work like that. The number of questions

you answer correctly yields your raw score. So you have

nothing to lose and everything to gain by guessing.

The more complicated answer to the question

“Should I guess?” depends on you—your personality

and your “guessing intuition.” There are two things you

need to know about yourself before you go into the

exam:

Are you a risk-taker?

Are you a good guesser?

You will have to decide about your risk-taking

quotient on your own. To find out if you are a good

guesser, complete the worksheet, Your Guessing Ability

on page 18.

� Step 7: Reach Your PeakPerformance Zone

Activity: Complete the Physical Preparation Check-

list.

To get ready for a challenge like a big exam, you have

to take control of your physical, as well as your men-

tal, state. Exercise, proper diet, and rest in the weeks

prior to the test will ensure that your body works with,

rather than against, your mind on test day, as well as

during your preparation.

ExerciseIf you don’t already have a regular exercise program

going, the time during which you are preparing for an

exam is actually an excellent time to start one. And if

you are already keeping fit—or trying to get that

way—don’t let the pressure of preparing for an exam

fool you into quitting now. Exercise helps reduce stress

by pumping feel-good hormones, called endorphins,

into your system. It also increases the oxygen supply

throughout your body, including your brain, so you

will be at peak performance on test day.

A half hour of vigorous activity—enough to raise

a sweat—every day should be your aim. If you are

really pressed for time, every other day is OK. Choose

an activity you like and get out there and do it. Jogging

with a friend always makes the time go faster, or take a

portable radio or CD player.

But don’t overdo it. You don’t want to exhaust

yourself. Moderation is the key.

DietFirst of all, cut out the junk. Go easy on caffeine and

nicotine, and eliminate alcohol from your system at

least two weeks before the exam. What your body

needs for peak performance is simply a balanced diet.

Eat plenty of fruits and vegetables, along with protein

and carbohydrates. Foods that are high in lecithin (an

amino acid), such as fish and beans, are especially good

“brain foods.”

The night before the exam, you might “carbo-

load” the way athletes do before a contest. Eat a big

plate of spaghetti, rice and beans, or whatever your

favorite carbohydrate is.

RestYou probably know how much sleep you need every

night to be at your best, even if you don’t always get it.

Make sure you do get that much sleep, though, for at

least a week before the exam. Moderation is important

here, too. Extra sleep will just make you groggy.

If you are not a morning person and your exam

will be given in the morning, you should reset your

internal clock so that your body doesn’t think you are

taking an exam at 3 A.M. You have to start this process

well before the exam. The way it works is to get up half

an hour earlier each morning, and then go to bed half

an hour earlier that night. Don’t try it the other way

around; you will just toss and turn if you go to bed

early without having gotten up early. The next morn-

ing, get up another half an hour earlier, and so on.

How long you will have to do this depends on how late

you are used to getting up.


20

� Step 8: Get Your Act Together

Activity: Complete Final Preparations worksheet.

You are in control of your mind and body; you are in

charge of test anxiety, your preparation, and your test-

taking strategies. Now it is time to take charge of exter-

nal factors, like the testing site and the materials you

need to take the exam.

Find Out Where the Test Is andMake a Trial RunThe testing agency or your nursing assistant instructor

will notify you when and where your exam is being

held. Do you know how to get to the testing site? Do

you know how long it will take to get there? If not,

make a trial run, preferably on the same day of the

week at the same time of day. Make note, on the work-

sheet Final Preparations on page 22, of the amount of

time it will take you to get to the exam site. Plan on

arriving at least 10–15 minutes early so you can get the

lay of the land, use the bathroom, and calm down.

Then figure out how early you will have to get up that

morning, and make sure you get up that early every

day for a week before the exam.

Gather Your MaterialsThe night before the exam, lay out the clothes you will

wear and the materials you have to bring with you to

the exam. Plan on dressing in layers; you won’t have

any control over the temperature of the examination

room. Have a sweater or jacket you can take off if it is

warm. Use the checklist on the worksheet Final Prep-

arations on the following page to help you pull

together what you will need.

Don’t Skip BreakfastEven if you don’t usually eat breakfast, do so on exam

morning. A cup of coffee doesn’t count. Don’t eat

doughnuts or other sweet foods, either. A sugar high

will leave you with a sugar low in the middle of the

exam. A mix of protein and carbohydrates is best:

cereal with milk and just a little sugar, or eggs with

toast, will do your body a world of good.

� Step 9: Do I t !

Activity: Ace the nursing assistant exam!

Fast forward to exam day. You are ready. You made a

study plan and followed through. You practiced your

test-taking strategies while working through this

book. You are in control of your physical, mental, and

emotional states. You know when and where to show

up and what to bring with you. In other words, you are

better prepared than most of the other people taking

the nursing assistant exam with you. You are psyched.

Just one more thing. . . . When you are done with

the exam, you deserve a reward. Plan a celebration.

Call up your friends and plan a party, or have a nice

dinner for two—whatever your heart desires. Give

yourself something to look forward to.

And then do it. Go into the exam, full of confi-

dence, armed with test-taking strategies you have prac-

ticed until they are second nature. You are in control of

yourself, your environment, and your performance on

the exam. You are ready to succeed. So do it. Go in

there and ace the exam. And look forward to your

future career as a nursing assistant!


21

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

Final Preparations

22

� 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.


23

Time Preparation

Days 1–3 Skim over 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 Chap-

ter 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. Iden-

tify 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 prac-

tice exams you have taken so far, with

special attention to the answer explana-

tions.

Time Preparation

Day 17 Take the third practice exam.

Day 18 Once again, identify one area to review,

based on your score on the third prac-

tice 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 Chap-

ter 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

the exam exam and go to bed at a reasonable

hour.

� 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.


24

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.

Time Preparation

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 Chap-

ter 6 and score it.

Day 10 Use your last study day to brush up on

any areas that are still giving you trou-

ble and then take the fifth practice

exam.

Day before Relax. Do something unrelated to the

the exam exam and go to bed at a reasonable

hour.

IF YO U A R E 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:

■ Physical Care Skills—activities of daily living, basic nursing skills, restorative skills■ Psychosocial Care Skills—emotional- and mental-health needs, spiritual and cultural needs■ Role of the Nurse Aide—communication, client rights, legal and ethical behavior as a member of the

healthcare team

The exam is not divided into these sections; you may find questions on very different topics right next to

each other.

The first ten questions are a short Pretest to get you warmed up—don’t count them as part of your score.

These questions are designed to familiarize you with the types of questions you will see on the test.

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

C H A P T E R Nursing Assistant/NurseAide PracticeExam 1CHAPTER SUMMARYThis 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 weakness.

3

25

next page. After the exam is an answer key, with all the

answers explained. These explanations will help you

see your areas of strength and weakness. Then you will

know which parts of your training materials to study

before you take the second practice exam. You can refer

to Appendix A for a breakdown of the question types.

The chart will help you understand which kinds of

questions are most difficult for you so you can focus

on those skills for next time. Generally, a score of 75%

or more is considered passing.

–NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 1–

26

–NURSING ASSISTANT/NURSE AIDE ANSWER SHEET–

27

Practice Pretest

Exam 1

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60. a b c d

� Pretest Pract ice

1. When assisting a client in learning to use a

walker, it is important to

a. stand behind him and use a transfer belt.

b. put padding all the way around the top rim.

c. let him walk by himself so he gains independ-

ence.

d. let him practice using the walker on the day

he is discharged.

2. Urinary retention refers to

a. normal output of urine.

b. inability to urinate.

c. incontinence.

d. large output of urine.

3. Normal hearing loss in aging is usually related to

the ability to hear

a. high-pitched sounds.

b. loud sounds.

c. all sounds.

d. rapid speech.

4. The best way to safely identify your patient is by

a. asking his name.

b. calling his name and waiting for his response.

c. checking the bed plate.

d. checking the name tag.

5. OSHA rules specify that, when washing out

soiled linens, the following must be worn

a. gloves

b. goggles

c. gloves and goggles

d. gloves, goggles, and apron

6. The proper medical abbreviation for before

meals is

a. p.c.

b. b.i.d.

c. a.c.

d. t.i.d.

7. The proper medical term for high blood pres-

sure is

a. diabetes.

b. hypertension.

c. hypotension.

d. CVA.

8. A patient who has difficulty chewing or swallow-

ing will need what type of diet?

a. clear liquid

b. low residue

c. bland

d. mechanical soft

9. When shaving a male patient’s face, it is impor-

tant to

a. apply shaving cream sparingly.

b. use upward strokes when shaving the cheeks.

c. apply Betadine to any nicks.

d. none of the above

10. How often should a patient’s intake and output

records be totaled?

a. once each shift

b. twice a day

c. every 4 hours

d. every 12 hours


29

� Exam 1

1. Which of the following should you observe and

record when admitting a client?

a. color of the stool and amount of urine voided

b. how much the client has eaten and drunk

c. bruises, marks, rashes, or broken skin

d. insurance information

2. When responding to a client on the intercom,

you should

a. ask for the client’s name.

b. say, “What do you want?”

c. give your name and position and say “may I

help you?”

d. say, “The nurse will answer your call.”

3. Which of the following things should you do to

familiarize a new client with his or her surround-

ings?

a. Show the client where the call light is and how

to work it.

b. Tell the client not to operate the TV.

c. Ask visitors to leave the room while you finish

admitting the client.

d. Raise the side rails of the bed and raise the

bed to high position.

4. When arranging a patient’s room, you should do

all of the following EXCEPT

a. check signal cords.

b. adjust the back and knee rests as directed.

c. administer medications.

d. check lighting.

5. When assisting a client in and out of bed, the

nurse aide should always

a. employ body mechanic techniques.

b. get another person to help.

c. pull the client’s feet out first, and then lift the

back up.

d. put shoes on the client because the patient

may slip.

6. When should you wash your hands?

a. when you notice they look or feel dirty

b. when the charge nurse tells you to

c. at least twice a day

d. before and after contact with a patient

7. Which of the following is the correct procedure

for serving a meal to a client who must be fed?

a. serve the tray along with all the other trays,

and then come back to feed the client

b. bring the tray to the client last; feed after you

have served all the other clients

c. bring the tray into the room when you are

ready to feed the client

d. have the kitchen hold the tray for one hour

8. The MOST serious problem that wrinkles in the

bedclothes can cause is

a. restlessness.

b. sleeplessness.

c. decubitus ulcers.

d. bleeding and shock.

9. An important way to reduce the incidence of

decubitus ulcers is to

a. keep the client in bed.

b. force fluids every 2 hours.

c. change position every 2 hours.

d. all of the above


30

10. You are told to put a client in Fowler’s position.

Before changing the position of the client’s bed,

you should

a. open the window.

b. explain the procedure to the client.

c. check with the client’s family.

d. remake the bed.

11. During hand washing, the nurse aide acciden-

tally touches the inside of the sink while rinsing

the soap off. The NEXT action is to

a. allow the water to run over the hands for two

minutes.

b. dry the hands and turn off the faucet with the

paper towel.

c. repeat the wash from the beginning.


12. When giving mouth care to an unconscious

patient, the safest position to prevent aspira-

tion is

a. on her or his back.

b. in semi-Fowler’s position.

c. with the head turned to the side.

d. in the supine position.

13. Mr. Roark, a newly admitted conscious client,

has been put to bed. Before leaving him alone,

the FIRST action would be to

a. ask him if he is hungry.

b. inspect his skin.

c. complete the listing of his clothing and valu-

ables.

d. make sure he knows how to use the call light.

14. When lifting a heavy object, the correct method

would be to bend at the

a. waist, keeping your legs straight.

b. waist, rounding your shoulders.

c. knees, keeping your back straight.

d. knees and waist.

15. When cleaning a client’s dentures at the sink, the

reason to either line the emesis basin with a

paper towel or to fill the sink with water is to

a. prevent contamination of the dentures.

b. hide the dentures from view.

c. guard against breaking the dentures.

d. protect the basin from scratches.

16. When assisting a client with eating, one of the

FIRST things the nurse aide should do is

a. cut the food into large bite-size pieces.

b. wash his/her hands and the client’s hands.

c. butter the client’s bread.

d. provide the client with privacy.

17. A patient has a new cast on his right arm. While

caring for him, it is important to FIRST observe

for

a. pulse above the cast.

b. color and hardness of the cast.

c. warmth and color of fingers.

d. signs of crumbling at the cast end.

18. Encouraging a client to take part in activities of

daily living (ADLs) such as bathing, combing

hair, and feeding is

a. done only when time permits.

b. the family’s responsibility.

c. necessary for rehabilitation.

d. a violation of client rights.

19. In caring for a confused elderly man, it is impor-

tant to remember to

a. keep the bedrails up except when you are at

the bedside.

b. close the door to the room so that he does not

disturb other patients.

c. keep the room dark and quiet at all times to

keep the patient from becoming upset.

d. remind him each morning to shower and

shave independently.


31

20. Before assisting a client into a wheelchair, the

FIRST action would be to check if the

a. client is adequately covered.

b. floor is slippery.

c. door to the room is closed.

d. wheels of the chair are locked.

21. While giving an unconscious patient a bath, it is

important to

a. give passive range of motion to all joints.

b. let the charge nurse exercise the patient’s

joints.

c. call the physical therapist to exercise the

patient afterwards.

d. exercise the patient only if the doctor has

ordered it.

22. You are assigned to assist Mrs. Kelley with her

lunch. She is on bed rest. The BEST position for

her, if permitted, would be

a. Tredelenberg position.

b. hyperextension.

c. legs dangling at the side of the bed.

d. Fowler’s position.

23. When moving a wheelchair onto an elevator, you

should stay

a. behind the chair, pulling it toward you.

b. behind the chair, pushing it away from you.

c. in front of client to observe his or her condi-

tion.

d. to the side and hold the door open.

24. The Foley bag must be kept lower than the

client’s bladder so that

a. urine will not leak out, soiling the bed.

b. urine will not return to the bladder, causing

infection.

c. the bag will be hidden and the client will not

be embarrassed.

d. the client will be more comfortable in bed.

25. Mrs. Black is a diabetic. For her midafternoon

nourishment, the kitchen has sent a carton of

chocolate ice cream. Your FIRST action should

be to

a. substitute diet cola for ice cream.

b. hold the nourishment and report to the

charge nurse.

c. ask the secretary to notify the kitchen of an

error.

d. ask Mrs. Black if she likes ice cream.

26. When assisting a client to use the bedside com-

mode, it is important to

a. leave the call light within reach.

b. place toilet tissue close by.

c. return to check on the client periodically.

d. all of the above

27. When assisting Mr. Byrd, a blind client, with his

meal, it is NECESSARY to

a. sit next to him to help.

b. identify each item on his tray.

c. feed him so he won’t spill his food.

d. insist that he use only a spoon.

28. The purpose of cold applications is usually to

a. speed the flow of blood to the area.

b. prevent heat exhaustion.

c. prevent or reduce swelling.

d. prevent the formation of scar tissue.

29. The hot water bottle is an example of a

a. local dry heat application.

b. generalized dry heat application.

c. local moist heat application.

d. generalized moist heat application.


32

30. Clients receiving an enema are usually placed

a. on the right side.

b. on the left side.

c. flat on the back.

d. in a semisitting position.

31. A female client’s perineal area should be cleansed

before which specimen is collected?

a. 24-hour urine specimen

b. midstream clean-catch urine specimen

c. pediatric routine urine specimen

d. routine urine specimen

32. The most common site for counting the pulse is

the

a. carotid artery.

b. femoral artery.

c. brachial artery.

d. radial artery.

33. When counting respirations, the nurse aide

should

a. wait until after the client has exercised.

b. not tell the patient what you are going to do.

c. count five respirations and then check your

watch.

d. have the client count respirations while you

take her pulse.

34. With catheterized patients, which of the follow-

ing is NOT the nurse aide’s responsibility?

a. insertion of catheter

b. prevention of infection

c. checking to make sure the catheter is draining

properly

d. recording output

35. When giving information to the charge nurse for

an incident report, the nurse aide should

a. write in the client’s chart that an incident

occurred.

b. keep the report in your personal file.

c. state the facts clearly.

d. give your opinions as to the cause of the inci-

dent.

36. All long-term-care nurse aides must be compe-

tency evaluated and must complete a distinct

educational course. These requirements are

set by

a. OBRA.

b. OSHA.

c. CDC.

d. FDA.

37. Sexuality changes in aging can result in

a. decreased sexual desire.

b. unchanged sexual desire.

c. increased sexual desire.

d. all of the above

38. When family members visit a client, the visitors

should

a. stay in the day room.

b. stay a short while so as not to tire the client.

c. be expected to help with care.

d. be allowed privacy with the client.

39. You may attend resident council meetings in an

eldercare facility (ECF) if

a. you are invited to attend.

b. your superior assigns you to attend.

c. you are interested in what the residents are

discussing.



33

40. Which of the following is considered a client’s

right?

a. having curtains pulled during personal care

b. having personal information kept confidential

c. receiving and sending private mail

d. all of the above

41. An ECF resident wishes to wash her own under-

wear. You should

a. ignore the request.

b. tell her that clothing must go to the laundry.

c. tell her you will do it.

d. help her obtain supplies.

42. In the long-term-care facility, the family mem-

bers should be asked to

a. leave during treatments.

b. attend care-planning meetings.

c. avoid visiting during mealtimes.

d. help perform client care.

43. Sexuality in long-term-care clients may include

all of the following except

a. needing private time with a partner.

b. caring about one’s physical appearance.

c. engaging in public fondling.

d. desiring sexual interaction.

44. Which statement about some patients with

developmental disabilities is correct?

a. They usually have no ADL skills.

b. They are usually bed bound.

c. They can learn, but at a slow pace.

d. They are dangerous because they are always

strong.

45. A goal for an ECF resident is that she not swear

at the nurses or aides. When she calls you by

your name, your appropriate action is to

a. smile and give the appropriate reward.

b. continue whatever task that is being done.

c. tease the resident about not swearing.

d. tell all of the staff that she didn’t swear.

46. An agitated resident must be turned every two

hours all night long. The first action of the nurse

aide when waking up this resident is to

a. turn on the light.

b. speak quietly and calmly.

c. touch her shoulder.

d. shout her name.

47. If a client objects to certain food for religious or

cultural reasons, the appropriate action would

be to

a. tell him to wait for the next meal.

b. offer to substitute something different for

him.

c. call the dietician on the next day.

d. tell him he needs to eat what is on his tray.

48. The client’s religion forbids eating pork. Bacon is

being served for breakfast. The MOST appropri-

ate response is to

a. encourage the client to eat it because she

needs protein.

b. tell the client it is all right since her doctor

ordered the diet.

c. call the kitchen for a tray without bacon.

d. tell the client that restrictions don’t pertain in

times of illness.


34

49. If a client asks a question you cannot answer, the

best response is to

a. tell the client you will ask another aide.

b. ask the charge nurse to talk to the client.

c. call the doctor to talk to the client.

d. tell the client that you cannot answer the

question.

50. Before bathing a client, the nursing assistant

should

a. close the door and pull the curtain.

b. gather a change of clothing.

c. check for a doctor’s order.

d. all of the above

51. On entering a room, you notice that the client is

not breathing. Your FIRST action should be to

a. call for help.

b. lay the client down on his back.

c. give four quick breaths.

d. give 8–10 abdominal thrusts.

52. A client’s dentures are lost. The first action

would be to

a. notify the administrator.

b. look for them.

c. notify the doctor.

d. notify the charge nurse.

53. As a nurse aide, it is your responsibility to

a. plan the client’s care.

b. do the tasks the supervisor assigns to you.

c. do the best you can without asking for help.

d. compare assignments with your coworkers.

54. A patient turns on the call light when he needs to

urinate. The appropriate action is to

a. ignore the light since he is not your client.

b. announce on the intercom that there are two

patients ahead of him.

c. answer the call light and get the urinal.

d. answer the call light when you have the time.

55. A prosthesis is

a. an artificial substitute for a missing body part.

b. a device for moving patients.

c. an expected condition of the aging process.

d. a disease of the circulatory system.

56. When performing catheter care, the nurse aide

should wash the catheter

a. toward the meatus.

b. with Betadine soap.

c. away from the meatus.

d. with alcohol.

57. A nurse aide who applies restraints on a client

without directions from the charge nurse may be

accused of

a. slander.

b. battery.

c. false imprisonment.

d. negligence.

58. H.S. care is care that is given

a. before meals.

b. before bedtime.

c. after meals.

d. upon awakening.

–CHAPTER TITLE–

35


59. The BEST food choices for a geriatric client with

no teeth would include

a. hamburger, french fries, corn, and ice cream.

b. baked chicken, dressing, green beans, and

coconut macaroons.

c. spare ribs, macaroni and cheese, coleslaw, and

fruit cocktail.

d. baked fish, whipped potatoes, spinach soufflé,

and tapioca.

60. The family wants to talk about Bill’s approaching

death, but Bill does not. The family should be

encouraged to

a. carry on the conversation away from Bill.

b. talk freely in the room regardless of Bill’s

wishes.

c. wait until Bill dies.

d. try to encourage Bill to take part in the con-

versation.


36

Pretest Practice1. a. Standing behind him and using a transfer belt

protects both the client and the aide.

2. b. Retention of urine is a symptom that should

be reported to the charge nurse as soon as it is

noted.

3. a. Because of this aspect of hearing loss, the aged

hear better if you lower your voice. Shouting

in a high-pitched voice does not help.

4. d. A confused patient may answer to any name

or lie down in any bed.

5. c. To protect yourself, you must wear gloves and

goggles.

6. c. The proper medical abbreviation for before

meals is a.c.

7. b. The proper medical term for high blood pres-

sure is hypertension.

8. d. A mechanical soft diet is easy to chew, swal-

low, and digest.

9. d. All of the answers a–c are wrong.

10. a. Input and output are totaled once per shift as

well as every 24 hours.

Exam 11. c. Failure to notice bruises or marks on the skin

on admission may later cause someone to

believe you were involved in abuse.

2. c. When responding to a patient on the inter-

com, you should give your name and position.

3. a. You should never leave a new admit until the

patient knows how to call for help.

4. c. Nursing assistants are never allowed to give

medications.

5. a. You should always use good body mechanics

when moving patients.

6. d. You should wash your hands before and after

contact with a patient.

7. c. You should not bring the tray into the room

until you have time to feed.

8. c. The most serious problem that wrinkles in the

bedclothes can cause patients are decubitus

ulcers, or decubiti.

9. c. Changing the patient’s position every two

hours prevents bedsores.

10. b. You should always explain procedures first, so

b is the correct answer.

11. c. You have contaminated your hands and must

start over.

12. c. Turning the head to the side will assist in

drainage out of the mouth.

13. d. Always make sure new patients can call for

help.

14. c. Keeping your back straight forces you to use

your strong leg muscles.

15. c. The purpose of this procedure is to prevent

breakage.

16. b. Always remember to consider infection con-

trol.

17. c. A new cast may cut off circulation. Choice c

reminds you to check for circulatory impair-

ment.

18. c. Rehabilitation should always be part of the

care plan.

19. a. Make sure to follow agency policy.


37

� Answers and Explanat ions

20. d. Before assisting a patient into a wheelchair,

check to see if the wheels of the chair are

locked.

21. a. Passive ROM should always be given with the

bath on an unconscious patient.

22. d. Semi-Fowler’s position is correct because the

patient is on bed rest.

23. a. You must stay behind the chair to control it,

but it should go on and come off an elevator

backwards to prevent the wheels from falling

into the door opening.

24. b. Raising the bag above the bladder level can

lead to backflow of the urine, with its bacteria,

into the bladder.

25. b. Always report abnormal conditions.

26. d. All of the answers listed are correct.

27. b. A blind patient should know what you are giv-

ing him before it enters his mouth.

28. c. The purpose of cold applications is usually to

prevent or reduce swelling.

29. a. A hot water bottle applied by itself is dry heat.

30. b. Placing the patient on the left side allows bet-

ter entry into the colon.

31. b. The clean-catch specimen requires cleaning

the perineum.

32. d. The other sites are rarely used by the nursing

assistant.

33. b. Telling the patient you are watching her

breathing will cause her to slightly change her

breathing pattern.

34. a. A nursing assistant is responsible for the other

options but never inserts a catheter.

35. c. An incident report becomes a permanent part

of the legal record. Make sure the facts are

clear.

36. a. OBRA stands for the Omnibus Budget and

Reform Act.

37. d. Sexual desire is related to emotions as well as

physical ability, so all the answers listed may

be correct for different individuals.

38. d. The family members should expect and be

allowed private time with their loved one.

39. a. The resident council is a meeting of the resi-

dents, and no staff may attend unless invited.

40. d. All of the answers given are rights of the resi-

dent.

41. d. The patient has the right to wash her own

clothes if she so wishes. You must help her to

do so.

42. b. Federal law states that residents have the right

to have family involvement in care planning.

43. c. As long-term-care providers, nursing assis-

tants must respect the resident’s right to sexu-

ality. However, engaging in public fondling is

inappropriate and may infringe on other resi-

dents’ rights.

44. c. Patients with mental retardation are all differ-

ent. The important thing to remember is that

many of them can learn; those who can just

do so more slowly than other people.

45. a. You want to positively reinforce the resident’s

appropriate behavior, so smiling and reward-

ing her good behavior is the best action.

46. b. Do not startle the resident, as this may agitate

her. Speak as you enter the room.

47. b. Consideration of cultural or religious beliefs is

important to all patients.


38

48. c. The other answers do not address the resi-

dent’s right to practice their religion.

49. b. Always refer such questions to the charge

nurse to handle.

50. a. Choice b is incorrect because some residents

are capable of choosing their own clothing.

Choice c is incorrect because there will not be

a doctor’s order for a bath. Choice d, there-

fore, is also incorrect.

51. a. Always call for help first in an emergency.

52. d. The first step for any lost belongings is always

to notify the charge nurse.

53. b. Choice a is incorrect because you are a mem-

ber of the planning team, not the major plan-

ner. Choice c is incorrect because in

healthcare the correct action is often to ask for

help. Choice d is incorrect because there is no

legitimate reason to compare notes with

coworkers.

54. c. Answer any call light as soon as possible.

55. a. Examples of prostheses include artificial

limbs, hearing aids, and dentures.

56. c. You should follow the clean-to-dirty princi-

ple, with the meatus considered cleaner than

the catheter tubing.

57. c. Applying restraints without an order/without

consent can be considered false imprison-

ment.

58. b. H.S. is the abbreviation for hour of sleep.

59. d. Of the choices listed, only d is a soft diet.

60. a. Involve Bill if he chooses, but have the family

talk privately otherwise.


39

LI K E T H E F I R S T exam in this book, the exam in this chapter follows the NNAAP 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 expla-

nations carefully; they will help you see why you missed the questions you did. You can also use the explanations

to help you brush up on areas that give you trouble. Then refer to the chart in Appendix A 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.

C H A P T E R Nursing Assistant/NurseAide PracticeExam 2CHAPTER SUMMARYThis is the second of five practice exams in this book based on the

National Nurse Aide Assessment Program (NNAAP) written exam. This

exam will give you more practice with the kinds of questions you are

likely to see on the exam.

4

41


43

Pretest Practice

Exam 2

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� Pretest Pract ice

1. Decubitus ulcers may develop in clients who are

a. incontinent.

b. paralyzed.

c. poorly nourished.

d. all of the above

2. A walker may be used if the client can

a. support some weight.

b. use her hands well.

c. balance without help.

d. walk independently.

3. A cane should be used on

a. the affected (weak) side of the body.

b. the unaffected (strong) side of the body.

c. the side with the strongest arm.

d. the weak side one day, strong side next day.

4. Which of the following statements about ROM is

FALSE?

a. Active ROM means the client does the exer-

cises.

b. Passive ROM means the nursing assistant does

the exercises.

c. Active ROM means the resident does the

exercises.

d. Active ROM is best, if possible.

5. When helping a client use a walker, it is impor-

tant to tell him to

a. move the walker and his feet at the same time.

b. move the walker, place the walker firmly, and

step.

c. move the walker and then slide his feet.

d. take several steps, slide the walker, and then

place the walker firmly.

6. The purpose of correctly positioning the client

is to

a. prevent skin breakdown.

b. maintain function of joints and muscles.

c. increase comfort.

d. all of the above

7. Which of the following statements about dress-

ing ECF residents is true?

a. It is not necessary for handicapped residents

to dress in street clothes.

b. Residents like staff members to dress them.

c. Residents are concerned about how they look.

d. Residents are used to being dressed in front of

others.

8. The preferred way to remove a bedpan from a

client who is unable to lift her buttocks is to

a. use a mechanical lifting device.

b. have another nursing assistant lift the client.

c. turn the client to the side while holding the

pan.

d. slowly slide the pan from under the client.

9. At the beginning of your shift, you give a client a

water pitcher containing 270 cc (9 oz.) of water.

At the end of your shift, you note that 35 cc of

water is left in the pitcher. How much water has

been consumed?

a. 35 cc

b. 135 cc

c. 175 cc

d. 235 cc

10. When a client complains that his dentures are

hurting, the appropriate action is to

a. encourage him to wear the dentures more

often.

b. report the complaint to the charge nurse.

c. report the complaint to the physician.

d. put the dentures on the bedside table.


45

� Exam 2

1. A water pitcher has tipped over and you notice

water on the floor. The BEST action is to

a. wipe it up immediately.

b. throw a towel over the water to prevent acci-

dents.

c. notify the charge nurse.

d. call housekeeping.

2. On entering a room, you notice that the patient

is not breathing. Your FIRST action should be to

a. call for help.

b. lay the resident down on his back.

c. give four quick breaths.

d. give 8–10 abdominal thrusts.

3. When making an occupied bed, it is impor-

tant to

a. make half of the bed at one time.

b. have one side rail up and one down.

c. make a toe pleat in the top covers.

d. all of the above

4. Decubitus ulcers can be prevented by

a. changing the client’s position frequently.

b. placing an egg-crate mattress on top of the

mattress.

c. increasing the patient’s vitamin C consump-

tion.

d. both a and b

5. The first step in getting a client up to walk is to

a. sit the client on the side of the bed.

b. put the client’s slippers on.

c. check the activity order.

d. tell the client what you want him to do.

6. The patient’s TPR is 98.8-80-30. The finding that

should be reported at once is

a. pulse.

b. temperature.

c. respiration.

d. all of the above

7. Which of the following can cause an inaccurate

oral temperature reading?

a. drinking hot or cold liquids within ten min-

utes of the reading

b. failure to shake down a mercury thermometer

c. vigorous exercise prior to measuring tem-

perature

d. all of the above

8. Systolic blood pressure is determined by

a. reviewing previous readings.

b. listening for the first clear sound.

c. waiting for a change in sound.

d. listening for the last clear sound.

9. The order “weigh client q.o.d.” means to weigh

the client every

a. other week.

b. other day.

c. morning.

d. week.

10. The FIRST step in performing any procedure

is to

a. explain the procedure.

b. gather needed equipment.

c. wash your hands.

d. provide privacy.


46

11. Which of the following procedures best destroys

all bacteria?

a. soaking in alcohol

b. washing with bleach

c. sterilizing

d. all of the above

12. In the event of a fire in a client’s room, your

FIRST action should be to

a. notify the charge nurse.

b. turn in a fire alarm.

c. get the client to a safe place.

d. get the fire extinguisher.

13. Safe use of oxygen therapy includes

a. always setting the flow meter at 2–3 liters per

minute.

b. using wool blankets only.

c. cleansing the nasal prongs each shift with

alcohol.

d. posting a “no smoking” sign on the door.

14. When you perform CPR, the client should be

lying

a. flat on a hard surface.

b. with head and shoulders elevated.

c. with the head and feet raised slightly.


15. A procedure manual is a

a. written set of instructions on how to perform

procedures.

b. set of directions needed to complete your job

description.

c. book of directions for administering medica-

tions.

d. book listing the procedures you have been

assigned to do.

16. If a client cannot speak English, the nurse aide

should

a. have the family interpret.

b. ask the charge nurse to arrange for an inter-

preter.

c. call the doctor to talk to the client.

d. tell the client that you cannot answer the

question.

17. The accepted way to identify a client is to

a. check the bed name and number.

b. check the identification band.

c. ask the client’s name.

d. call the client by name.

18. Which of the following best describes nail care?

a. Nail care is not needed for the elderly.

b. Use scissors for all nail care.

c. All clients need nail care.

d. Check with the charge nurse for nail-care

instructions.

19. When performing perineal care on a male,

always

a. clean the scrotum first.

b. retract the foreskin if uncircumcised.

c. clean from front to back.

d. hold the penis at a 90-degree angle.

20. The reasons for rubbing a client’s back include

a. improving circulation.

b. increasing one-on-one interaction time.

c. relaxing the client.

d. all of the above

21. The client’s elbows are dry and red. You should

a. report this to the charge nurse.

b. rub them with lotion.

c. apply elbow protectors.

d. all of the above


47

22. A decubitus ulcer is caused by

a. poor circulation.

b. pressure on the skin.

c. poor nutrition.

d. all of the above

23. You would shampoo a client’s hair to improve

a. circulation to the scalp.

b. the client’s general appearance.

c. the client’s feeling of well-being.

d. all of the above

24. When removing a soiled gown from a client who

has an IV, the BEST action is to

a. remove the opposite arm from the gown first.

b. have the nurse remove the IV needle.

c. disconnect the bag and tubing.

d. slip the gown over the IV solution bag.

25. If your client does not eat all the food on his tray,

the FIRST thing you should do is

a. notify the charge nurse.

b. ask the client why.

c. remove the tray.

d. urge the client to eat all the food.

26. The client states that a mistake has been made:

There is salt on her tray, although the doctor has

ordered a low-salt diet. The nurse aide should

a. explain this means no salt when preparing

food.

b. tell the client not to use the salt.

c. check the diet order with the charge nurse.

d. call the kitchen for a new tray.

27. The MAIN safety factor in transferring a client

is to

a. always transfer slowly.

b. raise the side rails.

c. secure adequate assistance.

d. make sure the client is not tired.

28. Before transferring a client from the bed to a

wheelchair, the nurse aide should sit him or her

on the edge of the bed for a few minutes to

a. rearrange his or her gown or clothing.

b. prevent orthostatic hypotension.

c. position and secure the wheelchair.

d. rest and remove the transfer belt.

29. The client’s religion forbids eating meat. Beef

stew is being served for lunch. The nurse aide

should

a. tell the client to eat it because she needs pro-

tein.

b. tell the client it is all right since her doctor

ordered the diet.

c. ask the nurse to call the kitchen.

d. tell the client that restrictions don’t pertain in

times of illness.

30. It is important to remember that dying patients

a. have the same needs for care as other patients.

b. need to be by themselves in a quiet room.

c. do not need to be consulted regarding their

care.

d. are usually in pain.

31. Dying patients and their families

a. always pass through five stages of dying in

order.

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.

32. A sign of dementia in elderly clients is

a. a need to eat regular meals.

b. not knowing who and where they are.

c. an ability to figure out problems.

d. a good memory for recent events.


48

33. Clients with Alzheimer’s disease may show which

of the following signs/symptoms?

a. physical and mental wasting away

b. extremely clear memory

c. frequent pacing or wandering

d. a and c only

34. When a client turns on the call light every few

minutes, the appropriate response is to

a. ask the client not to call so often.

b. stop by the room more often.

c. place the call light out of reach.

d. tell the client how busy you are.

35. Many older adults suffer loss of

a. income.

b. physical strength.

c. loved ones.

d. all of the above

36. How a client reacts to illness and disability is

MOST dependent on his or her

a. age and stage of life.

b. spouse’s support.

c. income and level of education.

d. support system and life history.

37. An 85-year-old client tells you that his mother is

coming to visit. Your BEST response would be

a. “That’s impossible. Your mother can’t come to

see you.”

b. “That’s nice, when is she coming?”

c. “Tell me how old your mother is.”

d. “Are you wishing you could see your mother?”

38. A client hits you during lunch. The appropriate

response is to

a. call the charge nurse for help.

b. continue to feed her.

c. apply a restraint.

d. yell at her to stop hitting you.

39. The nurse aide must report abuse of a client by

a. the family.

b. the staff.

c. another client.

d. all of the above

40. If the client is in traction, the nurse aide should

never

a. monitor affected skin temperature.

b. give a total bed bath.

c. change the position of weights.

d. monitor distal pulses.

41. Security for a client’s dentures includes

a. keeping them in a tissue in a dresser drawer.

b. placing them in a labeled denture cup.

c. insisting the resident wear the dentures.

d. placing an identifying mark on the dentures.

42. If family members bring new clothes in for an

ECF resident, the nurse aide should

a. put them in the resident’s dresser drawers.

b. label them with the resident’s name.

c. ask the family to remove an equal number of

old clothes.

d. make sure the charge nurse sees the clothes.

43. The charge nurse instructs you to clean an ECF

resident’s closet. You should

a. throw away all torn clothes.

b. ask the family to come do it.

c. enlist the help of the resident.

d. tell the nurse you are too busy.

44. Before dressing an ECF resident, the nurse aide

should

a. close the door and pull the curtain.

b. choose the proper clothes.

c. check for a doctor’s order.

d. all of the above


49

45. Confidentiality refers to

a. never sharing information with anyone.

b. the right of the patient to privacy.

c. only sharing information with those involved

in the client’s care.

d. both b and c

46. As a nurse aide, it is your responsibility to

a. plan the client’s care.

b. do the tasks the supervisor assigns to you.

c. do the best you can without asking for help.

d. compare assignments with your coworkers.

47. Maintaining good interpersonal relationships

depends on

a. going along with the crowd.

b. communicating clearly with others.

c. following orders without questioning.

d. all of the above

48. If you do not know how to do an assigned task,

you should

a. call another nursing assistant for help.

b. ask the client how she prefers to have it done.

c. call the charge nurse and ask for help.

d. follow the instructions in the procedure

manual.

49. Reporting exactly what you see is an example of

a (an) observation.

a. clinical

b. objective

c. personal

d. subjective

50. The purpose of using restraints is to

a. position an atrophied extremity.

b. protect the client and others from injury.

c. prevent wandering in the halls.

d. all of the above

51. Failure to raise the side rails on the bed of a con-

fused client is an act of

a. malpractice.

b. negligence.

c. overt commission.

d. breaking a criminal law.

52. During a job interview, it is important to tell the

interviewer about your

a. scheduling needs.

b. childcare needs.

c. qualifications.

d. all of the above

53. When you are unable to work due to illness, you

should

a. arrange for someone to cover for you.

b. call the facility as early as possible.

c. call your charge nurse an hour before your

scheduled time.

d. notify the facility at least 30 minutes before

your scheduled time.

54. The primary reason for laundering a nursing

uniform after each day’s wearing is to

a. look professional.

b. look neat.

c. remove body odor.

d. prevent the spread of germs.

55. The client asks to see a priest. The nurse aide

should

a. ask the charge nurse to call a priest.

b. tell the client to see if a priest walks by his or

her door.

c. call the doctor.

d. tell the client to call herself.


50

56. When caring for a client who has just been

placed on NPO, the nurse aide should first

a. encourage the client not to think about food

and water.

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.

57. A client states that his wallet is lost. The FIRST

action of the nurse aide would be to

a. help to look for it.

b. notify the doctor.

c. ask all of the other clients if they have seen it.

d. notify the charge nurse.

58. Which statement about mouth care for uncon-

scious residents is correct?

a. Unconscious residents may be able to hear

you speaking to them during mouth care.

b. Unconscious residents can both swallow and

spit.

c. Unconscious residents do not need to be

observed for mouth sores.

d. Unconscious residents have very moist gum

tissue.

59. A client is hearing impaired. The client has the

right to

a. written notes.

b. a professional interpreter.

c. assistance with hearing aids.

d. all of the above

60. A coworker states that she will need help in lift-

ing a heavy client. The nurse aide should

a. offer to get a Hoyer lift.

b. locate additional coworkers.

c. state that she has back trouble.

d. a and b

–CHAPTER TITLE–

51


Pretest1. d. Any patient who is bed bound may develop a

decubitus ulcer. Those who also are inconti-

nent, paralyzed, or poorly nourished will

develop ulcers more rapidly.

2. a. A resident must be able to support some

weight before using a walker.

3. b. If the cane is not used on the strong side, the

resident may fall.

4. c. Active ROM means the resident moves his or

her own limbs.

5. b. Choice a is incorrect because it is impossible

to move the walker and the feet at the same

time. Choices c and d are incorrect because

you should encourage clients not to slide their

feet or the walker.

6. d. Correctly positioning a patient should prevent

skin breakdown, increase comfort, and main-

tain the function of joints and muscles.

7. c. Choice c is the only answer that addresses res-

ident privacy, modesty, and personal choice.

8. c. Turning the resident is the easiest method,

and it is important to hold the pan to prevent

spilling the contents.

9. d. The correct answer is obtained by subtracting

the amount of fluid left from the fluid

amount the resident started with.

10. b. Always bring such complaints to the charge

nurse.

Exam 21. a. Take care of spills immediately, or a patient

may be injured while waiting for housekeep-

ing.

2. a. Always call for help first in an emergency.

3. d. When making an occupied bed, it is impor-

tant to make half of the bed at one time, to

have one side rail up and one down, and to

make a toe pleat in the top covers.

4. d. While choices a and b are correct, there is no

data to suggest that choice c is correct.

5. c. Always make sure the resident is allowed to

get up first.

6. c. Only respirations are out of normal range.

7. d. All three answers are correct.

8. b. Systolic is always marked as the first clear

sound.

9. b. The abbreviation q.o.d. means every other

day.

10. c. Infection control (hand washing) is always the

first step in a procedure.

11. c. Only sterilizing destroys bacteria.

12. c. Always remove the resident from danger first.

13. d. Choice a is wrong because the flow is set by

the physician. Choice b is wrong because wool

can cause sparks, and c is wrong because alco-

hol causes drying. Therefore, only choice d is

correct.

14. a. The patient must be flat on a hard surface or

the compressions will be inadequate to circu-

late blood.

15. a. A procedure manual is a written set of

instructions on how to perform procedures.

–CHAPTER TITLE–

52



16. b. It is mandatory to provide a certified inter-

preter to clients not fluent in English.

17. b. Only an identification band is a sure thing. A

confused patient may answer to any name.

18. c. All residents need nail care. The nursing assis-

tant should be able to obtain information

needed from the care plan.

19. b. Material may build up under the foreskin in

uncircumcised males unless the foreskin is

retracted for cleaning.

20. d. A correctly given backrub improves circula-

tion, thus relaxing the patient while giving

you an opportunity for one-on-one interac-

tion.

21. a. There may be many reasons for dry skin,

including medication reactions. The charge

nurse should see the problem before any

lotion is applied.

22. d. Choices a, b, and c are all common causes of

decubitus ulcers.

23. d. Choices a, b, and c are all expected outcomes

of a shampoo. Therefore, d is the best answer.

24. a. Remove the sleeve from the arm without tub-

ing first.

25. b. The patient may not be eating due to personal

dislike of the food. Asking first allows you to

request a replacement if the problem is this

simple.

26. c. Any diet question must be answered before

the resident eats.

27. c. Transferring safely means planning ahead,

including obtaining help.

28. b. Orthostatic hypotension is the light-headed

feeling we all get when we rise too fast.

29. c. The other answers do not address the resi-

dent’s right to practice religion or her right to

choice.

30. a. Not all dying patients have the same prob-

lems, but they have all the same care needs as

anyone else.

31. c. Because each dying resident has unique emo-

tional needs, each person will go through the

stages at different times and in different order.

32. b. Only choice b is usually seen in dementia.

33. d. Physical and mental wasting away are com-

mon symptoms of Alzheimer’s disease, as is

frequent pacing or wandering and loss of

memory.

34. b. Patients who use their call bell frequently are

usually afraid they will be ignored if they

don’t call often. Stopping in frequently reas-

sures them.

35. d. As people age, many suffer loss of income

(retirement usually means a fixed income),

physical strength, and loved ones.

36. d. A person’s total environment always affects

everything that person does and thinks.

37. d. “Are you wishing you could see your mother?”

is the only response that uses therapeutic

communication skills.

38. a. Obtaining assistance is the only correct way to

deal with abuse by a resident.

39. d. Federal and state laws require reporting of any

abuse, whether it comes from staff, family, or

other residents.

40. c. Position of weights in traction is ordered by a

doctor. Therefore, the nursing assistant should

never change the position of weights without

an order.


53

41. b. Every resident with dentures must have a

labeled denture cup to ensure security of the

costly dentures.

42. b. All residents have the right to their own per-

sonal possessions. Labels allow you to better

provide protection.

43. c. The resident has the legal right to decide on

keeping or throwing away personal belong-

ings.

44. a. Choice b is incorrect because some residents

are capable of choosing their own clothing.

Choice c is incorrect because there will not be

a doctor’s order for dressing. Choice d is

therefore also incorrect.

45. d. Choice a is incorrect because important

patient information would be missed if you

never shared information with anyone. Choice

d is the correct answer because both b and c

are true.

46. b. Choice a is incorrect because you are a mem-

ber of the planning team, not the major plan-

ner. Choice c is incorrect because in

healthcare the correct action is often to ask for

help. Choice d is incorrect because there is no

legitimate reason to compare notes with

coworkers.

47. b. Choices a and c are both incorrect as they may

lead to poor patient care. Choice d is wrong if

both a and c are wrong.

48. c. Asking for help when you are unsure of your-

self is a critical element of employability skills.

49. b. Objective means something you can see, feel,

smell, or touch.

50. b. According to federal law, protection from

injury to self or others is the only acceptable

reason for using restraints.

51. b. Negligence is an unintentional act of injury.

52. c. A job interview is the time to sell yourself, so

tell the interviewer your qualifications. You

should not discuss childcare or scheduling

needs until after you are offered the job.

53. b. Each shift you work may have a different time

requirement.

54. d. Preventing the spread of germs is the princi-

pal reason for all infection-control measures.

55. a. It is a client’s right to have clergy available as

requested.

56. c. NPO means nothing by mouth, so removing

all food and water will reduce temptations.

57. d. The first step for any lost belongings is always

to notify the charge nurse.

58. a. The last sense to leave is hearing. Speak with

kindness and be aware of what you say.

59. d. Mandates are in place to help the hearing

impaired in communication.

60. d. It is necessary to work as a team for the safety

and well-being of staff as well as clients.


54

YO U A R E N OW beginning to be very familiar with the format of the nursing assistant exam. Your

practice test-taking experience will help you most, however, if you have created a situation as close

as possible to the real one. In this test, you will notice that the short, ten-question pretest is not sep-

arated out like it was in the first two practice exams, but rather these questions are incorporated into the test to

reproduce, even more closely, official test-taking conditions.

For this third exam, simulate taking the real test. Find a quiet place where you will not be disturbed. Have

with you sharpened pencils and a good eraser. Complete the test in one sitting, setting a timer or a stopwatch.

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 Appendix A, you will

know which parts of your training materials you need to concentrate on before you take the fourth exam.

C H A P T E R Nursing Assistant/NurseAide PracticeExam 3CHAPTER SUMMARYThis is the third of five practice exams in this book based on the

National Nurse Aide Assessment Program (NNAAP) written exam.

Use this test to identify which types of questions are still giving you

problems.

5

55


57

Exam 3

1. a b c d

2. a b c d

3. a b c d

4. a b c d

5. a b c d

6. a b c d

7. a b c d

8. a b c d

9. a b c d

10. a b c d

11. a b c d

12. a b c d

13. a b c d

14. a b c d

15. a b c d

16. a b c d

17. a b c d

18. a b c d

19. a b c d

20. a b c d

21. a b c d

22. a b c d

23. a b c d

24. a b c d

25. a b c d

26. a b c d

27. a b c d

28. a b c d

29. a b c d

30. a b c d

31. a b c d

32. a b c d

33. a b c d

34. a b c d

35. a b c d

36. a b c d

37. a b c d

38. a b c d

39. a b c d

40. a b c d

41. a b c d

42. a b c d

43. a b c d

44. a b c d

45. a b c d

46. a b c d

47. a b c d

48. a b c d

49. a b c d

50. a b c d

51. a b c d

52. a b c d

53. a b c d

54. a b c d

55. a b c d

56. a b c d

57. a b c d

58. a b c d

59. a b c d

60. a b c d

61. a b c d

62. a b c d

63. a b c d

64. a b c d

65. a b c d

66. a b c d

67. a b c d

68. a b c d

69. a b c d

70. a b c d

� Exam 3

1. Inactivity and immobility may cause all of the

following EXCEPT for

a. skin breakdown.

b. permanent contractures.

c. increased intestinal peristalsis.

d. secretions remaining in the lungs.

2. The nurse aide knows that the term “up ad lib”

means the client

a. is not permitted out of bed.

b. is independent with balanced periods of rest

and activity.

c. is out of bed at mealtime only.

d. will need assistance of two for all activities of

daily living.

3. Mr. Perez is very weak and uncoordinated from a

previous stroke. The nurse aide selects which

device to assist Mr. Perez in walking safely?

a. geri-chair

b. transfer belt

c. trochanter roll

d. Hoyer lift

4. A common sign of approaching death is

a. increased appetite.

b. normal or elevated vital signs.

c. severe, unceasing pain.

d. decreased body functions.

5. The BEST definition of the range-of-motion

term abduction is to

a. bring a body part to a center or middle line.

b. bend the sole of the foot.

c. overextend a limb or part.

d. move a body part away from a center or mid-

dle line.

6. You notice that Mrs. Small’s vital signs are

decreasing and her respirations are zero. You

SHOULD

a. continue with her normal care.

b. wait five minutes and take her vital signs

again.

c. tell the family that she is dead.

d. contact the charge nurse immediately.

7. After Mrs. Small’s death, her husband wishes to

share his feelings and emotions. The nurse aide

SHOULD

a. listen and try to comfort him.

b. change the subject.

c. tell him to go to a counselor.

d. tell him to keep his feelings to himself.

8. An example of a special device to help prevent

contractures is a (an)

a. handroll.

b. doppler.

c. air mattress.

d. manometer.

9. Saying that a coworker took a client’s money

when this is UNTRUE is an example of

a. negligence.

b. assault.

c. defamation.

d. hoarding.

10. Paraplegia refers to paralysis of the

a. legs or lower part of the body.

b. the left half of the body.

c. all four extremities.

d. arms or upper part of the body.


59

11. The MOST accurate method of measuring body

temperature is

a. rectal.

b. oral.

c. axial.

d. feeling the forehead.

12. Which of the following sets of vital signs should

be reported IMMEDIATELY?

a. T–98.6, P–60, R–14, BP–120/60

b. T–102.4, P–100, R–32, BP–180/100

c. T–99.6, P–80, R–16, BP–132/70

d. T–97.6, P–82, R–20, BP–110/60

13. A large glass holds 240 cc. The patient drank

one-third of the large glass. The nurse aide

would record this as

a. �13� of 240 cc.

b. 30 cc.

c. 80 cc.

d. 120 cc.

14. Mr. Jones is placed on strict intake and output

after surgery. The nurse aide SHOULD

a. keep Mr. Jones NPO.

b. record all of the solid foods Mr. Jones eats.

c. record all fluid intake and output every shift.

d. measure only the first voiding after surgery.

15. Which of the following would be included in a

client’s output record?

a. urine, food eaten, and IV solutions

b. urine, emesis, and bleeding

c. liquids taken in during the shift

d. bowel movements only

16. Which of the following is an intake-and-output

problem that the nurse aide MUST report?

a. The client states that he is not hungry.

b. The client requests a bedpan.

c. The client has not voided in eight hours.

d. The client’s eight-hour output is 600 cc.

17. Mrs. Brown’s water pitcher holds 600 cc. The

pitcher is full at the beginning of the shift.

Halfway through the shift, the pitcher is empty,

and you refill it. At the end of the shift, the

pitcher is one-half full. Total water intake for the

shift is

a. 1,200 cc.

b. 600 cc.

c. 900 cc.

d. 300 cc.

18. The nurse aide finds a damaged piece of equip-

ment. The nurse aide SHOULD

a. dispose of it immediately.

b. use it until new equipment arrives.

c. report it immediately.

d. repair it herself and then use it.

19. The nurse aide shouts at Mr. Moore for climbing

out of bed. This behavior is not acceptable and is

considered to be

a. verbal abuse.

b. neglect.

c. physical abuse.


20. The nurse aide finds ants in the client’s room.

The nurse aide SHOULD

a. ask the client to wear slippers in the room.

b. contact housekeeping immediately.

c. ask the client not to eat in the room.

d. place ant traps around the room.


60

21. When restraints are in use, the nurse aide

SHOULD report

a. the type of device being used.

b. the time the restraint was released.

c. any unusual observations about the patient’s

skin condition.

d. all of the above

22. The pulse located in the neck is called the

a. apical pulse.

b. femoral pulse.

c. radial pulse.

d. carotid pulse.

23. Mrs. Wilson complains of numbness on one side

of her body. You notice that her grip is weak and

her speech is slurred. You SHOULD

a. realize that this may be a sign of a CVA and

notify the charge nurse.

b. call the doctor and tell him Mrs. Wilson had a

CVA.

c. check to see if Mrs. Wilson’s condition is the

same the next day.

d. accept the condition as normal and reassure

Mrs. Wilson.

24. Common signs and symptoms of a urinary tract

infection may include

a. extreme thirst and hunger.

b. lack of appetite and stomach pain.

c. constipation alternating with diarrhea.

d. frequent urination with burning sensation.

25. The order “vital signs q.i.d.” means to record

vital signs

a. four times per day.

b. twice per day.

c. morning and evening.

d. once per shift.

26. The nurse aide notices that Mrs. Nix has an open

red area on her coccyx that is draining. The

nurse aide SHOULD

a. wash the area with soap and water and apply

alcohol.

b. ask another nursing assistant to look at it and

give her opinion.

c. check it again at the same time the next day.

d. tell the charge nurse so she can check it.

27. While you are walking Mrs. Grey in the hallway,

she complains of chest pain and dizziness. Your

FIRST response should be to

a. sit her on the floor and go get help.

b. call for help immediately but stay with her.

c. continue the walk so as not to alarm her.

d. tell her to relax because everything will be

okay.

28. Mr. Smith has just smoked a cigarette. It is time

to take his temperature. The nurse aide

SHOULD

a. wait 15–20 minutes and then take an oral

temperature.

b. take an oral temperature immediately.

c. give him some cold water to counter the effect

of smoking and then take an oral tempera-

ture.

d. take a rectal temperature to discourage him

from smoking.

29. Which of the following observations should be

reported IMMEDIATELY?

a. T–98.2, P–88, R–20

b. yellow-colored urine

c. bluish tint to lips and skin

d. skin that is warm and dry to the touch


61

30. Microorganisms can be spread by direct and

indirect contact. An example of indirect contact is

a. bathing the patient.

b. using contaminated blood.

c. touching objects or dirty instruments.

d. breathing dust particles in the air.

31. Which statement about the hand-washing proce-

dure is CORRECT?

a. The faucet is clean and may be touched dur-

ing hand washing.

b. Wash at least two inches above the wrist.

c. As long as soap is used, the temperature of the

water doesn’t matter.

d. All of the above are correct.

32. The call light in the shower comes on. As you

enter the shower, you find Mrs. Shepard lying on

the floor. You should IMMEDIATELY

a. run back to the nurses’ station to get help.

b. help her to a chair, and then resume her

shower.

c. shake her gently and shout “Are you okay?”

d. scold her for not asking for assistance with her

shower.

33. Which statement about use of fire extinguishers

is CORRECT?

a. Any fire extinguisher can be used on any fire.

b. Each extinguisher should be used for the cor-

rect type of fire.

c. Nurse aides are not responsible for using fire

extinguishers.

d. Fire extinguishers should not be used around

patients.

34. As you feed Mrs. Sanford, she begins to choke.

Mrs. Sanford is conscious, but she is unable to

speak or cough. The nurse aide SHOULD

a. administer abdominal thrusts.

b. look in her mouth to see what she is choking

on.

c. get the doctor at once.

d. keep feeding her to push the food down.

35. The nurse aide SHOULD tell the licensed nurse

if a patient with does not finish the

food on his tray.

a. stroke

b. cancer

c. diabetes

d. Alzheimer’s disease

36. Techniques to keep the client’s skin clean and

healthy include

a. using prescription soaps only.

b. using clear water but no soap.

c. rinsing the skin well after soaping.

d. using a lot of suds.

37. Giving good oral care to a client includes all of

the following EXCEPT

a. wearing gloves.

b. handling and storing dentures carefully.

c. using dental floss.

d. removing oxygen before brushing.

38. To prevent infection in a client with an

indwelling catheter, the nurse aide SHOULD

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.


62

39. Mr. Spear is on a full liquid diet. You would

expect to find which of the following food items

on his breakfast tray?

a. oatmeal, juice, and coffee

b. pureed eggs and toast

c. clear broth, gelatin, and milk

d. pancakes, bacon, and tea

40. Which statement about injuries to clients and

staff members is CORRECT?

a. Injuries should be treated and reported on an

incident report.

b. Injuries can be ignored if they are minor.

c. Injuries should be reported only if they are

major.

d. Injuries should be treated but do not need to

be reported.

41. Which statement about horseplay and practical

jokes is CORRECT?

a. They are permitted if no one is insulted.

b. They are acceptable during breaks.

c. They can cause accidents and are unaccept-

able.

d. They are allowed because they cheer up the

patients.

42. The nurse aide used an electric razor to shave

Mr. Bailey and nicked him on the chin. The

nurse aide SHOULD

a. ignore the nick and continue.

b. call the doctor.

c. report the nick to the licensed nurse.

d. put alcohol on the nick.

43. Nonverbal communication includes

a. talking to the client.

b. observing the client’s body language.

c. asking the client if she is in pain.

d. speaking to the client quietly.

44. When clients are in a healthcare institution, they

expect to be treated as stated in the

a. Infection Control Manual.

b. Patient’s Bill of Rights.

c. Policy and Procedure Manual.

d. Physician’s Code of Ethics.

45. A conversation about a client in the hospital’s

elevator is against the

a. client’s right to privacy.

b. client’s right to medical care.

c. client’s right to review their records.

d. client’s right to ask questions.

46. Several members of the healthcare team have

received verbal sexual comments from Mr. Har-

ris, a client on the unit. In discussing this prob-

lem at a staff meeting, the team decides the

MOST appropriate response would be

a. “You are making me blush, Mr. Harris.”

b. “Mr. Harris, your comments are not accept-

able to me.”

c. “You really have a great sense of humor, Mr.

Harris.”

d. “Mr. Harris, you really should be ashamed of

yourself!”

47. Which one of your five senses would BEST

detect Joan Dillon’s body rash?

a. sight

b. smell

c. touch

d. hearing


63

48. The BEST way a nurse aide can clean an infant’s

eyes is with a (an)

a. Q-tip swab lubricated with Vaseline.

b. moist cotton ball, wiping from the inner to

the outer corner.

c. alcohol wipe, using circular motions.

d. hot towel, wiping from the outer to the inner

corner.

49. Mrs. Enbody is hard of hearing and repeatedly

turns her call light on. When responding to her

call light, the nurse aide SHOULD

a. take time to listen to her to determine her

needs.

b. talk loudly to her since she is hard of hearing.

c. unplug the call light.

d. tell the charge nurse that Mrs. Enbody is

uncooperative.

50. Mrs. Jones states, “I’m not nervous about this

surgery,” but she is restless and unable to get

comfortable. The nurse aide SHOULD

a. recognize that Mrs. Jones’s body movements

indicate fear and ask the nurse to speak with

her.

b. pad the side rails on the bed to prevent an

accident.

c. ask Mrs. Jones’s family members to leave so

she will be able to settle down.

d. tell her everyone is nervous about surgery and

that she should relax.

51. Which member of the healthcare team is respon-

sible for the client’s discharge plan?

a. nurse aide

b. ward/unit clerk

c. registered nurse

d. dietician

52. A two-month-old infant has been crying contin-

uously. The nurse aide SHOULD

a. check the baby’s diaper.

b. see if it is time for a feeding.

c. cuddle or rock the baby.

d. all of the above

53. Mrs. Beck’s husband refuses to leave the room in

which you are bathing her. You SHOULD

a. insist that he leave.

b. allow him to help you.

c. refuse to bathe Mrs. Beck.

d. say “Fine, do it yourself,” and leave.

54. While providing personal care for a client, the

nurse aide SHOULD

a. uncover the client completely so he or she can

work quickly.

b. uncover only the area he or she is working on.

c. keep the client completely covered and work

under the covers.

d. leave the curtain open at all times.

55. When providing morning (A.M.) care for the

client, the nurse aide SHOULD

a. let the client do as much as he is able to.

b. do everything for the client so it is done cor-

rectly.

c. care only for clients who are the same sex.

d. work as quickly as possible.

56. After Mr. Hall’s stroke, his right arm is weak and

stiff. He SHOULD be taught to

a. put his right arm into his shirt first.

b. put his left arm into his shirt first.

c. put both arms in the shirt at the same time.

d. wear a gown to make dressing easier.


64

57. Dressing will be difficult for a client who

a. has a contracted arm.

b. is left-handed.

c. has impaired speech.

d. is elderly.

58. If a client objects to certain food for religious or

cultural reasons, the nurse aide SHOULD

a. tell him to grow up and eat like an adult.

b. offer to get something different for him.

c. tell him he will have to speak to the dietician

tomorrow.

d. tell him he will be given a tube feeding if he

won’t eat.

59. Bill, a terminally ill resident, refuses his bath and

throws the water basin across the room. He is in

what stage of dying?

a. denial

b. bargaining

c. acceptance

d. anger

60. Mrs. Jones begs, “Just let me live until my grand-

child is born.” She is in what stage of dying?

a. acceptance

b. anger

c. bargaining

d. denial

61. An important thing the nurse aide can do for a

dying client is to

a. leave him alone to allow for privacy.

b. give physical and emotional support.

c. encourage him to believe that a miracle may

occur.

d. force him to eat three meals a day to keep up

his strength.

62. What is MOST important to show the client in

his new room?

a. the television remote control

b. how to lower and raise the bed

c. the location of the call bell and how to use it

d. where to store personal belongings

63. The older adult likes to feel positive about him-

or herself by sharing past achievements and

experiences. The BEST way the nurse aide can

encourage this is by

a. pairing the older adult with another talkative

resident.

b. encouraging frequent rest periods to save

energy for socializing.

c. listening to the older adult’s past experiences.

d. telling the older adult that you are too busy to

listen to stories.

64. In caring for the client with anxiety, the nurse

aide SHOULD

a. remain calm.

b. use simple, easy-to-understand words.

c. provide a quiet atmosphere.

d. all of the above

65. A client asks the nurse aide if she could have a

few minutes to pray before her bath. The BEST

response by the nurse aide would be to

a. tell her that her bath comes first.

b. allow her some private time to pray.

c. tell her to wait until clergy visits.

d. ignore her request and start bathing her.

–CHAPTER TITLE–

65


66. During orientation of your new job, you realize

your shift ends at 3:30 P.M. and not at 3:00 P.M. as

you had thought. Your child needs to be picked

up every day by 3:15 P.M. You SHOULD

a. discuss this with the charge nurse as soon as

possible.

b. ask the other nurse aide to cover you for fif-

teen minutes.

c. leave early and hope no one notices your

absence.

d. come in 15 minutes earlier in the morning.

67. The BEST definition of a certified nursing assis-

tant is a

a. graduate nurse who is registered and licensed

by the state to practice nursing.

b. licensed person who provides education about

special diets.

c. person who transcribes the physician’s orders

for patient care.

d. person who is certified to give care under the

direct supervision of a registered or licensed

practical nurse.

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.

69. When you are giving a bedbath to a client, you

SHOULD

a. put the bed in the low position.

b. cover the resident with a bath blanket.

c. wash the perineal area from back to front.

d. put the dirty towels and linen on the floor.

70. An indwelling catheter drains the bladder of

a. feces

b. emesis

c. urine

d. blood


66

Exam 31. c. Intestinal peristalsis decreases with inactivity

and immobility.

2. b. “Up ad lib” is an activity order suggesting the

client can perform ADLs independently with

periods of rest as needed.

3. b. A transfer belt (also called safety, ambulation

belt) is used by caregivers to assist the client to

transfer or walk safely.

4. d. As circulation slows, body functions decrease.

5. d. Abduction refers to the movement of a body

part away from a center or middle line.

6. d. Lack of respiration and low vital signs may

signify approaching death. Report this imme-

diately.

7. a. Caring for the family is just as important as

caring for the client. Allow the husband to

vent his feelings.

8. a. A handroll is placed in the palm of the hand

to prevent the hand and fingers from con-

tracting in the flexed position.

9. c. Defamation is harming a person’s reputation

by words that you say (slander) or write (libel)

intentionally.

10. a. Paraplegia is paralysis of the leg or lower part

of the body.

11. a. The rectal temperature method is considered

the most accurate as the thermometer is in

direct contact with membranes.

12. b. A temperature of 102.4 is elevated. The

patient’s pulse indicates tachycardia. The

patient also has hypertension.

13. c. One-third of 240 equals 80.

14. c. Any fluid taken in or released from the body is

considered when the patient is on I and O.

15. b. Urine, emesis, and bleeding are all considered

output.

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

failure.

17. c. 600 cc + 300 cc (half of the pitcher) is the

total, or 900 cc.

18. c. Reporting damage to equipment immediately

will prevent an accident.

19. a. Verbal abuse such as shouting or name calling

is not professional behavior and violates the

client’s rights.

20. b. Insects carry diseases and should not be found

in the health care setting.

21. d. All checks are necessary to prevent accidents

from occurring.

22. d. The carotid pulse is located in the neck.

23. a. The nurse aide must be familiar with unusual

signs and symptoms and report them as soon

as possible.

24. d. Both signs and symptoms are due to the infec-

tious process.

25. a. “Q.i.d.” means four times per day.

26. d. An opening in the skin predisposes the client

to infection and must be checked by the

nurse.

27. b. Never leave a patient alone in the time of an

emergency. Get help immediately.

28. a. Smoking may cause a misreading of the

client’s body temperature.


67


29. c. Blush discoloration (cyanosis) indicates a low

oxygen level in the body. The condition can be

life threatening.

30. c. Objects such as bed linens, dishes, and dirty

instruments harbor microorganisms.

31. b. Washing above the wrist is part of the correct

hand-washing procedure.

32. c. Shake and shout to determine if the client is

oriented and/or conscious.

33. b. Different extinguishers are used on various

types of fires.

34. a. The abdominal thrust will dislodge the food.

35. c. A diabetic’s blood sugar is controlled by diet

and medication. Any food not eaten will affect

the blood sugar level.

36. c. Rinsing the soap off thoroughly helps prevent

drying of the skin.

37. d. Oxygen does not interfere with oral hygiene.

38. b. Always wipe from front to back to prevent

rectal germs from entering the vagina or uri-

nary tract.

39. c. Any liquids are considered to be part of a full-

liquid diet, including milk products.

40. a. Minor and major injuries must be docu-

mented.

41. c. The role of the caregiver is to act profession-

ally and focus on the client care.

42. c. Any body scratches, lacerations, or cuts must

be reported immediately.

43. c. Body language includes posture, gestures, and

facial expressions that a person uses in com-

municating with others.

44. b. Patient’s Bill of Rights is a written statement

that includes the rights clients are entitled to

when receiving healthcare.

45. a. Conversations regarding a client should never

take place in a public area such as an elevator.

This violates the client’s right to privacy.

46. b. Sexual comments by a client are inappropri-

ate. The health worker must let the client

know that the comments are unacceptable.

47. a. Skin rashes are observed by inspecting the

body daily.

48. b. Infant’s eyes are cleaned from inner to outer

to prevent the spread of infection. A moist

cotton ball is soft and will not injure the eye.

49. a. Listening carefully to the patient’s needs

encourages communication and builds trust.

50. a. Nonverbal communication such as body

movement indicates the client’s anxiety.

51. c. The registered nurse is the team member

listed who is responsible for the discharge.

52. d. Crying indicates the infant needs attention.

Check or do all of the above.

53. b. Encourage family members to be involved in

all aspects of care.

54. b. Covering the areas you are not working on

will allow privacy and keep the body warm.

55. a. Encouraging independence allows clients to

feel self-worth by participating in their own

care.

56. a. Always put the affected limb into the clothing

first to prevent injury to the limb.

57. a. The contracted arm limits the range of

motion.

58. b. Consideration of cultural or religious beliefs is

important to all clients.


68

59. d. Talking to Bill will allow him to express anger

appropriately.

60. c. The stages of death vary from client to client

as death occurs. Assist Mary in expressing her

concerns.

61. b. All aspects of care are vital to terminal clients.

62. c. Providing a means to call a nurse is important

to avoid injury and meet the client’s needs.

63. c. Listening tells the clients you are interested in

what they have to say.

64. d. Remain calm, using simple and easy words to

understand, and providing a quiet atmosphere

are all conducive to caring for a client with

anxiety.

65. b. Respecting a client’s spiritual needs is an

important aspect of the client’s care.

66. a. Being honest and up-front with your supervi-

sor is the best approach.

67. d. This is the only correct definition of a certified

nursing assistant. The nurse assistant is always

under the direct supervision of a licensed

nurse.

68. b. Nursing is caring. It is an attitude of interest

and concern.

69. b. Privacy and warmth are in accordance with

the client’s Bill of Rights.

70. c. A catheter inserted in the bladder drains urine

from the body.


69

TH I S I S T H E 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 repre-

sentation of what you might expect for the real test. Just like in the third practice test, the pretest ques-

tions have been integrated into the 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.

C H A P T E R Nursing Assistant/NurseAide PracticeExam 4CHAPTER SUMMARYThis is the fourth of five practice exams in this book based on the

National Nurse Aide Assessment Program (NNAAP) written exam. Use

this test and the question breakdown in Appendix A to identify which

types of questions are still giving you problems.

6

71


73

Exam 4

1. a b c d

2. a b c d

3. a b c d

4. a b c d

5. a b c d

6. a b c d

7. a b c d

8. a b c d

9. a b c d

10. a b c d

11. a b c d

12. a b c d

13. a b c d

14. a b c d

15. a b c d

16. a b c d

17. a b c d

18. a b c d

19. a b c d

20. a b c d

21. a b c d

22. a b c d

23. a b c d

24. a b c d

25. a b c d

26. a b c d

27. a b c d

28. a b c d

29. a b c d

30. a b c d

31. a b c d

32. a b c d

33. a b c d

34. a b c d

35. a b c d

36. a b c d

37. a b c d

38. a b c d

39. a b c d

40. a b c d

41. a b c d

42. a b c d

43. a b c d

44. a b c d

45. a b c d

46. a b c d

47. a b c d

48. a b c d

49. a b c d

50. a b c d

51. a b c d

52. a b c d

53. a b c d

54. a b c d

55. a b c d

56. a b c d

57. a b c d

58. a b c d

59. a b c d

60. a b c d

61. a b c d

62. a b c d

63. a b c d

64. a b c d

65. a b c d

66. a b c d

67. a b c d

68. a b c d

69. a b c d

70. a b c d

� Exam 4

1. When assisting a blind client to eat, the nurse

aide SHOULD

a. set the plate as a clock with food at 1:00, 5:00,

8:00, and 11:00.

b. set the plate as a clock with food at 12:00,

3:00, 6:00, and 9:00.

c. give him the plate and tell him where the

food is.

d. feed him herself to save time.

2. Lena, a 70-year-old resident, wishes to write out

her own Christmas cards. The nurse aide

SHOULD

a. call her daughter to do it for her.

b. provide her with supplies and an appropriate

working space.

c. let her manage it entirely by herself.

d. write the Christmas cards out for her.

3. A cane SHOULD be used on

a. the affected side.

b. the unaffected side.

c. either side, depending on how the client feels.

d. the weak side one day and the strong side the

next.

4. The client who is at high risk of developing a

pressure sore is one who

a. eats poorly.

b. moves herself often.

c. has an unwrinkled bed.

d. has Alzheimer’s disease.

5. Which of the following helps prevent decubitus

ulcers?

a. bed rest

b. liquid diet

c. back rubs

d. support hose

6. The nurse aide, a member of the healthcare

team, can participate in the nursing process

EXCEPT for

a. collecting data.

b. planning the care.

c. making observations.

d. carrying out selected interventions.

7. When using crutches, the client’s weight MUST

rest on the

a. armpit.

b. knees.

c. hand rests.

d. shoulders.

8. How often should a client be repositioned if he

cannot move himself?

a. every hour

b. every two hours

c. every three hours

d. every four hours

9. Correct range of motion for the neck includes

a. flexion, extension, hypertension, and rotation.

b. abduction, adduction, flexion, and extension.

c. rotation, abduction, adduction, and extension.

d. pronation, supination, and flexion.

10. The goal of bladder training is to

a. stop using a catheter.

b. gain voluntary control of urination.

c. prevent skin problems caused by inconti-

nence.

d. all of the above

11. Mr. Scranton sometimes chokes while he is eat-

ing. The nurse aide SHOULD

a. stay close by while he is eating.

b. instruct his roommate to watch him eat.

c. feed him to prevent problems.

d. use the Heimlich maneuver between bites.


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12. If a client complains of a burning, tingling area

on his skin, you should FIRST

a. rub the area well with lotion.

b. report the complaint to the licensed nurse.

c. keep an eye on the area for a few days.

d. use cornstarch on the area.

13. When changing a pillowcase, you should NOT

hold the pillow under your chin because this

would

a. tear the pillowcase.

b. drop the pillowcase.

c. dampen the pillowcase.

d. spread bacteria.

14. A nonsterile dressing is one that is

a. wet

b. dry

c. clean

d. new

15. If you are asked to clean or put a soak on a resi-

dent’s eye, you SHOULD

a. clean it from the inner corner to the outer

edge.

b. use a clean surface of the cloth each time you

touch the eye.

c. report any exudate.

d. all of the above

16. Before giving any hot or cold treatment, the

nurse aide should be sure to have

a. a doctor’s order.

b. a sign for the door.

c. disposable equipment.

d. a form to chart on.

17. Safety precautions for hot treatments SHOULD

include

a. leaving on the treatment for the time ordered.

b. stopping the treatment if the skin is reddened.

c. giving the treatment through a protective pad.

d. both a and b

18. The nurse aide has been caring for Mrs. Jewell

for four hours, and during that time she has

asked the aide to take her to the bathroom every

fifteen minutes. The nurse aide’s BEST action

is to

a. trade clients with another nurse aide.

b. put her to bed on a waterproof underpad.

c. discuss this issue with the licensed nurse.

d. ignore her for a while.

19. If an elderly resident begins to wander and

becomes confused, you SHOULD

a. leave her in her pajamas for easier care.

b. joke with her about her funny ideas.

c. report her behavior for evaluation.

d. tell her family she is near death.

20. The Hoyer lift is used to

a. prevent injuries to healthcare workers.

b. move clients who are very heavy or weak.

c. move a client when only one worker is free.

d. all of the above

21. When you perform passive range-of-motion

exercises for a resident, you should do all the fol-

lowing EXCEPT

a. use good body mechanics.

b. move the joint until the resident feels pain.

c. keep the body covered except for the joint

being exercised.

d. make the resident perform as much of the

exercising as he can.


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22. Using a broad base of support means

a. keeping your feet comfortably apart.

b. keeping your knees locked in place.

c. holding objects away from your body.

d. all of the above

23. If a client is in traction, you should NOT

a. monitor affected skin temperature.

b. give a complete bedbath.

c. change the position of the weights.

d. monitor distal pulses.

24. When the nurse aide is moving the client up in

bed, the pillow goes

a. on the chair, out of the way.

b. at the foot of the bed, out of the way.

c. at the head of the bed, to protect the head.

d. anywhere the client wants it.

25. Dangling a client’s legs over the side of the bed is

done to

a. make sure she is able to sit up first.

b. give her time to put on her shoes.

c. prevent decubitus ulcers.

d. prevent orthostatic hypotension.

26. Walking with a client is safest if done with a

a. transfer belt.

b. wheelchair a few steps behind him.

c. Hoyer lift.

d. nurse or doctor ready for emergencies.

27. When you have a client sit up and dangle her legs

before getting up, you should watch for

a. sudden paleness.

b. excessive sweating.

c. increased respirations.

d. all of the above

28. When the nurse aide is transferring a client from

the bed to the wheelchair, she should ALWAYS

a. unlock the brakes on the wheelchair.

b. lock the brakes on the wheelchair first.

c. use a Hoyer lift.

d. put socks on the client first.

29. Before any transfer, the nurse aide SHOULD

a. have the nurse’s approval.

b. know the proper procedure.

c. use a transfer belt if needed.

d. all of the above

30. The pulse located in the wrist is called the

a. carotid pulse.

b. apical pulse.

c. femoral pulse.

d. radial pulse.

31. Mr. Salzberg drinks five ounces of juice. The

nurse aide would record this as

a. 500 cc.

b. 150 cc.

c. 6 cc.

d. 5 cc.

32. Which of the following sets of vital signs should

be reported IMMEDIATELY?

a. T–98.2 P–122 R–20 BP–84/40

b. T–99.0 P–72 R–16 BP–134/82

c. T–98.8 P–66 R–14 BP–100/62

d. T–98.6 P–90 R–18 BP–120/70

33. A piece of linen that is placed beneath the client

from shoulders to thighs is called

a. an underpad.

b. a spread.

c. a drawsheet.

d. a sheet.


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34. Which bedmaking procedure is used when the

client remains in the bed?

a. occupied bedmaking procedure

b. unoccupied bedmaking procedure

c. circle bedmaking procedure

d. procedure using only fitted sheets

35. Which complication may happen if a post-op

client does NOT take in adequate fluids?

a. constipation

b. blood clots

c. infection

d. foot drop

36. Which type of client is most likely to have prob-

lems as a result of poor nail care?

a. a cancer client

b. a diabetic client

c. a stroke client

d. a mentally retarded client

37. Mrs. Nelson has right-sided weakness. For her

mouth care, the nurse aide SHOULD

a. do it for her.

b. pay particular attention to the left side of her

mouth.

c. tell her to get out the equipment and do it

herself.

d. let her do as much as she can and assist as

needed.

38. A cane, walker, and crutches are all used to help a

client walk. What else do they have in common?

a. Clients must know how to use them correctly.

b. They all must have rubber tips to prevent slip-

ping.

c. They all must be fitted to the client.

d. all of the above

39. A resident with a paralyzed left arm may be able

to feed herself if she uses a

a. plate guard.

b. built-up spoon.

c. zipper pull.

d. a and b only

40. Which statement about residents with mental

retardation is generally CORRECT?

a. They should be treated like children.

b. They cannot walk or talk.

c. They learn at a slower pace.

d. They are suspicious of all teenagers.

41. A diabetic client has had her leg amputated. Her

need for sexuality will

a. be more important for a while.

b. be less important for a while.

c. disappear forever.

d. be unaffected.

42. Clients with Alzheimer’s disease may show which

of the following symptoms?

a. high fever accompanied by chills

b. clear memory of the recent and distant past

c. chest pains and difficulty breathing

d. physical and mental decline

43. If a client is upset and is yelling, the nurse aide

SHOULD respond by

a. saying sternly, “Quiet down!”

b. offering to call her doctor.

c. shutting her door for privacy.

d. calmly sitting down with the client and

listening.

44. A common sign of depression is

a. attending activities daily.

b. laughing and smiling.

c. decreased appetite.

d. socializing with friends.


78

45. Linda is a 35-year-old client with multiple scle-

rosis whose mother has always taken care of her.

It would be normal for Linda to

a. look to her father for care.

b. refuse to see her mother.

c. want to make her own decisions.

d. ask her mother’s advice about everything.

46. A client who is in middle adulthood would be

likely to be concerned about her

a. teenage children.

b. elderly parents.

c. grandchildren.

d. a and b only

47. A Catholic client refuses to eat meat on Fridays.

Her lunch one Friday consists of a roast beef

sandwich and a salad. The nurse aide SHOULD

first

a. tell the client to eat only the salad.

b. offer to get her a meatless lunch.

c. ask family members to bring in something

else.

d. request that a priest come and speak with her.

48. What is the BEST way you can understand cul-

tural practices different from your own?

a. Avoid giving care to clients with cultural prac-

tices different from yours.

b. Try to understand other cultural practices by

learning more about them.

c. Eat out at different ethnic restaurants to taste

various foods.

d. Discuss your own beliefs and values with

clients whose cultural practices are different

from yours.

49. Beth is a 58-year-old permanently handicapped

resident. She tends to be very quiet and to act as

if nothing matters. The nurse aide can BEST

show respect for her by

a. telling her she is very lucky to retire so early.

b. including her in her plan of care.

c. serving her dinner first.

d. calling her “Mom.”

50. An example of using body language while com-

municating is

a. using gestures and facial expressions.

b. writing the message on paper.

c. sharing your feelings and concerns.

d. offering your advice and opinions.

51. The nurse aide nods her head and smiles while

she sits with Mrs. Crane. This type of nonverbal

communication BEST demonstrates

a. encouragement for the client to continue

talking.

b. displeasure at having to listen to the client.

c. support for the terminally ill client.

d. lack of work available for the nurse aide.

52. Mr. Jacko states, “I’m feeling really sad today.”

The nurse aide responds by saying, “You are feel-

ing sad?” This is an example of a communication

technique called

a. active listening.

b. clarification.

c. silence.

d. reflection.

53. If a client asks a question about the health status

of another client, the nurse aide SHOULD reply

a. “That’s a good question, but I really don’t

know.”

b. “I cannot share that information with you.”

c. “I will let you look at his chart later.”

d. “Why don’t you ask him yourself?”


79

54. Miss Talcott, an alert and oriented client, refuses

to bathe this morning. The BEST response by the

nurse aide would be

a. “You are going to bathe today whether you

like it or not.”

b. “I don’t think your roommate will appreciate

the smell in here.”

c. “Can you tell me why you don’t feel like

bathing today?”

d. “Fine with me. I’ll get my work done earlier

today.”

55. An example of false imprisonment is

a. using restraints without a doctor’s order or

the client’s consent.

b. closing the door to the client’s room.

c. treating the client differently because of their

religious beliefs.

d. refusing to answer a call light that rings fre-

quently.

56. You are aware that a coworker is not providing

the required care to certain residents on your

floor. The nurse aide SHOULD

a. keep a list of the activities not performed.

b. tell all the other staff members.

c. provide the care yourself.

d. report this to the charge nurse as soon as pos-

sible.

57. If you are ill and cannot report to work that day,

it is BEST to

a. arrange for your sister to cover you.

b. bring in a note when you return back to work.

c. call the facility as early as possible.

d. call the facility after you have seen your

doctor.

58. Mrs. Larkin, age 52, was the victim of an indus-

trial accident. She was a foreman and a union

leader. To help her maintain her dignity as an

adult, you might suggest that she

a. read industrial magazines.

b. serve on the resident council.

c. rent movies.

d. attend bingo.

59. A client’s daughter wants to help with her

mother’s care. You should tell her that she

a. cannot help.

b. can only bathe her mother.

c. can do whatever care she wants.

d. can do whatever the nurse agrees to.

60. It is important to remember that a client in the

last stage of a terminal illness SHOULD

a. be left alone to grieve.

b. be offered care to meet their physical and

emotional needs.

c. be cared for only by relatives and close

friends.

d. not be offered any choices about their care.

61. Dressing a resident in personal clothing every

day contributes to the resident’s

a. overall appearance.

b. feeling of well-being.

c. pulse rate.

d. a and b only


80

62. Mr. Collins, a 42-year-old postoperative client,

has his door closed. The nurse aide needs to take

a set of routine vital signs. She SHOULD

a. knock on the door and wait for the client to

respond.

b. assume this means he does not want to be dis-

turbed.

c. open the door immediately, as doors should

not be closed.

d. knock and enter without waiting for a

response.

63. Which of the following are listed in the Patient’s

Bill of Rights?

a. the right to privacy and confidentiality

b. the right to make decisions about the plan of

care

c. the right to have a living will

d. all of the above

64. Mrs. Philly insists on dressing in a striped green

blouse and plaid pants. Knowing that the clothes

don’t match, the nurse aide SHOULD

a. insist on selecting another outfit for her.

b. tell her she will look ridiculous in that outfit.

c. respect her choice of clothing.

d. have her remain in her night clothes until she

changes her mind.

65. Failure to perform service for which a person is

trained is called

a. discrimination.

b. malpractice.

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 her bed while she is sitting on the com-

mode.

d. tell her she can only use the commode once a

shift.

67. The healthcare team can include all of the fol-

lowing EXCEPT for the

a. nurse aide.

b. registered nurse.

c. receptionist.

d. physical therapist.

68. In order to keep your job as a nurse aide, you will

need to follow institutional guidelines that may

include

a. reporting to work on time.

b. following the institution’s dress code.

c. completing only tasks for which you have

been trained.

d. all of the above

69. Members of the healthcare team know that the

MOST important reason to all work together

is to

a. provide the best possible care to the client.

b. eliminate arguments among team members.

c. form long-lasting friendships.

d. be able to do each other’s assignments.

70. During a job interview, you should NEVER

a. bring up your scheduling needs.

b. make negative comments about your previous

boss.

c. ask about job responsibilities.

d. share your strengths and weaknesses.

–CHAPTER TITLE–

81


Exam 41. b. Explain to the patient what is located at each

“time” using the clock method. This promotes

independence.

2. b. Encourage Lena to do as much as possible by

helping her obtain the materials she needs to

perform this task.

3. b. This position will provide balance and sup-

port for the client. The cane should be prop-

erly fitted.

4. a. Nutritional status affects the health of the skin

and other body systems.

5. c. Back rubs are soothing and promote blood

flow to the area.

6. b. The planning phase of the nursing process can

only be done by the registered nurse.

7. c. Proper instructions for hand placement pre-

vent nerve damage, which may cause paralysis

to the arm.

8. b. This is the maximum time a resident should

be left in one position. Frequent turning pro-

motes good circulation.

9. a. The neck is capable of all the movements

listed here.

10. d. Bladder training promotes a regular pattern of

continence.

11. a. Observe the patient who has a chewing dys-

function. Choking can cause an airway

obstruction.

12. b. This may be an indication of a serious condi-

tion and should be reported immediately.

13. d. Inhaling the bacteria can cause infection to

the healthcare worker.

14. c. A clean dressing is nonsterile but promotes

protection to the skin. A Band-Aid is an

example of a clean dressing.

15. d. Cleaning from the inside outward prevents

contamination to the other eye. Using a clean

cloth and reporting any drainage promotes

healing.

16. a. The physician must order any treatments that

the patient receives.

17. d. Check the skin frequently for redness and

remove the soak if the patient complains of

burning.

18. c. Ask the nurse if this is normal behavior for

Mrs. Jewell.

19. c. Any unusual or new behavior should be

reported for accurate diagnosis by the physi-

cian.

20. d. The lift ensures safety for both client and

healthcare worker. It can be used on obese,

paralyzed, or blind residents.

21. b. Never extend the joint to the point of pain.

22. a. A broad base of 12 inches apart will allow the

center of gravity to assist in the transfer.

23. c. Changing the position of weights requires a

doctor’s order.

24. c. The pillow provides safety and prevents the

client from striking the head on the bed.

25. d. Sitting the resident on the side of the bed

allows the blood to drain to the lower extrem-

ities and prevents the client from fainting.

26. a. The transfer belt provides a lift mechanism

and prevents the client from falling.

–CHAPTER TITLE–

82



27. d. Any sudden change in the client’s condition

must be reported immediately.

28. b. Locking the brakes will prevent the chair from

rolling and the client from falling.

29. d. Always know the procedure you are perform-

ing and use the proper equipment.

30. d. Though all of the listed options are pulse

points, the radial pulse is located at the wrist

and is most commonly used.

31. b. One ounce is 30 cc, so 5 ounces is 5 × 30 or

150 cc.

32. a. The pulse indicates tachycardia and the BP is

abnormally low. These vital signs need to be

reported immediately.

33. c. The drawsheet saves on bed changes and can

be used as a lift sheet to move the client in

bed.

34. b. When the client is bedridden, the bed sheets

need to be changed with the client in bed.

This is called an occupied bed.

35. a. Constipation is a common complication post-

operatively from the effects from anesthesia.

Not taking in adequate fluids will increase the

risk of this complication.

36. b. Poor nail care can lead to infection in the dia-

betic client. Diabetic clients require licensed

personnel to provide nail care.

37. d. Encourage independence as much as possible.

38. d. Clients vary in height and weight, and all

equipment must be safe.

39. d. Encourage independence by using mechanical

devices to assist the client.

40. c. In many mentally retarded clients, learning is

slower than normal, but it still occurs and

should be encouraged.

41. b. The diabetic patient needs to accept the

amputation and realize this does not affect

sexuality.

42. d. The Alzheimer’s patient suffers from physical

and mental decline.

43. a. Calm the patient down and allow her to voice

her concerns in a constructive way.

44. c. Lack of appetite may be caused by many dis-

eases, especially depression.

45. c. Linda has a physical disorder but needs to

continue to make her own decisions to keep

her self-esteem and mental-health capability.

46. d. As middle-aged adults, parents worry about

their teenage children and their elderly par-

ents.

47. b. The nurse aide should make every effort to

respect the client’s religious needs.

48. b. With learning usually comes greater apprecia-

tion and understanding.

49. b. Allow Beth to make decisions about her

healthcare. This will prevent depression and

allow her to make choices.

50. a. Gestures, facial expressions, and posture are

all examples of body language.

51. a. Head nodding and smiling while someone is

speaking to you demonstrates interest and

says, “tell me more.”

52. d. Reflection is a communication technique in

which the care provider uses key words the

client says to reflect a main idea back to them.

It allows the client to expand on the topic.

53. b. Always respect the client right of patient con-

fidentiality.

54. c. Asking the question will help determine if

there are any underlying physical or psycho-


83

logical reasons why the client chooses not to

bathe.

55. a. False imprisonment is the act of restraining

another person.

56. d. As a team member, you are required to report

this to the charge nurse. Any activity that

affects patient care needs to be reported.

57. c. Always call the facility as early as possible so

that they can find a replacement for you.

58. b. As a former foreman and leader, Mrs. Larkin

needs to feel useful and involved.

59. d. If the daughter feels comfortable in caring for

the client, she should let the nurse know. The

nurse will consider the health of the client.

60. b. Terminally ill clients have physical and emo-

tional needs that need to be met.

61. d. Both choices have a positive effect on the resi-

dent.

62. a. Always knock on a closed door and wait for a

response to ensure client privacy.

63. d. All choices are listed in the Patient’s Bill of

Rights.

64. c. As long as it is a safe choice, allow the client to

make personal choices.

65. b. Malpractice is the failure to give service for

which one is trained.

66. b. As long as the client is safe, provide privacy

while on the commode.

67. c. The healthcare team is the group of caregivers

involved in providing care to patients.

68. d. All of the guidelines listed are necessary to fol-

low in order to remain employed as a nurse

aide.

69. a. The primary function of the healthcare team

is to provide the best patient care possible.

70. b. Saying negative comments about another per-

son (slander) during a job interview will only

cast a negative image upon yourself. Keep the

interview positive.


84

TH I S I S T H E last sample National Standards Nursing Assistant 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 taking the real

test in your living room. In addition, draw on what you have learned from reading the answer explanations.

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 Appendix A 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!

C H A P T E R Nursing Assistant/NurseAide PracticeExam 5CHAPTER SUMMARYThis is the fifth and final nursing assistant exam. By the time you fin-

ish this exam, you should be prepared for the real thing.

7

85


87

Exam 5

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� Exam 5

1. Nursing orders frequently instruct you to “assist

patient to cough and deep breathe.” This activity

helps the patient avoid

a. decubitus ulcers.

b. pneumonia.

c. internal bleeding.

d. dyspnea.

2. What position should a patient be in to receive

an enema?

a. supine

b. Fowler’s

c. prone

d. left Sim’s

3. Which of the following lists only items that

would be included in fluid intake?

a. milk, ham sandwich, ice cream bar

b. water, mashed potatoes, gelatin

c. milk, custard, soup

d. orange juice, soft-boiled egg, toast

4. The nurse aide must use a stethoscope to deter-

mine the

a. apical pulse rate.

b. carotid pulse rate.

c. popliteal pulse rate.

d. brachial pulse rate.

5. Another name for urination is

a. defecation.

b. voiding.

c. wetting the bed.

d. flatus.

6. As you bathe Mrs. Sweeney, she complains of an

ache or sore spot in her calf. You should

a. massage her legs with lotion.

b. stop the bath and ask the nurse to check the

ache.

c. tell Mrs. Sweeney to get up and walk to relieve

the cramping.

d. continue the bath and report the complaint to

the nurse later.

7. An example of contamination through indirect

contact is

a. bathing the resident.

b. touching instruments or linens the resident

has used.

c. the resident sneezing or coughing on you.

d. all of the above

8. As you walk down the hall, you hear a scream

and find smoke and flames coming from Mr.

Smith’s room. You should

a. attempt to get the resident out of the room if

possible and close the door.

b. throw water on the flames.

c. take Mr. Smith’s cigarettes away.

d. run to the telephone and call the fire depart-

ment.

9. Placing a client in good alignment means you

should

a. keep his joints lubricated.

b. keep him as straight as possible.

c. keep him sitting up during the day.

d. make sure he stands at least five hours per day.

10. When using a cane or walker, the resident’s

elbows must be

a. bent at a 60-degree angle.

b. bent at a 15-degree angle.

c. bent at a 90-degree angle.

d. straight.


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11. Which of the following conditions needs to be

reported immediately to the charge nurse?

a. rash that appears suddenly

b. warm, dry, and pink skin

c. tough skin on the feet

d. scarred skin

12. To prevent a client from getting decubitis, it is

necessary to

a. wash urine and feces off with only water.

b. put baby powder on the skin to keep it dry.

c. rub the reddened area once a day.

d. turn the client every 2 hours.

13. Mr. Brook has a broken hip and needs to have an

enema. The best type of bedpan to use would be a

a. fracture pan.

b. plastic pan.

c. child-sized pan.

d. metal pan.

14. Which of the following is true regarding visually

challenged clients?

a. Clients use a “clock” system to locate food.

b. Clients usually prefer to eat alone.

c. Clients prefer to be fed to prevent spills.

d. All of the above are true.

15. Before you ambulate a client who has a Foley

catheter, the FIRST action would be to

a. clamp off the catheter and disconnect it, since

the bag would be in the way.

b. leave the catheter dangling between the

client’s legs.

c. carry the bag below the level of the bladder.

d. hide the bag in a pillowcase so the client will

not be embarrassed.

16. After positioning a client, it is MOST impor-

tant to

a. examine the client thoroughly.

b. close the door to the client’s room so she can

rest.

c. offer the client a drink of juice.

d. check the position of nonfunctional limbs.

17. As you are transferring a client, the client

becomes weak and starts to fall. Your FIRST

action would be to

a. hold the client’s transfer belt and lean away

from the fall.

b. call for help.

c. grasp the transfer belt and lower the client to

the floor along your bent leg.

d. hold the client tightly and lean backwards.

18. Accurate daily weights are measured

a. at the same time each day.

b. with the client fully clothed.

c. in the morning.

d. all of the above

19. The MOST important factor in preventing the

spread of infection is to

a. place the client in isolation.

b. wash hands between client contacts.

c. clean the unit each day.

d. wear sterile gloves to care for all clients.

20. The purpose of the cleansing bath is to

a. provide cleanliness.

b. promote circulation.

c. observe skin condition.

d. all of the above


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21. OSHA rules require all healthcare workers to be

offered immunization against

a. hepatitis B.

b. hepatitis A.

c. hepatitis C.

d. AIDS.

22. When a client is placed on I and O after surgery,

this means that you must

a. measure only the first voiding after surgery.

b. record the color of the client’s urine.

c. record all fluid intake and output.

d. record the first solid food the client eats.

23. Mr. Johnson has not had a bowel movement for

five days. He might complain of

a. abdominal cramping.

b. lack of appetite.

c. slight nausea.

d. all of the above

24. Mr. Kull is weak and unsteady. He needs to uri-

nate. You could safely leave him alone to use

a. a bedside commode.

b. the toilet.

c. a bedpan.

d. a urinal.

25. For a client who is classified as wound-and-skin

isolation, the soiled linen should be

a. placed in the linen hamper.

b. discarded.

c. bagged before removing from the room.

d. taken directly to the laundry.

26. If a resident begins to choke while being fed and

is unable to speak, the nurse aide should call for

help and begin doing

a. back blows.

b. mouth-to-mouth ventilations.

c. a finger sweep.

d. abdominal thrusts.

27. When you make a bed, you should place the

soiled linen

a. on the bedside table.

b. on the overbed table.

c. in a laundry bag.

d. on a chair.

28. You have come upon a patient lying on the floor

who is not moving. Your first action should be to

a. call for help.

b. gently shake the victim and ask, “Are you all

right?”

c. check to see if the patient is breathing.

d. check to see if the patient has a pulse.

29. If a client is receiving forced-fluid treatment, you

should

a. provide at least 2,000 cc of fluid per shift.

b. provide high-protein fluids.

c. offer liquids every hour.

d. all of the above

30. When a client complains that his hearing aid is

hurting, you should

a. encourage him to leave the hearing aid in.

b. report the complaint to the charge nurse.

c. report the complaint to the physician.

d. put the hearing aid in the bedside table.


91

31. Security for a client’s dentures includes

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.

32. A client who is too large for staff members to

transfer safely is

a. moved with a mechanical lifting device.

b. placed on a calorie-controlled diet.

c. left in bed, but turned every two hours.

d. left in bed, but repositioned every hour.

33. Mr. Jones drinks five ounces of juice. You would

record this as

a. 500 cc.

b. 150 cc.

c. 6 cc.

d. 5 cc.

34. Mr. Smith has just had a cup of hot tea. You need

to take his temperature. You should

a. take a rectal temperature.

b. take an oral temperature immediately.

c. wait 15–20 minutes and then take an oral

temperature.

d. give him some cold water, and then take an

oral temperature.

35. Which of the following vital signs should be

reported immediately?

a. T–98.6, P–70, R–14, BP–120/60

b. T–95.4, P–40, R–10, BP–80/40

c. T–98.8 “R,” P–60, R–20, BP–132/70

d. T–97.6 “ax”, P–78, R–16, BP–110/60

36. The Patient’s Bill of Rights is

a. A verbal agreement given to those receiving

healthcare.

b. A list of requests that patients submit when

admitted to a healthcare facility.

c. A written statement of rights entitled to those

receiving healthcare.

d. A bill for their stay at a healthcare institution.

37. When giving daily care, you should observe all

clients for

a. general appearance.

b. mental condition.

c. skin condition.

d. all of the above

38. When should you wash your hands?

a. after going to the bathroom

b. before and after each client contact

c. before eating

d. all of the above

39. While bathing a resident, you notice a rash on

both of her legs. You should

a. ignore the rash if the resident hasn’t com-

plained about it.

b. scrub the rash to see if it disappears after the

bath.

c. notify the charge nurse at once.

d. put alcohol on the rash to dry it out.

40. Nurse aides should report the care given to resi-

dents by

a. telling the charge nurse directly.

b. entering it in the chart.

c. telling the desk clerk to tell the supervisor.

d. leaving a note for the supervisor.


92

41. Mr. Brown starts to jerk and goes into a seizure

while you are bathing him. You should

a. hold him down so he doesn’t fall out of bed.

b. shove the washcloth into his mouth.

c. protect him from injuring himself.

d. run and get help.

42. Body mechanics means

a. the way the body parts are aligned with each

other.

b. always using a transfer belt.

c. using the body in a safe and efficient manner.

d. all of the above

43. To change your direction, you should

a. turn your whole body by moving your feet.

b. twist from the waist.

c. move your body in sections.

d. move very slowly.

44. To turn the client toward you, you should

a. cross his far leg over the leg nearest you.

b. cross his near arm over his chest.

c. bend his far arm at the elbow.

d. grab his shoulders and pull him toward you.

45. To help a client into a wheelchair, the nurse aide

should position the chair

a. at the side of the bed, facing the head of the

bed.

b. at the foot of the bed.

c. at the head of the bed.

d. at the side of the bed, facing the foot of

the bed.

46. To transfer a resident correctly from the bed to a

stretcher, you MUST

a. use good body mechanics.

b. use a Hoyer lift.

c. have the help of seven coworkers.

d. raise the side rail on the stretcher first.

47. Which statement about dressing residents is

correct?

a. Dressing is a waste of time for a handicapped

resident.

b. Residents are used to dressing in front of

others.

c. Residents care about what they wear.

d. Residents like the nurse aide to dress them.

48. A mentally ill resident is likely to

a. believe she is someone other than herself.

b. be fearful, without good reason.

c. live in her own world.

d. all of the above

49. Reality orientation techniques include

a. labeling items in the resident’s room.

b. putting up calendars and clocks.

c. using familiar items in the resident’s room.

d. all of the above

50. Jane is a 24-year-old resident with muscular dys-

trophy. She has a supportive family, but she talks

often of her desire to have a boyfriend. This feel-

ing is best described as

a. normal

b. foolish

c. both a and b

d. hopeless

51. Rhonda, an 18-year-old, is a resident admitted

for long-term rehabilitation. She tells you she

wants to attend the local community college.

This seems

a. appropriate for her age.

b. a waste of time.

c. an excuse to leave the facility.

d. a waste of money.


93

52. Two residents have decided to become a couple.

They may

a. hold hands.

b. spend a lot of time together.

c. insist on eating together.

d. all of the above

53. Which statement about bathing for unconscious

clients is correct?

a. Unconscious clients may be able to hear you

speaking to them during the bath.

b. Unconscious clients can turn in bed when

asked.

c. Unconscious clients do not need to be

observed for decubiti.

d. Unconscious clients have very moist skin.

54. Mr. Dobbs wants to know what kind of surgery

his roommate is going to have the next day. The

best response by the nurse aide is

a. “It really should not be any concern of yours.”

b. “I’ll speak to the surgeon and find out.”

c. “I cannot share that information with you.”

d. “You can call the OR and ask yourself.”

55. The best and most effective form of communica-

tion is

a. written communication.

b. face-to-face communication.

c. telecommunication.

d. third-party communication.

56. A ten-month-old infant cries and pulls at his left

ear. You should

a. check the baby’s diaper.

b. report this to the charge nurse.

c. cuddle or rock the baby.

d. all of the above

57. A client is hard of hearing and repeatedly turns

her call light on. The nurse aide should

a. take time to listen to her to determine her

needs.

b. talk loudly to her since she is hard of hearing.

c. unplug the call light.

d. tell the supervisor that the client is uncooper-

ative.

58. If you are giving a client a tub or shower bath,

you should

a. ensure the client’s privacy.

b. check the water temperature.

c. gather all supplies before beginning.

d. all of the above

59. A client who is eating poorly should be offered

a. vitamin pills.

b. tube feeding.

c. clear broth.

d. dietary supplements.

60. The nurse aide is encouraged to attend resident

council meetings if

a. invited to attend.

b. the superior assigns you to attend.

c. interested in what the residents are discussing.


61. It is Good Friday and a Catholic client was

served chicken and requests a meatless meal. The

nurse aide should

a. offer to get another meal within the client’s

diet.

b. call the bishop for a dispensation.

c. tell them that is all right since they are in the

hospital.

d. tell them the aide will check with the dietician

for the next day’s meal.


94

62. A client is observing the Islamic Holy Month of

Ramadan by fasting from sunup to sundown.

The most appropriate action for the nurse aide

would be to

a. tell her that all clients have to eat at the same

time.

b. check with the doctor.

c. find out when she may eat or drink.

d. both b and c

63. An ECF resident tells the nurse aide something

in confidence about her family. The nurse aide

a. can tell any staff member.

b. ethically cannot tell anyone else.

c. can tell the charge nurse only.

d. can tell anyone who does not know the resident.

64. A nurse aide observes a client fall in the hallway.

It is important to report

a. what she or he thinks happened.

b. exactly what was observed.

c. nothing if she or he chooses.

d. all of the above

65. Which of the following behaviors may the client

consider caring?

a. making the client comfortable

b. getting the work done before lunch

c. showing interest in answering questions

d. a and c only

66. Mrs. Farber is an 88-year-old resident on your

floor. She has cared for herself and her husband

until recently when he passed away. The nurse

aide recognizes that Mrs. Farber needs to

a. be involved in planning her own care as much

as possible.

b. be left alone to grieve for her husband.

c. be told not to cry since it only upsets her.

d. be involved in planning care for other

residents.

67. A resident refuses to go to physical therapy one

morning. The nurse aide reports this to the

charge nurse, who discusses this with the resi-

dent. The resident states that she will go to phys-

ical therapy the next day. The nurse aide

understands that the resident

a. has the right to refuse treatment.

b. should not be given choices in his therapy.

c. does not have the right to refuse therapy.

d. could refuse therapy only with the doctor’s

permission.

68. A person admitted to a hospital or extended-care

facility can be expected to be treated according

to the

a. State Hospital Association.

b. Caregiver’s Bill of Rights.

c. Patient’s Bill of Rights.

d. Physician’s Association.

69. The nurse aide is told to bring a client by wheel-

chair to the X-ray Department and covers the

client with a robe, blanket, and slippers. The

nurse aide has maintained the client’s

a. right to confidentiality.

b. right to privacy.

c. right to nursing-care plans.

d. right to refuse.

70. Nurse aides need to identify themselves with

their names and title of CNA before giving any

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.

–CHAPTER TITLE–

95


Exam 51. b. Coughing and deep breathing forces lower-

lung movement.

2. d. The correct answer is left Sim’s. This allows

better irrigation of the colon.

3. c. Only choice c lists liquids only.

4. a. Only a stethoscope can “hear” the apical pulse.

5. b. Voiding means urinating.

6. b. Always report patient complaints to the nurse

as soon as possible.

7. b. The germs from the resident are on the soiled

instruments and stay there until they are

washed and sterilized. Wear gloves when

washing dirty equipment.

8. a. Always try to rescue the victim first if possible;

then call the fire department.

9. b. Body alignment promotes circulatory status

and prevents contractions.

10. b. This position will create a balance between the

resident and the walker to prevent a fall.

11. a. Of the answers listed, only a is an acute

change.

12. d. Turning the client is the best way to protect

against bedsores.

13. a. Choose a fracture pan so Mr. Brook will have

a minimal distance to lift his hips.

14. a. Most blind patients can feed themselves in a

dining-room setting if they can visualize their

food on a plate. A clock system allows them to

do this.

15. c. You cannot disconnect the bag without an

order, but you still must ensure that the bag

remains below the bladder level. Choice c is

correct.

16. d. A client may be lying on a nonfunctional limb

and have no awareness of it.

17. c. Grasp the transfer belt and lower the resident

to the floor along your bent leg.

18. a. Weight may fluctuate during the day, so to be

accurate you must weigh clients at the same

time each day.

19. b. The most important factor in preventing the

spread of infection is to wash your hands

between client contacts.

20. d. A bath correctly given promotes circulation at

the same time as it provides an excellent

opportunity to observe the skin.

21. a. OSHA rules require all healthcare workers be

offered immunization for hepatitis B.

22. c. I and O includes any liquid entering or leaving

the body.

23. d. Lack of peristalsis causes all of these symp-

toms and must be documented and reported.

24. c. Keep the client in bed to prevent a fall, but

allow privacy while voiding.

25. a. Wound-and-skin isolation means high likeli-

hood of linen contamination, but according

to Standard Precautions, all linen is consid-

ered potentially infective.

26. d. Abdominal thrusts are always the first step for

airway obstructions.

27. c. Soiled linen should be directly placed in laun-

dry bags to prevent contamination.

28. b. Determine that there is a problem before call-

ing for help.

–CHAPTER TITLE–

96



29. c. Choice a is incorrect because the doctor

should specify the amount of liquid. Choice b

is incorrect because a force-fluid diet is differ-

ent from high-protein fluids. Choice d cannot

be correct if a and b are incorrect.

30. b. Always bring such complaints to the charge

nurse.

31. b. Every resident with dentures must have a

labeled denture cup to ensure security of the

costly dentures.

32. a. Use a mechanical device to protect both the

client and the staff.

33. b. One ounce is 30 cc, so 5 ounces is 5 × 30 or

150 cc.

34. c. Drinking hot liquids may cause an abnormal

reading on the thermometer.

35. b. This patient’s vital signs are all very low.

36. c. The Patient’s Bill of Rights is a written state-

ment of the rights that patients are entitled to

when receiving healthcare.

37. d. All observations are important in healthcare.

38. d. Standard precautions include washing your

hands before and after patient contacts.

39. c. Any abnormality must be reported as soon as

possible.

40. a. Reporting to the charge nurse or chain of

command is in the role of the nurse aide as

part of the health team.

41. c. Do not restrain the patient. Move all furniture

and equipment away to protect him from

injury.

42. c. Good body mechanics ensure safety for both

the healthcare worker and the patient.

43. a. Moving the whole body prevents twisting the

back muscles and an injury.

44. a. This will promote motion and help you move

the patient.

45. d. Proximity of the bed to the chair will allow

easier client transfer and the client will be fac-

ing the front of the room.

46. a. Body mechanics promote good musculoskele-

tal alignment.

47. c. Self-esteem promotes wellness. We all want to

look nice and care about our personal appear-

ance.

48. d. Thought processes of the mentally ill may

include delusions and irrational fear.

49. d. These aids assist the resident to know where

his room is and what date it is.

50. a. All patients need to feel wanted and to share

their feelings with another person. This is

normal behavior.

51. a. Rhonda wants to continue her education and

socialize with people her own age.

52. d. Relationships are common in a nursing home

and allow both individuals to feel needed and

desirable.

53. a. The last sense to leave is hearing. Speak with

kindness and be aware of what you say.

54. c. The response reflects confidentiality for all

clients as well as an appropriate, nonoffensive

response to the roommate.

55. b. Face-to-face communication is the most direct

with the least chance for misinterpretation.

56. d. Crying indicates the infant needs attention;

pulling at the ear could indicate an ear infec-

tion. Check or do all of the above.

57. a. Listening carefully to the client’s needs

encourages communication and builds trust.

58. d. All of the responses given are correct.


97

59. d. Dietary supplements are high in the necessary

vitamins and minerals.

60. a. The resident council is a meeting of the resi-

dents, and no staff may attend unless invited.

61. a. It is important to accommodate religious

needs of the client.

62. c. It is important to accommodate cultural

needs of the client; however, some patients’

health may become severely compromised if

they do not eat for many hours. Islam gener-

ally allows exemptions in medical cases, so

you should check with the doctor to confirm

that the client’s health will not suffer as a

result of fasting.

63. b. Anything told in confidence cannot be

revealed.

64. b. All incidents need to be described exactly as

observed.

65. d. Choices a and c are correct because comfort-

ing and interest or time to answer questions

are behaviors that suggest caring. Choice b is

incorrect because just getting work done is a

fact or neutral behavior.

66. b. Residents have a right to be alone to grieve

after the death of a loved one.

67. a. Residents can refuse treatment because of the

Patient’s Bill of Rights.

68. c. All clients are treated according to the

Patient’s Bill of Rights.

69. b. All clients have the right to privacy and should

be properly covered at all times.

70. c. The right to know the identity of physicians,

nurses, and others involved in their care.


98

ON E T R E N D I N healthcare certification is the requirement that a job candidate physically demon-

strate that they can perform the tasks they learned in their training programs. In order to be cer-

tified as a nursing assistant and be hired by a prospective employer, you will be asked to perform

five randomly selected job-related skills. You will have approximately 25 minutes to perform these skills—you

must execute five out of five correctly in order to pass. A nurse aide evaluator will assess and record your per-

formance.

On the next several pages is a listing of four job-related skills you might be asked to perform: taking vital

signs, wheelchair use, measuring and reporting urinary output, and positioning a client on their side. There are

instructions listed and a description of each skill. Gather the equipment—including a friend to act as your

client—and then do each task as listed. Use the worksheet on the next page to record vital signs. Go over the skills

checklist afterwards and make sure you did not miss any steps. On the actual day of testing, the evaluator will not

instruct you or answer any questions. If you think you have made a mistake, tell the evaluator at the time and you

will be allowed to go back and start again—one time only. Practice these skills until you become proficient.

C H A P T E R Nursing Assistant/NurseAide PracticalSkills ExamCHAPTER SUMMARYFor most states’ certification requirements you will be asked to com-

plete 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 do.

8

99

� Sample Task: Vital Signs

Instructions to Participant:1. Using the necessary equipment and procedures,

inform the client what you are doing.

2. Take and record the following:■ Oral temperature■ Radial pulse■ Respiration rate■ Weight

� Vital Signs Worksheet

Client’s Number:

Age: Gender:

Oral Temperature:

Radial Pulse:

Respiration Rate:

Weight:

Recorded by:

Signature:

Evaluation CriteriaHand washing

■ Make sure paper towels are within reach■ Turn on water at sink■ Wet hands and wrists■ Apply soap■ Rub hands, wrists, and fingers for at least ten seconds■ Rinse thoroughly■ Dry with paper towel thoroughly■ Use paper towel to turn off faucet■ Dispose of paper towel into wastebasket

Entry into the room and identification of self■ Appropriate signal before entry into room■ Identification of self to client

Identification of client and explanation of procedures■ Use of correct language level for client compre-

hension■ Content of explanation

Questioning of client■ Audible questioning■ Questioned about: eating, drinking, smoking,

physical activity

Procedure to obtain oral temperature■ Mercury: Holds thermometer correctly and starts

initial reading at 96 degrees or lower

OR■ Digital: Applies probe cover■ Correct placement in mouth under tongue■ Length of time in mouth (at least 3 minutes)

Reading/recording of oral temperature■ Reads thermometer and records temperature

within ±0.2 degrees of examiner’s reading■ Mercury: Rinses thermometer

OR■ Digital: throws away probe cover■ Returns thermometer to storage

Procedure to obtain radial pulse■ Choice of proper site■ Pulse regularity■ Pulse assessment time

Taking/recording of radial pulse■ Rate ±2 beats■ Rate, rhythm, volume recorded

Procedure to obtain respiration■ Respiration rate and character■ Respiratory assessment time (one minute)■ Records respiration ±2 breaths

Taking/recording of weight■ Scale correctly balanced or registering at zero

without weight■ Scale placed on a hard surface■ Assists patient to step on the scale■ Reports and records weight within ±1 pound of

examiner’s reading

–NURSING ASSISTANT/NURSE AIDE PRACTICAL SKILLS EXAM–

100

� Sample Task: Wheelchair Use

Estimated Completion Time: 20 minutes

Instructions to Participant1. Using the proper equipment, supplies, and tech-

niques, complete the following:

A. Transfer a client with left-side hemiplegia

from a bed to a wheelchair.

B. Push the wheelchair along a hallway.

C. Demonstrate how to get in and out of an ele-

vator.

D. Transfer the client from the wheelchair to

the bed.

2. When you have completed this procedure,

inform the evaluator.

Instructions to EvaluatorThe participant will demonstrate transferring a client

from bed to wheelchair. The client will be wheeled

down the hall and into and out of an elevator and

returned to bed.

Provide the following:

Hospital bed

Call bell

Chart

Transfer belt (optional)

Wheelchair

Lap robe

Blanket

Slippers

Client with left-side hemiplegia and name

bracelet

Hand soap

Sink

Paper towels

Elevator simulation (doorway with raised

elevation)


■ Make sure paper towels are within reach■ Turn on water at sink■ Wet hands and wrists■ Apply soap■ Rub hands, wrists, and fingers for at least ten

seconds■ Rinse thoroughly■ Dry with paper towel thoroughly■ Use paper towel to turn off faucet■ Dispose of paper towel into wastebasket




Preparation of wheelchair■ Places bed in appropriate and safest position for

client■ Positions wheelchair next to bed■ Folds up footrests and locks brakes

Assisting client to sitting position■ Supports client and assists to sitting position with

feet flat on the floor■ Applies transfer belt (optional)■ Makes sure resident has nonskid footwear on

Assisting client to standing position■ Uses body mechanics for lifting■ Signals as transfer of client begins to standing

position■ Observes client as needed

Assisting client into wheelchair■ Pivots feet to turn to client■ Gently lowers client safely into the wheelchair


101

Client comfort and security in chair■ Removes transfer belt■ Adjusts client■ Adjusts footrests■ Gives client signaling device■ Washes hands

Wheelchair operation■ Releases brakes■ Stays to right of hallway (if applicable)■ Enters and exits elevator by pulling backwards■ Returns to room

Return of client to bed■ Placed chair on client’s unaffected side of bed■ Applied brakes■ Applied transfer belt (if applicable)■ Moved footrests out of way■ Used proper body mechanics to lift, pivot, and

return patient to bed

Client comfort and security in bed■ Proper body alignment■ Call belt in place (if applicable)■ Side rails up

Storage of wheelchair and other items■ Folding and placement of chair in proper loca-

tion

Hand washing■ Make sure paper towels are within reach■ Wet hands and wrists■ Apply soap■ Rub hands, wrists, and fingers for at least ten sec-

onds■ Rinse thoroughly■ Dry with paper towel thoroughly■ Use paper towel to turn off faucet■ Dispose of paper towel into wastebasket

� Sample Task: Measuring andRecording Urinary Output


■ Make sure paper towels are within reach■ Wet hands and wrists■ Apply soap■ Rub hands, wrists, and fingers for at least ten

seconds■ Rinse thoroughly■ Dry with paper towel thoroughly■ Use paper towel to turn off faucet■ Dispose of paper towel into wastebasket

Measuring urine content■ Puts on gloves■ Pours contents of urine from bedpan into meas-

uring container without spilling or splashing■ Keeps the container level

Cleaning the container and bedpan■ Empties the container into the toilet cleanly■ Cleans container with water; pours water into

toilet■ Cleans bedpan with water; pours water into toilet■ Stores container and bedpan

Recording urine output■ Removes disposable gloves■ Washes hands■ Records content ± 25 ccs/mls of examiner’s

reading


102

� Sample Task: Posit ions Cl ienton Side


■ Make sure paper towels are within reach■ Turn on water at sink■ Wet hands and wrists■ Apply soap■ Rub hands, wrists, and fingers for at least ten sec-

onds■ Rinse thoroughly■ Dry with paper towel thoroughly■ Use paper towel to turn off faucet■ Dispose of paper towel into wastebasket




Turning the client■ Makes sure client has privacy■ Lowers head of bed■ Moves client’s body towards self■ Raises side rail of bed■ Supports client’s body and turns towards raised

side rail■ Adjusts client’s body properly■ Covers client with bedding■ Gives client signaling device■ Leaves bed in lowest position■ Washes hands


103

TH E R E I S N O national organization of certified nursing assistants (CNAs) to say what the certifica-

tion process for this profession should be, what types of classes should be in a training program for

CNAs, or what kind of examination should be used to test the knowledge of people who want to be

CNAs. Neither are there any federal laws on education and training for nursing assistants. However, national stan-

dards have now been established for healthcare professions, and these standards are likely to lead to more regu-

lation, at the state or national level, of professions such as CNAs.

� State Cert i f icat ion 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, NAs

are required to go through a minimum of 75 hours of training approved by the federal government to be certi-

fied. Most programs are between 75 and 150 hours and vary by state—the average number of training hours

C H A P T E R

CertificationRequirementsand Trends

CHAPTER SUMMARYThis chapter provides an overview of state certification and licensing

requirements for nursing assistants. It will also help you keep abreast

of the trends—what’s new in healthcare certification.

9

105

is 80. Some states have created their own standards

for nursing assistants. These standards include the

minimum training requirements as well as a written

exam of multiple-choice questions and clinical/

practical skills evaluation. Most healthcare facilities

now require that nurse aides have a high school

diploma or GED and pass a state-approved program.

Nurse aides completing these programs must obtain

certification within four months of being hired at a

healthcare facility. Once you pass the written exam,

you will be placed on your state’s registry for Nurse

Aides—your certification is then valid for 24 months.

After being certified, CNAs are usually required to earn

continuing-education credits, usually through in-

service training.

Training ProgramsIn New York State, 120 hours of training are required

and a person must pass his or her clinical exam before

taking the written (or oral) exam. Washington State

requires 85 hours of training in a state-approved NA

program along with at least seven hours of training in

HIV and AIDS.

In any states that require the certification of

nursing assistants, the training program is likely to be

similar to the samples shown on the following pages.

The following are sample classes from a nurse aide

training course given by the Nursing Assistant Training

Institute in Shoreline, Washington. The classes consist

of 40 hours of training, in addition to 12 hours of

hands-on skills practice and demonstration, and 50

hours of clinical experience.

1. Role of the Nursing Assistant

Rules and Regulations Governing Care

Understanding Your Resident

Physical and Psychosocial Aging Changes

2. Safety/Fire and Disaster

Body Mechanics

Transferring, Positioning, Ambulation

Restraints: The Last Resort

3. Communication

Medical Terminology

Observations

Vital Signs

Height & Weights

4. Personal Care: Hygiene, Bathing, Grooming

Oral Care, Foot Care, Skin Care, Decubitus Pre-

vention

Infection Control

5. Gastrointestinal & Urinary Systems

Nutrition

Fluids, Intake & Output

6. Rehabilitation & Restorative Concepts

Prosthesis

Specimen Collection

Common Health Problems

7. Human Immunodeficiency Virus and AIDS

8. Blood Borne Pathogens: Hepatitis B & C, HIV

Death and Dying

9. Cardiopulmonary Resuscitation and the

Heimlich Maneuver

10. Understanding & Managing Difficult Behavior

Dementia Care

Preparation for Final & Competency Exam

Source: Nursing Assistant Training Institute, http://

nursingassistanttraining.homestead.com

Pennsylvania requires a minimum of 75 hours of

training—37.5 hours of theory and 37.5 hours of clin-

ical. Training programs throughout the state do

vary—the Institute for Caregiver Education in Cham-

bersburg, Pennsylvania, has a four-week, 140-hour

nurse assistant training program. Topics covered

include:

Week 1: (35 hours)A. CommunicationB. Work EthicC. Getting Along with Supervisors and

CoworkersD. AttitudeE. Customer ServiceF. Stress Management

–CERTIFICATION REQUIREMENTS AND TRENDS–

106

G. Time ManagementH. Problem SolvingI. Conflict ResolutionJ. TeamworkK. Aging SensitivityL. Special Needs ClientsM. Managing Difficult Clients

Weeks 2–4: (105 hours)A. Role and Function of the Nursing AssistantB. Infection ControlC. Residents’ RightsD. Nutrition and Special DietsE. Personal Care SkillsF. BedmakingG. Transferring and AmbulatingH. Death and DyingI. Post-Mortem CareJ. Toileting and I & OsK. Aging Process—Review of SystemsL. Vital SignsM. Data Collection and Observation SkillsN. Rehab and Restorative CareO. Catheter CareP. Resident Assignments (beginning with one

and working up to four residents per stu-dent)

Q. Debriefing and Skills Review (after each dayof clinical experience)

Source: The Institute for Caregiver Education, www.caregivereducation.org

A major part of the job of being a CNA involves

being able to manipulate patients physically in order to

clean them and help them change their clothes, exer-

cise, or use the bathroom. The clinical part of the

training programs help to determine if a student is

capable of performing these tasks.

Training programs are given in a number of set-

tings, including both public and private vocational-

technical schools, community colleges, public-health

agencies, and for-profit and not-for-profit healthcare

agencies, such as Visiting Nurse Associations. Since

hands-on clinical experience is usually required,

schools that do not have their own healthcare services

often affiliate with a healthcare facility. Then the course

work is given in the school and the clinical work is per-

formed in the healthcare facility or in a home setting

served by a healthcare agency.

In the states that require certification, there are

usually a large number of locations that offer training

programs. In Illinois, for example, there are some 300

approved CNA training programs. Agencies that offer

training programs often hire the people they have

trained, so they are good places to sign up for a train-

ing program that may lead to a job offer when you

complete the course.

� Exams

Training programs usually conclude with a written (or

oral) examination that determines whether the student

is qualified to receive certification. Some institutions

that offer training make up their own examinations,

while others may use an exam prepared by a company

that specializes in developing tests. Tests typically range

from 50 to 150 questions and are in sections that relate

directly to the subject areas covered in the training,

such as patient-care procedures, emergency proce-

dures, or observation and charting. Usually a candidate

must achieve a passing grade in each of the sections,

and not just overall, in order to qualify for certification.

� Why Cert i f icat ion?

The main reason behind the trend to CNA certification

is the growth of home healthcare. Home-based health-

care has been on the increase because of cost-saving

measures in the health industry: Patients are being

encouraged to leave relatively expensive hospital-based

care to complete their recuperations in lower-cost

alternative settings, including short-term and long-

term care facilities, as well as the home. Nursing assis-

tants work in a wide variety of healthcare settings,


107

including skilled-nursing facilities, doctors’ offices,

hospices, board-and-care retirement facilities, acute-

care hospitals, clinics, rehabilitation hospitals, psychi-

atric hospitals, facilities for the developmentally

disabled, and daycare facilities. But the delivery of

services in patient homes is what has increased aware-

ness of state and national authorities, leading to the

increase of requirements for certification.

Certification offers assurance that nursing assis-

tants, who have such immediate, important, and inti-

mate contact with elderly or disabled persons, have

been properly trained to deal with the many and var-

ied tasks they will have to perform. This is very impor-

tant to the healthcare agencies that the CNAs work for,

as well as to the families of the patients. The federal

government, which is often the funding source for

home healthcare under the Medicare program, also

wants to know that its funds are being spent for high-

quality services.

� Emphasis on InterpersonalSki l ls

While it has always been important for healthcare pro-

fessionals of all kinds to be able to make patients feel

safe and comfortable, these skills become even more

crucial when care is being delivered in the patient’s

own home or in long-term care. Thus, many training

programs are now emphasizing interpersonal skills

more than ever before. In the sample training pro-

grams shown earlier in this chapter, you can see inter-

personal skills such as Understanding Your Resident in

the first curriculum and Communication in the sec-

ond curriculum are emphasized and listed at the

beginning of each program.

� Combining CNA and HomeHealth Aide Cert i f icat ion

The trend to certification is also spurred by the fact

that the training programs for nursing assistants typ-

ically include the training requirements for the job

of home health aide (HHA), as well. HHA training

follows a federally mandated 75-hour curriculum.

The federal mandate is there because home-healthcare

agencies are eligible for Medicare funds for the services

they provide to the elderly.

Since CNAs can perform medical tasks beyond

what HHAs are trained to do, someone who has train-

ing and certification in both job categories is obviously

of greater value to the agency doing the hiring. The

employer is better off hiring one person who can per-

form the work of two persons, even if that one person’s

salary is a little higher than that of a person with one

certification.

A representative of one major home-healthcare

agency in Austin, Texas, reported that the Sunday

newspaper usually contains almost a full page of ads

from home-healthcare agencies calling for people to

work as home health aides. However, she noted that

most of these ads want CNAs to fill these positions

because they have skills that go beyond those required

of a home health aide.

The home health aide profession is growing

faster than average and should continue growing

through 2010. The reason for this is the increased need

for home care of the elderly—patients are being moved

out of hospitals and nursing homes to lower healthcare

costs. In the year 2000, more than 600,000 people were

employed as home health aides and most were

employed in home-health agencies, nursing facilities,

hospitals, visiting-nurse associations, residential-care

facilities, and temporary-help firms. Full-time aides

work about 40 hours per week, while many aides work

part-time. The actual job can be difficult both physi-

cally and emotionally; it includes a good portion of

standing, lifting, changing bed linens, and dealing with


108

uncooperative clients. Generally a home health aide

works independently and with a variety of patients.

Supervisors visit sporadically, and the aide is always

given explicit instructions pertaining to schedule and

patient care.

In Massachusetts, persons entering home health

aide programs are often encouraged to undergo dual

training and become CNAs in order to improve their

employment opportunities.

In some states, such as Illinois, people who want

to become home health aides are required to take the

same training program as CNAs. The HHA training is

included within the program as part of the CNA train-

ing. As a result, the certification that follows the suc-

cessful completion of the CNA training and the pas-

sage of the written competency examination serves as

a dual certification for home health aides as well.

And in November 2001, the state of Washington

passed Initiative 775, founding a Home Care Qualita-

tive Authority that will “regulate and improve the qual-

ity of long-term in-home care services by recruiting,

training, and stabilizing the workforce of individual

providers.”

The good news for people who want to become

nursing assistants is that the growth of healthcare in

alternative settings ensures that workers will be

needed. CNAs can look forward to good job prospects

for the foreseeable future.


109

IF YO U A R E just getting started on your new healthcare career—or if you are wondering how you can

go about finding a job—the resources listed in this chapter can give you valuable background informa-

tion. Included here are lists of professional organizations, directories, placement services, and homecare

organizations.

� Professional Associat ions

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.

In addition, many professional associations offer job placement or referral services. Many publish newslet-

ters, magazines, books, and other publications, as well as multimedia products such as videos and CD-ROMs.

C H A P T E R

ImportantResources

CHAPTER SUMMARYThis chapter identifies numerous healthcare organizations and serv-

ices—potentially valuable resources in your search for the right job.

10

111

Many also sponsor seminars, workshops, and other

educational forums. All of these efforts can help inter-

ested individuals keep up on current happenings in a

given field.

Agency for Healthcare Research and Quality2101 E. Jefferson Street, Suite 501Rockville, MD 20852Phone: 301-594-1364www.ahrq.gov

American Association for Homecare625 Slaters Lane, Suite 200Alexandria, VA 22314-1171Phone: 703-836-6263Fax: 703-836-6730www.aahomecare.org

American Association of Homes and Services forthe Aging2519 Connecticut Avenue NWWashington, DC 20008-1520Phone: 202-783-2242Fax: 202-783-2255www.aahsa.org

American Healthcare Association1201 L Street NWWashington, DC 20005Phone: 202-842-4444Fax: 202-842-3860www.ahca.org

American Hospital Association (headquarters)One North FranklinChicago, IL 60606 Phone: 312-422-3000 Fax: 312-422-4796www.aha.org

American Medical Association515 North State Street Chicago, IL 60610 Phone: 312-464-5000www.ama-assn.org

American Public Health Association800 I Street NWWashington, DC 20001-3710Phone: 202-777-APHAFax: 202-777-2534www.apha.org

Department of Health and Human Services200 Independence Avenue SWWashington, DC 20201Phone: 202-619-0257Toll Free: 877-696-6775www.os.dhhs.gov

Home Care Aide Association of America228 7th Street SEWashington, DC 20003Phone: 202-547-7424Fax: 202-547-3540www.nahc.org/HCA/home.html

Home Healthcare Nurses Association 228 7th Street SEWashington, DC 20003Phone: 202-546-4754www.hhna.org

Hospice Association of America228 7th Street SEWashington, DC 20003Phone: 202-546-4759Fax: 202-547-9559www.hospice-america.org

Hospice Foundation of America2001 S Street NW, #300Washington, DC 20009Phone: 800-854-3402Fax: 202-638-5312www.hospicefoundation.org

National Association for Home Care*228 7th Street SEWashington, DC 20003Phone: 202-547-7424Fax: 202-547-3540www.nahc.org*affiliates include Home Care Aide Association of America,Home Healthcare Nurses Association, HospiceAssociation of America, and Hospital Home CareAssociation of America

National Council on the Aging (NCOA)*409 3rd Street SWSuite 200Washington, DC 20024Phone: 202-479-1200Fax: 202-479-0735www.ncoa.org*geriatric care

–IMPORTANT RESOURCES–

112

National Rural Health AssociationOne West Armour Boulevard, Suite 203Kansas City, MO 64111-2087Phone: 816-756-3140www.nrharural.org

� Director ies

Consult the directories on the following list for . . . well,

mostly more lists. Just like your local phone book,

these directories offer you long lists of names,

addresses, phone numbers, and contact persons—in

this case, at hospitals, HMOs, private practices, geri-

atric facilities, and more. Directories can be especially

useful when you are researching education programs

or scoping out job prospects in your region or across

the country.

AHA Guide to the Health Care FieldAmerican Hospital AssociationOne North Franklin, 27th FloorChicago, IL 60606Toll Free: 800-242-2626www.ahaonlinestore.com(hospitals, clinics, other healthcare organizations)

American Association of Homes and Services forthe Aging2519 Connecticut Avenue NWWashington, DC 20008-1520Phone: 770-442-8633, ext 369Toll Free: 800-508-9442www.aahsa.org/public/books.htm(assorted books on geriatric care)

American Medical Group Association1422 Duke StreetAlexandria, VA 22314-3430Phone: 703-838-0033Fax: 703-548-1890www.amga.org(assorted books on physicians–private medical practices)

Assisted Living and Extended Care Facilities,Hospital Blue Book, and Managed HealthcareOrganizations

Billian’s HealthDATA Group2100 Powers Ferry RoadAtlanta, GA 30339Phone: 770-955-8484Fax: 770-955-8485www.billianshealthdata.com(assorted directories on healthcare facilities, hospitals,and managed-care organizations)

Case Management Resource GuideAAHP/Dorland Directory of Health Plans Directory of Physician Groups & Networks

Dorland Healthcare Information1500 Walnut Street—Suite 1000Philadelphia, PA 19102Phone: 215-875-1212Toll Free: 800-784-2332Fax: 215-735-3966Product Inquiries: [email protected](healthcare facilities, HMOs, adult daycare, cancercenters, other)

Directory of Privately Owned Hospitals, HospitalManagement Companies and Health Systems,Residential Treatment Facilities and Centers, andKey Management Personnel

Federation of American Hospitals1405 North Pierce, Suite 311Little Rock, AR 72207Phone: 501-661-9555(healthcare facilities nationwide)

American Hospital Directory3630-A Brownsboro Road, #200Louisville, KY 40207-1861Fax: 502-899-7738www.ahd.com E-mail: [email protected](hospitals)

Medical and Health Information Directory

Gale Research CompanyP.O. Box 9187Farmington Hills, MI 48333-9187Phone: 800-877-GALEFax: 800-414-5043www.galegroup.comE-mail: [email protected](medical associations, schools, federal agencies, other)


113

� Placement Services and JobSearches

Many organizations nationwide provide employment

services for healthcare workers. In fact, it is a growing

field precisely because the number of jobs is grow-

ing so fast. The list below covers just a few of the

organizations and government agencies nationwide

working to identify available jobs in healthcare, link

candidates to employers and vice versa, or aid in the

actual hiring process.

Tip: For those of you who are savvy with online

computer services, make the Internet and the World

Wide Web part of your job-hunting process. Both pri-

vate industry and government bureaus sponsor career-

and employment-related websites. Virtually every

major “search engine,” such as Yahoo or AltaVista,

offers a list of predesignated employment databases or

online classifieds to help you start your search. We have

also included some pertinent website listings here. You

also can tap into bulletin boards and discussion groups

on the Internet that are frequented by healthcare pro-

fessionals, where you can post your credentials, ask

ever so politely for referrals, or respond to specific job

listings.

American Association of Managed Care Nurses, Inc.Job Placement Services4435 Waterfront Drive, Suite 101Glen Allen, VA 23060Phone: 804-527-1905Fax: 804-747-5316www.aamcn.org

American Nursing ServicesPhone: 800-444-NURS (6877)www.american-nurse.com

American Public Health Association CareerMart(online only)www.apha.org/career

CompHealth4021 South 700 East, Suite 300Salt Lake City, UT 84107Phone: 800-453-3030; 801-264-6400 Fax: 801-264-6464www.comphealth.com

Department of Health and Human Services200 Independence Avenue SWWashington, DC 20201Phone: 202-619-0257Toll Free: 877-696-6775For 24-hour Job Information: 912-757-3000www.hhs.gov/jobs(federal jobs)

Department of Veterans Affairs810 Vermont Avenue NWWashington, DC 20420Phone: 202-273-5400www.va.gov(federal jobs)

Health Personnel Options8150 Corporate Park Drive, Suite 300Cincinnati, OH 45242Phone: 513-936-3468Toll Free: 877-936-4762Fax: 513-891-6145www.healthpersonnel.com(temporary assignments and temporary to permanent)

NursingHands.comwww.NursingHands.com/CC/

NursingJobs.comPhone: 877-435-2131E-mail: [email protected]

Nurse Web Search—The Nurse Directorywww.nursewebsearch.com/nursing_employment.htm(provides listings of assorted websites for nurse-relatedissues, including employment)

NurseZone12235 El Camino Real, Suite 200San Diego, CA 92130Phone: 877-585-5010Fax: 888-458-0197www.NurseZone.com


114

� Homecare Organizat ions by State

One of your best bets in finding a job is one of the

more than 20,000 home-healthcare providers operat-

ing in the United States as of 2000. The National Asso-

ciation for Home Care (NAHC) defines homecare

organizations as home-health agencies, homecare-aide

organizations, and hospices. Types of homecare agen-

cies include visiting-nurse associations (VNAs), pub-

lic (government) agencies, proprietary (for profit)

agencies, private not-for-profit agencies, and hospital-

based agencies.

Members of the NAHC are featured in the state-

by-state listing of homecare organizations below.

ALABAMAAlabama Association of Home Health AgenciesP.O. Box 40Montgomery, AL 36101334-395-9949800-934-4312334-832-1430 fax

Medical Center Home Health11491 US Highway 431Albertville, AL 35950256-878-7022256-878-7067 fax

ALASKAAlaska Home Care AssociationGeneva Woods Home Health Care501 West International Airport RoadSuite 1AAnchorage, AK 99518907-565-6100907-565-6112 fax

ARIZONAArizona Association for Home Care2334 South McClintockTempe, AZ 85282 480-967-2624 480-966-0442 fax

Carondelet Home Health1120 South Swan RoadTucson, AZ 85711520-721-3822520-512-0439 fax

ARKANSASHome Care Association of Arkansas411 South VictorySuite 205Little Rock, AR 72201501-376-2273 501-376-7107 fax

Home Health ProfessionalsP.O. Box 704Blytheville, AR 72316870-762-1825870-762-2299 fax

Arkansas Hospital Association419 Natural Resources Drive Little Rock, AR 72205-1576501-224-7878501-224-0519 faxwww.arkhospitals.org

CALIFORNIACalifornia Association for Health Servicesat Home723 S StreetSacramento, CA 95814-7021916-443-8055916-443-0652 faxwww.cahsah.org

Community Hospital Home Health Services/Hospice of the Central Coast555 Abrego StreetMonterey, CA 93940831-658-3901831-648-7741 fax

COLORADOHome Care Association of Colorado7853 East Arapahoe Road Suite 2100Englewood, CO 80112303-694-4728303-694-4869 faxwww.hcaconline.org


115

Caring Plus420 West 29th StreetPueblo, CO 81008719-544-4197719-544-0657 fax

CONNECTICUTConnecticut Association for Home Care, Inc.110 Barnes RoadP.O. Box 90Wallingford, CT 06492-0090203-265-9931203-949-0031 faxwww.cthomecare.org

VNA of Central Connecticut205 West Main StreetNew Britain, CT 06052860-224-7131860-224-8303 fax

DELAWAREDelaware Association of Home Care andCommunity CareVeale Road Professional Center309 Veale RoadWilmington, DE 19810302-529-3000 302-529-3009 fax

Delaware Hospice Association3515 Silverside RoadSuite 100Wilmington, DE 19810302-478-5707800-838-9800302-479-2586 fax

FLORIDAAssociated Home Health Industries of Florida,Inc.512 North Calhoun StreetTallahassee, FL 32301-2600850-222-8967850-222-9251 faxwww.ahhif.org

Prime Care Health Agency3900 NW 79th Avenue, #334Miami, FL 33166305-591-7774305-594-8951 fax

Florida Hospital Association307 Park Lake CircleOrlando, FL 32803407-841-6230407-422-5948 faxwww.fha.org

GEORGIAGeorgia Association for Comprehensive HomeCare, Inc.2100 Roswell RoadSuite 200C - PMB 407Marietta, GA 30062770-565-4531770-565-1739 fax

Georgia Association of Community CareProviders168 North Johnston StreetSuite 304Dallas, GA 30132770-445-6640770-445-3893 fax

Georgia Home Care Association168 North Johnston StreetSuite 304Dallas, GA 30132770-445-3180770-445-3893 faxwww.gahca.org

Nursing Care, Inc.205 Boulevard NEGainesville, GA 30501770-536-0484770-536-3003 fax

HAWAIIHome Care and Hospice Division, Healthcare Association of Hawaii932 Ward AvenueSuite 430Honolulu, HI 96814-2126808-521-8961808-599-2879 faxwww.hah.org

Castle Home Care46-001 Kamehameha HighwaySuite 201Kaneohe, HI 96744808-247-2828808-236-1337 fax


116

IDAHOIdaho Association of Home Health AgenciesP.O. Box 6508Boise, ID 83707208-362-8190208-562-1366 fax

Guardian Home Care119 South Valley DriveSuite CNampa, ID 83686 208-461-1600

ILLINOISIllinois Home Care Council1926 Waukegan RoadSuite 1Glenview, IL 60025847-657-6960847-657-6963 fax

Partners Home Care2835 North Sheffield Avenue, #401Chicago, IL 60657773-549-5822 ext 150773-549-9122 fax

VNA First47 South Sixth Avenue, Suite 120LaGrange, IL 60525708-788-2047708-745-2920 faxwww.vnaf.org

INDIANAVNS—Indianapolis4701 North Keystone AvenueIndianapolis, IN 46205317-722-8200317-722-8250 fax

Indiana Association for Home and Hospice Care,Inc.8604 Allisonville Road, Suite 260Indianapolis, IN 46250317-844-6630317-575-8751 faxwww.ind-homecare.org

Interim HealthCare of ECI203�

12� North Broadway

Greenfield, IN 46140317-467-0787317-467-0790 fax

IOWAIowa Association for Home Care1520 High Street, Suite 203-BDes Moines, IA 50309515-282-3965515-282-8034 faxwww.iowahomecare.org

Visiting Nurse Association2530 UniversityWaterloo, IA 50701319-235-6201319-232-7296 fax

Iowa Hospice Organization100 East Grant Avenue, Suite 120Des Moines, IA 50309515-243-1046515-283-9358 fax

Hospice of North Iowa232 Second Street, SEMason City, IA 50401515-423-3508515-424-7827 fax

KANSASKansas Home Care Association1512 B Legend Trail DriveLawrence, KS 66047785-841-8611785-749-5414 faxwww.kshomecare.org

Stormont Vail Home Health833 SouthWest Garfield AvenueTopeka, KS 66604785-354-4300785-354-1058 fax

Association of Kansas Hospice1901 University Witchita, KS 67213316-263-6380 316-263-6542 fax

Hospice Services, Inc.P.O. Box 116Phillipsburg, KS 67661-0116913-543-2900913-543-5688 fax


117

LOUSIANAHomeCare Association of Louisiana233-A East Main StreetNew Iberia, LA 70562337-560-9610337-560-9606 faxwww.hcla2000.org

Acadian Home Health1340 Surrey StreetLafayette, LA 70501337-233-1307318-235-8037 fax

MAINEHome Care Alliance of Maine20 Middle StreetAugusta, ME 04330207-623-0345207-623-7141 faxwww.homecarealliance.org

Kno-Wal-Lin Home Care170 Pleasant StreetRockland, ME 04841207-594-9561207-594-2527 fax

MARYLANDMaryland-National Capital HomecareAssociation625 Slaters LaneSuite 200Alexandria, VA 22314703-535-1885703-519-9066 fax

Lauren Simpson Potomoc Home Health Care/Support6001 Montrose Road, Suite 307Rockville, MD 20852301-896-6998301-896-6275 fax

MASSACHUSETTSHome & Health Care Association ofMassachusetts31 James Avenue, Suite 780Boston, MA 02116617-482-8830617-426-0509 fax

VNA of Southeastern Massachusetts502 Bedford Street, 4th FloorFall River, MA 02720508-676-8251508-646-4017 fax

Massachusetts Council for Home Care AideServices31 New Chardon StreetBoston, MA 02114617-227-6641617-227-1190 fax

Health Force/Medi Force60 Lowell StreetArlington, MA 02174781-641-2800781-646-3150 fax

Visiting Nurses Association of New England55 Charles StreetNeedham, MA 02194-2905781-444-0713781-449-6563 fax

Community VNA of Attleborough141 Park StreetAttleborough, MA 02703508-222-0118508-226-1012 fax

MICHIGANMichigan Home Health Association2140 University Park Drive, Suite 220Okemos, MI 48864517-349-8089517-349-8090 faxwww.mhha.org

Henry Ford Extended Care24445 Northwestern Highway, Suite 110Southfield, MI 48075248-352-4890248-352-3224 fax

MINNESOTAMinnesota HomeCare Association1711 West County Road B, Suite 211SSt. Paul, MN 55113-4036651-635-0607651-635-0043 faxwww.mnhomecare.org


118

Perham Memorial Home Care665 Third Street, SWPerham, MN 56573218-346-1190218-346-1237 fax

MISSISSIPPIMississippi Association for Home CareP.O. Box 1468Ridgeland, MS 39158-1468601-853-7533601-853-7582 faxwww.mahc.org

Gilbert Home Health605 2nd Ave North, #203Columbus, MS 39701662-327-9669662-239-2015 fax

Mississippi Hospital AssociationP.O. Box 16444Jackson, MS 39236-6444601-368-3220601-368-3200 faxwww.mhanet.org

North Mississippi Medical Center Home Care/Hospice Department600 West Main StreetTupelo, MS 38801662-841-3611662-841-3990 fax

MISSOURIMissouri Alliance for Home Care2420 Hyde Park Road, Suite AJefferson City, MO 65109573-634-7772573-634-4374 faxwww.homecaremissouri.org

John Knox Village Home Health400 Northwest Murray RoadLee’s Summit, MO 64081816-524-1133816-524-9177 fax

Missouri Hospital Home Health CouncilP.O. Box 60Jefferson City, MO 65102573-893-3700573-893-2809 fax

MONTANAMontana Association of Home Health Agencies1905 River RoadMissoula, MT 59801406-721-4035406-721-4035 faxwww.mahha.org

Flathead County Home Health Agency711 East 13th StreetWhitefish, MT 59937406-862-9030406-862-9025 fax

Montana Hospital Association: An Association of Health Care ProvidersP.O. Box 5119Helena, MT 59604406-442-1911406-443-3894 faxwww.mtha.org

NEBRASKANebraska Association of Home and CommunityHealth Agencies7421 Forbes DriveLincoln, NE 68516402-489-1117402-489-1117 fax

Good Samaritan Hospital Home Care Services10 East 31st StreetKearney, NE 68847308-865-7090308-865-2923 fax

NEVADAHome Health Care Association of NevadaP.O. Box 186298Reno, NV 89511-0629775-323-6003775-853-2166 fax

Washoe Home Care780 KuenzliSuite 200Reno, NV 89502775-982-5877775-882-5795 fax


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NEW HAMPSHIREHome Care Association of New Hampshire8 Green StreetConcord, NH 03301603-225-5597603-225-5817 faxwww.homecarenh.org

Home Health & Hospice Care22 Prospect StreetNashua, NH 03060603-882-2941603-883-1515 fax

NEW JERSEYHome Health Assembly of New Jersey, Inc.14 Washington Road, Suite 211Princeton Junction, NJ 08550-1030609-275-6100609-936-9349 faxwww.homecarenj.org

Patient Care, Inc.100 Executive Drive, Suite 130 West Orange, NJ 07052973-669-5222973-243-5901 fax

Home Care Council of New Jersey201 Bloomfield Avenue, Suite 3Verona, NJ 07044973-857-3333973-857-1192 fax

Certified Health Aide of Somerset County205 West Main StreetSommerville, NJ 08876908-725-5533908-725-5648 fax

New Jersey Hospital Association760 Alexander RoadP.O. Box 1Princeton, NJ 08543-0001609-275-4000609-275-4265 faxwww.njha.com

NEW MEXICONew Mexico Association for Home Care3200 Carlisle Boulevard NE, Suite 117Albuquerque, NM 87110505-889-4556505-889-4928 faxwww.nmahc.org

Basin Home Health, Inc.200 North OrchardFarmington, NM 87401505-325-8231505-325-4516 fax

NEW YORKHome Care Association of New York State, Inc.194 Washington Avenue, Suite 400Albany, NY 12210518-426-8764518-426-8788 faxwww.hcanys.org

Independence Care Systems, Inc.257 Park Avenue SouthNew York, NY 10010212-584-2580212-584-2555 fax

New York State Association of Health CareProviders, Inc.90 State Street, Suite 200Albany, NY 12207518-463-1118518-463-1606 faxwww.nyshcp.org

New York Nursing Care527 Townline Road, Suite 302Hauppauge, NY 11788631-979-2200631-979-2265 fax

Health Care Association of New York StateOne Empire DriveRensselaer, NY 12144518-431-7600518-431-7915 faxwww.hanys.org

Cayuga Medical Center at Ithaca101 Dates DriveIthaca, NY 14850607-274-4443607-274-4527 fax

Hospice and Palliative Care Association of New York State21 Aviation Road, Suite 9Albany, NY 12205518-446-1483518-446-1484 faxwww.hpcanys.org


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Hospice of Central New York990 Seventh North StreetLiverpool, NY 13088-6148315-634-2181315-634-1111

Home Care Council of New York City25 West 43rd Street, 3rd FloorNew York, NY 10036-7406646-366-0860646-366-0864 fax

Union Settlement Home Care219 East 115 StreetNew York, NY 10029212-828-6182 ext 204212-828-6190 fax

NORTH CAROLINAAssociation for Home Care and Hospice of NorthCarolina, Inc.226 West Millbrook RoadRaleigh, NC 27609919-848-3450919-848-2355 faxwww.homeandhospicecare.org

Baptist Hospital Home & Community HealthMedical Center BoulevardWinston-Salem, NC 27157828-252-2255828-252-9355 fax

The Carolinas Center for Hospice and End of Life Care1011 Dresser CourtRaleigh, NC 27609-7323919-878-1717919-878-0191 faxwww.carolinasendoflifecare.org

Johnston Memorial Home Care & HospiceP.O. Box 1376Smithfield, NC 27577919-989-1563919-989-2129 fax

NORTH DAKOTANorth Dakota Association for Home Carec/o APT, Inc.P.O. Box 2175Bismarck, ND 58502-2175701-224-1815701-224-9824 faxwww.aptnd.com/ndahc

Midwest Home Health Care1711 South University DriveFargo, ND 58103701-280-2802701-280-4030 fax

OHIOOhio Council for Home Care1395 East Dublin Granville Road, Suite 350Columbus, OH 43229614-885-0434614-885-0413 faxwww.homecareohio.org

Northcoast Health Care Group Co.Warrensville Center Road, #124Shaker Heights, OH 44122216-921-4000216-921-3540 fax

Ohio Hospice & Palliative Care Organization1646 West Lane Avenue, Suite 2Columbus, OH 43221614-485-0021614-485-0560 faxwww.ohpco.org

VNA of Cleveland Hospice2500 East 22nd StreetCleveland, OH 44115-3204216-931-1450 216-694-6355 fax

OKLAHOMAOklahoma Association for Home Care8108 NorthWest Tenth, Suite C3Oklahoma City, OK 73127405-495-5995405-495-5993 faxwww.oahc.com

Excell Home Health5350 South Western Avenue Suite 301Oklahoma City, OK 73109405-631-0521405-631-2661 fax

OREGONOregon Association for Home Care1249 Commercial Street SESalem, OR 97302503-364-2733503-399-1029 faxwww.oahc.org


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Willamette Valley Hospice2700 Market Street, NESalem, OR 97301503-588-3600503-363-3891 fax

PENNSYLVANIAPennsylvania Homecare Association20 Erford Road, Suite 115Lemoyne, PA 17043717-975-9448717-975-9456 faxE-mail: [email protected]

Home Nurse, Inc.512 West Lancaster Avenue, Suite 2Homestead, PA 19087610-975-9600610-975-0752 fax

PUERTO RICO

Puerto Rico Home Health Agencies andHospices AssociationP.O. Box 192152San Juan, Puerto Rico 00909-2152787-774-8181787-746-1066 fax

RHODE ISLANDRhode Island Partnership for Home Care, Inc.P.O. Box 603309Providence, RI 02906401-751-2487401-751-2487 fax

Memorial Hospital of Rhode Island Home Care111 Brewster StreetPawtucket, RI 02860401-729-3108401-729-2754 fax

SOUTH CAROLINASouth Carolina Home Care AssociationP.O. Box 1763Columbia, SC 29202803-254-7355803-252-0589 fax

Tuomey Home Health31 E. Calhoun StreetSumter, SC 29150803-773-4663803-436-5694 fax

Hospice for the CarolinasP.O. Box 6009West Columbia, SC 29171-6009803-791-4220803-791-5664 faxwww.hospice-nc-sc.org

Hospice of Charleston3996 Leeds AvenueCharleston, SC 29405843-529-3100843-529-3111 fax

TENNESSEETennessee Association for Home Care, Inc.131 Donelson PikeNashville, TN 37214-2901615-885-3399615-885-4191 faxwww.tahc-net.org

UT Medical Center Home Health2220 Southerland Avenue, Suite 102Knoxville, TN 37919865-544-6200865-544-6240 fax

Tennessee Hospital Association Home CareAlliance500 Interstate Boulevard SouthNashville, TN 37210-4634615-256-8240615-242-4803 fax

Gateway Home CareGateway Medical CenterClarksville, TN 37040931-648-4576

TEXASTexas Association for Home Care3737 Executive Center Drive, Suite 268Austin, TX 78731512-338-9293512-338-9496 faxwww.tahc.org

Girling Health CareP.O. Box 4294Austin, TX 78765512-452-5781512-302-1446 [email protected] (e-mail)


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UTAHUtah Association of Home Health Agencies6949 South High Tech Drive, Suite 150Midvale, UT 84047801-255-5888801-568-6882 fax

Health Watch1750 North 680 WestOrem, UT 84057801-785-8848801-785-0821 fax

VERMONTVermont Assembly of Home Health Agencies10 Main StreetMontpelier, VT 05602802-229-0579802-223-6218 faxwww.vnavt.com

Caledonia Home Health Care and HospiceP.O. Box 383St. Johnsbury, VT 05819802-748-8116802-748-4628 fax

VIRGINIAVirginia Association for Home Care5407 Patterson Avenue, Suite 200BRichmond, VA 23226804-285-8636800-755-8636804-288-3303 faxwww.vahc.org

Circle Home Care600 Ridge RoadWytheville, VA 24382540-228-0488540-288-0489 fax

Virginia Hospital and Health Care AssociationP.O. Box 31394Richmond, VA 23294804-965-1249804-965-0475 faxwww.vhha.com

WASHINGTONHome Care Association of WashingtonP.O. Box 2016Edmonds, WA 98020425-775-8120425-771-9588 faxwww.hcaw.org

Visiting Nurse Services of the Northwest 6100 219th Street SW, Suite 400Mountlake Terrace, WA 98043425-778-2400425-744-2497 fax

WEST VIRGINIAWest Virginia Council of Home Care Agencies,Inc.Route 1, Box 190Elk Fork RoadMiddlebourne, WV 26149304-758-4312304-758-4354 fax

Elite Health Care1832 Harper RoadBeckley, WV 25801304-256-0070304-256-3703 fax

WISCONSINWisconsin Homecare Organization5610 Medical Circle, Suite 33Madison, WI 53719608-278-1115608-278-4009 faxwww.wishomecare.org

Ministry Home Care303 Upham Street, #208Marshfield, WI 54449715-387-9685715-389-3950 fax

WYOMINGHome Health Care Alliance of Wyoming 1515 South Spruce StreetCasper, WY 82601307-237-7042 (phone and fax)

Central Wyoming Home Care401 East MainRiverton, WY 82501307-857-0599307-857-2778 fax


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You can use the charts on the next five pages to assess the areas in which you need more study. The column onthe left indicates the topics tested, and the right column indicates the question numbers in that topic.

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APPENDIXNursing Assistant/Nurse Aide

Practice Exam Question Outline

NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 1

PRETEST 1

Topic Question Numbers

Activities of Daily Living 2, 9,10

Basic Nursing Skills 3, 4, 5, 6, 7

Restorative Skills 1, 8

TEST 1

PHYSICAL CARE SKILLS


Activities of Daily Living: 7, 12, 21, 22, 58, 59■ Hygiene■ Dressing and Grooming■ Nutrition and Hydration■ Elimination■ Rest/Sleep/Comfort

Basic Nursing Skills: 1, 5, 6, 11, 15, 16, 17, 20, 23, 24, 25, 26, 28,

29, 30, 31, 32, 33, 35, 51, 55, 56, 57■ Infection Control■ Safety/Emergency■ Therapeutic/Technical Procedures■ Data Collection and Reporting

Restorative Skills: 8, 9, 14■ Prevention■ Self-Care/Independence

PSYCHOSOCIAL CARE SKILLS


Emotional and Mental Health Needs 37, 43, 44, 45, 46, 60

Spiritual and Cultural Needs 47, 48

ROLE OF THE NURSE AIDE


Communication 2, 3, 10, 13, 27, 49

Client Rights 18, 19, 36, 38, 40, 41, 42, 50, 54

Legal and Ethical Behavior 35, 52, 57

Member of the Healthcare Team 4, 34, 39, 50, 53

–APPENDIX–

126


PRETEST 2


Activities of Daily Living 8, 9

Basic Nursing Skills 10

Restorative Skills 1, 2, 3, 4, 5, 6

Emotional and Mental Health Needs 7

TEST 2



Activities of Daily Living: 18, 19, 20, 23■ Hygiene■ Dressing and Grooming■ Nutrition and Hydration■ Elimination■ Rest/Sleep/Comfort

Basic Nursing Skills: 1, 2, 3, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 17, 21,

24, 25, 26, 27, 28, 40, 56■ Infection Control■ Safety/Emergency■ Therapeutic/Technical Procedures■ Data Collection and Reporting








Communication 16, 34, 47, 48, 49, 58

Client Rights 30, 41, 42, 43, 44, 45, 50, 57, 59



–APPENDIX–

127


TEST 3



Activities of Daily Living: 16, 24, 35, 37, 39, 57, 70■ Hygiene■ Dressing and Grooming■ Nutrition and Hydration■ Elimination■ Rest/Sleep/Comfort

Basic Nursing Skills: 11, 12, 13, 14, 15, 17, 18, 20, 22, 23, 25, 26,





Emotional and Mental Health Needs 59, 60, 61, 63, 64




Communication 19, 43, 46, 49, 50, 52

Client Rights 21, 44, 45, 53, 54, 55, 62, 69


Member of the Healthcare Team 51, 66, 67, 68

–APPENDIX–

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TEST 4



Activities of Daily Living: 33, 34, 35, 36■ Hygiene■ Dressing and Grooming■ Nutrition and Hydration■ Elimination■ Rest/Sleep/Comfort

Basic Nursing Skills: 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22,





Emotional and Mental Health Needs 40, 41, 42, 43, 44, 45, 46




Communication 49, 50, 51, 52, 53, 54

Client Rights 58, 59, 60, 61, 62, 63, 64, 65, 66


Member of the Healthcare Team 67, 68, 69, 70

–APPENDIX–

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TEST 5



Activities of Daily Living: 2, 3, 5, 18, 20, 22, 23■ Hygiene■ Dressing and Grooming■ Nutrition and Hydration■ Elimination■ Rest/Sleep/Comfort

Basic Nursing Skills: 1, 4, 6, 7, 8, 11, 13, 15, 17, 19, 25, 26, 27, 28, 29,

33, 34, 35, 37, 38, 39, 41, 42, 43, 44, 45, 46■ Infection Control■ Safety/Emergency■ Therapeutic/Technical Procedures■ Data Collection and Reporting

Restorative Skills: 9, 10, 12, 16, 24■ Prevention■ Self-Care/Independence







Communication 14, 53, 54, 55, 56, 57

Client Rights 36, 58, 59, 65, 66, 67, 68, 69, 70



–APPENDIX–

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nursing assistant - nurse aid exam, 2ed

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