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California Certified Nursing Assistant — Requirements & Free Practice

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Certified Nurse Assistant (CNA)

The nurse-assistant certificate established by Health and Safety Code Article 9. The temporary and trainee employment categories in section 1337.5 are pre-certification employment permissions, not separate department-issued certificates.

Licensing authority: California Department of Public Health · Application information

Equivalency for an RN or LVN licensed in another state or country

At least one of the following alternatives:

  • All of the following:

  • All of the following:

    • California Nurse Aide Knowledge/Audio Exam (practice unavailable)
    • California Nurse Aide Manual Demonstration Skill Test (assessment without a question bank)
Criminal Clearance
Complete the CDPH criminal record review and maintain clearance; submit the prescribed fingerprint documentation.
Department Approval
CDPH reviews the equivalency request and may excuse further CNA training; examination passage and criminal clearance remain required.
Documentation
Submit CDPH 283E, fingerprint documentation and transcripts or a sealed school letter showing nursing fundamentals, completion dates and hours/units. A photocopy of a foreign transcript is accepted.
Identity
Provide a Social Security number or Individual Taxpayer Identification Number under HSC section 1337.2(b).
Minimum Age
At least 16 years of age under HSC section 1337.2(a)(1).
Qualifying License
Hold a valid RN or LVN license issued by another U.S. state or foreign country and satisfy CDPH review under HSC 1337.2(d). A prior nursing examination is evidence of that other-profession qualification, not a CNA examination leaf.
Recent Practice
Provide a paystub or W2 for compensated nursing-related work under a licensed health professional within the last two years; waived for current nursing students or a degree obtained within the last two years. For agency-paid facility work, obtain the facility confirmation letter.
Testing Approval
Obtain CDPH competency-evaluation approval and comply with the period in the approval letter. The general vendor attempt/time rules apply where based on a training completion date.
Equivalency for military medical training

At least one of the following alternatives:

  • All of the following:

  • All of the following:

    • California Nurse Aide Knowledge/Audio Exam (practice unavailable)
    • California Nurse Aide Manual Demonstration Skill Test (assessment without a question bank)
Criminal Clearance
Complete the CDPH criminal record review and maintain clearance; submit the prescribed fingerprint documentation.
Department Approval
CDPH reviews the equivalency request and may excuse further CNA training; examination passage and criminal clearance remain required.
Documentation
Submit CDPH 283E, fingerprint documentation and transcripts or a sealed school letter showing nursing fundamentals, completion dates and hours/units. A photocopy of a foreign transcript is accepted.
Identity
Provide a Social Security number or Individual Taxpayer Identification Number under HSC section 1337.2(b).
Military Documentation
If discharged from the military, a DD-214 may substitute for an official transcript.
Minimum Age
At least 16 years of age under HSC section 1337.2(a)(1).
Qualifying Training
Have medical training in the military and qualify through CDPH review.
Recent Practice
Provide a paystub or W2 for compensated nursing-related work under a licensed health professional within the last two years; waived for current nursing students or a degree obtained within the last two years. For agency-paid facility work, obtain the facility confirmation letter.
Testing Approval
Obtain CDPH competency-evaluation approval and comply with the period in the approval letter. The general vendor attempt/time rules apply where based on a training completion date.
Equivalency for RN or LVN nursing coursework

At least one of the following alternatives:

  • All of the following:

  • All of the following:

    • California Nurse Aide Knowledge/Audio Exam (practice unavailable)
    • California Nurse Aide Manual Demonstration Skill Test (assessment without a question bank)
Criminal Clearance
Complete the CDPH criminal record review and maintain clearance; submit the prescribed fingerprint documentation.
Department Approval
CDPH reviews the equivalency request and may excuse further CNA training; examination passage and criminal clearance remain required.
Documentation
Submit CDPH 283E, fingerprint documentation and transcripts or a sealed school letter showing nursing fundamentals, completion dates and hours/units. A photocopy of a foreign transcript is accepted.
Identity
Provide a Social Security number or Individual Taxpayer Identification Number under HSC section 1337.2(b).
Minimum Age
At least 16 years of age under HSC section 1337.2(a)(1).
Qualifying Training
Have completed nursing fundamentals in an approved RN or LVN school with training substantially equivalent to the CNA program; current enrollment or completed nursing education is reviewed by CDPH.
Recent Practice
Provide a paystub or W2 for compensated nursing-related work under a licensed health professional within the last two years; waived for current nursing students or a degree obtained within the last two years. For agency-paid facility work, obtain the facility confirmation letter.
Testing Approval
Obtain CDPH competency-evaluation approval and comply with the period in the approval letter. The general vendor attempt/time rules apply where based on a training completion date.
Equivalency for Licensed Psychiatric Technician training or license

At least one of the following alternatives:

  • All of the following:

  • All of the following:

    • California Nurse Aide Knowledge/Audio Exam (practice unavailable)
    • California Nurse Aide Manual Demonstration Skill Test (assessment without a question bank)
Criminal Clearance
Complete the CDPH criminal record review and maintain clearance; submit the prescribed fingerprint documentation.
Department Approval
CDPH reviews the equivalency request and may excuse further CNA training; examination passage and criminal clearance remain required.
Documentation
Submit CDPH 283E, fingerprint documentation and transcripts or a sealed school letter showing nursing fundamentals, completion dates and hours/units. A photocopy of a foreign transcript is accepted.
Identity
Provide a Social Security number or Individual Taxpayer Identification Number under HSC section 1337.2(b).
Minimum Age
At least 16 years of age under HSC section 1337.2(a)(1).
Qualifying Training
Be presently enrolled in or have completed a Licensed Psychiatric Technician program, or hold that license from another U.S. state or foreign country, as specified by the CDPH equivalency instructions.
Recent Practice
Provide a paystub or W2 for compensated nursing-related work under a licensed health professional within the last two years; waived for current nursing students or a degree obtained within the last two years. For agency-paid facility work, obtain the facility confirmation letter.
Testing Approval
Obtain CDPH competency-evaluation approval and comply with the period in the approval letter. The general vendor attempt/time rules apply where based on a training completion date.
Initial certification by approved training and examination

At least one of the following alternatives:

  • All of the following:

  • All of the following:

    • California Nurse Aide Knowledge/Audio Exam (practice unavailable)
    • California Nurse Aide Manual Demonstration Skill Test (assessment without a question bank)
Criminal Clearance
Complete the CDPH criminal record review and maintain clearance; submit the prescribed fingerprint documentation.
Employment Before Certification
HSC 1337.5 identifies limited pre-certification employment categories; 22 CCR 71835(j) and 71837(b) require completion/certification within four months of employment. No separate temporary certificate is issued by those provisions.
Identity
Provide a Social Security number or Individual Taxpayer Identification Number under HSC section 1337.2(b).
Medical Screening
22 CCR 71835(f) requires a medical history, physical examination, tuberculosis screening and a signed report before patient-contact training. This health examination is an applicant condition.
Minimum Age
At least 16 years of age under HSC section 1337.2(a)(1).
Testing Window
Pass both examinations within two years of training completion; three attempts are allowed for each portion, after which retraining is required.
Training
Complete a CDPH-approved program with at least 60 classroom and 100 supervised clinical hours, including the statutory pre-contact orientation and abuse/rights training.
Training Credit
22 CCR 71835(d) credits portions of an approved California program completed within the previous two years; out-of-state or foreign course credit requires Department review of an original transcript.
Training Hours Rule Conflict
HSC 1337.1(b) and 1337.3(c) control the 60-hour classroom requirement. The older text in 22 CCR 71835(m)(2) states: (2) A minimum of fifty (50) hours of classroom instruction shall be conducted in either a nursing facility, an agency or a public educational institution.
Renewal within two years after expiration with renewal requirements met
No examination is required for this applicant pathway.
Application
Submit CDPH 283C with required education and employment documentation.
Continuing Education
Complete 48 hours of approved in-service training/continuing education within the certification period, at least 12 in each year; at most 24 may be approved online hours.
Criminal Clearance
Maintain the required criminal record clearance.
Employment
Provide compensated nursing or nursing-related services in a health care facility under a licensed health professional within the most recent certification period.
Regulation Difference
HSC 1337.6(a) and the current CDPH application use at least 12 hours in each year. The older 22 CCR 71839(b)(2) states: (2) An application is considered complete when the correct fee is received and the accompanying documentation verifies completion of required twenty- four (24) hours of in-service training or continuing education per year for a total of forty-eight (48) hours within the two (2) year renewal period. The in-service training and continuing education shall include multiple topics.
Renewal Time
Apply within two years after expiration with the requirements completed by expiration; no practice as a CNA until the certificate is renewed and active.

Official no-examination sources

Effective from 2026-09-22.

Reactivation when ordinary renewal requirements are unmet

At least one of the following alternatives:

  • All of the following:

  • All of the following:

    • California Nurse Aide Knowledge/Audio Exam (practice unavailable)
    • California Nurse Aide Manual Demonstration Skill Test (assessment without a question bank)
Certificate Status
Previously certified CNA who cannot meet one or both renewal requirements; certificate unexpired or expired no more than two years.
Criminal Clearance
Maintain criminal record clearance.
Department Approval
Submit CDPH 283C, question 6 Yes, and obtain CDPH examination approval.
Testing Window
Pass both written/knowledge and skills portions within two years of the certificate expiration date; CDPH permits application up to six months before expiration.
Certification by reciprocity from another U.S. state
No examination is required for this applicant pathway.
Application
Submit CDPH 283E and fingerprint documentation. CDPH 931 is required if the certificate cannot be verified online or CDPH requests it.
Criminal Clearance
Complete the CDPH criminal record review and maintain clearance; submit the prescribed fingerprint documentation.
Current Certificate
Hold an active CNA certification in good standing on another state registry; submit a copy or verifiable registry record.
Examination Exemption
CDPH 283E, B) Reciprocity expressly permits certification without CNA training or the Competency Evaluation; the other-state certificate is an applicant condition.
Identity
Provide a Social Security number or Individual Taxpayer Identification Number under HSC section 1337.2(b).
Minimum Age
At least 16 years of age under HSC section 1337.2(a)(1).
Recent Practice
If initially certified more than two years ago, provide compensated nursing-related facility work under a licensed health professional within the last two years; otherwise proof of work is waived. Staffing-agency pay requires a confirming facility letter.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement when the term of suspension expires
No examination is required for this applicant pathway.
Certificate Currency
A suspended certificate remains subject to expiration. If it expired, satisfy the separate applicable renewal/restoration route; renewal alone does not authorize practice during suspension.
Examination Scope
HSC 1337.9(i) defines reinstatement on expiration of suspension without a new examination requirement; any separate expired-certificate route retains its own examinations.
Suspension
The term of suspension has expired; the Department reinstates the certificate unless the person practiced as a CNA during suspension, in which case it revokes it.

Official no-examination sources

Effective from 2026-09-22.

Renewal of an unexpired certificate
No examination is required for this applicant pathway.
Application
Submit CDPH 283C with required education and employment documentation.
Continuing Education
Complete 48 hours of approved in-service training/continuing education within the certification period, at least 12 in each year; at most 24 may be approved online hours.
Criminal Clearance
Maintain the required criminal record clearance.
Employment
Provide compensated nursing or nursing-related services in a health care facility under a licensed health professional within the most recent certification period.
Regulation Difference
HSC 1337.6(a) and the current CDPH application use at least 12 hours in each year. The older 22 CCR 71839(b)(2) states: (2) An application is considered complete when the correct fee is received and the accompanying documentation verifies completion of required twenty- four (24) hours of in-service training or continuing education per year for a total of forty-eight (48) hours within the two (2) year renewal period. The in-service training and continuing education shall include multiple topics.
Renewal Time
Apply on or before the certificate expiration date; the renewal period is two years and expires on the certificate holder’s birthday.

Official no-examination sources

Effective from 2026-09-22.

Restoration more than four years after expiration

At least one of the following alternatives:

  • All of the following:

  • All of the following:

    • California Nurse Aide Knowledge/Audio Exam (practice unavailable)
    • California Nurse Aide Manual Demonstration Skill Test (assessment without a question bank)
Application
CDPH instructs submission of an initial application on enrollment and fingerprint documentation, followed by the competency evaluation.
Criminal Clearance
Complete the CDPH criminal record review and maintain clearance; submit the prescribed fingerprint documentation.
Current Department Instruction
CDPH Renewal FAQ, “My certificate has been expired for more than two years,” states: My certificate has been expired for more than two years, what do I do to become recertified? To obtain an active certificate, you must re-train through a CDPH-approved CNA training program. You must complete and submit the following to CDPH :  an Initial Application (CDPH 283B) , upon enrollment in the training program and prior to patient contact and a copy of the Request for Live Scan Service (BCIA 8016) form. Please also download the Request for Live Scan Service Sample (BCIA 8016 Sample) , which will show you how to correctly complete the BCIA 8016 form.  Once you have completed a CDPH-approved training program, you will need to successfully pass the Competency Evaluation.  If you successfully pass the Competency Evaluation, you must allow at least sixty (60) days for CDPH to receive your examination results from the testing vendor.​ ​
Department Discretion
HSC 1337.6(h) requires completion of a certification program unless the Department deems otherwise and the statutory conditions are met; subdivision (i) preserves the 75-hour competency-training renewal alternative. No circumstance may justify revocation or suspension for the discretionary exception.
Expiration
Certificate expired more than four years.
Identity
Provide a Social Security number or Individual Taxpayer Identification Number under HSC section 1337.2(b).
Minimum Age
At least 16 years of age under HSC section 1337.2(a)(1).
Statutory Training
HSC 1337.6(f) and (i) provide approved 75-hour competency evaluation training, a passed competency test and criminal clearance.
Testing Window
Complete the prescribed training and both current competency-evaluation examinations; general completion-date attempt and time rules apply.
Restoration more than two and no more than four years after expiration

At least one of the following alternatives:

  • All of the following:

  • All of the following:

    • California Nurse Aide Knowledge/Audio Exam (practice unavailable)
    • California Nurse Aide Manual Demonstration Skill Test (assessment without a question bank)
Application
CDPH instructs submission of an initial application on enrollment and fingerprint documentation, followed by the competency evaluation.
Criminal Clearance
Complete the CDPH criminal record review and maintain clearance; submit the prescribed fingerprint documentation.
Current Department Instruction
CDPH Renewal FAQ, “My certificate has been expired for more than two years,” states: My certificate has been expired for more than two years, what do I do to become recertified? To obtain an active certificate, you must re-train through a CDPH-approved CNA training program. You must complete and submit the following to CDPH :  an Initial Application (CDPH 283B) , upon enrollment in the training program and prior to patient contact and a copy of the Request for Live Scan Service (BCIA 8016) form. Please also download the Request for Live Scan Service Sample (BCIA 8016 Sample) , which will show you how to correctly complete the BCIA 8016 form.  Once you have completed a CDPH-approved training program, you will need to successfully pass the Competency Evaluation.  If you successfully pass the Competency Evaluation, you must allow at least sixty (60) days for CDPH to receive your examination results from the testing vendor.​ ​
Expiration
Certificate expired more than two and no more than four years.
Identity
Provide a Social Security number or Individual Taxpayer Identification Number under HSC section 1337.2(b).
Minimum Age
At least 16 years of age under HSC section 1337.2(a)(1).
Statutory Training
HSC 1337.6(f) and (i) provide approved 75-hour competency evaluation training, a passed competency test and criminal clearance.
Testing Window
Complete the prescribed training and both current competency-evaluation examinations; general completion-date attempt and time rules apply.

California Nurse Aide Knowledge/Audio Exam

Provider
D&S Diversified Technologies LLP – Headmaster LLP
Format
Computer-delivered multiple-choice knowledge examination; audio option available
Exam questions
75 multiple-choice questions
Time limit
60 minutes
Passing score
75% or better
Examination outline
  • Aging Process and Restorative Care (4 questions)
    • Aging Process and Restorative Care: Questions concerning the process and progression of humans becoming what they will be as they move along the timeline of their lives, and the maintenance of physical, mental, and psychosocial function.
  • Basic Nursing Skills (15 questions)
    • Basic Nursing Skills: Questions concerning any act or activity that would be considered a basic skill necessary to perform the job of a CNA.
  • Care Impaired (5 questions)
    • Care Impaired: Questions concerning dealing with residents who are physically or mentally limited from receiving “standard” care. CNAs must perform more extensively or differently to accommodate these residents.
  • Communication (5 questions)
    • Communication: Questions concerning any type of communication, verbal and nonverbal, written, spoken, or any communication related to hearing, seeing, feeling, tasting, or smelling.
  • Data Collection (4 questions)
    • Data Collection: Questions concerning data acquisition, handling, and routing.
  • Disease Process (4 questions)
    • Disease Process: Questions concerning the stages of diseases and/or the theory of diseases, and the detection, prevention, or treatment of diseases.
  • Infection Control (6 questions)
    • Infection Control: Questions concerning the nature of infections, infection causes and prevention, and correct methods and procedures for dealing with infections.
  • Mental Health (6 questions)
    • Mental Health: Questions concerning the mental processes of residents, the signs and stages of mental states of residents, both normal and care impaired, or the mental well-being and interaction of the CNA and their co-workers.
  • Personal Care (4 questions)
    • Personal Care: Questions concerning activities or acts performed by the CNA for or to residents that are personal in nature.
  • Resident Rights (8 questions)
    • Resident Rights: Questions concerning the rights to which the residents are legally entitled and the facility and CNA’s role in ensuring those rights.
  • Role and Responsibility (6 questions)
    • Role and Responsibility: Questions concerning any act or activity that would be considered part of the basic role of the CNA in the workplace or a basic responsibility of a CNA in the workplace.
  • Safety (8 questions)
    • Safety: Questions concerning the safety of residents, CNAs, facility safety issues, and the safety of facility personnel in general.
Examination sources

California Nurse Aide Manual Demonstration Skill Test

This assessment does not have a question bank.

Provider
D&S Diversified Technologies LLP – Headmaster LLP
Format
Observed manual demonstrations of nurse aide tasks
Time limit
30 minutes
Passing score
All critical steps and at least 80% of non-key steps on every assigned task
Examination outline
  • APPLY A KNEE-HIGH ANTI-EMBOLIC (ELASTIC) STOCKING TO A RESIDENT’S LEG
    • 1. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
    • 2. Explain the procedure to the resident.
    • 3. Raise bed height.
    • 4. Provide for the resident’s privacy.
    • 5. Provide for the resident's privacy by only exposing one leg.
    • 6. Roll, gather, or turn the stocking down inside out to at least the heel.
    • 7. Place the foot of the stocking over the resident's toes, foot, and heel.
    • 8. Roll -or- pull the top of the stocking over the resident’s foot, heel, and up the leg.
    • 9. Check toes for possible pressure from the stocking.
    • 10. Adjust the stocking as needed.
    • 11. Leave the resident with a stocking that is smooth/wrinkle-free.
    • 12. Lower bed.
    • 13. Place the call light or signal calling device within easy reach of the resident.
    • 14. Maintain respectful, courteous interpersonal interactions at all times.
    • 15. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
  • ASSIST A DEPENDENT RESIDENT WITH A MEAL IN BED
    • 1. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
    • 2. Explain the procedure to the resident.
    • 3. Ask the resident to state their name and verify that the name matches the name on the diet card.
    • 4. Position the resident in an upright, sitting position BEFORE feeding, at least 75-90 degrees.
    • 5. Protect clothing from soiling using a napkin, clothing protector, or towel.
    • 6. Provide hand hygiene for the resident BEFORE feeding. (Candidate may use a disposable wipe and dispose of it in a trash can, or wash the resident’s hands with soap and a wet washcloth, or they may rub hand sanitizer over all surfaces of the resident’s hands until dry.)
    • 7. Ensure the resident's hands are dry BEFORE feeding. (If a wet washcloth with soap was used, the candidate will need to dry the resident’s hands. If a disposable wipe or hand sanitizer was used, the hands must be dry.)
    • 8. Place soiled linen in a designated laundry hamper or dispose in an appropriate container if used.
    • 9. Sit in a chair, facing the resident, while feeding the resident.
    • 10. Describe the food and fluid being offered to the resident.
    • 11. Offer each fluid frequently.
    • 12. Offer small amounts of food at a reasonable rate.
    • 13. Allow resident time to chew and swallow.
    • 14. Wipe the resident's hands and mouth AFTER the feeding demonstration.
    • 15. Remove the clothing protector and place it in a designated laundry hamper. If a napkin is used, dispose of it in a trash container.
    • 16. Leave the resident sitting upright in bed with the head of the bed set up to at least 75-90 degrees.
    • 17. Record intake as a percentage of total solid food eaten on the previously signed recording form.
    • 18. The candidate's calculation must be within 25 percentage points of the RN Test Observer’s calculation.
    • 19. Record estimated intake as the sum total fluid consumed in mLs on the previously signed recording form.
    • 20. The candidate's calculation must be within 30mLs of the RN Test Observer's calculation.
    • 21. Place the call light or signaling device within easy reach of the resident.
    • 22. Maintain respectful, courteous interpersonal interactions at all times.
    • 23. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
  • ASSIST A RESIDENT TO AMBULATE USING A GAIT BELT
    • 1. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
    • 2. Explain the procedure to the resident.
    • 3. Obtain a gait belt for the resident.
    • 4. Assist the resident in putting on non-skid shoes/footwear.
    • 5. Adjust the bed height to ensure that the resident’s feet are flat on the floor when the resident is sitting on the edge of the bed.
    • 6. Lock the bed brakes to ensure the resident's safety.
    • 7. Lock wheelchair brakes to ensure the resident’s safety.
    • 8. Bring the resident to a sitting position.
    • 9. Place a gait belt around the resident’s waist to stabilize the trunk.
    • 10. Tighten the gait belt.
    • 11. Check the gait belt for tightness by slipping fingers between the gait belt and the resident.
    • 12. Face the resident.
    • 13. Grasp the gait belt on both sides with an upward grasp.
    • 14. Bring the resident to a standing position.
    • 15. Stabilize the resident.
    • 16. Ambulate the resident at least ten steps to the wheelchair.
    • 17. Assist the resident in pivoting/turning and sitting in the wheelchair in a controlled manner that ensures safety.
    • 18. Use proper body mechanics at all times.
    • 19. Remove gait belt.
    • 20. Place the call light or signaling device within easy reach of the resident.
    • 21. Maintain respectful, courteous interpersonal interactions at all times.
    • 22. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
  • ASSIST A RESIDENT WITH THE USE OF A BEDPAN, MEASURE AND RECORD URINE OUTPUT WITH HAND WASHING (One of the possible first mandatory tasks.)
    • 1. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
    • 2. Explain the procedure to the resident.
    • 3. Provide for the resident’s privacy.
    • 4. Put on gloves.
    • 5. Position the resident on the bedpan safely and correctly. (The pan is not upside down, it is centered, etc.)
    • 6. Raise the head of the bed to a comfortable level.
    • 7. Leave tissue within reach of the resident.
    • 8. Leave the call light or signaling device within reach of the resident.
    • 9. Step behind the privacy curtain to provide privacy for the resident.
    • 10. When the RN Test Observer indicates the candidate returns.
    • 11. Lower the head of the bed.
    • 12. Gently remove the bedpan.
    • 13. Hold the bedpan for the RN Test Observer while an unknown quantity of liquid is poured into the bedpan.
    • 14. Place the graduate on a designated level flat surface.
    • 15. Pour bedpan contents into the graduate.
    • 16. With the graduate at eye level, measure output.
    • 17. Empty the equipment into the designated toilet/commode.
    • 18. Rinse equipment used and empty rinse water into the designated toilet/commode.
    • 19. Return equipment to storage.
    • 20. Wash/assist the resident in washing and drying hands with soap and water.
    • 21. Place soiled linen in a designated laundry hamper.
    • 22. Remove gloves, turning them inside out as they are removed, and dispose of them in a trash container.
    • 23. Record output in mLs on the previously signed recording form.
    • 24. The candidate's recorded measurement is within 25mLs of the RN Test Observer's reading.
    • 25. Place the call light or signaling device within easy reach of the resident.
    • 26. Maintain respectful, courteous interpersonal interactions at all times.
    • 27. Turn on the water.
    • 28. Wet hands and wrists thoroughly.
    • 29. Apply soap to hands.
    • 30. Rub hands together using friction with soap.
    • 31. Scrub/wash hands together with soap for at least twenty (20) seconds.
    • 32. Scrub/wash with interlaced fingers pointing downward with soap.
    • 33. Wash all surfaces of your hands with soap.
    • 34. Wash wrists with soap.
    • 35. Clean fingernails by rubbing fingertips against the palm of the opposite hand.
    • 36. Rinse fingers, hands, and wrists thoroughly under running water with fingers pointed downward.
    • 37. Starting at the fingertips, dry fingers, hands, and wrists with a clean paper towel(s).
    • 38. Discard paper towels in a trash container as used.
    • 39. Turn off the faucet with a clean, dry paper towel and discard the paper towel in a trash container as used.
    • 40. Do not recontaminate hands at any time during the hand-washing procedure. (For example, do not touch the sides of the sink during the procedure or crumple up the paper towel used to turn off the faucet with both hands before discarding it.)
  • CATHETER CARE FOR A FEMALE RESIDENT WITH HAND WASHING (One of the possible first mandatory tasks.) [DEMONSTRATED ON A MANIKIN]
    • 1. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
    • 2. Explain the procedure to the resident.
    • 3. Provide for the resident’s privacy.
    • 4. Fill a basin with comfortably warm water.
    • 5. Put on gloves.
    • 6. Expose the area surrounding the catheter, only exposing the resident between the hip and knee.
    • 7. Hold the catheter where it exits the urethra with one hand.
    • 8. While holding the catheter, clean at least 3-4 inches down the drainage tube.
    • 9. Clean with strokes only away from the urethra.
    • 10. Use a clean portion of the washcloth for each stroke.
    • 11. While holding the catheter, rinse at least 3-4 inches down the drainage tube.
    • 12. Rinse using strokes only away from the urethra.
    • 13. Rinse using a clean portion of the washcloth for each stroke.
    • 14. Pat dry, does not air or wipe dry.
    • 15. Do not allow the tube to be tugged/pulled at any time during the procedure.
    • 16. Replace the top cover over the resident.
    • 17. Place soiled linen in a designated laundry.
    • 18. Empty equipment.
    • 19. Rinse equipment.
    • 20. Dry equipment.
    • 21. Return equipment to storage.
    • 22. Remove gloves, turning them inside out as they are removed, and dispose in a trash container.
    • 23. Place the call light or signaling device within easy reach of the resident.
    • 24. Maintain respectful, courteous interpersonal interactions at all times.
    • 25. Turn on the water.
    • 26. Wet hands and wrists thoroughly.
    • 27. Apply soap to hands.
    • 28. Rub hands together using friction with soap.
    • 29. Scrub/wash hands together with soap for at least twenty (20) seconds.
    • 30. Scrub/wash with interlaced fingers pointing downward with soap.
    • 31. Wash all surfaces of your hands with soap.
    • 32. Wash wrists with soap.
    • 33. Clean fingernails by rubbing fingertips against the palm of the opposite hand.
    • 34. Rinse fingers, hands, and wrists thoroughly under running water with fingers pointed downward.
    • 35. Starting at the fingertips, dry fingers, hands, and wrists with a clean paper towel(s).
    • 36. Discard paper towels in a trash container as used.
    • 37. Turn off the faucet with a clean, dry paper towel and discard the paper towel in a trash container as used.
    • 38. Do not recontaminate hands at any time during the hand-washing procedure. (For example, do not touch the sides of the sink during the procedure or crumple up the paper towel used to turn off the faucet with both hands before discarding it.)
  • DENTURE CARE – CLEAN AN UPPER OR LOWER DENTURE [ONLY ONE PLATE IS USED FOR TESTING]
    • 1. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
    • 2. Explain the procedure to the resident.
    • 3. Line the bottom of the sink with a protective lining that will help prevent damage to the dentures. (Towels, washcloths, or paper towels are all acceptable.)
    • 4. Put on gloves.
    • 5. Apply denture cleanser (paste) to denture brush (or toothbrush).
    • 6. Remove the denture from the cup.
    • 7. Handle the denture carefully to avoid damage.
    • 8. Rinse the denture under cool running water before brushing.
    • 9. Thoroughly brush the inner surfaces of an upper or lower denture.
    • 10. Thoroughly brush the outer surfaces of an upper or lower denture.
    • 11. Thoroughly brush the chewing surfaces of an upper or lower denture.
    • 12. Rinse all surfaces of the denture under cool running water after brushing.
    • 13. Rinse the denture cup and lid.
    • 14. Place the denture in the rinsed cup.
    • 15. Add cool, clean water to the denture cup and replace the lid on the denture cup.
    • 16. Rinse equipment.
    • 17. Return equipment to storage.
    • 18. Discard the sink protective lining in an appropriate container.
    • 19. Remove gloves, turning them inside out as they are removed, and dispose of them in a trash container.
    • 20. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
    • 21. Place the call light or signaling device within easy reach of the resident.
    • 22. Maintain respectful, courteous interpersonal interactions at all times.
  • DON (PUT ON A GOWN AND GLOVES), EMPTY A URINARY DRAINAGE BAG, MEASURE AND RECORD URINE OUTPUT, AND DOFF (REMOVE) THE GOWN AND GLOVES WITH HAND WASHING (One of the possible first mandatory tasks.)
    • 1. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
    • 2. Unfold the gown.
    • 3. Face the back opening of the gown.
    • 4. Place arms through each sleeve.
    • 5. Secure the neck opening.
    • 6. Secure the gown at the waist, ensuring the back flaps cover the clothing as completely as possible.
    • 7. Put on gloves.
    • 8. The cuffs of the gloves overlap the cuffs of the gown.
    • 9. Explain the procedure to the resident.
    • 10. Provide for the resident’s privacy.
    • 11. Place a barrier on the floor under the drainage bag.
    • 12. Place the graduate on the previously placed barrier.
    • 13. Open the drain to allow the urine to flow into the graduate until the bag is completely empty.
    • 14. Avoid touching the graduate with the tip of the tubing.
    • 15. Close the drain.
    • 16. Wipe the drain with an alcohol wipe AFTER emptying the drainage bag.
    • 17. Place the graduate on a level, flat surface.
    • 18. With the graduate at eye level, measure output.
    • 19. Empty the graduate into the designated toilet/commode.
    • 20. Rinse equipment, emptying rinse water into the designated toilet/commode.
    • 21. Return equipment to storage.
    • 22. Record the output in mLs on the previously signed recording form.
    • 23. The candidate's recorded measurement is within 25mLs of the RN Test Observer's measurement.
    • 24. Place the call light or signaling device within easy reach of the resident.
    • 25. Maintain respectful, courteous interpersonal interactions at all times.
    • 26. Remove gloves BEFORE removing the gown.
    • 27. With one gloved hand, grasp the other glove at the palm to remove.
    • 28. Slip fingers from the ungloved hand underneath the cuff of the remaining glove at the wrist and remove the glove, turning it inside out as it is removed.
    • 29. Dispose of gloves in the trash container without contaminating yourself.
    • 30. Unfasten the gown at the waist.
    • 31. Unfasten the gown at the neck.
    • 32. Remove the gown without touching the outside of the gown.
    • 33. While removing the gown, turn the gown inward and keep it inside out.
    • 34. Dispose of the gown in a designated container without contaminating yourself.
    • 35. Turn on the water.
    • 36. Wet hands and wrists thoroughly.
    • 37. Apply soap to hands.
    • 38. Rub hands together using friction with soap.
    • 39. Scrub/wash hands together with soap for at least twenty (20) seconds.
    • 40. Scrub/wash with interlaced fingers pointing downward with soap.
    • 41. Wash all surfaces of hands with soap.
    • 42. Wash wrists with soap.
    • 43. Clean fingernails by rubbing fingertips against the palm of the opposite hand.
    • 44. Rinse fingers, hands, and wrists thoroughly under running water with fingers pointed downward.
    • 45. Starting at the fingertips, dry fingers, hands, and wrists with a clean paper towel(s).
    • 46. Discard paper towels in a trash container as used.
    • 47. Turn off the faucet with a clean, dry paper towel and discard the paper towel in a trash container as used.
    • 48. Do not recontaminate hands at any time during the hand-washing procedure. (For example, do not touch the sides of the sink during the procedure or crumple up the paper towel used to turn off the faucet with both hands before discarding it.)
  • DRESS A RESIDENT WITH AN AFFECTED (WEAK) SIDE IN BED
    • 1. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
    • 2. Explain the procedure to the resident.
    • 3. Provide for the resident’s privacy.
    • 4. Raise bed height.
    • 5. Keep the resident covered while removing the gown.
    • 6. Remove the gown from the unaffected side first.
    • 7. Place the soiled gown in a designated laundry hamper.
    • 8. Dress the resident in a button-up shirt. Insert your hand into the sleeve of the shirt and grasp the resident's hand.
    • 9. When dressing the resident in a button-up shirt, always dress from the affected (weak) side first.
    • 10. Assist the resident to raise their buttocks or turn the resident from side to side and draw the pants over the buttocks and up to the resident's waist.
    • 11. When dressing the resident in pants, always dress the affected (weak) side leg first.
    • 12. Put on the resident's socks. Draw the socks up the resident's foot until they are smooth.
    • 13. Leave the resident comfortably/properly dressed (pants pulled up to the waist front and back and shirt completely buttoned).
    • 14. Lower bed.
    • 15. Place the call light or signaling device within easy reach of the resident.
    • 16. Maintain respectful, courteous interpersonal interactions at all times.
    • 17. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
  • FOOT CARE - ONE FOOT
    • 1. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
    • 2. Explain the procedure to the resident.
    • 3. Fill a basin with comfortably warm water.
    • 4. Remove a sock from the resident’s (right/left) foot. (The scenario read to you will specify right or left.)
    • 5. Immerse the resident’s foot in warm water.
    • 6. You MUST verbalize the 5 to 20 minutes of soaking time after you begin soaking the foot. Use water and a soapy washcloth.
    • 7. Wash the entire foot.
    • 8. Wash between toes.
    • 9. Rinse the entire foot.
    • 10. Rinse between toes.
    • 11. Dry foot thoroughly.
    • 12. Dry thoroughly between toes.
    • 13. Apply lotion to the top and bottom of the foot.
    • 14. Avoid getting lotion between the resident’s toes.
    • 15. If any excess lotion is on the foot, wipe with a towel/washcloth.
    • 16. Replace the sock on the resident’s foot.
    • 17. Empty equipment.
    • 18. Rinse equipment.
    • 19. Dry equipment.
    • 20. Return equipment to storage.
    • 21. Placed soiled linens in a designated laundry hamper.
    • 22. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry
    • 23. Place the call light or signaling device within easy reach of the resident.
    • 24. Maintain respectful, courteous interpersonal interactions at all times.
  • MODIFIED BED BATH- FACE AND ONE ARM, HAND AND UNDERARM
    • 1. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
    • 2. Explain the procedure to the resident.
    • 3. Provide for the resident’s privacy.
    • 4. Raise bed height.
    • 5. Cover the resident with a bath blanket.
    • 6. Remove the remaining top covers. Fold to the bottom of the bed or place aside.
    • 7. Remove the resident's gown without exposing the resident and place the soiled gown in a designated laundry hamper.
    • 8. Fill a basin with comfortably warm water.
    • 9. Beginning with the eyes, wash eyes WITHOUT SOAP using a clean portion of the washcloth for each stroke, washing from the inner aspect to the outer aspect.
    • 10. Wash the resident’s face WITHOUT SOAP.
    • 11. Pat dry face.
    • 12. Place a towel under the resident’s arm, exposing one arm.
    • 13. Wash the resident’s arm with soap.
    • 14. Wash the resident’s hand with soap.
    • 15. Wash the resident’s underarm with soap.
    • 16. Rinse arm.
    • 17. Rinse hand.
    • 18. Rinse underarm.
    • 19. Pat dry arm.
    • 20. Pat dry hand.
    • 21. Pat dry underarm.
    • 22. Assist the resident in putting on a clean gown.
    • 23. Empty equipment.
    • 24. Rinse equipment.
    • 25. Dry equipment.
    • 26. Return equipment to storage.
    • 27. Place soiled linen in a designated laundry hamper.
    • 28. Lower bed.
    • 29. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
    • 30. Place the call light or signaling device within easy reach of the resident.
    • 31. Maintain respectful, courteous interpersonal interactions at all times.
  • MOUTH CARE—BRUSH A RESIDENT’S TEETH
    • 1. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
    • 2. Explain the procedure to the resident.
    • 3. Provide for the resident’s privacy.
    • 4. Drape the resident's chest with a towel to prevent soiling.
    • 5. Put on gloves BEFORE cleaning the resident’s mouth.
    • 6. Wet the toothbrush and apply a small amount of toothpaste.
    • 7. Gently brush the inner surfaces of the resident’s upper and lower teeth.
    • 8. Gently brush the outer surfaces of the resident’s upper and lower teeth.
    • 9. Gently brush the chewing surfaces of the resident’s upper and lower teeth.
    • 10. Gently brush the resident's tongue.
    • 11. Assist the resident in rinsing their mouth.
    • 12. Wipe the resident's mouth.
    • 13. Remove soiled linen.
    • 14. Place soiled linen in the designated laundry hamper.
    • 15. Empty container. (The container may be an emesis basin or a disposable cup.)
    • 16. Rinse the emesis basin, if used, or discard disposable items in a trash can.
    • 17. Dry emesis basin, if used.
    • 18. Rinse the toothbrush.
    • 19. Return equipment to storage.
    • 20. Remove gloves, turning them inside out as they are removed, and dispose of them in a trash container.
    • 21. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
    • 22. Place the call light or signaling device within easy reach of the resident.
    • 23. Maintain respectful, courteous interpersonal interactions at all times.
  • PASSIVE RANGE OF MOTION FOR A RESIDENT’S HIP AND KNEE
    • 1. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
    • 2. Explain the procedure to the resident.
    • 3. Provide for the resident’s privacy.
    • 4. Raise bed height.
    • 5. Position the resident supine (bed flat).
    • 6. Correctly support joints at all times by placing one hand under the resident’s knee and the other hand under the resident’s ankle.
    • 7. Gently move the resident’s entire leg away from the body. a. Abduction
    • 8. Gently return the resident’s leg toward the body. a. Adduction
    • 9. Gently complete abduction and adduction of the hip at least three times.
    • 10. Correctly support joints at all times by placing one hand under the resident’s knee and the other hand under the resident’s ankle.
    • 11. Gently bend the resident’s knee and hip toward the resident’s trunk. a. Flexion of the hip and knee at the same time.
    • 12. Gently straighten the resident’s knee and hip. a. Extension of the hip and knee at the same time.
    • 13. Gently complete flexion and extension of the knee and hip at least three times.
    • 14. Do not force any joint beyond the point of free movement.
    • 15. The candidate must ask at least once during the PROM exercise if there is/was any discomfort/pain.
    • 16. Lower bed.
    • 17. Place the call light or signaling device within easy reach of the resident.
    • 18. Maintain respectful, courteous interpersonal interactions at all times.
    • 19. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
  • PASSIVE RANGE OF MOTION FOR A RESIDENT’S SHOULDER
    • 1. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
    • 2. Explain the procedure to the resident.
    • 3. Provide for the resident’s privacy.
    • 4. Raise bed height.
    • 5. Position the resident supine (bed flat).
    • 6. Correctly support joints at all times by placing one hand under the resident’s elbow and the other hand under the resident’s wrist.
    • 7. Gently raise the resident's straightened arm up and over the resident's head to ear level. a. Flexion
    • 8. Gently bring the resident's arm back down to the side of the resident's body. a. Extension
    • 9. Gently complete flexion and extension of the shoulder at least three times.
    • 10. Continue the same support for the shoulder joints by placing one hand under the resident’s elbow and the other hand under the resident’s wrist.
    • 11. Gently move the resident's entire arm away from the side of the resident’s body to shoulder level. a. Abduction
    • 12. Gently return the resident’s arm to the side of the resident's body. a. Adduction
    • 13. Gently complete abduction and adduction of the shoulder at least three times.
    • 14. Do not force any joint beyond the point of free movement.
    • 15. The candidate must ask at least once during the ROM exercise if there is/was any discomfort/pain.
    • 16. Lower bed.
    • 17. Place the call light or signaling device within easy reach of the resident.
    • 18. Maintain respectful, courteous interpersonal interactions at all times.
    • 19. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
  • PERINEAL CARE FOR A FEMALE RESIDENT WITH HAND WASHING (One of the possible first mandatory tasks.) [DEMONSTRATED ON A MANIKIN]
    • 1. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
    • 2. Explain the procedure to the resident.
    • 3. Provide for the resident’s privacy.
    • 4. Fill a basin with comfortably warm water.
    • 5. Raise bed height.
    • 6. Put on gloves.
    • 7. Turn the resident or raise the hips and place a waterproof pad under the resident’s buttocks.
    • 8. Expose the perineal area only.
    • 9. Separate the labia. (It is helpful if you verbalize separating the labia as you demonstrate separating the labia.)
    • 10. Use water and a soapy washcloth (peri-wash or no-rinse soap is not allowed).
    • 11. Clean one side of the labia from front to back.
    • 12. Use a clean portion of the washcloth and clean the other side of the labia from front to back.
    • 13. Use a clean portion of the washcloth, and clean the vaginal area from front to back.
    • 14. Use a clean washcloth with water and rinse from one side of the labia from front to back.
    • 15. Use a clean portion of the washcloth and rinse the other side of the labia from front to back.
    • 16. Use a clean portion of the washcloth, rinse the vaginal area from front to back.
    • 17. Pat dry, does not air or wipe dry.
    • 18. Assist the resident (manikin) to turn onto the side, away from the candidate, toward the center of the bed.
    • 19. Use a clean washcloth with water and soap (peri-wash or no-rinse soap is not allowed).
    • 20. Wash from the vagina to the rectal area.
    • 21. Use a clean portion of the washcloth with any stroke.
    • 22. Use a clean washcloth with water and rinse the rectal area from front to back.
    • 23. Use a clean portion of the washcloth with any stroke.
    • 24. Pat dry, does not air or wipe dry.
    • 25. Safely remove the waterproof pad from under the resident’s buttocks.
    • 26. Position the resident on its back.
    • 27. Place soiled linen in a designated laundry hamper.
    • 28. Empty equipment.
    • 29. Rinse equipment.
    • 30. Dry equipment.
    • 31. Return equipment to storage.
    • 32. Remove gloves, turning them inside out as they are removed, and dispose of them in a trash container.
    • 33. Lower bed.
    • 34. Place the call light or signaling device within easy reach of the resident.
    • 35. Maintain respectful, courteous interpersonal interactions at all times.
    • 36. Turn on the water.
    • 37. Wet hands and wrists thoroughly.
    • 38. Apply soap to hands.
    • 39. Rub hands together using friction with soap.
    • 40. Scrub/wash hands together with soap for at least twenty (20) seconds.
    • 41. Scrub/wash with interlaced fingers pointing downward with soap.
    • 42. Wash all surfaces of your hands with soap.
    • 43. Wash wrists with soap.
    • 44. Clean fingernails by rubbing fingertips against the palm of the opposite hand.
    • 45. Rinse fingers, hands, and wrists thoroughly under running water with fingers pointed downward.
    • 46. Starting at the fingertips, dry fingers, hands, and wrists with a clean paper towel(s).
    • 47. Discard paper towels in a trash container as used.
    • 48. Turn off the faucet with a clean, dry paper towel and discard the paper towel in a trash container as used.
    • 49. Do not recontaminate hands at any time during the hand-washing procedure. (For example, do not touch the sides of the sink during the procedure or crumple up the paper towel used to turn off the faucet with both hands before discarding it.)
  • POSITION A RESIDENT IN BED ON THEIR SIDE
    • 1. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
    • 2. Explain the procedure to the resident.
    • 3. Provide for the resident’s privacy.
    • 4. Position the bed flat.
    • 5. Raise bed height.
    • 6. Raise the side rail or direct the RN Test Observer to stand on the side of the bed opposite the working side to provide safety.
    • 7. From the working side of the bed – gently move the resident's upper body toward yourself.
    • 8. From the working side of the bed – gently move the resident's hips toward yourself.
    • 9. From the working side of the bed – gently move the resident's legs toward yourself.
    • 10. Gently assist/turn the resident to slowly roll onto the side toward the raised side rail or toward the RN Test Observer standing at the side of the bed.
    • 11. Place or adjust the pillow under the resident’s head for support.
    • 12. Reposition the resident’s arm and shoulder so that the resident is not lying on their arm.
    • 13. Place a support device under the resident's upside arm.
    • 14. Place a support device behind the resident’s back.
    • 15. Place a support device between the resident’s knees.
    • 16. Lower bed.
    • 17. Place the call light or signaling device within easy reach of the resident.
    • 18. Maintain respectful, courteous interpersonal interactions at all times.
    • 19. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
  • TRANSFER A RESIDENT FROM THEIR BED TO A WHEELCHAIR USING A GAIT BELT
    • 1. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
    • 2. Explain the procedure to the resident.
    • 3. Provide for the resident’s privacy.
    • 4. Obtain a gait belt for the resident.
    • 5. Position the wheelchair at the head of the bed or the foot of the bed.
    • 6. Assist the resident in putting on non-skid shoes/footwear.
    • 7. Adjust the bed height to ensure that the resident’s feet are flat on the floor when the resident is sitting on the edge of the bed.
    • 8. Lock the bed brakes to ensure the resident's safety.
    • 9. Lock wheelchair brakes to ensure the resident’s safety.
    • 10. Bring the resident to a sitting position.
    • 11. Place a gait belt around the resident’s waist to stabilize the trunk.
    • 12. Tighten the gait belt.
    • 13. Check the gait belt for tightness by slipping fingers between the gait belt and the resident.
    • 14. Face the resident.
    • 15. Grasp the gait belt on both sides with an upward grasp.
    • 16. Bring the resident to a standing position.
    • 17. Assist the resident to pivot in a controlled manner that ensures safety.
    • 18. Lower the resident into the wheelchair in a controlled manner that ensures safety.
    • 19. Position the resident with the resident’s hips touching the back of the wheelchair.
    • 20. Remove the gait belt.
    • 21. Place the call light or signaling device within easy reach of the resident.
    • 22. Maintain respectful, courteous interpersonal interactions at all times.
    • 23. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
  • VITAL SIGNS – COUNT AND RECORD THE RESIDENT’S RADIAL PULSE AND RESPIRATION
    • 1. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
    • 2. Explain the procedure to the resident.
    • 3. Locate the resident’s radial pulse by placing fingertips on the thumb side of the resident's wrist.
    • 4. Count the resident’s radial pulse for one full minute. a. Tell the RN Test Observer when you start counting and tell them when you stop counting.
    • 5. Record your radial pulse rate reading on the previously signed recording form.
    • 6. The candidate’s recorded radial pulse rate is within four (4) beats of the RN Test Observer's recorded rate.
    • 7. Count the resident’s respiration for one full minute. a. Tell the RN Test Observer when you start counting and tell them when you stop counting.
    • 8. Record the resident’s respiration reading on the previously signed recording form.
    • 9. The candidate’s recorded respiratory rate is within two (2) breaths of the RN Test Observer's recorded rate.
    • 10. Place the call light or signaling device within easy reach of the resident.
    • 11. Maintain respectful, courteous interpersonal interactions at all times.
    • 12. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
  • VITAL SIGNS – TAKE AND RECORD THE RESIDENT’S MANUAL BLOOD PRESSURE
    • 1. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
    • .2 Explain the procedure to the resident.
    • 3. Provide for the resident's privacy.
    • 4. Position the resident with the forearm supported in a palm-up position.
    • 5. Position the resident with the forearm approximately at the heart level.
    • 6. Roll the resident's sleeve up about 5 inches above the elbow if the actor is wearing a top with sleeves.
    • 7. Apply the appropriate size cuff around the resident's upper arm just above the elbow.
    • 8. Line cuff arrows up with the resident's brachial artery.
    • .9 Clean the earpieces of the stethoscope and place the stethoscope earpieces in your ears.
    • 10. Clean the diaphragm of the stethoscope.
    • 11. Locate the resident's brachial artery with your fingertips.
    • 12. Place the stethoscope diaphragm over the brachial artery.
    • 13. Hold the stethoscope diaphragm snugly in place.
    • 14. Inflate the cuff to 160-180 mmHg.
    • 15. Slowly release air from the cuff until the disappearance of pulsations.
    • 16. Remove cuff. a. If needed, the candidate will be allowed a maximum of three attempts (including any re-attempts or corrections). → Switching arms between attempts is recommended. b. The RN Test Observer will inform the candidate when they have reached their three attempts and state, “You have reached three attempts; please move forward with your task.”
    • 17. Record the blood pressure reading on the previously signed recording form.
    • 18. The candidate’s recorded diastolic and systolic blood pressure are within 6 mmHg of the RN Test Observer’s recorded blood pressure.
    • 19. Place the call light or signaling device within easy reach of the resident.
    • 20. Maintain respectful, courteous interpersonal interactions at all times.
    • 21. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer. b. Rub your hands together until they are completely dry.
Examination sources

National Nurse Aide Assessment Program (NNAAP) Skills Evaluation

This assessment does not have a question bank.

Provider
Credentia Nurse Aide LLC (develops and manages the NNAAP exam); administered by Credentia at test centers
Format
Performance evaluation at a test center, scored and retaken separately from the Written (or Oral) Examination: the candidate performs five skills on a candidate volunteer acting as the client and is rated by a Nurse Aide Evaluator; each skill is scored Satisfactory or Unsatisfactory and all five must be Satisfactory to pass
Time limit
30 minutes
Examination sources

NNAAP Written (or Oral) Examination

Provider
Credentia Nurse Aide LLC (develops and manages the NNAAP exam); administered by Credentia online or at test centers
Format
Multiple-choice examination taken online or at a test center, in English or Spanish, scored and retaken separately from the Skills Evaluation; candidates may choose the Oral Examination form, in which the multiple-choice questions are read aloud by recorded voice (MP3 player at test centers) and ten reading comprehension (word recognition) questions are added, and both Oral sections must be passed
Exam questions
70 multiple-choice items: 60 scored and 10 pretest (non-scored); the Oral form has 60 multiple-choice items and 10 reading comprehension (word recognition) items
Time limit
2 hours
Examination outline
  • I. Physical Care Skills — A. Activities of Daily Living (22% of the exam; 13 questions) (22%)
    • Activities of Daily Living — 1. Hygiene
    • Activities of Daily Living — 2. Dressing and Grooming
    • Activities of Daily Living — 3. Nutrition and Hydration
    • Activities of Daily Living — 4. Elimination
    • Activities of Daily Living — 5. Rest/Sleep/Comfort
  • I. Physical Care Skills — B. Basic Nursing Skills (35% of the exam; 21 questions) (35%)
    • Basic Nursing Skills — 1. Infection Control
    • Basic Nursing Skills — 2. Safety/Emergency
    • Basic Nursing Skills — 3. Therapeutic/Technical Procedures
    • Basic Nursing Skills — 4. Data Collection and Reporting
  • I. Physical Care Skills — C. Self-Care and Independence (7% of the exam; 4 questions) (7%)
    • Self-Care and Independence
  • II. Psychosocial Care Skills — A. Emotional and Mental Health Needs (8% of the exam; 5 questions) (8%)
    • Emotional and Mental Health Needs
  • II. Psychosocial Care Skills — B. Spiritual and Cultural Needs (2% of the exam; 1 question) (2%)
    • Spiritual and Cultural Needs
  • III. Role of the Nurse Aide — A. Communication (7% of the exam; 4 questions) (7%)
    • Communication
  • III. Role of the Nurse Aide — B. Client Rights (8% of the exam; 5 questions) (8%)
    • Client Rights
  • III. Role of the Nurse Aide — C. Legal and Ethical Behavior (5% of the exam; 3 questions) (5%)
    • Legal and Ethical Behavior
  • III. Role of the Nurse Aide — D. Member of the Health Care Team (6% of the exam; 4 questions) (6%)
    • Member of the Health Care Team
Examination sources