Free NNAAP Written (or Oral) Examination Practice Questions

Sample Practice Questions

Try these 10 sample questions from the NNAAP Written (or Oral) Examination practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1A nurse aide is giving a resident a partial bed bath and begins with the face. How should the nurse aide wash the resident's eyes?

   1. A. Wet washcloth without soap, wiping from the inner to the outer corner, using a clean area of the cloth for each stroke
   2. B. Soapy washcloth, wiping from the outer to the inner corner, rinsing the cloth in the basin between the two eyes
   3. C. Wet washcloth without soap, wiping from the outer to the inner corner, using the same area of the cloth for both eyes
   4. D. Soapy washcloth, wiping from the inner to the outer corner, then rinsing both eyes with a second clean washcloth

   Answer: A

   Explanation: The NNAAP skills listing for the modified bed bath states: "Beginning with eyes, washes eyes with wet washcloth (no soap), using a different area of the washcloth for each stroke, washing inner aspect to outer aspect then proceeds to wash face." Soap is left out because it irritates the eyes, and wiping inner to outer with a fresh area of cloth for each stroke keeps drainage away from the tear duct and avoids carrying material from one eye to the other.

   Reference: Credentia — Pennsylvania NNAAP Candidate Handbook: Skills — Skill 11 — Gives Modified Bed Bath, eye-washing step

2. 2After cleaning a resident who was incontinent of stool, a nurse aide removes her gloves and sees stool on her wrist. How should she clean her hands?

   1. A. Use alcohol-based hand rub, because it kills more germs than soap
   2. B. Wipe with a disposable washcloth and then put on a new pair of gloves
   3. C. Rinse under warm running water only, because soap dries the skin
   4. D. Wash with soap and water, because her hands are visibly soiled

   Answer: D

   Explanation: CDC states: "Unless hands are visibly soiled, ABHS is preferred over soap and water in most clinical situations". Alcohol-based hand sanitizer is the usual choice, but visibly soiled hands are the exception and must be washed with soap and water.

   Reference: CDC — Clinical Safety: Hand Hygiene for Healthcare Workers — Know when to use alcohol-based hand sanitizer (ABHS) versus soap and water

3. 3A resident recovering from a stroke can wash his face and chest but is slow. The nurse aide is behind schedule. What approach supports his independence?

   1. A. Wash him completely herself today to make up for lost time
   2. B. Skip his bath today and let him wash himself fully tomorrow
   3. C. Encourage him to wash the parts he can and help only with the rest
   4. D. Ask a coworker to bathe him so that she can finish on time

   Answer: C

   Explanation: The CMS ADL pathway asks whether "staff encourage the resident to perform ADLs or participate as much as the resident is able?" Doing the whole task for him, even to save time, takes away abilities he still has.

   Reference: CMS — Activities of Daily Living (ADL) Critical Element Pathway (Form CMS-20066) — Observation — ADLs by CNA, restorative, or therapy

4. 4A resident with dementia repeatedly pulls at her clothes and calls out in the afternoon. How does the CMS Hand in Hand training ask nurse aides to view this kind of behavior?

   1. A. As a bad habit that should be ignored so it is not rewarded
   2. B. As a form of communication that may be telling staff about a need
   3. C. As a sign of a bad temper that calls for firm correction each time
   4. D. As part of dementia that has no cause and that cannot be changed

   Answer: B

   Explanation: Hand in Hand teaches: "Behavior, or how a person acts, is a form of communication." It adds that it is important "to look at all the possible reasons behind a person with dementia’s actions to understand what the person might be trying to tell us."

   Reference: CMS — Hand in Hand: A Training Series for Nursing Homes, Instructor's Guide — Module 3: Being with a Person with Dementia: Actions and Reactions — introduction

5. 5A resident asks the nurse aide for help getting to the weekly religious service held in the facility's chapel. The aide had planned to give her shower at that time. What should the aide do?

   1. A. Give the shower first, since personal care takes priority over activities
   2. B. Help her attend the service and arrange her shower for another time she prefers
   3. C. Tell her she may attend only if she finishes her shower before it starts
   4. D. Suggest she watch a service on TV instead so the schedule is not disrupted

   Answer: B

   Explanation: Federal resident rights state: "The resident has a right to participate in other activities, including social, religious, and community activities that do not interfere with the rights of other residents in the facility." Care schedules are adjusted to support her religious participation.

   Reference: CMS State Operations Manual Appendix PP — Guidance to Surveyors for Long Term Care Facilities — F561, §483.10(f)(8)

6. 6A nurse aide is about to help a resident with range-of-motion exercises. How should she explain the procedure?

   1. A. Explain it quickly from the doorway so the resident knows care is starting
   2. B. Explain it while standing behind her as you position her leg
   3. C. Speak clearly, slowly, and directly, keeping face-to-face contact when possible
   4. D. Skip the explanation, since the resident has had this exercise before

   Answer: C

   Explanation: Each NNAAP skill begins: "Explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible." Face-to-face explanation helps the resident understand and take part in care.

   Reference: Credentia — Pennsylvania NNAAP Candidate Handbook: Skills — Skills 2-22 — opening step (e.g., Skill 15)

7. 7A nurse aide arrives to help a resident get ready for bed. The door to the resident's room is closed. What should the aide do?

   1. A. Open the door quietly so she does not wake him
   2. B. Knock and ask permission before entering the room
   3. C. Walk in, since staff may enter rooms during care
   4. D. Knock once and then enter without waiting at all

   Answer: B

   Explanation: CMS lists as an example of dignity: "Protecting and valuing residents’ private space (for example, knocking on doors and requesting permission before entering, closing doors as requested by the resident);". A resident's room is his private space.

   Reference: CMS State Operations Manual Appendix PP — Guidance to Surveyors for Long Term Care Facilities — F550, Guidance — examples of treating residents with dignity

8. 8A nurse aide angrily shoves a resident back into her chair. Later she says she never meant to hurt her. Under the federal definition of abuse, what does "willful" mean?

   1. A. The aide intended to cause injury, so an action without that intent is never abuse
   2. B. The aide acted deliberately, whether or not she intended to cause injury or harm
   3. C. The aide acted while the resident was able to understand and report what happened
   4. D. The aide acted in front of at least one other staff member or a visitor who saw it

   Answer: B

   Explanation: The federal definition states: "Willful, as used in this definition of abuse, means the individual must have acted deliberately, not that the individual must have intended to inflict injury or harm." A deliberate shove can be abuse even if the aide says she did not mean to hurt the resident.

   Reference: CMS State Operations Manual Appendix PP — Guidance to Surveyors for Long Term Care Facilities — F540, §483.5 Definitions — Abuse

9. 9Under federal rules, which member of the nursing staff must be part of the interdisciplinary team that prepares a resident's comprehensive care plan, along with the attending physician and a registered nurse?

   1. A. Any nurse aide assigned to the facility that week
   2. B. The nurse aide with the most years of experience
   3. C. A nurse aide from a different unit for objectivity
   4. D. A nurse aide with responsibility for the resident

   Answer: D

   Explanation: The regulation states the care plan must be "Prepared by an interdisciplinary team, that includes but is not limited to—" the attending physician, a registered nurse with responsibility for the resident, and "A nurse aide with responsibility for the resident." The aide who gives daily care knows the resident's routines, abilities, and preferences.

   Reference: eCFR — 42 CFR Part 483, Requirements for States and Long Term Care Facilities — 42 CFR 483.21(b)(2)(ii)

10. 10A nurse aide is washing the feet of a resident who has diabetes and reduced feeling in both feet. Which washing practice is safest?

    1. A. Soak the feet in warm, soapy water for about 20 minutes to soften dry skin before washing
    2. B. Wash the feet in hot water so that circulation to the toes improves before lotion is applied
    3. C. Wash the feet with soap in warm water that has been tested first, without soaking them
    4. D. Soak the feet in cool water for about 10 minutes, then wash them with a dry, soapy cloth

    Answer: C

    Explanation: NIDDK foot-care guidance says: "Wash your feet with soap in warm, not hot, water." It adds that the water should be tested and warns: "Do not soak your feet because your skin will get too dry." A resident with nerve damage may not feel water that is too hot, so the nurse aide tests the water and washes without prolonged soaking.

    Reference: NIDDK — Diabetes & Foot Problems — How can I take care of my feet? — Wash your feet every day